Not that I'm aware of.
Evidence of meeting #45 for Health in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was medicine.
A recording is available from Parliament.
Evidence of meeting #45 for Health in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was medicine.
A recording is available from Parliament.
5 p.m.
President, Canadian Association of Nuclear Medicine
Not that I'm aware of.
5 p.m.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Thank you.
Dr. McEwan, I'd like to ask again about this November 30 report. Will it be made public in its entirety, or will only parts be shared? Maybe you can't answer that, sorry. When will the government be responding to that report?
5:05 p.m.
Special Advisor on Medical Isotopes to the Minister of Health, As an Individual
Madam Chair, again, I'd like to remind the committee that this is a report from NRCan. It is not from Health Canada. I would love to be able to answer that question, because I suspect that, of everybody in this room, I would like to see it the most. I'm sorry I can't give you any more information than that.
5:05 p.m.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
That's fine. Thank you.
Dr. Urbain, I don't know if you're able to answer this, but I'd like to have your ideas. How you feel the government has handled this crisis? What do you think could be done to help patients at this point?
5:05 p.m.
President, Canadian Association of Nuclear Medicine
It's a very complex crisis. You heard from Dr. Patrick Bourguet that it's affecting the entire world. I think the crux of the question is really the supply of isotopes across the world. Canada was producing 40% for the rest of the world and suddenly it went down to zero. As you know, the announcement was made that Canada will get out of the business. Where will that leave the rest of the world and Canada?
I wish there had been a plan in place before making this type of announcement. We have said multiple times that, unfortunately, Canada was already 20 years behind in terms of isotopes available and in terms of the technology. We keep repeating this, and it's very true. You can verify this with our colleagues south of the border and also in Europe. Today we have to practise medicine and manage patients with 20th century tools. In terms of being at the cutting edge, as Canada was 20 years ago, I don't feel Canada is using its resources appropriately.
5:05 p.m.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Thank you.
Dr. McEwan, I don't know if anyone here can answer this, but do we have an idea when the NRU will be coming back online?
5:05 p.m.
Special Advisor on Medical Isotopes to the Minister of Health, As an Individual
My understanding is that they have some confidence that they will meet the quarter-one expectations.
5:05 p.m.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
When will that be in the first quarter? As Dr. Urbain has said--and it has been said today--there needs to be a contingency plan, and it's hard for doctors and hospitals to plan. We really need a date so they can do proper planning.
5:05 p.m.
Special Advisor on Medical Isotopes to the Minister of Health, As an Individual
AECL will let us know as soon as they have some confidence that their repair methodologies are working. My immediate action now is to look at the medium term and plan for the worst-case scenario. So that is what I am doing with my colleagues at the moment.
5:05 p.m.
Conservative
5:05 p.m.
Conservative
Bradley Trost Conservative Saskatoon—Humboldt, SK
Thank you, Madam Chair.
I would like to finish, for my own clarity, what Mr. Carrie was asking about.
Do I understand correctly that the future of nuclear medicine looks bright, but it's likely that we'll be using different or a more diverse pool of isotopes? So the usage of technetium-99 may not necessarily be going up, and instead we may be using a more diverse pool of isotopes. Am I understanding that correctly?
I see one head nodding. It'll take two people to answer this one.
5:05 p.m.
President, Canadian Association of Nuclear Medicine
I think you are absolutely correct. The issue is that technetium will not disappear any time soon. Technology exists. You don't go from 80% technetium usage to 0%, even in five years.
The problem is a lack of foresight by Canada over the past 20 years, and I mean Canada in the largest possible meaning. It could be the government, Health Canada, physicians, or whatever. We did not put in place enough alternatives to technetium, so today we are paying a big price. Europe has done it differently. They have evolved a positron emission tomography program across all the countries, and that basically enables them to navigate the crisis better.
5:05 p.m.
Conservative
5:10 p.m.
President Elect, Professor of Nuclear Medicine, European Association of Nuclear Medicine
I do not entirely agree with my colleagues on the subject of substitution. We, in Europe, are absolutely convinced that technetium has a life expectancy of several decades, if only because developing countries will need it and because the ratio of PET scanners that my colleague Urbain was just referring to is 1 to 10 compared with regular scanners. Tests using technetium are perfectly achievable.
We have a tendency to mix the two up. Currently, the main area of use of PET is oncology. This is not as a substitute for technetium tests, but it really is a whole new field. Take France for example, where we developed a new program called “Cancéro” six years ago. We have set up 80 PET machines that are entirely dedicated to cancer treatment and in no way substitute for technetium tests, which are now, in many centres, the first tests that patients will undergo.
Therefore, do not confuse PET and technetium. In my opinion, technetium will still be in use for several decades, which leads us to believe that a project such as the one we are attempting to build around new reactors is credible in terms of the lifespan of a reactor.
5:10 p.m.
Conservative
Bradley Trost Conservative Saskatoon—Humboldt, SK
Thank you.
I guess this is leading to conclusions from committee members, because the sorts of isotopes we're looking for also impact what we will design to produce the isotopes.
To you gentlemen and Mrs. Doig, instead of concentrating all our efforts on one particular reactor or production regime, do you think we should diversify our efforts into the broadest scope of projects, without stretching resources too far, so we have more sources because of the variety of isotopes? Would that be a prudent and well-thought-out strategy from your perspective--yes or no, and why?
5:10 p.m.
President, Ontario Association of Nuclear Medicine
Very much so.
There isn't going to be a grand-slam, home-run solution to this. There's going to be multiple 25-cent solutions to enable us to have a proper management for medical isotope and health care accessibility in Canada from the nuclear medicine perspective.
It's going to be important, from an Ontario perspective, to put in a plan that is tried and true and relatively accepted. This is a good thing to do for medical isotope production, something along the lines of Europe, where they're moving forward with a reactor-based program.
I do agree that technetium is going to be around for decades, because PET imaging and the other types simply cannot be replaced in a cost-effective way such as we have now, but you also have to have a more balanced approach. We don't want to put all of our eggs in one basket, so I believe we need to have a tried and true technique, possibly reactor-based. We also have to support new and innovative approaches to medical isotope supply as well, but don't put those new and innovative sources as the main crux of what we're doing now. We need that balance. We need to be able to use existing medical isotopes in a more efficient manner as well, because costs will go up. Hence, we need modernized equipment on the ground.
5:10 p.m.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
In answering my question, Dr. Bourguet was saying that we should have a transatlantic solution in order to ensure a long-term supply of technetium.
In response to Mr. Trost's question, he was saying that technetium still has a lifespan of several decades, because alternative solutions are not quite ready to take over all of the jobs currently being done by technetium.
The only nuclear reactor project that was currently planned, even though it has been abandoned, is the MAPLE project. What several groups seem to have been asking for since the beginning of this is a reassessment by an international group of experts on the shutdown of the MAPLE project.
In light of the discussions we have had, I'm wondering what is preventing the government from moving forward, not to relaunch the project, but simply to have its relevance assessed by a group of independent experts.
Is there anyone around the table who might like to tell me, because of the information they have and through their own experience, why the government does not want to agree to this request being made by more and more groups involved in the area of nuclear medicine. Perhaps the special adviser to the minister or Dr. O'Brien...
5:15 p.m.
President, Ontario Association of Nuclear Medicine
It's a very important point that you make. Our perspective is that the decision to abandon the MAPLE reactors may have been premature, without taking into consideration all the collateral damage that has potentially arisen because of this, and there may be regulatory issues from the Canadian Nuclear Safety Commission that may have a problem with licensing the reactor. But this has to be looked at in an open public forum. If there is documentation supporting the abandonment of the MAPLEs, then that should be allowed to come forward. So far we do not know if there has been any real evaluation of the MAPLEs in a thoughtful, fruitful way that evaluates all the implications on research, on jobs for Canadians, on distribution, on access to health care for our patients.
Medical isotope production is a Canadian industry that we are about to lose, and with that goes multiple jobs and research capabilities and avenues for post-doctorate trainees or Ph.D. individuals. Where will they go if we do not have a infrastructure to support them?
So definitely, not only from a health perspective but from a Canadian perspective, this should be re-evaluated.
5:15 p.m.
President, Canadian Association of Nuclear Medicine
I'll make a brief comment.
I beg to differ with Dr. McEwan about the relevancy of the CIHR-funded project. One question we might want to ask ourselves is that.... We spent $6 million on a project that clearly will not yield anything within two years, where we probably should have spent $100,000 to have a panel of experts looking at the MAPLEs.
