• Based on the available evidence, there is a direct link between resistance in human pathogens, and resistance in a reservoir of environmental bacteria.
• Several human activities, including wastewater discharges, land spreading of manures from medicated animals, and effluents from drug manufacturing have the potential to increase the environmental reservoir of antibiotic resistance.
• More new antibiotics to replace those that are no longer effective are desperately needed.
• We conclude that there is an urgent need to develop an aggressive policy and research agenda, and deploy the necessary resources to deal with the seminally important health issue of antibiotic resistance development.

Only immediate effective action on a global scale will prevent a ‘perfect storm’ of antibiotic resistance that will compromise the use of drugs indispensable for health care. Health care considerations are paramount, and unless these critical therapeutic agents are preserved by science-based policy actions it is highly likely that we will return to the pre-antibiotic era. We applaud the announcement on June 12/2013 by the G8 science ministers concerning the need to maintain effective antibiotics for the treatment of disease. We encourage the Governments of Canada and indeed all countries to implement policies that avoid the misuse of antibiotics in agriculture and medicine, stimulate the antimicrobial research and development pipeline, support international collaboration, and fund theoretical and applied research to understand the origin, spread, evolution and development of antimicrobial resistance.