Thank you, Mr. Chair, and honourable committee members. It's an honour to be able to address this committee.
Before I begin, I'd like to acknowledge that I'm currently speaking from what I believe to be the unceded ancestral territory of the Haudenosaunee, which is where my family home currently rests.
I'm a professor of medicine at the University of Toronto and a consultant in infectious diseases at Sinai Health and the University Health Network. Prior to this pandemic, most of my academic work was really focused around antimicrobial resistance—drug-resistant infections. I've been doing work on behalf of the Public Health Agency of Canada, along with Gerry Wright, to develop a pan-Canadian network to tackle antimicrobial-resistant infections.
This is my third such appearance before the Standing Committee on Health in relation to infectious diseases in the past four years. I'm really privileged to be invited again. As I will remind this committee—in fact, the only familiar face I see here is Mr. Davies', so there are many new faces—much of the action that I've urged this committee to act on previously has not occurred.
Although it was self-evident at the beginning of the pandemic when the virus was first isolated, it's worth reminding everyone that COVID-19 is just one of a host of drug-resistant infections. There are many drug-resistant infections that affect Canadians annually. Sadly, we estimate that we've lost around 22,000 people to COVID-19 over the past 12 months, and many more have become sick. We lose about one quarter of that figure annually due to drug-resistant infections at a cost to the Canadian health care system of $1.4 billion, with a reduction in GDP of about $2 billion. We expect that those numbers are going to rise to about $7.6 billion in health care costs and $21 billion in GDP by 2050.
We're now roughly a year into this pandemic, and it would be sufficient to say that the lives that we're going to continue to see lost around the world, including in Canada, will be due to a combination of two things. One is insufficient vaccination, primarily limited by supply, and the other one will be ineffective antimicrobial therapy. I do want to point out, as Dr. Langley also pointed out, that as citizens of the world, both of these issues affect people throughout the globe.
We need to invest in infectious diseases prevention, surveillance, diagnostics and therapeutics. I think I'm going to attenuate what I was going to say for reasons of time, but I will point out that our surveillance systems in particular remain so poor that at present we've had to put together a hodgepodge of genomic sequencing resources to try to give us the surveillance information that countries like Denmark, which has one tenth of Canada's population, and the U.K., which has roughly double our population, can provide to their own citizens. We also lack the capacity to develop antimicrobials, and we're unable to produce vaccines to serve our citizens.
We have not been able to mount a coordinated response to infectious diseases, and I really want to focus for the next while on drug therapy. I will start by pointing out that there are two evidence-based therapeutic treatments for COVID-19 that unequivocally save lives in hospitalized patients: dexamethasone, which is a cortisone-like medication, and tocilizumab, which is a monoclonal antibody that blocks a component of the immune system. Both of these agents are life-saving with comparable and additive effects.
At present, we have sufficient supply of dexamethasone across the country. It's a cheap, generic drug. On the other hand, we have insufficient supply of tocilizumab for the needs of Canadians. Whereas I do understand that the federal government along with the provincial governments have been making efforts to procure sufficient supply, provinces have been sheepish to provide tocilizumab to patients whose conditions merit its use because of uncertain drug supply. This is an unquestionably life-saving drug.
The last point I want to make is to contrast these stories with the stories of remdesivir and bamlanivimab. Yes, if you're wondering, as an infectious disease physician I'm used to pronouncing organism and drug names that the rest of humanity struggles to pronounce.
Remdesivir is an antiviral drug whose effectiveness remains uncertain to me and many others, including the WHO. Bamlanivimab is a monoclonal antibody that targets the virus itself. It's a drug that the Canadian Agency for Drugs and Technologies in Health evaluated as neither practically implementable nor of clinical value.
The federal government, through Health Canada, purchased remdesivir at a cost that is not publicly known, but that I would estimate to be $75 million. On the other hand, the government also purchased what I believe to be $32 million worth of bamlanivimab. This expenditure of approximately $100 million on effectively useless drugs contrasts with the shortage of the two life-saving treatments that currently exist.
What is urgently needed is a pan-Canadian committee of national experts with experience in clinical practice guidelines and expertise relevant to COVID-19, comparable to NACI, the National Advisory Committee on Immunization, who can share knowledge and data and come up with sensible recommendations.
I'm sensitive to the challenges faced by our federal government in nudging provinces and territories to row in the same direction. Clearly, this is an area in which the government has not been successful. Accordingly, I, along with several of my colleagues from around the country who have been involved in the development of provincial guidance, have decided to mobilize, mainly because of the urgency of the need and the importance of this to Canadians. These challenges are too great to defer any longer to the various levels of government.
In the meantime, it would be wise for this committee and the federal government to figure out how our group of national experts can either be supported immediately or catapulted to a future state where such a committee exists for all infectious diseases. As I said at the beginning, drug-resistant infections are not going away, and we need to approach their treatment with a pan-Canadian, evidence-based lens that brings together the interests and expertise of all people from coast to coast to coast.