Science and Research Committee on Oct. 22nd, 2025

[Jennifer McKelvie, Liberal, Ajax, ON]

Thank you, Madam Chair.

Dr. Rubin, you mentioned a term I hadn't heard before: “harmonized susceptibility testing”. I'm hoping you can outline more what the recommendations would be regarding that and also regarding surveillance in general and how we can do better.

[Dr. Joseph Rubin]

When bacteria are tested for antibiotic resistance, it's essential that this testing is done in a highly standardized way. In veterinary medicine, there are quite a number of organisms for which we don't have internationally agreed-upon testing guidelines. This has left diagnostic labs in many cases to work around these gaps, which has led to some fragmented approaches across the country in terms of how some bacteria are tested and characterized.

I think that, working together, we could come up with some more harmonized approaches for how this might be done, whether it's in terms of interpreting the test results or actually conducting the tests themselves.

Animals are infected with many bacteria that aren't widely encountered in human medicine as well, so these are bacteria that are under-researched. There is less information known about them, so we lack some of those standardized methods.

With respect to surveillance, having standardized methods allows us to directly compare what's done in my lab with what's done in a lab on the other side of the country. We know that both researchers or both diagnosticians would get the same result if working with the same organism when using standardized conditions. It really facilitates the use of routinely generated diagnostic data, which is paid for by someone else. It's paid for by the end-user, the client who has requested those tests or the veterinarian who has requested those tests. It gives us a window into what's going on from a resistance perspective without having to put in as many financial resources as are required for active surveillance.

[Jennifer McKelvie, Liberal, Ajax, ON]

Dr. Rubin, who would be our best international partners on such approaches? Is it the WHO? Who do we need to be working with better?

[Dr. Joseph Rubin]

The perspective of surveillance is a bit outside of my area of expertise. Certainly within Canada we actually have a lot of our own domestic knowledge and some very well-respected researchers and scientists within the Public Health Agency of Canada. As we heard from Dr. Wright, there's a lot of strength there.

Within the agricultural animal and food sector, the CIPARS program does fantastic work and is really an international model for how to do resistance surveillance.

I think a lot of that expertise is really homegrown and easily available to us here in Canada.

[Jennifer McKelvie, Liberal, Ajax, ON]

Thank you.

Dr. Nguyen, you mentioned the human, the animal and the veterinarian...and that collaboration.

Looking internationally, are there other countries that are having those groups talk together in a good way that we could use as a model?

[Dr. Dao Nguyen]

I can speak perhaps from the research standpoint. I think that Sweden is certainly an example, and Denmark is an example of where they have done remarkable work in integrating research in the policy-making and the industry, as well as in how to integrate human, animal and environmental health together.

[Jennifer McKelvie, Liberal, Ajax, ON]

Great.

Dr. Skinner, you really eloquently laid out that it's easy to focus on the low mortality, bulk and organisms where you can mass produce, and how there's maybe not as much investment into rarer or more deadly.... Then you mentioned some international participation around pull incentives.

I was wondering if you could lay that out a little more. How do we ensure that we're focusing on the most problematic micro-organisms?

[Dr. Henry Skinner]

That's a great question.

Simply put, there are a number of organizations around the world that look to address this. The World Health Organization semi-annually produces a report that identifies the most dangerous drug-resistant organisms. It surveys around the world and does surveillance to understand those that are the greatest risk for humans. That's published semi-annually and prioritized into the highest concern, middle concern and lower concern but still of great concern. The CDC does something similar. Other jurisdictions do likewise.

With the surveillance in hospitals to understand the morbidity and mortality that these organisms cause, the lack of effective antibiotics is pretty clearly identified, so the pull incentives ought to be and have been designed to incentivize antibiotics that treat these most dangerous pathogens. It's important to keep that in mind. [Technical difficulty—Editor] that, and I believe the pilot would do exactly that.

[Jennifer McKelvie, Liberal, Ajax, ON]

I have only seven seconds.

I get another round. I can ask more questions later.

[The Chair, Liberal, Salma Zahid]

Thank you.

With that, we will now proceed to MP Blanchette-Joncas for six minutes.

Please, go ahead.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Thank you, Madam Chair.

Dr. Nguyen, you mentioned the disastrous economic consequences of inaction on antimicrobial resistance. However, Canada is the only G7 country that invested less in research and development over a sustained 20-year period in proportion to its GDP.

In your opinion, could the failure to make bold investments in prevention, which is one of the five pillars of the One Health project, cost significantly more in the long run?

[Dao Nguyen]

I'm not an economist. I don't think I'm the best person to talk about specific economic costs. However, I'd say there's unrealized potential in that regard.

For example, in Quebec, we have a lot of work to do, including mobilizing political will. We could simply begin with a national action plan on antimicrobial resistance, or AMR.

In my opinion, that's where we need to start. Then, we could truly mobilize the necessary actions.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Thank you. I understand your message quite clearly.

Experts agree that there'll be other pandemics, amplified by antimicrobial resistance, in particular, and by climate change. Yet the current government is betting on energy projects, including a pipeline that will cost $34 billion. I am referring to the Trans Mountain pipeline.

As a scientist, do you believe this vision is compatible with the fight against antimicrobial resistance?

[Dao Nguyen]

In my opinion, Canada should think much more broadly about the future. To maintain health and national security, both in terms of population and economic health, it's absolutely essential to respond to the AMR crisis.

In the past, we've seen that Canada is capable of investing. For example, around 2004, when HIV and AIDS first appeared, Canada established a Canadian strategy promoting annual investments of $80 million in the fight against HIV. Today, it still invests $43 million per year to combat HIV and hepatitis C.

Canada is therefore capable of investing. If it's also capable of seeing AMR as something that must be addressed to ensure its present and future security, as well as the health of its population and national security, I believe that political will could set in motion the changes that will make a difference.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Thank you, Dr. Nguyen.

Your comments could give rise to a new slogan during the next election campaign: Where there's a will, there's a way.

You recommend that the scientific ecosystem be better funded and given greater consideration. I mentioned the fact that, for 20 years, research and development in Canada has been chronically underfunded compared to other G7 countries and other countries in the Organization for Economic Co-operation and Development, or OECD.

What role could universities play in combatting antimicrobial resistance, without necessarily having the means to do so?

Why do you think their contribution is essential to the implementation of a national strategy?

[Dao Nguyen]

As I said in my introductory remarks, when it comes to innovation, we often forget that the seed is planted at university. Statistically, there are a huge number of innovations that originate in universities, in all sectors, including health. However, there's not enough water to make them sprout.

There is also the ecosystem. The university community trains the experts and scientists of the future. We need that future. The university community is also a mobilizing force that perpetuates a tradition of collaboration. As we see in Quebec, through university communities, there is a way to mobilize government, public and industrial sectors to foster the creation of an ecosystem.

I'd say that the university community represents both the solution and the vector for the solution to the AMR crisis.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Your comments are extremely interesting. You've taken the words right out of my mouth because, at present, we're seeing the government promoting economic and industrial diversification. However, research is the foundation of all technological innovation. There can be no innovation without research. Today, we seem to be overlooking research and thinking that we'll still make great technological advances. It's like trying to grow a plant without watering it.

Could you tell us what lever we need to activate to better leverage the strengths already present in Quebec and Canada in this area?

[Dao Nguyen]

There are already strengths in research and innovation. I mentioned artificial intelligence, for example. In Canada, there are individual researchers and world-class teams working on AMR. I think we first need to allocate financial resources to nurture these seeds and turn them into small plants.

We then need leadership, a clear vision carried by an entity that truly has the power to transcend territories and break down the many barriers, some of which are administrative and political in nature, in order to restore the initiatives. There is already a multitude of initiatives, some of which are of excellent quality, but—

[The Chair, Liberal, Salma Zahid]

I'm sorry for interrupting. Time is up. Maybe you will get another opportunity for questions in the next round.

We'll now start our second round, with Mr. Holman for five minutes.

Please go ahead.

[Kurt Holman, Conservative, London—Fanshawe, ON]

Thank you, Madam Chair, and thank you to all the witnesses who have joined us tonight.

Recent AMR stats in Canada can be compared only against 2018 stats referenced by the pan-Canadian action plan on AMR. The current stats referenced are very outdated.

My question is for Dr. Skinner.

Do you feel, since 2018, with regard to Canada and AMR, that it is getting worse, or is it stable? How bad is it in Canada?

[Dr. Henry Skinner]

I think that's a question that really demands data, and, to your point, with data from 2018, it is very difficult to understand what that means today, seven years later.

I can tell you that around the rest of the world, based on reports that are recently out, including one from the WHO this month, AMR has become significantly worse over the past seven years. We know that, during COVID, AMR got worse in the United States. It's hard to believe that it didn't get worse every place else.

It is a growing problem. A genie out of the bottle is very difficult to get control of, even with all the tools we have. We need to dedicate more work to that holistically, in everything from infection prevention to proper diagnostics, antibiotic stewardship and delivering the right antibiotic to the patient at the right time.

[Kurt Holman, Conservative, London—Fanshawe, ON]

I have some follow-up questions, sir.

Outside of the United States, what countries suffer the most from AMR, what countries suffer the least, and what is the regional spread of AMR across Canada?

[Dr. Henry Skinner]

The answer to your last question is also very challenging. That demands surveillance across the geographies, and surveillance is more easily done in urban centres and tertiary hospitals than it is in rural communities. That's true in Canada, that's true in the United States, and that's true around the world.

The global burden of AMR is highest in many of the low- and middle-income countries. India reports a very high burden. Parts of Africa and Southeast Asia have extremely high burdens, and they are growing. We know that eastern Europe has high burdens relative to western Europe. We know that the Nordic countries do extremely well with respect to antimicrobial resistance due to a number of policies they have, including understanding who enters the hospital carrying a drug-resistant microbe and being very active in containment of those patients and the like.

It varies widely across the world. It varies substantially within jurisdictions, between rural and urban settings and between cities.

[Kurt Holman, Conservative, London—Fanshawe, ON]

As the leader of the AMR Action Fund, how do you feel about the state of AMR research, innovation and commercialization in Canada?

[Dr. Henry Skinner]

There is first-class research in Canada, and we've known that for a long time. I've worked in the biotech and pharmaceutical industry and been investing for many decades; I have invested in Canada.

I think the challenge in the AMR space specifically is that the market is broken, so investors are lacking. Trying to take innovation coming out of academia, advancing that, translating that into drugs and bringing those to patients is really the critical shortfall. Good ideas are just not financeable when investors won't invest, and that's the current state of affairs. That's why we need the pull incentives we've been talking about to make sure that there is a financial incentive in Canada and around the world to bring investors back into the field to ensure that innovation can advance and that we can have the new drugs that patients need desperately.