I think things have somewhat changed in terms of intense change. We have this federal framework and there's been work in terms of developing policy and having FPT partners signing off on this. I consider that a move forward in terms of addressing AMR.
There's been increasing money to CIHR to address a variety of different research priorities that CIHR has around AMR. I think there's been some progress there, including through their participation in the joint programmatic initiative on AMR, which is an international effort.
In terms of what's needed for understanding and having better data, a better repository of information, it's going to have to be almost certainly something that's staged in nature, and there will have to be a ramp-up. To my mind, you start off with understanding existing datasets and validating them to make sure that what they're supposedly saying they really are saying. A lot of the data in these is actually from proprietary information that the Canadian government doesn't even own. On top of that, you need to start with probably the easiest systems to put in place, which would be understanding use in hospitals, and then you need to expand that to long-term care and then community practices in provinces. You need standards.
Shelita has already alluded to the need to have national standards for how statistics on antibiotics and resistance are collected and reported. Initial investment for that is probably going to require several million dollars, but over time it is going to be considerably larger than that because many provinces currently don't have that infrastructure. Some do; some provinces have an ability to track antimicrobial use in a much more granular way than most other provinces can, so we're talking about tens of millions of dollars.