Science and Research Committee on Oct. 20th, 2025

[The Chair, Liberal, Salma Zahid]

Good morning, everybody. I call this meeting to order. Welcome to meeting nine of the Standing Committee on Science and Research.

Pursuant to the motion of the House on June 18, 2025, the committee is meeting to study antimicrobial resistance.

Today's meeting is taking place in a hybrid format, pursuant to the Standing Orders. Members are attending in person in the room and remotely by using the Zoom application.

Before we continue, I would ask all in-person participants to consult the guidelines written on the cards on the table. These measures are in place to help prevent audio and feedback incidents and to protect the health and safety of all participants, including the interpreters. You will also notice a QR code on the card, which links to a short awareness video.

I would like to make a few comments for the benefit of the witnesses and members. Please wait until I recognize you by name before speaking. For those participating by video conference, click on the microphone icon to activate your mic, and please mute yourself when you are not speaking. For interpretation, for those on Zoom, at the bottom of your screen you can select the appropriate channel—either floor, English or French; for those in the room, you can use the earpiece and select the desired channel. I remind you that all comments should be addressed through the chair. For members in the room, if you wish to speak, please raise your hand. For members on Zoom, please use the “raise hand” function. The clerk and I will manage the speaking order as best as we can. We appreciate your patience and understanding in this regard.

I would like to welcome our witnesses. Today we are joined by Infection Prevention and Control Canada, represented by Dr. Kevin Stinson, program manager, infection prevention and control, Waterloo Regional Health Network. Welcome. He's here in person. We are also joined, by video conference, by Innovative Medicines Canada, represented by Dr. Bettina Hamelin, president and chief executive officer, and Jennifer Buckley, senior director, regulatory affairs and clinical research transformation.

Our third witness for today was supposed to be from Patients for Patient Safety Canada. Kim Neudorf, the patient partner, was supposed to log in through video conference, but she is having some challenges with the Internet. It is a problem on her end, but not from her. She doesn't have stable Internet, so she will not be able to log in. In the case that she can get to some other location or something, we will see, but right now she has not been able to log in because of her Internet situation.

All of the witnesses will have five minutes for their opening remarks, and then we will go into our round of questioning.

Today we will start with Dr. Stinson. Please go ahead. You will have five minutes for your opening remarks. Thank you.

[Kevin Stinson, Program Manager, Infection Prevention and Control, Waterloo Regional Health Network, Infection Prevention and Control Canada]

Thank you, Madam Chair and members of the committee, for having me here today.

We've heard in previous sessions about the significant economic and direct human health impacts that AMR is already having in Canada and across the world, and how that's going to be scaling and increasing in the coming years and decades. I'm here today speaking on behalf of the perspective of a microbiologist and an infection control professional.

While I work in the acute care hospital sector in Kitchener, Ontario for the Waterloo Regional Health Network, I'm representing today infection control professionals across Canada and across the continuum of health care through our professional association, IPAC Canada. Also, I would be remiss if I didn't mention that, serendipitously, today represents the start of national infection prevention week in Canada.

We've described AMR in past sessions as a “silent pandemic”. What this means is that a significant amount of transmission and a significant number of cases go undetected. Now, contrary to what we think of when we hear the term “pandemic” or “epidemic”, especially with recent memory, AMR has a bit of a unique challenge here. Anti-microbial resistant organisms, or AROs, have an ability to transfer genetic material that confers resistance from one bacteria to another. This includes transferring it into our human microbiome, the bacteria that naturally inhabit our bodies, and this leads people to become persistently colonized. The challenge with this is that then these people are more at risk of developing a resistant infection downstream, and they can act as reservoirs to transmit to others.

We see right now that nearly one in 10 Canadians admitted to acute care hospitals is colonized with at least one ARO. Those numbers increase dramatically when we look at low- and middle-income countries overseas.

There are major knowledge gaps in understanding this transmission and thus in understanding control measures to put in place to stop the spread. Our surveillance network and programs in Canada largely act as sentinels of large AMR trends, but they lack the depth and breadth to truly map transmission. They're also often generalized to a national or provincial level, which then lacks the granularity to take that information and translate it into meaningful practice to impact local policies and guidance.

In the health care setting, the infection control professionals represent a major aspect of the surveillance programs in health care. We utilize that information about AMR data to inform AMR surveillance policies, as well as control measures in our health care institutions, in trying to balance the needs of the community, but also in trying to balance clinical operational needs and financial stewardship.

Without that data, ICPs are left with trying to develop this epidemiological data themselves. Unfortunately, ICPs are not able to access or often unable to access—

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

Madam Chair, I have a point of order. We don't have interpretation at the moment.

[The Chair, Liberal, Salma Zahid]

Okay. We'll stop. Let us figure it out.

Go ahead.

[Kevin Stinson]

Thank you, Madam Chair.

ICPs developing these control programs and surveillance programs in hospitals without that access to data that reflects their communities are left trying to develop that data themselves. Unfortunately, these infection control professionals often lack access to research dollars to be able to do the work needed to optimize their programs. That's especially true for rural hospitals and areas outside of the acute care sector, such as long-term care facilities.

In looking at solutions to these challenges, as short-term opportunities, we would include looking at how we better access research dollars and widen that access to the research dollars that are currently available. That includes looking at the idea of carving out a subset of that for small-cap applied research methodologies that are knowledge user-driven and directly aimed at targeting cost-effective and targeted control and surveillance initiatives in health care.

As a medium-term opportunity, we have to look to continue to grow and expand the infection control workforce in Canada, including through the development of training programs and training grants to bring more people into the field. Then it's to do continuous professional development and learning to increase epidemiology, surveillance, research and leadership skills for ICPs within the field.

As a long-term initiative, we need to look at how we improve our overall surveillance approach. How do we get to a point where we have an integrated, multi-sector approach that focuses on truly understanding transmission dynamics and finding control points, both in and out of the health care setting?

With that, I would like to, again, thank you all for the opportunity to present today. I have submitted a written brief that goes over these concepts in greater detail. I look forward to our conversation today.

Thank you so much.

[The Chair, Liberal, Salma Zahid]

Thank you, Mr. Stinson.

We will now proceed to Innovative Medicines Canada.

Dr. Hamelin, the floor is yours. You will have five minutes for your opening remarks. Please go ahead.

[Bettina Hamelin, President and Chief Executive Officer, Innovative Medicines Canada]

Thank you, Madam Chair.

Good morning, committee members.

Other countries have acted, while Canadians risk dire consequences of AMR. This is why I'm here today.

While I represent Canada's innovative pharmaceutical industry—the industry that is discovering, developing and delivering life-changing medicines, diagnostics and vaccines—I want to begin with a story from the hospital floor.

A Canadian hospital pharmacist was recently called to consult on a patient with a severe infection caused by multidrug-resistant bacteria. Lab results confirmed that none of the usual antibiotics worked. One newer medicine that might have helped was not on the hospital's formulary. The care team scrambled to find a solution, but every hour mattered. The infection spread and the patient's condition deteriorated. That pharmacist said something that still haunts me: “This isn't rare anymore. This is becoming routine.” Antimicrobial resistance is not a future threat; it is a present crisis. Globally, drug-resistant infections already claim over one million lives each year. By 2050, that could rise to 10 million, with an economic toll in the trillions.

At its core, this crisis is about innovation and access. We are running out of effective antibiotics, and we're not replacing them fast enough. Development is scientifically complex, economically unrewarding and, in Canada, slowed by regulatory and reimbursement processes that, in fact, deter innovation. Between 2010 and 2021, Canada secured access to only three of the 18 new antibiotics launched globally, putting patients and providers at a serious disadvantage. Solving this requires both urgency and action.

IMC, alongside our national and global partners, supports the full implementation of the pan-Canadian action plan on AMR. This includes a pull incentive that rewards innovation and ensures timely access to new antibiotics. We welcome the federal program under development and urge the government to adopt the proposed refinements from the Canadian Antimicrobial Innovation Coalition and build a learning policy environment that evolves with evidence rather than political cycles.

Other countries have already moved. The U.K. has implemented a subscription-style pull incentive, Italy introduced one during its G7 presidency, and France will make AMR a priority in its upcoming G7 leadership. Canada's G7 leadership is rapidly ending. We must lead, not follow. Incentives alone aren't enough. Regulatory and reimbursement systems remain duplicative and slow. Health Canada must rely on efforts by trusted international reviews, a key step towards faster approvals without compromising safety.

Access delays persist. On average, it takes two and half years from Health Canada authorization to public formulary listing. For antibiotics targeting MDR bugs, every day matters. AMR is not just a health issue; it's an economic, security and geopolitical issue.

With the U.S. increasingly focused on domestic priorities, Canada cannot assume its support in a crisis. We must secure our own antibiotic supply chain, strengthen innovation at home and build alliances with countries committed to science and global health security.

This is about Canada's resilience. It's about ensuring Canadians have access to the medicines they need when they need them. If we act decisively, we won't just contain AMR; we'll build a stronger, more secure Canada.

Thank you, Madam Chair, and thank you to the committee. I look forward to your questions.

[The Chair, Liberal, Salma Zahid]

Thank you, Dr. Hamelin.

The clerk has just informed me that Kim Neudorf has been able to log in. We will do a quick sound check, so that we can give her five minutes for opening remarks. I'll suspend the meeting for a minute so we can do the sound check for her.

Thank you.

[The Chair, Liberal, Salma Zahid]

I call the meeting to order.

Welcome, Ms. Neudorf. You will have five minutes for your opening remarks.

Please go ahead.

[Kim Neudorf, Patient Partner, Patients for Patient Safety Canada]

Thank you.

I'm sorry for the disruption. It's been quite a morning.

Thank you so much for this opportunity. I'm from Saskatchewan. I represent Patients for Patient Safety Canada, which is a not-for-profit advocacy group. We examine how AMR and sepsis contribute to preventable physical and psychological harm.

The following experience involves an extended family member. It illustrates the human tragedy behind the science and the clinical, economic and social burden of AMR. It is shared with permission.

A healthy 70-year-old had a simple fracture of her foot. Two days later, there was pain in the cast, and her vital signs and cognition were worrisome. When the cast was removed, the foot looked terrible. Sepsis was eventually diagnosed. MRSA, an AMR pathogen, was identified. There were 419 consecutive days of hospital care. She lost her foot and averted amputation of her arm by two hours. Sepsis returned a second time and, in the end, MRSA and sepsis cost her her life.

Health care costs were estimated at $750,000. She never received a prosthesis, but a prosthetic foot can cost $15,000. For a hand, it's potentially $250,000. Her devoted husband was at her side each of those 419 days, incurring hotel, food and fuel costs. He did not go to work.

Patients for Patient Safety Canada incorporates a people-centred approach that extends horizontally across the five pillars of the action plan. We support the ecology of “one health”, but given our mandate, our recommendations centre on the central theme of engagement and empowerment.

The first recommendation is to support health promotion, infection prevention and early recognition by promoting personal agency in our communities, promoting personal agency as a patient or resident in congregate settings to prevent facility-associated infections, calling for health care accountability and adherence to standards developed by CSA, HSO and IPAC Canada, and research and innovation.

In terms of research and innovation, we'd like to see wearables or smart phone technology designed to alert us to critical vital signs, rapid diagnostics for accurate antimicrobial prescription and early recognition of sepsis, built environments designed to contribute to infection prevention and control, hand hygiene and environmental monitoring systems tied to performance reviews, and demographics and surveillance data to better understand the social burden of AMR. As well, given the alarming increases in STBBIs, more needs to be done upstream and downstream in terms of sustainable ergonomic environmental cleaning and disinfection innovations, continuing to fund the good work of the Sepsis Canada network, recognizing the current work of CIHR's national one health AMR research strategy to engage patients with lived experience, and mandating IPC education for all long-term care staff, including environmental cleaners.

The second recommendation is to develop resources for those of us who live with AMR. We live with AMR—

[The Chair, Liberal, Salma Zahid]

Can you please wind up? Your time is up.

[Kim Neudorf]

Yes.

We live with AMR, yet self-management resources are lacking in access and quality, thereby affecting personal agency and the risk of transmission.

The third recommendation—and there's a whole series there—is to grow our public awareness. I've submitted a brief about that.

Thank you so much.

[The Chair, Liberal, Salma Zahid]

Thank you, Ms. Neudorf.

With that, we will go to our round of questioning.

Our first round of questioning is for six minutes each.

We will start with MP Baldinelli.

Please go ahead. You have six minutes.

[Tony Baldinelli, Conservative, Niagara Falls—Niagara-on-the-Lake, ON]

Thank you, Madam Chair, and thank you to the witnesses for being with us today.

I'm going to begin with Dr. Hamelin and your comments that spoke to the need and the urgency of the issue. You specifically said that when every minute counts, we need to act, and that AMR is not “rare”; AMR is a “crisis”. You indicated that while other countries have acted, Canada is falling behind.

We have had other witnesses testify before the committee. For example, Dr. Castonguay indicated that it cost the provincial health care systems about $1.4 billion. We also had Dr. Leung appear, and he mentioned that Canada is falling behind in terms of antimicrobial therapies. You and Dr. Salama have said that as of now, “only three out of 18” new antibiotics launched worldwide are available in Canada.

I'd like to probe that a little further and find out why this is.

We have the Health Canada special access program. Is it costs? Is it the pharmaceutical companies having regulatory burdens in their way and not finding the ability to get drugs to the market?

You talked about the need to reward innovation. How does that work? How do we do that? How do we get to a place where we have access to all those drugs?

[Bettina Hamelin]

That is a very good question. I want to start by saying that I am seeing that our members have been at the ready since the very first federal consultation on AMR in 2018. What is really holding us back in Canada is that we do not have a predictable market structure for the industry to bring these medicines to Canada and commercialize them here. Government still has to finalize that structure.

I'd also like to emphasize that the engagement of the industry in this country has been constant. Every year, the industry invests $3.2 billion in research and development, which has an impact on our economy of $18.4 billion, creating 110,000 jobs. There is a presence of the industry here in Canada, but the missing piece is really a clear mechanism for sustained collaboration with all levels of government, with shared accountability and shared risk between government and innovators.

We are the last in the G7 when it comes to providing access to medicines in Canada. That's across all medicines. For antibiotics, where every minute counts, as we just heard from Ms. Neudorf, we just don't have two and a half years to go through all the red tape that we have to go through in Canada to bring these medicines to Canada.

Countries like the U.K. and Italy have figured out a collaboration with the industry to ensure these antibiotics make it into their countries. We are lacking that system here in Canada.

[Tony Baldinelli, Conservative, Niagara Falls—Niagara-on-the-Lake, ON]

Thank you for those comments. It's disappointing to learn that we're last again, in something else with regard to being members of the G7, which finds itself here.

Dr. Stinson, with Infection Prevention and Control Canada, you represent individuals, people on the ground who work at the hospitals. Is there an aspect that you can speak to regarding the Health Canada special access program and what you're seeing on the ground?

[Kevin Stinson]

My side of the house is less with the direct treatment of patients and more with looking within a health care situation, with how we look at the population writ large and the transmission across that population.

I will say that we are now seeing far more complicated pathogens routinely coming into the hospital, not only as colonizations but also spilling into infections. We're seeing the rise in Canada of a pathogen—and I'm just going to call it “CPE” for simplicity's sake—that, when it causes a bloodstream infection, has about a 60% mortality rate associated with it. There are actually some novel drugs coming to market—or in market, just not in Canada—that could be targeted towards that. We don't have current access to that.

I know that my colleague, Dr. Greg Rose, who presented to this committee earlier, had discussions to that effect in previous conversations around a similar patient he could not find drugs for.

[Tony Baldinelli, Conservative, Niagara Falls—Niagara-on-the-Lake, ON]

Thank you, Dr. Stinson.

My time is almost up, and again, you're talking about the representatives you work with who are on the ground. You talked about a lack of being able to apply for funding to do the type of research you're doing on the ground at the hospital level. I was wondering, as my time gets short, if perhaps you could share some of the ideas on how funding opportunities may be able to flow downward to on-the-ground officials like you.

[Kevin Stinson]

Yes, certainly.

Going back to that organism, CPE, right now a lot of hospitals in Canada are trying to work through the cost-benefit analysis of, “Do we bring in screening programs for that?”, and this isn't just for small community hospitals. Large hospitals are having to fight the same problem. It doesn't cost a ton of money. You're looking at, depending on the size of your hospital, only $20,000 to $80,000 or $100,000, but this is a pathogen with significant risks to patient safety, and getting funds to pilot that kind of a surveillance program can help inform us: Does this make sense for our community?

[Tony Baldinelli, Conservative, Niagara Falls—Niagara-on-the-Lake, ON]

Thank you.

[The Chair, Liberal, Salma Zahid]

Thank you.

We will now go to MP Noormohamed for six minutes.

Please go ahead.

[Taleeb Noormohamed, Liberal, Vancouver Granville, BC]

Thank you, Madam Chair.

Thank you to the witnesses for being here.

As Dr. Stinson points out, I don't know if it's “happy” national infection prevention and control week, but we acknowledge this week. Of course, the theme this week is to unite, prevent, protect and prevail, and I'm glad we're having this conversation on this matter today.

Dr. Hamelin, I'd like to start with you. You mentioned Italy and the United Kingdom. These are single-jurisdiction health care systems. One of the big challenges we face in Canada is the notion that a federal approval happens for drugs and then 13 different jurisdictions get to decide how it is going to play out in their respective jurisdictions. We've seen certain provinces that have been far more hesitant than others in terms of bringing in new drugs.

Would you recommend the elimination of the 13 different jurisdictions and support a single approval at the federal level and then, downstream, a decision from there, as opposed to having 13 different decisions?

[Bettina Hamelin]

I think what's really important is to recognize the uniqueness of Canada. Canada is a federation; there are roles for the federal government and there are roles for each of the jurisdictions. We have to acknowledge that and work with all levels of government, because everyone has a really important role to play.

In this instance, the federal government has an important coordination role to play to ensure drug supply and to ensure that there is a list of the most pressing resistant bugs that would be the target for the next list of antibiotics that we need to bring into the country, but between the regulator—Health Canada—and the jurisdictions, there are actually multiple organizations that have played various roles and added significant red tape, which leads to that two-and-a-half-year period after Health Canada approval.

There is Canada's Drug Agency, which doesn't really recognize the value of innovation as much as other jurisdictions. We then have the pan-Canadian Pharmaceutical Alliance, which negotiates pricing on behalf of the provinces—pricing that provinces may or may not accept—and then industry negotiates again with the provinces. There are all of these different steps.

There's a way we need to find in Canada to tackle the fragmentation. In the industry, we are at the ready to work with the federal government and the provincial governments to tackle that, because it's just not sustainable with everything that goes on geopolitically, particularly in disease areas, where every hour counts.

[Taleeb Noormohamed, Liberal, Vancouver Granville, BC]

Thank you very much.

You mentioned that every hour counts, and it seems to me that two and a half years once Health Canada has approved a drug is certainly problematic. If you have any specific ideas—anything you have on that, and ways in which we might take that forward—could you submit that to us in written form? I think that would be very much appreciated by all members of this committee.

[Bettina Hamelin]

I'd be delighted to do that.