Thank you, honourable Chair and members of the committee.
I'm here today both as a pharmacist-researcher practising in antimicrobial stewardship and infectious diseases and as the chief pharmacy officer at the Canadian Society of Healthcare-Systems Pharmacy. I'd like to express strong support for this motion to continue funding antimicrobial resistance research and innovation.
Antimicrobial resistance represents one of the most pressing public health challenges of our time. Resistant organisms are no longer confined to hospitals; they're present in our communities, food supply and environment.
My colleagues have already highlighted that there have been great social and economic impacts of antimicrobial resistance. In 2023, the Government of Canada acknowledged that and released the pan-Canadian action plan on antimicrobial resistance, which set out five key pillars. This framework is essential, but meaningful impact will require ongoing funding and cross-jurisdictional coordination.
Now, under these key areas, I want to highlight a few additional opportunities.
Under the pillar of “surveillance”, the Canadian nosocomial infection surveillance program, CNISP, has tracked resistance trends for decades. Its most recent data confirms the threat. Rising rates of carbapenem-resistant organisms and methicillin-resistant staphylococcus aureus continue to be a problem. This confirms that Canada is not immune to global trends.
We know that the drivers of antimicrobial resistance are multifactorial: inappropriate prescribing, agricultural use of antimicrobials, global travel, and gaps in infection prevention and surveillance. Increasingly, research is highlighting the interplay of planetary health—or the climate crisis—with antimicrobial resistance. We're now learning that microplastics as small as five millimetres have been shown to facilitate the spread of antimicrobial resistance, particularly the resistance genes, by just providing enough surface for biofilm development.
Again, this evidence on the links is emerging. A lot remains to be understood, but it's certainly an opportunity.
Parallel to antimicrobial resistance monitoring, Canada has also demonstrated leadership in measuring antimicrobial use more broadly. In addition to pathogen surveillance, CNISP has expanded capacity to monitor any microbial use amongst both adult and pediatric inpatients in Canadian hospitals. The CLEAR registry, which is the Canadian LEadership on Antimicrobial Real-life usage registry, has shown that structured data collection on new antimicrobial prescribing is feasible and gives us some insights on patterns of prescribing, particularly on new antimicrobials, at a national scale. This monitoring to date has been limited to hospital settings, mostly acute care facilities. That still leaves us with some gaps in our understanding of community and long-term care antimicrobial use.
On the research and innovation front, the Public Health Agency of Canada has begun exploring push-and-pull incentives for antimicrobial development and access. Again, that includes mechanisms for early discovery research as push incentives and market-entry rewards as pull incentives to make new antibiotics financially viable and accessible in Canada. It's definitely promising work that requires more attention and long-term commitment if Canada's going to be able to develop and access the global pipeline of new antimicrobial agents.
Lastly, I want to acknowledge that, at point of care, Accreditation Canada has made antimicrobial stewardship and infection control practices required organizational practices for all acute care hospitals. Again, that emphasizes that antimicrobial resistance is a core element of patient safety and quality care. Now most hospitals have IPAC and stewardship programs, but the depth and the resources vary widely across the country.
Canada does have the scientific talent and potentially some infrastructure to lead in this field, but our research efforts remain fragmented and underfunded compared to the scale of the threat.
We'd ask for a coordinated and adequately resourced national strategy that's anchored in the pillars of research, surveillance, stewardship and innovation. That's essential if we are to safeguard the effectiveness of existing antimicrobials and prepare for future threats. Without urgent attention, we risk entering the post-antibiotic era, where routine surgeries, cancer therapies and even minor infections once again becoming life-threatening.
Thank you.