Health Committee on Jan. 27th, 2026

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Thank you.

Dr. Semret, you're very involved in surveillance, stewardship and so on. One recommendation we've heard at this committee is that we should look more closely at long-term care facilities for both stewardship and surveillance. We have, as pointed out by many of you, a very fragmented system in terms of data collection across the country, within provinces, between institutions and so on.

Would you see it as an important source of information if we looked more closely at long-term care facilities?

[Makeda Semret]

Yes, I would, absolutely. We definitely need to expand beyond acute care hospitals.

In my remarks, I mentioned that the resource-intensive nature of performing effective stewardship interventions is the reason we're not doing it in the community or in long-term care facilities. If we start coordinating to make some of these definitions more pragmatic and if we have better ways of implementing stewardship, I believe it will be very organic and natural for these good practices to be deployed across the spectrum of health care institutions. There are many things we can do before forcing mandatory stewardship programs in settings that are poorly resourced.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Do I have any time left, Madam Chair?

[The Chair, Liberal, Hedy Fry]

Yes. You have one minute and 19 seconds, Helena.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Dr. Bogoch, we've heard a tragic story from Ms. Neudorf related to sepsis. I think most of us are aware of MRSA, VRE, Clostridium difficile, and so on, as being very difficult infections to treat.

In your experience as a clinician, what kind of progress are we making? Are we lacking some appropriate new antibacterials or antimicrobials? What is your experience around some of these very tragic situations?

[Isaac Bogoch]

Thank you.

Yes, it's very challenging. Anyone who practises hospital-based medicine, whether it's an infectious disease physician, a general internist, a surgeon or an intensivist, is going to see them every day. We see them every single day.

Much of the time we have the existing tools, but when we don't have them, we have to go through the special access program, SAP, which is extremely cumbersome and actually delays care. There are drugs that we need but that just aren't available to us.

Sadly, we need them more frequently. It's easy to say that SAP doesn't work, that it is cumbersome and outdated, but I think it's time to actually implement something better. It would be a good idea to get smart people in the room to sort out a much more efficient mechanism to gain timely access to antibiotics that we don't have readily available to us and that we're needing more and more.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

I'll go to one final round. I will begin with the Conservatives and Mr. Mazier for five minutes, please.

Go ahead, Dan.

[Dan Mazier, Conservative, Riding Mountain, MB]

Thank you, Chair.

I thank all the witnesses for coming here today.

In October 2023, the Auditor General released a report examining the federal government's approach to antimicrobial resistance. One theme identified by the Auditor General is that, while the federal government recognizes antimicrobial resistance as a serious public health threat, the national action plan does not include clear targets, timelines or accountability mechanisms.

From your perspectives, what are the risks of responding to antimicrobial resistance without measurable goals or clear accountability outcomes?

I'll start with Dr. Bogoch.

[Isaac Bogoch]

Thank you. That's a great question.

Yes, we have to measure it. We have to have outcomes, and we have to measure them. We have to know how we're doing.

One of the challenges, though, as I mentioned earlier, is that we can do everything right and still get throttled by AMR because of what's happening elsewhere in the world. This doesn't mean we shouldn't be acknowledging that this is an issue and setting up programs to better measure and control it.

The measurements don't necessarily have to be morbidity and mortality—which, of course, are important measurements. They could be on how many programs you have set up, the timely access to drugs that might not be available in Canada and training programs.

These are very important issues that obviously need to be implemented, but we also have to measure how we're doing.

[Dan Mazier, Conservative, Riding Mountain, MB]

Dr. Semret, I believe you made some comments around feedback, so I would like to hear from you on this as well.

[Makeda Semret]

Yes, I think the issue of what we measure is a really important one.

In acute care hospitals, we've been focused on what I would call process outcomes on what we're doing—how many antibiotics and prescriptions we are reducing and the quality of the prescriptions. We have been less focused on patient-centred outcomes, which I think would be an important incentive for hospitals and for health care in general.

Antimicrobial stewardship, as has been said by multiple people, is about patient safety and health system sustainability. The success of our stewardship efforts should not be judged only by the reduction of antimicrobial use or even the improvement of prescription quality; it should really include clinical cure.

You'd be surprised, but we don't systematically measure outcomes from infectious diseases anywhere—not in acute care hospitals, not even in the intensive care units of our hospitals. I think that's an incentive that should be created and that acute care hospitals should start measuring this systematically.

This could be rendered much easier with IT support. Victor and several of my colleagues mentioned that electronic prescribing systems across settings would facilitate the development of structured datasets. This would not only make processes more efficient but would also give us very useful metrics.

[Dan Mazier, Conservative, Riding Mountain, MB]

Thank you very much.

With that, I'll hand my remaining time over to Ms. Konanz.

[The Chair, Liberal, Hedy Fry]

You have one minute.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Thank you.

Yes, I'll take this time to make a motion.

I move:

That, given the Order in Council appointment referred to the Standing Committee on Health on December 4, 2025, by the Board of Directors of the Canadian Centre on Substance Abuse; the committee invite all Governor-in-Council appointees currently serving in the Canadian Centre on Substance Abuse, to appear for one meeting to discuss their work before February 13, 2026.

I just want to add that this is a new committee, and we haven't met them. I think it's important that we all get to chat with them.

If, for some reason, we need to move the meeting to a week later than February 13—I know we're running out of time a bit—we can do that. We can move it by a week.

[The Chair, Liberal, Hedy Fry]

I'm sorry, Helena. What did you just say about a week?

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Well, the motion says that we need to discuss their work and meet them before February 13, 2026. That's the original motion I made. If we need to extend that by a week, then that would be fine, because we have a lot on our plate.

I think it's a good idea for the committee to meet with—

[The Chair, Liberal, Hedy Fry]

I just want to ask everyone if they have the motion in English and French. It was moved a while ago, but she's now amending it somewhat.

Here we go. I'm going to read the motion slowly. It was submitted on December 10.

The motion was:

That, given the Order in Council appointment referred to the Standing Committee on Health on December 4, 2025, by the Board of Directors of the Canadian Centre on Substance Abuse; the committee invite all Governor-in-Council appointees currently serving in the Canadian Centre on Substance Abuse, to appear for one meeting to discuss their work before February 13, 2026.

Ms. Konanz has just added that she's prepared to extend that by one week, given that we have a lot on our plate.

You have a motion on the table that had been duly circulated awhile ago.

Maggie, go ahead on the motion.

[Maggie Chi, Liberal, Don Valley North, ON]

Chair, may we suspend the meeting for a quick moment, so we can examine the motion? It was tabled a while ago, so we just need to take a look.

[The Chair, Liberal, Hedy Fry]

We'll suspend.

[The Chair, Liberal, Hedy Fry]

We will resume the meeting. I will entertain discussion on the motion.

Go ahead, Ms. Chi.

[Maggie Chi, Liberal, Don Valley North, ON]

Do we need to change the motion, Chair? We just need to update the date.

[The Chair, Liberal, Hedy Fry]

She said a week.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

We agreed on another date—February 26.

[The Chair, Liberal, Hedy Fry]

You've all agreed on that. That's good.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Do we need to change any of the wording?