Antibiotic Access & Capacity Proposal

This proposal is the result of a grassroots endeavour to explore and present solutions to extensive issues surrounding access to and capacity for novel antibiotics in Canada. Jointly led by McMaster University and the Canadian Antimicrobial Innovation Coalition (CAIC), this project was catalyzed by the urgent need to slow the spread of antimicrobial resistance (AMR).

This work resulted in a set of 30 concise recommendations and an integrated solution designed to improve antibiotic access and capacity, and to protect these vital medications through stewardship efforts and improved surveillance of resistance rates in Canada.


Today, a number of novel antibiotics — drugs with efficacy against otherwise resistant bacteria — have been approved for use in other jurisdictions but are unavailable to Canadian patients. In fact, of 18 novel antibiotics approved and commercially launched in 14 high-income countries between 2010-2019, only two had been introduced in Canada — the fewest number on the entire list — while other countries, like the U.S., introduced as many as 17.

We believe this can be rectified through incentivization and regulatory improvements, and by expanding front-line access through measures related to data, costs, distribution, and supply and demand.

Specifically, we propose that Canada should enact guaranteed minimum revenue agreements for manufacturers of novel antibiotics, establish antibiotic- and diagnostic-specific funding envelopes for hospitals, improve data collection and reporting processes, and invest in infrastructure to improve antimicrobial stewardship at a pan-Canadian level.

Download: English summary document
Download: French summary document

Steering Committee

Lori Burrows (Project Chair) | McMaster University
Alfonso Iorio | McMaster University
Mark Loeb | McMaster University
Jacqueline McCarles | CAIC
Wes Miyai | CAIC
Dani Peters | CAIC
Jean-Éric Tarride | McMaster University
Gerry Wright | McMaster University

Project Team

Julie Barré | Project Director
Blake Dillon | Communications Specialist
Pia Lindemann Kristensen | Special Collaborator
Laurel Person Mecca | Project Coordinator
Luke Yaeger | Research Support

Relevant Literature

Patient access in fourteen high-income countries to new antibacterials approved by the FDA, EMA, PMDA, or Health Canada, 2010-2020 (Clinical Infectious Diseases, 2021).

When Antibiotics Fail The Expert Panel on the Potential Socio-Economic Impacts of Antimicrobial Resistance in Canada (Council of Canadian Academies, 2019)

Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis (The Lancet, 2022)

Global antibiotic consumption and usage in humans, 2000–18: a spatial modelling study (The Lancet, 2021)

In Conversation

Dr. Lori Burrows, Associate Director of the Michael G. DeGroote Institute for Infectious Disease Research (IIDR) and Chair of this project, appeared on the AMR Action Podcast to discuss this proposal.

Listen to the full episode here.