Health Committee on Nov. 30th, 2009

[The Chair, Conservative, Joy Smith]

This has to be agreed to by the committee. We certainly can do that, because your motion says until December 9. We also have the HHR panel on the 9th, where we could do it as well.

They tell me that the report can be done within an hour, so we could have the first hour with witnesses and the second hour the report.

[Carolyn Bennett, Liberal, St. Paul's, ON]

The clerk is saying before the 9th.

[The Chair, Conservative, Joy Smith]

Sorry, Dr. Bennett.

Ms. Wasylycia-Leis, you have the floor.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

My motion mentions the 9th because that's the standing order requirement, that this committee must report to the House before December 9, so it has to be on the 7th.

[The Chair, Conservative, Joy Smith]

That's perfectly okay. So you're bringing before the committee...who else is there?

Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

I was going to say, Madam Chair, after today, if they would like to bring some more witnesses for an hour, we don't have a problem with that.

[The Chair, Conservative, Joy Smith]

Yes, no problem.

[Colin Carrie, Conservative, Oshawa, ON]

But I would like move on, as I do have some important questions for the witnesses. If we only have 45 minutes now, it would be good if we--

[The Chair, Conservative, Joy Smith]

Is it agreed then, first of all, that on the 7th we have an hour bringing witnesses in on this topic that we're dealing with now?

[Some hon. members]

Agreed.

[The Chair, Conservative, Joy Smith]

Thank you.

We will now proceed.

I would like to go, first of all, to Mr. Bernard Prigent of the Canadian Institutes of Health Research governing council.

You have 10 minutes for a presentation, sir, on whatever you like.

[Dr. Bernard Prigent, Member, Canadian Institutes of Health Research Governing Council, As an Individual]

Thank you, Madam Chair.

I wish to thank you and your colleagues for providing me with the opportunity to outline my role and contribution as a member of the governing council of the Canadian Institutes of Health Research.

Let me begin by sharing with you my experience and credentials, which are relevant and consistent with CIHR's overall objectives and mandate.

I received my general medical training in France. At the start of my career, I had to deal with the major clinical and public health problems experienced by immigrants settling in the suburbs of Paris.

My interest in global health issues stems from my involvement in a medical mission to Cambodia, in a war zone where, among other threats, civilians suffered from the ravages of multi-resistant malaria. That experience led me to write my thesis on tropical medicine and public health.

I also worked for five years in various demanding clinical and hospital environments in France, Asia and Australasia. The diverse nature of those clinical experiences led me to discover emergency medicine, obstetrics, but especially, for nearly two years, the role of district physician. That was in a tropical environment, in Samoa. There, as the only practitioner, I had to provide care and promote public heath to a rural population of 20,000 inhabitants.

All those experiences formed me and made me always keep in mind the viewpoint and interest of the patient, even when my career strayed from clinical medicine to medicine in a pharmaceutical environment.

I joined the pharmaceutical industry in 1984, working for the international medical and clinical research operations of three major European pharmaceutical companies before joining Pfizer in Canada in 1995. I have worked on the clinical development and commercialization of new medicines in a variety of therapeutic areas, including cardiology, respiratory medicine, infectious diseases, rheumatology, urology, neurology, and oncology. I was able to pioneer the conduct of pivotal studies more than 20 years ago in countries like Poland, Hungary, and Russia, and developed medical and clinical capabilities in Africa and in the Middle East.

My interest in the management of research and development led me to complete an MBA in the United Kingdom at the Henley Management College, where my main research was on the management of global research and development organization.

In Canada I'm actively involved in the building of research and development capabilities that foster the collaboration between the public and the private sectors. Such activities have enabled me to become chair of the scientific committee of the research foundation of Canada's Research-Based Pharmaceutical Companies; a member of the strategic advisory committee of the Centre of Excellence in Personalized Medicine; a board member of the Centre of Excellence in the Prevention of Organ Failure; chairman of the strategic orientation committee of the Québec Consortium for Drug Discovery; a member of the national advisory board of the Canadian Dementia Knowledge Translation Network; and co-president of the research working group of Montréal InVivo.

I believe that my international clinical experience and my contribution to developing new drugs and to their accessibility for patients will be useful on the governing council of the Canadian Institutes of Health Research. The CIHR recently launched its five-year strategic plan. In particular, that plan emphasizes the importance of cooperation between the industry and the research community so that research work leads to improved health products, technologies, tools and services.

More specifically, the plan sets out a commitment to launch a new flagship initiative in patient-based research that will enable Canada's health system to more effectively use research results to improve care and health.

In recent years we've seen some measure of success in patient-oriented research, most notably in cardiovascular care, critical care, stroke, and HIV. However, Canada is rapidly falling behind other industrial countries in terms of the capacity to carry out high-level, patient-oriented research. In Canada we have some of the best health researchers in the world. Where we are less successful is in moving health research results out of the laboratory and into hospitals and clinics where they can improve health outcomes.

I believe my significant experience in clinical research and multilateral research collaborations across the world involving industry and academic-based research can assist CIHR in developing solutions to remedy these shortcomings.

As a member of the CIHR governing council, I undertake to strictly observe the Conflict of Interest Act, the Ethical Guidelines for Public Office Holders, the Guidelines for the Political Activities of Public Office Holders and the CIHR's Policy on Conflict of Interest and Confidentiality in the Context of Merit, Relevance and Peer Review. As a new member of the governing council, I have received orientation from CIHR management personnel and have carefully read all documents.

In closing, I repeat to the committee my dedication and commitment to meeting the highest ethical standards in this position, as I have in all those I have held in the past.

I now welcome the opportunity to answer any questions you may have. Thank you.

[The Chair, Conservative, Joy Smith]

Thank you very much.

Now we'll go to Mr. Beaudet.

[Dr. Alain Beaudet, President, Canadian Institutes of Health Research]

Thank you, Madam Chair. I'm pleased to appear before you as part of the review of Dr. Prigent's recent appointment to the CIHR governing council.

Let me tell you right at the outset how much CIHR's governing council and I personally welcome and support this superb addition to our board. Dr. Prigent was appointed by Governor in Council because of his vast knowledge, his unique experience, and his keen understanding of the Canadian international health research landscape. Like all other council members, Dr. Prigent was appointed as an individual and not as a representative of his employer.

The mandate of the CIHR's governing council is to oversee the agency's orientation and management. It defines its strategic orientations, objectives and policies, and assesses its overall performance. It is important to emphasize that it is not the council's responsibility to examine or approve funding applications. There is no doubt in my mind that Dr. Prigent's appointment meets the criteria for the appointment of members to the governing council as set out in the Canadian Institutes of Health Research Act.

That act states that council members must meet the highest standards of scientific excellence and represent a range of relevant disciplines and communities. No one will doubt Dr. Prigent's exceptional qualifications and experience in this regard.

Dr. Prigent is a distinguished international researcher and vice-president of Pfizer Canada Inc. He is a member of the Canadian Society of Clinical Pharmacology and the Canadian Arthritis Network. He sits on the board and chairs the Scientific Advisory Council of Rx&D's Health Research Foundation, and he co-chairs the research committee of Montréal InVivo, a non-profit group of over 600 public and private organizations in Montreal that promotes scientific partnership and innovation.

Dr. Prigent brings to the council an unparalleled background in matters ranging from global health to research management, particularly a vast experience in innovation and commercialization, thereby filling what the governing council had identified as a major expertise gap in its midst. His unique knowledge in this field will enable us to better fulfill our responsibilities with respect to the achievement of CIHR's objectives, as stated in section 4 of the CIHR Act:

to excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products, and a strengthened Canadian health care system, by

(i) encouraging innovation, facilitating the commercialization of health research in Canada and promoting economic development through health research in Canada;

Innovation and commercialization are key elements in the CIHR's mandate for improving the health of Canadians and the effectiveness of our health system.

As you are aware, Canada ranks poorly in private sector research and development investment. In fact, in its last report card on innovation, the Conference Board of Canada gave the country a D for its innovation performance in the past three decades.

This unfulfilled need has been underscored in the Government of Canada's National Science and Technology Strategy which, on this point, specifically recommends:

As the government fills vacancies on the councils' governing bodies, it will seek out more business and community representation to ensure that the composition of granting council governing bodies reflects Canada's broad economic and national interests.

Up until now, this call had been heard by virtually every single federal research agency except CIHR. Indeed, members from the biopharmaceutical sector sit on the boards of Genome Canada, the National Research Council, the Natural Sciences and Engineering Research Council, and the Canadian Foundation for Innovation.

Several provincial health research organizations, including the Manitoba Health Research Council and the Fonds de la recherche en santé du Québec, also have members from the biopharmaceutical industry sitting on their boards. Likewise, sister councils in other countries—for instance, the Medical Research Council in the U.K.—have board members from this sector.

In all cases, these individuals have been appointed not as representatives of their employers but as unique individuals willing to share their knowledge and able to help build bridges between the private and public sectors for the common good.

In closing, I would like to remind the committee that all governing council members must observe the Conflict of Interest Act, the ethical guidelines for public office holders, and the guidelines for the political activities of public office holders, as a condition of appointment.

In addition, disclosure of conflict of interest is a standing item on governing council meeting agendas.

I am deeply convinced that Dr. Prigent's appointment will have no negative impact on the CIHR's integrity. Quite the contrary, his presence will be of great assistance in carrying out our mission. Dr. Prigent shares CIHR's vision and brings unique expertise to its implementation.

Thank you.

[The Chair, Conservative, Joy Smith]

Thank you.

We'll now go to our seven-minute round of questions and answers, beginning with Dr. Bennett.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Madam Chair, if you'd rather take five-minute rounds to allow more members to participate, I would be happy with that.

[The Chair, Conservative, Joy Smith]

Is that agreed by the committee, a five-minute round?

[Some hon. members]

Agreed.

[The Chair, Conservative, Joy Smith]

Okay, we'll have five-minute rounds.

Thank you, Dr. Bennett.

[Carolyn Bennett, Liberal, St. Paul's, ON]

I have to admit, Madam Chair, that I've been quite taken aback by the objections to this appointment that have been flooding into my office. I think we all know that part of the mandate of CIHR is the commercialization. I think there was, from a lot of the community, a well-articulated need to have someone on the board that had some experience in getting research into practice and into the market.

Dr. Beaudet, you have stated the ethical declaration, the conflict of interest. What's also being expressed is that a present employee of a company that has its prime responsibility to its shareholders.... The concern would be in terms of the conflict of interest declaration. There has obviously been articulated a great deal of concern about recusing oneself at multiple policy-setting positions of the governing council, which could provide a huge gap if there were another appointment, like somebody from an incubator side, or somebody from the MaRS side, or a retired professor emeritus who doesn't actually see that. I don't think any of us wants to see CIHR reduced in the estimation of the public by the fact that any policy decision could be perceived to be questioned because of the interest of the pharmaceutical industry.

I want to know how you would deal with the perception, but also the actual practice of declaring a conflict of interest on so many issues that would come to the governing council, and how often it would be seen as inappropriate. I think you actually have to deal with the fact that the advisor, unfortunately, has a history of transgressions against the integrity of science, and since 2002 has paid substantial--

[The Chair, Conservative, Joy Smith]

Dr. Bennett, this is out of the scope. You know the purpose here is to see the person who has been appointed. You're way off scope here, and I don't want to have to cut you off.

[Carolyn Bennett, Liberal, St. Paul's, ON]

I'm afraid the company he represents has paid $2.3 billion in fines for off-label use of medication--

[The Chair, Conservative, Joy Smith]

Dr. Bennett, I want to remind members that in looking at the order in council appointments, committees can ask someone to come and present themselves after they've been appointed. I'll read right from the order in council documentation, just to make sure that you all know how your questions should be directed. It says:

Among the areas usually considered to be outside the scope of the committee’s study are the political affiliation of the appointee or nominee, his or her contributions to political parties, and the nature of the nomination process itself. Any question may be permitted if it can be shown that it relates directly to the appointee’s or nominee’s ability to perform the duties of the office.

You know the resumé. Just be careful.

Carry on, Dr. Bennett. We stopped the clock.

[Carolyn Bennett, Liberal, St. Paul's, ON]

The ability and perception of being able to make the ethical declaration and the conflict of interest declaration is the concern that I think needs to be addressed, if you wouldn't mind.

[Dr. Bernard Prigent]

As I said in my presentation, there is a very strong framework that's put in place to manage conflict of interest. But before we talk about the tools, I want to refer to the fact that you don't leave integrity and standards of integrity when you move from a sector to another. The responsibility of individuals serving the governing council is to, first of all, be driven by standards of integrity, and I think that throughout my career I've demonstrated the highest integrity in everything I've done.

Now, in terms of managing what is available in terms of managing the conflict of interest, there is clearly the Conflict of Interest Act, there are the ethical guidelines for public office holders and the guidelines for political activities. In addition, conflict of interest declarations have to be made in a preamble of any agenda of the governing council. Every member of the governing council may be in a position of conflict of interest. Conflict of interest does not belong just to one sector. Every one of us, as individuals...we're all representing different institutions and we all have potential conflicts of interest. So the best way to manage it is to have a strong framework, as defined by the act, and to have procedures, which are indeed put in place by CIHR.

The number of activities that I've mentioned to you follow exactly the same guidelines, where you have around the table very often people representing private interests, public interests, government interests, and we all have to declare any conflict of interest before any decision is made.

In addition, there is something that is very important to realize: the governing council does not make decisions on investment towards any institution or any projects. So the review of funding is not a mandate of the governing council. I think it's very important for this committee to understand.