Public Accounts Committee on March 10th, 2009

[The Chair, Liberal, Shawn Murphy]

Mr. Kramp.

[Daryl Kramp, Conservative, Prince Edward—Hastings, ON]

Thank you, Chair.

I want to deal with the zymotic issue just for a second. I have a company called Bioniche in my riding. They are the people who created and manufacture the E. coli vaccine. As such, knowing the immunization for E. coli is done at the animal level and it stops the reproductive cycle, obviously it has no effect on humans at that point so it is not necessary to inoculate humans. Would it be desirable to have something like that on a national scale? Would it be helpful or effective?

[Dr. David Butler-Jones]

There are a number of different strategies. This is one that is quite innovative and very interesting. There are others in terms of using phages...the way you feed animals, in other words. If you change the percentage of feed, you can change the risk for those animals for E. coli and other infections. So there is a lot of very interesting research going on now. I'm not the expert to comment on which is best, but our scientists work with CFIA scientists and others in terms of what makes the most sense. As the consensus develops, then obviously those guidelines are shared.

[Daryl Kramp, Conservative, Prince Edward—Hastings, ON]

On the E. coli situation, how involved are you actually with assessment of E. coli now? It could be on spinach. It has all kinds of degrees of severity. By all standards and by most people's knowledge, it's a lot more prevalent than it actually is reported to be on the deadly stage, such as the Walkerton deal. I'm wondering just how current you are and how effective and involved you are with the assessment of E. coli.

[Dr. David Butler-Jones]

E. coli is a normal bug in the gut. We all have E. coli in our gut. It's the O517:H7 or other strains that are more toxigenic and create the problems. We're very much involved from the human health standpoint.

In terms of vaccines, we're not the regulator of these things. We engage with our partners both in the health portfolio as well as CFIA and others around the public health perspective on these issues, but ultimately the regulatory decisions, etc., are theirs.

[Daryl Kramp, Conservative, Prince Edward—Hastings, ON]

There's a bit of an interesting sidebar here. Anecdotally, the flu shot we all get, or many of us do get or should get or whatever.... It's been told to many of us that it wasn't a good choice this year and that it hasn't been as effective because it was obviously not directed to the virus it should have been directed to. Is that correct? If that is correct, what precautions could be taken to alleviate that situation?

[Dr. David Butler-Jones]

Influenza is an amazing bug. It is constantly variable. It's full of surprises. That's why we have pandemics two or three times a century. It's constantly changing its genetic makeup and is very adaptive. Every year, you have to have guessed the year before what the most likely strains are. Usually in the vaccine there will be two of the A influenza type and one of the B. This year, for one of those three, there was not as good a match as sometimes. You still have protection against the other ones. You still have partial protection against this one. But it's not 100%.

Even where there is an absolutely good match, there are still surprises. Even mid-year—a few years ago, for example—the virus can change. You get a slightly different virus, so some of us get sick. But having the immunization, if you do get sick, you tend to be less sick, less likely to be in the hospital, and less likely to die, because there's some protection.

[Daryl Kramp, Conservative, Prince Edward—Hastings, ON]

Okay. Thank you.

On the departmental report and the progress to date, you've made progress on a number of significant issues, but I'm also concerned with the ones where either no progress or limited progress has been made. I'd like to know what issues you're either not willing or unable to address.

[Dr. David Butler-Jones]

Sorry, in which—

[Daryl Kramp, Conservative, Prince Edward—Hastings, ON]

With regard to the concerns of the Auditor General.

[Dr. David Butler-Jones]

We're planning to address them all. I don't think there are any that we—

[Daryl Kramp, Conservative, Prince Edward—Hastings, ON]

I just want to ensure that there's nothing outstanding that you either disagree with or you don't feel you can comfortably handle, given a reasonable amount of time.

[Dr. David Butler-Jones]

No, I think we're really focusing our energies on this one. As I said before, it is fundamental to us. There are other things that aren't in the Auditor General's report, like the building of relationships, the strengthening of the network, etc., that we will continue to do because they are fundamental to good public health.

[Daryl Kramp, Conservative, Prince Edward—Hastings, ON]

I do understand that. I think as far as Ms. Crombie's situation.... Yes, we just received this here today too, but I think it's been on the Internet since 2008. But, yes, I haven't accessed it.

[Bonnie Crombie, Liberal, Mississauga—Streetsville, ON]

That's the old version. This is the new version.

[The Chair, Liberal, Shawn Murphy]

Thank you very much, Mr. Kramp.

Monsieur Desnoyers.

[Luc Desnoyers, Bloc, Rivière-des-Mille-Îles, QC]

Thank you, Mr. Chairman.

I have the same concerns as a number of my colleagues, both the Chair and my NDP colleague, concerning the Auditor General's report in which she raises a number of major problems. Those problems haven't been addressed quickly, or as they should have been addressed. Moreover, Mr. Neil states in his report:

“We are concerned that a nationally standardized approach to disease reporting remains years away.”

So we're talking about agreements here. This is troubling. There may be another way to activate this approach. It is important to know what is going on across the country when it comes to infectious diseases.

You said there are no problems with communication and cooperation. I entirely agree with my colleagues, who believe that's the case, particularly when you look at the MOUs, the question of the WHO raised by Ms. Crombie, and the entire legislative framework that provides you with no support. My first question concerns measures for activating the process of signing MOUs so that you have access to that information as soon as possible.

You've also submitted an action plan which is supposed to be important and which, I think, requires very quick implementation. That may result in additional expenditures. I don't know whether you've provided for that eventuality or whether you have made requests for that purpose. If not, perhaps you should think about it and do so quickly in order to protect Canadians adequately. This involves training, equipment and laboratories.

Can you tell me where the laboratories are located in Canada where a situation can be analyzed quickly so as to respond immediately to the various needs respecting infectious diseases? You mentioned a few of them earlier: West Nile virus, bird flu and SARS, which was devastating. I'd like to have some answers to these questions that I've asked.

[Dr. David Butler-Jones]

Thank you for the questions.

We don't need MOUs to find information. All the provinces provide us with the information we need. There's no problem, but there may be a risk. Formalizing the relationship is a good thing. For more than four years now, we've had no problems with the provinces or territories in obtaining the information we need. The same is true of the WHO and the international situation. Our cooperation, the information we give the WHO and the information we receive from the WHO are not a problem. There's no deficiency.

[Luc Desnoyers, Bloc, Rivière-des-Mille-Îles, QC]

I don't know whether we've misunderstood each other, but, in paragraph 5 of his report, Mr. Neil clearly states that there are major problems. Talking about information-sharing with the various provinces, he says he is concerned, and I quote:

“[...] that a nationally standardized approach to disease reporting remains years away.”

I don't know whether you have access to recent information, but the Auditor General says there is a problem and you're saying the contrary. I'm just trying to understand.

[Dr. David Butler-Jones]

I'll answer in English, please.

[Luc Desnoyers, Bloc, Rivière-des-Mille-Îles, QC]

Say it in English.

[Dr. David Butler-Jones]

In a way, it's a matter of degree. We do not have any problem. We have the full cooperation of the provinces. Any information we ask for, we get. That's not an issue. It's the same with our relationship with the OMS.

What I think the Auditor General is asking is how we can be sure unless we have memoranda signed and agreed to. The challenge for memoranda is that with legal and other things, they take time. And if there's something new, again, if we have a call that day, the chief medical officers will start reporting. That has not been an issue in the four and half years of the agency.

The operative word is “may” be a problem. They're pointing out a potential risk, which I think is a legitimate thing to point out. It's part of the reason we're pursuing as quickly as we can all these agreements. Again, they're to give more clarity, formality, and common understanding to as much as possible. In the meantime, we've not had a problem. We've had many problems we've had to deal with, and we've dealt with them successfully with our partners.

[Luc Desnoyers, Bloc, Rivière-des-Mille-Îles, QC]

Among other things, the implementation of your action plan may require much larger amounts of money. If so, have you filed a request for that purpose with the Treasury Board?

[Dr. David Butler-Jones]

The agency has actually received, in previous budgets, money related to pandemic preparation and planning, etc. That has been a very beneficial resource to help us to move forward on surveillance and a whole range of things in preparing ourselves and the country for dealing with it.

The national lab, which is in Winnipeg, is the reference lab. Again, there has been good collaboration with laboratories across the country, provincial laboratories and others. We do the reference so they can take tests to a certain point, and then we can follow up from there.

There's still more to be done. I don't want to be naive about this, because we're always finding new things. Every year there are new diseases that we're discovering and new capacities that we can bring to bear, but we're continuing to make progress.

[Luc Desnoyers, Bloc, Rivière-des-Mille-Îles, QC]

Mr. Chairman, he didn't answer my question.