Health Committee on March 5th, 2013

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Edwards.

Mr. Brown.

[Patrick Brown, Conservative, Barrie, ON]

Thank you.

One question I've asked our different panels has been with regard to the federal role in the regulation of medical devices. Obviously medical devices can be a tool in innovation. In your involvement in the medical and scientific community, what has your impression been? Do we have a process in Canada that is slow, or is it something that you think is fair and balanced?

A lot of things in health care obviously are beyond federal control, but in that specific area we do govern. We've had doctors here: last week we had a doctor who said it was fast and efficient, with no problems; two weeks before, we had two doctors who said it was costly and incredibly frustrating.

I want to know what your impressions are, if you've had any involvement with that process.

[Dr. Pierre Meulien]

As funders, we don't have direct links or experience with the regulatory authorities. It would be companies involved in our projects who would bring something forward to the regulators.

I've heard both stories as well, and I don't really have an opinion.

[Dr. Aled Edwards]

I think another driver is the fact that we have a small market. If I have a little company and I have a product to sell, I'm not going to bother with Canada first. I'm going to go and do it in America, where the market is huge.

We're really sort of an inconsequential player in the approval process. I don't think much gets approved here, usually, and that's just for business reasons, not for regulatory reasons, etc. I mean, it's just obvious; you have a ginormous market and a little market.

Our regulators in the drug approval stuff tend to be a little more cautious. They tend to be under-resourced compared with those in America. I think we get our medicines fast enough. If you go too fast, it's risky, and if you go too slow, it's risky. We probably have the right balance.

But you have to remember perspective, right? Very few times will Canada be the launch point for one of these technologies, purely because our market is small.

[Patrick Brown, Conservative, Barrie, ON]

You've mentioned type 2 diabetes a few times in the discussion so far today. We actually had representatives from JDRF, a type 1 diabetes foundation, here about six months ago on a health committee hearing. Have you had any findings on type 1?

[Dr. Pierre Meulien]

We have funded some projects. I don't know the details.

[Patrick Brown, Conservative, Barrie, ON]

Their remarks caused me to ask a question to a few witnesses about international collaboration on research. Are we seeing enough collaboration? They mentioned to me that they were making rapid progress on the project they were doing in Hamilton and Waterloo on an artificial pancreas, which was exciting. The same project was happening in Australia and, in that case, they are working together. That was encouraging. Do you see that? Do you see a lot of collaboration internationally?

[Dr. Pierre Meulien]

We've seen an enormous amount of collaboration in Canada between researchers and internationally. Most of our projects, because of their size, have some international link, sometimes pivotal, sometimes part of a looser consortium, but sometimes absolutely pivotal. Canada's incredibly collaborative, and we're very lucky to have that kind of culture. Absolutely. It's very strong.

[Dr. Aled Edwards]

It's one of our competitive advantages.

[Patrick Brown, Conservative, Barrie, ON]

I remember we had the Minister of Health in here. She talked about the work we're doing on Alzheimer's and dementia, and that being an extensive and collaborative study. Obviously it gives it a lot more strength.

I know you've been asked a lot of questions so far on similar topics, but are there any areas that we haven't itemized today where you believe we could do a better job federally in supporting your work?

[Dr. Pierre Meulien]

Canada has been criticized too much, in my opinion. We do brilliant research. We punch above our weight when it comes to research, but it stays in academia. We need anything we can do to facilitate translation in terms of creating the right clinical infrastructure networks. That is something, and it's not a small topic because it includes information systems and e-health records in the case of health. A lot of different things need to get done. The federal government can certainly do that.

[The Chair, Conservative, Joy Smith]

Thank you so much, Doctor.

Now welcome to Mr. Boulerice. We're so happy you're here. You're on.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

Thank you very much, Madam Chair. And thank you for that welcome. This is my first time here but hopefully not my last.

Today's presentations by our two witnesses were truly fascinating. Thank you both for being here.

Mr. Edwards, I have to admit I was under the same impression as your mother. I thought that scientists discovered things and that terra incognita was still a driving force in their research. But it's clear from your graph that everyone's at the same party, so to speak.

I fully realize that you are eager for Canada to take bigger risks as far as all those more or less neglected genes go. According to your graph, the United States, China and the European Union are working on the first 50 to 100 most popular genes, and Canada is working on all the rest, all on its own. Isn't that a bit of a heavy load for us to bear on our own?

[Dr. Aled Edwards]

Not yet. We could occupy.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

Oh, okay. It's not a done deal.

Mr. Meulien, do you share Mr. Edward's opinion on our lack of initiative and risk taking? What could your organization do to help with that?

[Dr. Pierre Meulien]

There is no question that Mr. Edwards is giving an accurate depiction of the reality. What can we do? We can be more open to certain studies that don't involve the same series of genes.

It's up to us, as a research-funding organization, to revisit our peer review systems, which could be seen as more cautious. So it's up to us to change things.

We are always revisiting how we approach peer reviews. So I think there are things we can do in that respect.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

Indeed, it's quite apparent that things need to be done, especially if we consider what you said at the beginning. We have trouble innovating because we don't understand enough about human biology. If we open up the gate a bit wider, we will increase our chances of finding cures and preventing certain diseases. This overcautious or conservative mentality does affect the health care system and people's lives.

And I hope you will continue to work with that in mind.

[Dr. Aled Edwards]

The thing is that industry knows it; we know it. Health research budgets aren't going to grow that much, so why not add to it with industry money? We have the carrot with the public funds for industry to spend the money in Canada. “Here are the rules.” We share all the data, and they'll come. They are coming.

I think we can get massive amounts of industry investment from around the world into Canada for this pre-competitive discovery into the terra incognita, as you say.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

I very much like looking at medicine from the P4 standpoint, which includes a preventive and more participatory approach to care. I would say that, ever since the Second World War, our approach to medicine has been much more focused on giving medication after the disease strikes. We talked about diabetes, Alzheimer's and cancer.

What potential do the human genome and genomics research hold for degenerative diseases?

[Dr. Pierre Meulien]

There is tremendous potential because people are either at risk of developing these types of diseases or they are not. Knowing that information earlier in their lives is important. They don't have to wait until they are 70 years old to understand what's going on. As I see it, that knowledge would enable us to do a much better job of managing our lives. I think there is huge potential in terms of prevention.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

How much time do I have left?

[The Chair, Conservative, Joy Smith]

You have 30 seconds.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

That's how long I have to ask a question in the House during question period.

Could you quickly tell me whether the Canadian government—

[The Chair, Conservative, Joy Smith]

Now you have 15 seconds.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

What more can we do to improve the Canadian model?