Building Canada's National One Health AMR Research Strategy: Priorities
Dynamics of Transmission & Drivers of AMR
Investigate global AMR transmission pathways and dynamics across One Health settings considering a range of contributing factors (e.g., human and wildlife movement, ecological processes, climate change, international trade, industrial and agricultural waste) that influence the spread of resistance across national borders.
Compare AMR pathogens and genes across One Health settings to map transmission pathways, identify high-risk species/hotspots (e.g., wastewater, at-risk aquatic zones, hospital/LTC), and pinpoint prevention and intervention points to reduce AMR transmission.
Investigate ecological, occupational, and behavioural factors influencing exposure to AMR across diverse human, animal, agriculture and environmental contexts to identify practices and conditions that contribute to AMR emergence and spread.
Expand research on commensal organisms across One Health settings, which can act as reservoirs of resistance genes transferable to bacterial pathogens, by understanding their role in the spread of AMR.
Underlying Biology of AMR
Identify and investigate the mechanisms and factors (such as selection pressures) that contribute to the emergence and spread of AMR among bacteria at the genetic, organism and host levels.
Study the biological mechanisms and structures of critical AMR pathogens (including bacteria, viruses, fungi, and parasites) to develop vaccines, new antimicrobials, and alternatives to traditional antimicrobials, such as bacteriophage, probiotics, small molecules, and prebiotics.
Assess the impact of agricultural AMU practices (e.g. livestock, crop production, aquacultural) on AMR in humans, animals (including wildlife and companion animals), and environmental reservoirs by mapping and quantifying pathways of resistant bacteria and gene transfer.
Analyze the ecology, evolution and transmission dynamics of AMR pathogens, including the maintenance and transfer AMR genes (e.g. plasmids and other mobile genetic elements) and impact of environmental factors (e.g. heavy metals, biocides), across One Health settings.
Surveillance & Monitoring
Develop, improve, and standardize surveillance methodologies for measuring and reporting AMU and AMR across human, animal, crop and environmental sectors, prioritizing innovative, context-specific approaches that address diverse geographies (e.g. remote and low-connectivity environments), while supporting national and international data integration.
Apply and advance research methods and tools (i.e. infectious disease modeling, genomic and sero-epidemiology, wastewater surveillance) for AMR and AMU to improve surveillance, early detection, risk assessment in high-exposure populations.
Identify and address gaps in AMR and AMU surveillance through cross-sectoral collaboration and data integration across One Health settings, including import/export of livestock, waterways (e.g. the Great Lakes), environmental reservoirs (e.g. fish farms), and human healthcare settings (e.g. hospitals, community healthcare).
Innovations in Diagnostics, Treatment & Prevention
Develop and validate safe and effective alternative treatment strategies (e.g., phage or derived biologics), to antibiotics for animal and crop health, ensuring they do not exacerbate AMR.
Develop and validate context-appropriate and cost-effective rapid diagnostic approaches (e.g. point-of-care) to detect AMR organisms and resistance genes across One Health settings to improve effectiveness in differentiating infections and detecting antimicrobial susceptibility.
Develop new treatment options and improvements to existing treatments, such as combinations of different antimicrobials or antimicrobials in combination with other treatments, or improved dosing of existing antimicrobials or new indications.
Advance foundational research to inform development and evaluation of vaccines that reduce AMR across One Health settings, with emphasis on human-use vaccines targeting high-burden pathogens with animal and environmental reservoirs and on optimizing target selection to reduce infection burden, AMU, carriage and resistance.
Infection Prevention & Control Strategies
Identify and develop innovative IPC approaches, with an emphasis on strategic outbreak response and control, that reduce AMU and limit the emergence and transmission of AMR across One Health settings (e.g., healthcare settings, waste/fertilizer management, animal/vector movement).
Advance research to inform the development and evaluation of vaccines and vaccination programs to maintain the health of farmed animals (aquatic and terrestrial) and support infection control, reducing the need for AMU and preventing secondary bacterial infections.
Assess the effectiveness and cost-effectiveness of AMR prevention and control practices across diverse geographic, socio-economic and One Health settings, accounting for environmental factors that may influence their impact.
Conduct evidence-based assessments of the safety, effectiveness, and relative advantages/disadvantages of pharmaceutical and non-pharmaceutical approaches for preventing and treating infections in humans and animals.
Developing & Understanding Impact of Policy
Identify and validate methods to develop, achieve, and report on appropriate and acceptable AMU or AMR indicators/targets for national government or specific sectors, ensuring these methods support effective prevention, control, and mitigation of AMR.
Develop strategies for strengthening feedback loops between monitoring, research, and education to support timely communication of AMR data across the One Health continuum, integrating PWLE perspectives to enhance relevance and impact.
Assess regulatory pathways and potential incentive mechanisms within Canadian contexts to identify evidence-informed opportunities to accelerate the development, approval and sustainable access of new antimicrobials and alternative treatments (e.g., probiotics, phage therapies, drugs approved in other countries) for use across sectors.
Leverage surveillance data to quantify and understand the societal costs incurred by AMR across diverse communities, including but not limited to rural and remote communities.
Understanding & Modifying AMU Behaviours
Characterize baseline AMU and understand prescriber and administrator behaviours—including differences between prescribed and actual use and the underlying knowledge/attitudes driving AMU to enhance stewardship, enable comparative benchmarking and improve human, animal, environment and crop health through cross-sector collaborations.
Evaluate and strengthen educational and training programs to improve communication and raise awareness among HCPs, patients and the pharmaceutical and animal husbandry sectors on AMR, healthcare hygiene, safe disposal of antimicrobials, infection control, and responsible AMU.
Explore evidence-based, patient- and caregiver-centred solutions to enhance science communication around AMR, ensuring research findings are accessible, relevant and actionable for all, including diverse communities and communities facing inequities (e.g. northern and remote regions).
Data Stewardship & Monitoring
Investigate barriers to effective data collection, exchange, analysis, and reporting, including challenges in accessing and integrating surveillance data, research findings, and samples across diverse sectors and laboratories and explore solutions such as open data science platforms.
Utilize surveillance data to assess stewardship effectiveness, conduct risk assessments, and develop integrated, multi-scale models that predict infection spread and identify contamination sources, environmental reservoirs, and exposure routes contributing to AMR emergence and spread across local, regional and global systems.
Develop a cross-sectoral data set for AMR and AMU monitoring by identifying and integrating key data sources, implementing standardized and, where contextually appropriate, harmonized data collection and documentation, and developing robust validation mechanisms to ensure accuracy and reliability of compiled data.