Health Committee on April 22nd, 2010

[Dr. David Butler-Jones]

I thought this project was actually intended to create and move forward on the development of a vaccine for HIV. It was not simply a vehicle for Canadian researchers, although Canadian research and leadership is key to that.

I'll just quickly answer the other questions.

McMaster is a not-for-profit facility, and there are others as well--

[The Chair, Conservative, Joy Smith]

I'm sorry, Dr. Butler-Jones. I'll give you time if you could just answer the question, because we're out of time, and the question for Mr. Sternthal as well. I'll give you both time to do that.

Ms. Wasylycia-Leis, there's no more time for your questions.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Would you table the information?

[Dr. David Butler-Jones]

We've already agreed to that.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Could you do it today, right down to the $51 million?

[Dr. David Butler-Jones]

As soon as possible. It's on our website. You can go to our website today and you can get it in both languages.

As Frank has identified, in terms of those who are actually looking for it, we have no problem finding capacity to do what we need to do, and others are finding the same thing. McMaster is a not-for-profit. It's a university facility, but researchers always include money in their grant submissions for whatever elements of what it is they need to do for research. It would not be free in any case, no matter where it is.

In terms of the reasons they did not pass, as I said at the outset, there were technical, management, and financial aspects and deficiencies in all the proposals. None of the proposals passed the bar. Some were better in some areas than others, but none passed the bar from the outset.

[The Chair, Conservative, Joy Smith]

Mr. Sternthal, would you like to proceed?

[Steven Sternthal, Acting Director, HIV/AIDS Policy, Coordination and Programs Division, Centre for Infectious Disease Prevention and Control, Population and Public Health Branch, Department of Health]

Sure, just briefly, and then of course we'll have information for the committee following this.

The $51 million is broken down as follows:

The $22 million is to support discovering social research. When I testified at the committee, I identified that 13 projects are currently in place. They're on our website, and we could provide that information. Additional calls for proposals will be coming out shortly.

The $16 million is currently being administered to the global health research initiative to support clinical trial capacity in Africa. Currently ten letters of intent are under review, with a funding announcement to take place in the next couple of months.

The $9 million is going to support communities as well as regulatory authorities for the World Health Organization.

The final $4 million is in support of Government of Canada coordination and oversight of the initiative.

[The Chair, Conservative, Joy Smith]

Thank you very much.

Mrs. Davidson.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thanks very much, Madam Chair.

I'd like to again thank Dr. Plummer and Dr. Butler-Jones for joining us again today. Certainly you're getting to be very familiar faces. We appreciate the expertise you bring to us and also to the issues at hand.

There are a couple of things that have come up so far today in the testimony from both the doctors, and I think those things need to be pointed out again.

I think it's extremely important that we recognize the fact that things do change. Dr. Butler-Jones, you referred to that in an answer to one of the other questions that was put to you. As a government, we need to be able to react to change. So the fact that the capacity has changed since the project was first announced until the time the last study was done and the fact that the government and the Gates Foundation were able to react to that change I think speaks well of both those organizations.

I think most Canadians would prefer to see their government be able to react in a way that is going to see that $88 million used to the best advantage. We certainly know we need to be working towards eradicating HIV/AIDS, and if we can use that $88 million to a far better use, then that's what we should be doing, and I support that.

We've heard from other members that we've had contradictions from different people giving testimony. I think we've heard statements from different people, and people are bound to have different points of view, but I don't think we've heard contradictions.

I just want to point out that as parliamentarians I think we need to be extremely careful that what we are doing is based on a national focus, not a narrow municipal focus. Some of us have been municipal politicians, some of us haven't, and some of us are probably better suited to being municipal politicians than federal politicians. But the bottom line is that sitting here as parliamentarians we need to react on issues with a national focus and we need to make sure federal resources are used to reflect things at a national focus.

Having said that, I would like to ask Dr. Plummer a question first, and then if I still have time I'd like to ask Dr. Butler-Jones a question.

Dr. Plummer, in your opening remarks you gave us a brief background of yourself. Certainly I'd like to say you have an impressive and highly credible background. You've been director of the National Microbiology Lab, professor of medicine and microbiology at the University of Manitoba, had appointment to the Order of Canada, and of course the work you did during the H1N1 was absolutely incredible.

Dr. Plummer, could you please describe your background in HIV research and your experience that has contributed to your expertise in this area?

[Dr. Frank Plummer]

Certainly.

Madam Chair, I've been involved in HIV research since pretty much the beginnings of the HIV pandemic. I was working in Kenya when it became apparent that there was a huge problem with HIV in sub-Saharan Africa. Much of our work in the early days described the emergence of the HIV pandemic in sub-Saharan Africa.

I worked in Kenya from 1984 until I took the job as the scientific director of the National Microbiology Lab in 2000. The work we did has produced seminal results that have changed global policy related to HIV prevention. For instance, we described the importance of commercial sex in fuelling the epidemic and described how you can intervene to prevent that. That strategy's now being used around the world and has resulted in tremendous declines in the HIV burden in India, Vietnam, Thailand, and other places.

We described the role of male circumcision in reducing the risk of men becoming infected with HIV. That's now global policy being used to prevent HIV transmission. We described the role of breastfeeding in transmitting HIV between mothers and their newborn children. That resulted in a change in policy at the global level.

More recently, we've described a group of individuals, female sex workers, who appear to be immune to HIV, and this has helped to inform HIV vaccine research. We're now in the process of putting together a global consortium of individuals who've been exposed to HIV but didn't get infected, to try to understand natural immunity. That work is being supported by the Bill and Melinda Gates Foundation and the Canadian Institutes of Health Research.

I have a tremendous interest in this Canadian HIV vaccine initiative. Although I'm disappointed in the turn this has taken and the controversy around it, I'm excited about the opportunity to have additional investments in basic research on HIV.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you, Dr. Plummer. You certainly have a truly remarkable track record. Thank you for all that you have done.

Dr. Butler-Jones, we know that the government has made significant investments in HIV/AIDS and remains dedicated to the CHVI. Can you elaborate on the government's commitment to finding an HIV vaccine for those who need it?

[Dr. David Butler-Jones]

I think I have sort of outlined and Steven has outlined how the money that has already been allocated is being used in research, etc. I think this partnership with Bill and Melinda Gates is fairly unique. It's an opportunity to demonstrate again the close cooperation between what's probably the largest NGO, in terms of working in this area of the world, and the Government of Canada and to particularly focus on and highlight, as Dr. Plummer did, the kind of remarkable work.... They are probably as good as...or the best in the world.

There are also many other exceptional researchers in Canada who have expertise to bring to this measure. People are looking to us, and I think the commitment of both the Government of Canada and the foundation will lead us forward.

We're in the midst of the discussions now, and given that we no longer need a facility, as Dr. Plummer said, having that resource to apply to something new that otherwise would not have been done is actually a huge opportunity.

Again, now that we have that decision and we're looking at the others, hopefully before long we will be able to come back to committee with a more comprehensive outline of what we expect to do over the next few years.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Plummer.

Now we'll go to Ms. Murray and Ms. Duncan. Who would like to begin?

Ms. Murray.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

Dr. Butler-Jones, as someone relatively new to federal politics and this committee, I will say this has been a very fascinating exercise. The need and concept for the project were identified in 2003. A complex partnership plan was worked out in detail in 2005. There was an announcement in 2007. Then at the very end point of this long, complex, and expensive process, the plug was suddenly pulled. I was very surprised to hear you say this is just the government grant process: you're in or you're out; it's black or white. I should disclose that I was the provincial minister responsible for the secretariat that did the complex deals for government with partners in the province of British Columbia. I was very involved with not the details, but the processes. The notion that it's in and out or that we didn't meet the criteria so it's pulled is quite opposite from the process as I know it.

Is it normal, in your experience, that an initiative that has had seven years of evolution would at the last minute be treated as a grant where you're in or out, and there is no opportunity for the lead bidder to work through whatever deficiencies may have been and always are identified in a proposal like this? There are always some things the government wants to be addressed.

You've described this as being simply a grant. Is this normal--yes or no?

[The Chair, Conservative, Joy Smith]

Dr. Butler-Jones.

[Dr. David Butler-Jones]

There are two aspects to your question, I think. One is whether this is normal. Yes, it is. In terms of government procurement, there are times when there's a call for proposals, and none of them are acceptable. Then you have to decide whether to issue another call for proposals or what you will do.

In this case, while none of the proposals was acceptable--none of them crossed the bar, so that process was done--we had the information to say that in fact it was no longer needed. In that kind of context, why would you go back to anybody? Why would you go out? Why would you initiate a new process?

That's why we had to take this. As you said, this was a long process, and we were all committed to it. We are trying to respond to a need, and it turns out that the need isn't there any more, so you have to change course. That's why we had discussions through the fall. We took all of the proposals seriously, and tried to look at them all in terms of what was necessary. At the end of the day, the decision was fairly simple.

We have capacity that the proposals that existed didn't meet. It would have been a different discussion if one of the proposals passed, and there wasn't the capacity need. That would be a different political challenge from what it would be if the capacity weren't there and none of the proposals met the need.

The fact is that given both facts, that the proposals didn't meet the bar and that the need was no longer there, for me there is a simple, scientific decision: why would you invest in something that's not needed any more?

[Joyce Murray, Liberal, Vancouver Quadra, BC]

Thank you. I appreciate that.

[Dr. David Butler-Jones]

You had two questions. May I answer the first question?

In terms of changing course, that's with regard to the process. For example, again, you have to pay attention to the data and the information at the time. When information changes, you can't ignore it.

For example, we've recognized for years that Tamiflu is only effective as an antiviral if it's given within the first two days. Even then, it might only reduce the severity of illness for a day.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

What was the information that changed last summer, Dr. Butler-Jones?

[Dr. David Butler-Jones]

No, I'm only talking about what we recognized in the first wave. For people who were becoming desperately ill, no matter when you gave them Tamiflu, they were better off than if you waited a day.

If we had done what you're saying, which is going through this long process, we'd have this evidence. We'd then suddenly be presented with new evidence and wouldn't change our minds.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

What's the new evidence?

[Dr. David Butler-Jones]

Thousands of people would then have died in the pandemic because we wouldn't have used Tamiflu because we'd have restricted ourselves.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

Excuse me. We're talking about the CHVI facility. Could you tell me what evidence suddenly changed, other than one study?