Health Committee on March 16th, 2010

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

Yes, so very quickly I'll ask my question.

Madam Minister, the rate of TB among Inuit is 185 times greater than among the rest of the population. In terms of first nations generally, it is at 51 times the rate for the general population. You have no strategy. There is nothing in your estimates. When are we going to see a plan of action, at least with respect to detection and then treatment?

[Leona Aglukkaq, Conservative, Nunavut, NU]

Again, I'll just start off by saying that health care is delivered to Inuit people by the provinces and territories. Health Canada does not deliver directly to the health populations—

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

Let's just address reserves then.

[The Chair, Conservative, Joy Smith]

Ms. Wasylycia-Leis, can we have the minister answer this, please?

[Leona Aglukkaq, Conservative, Nunavut, NU]

You asked me Inuit-specific, so I'm answering Inuit-specific. I can also say—

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

Could we have it for first nations on reserve then?

[Leona Aglukkaq, Conservative, Nunavut, NU]

--that there are a number of efforts being made to reduce that. One of the biggest challenges we have is overcrowding. We're made significant investments to housing. We've made significant investments to dealing with poverty, smoking, and so on. Those are plans in place by jurisdiction. As part of our investments, we'll continue to work with the provinces and territories to increase transfers, and not cut transfers as we saw happen in the 1990s. We will continue to work with the provinces to address the delivery of these programs.

Do you want to elaborate a bit more on that?

[The Chair, Conservative, Joy Smith]

Dr. Butler-Jones.

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

Could I have a point of order, Madam Chair?

[The Chair, Conservative, Joy Smith]

Our time is just about up.

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

It's a point of order.

[The Chair, Conservative, Joy Smith]

All right, Ms. Wasylycia-Leis, go ahead.

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

On a point of order, I thought the minister would have been concerned that the rates of TB among Inuit are 185 times greater than the rest of the population, and she wouldn't simply dump it on the provinces.

[The Chair, Conservative, Joy Smith]

That's not a point of order, Ms. Wasylycia-Leis. It's a matter of debate.

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

I asked a specific question about detection and treatment.

[The Chair, Conservative, Joy Smith]

It's not a point of order. Thank you.

Dr. Carrie, you're next.

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

I didn't ask about housing. I asked about detection and treatment.

[The Chair, Conservative, Joy Smith]

Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Madam Chair.

Minister, it's been a very busy year, and I for one would like to thank you. I've been elected since 2004, and I've sat on numerous committees, and I don't think we've ever had a minister that was more open and more available to a committee. I'd like to thank you for the record number of updates, the information sessions, and the briefings. I think those allow us, as a committee and as parliamentarians, to do our job better. I know you've been very good at making these briefings available to everyone.

You mentioned the briefing yesterday about isotopes. I found it extremely interesting, and that's what I'd like to talk about. I know this is a worldwide issue. I know that you and Health Canada have taken international leadership to develop new lines of communication among the suppliers along the supply chain. But I also know that Canadians are really concerned about their government and patients and front-line workers putting patients first.

We have been faced with these supply disruptions for many months. We're hearing that the situation is going to get worse in the next few months or few weeks as another reactor is going to be shut down.

I know you were discussing it a little bit earlier and you got cut off, but I would like to hear from you what actions and measures have been undertaken by the government to respond to the supply disruption of medical isotopes. I think these are things that Canadian patients and doctors on the front line would like to know.

So, Minister, could you reply to that?

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you for that question.

This is a global shortage. I think we forget that sometimes, that we're dealing with a global shortage of medical isotopes.

We have faced challenges for many months now, and it's also important to recognize the efforts of health care communities in the provinces and territories in responding to the disruption in the supply of medical isotopes. Thanks to their efforts, patients will be receiving the scans they require.

Health Canada continues to regularly interact with the provinces and the territories and the health community through bi-weekly calls where supply forecasts and best practices are shared. Through these calls and supply forecast messages, Health Canada has provided early notification of the week's supply period to these groups.

As well, Health Canada reissued a guidance document that was reviewed by my special advisor, Dr. Sandy McEwan, and the ad hoc group of medical experts and provincial and territorial officials. The guidance document captures the key strategies and measures that are well known and widely accepted, such as use of alternatives to free up TC-99, maximizing available TC-99 to avoid decay, and use of TC-99 on priorities where no other alternatives are available.

Health Canada is also using proactive measures to address regulatory requests, and we have expedited the reviews for submissions to increase the supply in Canada. As of last week, we have approved the supply from the Maria reactor in Poland to make TC-99 available in Canada as well. So Health Canada will continue to respond to applications received from other countries.

The special access program for emergency use, which will allow some products to be used at a physician's request, will be reviewed in 24 hours.

There are also clinical trials, which will undergo expedited review on a priority basis. The target is about seven days, which will respond to the use of products such as chloride, to be used at the Ottawa Heart Institute, as an example.

I also want to assure you that Health Canada will continue to support the provinces and the territories and the health community as they mobilize their strategies to respond to the lower period of the supply.

Thank you.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you, Minister.

I want to shift gears a little bit and talk about Canada's pandemic plan and the H1N1. We have just gone through an experience that we've never gone through before. You mentioned in your speech, on page 6:

Now is the time to learn from our experience in responding to the HINI pandemic. Looking back and fully assessing how we managed this public health event will help to inform and improve future responses.

I agree very much with that. I had the opportunity during the pandemic response to visit the United States, and I know that internationally we received accolades for the pandemic plan and the rollout. But I do know that as with anything, it can always be improved.

Here on committee we have questions about best practices--what worked with the communications, the dissemination of information. I wonder how you would rate the Government of Canada's performance in Canada's H1N1 pandemic plan, and if you could explain to the committee what you're looking at, as things roll forward.

[Leona Aglukkaq, Conservative, Nunavut, NU]

I would like to start off in responding to that by congratulating the provinces and territories and the medical community for doing a fantastic job in the rollout of the vaccine over the last 10 months and last year.

I'm very proud of the work Canada has done. In my view, it was an excellent job. This is the most successful immunization campaign, in my opinion, in the history of this country. I think we should all be proud of our health care system and our front line workers who make a difference in the lives of so many Canadians on a daily basis.

The outbreak of the H1N1 flu virus in Canada required a well-coordinated Government of Canada response in partnership with provinces and territories. To that end, the Government of Canada also worked with the provinces and territories to ensure that Canadians had the information they needed to make informed decisions and to protect themselves against H1N1.

As I mentioned before, it was the largest campaign in our history. Approximately 45% of Canadians received the vaccine, making our immunization rate, again, among the highest in the world. In addition, I'm very proud that rates were even higher among first nations communities, at 60%. In contrast, the United States had an overall vaccination rate of 20%, and Great Britain had a vaccination rate of 8%. Canada's successful strategy reflects a strong partnership between the provinces and territories and the federal government and our manufacturing companies.

The health and safety of Canadians was put at the forefront of our pandemic response. A secure domestic supply of vaccine made the vaccination rates among targeted groups even higher, including a 60% vaccination rate for first nations communities.

The Government of Canada will continue to respond to the needs and the broad effect. Efforts are being made to ensure optimal use of remaining vaccine, including contributing five million doses to WHO for global pandemic relief. We will take steps in Canada to manage the remaining vaccine supplies, including stockpiling for future contingencies.

In terms of provinces and territories working to look at how we can improve this plan, I continue to work with the provinces and territories to evaluate how we have done. I stated many times during the last 10 months, in responding to H1N1, that there will be lessons learned from this whole exercise. I have the full cooperation of the provinces and territories in examining areas where we could improve the rollout. Like any situation—we dealt with SARS before and with this plan and with implementing the 2006 pandemic plan—knowing where we can improve is the next step in dealing with this particular situation.

I have to say that the provinces and territories did a phenomenal job in their rollout. And they are committed to working with us to improve where we can to protect the health and safety of Canadians.

Thank you.

[The Chair, Conservative, Joy Smith]

Thank you, Minister Aglukkaq.

We're now going to go to the second round. The second round is five minutes for questions and answers. We have to be very tight with that.

We'll begin with Kirsty Duncan.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Madam Chair.

Thank you to the minister and the officials for coming.

I'd like to pick up on the issue of CHVI. Could I begin by asking if the scientific review committee met in May 2009?

[Dr. David Butler-Jones]

I don't have the dates at hand. There was a long process in terms of both the scientific review and the internal review and the administrative review.