Health committee  I can say there are lots of initiatives going on, too many to even enumerate. They're all happening, I think, in a somewhat ad hoc manner. There are campaigns such as “Do bugs need drugs”, etc. In the infection prevention and control setting it's certainly the mantra that we've been saying for years across the country, that handwashing is probably the single most effective method in preventing further spread.

Health committee  Yes, the first framework you refer to is the federal framework. That's really within the federal family. As you say, that was developed in 2014, and an action plan in terms of what federal departments could or should be doing was released in 2015. As I mentioned in my opening remarks, we recognize that the federal government alone is not the sole solution to the AMR problem.

Health committee  You mentioned veterinary practice, but that's not really what the World Health Organization is concerned with. The World Health Organization is more on the public health side, the human health side. It's really in terms of antibiotic use and stewardship in the human health world.

Health committee  Thank you very much. Dear members of the committee, good morning and thank you for the invitation to speak to you regarding antimicrobial resistance, or AMR. Let me begin with a quick summary of the issue. AMR is one of the most serious global health threats facing the world today.

Health committee  In terms of surveillance, since Lyme disease became a notifiable disease in 2009, the number of reported cases to the Public Health Agency of Canada went up from 144 to over 800. We also recognize that there probably is a degree of under-reporting. As we move forward, one of the key things we want to improve is surveillance, as we mentioned with regard to the framework, for both the human illness and the ticks.

Health committee  I wouldn't say that we do or don't support the development of any vaccine. As I said, there are a number of players. Certainly, vaccine manufacturers and researchers are in the process of trying to develop vaccines for a wide range of infectious diseases, including Lyme, HIV, and so on.

Health committee  Thank you very much for your question. Certainly, we believe that the patients you mention were obviously engaged. They were participating at the conference. If you look at the framework, you see that the actual proceedings of that conference are, in a sense, attached to the framework.

Health committee  I think it's fine as it is as a starting point. Moving forward, as you mentioned, I think that if we start looking at the research questions in terms of diagnosis and treatment, I certainly believe there is a role for engagement and involvement of patients and patient advocates in the process as we elaborate the types of research areas we should focus on.

Health committee  I don't think I'm disagreeing with the College of Family Physicians. As I mentioned before, one of the areas that we do recognize needs to be improved is diagnostics. Therefore, with the funding for research, we are focusing and saying that it is one area, along with treatment, that needs to be further dealt with in terms of research.

Health committee  No, the federal framework acknowledges that the development of actual treatment options is best undertaken by the professional organizations for the front-line practitioners, and it respects that expertise.

Health committee  Yes, another point is that the actual delivery of health care services and public health services is a provincial and territorial jurisdiction.

Health committee  For the Government of Canada specifically, we don't have any ongoing research into a vaccine for Lyme disease. I'm not personally aware, but I'm sure that probably researchers around the world are looking at developing a Lyme disease vaccine.

Health committee  Other federal departments, including NSERC, were involved and engaged in the development of the framework, and certainly as we move forward with the research agenda as the questions get further developed, I'm sure we'll engage with them as appropriate.

Health committee  At the national level, in terms of the U.S. CDC and us, no, there isn't.

Health committee  Yes, certainly. As we did at the conference, we recognize that it is important to engage all the stakeholders, including patients' advocates, as we move forward. One thing I mentioned before is that as we go forward with guidance we need to stick to what I believe are the principles of the scientific method.