VANCOUVER – Superbugs are likely to kill nearly 400,000 Canadians and cost the economy about $ 400 billion in gross domestic product over the next 30 years, a landmark report warns.
An expert panel warns in "When Antibiotics Fail: The Rising Price of Antimicrobial Resistance in Canada" that the proportion of treatment-resistant bacterial infections is likely to rise from 26% in 2018 to 40% by 2050.
This increase is expected to cost Canada 396,000 lives, $ 120 billion in hospital costs and $ 388 billion in gross domestic product over the next three decades.
"This is almost as big, if not greater, than climate change in some sense because it directly affects people. The numbers are just stunning, "said Brett Finlay, a professor of microbiology at the University of British Columbia who led the panel in an interview. "It's time to do something now."
The Canadian Public Health Agency has authorized the report on the socio-economic impacts of antimicrobial resistance and the Council of Canadian Academies has assembled an independent panel. The 268-page document, released on Tuesday, presents a comprehensive picture to date of the country's resilience rate, as well as its costs to the health system and the economy.
Antimicrobial resistance occurs when microorganisms, including bacteria, viruses, and fungi, evolve to counteract drugs that would otherwise kill them. Unnecessary antimicrobial use in humans and agriculture exacerbates the problem, and widespread international travel and trade helps resistant bacteria spread around the world.
The most common antimicrobials are antibiotics, which treat infections caused by bacteria. The report focuses on resistant bacteria but uses a broader term antimicrobial because surveillance data tends to be collected under this heading.
A Canadian Press investigation last year found that Canada was weak in responding to the growing threat. At the time, the federal government did not know how many Canadians were dying of resistant infections and did not develop a plan defining responsibilities for the provinces and territories.
The Pan-Canadian action plan has not yet materialized, but a new report estimates the annual death toll in Canada. The panel used the current 26% resistance rate to calculate that resistant infections contributed to over 14,000 deaths in 2018, of which 5,400 were directly attributable to infections – just slightly less than those caused by Alzheimer's disease.
Panel economists used a more cautious model to project impacts than the well-known international report by British economist Jimmy O'Neill, which predicted up to 10 million global deaths a year by 2050.
The findings of the Canadian report on the economic and social toll of antimicrobial resistance are severe. Currently, the problem is costing the national health system $ 1.4 billion annually and by 2050, that figure is projected to rise to $ 7.6 billion, the report said. GDP is expected to jump from $ 2 billion to $ 21 billion annually.
Resistant infections reduce the quality of life while increasing isolation and stigma, and the impact will be unevenly distributed as some socio-economic groups are at greater risk, the report added. These groups include indigenous, low-income and homeless people, as well as those traveling to developing countries, where microbes are less resistant.
"Discrimination may be directed at those with resistant infections or considered to be at risk of infection," the report warns. "Canadian society can become less open and trusted, with people less likely to travel and more support for closing Canada's borders for migration and tourists."
Antimicrobial resistance has the potential to affect everyone, says Finlay.
"He's changed the world," he says. "We all go to hospitals and we all get infections."
The report notes that resistance can increase the risk and reduce the availability of routine medical procedures, including kidney dialysis, joint replacement, chemotherapy and caesarean section. These procedures have all the threats of infection that are commonly prescribed antibiotics.
Limiting the impacts of antimicrobial resistance requires a "thorough reassessment" of healthcare in Canada, the report concludes.
The panel states that Canada lacks an effective federal, provincial and territorial surveillance system for antimicrobial resistance and use, with little comprehensive data describing the number of resistant infections and their characteristics.
It also calls for improved management of the inclusion of careful use of antimicrobials to preserve their efficacy, strict infection prevention and control through hand hygiene, cleaning of equipment and research and innovations for new treatments.
The report notes that it is unlikely that new broad-spectrum antimicrobials will be discovered. None have been found for decades and there is little incentive for pharmaceutical companies to invest in drugs that treat patients quickly. However, the commission calls for more flexible regulations and incentives to promote the discovery of new antimicrobials that treat infections caused by specific bacteria.
Alternative therapies are also being developed to treat or prevent resistant infections, including vaccines and phage treatments, which are viruses that attack bacteria, the report added.
Canada should immediately invest $ 120 million in research and innovation and up to $ 150 million in infection management, education and control across provinces and territories, said Dr. John Cole, a panel member and professor at the University of Calgary specializes in chronic diseases.
The government and the public should be "absolutely" concerned about antimicrobial resistance as much as they are about climate change, Cole said.
"It's a slow-moving tsunami. Like a tidal wave, it is out of the sea but will land on us much earlier than climate change. "
This Canadian press report was first published on November 12, 2019.
Laura Caine, Canadian Press