On 7 March 2016, the House of Commons Standing Committee on Health (the committee) agreed to undertake a study on the status of antimicrobial resistance (AMR) in Canada.^[1] The committee held six meetings with witnesses (two in June 2017, and four in November 2017), and received 17 briefs relating to this study. Over the course of its meetings on AMR, the committee heard from government officials, academics, international organizations and stakeholders in the fields of both human and animal health.

An antimicrobial is a natural, semisynthetic or synthetic substance that is used to inhibit the growth of microorganisms, such as bacteria, viruses, fungi and parasites, which can cause infections.^[2] Antimicrobial drugs include antibiotics, antivirals, antifungals and antiparasitics. The World Health Organization (WHO) explains that “[a]ntimicrobial resistance [AMR] occurs when microorganisms such as bacteria, viruses, fungi and parasites change in ways that render the medications used to cure the infections they cause ineffective.”[3] While AMR can occur naturally or from the use of antimicrobials, the inappropriate use of antimicrobials in health care, sanitation, animal health and food production accelerates its emergence and spread.^[4]

AMR is “one of the most serious global health threats facing the world today,” with significant impacts both domestically and internationally.^[5] The wide ranging impacts of AMR will be most acutely felt in middle- and low-income countries. In terms of the scope of the problem in Canada, more than 18,000 hospitalized patients acquire infections that are resistant to antimicrobials every year, according to the Public Health Agency of Canada.^[6]

International organizations, as well as individual countries, are addressing AMR in various ways. Some countries have adopted innovative approaches, such as diagnostic strategies and prescribing practices, to promote antimicrobial stewardship. In Canada, organizations in both the public and private sector are working to address AMR. Many of these activities are being coordinated through two main strategic plans: Antimicrobial Resistance and Use in Canada: A Federal Framework for Action[7] and Tackling Antimicrobial Resistance and Antimicrobial Use: A Pan-Canadian Framework for Action.[8] The 2017 Pan-Canadian Framework for Action has four main areas of focus: surveillance, infection prevention and control, stewardship and research and innovation.

With respect to Canada’s approach, witnesses who appeared before the committee emphasized the need for improved surveillance and data, improved stewardship (particularly outside hospital settings), and the need for funding for research and innovation.