Thank you very much.
When I was originally asked to come to this committee, I thought the discussion initially was going to be about the need for neurological research in general, and I was quite prepared to do that, because I still think that's the basis of how we're going to find answers to important questions about diseases that afflict so many Canadians.
There is a very strong research community in neuroscience in Canada. Particularly in the area of neuroscience many of our universities have some of their greatest strength. In MS, we have a group of clinicians and researchers who have been part of most of the advances that have been made in the disease in the last 50 years. There has been a network of clinics across the country, which now can put together a study like the genetics study, which can put 32,000 MS patients into a study to answer questions about the genetics of the disease. So the ability and the power is there, but it has to be understood that most advances that have come in MS as well as other diseases have come from basic science.
The importance, I think, is to make sure that we have adequate funding for all important questions, all peer-reviewed good research involving the neurosciences. In MS, we learn from other research and other fields, and so much of what we're beginning to understand about neuro-protection, about the recovery from damage to the brain, is coming from studies in stroke and is coming from studies in trauma, and all of that will reflect on our ability to manage patients with MS in the future.
We are now within a therapeutic era of MS. I started taking care of MS patients 40 years ago, and initially we had no therapies that altered the outcome of the disease. We now have six therapies that are approved in this country for MS patients that do alter the outcome of the disease, but unfortunately not for all. We have a number that are in the wings waiting to be approved, that have randomized clinical trials that show proof of benefit. We also have some that are now approved in the United States that are soon to come for approval in Canada. It's interesting that there's no media attention at all to these, which have randomized clinical trials to show efficacy.
When a question suddenly arises like CCSVI, it is important that it be treated respectfully and be assessed like all the other hypotheses, of which there are many at the present time. What we have asked for is that there be an accepted, standardized approach to answering the questions, and most of the clinicians involved in this have asked for it to be in two stages. One is to first assess what the importance is of the neck vein problem, because although it has been said to occur in 100% of MS patients, a recent study showed it to be 50%. It was said to be zero in the non-MS patients, and now we find there have been studies over the last five years to show that it is not that uncommon in the normal population. There are questions about what the importance of this is. What we need is a rational approach to answering, first, the basic questions about the importance of this, and then, if it does appear that there is strong evidence, a design of a standardized, randomized clinical trial to show benefit and safety.
One of the things about getting to the age I am is that you tend to become an historian. I have written a book on the history of multiple sclerosis, and there are 100 pages in the book on the history of therapies that have been said to be cures for the disease. Some of these therapies were given to MS patients for as long as 20 years before they disappeared.
All we ask is that there be a reasonable approach to how this question is being answered. If all patients are given the therapy, no one will go in a trial. If that occurs, we will not get the answers. We have had, in recent years, pressure in our clinics, not just for CCSVI, but for dorsal column stimulation. Many patients around the world, because it got into the media, had implanted electrodes on their spinal cords until that turned out to be unsuccessful and it got abandoned. The media never went back to the story of that failure.
We've had snake-venom therapy, bee-venom therapy, Cari Loder diets, hyperbaric oxygen chamber therapy, and our patients were pressuring us to send them and pay for the cost of that in Florida. It's still available. Two years ago the press was raising stories about sending people to China for stem cells. It goes on and on.
Is there any harm in all of this? Yes, there is. Over the years we've had repeated disappointment to the MS community about things that were initially said to be cures. All we ask is that there be a reasonable approach to the assessment of the neck vein problem, and later the therapy itself.