Canada hasn’t done enough to address the “concerning” rise in resistance to antimicrobial drugs, including antibiotics, Auditor General Karen Hogan said Thursday.
“The COVID-19 pandemic showed that the cost of not being prepared is measured in lives lost,” Hogan said at a press conference in Ottawa. “For this reason, antimicrobial resistance is concerning.”
Hogan released an audit about Canada’s actions regarding the issue on Thursday.
The World Health Organization has put antimicrobial resistance in the top 10 public health threats to the world and called it a “silent pandemic” in 2022, saying up to 5 million deaths occur from it worldwide each year.
Research published in the medical journal Lancet in early 2022 found that “superbugs,” or germs that are resistant to antibiotics, caused more than 1.2 million deaths globally in 2019.
While the federal government came up with a plan to address the resistance in June 2023, Hogan says she is concerned it is missing “critical elements,” including ways to track progress, timelines, concrete deliverables and details of who is accountable for each action.
“Without these elements, it is unlikely this plan will result in any progress,” she said.
In Canada, 26 per cent of infections in 2018 did not respond to first-line antimicrobials, resulting in 5,400 deaths, according to the audit’s report. That resistance is predicted to increase to 40 per cent by 2050, according to the Council of Canadian Academies, with annual deaths increasing to 13,700.
Hogan said that Health Canada and the Public Health Agency of Canada have not done enough to implement regulatory changes and economic incentives to improve access to antibiotics of last resort.
“Only two of the 13 new antibiotics used to fight drug-resistant infections are available in Canada, yet all 13 are available in the United States to successfully fight antimicrobial resistance,” she said.
The report also said that Canadians do not have market access to 19 of 29 antimicrobial drugs that the WHO has classified as ones of last resort.
Canada’s action on antimicrobial resistance was last audited in 2015, and since then data collection has improved though gaps remain, the report said.
However, Health Canada has not assessed whether any of its changes have been working as intended, Hogan’s report notes, and two-thirds of federal funding for action on resistance, besides research, was pulled from budgets in 2021-22 and 2022-23.
The report calls on the government to have a co-ordinated national response with “clear accountabilities, concrete deliverables, specific timelines, and measurable outcomes,” and to use national data to determine which antimicrobials Canadians need most, then “implement measures to support market access to these drugs.”
It notes that when existing antimicrobials are less effective, it forces Canada’s health-care system to rely on more expensive drugs of last resort, which can also become less effective over time.
In a statement, Health Minister Mark Holland thanked Hogan for her audit and said the federal government accepts the recommendations in the report.
“We recognize the urgent need to address AMR and have remained committed to working with partners to take increased and expedited action,” he said.