We urgently need a plan to fight antimicrobial resistance

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Pamela Fralick, President, Innovative Medicines Canada

This article originally appeared in iPolitics on November 17, 2021.

As COVID-19 cases fall and Canadians begin to return to their normal lives, public-health experts, researchers, and industry (both domestic and international) are increasingly worried that the next pandemic is looming.

Antimicrobial resistance (AMR) represents a severe threat to the health of Canadians and the good functioning of our health systems. Wide and inappropriate use of antibiotics, or overprescribing, has resulted in some bacteria developing resistance to commonly used antibiotic drugs, making existing therapies less and less effective. The microorganisms that produce antimicrobial resistance are sometimes referred to as “superbugs.”

COVID has compounded the threat of AMR. A recent study by the U.S. Pew Charitable Trusts found that, in the first six months of the pandemic, 52 per cent of COVID hospital admissions led to one or more antibiotics being given to patients, while only 20 per cent of those admitted with the virus were actually diagnosed with common bacterial infections.

AMR is a bigger problem than most people realize. Without effective antimicrobials for the prevention and treatment of infections, once-routine medical procedures such as organ transplants, cancer chemotherapy, or something as simple as a throat infection, will become life-threatening and increasingly high-risk.

As this is the World Health Organization’s annual World Antimicrobial Awareness Week, it appears that AMR isn’t just a bigger problem than most people realize; according to a survey by Leger, only 50 per cent of Canadians have heard of AMR.

This is shocking, when one considers the conclusion of the Council of Canadian Academies report, “When antibiotics fail: The growing cost of antimicrobial resistance in Canada”: The percentage of bacterial infections resistant to treatment is likely to grow — from 26 per cent in 2018 to 40 per cent by 2050.

As we’ve seen with COVID, pandemics have a ripple effect, severely damaging society and the economy. The Council of Canadian Academies report found that the increase in AMR is expected to cost 396,000 Canadian lives, $120 billion in hospital expenses, and $388 billion in gross domestic product over the next three decades.

There’s been global awareness of AMR for years. As early as 2015, the World Health Organization and the G7 acknowledged its effects, as well as the need for sustainable investment in research and development to identify and produce a new pipeline of therapeutics.

In the years during which AMR was discussed at international forums, however, little has been done to develop new antibiotics that can be used as a last resort when all existing antibiotics have proven ineffective.

Last year, industry parties came together to create the $1-billion U.S. AMR Action Fund, the world’s largest public-private partnership to support the development of new antibiotics. The fund will be a valuable boost to innovation, but it alone doesn’t provide the sustainable economic incentives required to tackle AMR.

Canadians expect more.

According to the Leger survey, of the Canadians who’d heard of AMR, 83 per cent believe Ottawa should deal with it. That leadership can’t come soon enough, as Canada lags behind other countries, according to the 2021 AMR Preparedness Index, particularly in investments in innovation and commitments to a national strategy.

With the Public Health Agency of Canada’s September release of a Pan-Canadian Framework for Action for Tackling Antimicrobial Resistance and Antimicrobial Use in 2017, the federal government recognized the threat of AMR and the urgent need for action.

The framework was the result of federal, provincial, and territorial governments working with academics, NGOs, and experts from the agriculture sector and in human and animal health.

What’s missing is a pan-Canadian action plan, which is necessary to fight the increase in resistance in Canada. To that end, the plan would encourage new programs for, and funding of, infection prevention and control, stewardship, surveillance, research, and innovation.

The COVID pandemic has made a pan-Canadian action plan even more urgent. We need it to ensure that our public health system is ready for faster rates of antimicrobial resistance in the post-COVID environment.

During the WHO’s World Antimicrobial Awareness Week, Canadians must be made aware of AMR and the global and domestic threats it poses. Here is an opportunity to harness Canadian innovation, expertise, and talent to protect Canadians.


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