Madam Chair, vice-chairs, honourable members of the committee, thank you for the invitation to speak today.
My name is Dr. Terry Wuerz, and I'm a practising infectious diseases physician from Winnipeg.
Antibiotics are foundational to modern medicine. They're not just treatments for infections; they're enablers of routine and life-saving care. Every day in Canada antibiotics make it possible to safely perform surgical procedures such as joint replacements and C-sections, chemotherapy and immunosuppressive therapy for cancer and autoimmune diseases, organ transplantation, intensive care interventions and safe care during premature labour or neonatal complications. Without effective antibiotics, these cornerstones of modern health care become unsafe or impossible.
However, the effectiveness of antibiotics is not guaranteed. We are already seeing them diminish.
One way to think about antibiotics is as a finite resource. I often describe them as a trust fund. Every time we prescribe one, we withdraw a little from that fund. When antibiotics are used appropriately, they save lives. When they are overused, misused, or used in situations where they provide no benefit, antibiotic resistance accelerates. If we don't reinvest in this resource through careful stewardship and access to new drugs, we risk stealing from the future to treat patients today. The consequence of that erosion is visible on the front lines.
In Manitoba and across Canada, we're seeing infections that no longer respond to first-line antibiotics, more frequent use of toxic or costly last-line drugs and sharply rising rates of resistant infections in both hospitals and in the community. Increasingly, we're encountering cases where no antibiotics work at all. These infections are caused by totally drug-resistant organisms—bacteria resistant to every available antibiotic in Canada. When that happens, we may be left with only one option, source control, meaning the physical removal of infected tissue. In the most severe cases, that could mean amputation of an infected limb. These are devastating outcomes for our patients and their families, and they represent the direction our health care system is headed if we don't act now.
We know what interventions reduce resistance and protect patients. The most effective is antimicrobial stewardship: the coordinated effort to ensure the right antibiotic is used only when necessary at the correct dose and duration. Stewardship programs save lives, reduce adverse drug events, shorten hospital stays and decrease the development of resistance. There are also cost savings for the health care system. Yet, despite the evidence, stewardship programs across Canada are chronically underfunded.
In my own province of Manitoba, including in our largest tertiary care hospitals, there is no dedicated stable funding for antimicrobial stewardship programs. This means that programs operate intermittently, rely on voluntary effort, or disappear when the temporary funding ends. We cannot protect antibiotics without protecting the programs that ensure they're used safely and appropriately.
Another challenge is access to new antimicrobials. Canada lags behind peer nations in bringing new antibiotics to market. Only a small fraction of newly developed antibiotics ever reach Canadian clinicians, and when they do, the path to reimbursement and formulary access is often delayed by years. This leaves clinicians caring for patients with highly resistant infections with very few options. The federal government already has a road map, the pan-Canadian action plan on antimicrobial resistance. It was released in 2023 and outlines the right priorities: stewardship, research, innovation and coordinated leadership across federal, provincial and territorial partners. What it does not yet include is implementation funding, timelines or mechanisms to ensure stewardship programs exist wherever antibiotics are prescribed.
To make meaningful progress, I would highlight three actionable federal priorities.
One, fund and standardize antimicrobial stewardship programs in all health care settings: acute care, long-term care and community practice. Stewardship is one of the most cost-effective interventions we have.
Two, support rapid access to new and effective antimicrobials through streamlined regulatory pathways and incentives.
Three, enable national coordination of antimicrobial resistance policy and implementation.
Antibiotics made modern medicine possible. If we protect them, Canadians will continue to benefit for generations. If we fail to protect them, we will see more preventable deaths, more avoidable amputations, more treatment failures and rising health care costs.
Thank you. I look forward to your questions.
