Evidence of meeting #3 for Health in the 39th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was report.

On the agenda

MPs speaking

Also speaking

David Butler-Jones  Chief Public Health Officer, Public Health Agency of Canada
Sonya Norris  Committee Researcher
Nancy Miller Chenier  Committee Researcher

11:50 a.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

Preparedness measures to fight a pandemic and other illnesses involve collaboration between the provinces, the territories and the federal government. Decisions are taken jointly, specifically regarding the various areas of jurisdiction of each level of government. Regarding pills and antivirals, decisions must be based on scientific advice and on joint decisions taken by the provinces.

Pursuant to the most recent budget, it may be possible to buy antivirals, as well as vaccines. Vaccines are the first tool to consider in the prevention and eradication of a pandemic. Joint decisions will be taken with Quebec, but we must also respect the decisions of the provinces in a country-wide context.

Nicole Demers Bloc Laval, QC

I have one last question.

You intend to have an office in each province and territory. However, because there is already a public health institute in Quebec, would it not be better to link up with the province, in order to save money and invest it where it really counts from a public health perspective?

11:55 a.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

We already have offices in the regions. In Quebec, through our collaboration with the Institut national de santé du Québec, we have national resources within the institute. We work in partnership with and support the activities of the institute.

Nicole Demers Bloc Laval, QC

Thank you.

11:55 a.m.

Conservative

The Chair Conservative Rob Merrifield

Thank you very much.

Mr. Scarpaleggia.

Francis Scarpaleggia Liberal Lac-Saint-Louis, QC

Dr. Butler-Jones, subclause 12(3) of the bill states that “The Chief Public Health Officer may prepare and publish a report on any issue relating to public health”, if I'm not mistaken. Could you tell us here today whether you have any such reports currently under way, and if yes, in what subject areas?

11:55 a.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

There are ongoing reports that come from the Public Health Agency, usually of a technical nature, that support best practices and advice on how we manage different issues in both infectious and chronic disease, etc. That's an ongoing thing. For example, the Public Health Agency supported the cancer strategy development with the provinces and territories and stakeholders initially, and that continues to evolve. And there are other reports as they develop.

In addition, the expectation is that once we have this legislation there would be a first report of the Chief Public Health Officer. We're currently looking at the elements of that report.

My personal desire is that it be a report that illustrates the various interactions of health and helps people make the connections between the different things we do to address the health of the public at different levels of government, as individuals, in terms of the linking between behaviours and communities, etc. It would really be to elucidate not only some of those issues for us—some of which we recognize—but also to identify ways in which people have demonstrated in the provinces and other places how we can move forward to improve the health of Canadians.

Francis Scarpaleggia Liberal Lac-Saint-Louis, QC

Do you intend to undertake a study, for example, into fetal alcohol spectrum disorder?

11:55 a.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

We're coming back at some point to talk about the issues. There is a framework that has been developed for that, and I know people are working on how we move it forward. Whether a Chief Public Health Officer report would be the piece needed in addition or as part of...is still open. Certainly those kinds of issues potentially could form the basis of a report.

Part of the practicality, obviously, is capacity—what is known, what is not known, and what is CPHO at the federal level, or what's my role vis-à-vis my provincial colleagues, many of whom issue regular reports as well.

11:55 a.m.

Conservative

The Chair Conservative Rob Merrifield

Thank you.

Mr. Dykstra.

11:55 a.m.

Conservative

Rick Dykstra Conservative St. Catharines, ON

It's probably not a fitting question for committee, but when I saw your name I thought you might have been a former baseball player. It would look perfect on the back of a baseball uniform.

More seriously, in terms of the actual legislation that was brought forward and the work I've done researching it, the power actually--and it feeds on a point Ms. Gagnon made with respect to how far outreaching the work actually will be.... From my understanding of it, and maybe you can clarify, the power basically is in two branches, an emergency branch and a national dimensions branch, a disposition that allows you, as you pointed out, to work with your provincial counterparts. The legislation is pretty clear. It certainly defines the role as one maybe intended to be somewhat overarching, but not certainly to delve into the issues of provincial jurisdiction.

Noon

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

I think that's a reasonable reflection. There are my federal accountabilities as a deputy within the federal system as well as a chief adviser on public health issues for the federal government, but also there are linkages through the public health network, which again is a collaboration—federal, provincial, territorial, and experts—regarding how we as a society and how multiple levels of government feel we can best approach these issues together.

I don't have authority over provincial chief medical officers—nor do the Centers for Disease Control and Prevention have authority over states in the United States—but we work together and try to figure out who's in the best position to do which pieces.

Our clear intent is that we do bring added value to what's already there. We bring expertise, we bring some resource, we bring some connections, we bring some capacity to pull the various kinds of expertise together. The intent is that wherever we are in the country, people have access to the best expertise, the needed resources, etc., to address the problems. We are an important contributor to that, but not the only one, obviously.

Noon

Conservative

Rick Dykstra Conservative St. Catharines, ON

Right. From your comments, I take it that it's a role of enhancement and a role of assistance more than anything else.

Noon

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

It relates to the provincial authorities and accountabilities.

We also have federal accountabilities around the Quarantine Act, borders, and issues that we have in terms of our own populations that we deal with, which are different in that way.

Noon

Conservative

Rick Dykstra Conservative St. Catharines, ON

Thank you very much for confirming my thoughts.

Noon

Conservative

The Chair Conservative Rob Merrifield

Thank you, Mr. Dykstra.

Mr. Batters.

Then we'll start with round two, and I think others have some follow-up questions.

Dave Batters Conservative Palliser, SK

Thank you very much, Mr. Chair.

I'd like to welcome Dr. Butler-Jones and Ms. Allain for appearing before our committee. I also appreciated the chance to hear from the minister this morning.

First of all, I'd like to congratulate Dr. Butler-Jones on his appointment as the Chief Public Health Officer for our country. As a Saskatchewan member of Parliament, I know that when he was named, it was a great day for Saskatchewanians. Dr. Butler-Jones previously worked in Weyburn, in the Sun Country Health Region, and we were all very proud of him. The health care of Canadians is in good hands.

Dr. Butler-Jones, as the legislation is set up, my understanding is that you are a deputy. I have a couple of questions.

Have you been working in close contact with other deputies—I'm especially thinking of the public security and emergency preparedness deputy—to monitor and prepare for potential threats to the public health of Canadians? Obviously, I'm talking along the lines of pandemics.

Regarding avian flu, which everyone in the world is certainly concerned about, it seems to be spreading from east to west, from country to country. I'd like you to comment a little on whether we are ready to tackle that in this country. Can you reassure Canadians that they are safe?

Maybe you can speak a little about Tamiflu, giving us an update regarding that. I think Ms. Demers' question perhaps touched on how many doses we have stockpiled and what percentage of Canadians that would cover. I've seen statistics that a low percentage of Canadians would be covered by the available Tamiflu.

Could you also give us an update as to whether private citizens can purchase Tamiflu, or has that been stocked by the manufacturer to protect the general public should Tamiflu be needed to tackle avian flu?

Those are a few different questions, and I'd appreciate your thoughts, my fellow Saskatchewanian.

Noon

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

I'm an adopted prairie boy, for sure.

Thank you very much for the questions. It's a good list.

First, in terms of relationships with other departments and deputies, there are the deputy-level relations I have on the committee that's specific to pandemics. But I also sit on other deputy committees that relate to public health, safety, and other public health aspects. We have regular discussions.

Also, when it comes to planning and thinking about pandemics, there are at least three departments that are really key: Agriculture and Agri-Food Canada, as well as the Canadian Food Inspection Agency, us in Health Canada, and Public Safety and Emergency Preparedness. And then there are other departments, too, depending on the issues. For example, there is Environment Canada, as it relates to wild birds, and others. So I think that's something that seems to be, from my perspective, working well and is very collaborative.

This isn't a plug, but I must say that I'm really impressed with the commitment of the people I deal with and their interest in engaging and addressing these issues. It's not just within government, but as I go across the country and internationally, there's a very different spirit about collaboration, the need to work together, and the recognition that none of us can do this alone. That's the positive.

In terms of preparation, it's important to make the distinction between the bird flu, the H5N1 Asian that we're seeing, and a pandemic of human flu. The bird flu is continuing to spread around the world. We don't know when we'll see it in wild birds in Canada; it may be as soon as this fall. That clearly is an agricultural issue. It's a biosecurity issue in terms of poultry flocks, contact with wild birds, and the risk to poultry flocks. It is a smaller issue, but a present issue, for humans, because we see a very small percentage of humans who get sick as a result of contact. It's from fairly extensive contact--and in a very small percentage of people--with this bird virus. It's not as if there's wild bird flu, and suddenly we're going to have all kinds of people sick.

So preparations continue from an agricultural perspective, but also with us working very closely with Agriculture and Agri-Food Canada and CFIA, including giving advice, in terms of the human implications. So if they do have to cull flocks, what's the best way to protect the workers who are having to deal with that?

Regarding the pandemic of influenza, no one knows, quite honestly. Nature is very inventive. The H5N1 may mutate, but that would require several steps. Or it could recombine with a human virus, which is a typical development of a pandemic of influenza, so that you have a new virus that none of our immune systems recognize that spreads quickly around the world. That's unpredictable, and that's why the work internationally, the work of the Global Public Health Intelligence Network and the work of the WHO with partner agencies around the world for surveillance, early identification, and control is critical.

Generally, as the minister said, Canada is looked at as probably one of the most comprehensively prepared in terms of planning, but we still have a lot of work to do. Even with all the preparation, emergencies and epidemics are full of surprises. To say that nobody will ever have a problem.... No one could ever say that. But what we can assure people is that each month we are better prepared than the month before. Our capacity in the last budget, in the budget processes, will help to ensure that Canadians are in a position to look at a very difficult, challenging situation and hopefully reduce it from a major problem to one we can manage and move forward from.

In terms of Tamiflu, we currently have in the country in government hands—not private hands, because there's a lot more in private hands and in hospitals, and so on—about 37 million doses, which is enough to treat 3.7 million people. As the minister was saying, there is a meeting of FPT ministers this weekend, and one of the things they will be considering is the next level we should consider for Canada.

The thing that's unique about Canada...well, there are two things. Often people say that WHO says 25%. The WHO never said that. What the WHO has said is that countries that can afford it as part of their comprehensive planning should include antivirals as part of that. We've done that.

The advantage we have is a vaccine program. We have a domestic manufacturer that can produce enough vaccine to protect all Canadians, so we need the antivirals—if they work, which we don't know if they will—to reduce the impact in the first wave, and then we have the vaccine. Maybe one other country in the world has that capacity, and that's what will really stop it. That's why it's a combined strategy that's important.

12:05 p.m.

Conservative

The Chair Conservative Rob Merrifield

Thank you for the information. His time was a little bit over, but because you were on a broader subject that we're all interested in I let it go.

Ms. Priddy, you have the next question.

Penny Priddy NDP Surrey North, BC

Thank you, Mr. Chair.

I realize that you can't answer part of this, but I need to ask the question out loud.

You will be the CEO, if you will, of a board that is appointed by government. They're Governor in Council appointees. Is that correct?

12:10 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

No, we will not have that structure; it'll be like a department.

Penny Priddy NDP Surrey North, BC

You will not have that structure, okay. It will be like the department.

Second, let me ask you, if I might, about whether there is some plan on your part...and I think my colleague from the Bloc may have referred to it earlier. Because there is such a focus on SARS in this, and because this has been, if I understand it correctly, moved under security.... Am I correct?

12:10 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

Public Safety coordinates overall government emergency preparedness.

Penny Priddy NDP Surrey North, BC

Right. In that case, for those people who are concerned about health care promotion, chronic disease, etc., that might send a different message—the public safety part of it. So are there some plans to reassure constituent groups and provinces that those areas will remain as important to the agency as the safety/pandemic pieces, if you will? If I were to look at that, I would think it is public safety, so my other part doesn't fit into it.

12:10 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

Certainly, what's visible does not necessarily reflect what's a priority or of importance. In public health, the prevention of disease, the control of both chronic and infectious disease, and preparation for pandemics are all important.

The public health capacity at the local level that can deal with pandemics and other things is the same capacity that, in between pandemics, is in a position to facilitate and reduce chronic disease, etc. It's not as if we're all “pandemic” all the time; in fact, much of the activity or work of the federal-provincial coordinating committees, etc., will continue and is absolutely essential. In the recent budget that has been proposed and in the previous budget, there are significant investments toward chronic disease activities.