November 12, 2019

When Antibiotics Fail

The Expert Panel on the Potential Socio-Economic Impacts of Antimicrobial Resistance in Canada

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Summary

Antimicrobials are life savers in Canada, enabling modern healthcare and playing a central role in agriculture. They have reduced the economic, medical, and social burden of infectious diseases and are part of many routine medical interventions, such as caesarean sections, joint replacements, and tonsillectomies.

As use of antimicrobials has increased, bacteria evolved to become resistant, resulting in drugs that are no longer effective at treating infections. Antimicrobial resistance (AMR) is increasing worldwide, and with widespread trade and travel, resistance can spread quickly, posing a serious threat to all countries. For Canada, the implications of AMR are stark.

When Antibiotics Fail examines the current impacts of AMR on our healthcare system, projects the future impact on Canada’s GDP, and looks at how widespread resistance will influence the day-to-day lives of Canadians. The report examines these issues through a One Health lens, recognizing the interconnected nature of AMR, from healthcare settings to the environment to the agriculture sector. It is the most comprehensive report to date on the economic impact of AMR in Canada.

The Sponsor:

The Public Health Agency of Canada

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Close

The Question

What is the socio-economic impact of antimicrobial resistance (AMR) for Canadians and the Canadian healthcare system?

Key Findings

More than 14,000 deaths in Canada in 2018 were associated with resistant infections. Of these, 5,400 deaths were directly attributable to AMR. Based on the Panel’s model, the cumulative number of lives lost in Canada between 2020 and 2050 that will be attributable to AMR would range between just under 256,000 if resistance to first-line antimicrobials stayed at today’s rates of 26%, to just over 396,000 if there is a gradual increase to 40% resistance.

AMR already places a significant financial burden on the Canadian healthcare system, costing about $1.4 billion in 2018. If resistance rates to first-line antimicrobials increase to 40% by 2050, it is estimated that the cumulative costs of AMR to the healthcare system will approach $120 billion. Likewise, AMR has had a sizable negative impact on the economy, having reduced Canada’s GDP by an estimated $2 billion in 2018. By 2050, if resistance rates remain at 26% or gradually increased to 40%, the economy could lose between $13 and $21 billion per year, respectively.

In a future where limited antimicrobials are a reality, more people in Canada will see their quality of life decline, with unequal distribution of impacts across socio-demographic groups. In addition to the substantial negative health impacts of AMR, there will be broad negative social impacts, decreasing well-being, social capital, and trust, and increasing inequality. Canadian society may become less open and trusting, with people less likely to travel and more supportive of closing Canada’s borders to migration and tourists.

The most effective way to address AMR is to take a multifaceted approach that coordinates initiatives related to four key mitigation strategies:

  • surveillance,
  • infection prevention and control (IPC),
  • stewardship, and
  • research and innovation.

Forecasting the future of antimicrobial resistance (AMR) in Canada

Using existing data and a quantitative model, a panel of experts found that, in Canada, 26% of infections are resistant to the drugs generally used to treat them. By 2050, resistance rates are likely to rise to 40%. That could result in the loss of 396,000 lives and $396 billion in GDP.

This tool lets you dig deeper into the numbers, projecting lives and GDP lost as the incidence and resistance of infections change.

By 2050, a total of lives could be lost in Canada.

Overall resistance rate in 2018
Likely resistance rate in 2050 as predicted by the expert panel
26% 100%
20

The resistance rate refers to the proportion of infections that don’t respond to the drugs generally used to treat them. Rising resistance could be mitigated by careful stewardship of antimicrobial use and ongoing research into alternative treatment strategies.

0% 40%
100

The incidence rate indicates how frequently infections occur. Effective infection prevention and control initiatives can reduce incidence rates. The baseline incidence rate is the 2018 average (2,600 per 100,000 people).

By 2050, AMR could reduce Canada’s annual GDP by B

Overall resistance rate in 2018
Likely resistance rate in 2050 as predicted by the expert panel
26% 100%
20

The resistance rate refers to the proportion of infections that don’t respond to the drugs generally used to treat them. Rising resistance could be mitigated by careful stewardship of antimicrobial use and ongoing research into alternative treatment strategies.

0% 40%
100

The incidence rate indicates how frequently infections occur. Effective infection prevention and control initiatives can reduce incidence rates. The baseline incidence rate is the 2018 average (2,600 per 100,000 people).

Expert Panel

The Expert Panel on the Potential Socio-Economic Impacts of Antimicrobial Resistance in Canada