Though global health crises have been in the spotlight long before the emergence of COVID-19, the pandemic offered a stark reminder of the limits of our public health systems and the need to quickly address looming threats. While our focus has been on COVID for good reason, other potential health emergencies also deserve our attention.
Antimicrobial resistance (AMR) is a serious threat to public health and could be the cause of the next global crisis. AMR occurs when microbes — bacteria, viruses, parasites, fungi — change over time, developing resistance against medicines such as antibiotics that were previously able to either defeat these microbes or stop them from spreading.
Canadians might recognize AMR by a more familiar term: “superbugs.”
The consequences of AMR can be devastating. Longer hospital stays for loved ones. Lengthier and more complicated treatments for common infections like pneumonia, sepsis and urinary tract infections. A higher risk of life-threatening infections for patients with weakened immune systems such as newborns and seniors, or those undergoing medical procedures like surgery, chemotherapy and dialysis.
According to an expert research panel convened by the Council of Canadian Academies (CCA), approximately 5,400 people in Canada died as a direct result of AMR in 2018, and the Canadian economy lost $2 billion due to the deaths and illnesses associated with resistant infections. By 2050, AMR is expected to cumulatively cause 396,000 Canadian deaths, increase health costs by $120 billion and reduce Canada’s GDP by $388 billion.
The World Health Organization (WHO) has identified AMR as one of the 10 most pressing threats to global health. It was responsible for 1.27 million deaths worldwide in 2019 alone, according to an analysis published in The Lancet.
But there are achievable, proven ways to move forward.
Today, several new antibiotics effective against these superbugs have been approved for use in many countries around the world, yet remain unavailable to Canadian patients. Of the 18 new antibiotics approved and introduced in 14 high-income countries in the past decade, only two have been introduced in Canada — the fewest of any country on the list, according to research published in the journal Clinical Infectious Diseases. The same study showed the US had introduced 17 new antibiotics in the same time frame, while the UK, Sweden and France had introduced 11, 10, and eight, respectively.
Without a focused, preventative national action plan to get these new antibiotics to doctors, hospitals and ultimately patients, Canada will remain underprepared to tackle this growing threat.
These improvements begin with a clear plan that focuses on collaboration, swift investment and action. We should move quickly and diligently to bring new antibiotic options to Canada so that we can slow the development of resistance, save lives and help reduce the ever-increasing pressure on our health systems.
This includes increasing awareness of AMR and its challenges, changing how new antibiotics are approved and accessed in Canada, and collaborating with domestic and international groups to develop economic incentives that help build a pipeline of new, proven antibiotics.
As part of this process, a coalition of health-care professionals, universities, research centers and medical associations organized World Antimicrobial Awareness Week in collaboration with the WHO. Running from Nov. 18 to 24, the week of action will raise awareness of AMR and its global tolls.
The time for Canada to act is now. A large-scale crisis is preventable, but only if health officials and federal and provincial governments take immediate action.
For governments to be able to meet both the current and future needs of our health-care systems, Canada must implement an effective plan to minimize the risk of AMR and introduce economic incentive policies to encourage the launch of new antibiotics. Failing to do so puts Canadians at risk.
As the WHO and countries around the world face this growing threat, Canada can be a leader in access to innovative, research-based medicine. To achieve this, we must develop an approach that considers our unique health-care systems, co-ordinates AMR efforts across the country and reduces the risk to Canadian patients — today and into the future.