Madam Chair, we do have national guidelines for treating various infectious diseases, but we also rely on guidelines published in other countries, especially in the United States and also in the U.K. They have different health care systems and different kinds of funding programs. Some of the medications that are newly available in these countries are very expensive, and that's obviously one of the biggest barriers.
We also publish and develop our own local clinical practice guidelines for how to treat different infectious diseases. We actually have a web page in our hospital that talks about how to treat bloodstream infections, urinary tract infections, etc.
For antimicrobial stewardship programs, which I'm actively involved in at my hospital as the physician lead, we are an advisory program. That means we can educate and develop clinical practice guidelines, but we cannot force physicians—or twist their arms, if you want to put it that way—in terms of how they can treat an infectious disease.
We do have influence on the hospital formulary regarding what antibiotics we have available in our hospital and who's allowed to prescribe them. For these newer antibiotics for the AMR pathogens, there would need to be a gatekeeping function in the hospital so that they're prescribed appropriately.
I'm sorry to hear the story about the child's mother dying. I may have read the story already because I do look at and read these cases in the news so that it doesn't happen again, and I reflect on it. I don't know how that occurred, whether there was a delay in initiation of therapy or whether it had to do with a drug-resistant organism.
There is a disconnect between the federal and provincial and territorial health programs in terms of antibiotics. For instance, we do have Health Canada approved antibiotics that we use in hospitals, but they're not covered by the provincial formulary.
For instance, in Ontario, we have to go through the exceptional access program. I've had requests denied very frequently, even for something that's clearly recommended by clinical practice guidelines. I do believe there are some outdated guidelines as well that the Ministry of Health in Ontario uses. I know this is not a provincial forum here, but I can tell you there is a bit of a disconnect.
Health Canada generally will not approve a medication for outpatient use if it's not approved by Health Canada, so there's that issue.
However, clinical practice guidelines exist for many different infections. There are differences of opinion. For instance, in treating eye infections, there's a difference of opinion between the Infectious Diseases Society of America and the American Academy of Ophthalmology in terms of how to treat them, so that may get in the way for certain things.
In general, though, we do have good clinical practice guidelines. We know how to treat these infections with first-line therapies. Really, the problem is having Health Canada approval. That process is delayed much more than the processes are in the European Union and the U.S., for instance. I think that's one thing.
I hope I answered your question well, and I'm happy to answer any other questions later on.
Thank you very much for the opportunity.