Health Committee on Nov. 2nd, 2010

[Drew Lyall]

Sure.

The concept behind the stem cell charter really arose from a lot of the debate around stem cell research over the years and to bring some focus to the key principles that the scientific community, as a starting point, thought should be observed. It talks about the integrity of the science. We heard from one of the other questioners about stem cell tourism. If therapies are going to be offered, they really ought to be therapies that have been proven in the clinic. There should be rigorous testing before we get there.

The charter also talks about transparency and openness, so that when all these tests are being undertaken and research is moving forward, it should be in full visibility of the public to ensure that the public and policy makers have confidence in the scientists, that we're moving forward in a responsible manner and people can take comfort from that.

Really, it's about the responsible advancement of the science and making sure that as it moves forward to the clinic, the public can have confidence in the therapies offered to Canadians.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

Perhaps I could request, through Madam Chair, that perhaps Dr. Lyall or Dr. Wall could forward to the committee some information on the stem cell charter and some of the initiatives under way for increasing awareness of being donors for the program.

If you could have that forwarded to the committee, I think it would be of great interest to all of our colleagues. We send out newsletters to our constituents that talk about some of the work that's being done, and I think this would be of interest to many people.

[The Chair, Conservative, Joy Smith]

That's a very good point.

I would ask anyone here on the panel today who has any of that information to send it to the clerk. She will translate it and give it to the committee members.

Thank you.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

I have one more question before I turn it over to my colleague.

[The Chair, Conservative, Joy Smith]

You have a minute.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

Okay.

Dr. Dhaliwal, you spoke about the increase in medical tourism and about ensuring that we provide...or Dr. Rossant spoke about harmonizing our regulatory frameworks.

If you could give one recommendation on that--Dr. Dhaliwal, and perhaps Dr. Rossant as well--it would be much appreciated, to ensure that Canadians receive the treatment here in our country versus having to travel abroad.

[Dr. Dhali Dhaliwal]

Dr. Rossant?

[Dr. Janet Rossant]

I was going to say, “Dr. Dhaliwal?”

[Voices]

Oh, oh!

[Dr. Janet Rossant]

One recommendation is really that any treatment that uses stem cells or is related to stem cell therapy has to go through full and careful clinical evaluation for safety and efficacy by all the means, through Health Canada regulation and through clinical trials.

We also need to educate people that stem cell tourism, in some cases, is very dangerous. When you look at treatments being offered in China or India, they are often not done under the same kind of clinical evaluation we have here.

[The Chair, Conservative, Joy Smith]

Dr. Dhaliwal, did you want to comment on it as well?

[Dr. Dhali Dhaliwal]

Yes.

There are examples of patients who have gone abroad and come back with infections, because their immune systems were compromised and the treatments being administered were not clear.

I would say that it is imperative that we develop a broad structure that allows rapid assessment of these therapies that the public can have good confidence in. Then we will not have the tourism that could occur.

I think that will be impacting the health care system in a big way, and all of the provinces are going to be mired in having to evaluate untested therapies. We have seen the problems that arise, such as the procedure for multiple sclerosis that's causing a lot of heartache and difficulties for the regulatory bodies.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Dhaliwal.

We'll now go to Ms. McLeod.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you, Madam Chair.

It's certainly been a fascinating discussion, and I've learned a lot. I'm also very pleased; I didn't realize that Canada had played such a role in terms of the development of stem cell research, so that's been added to my learning today.

This may be a bit elementary, but it would just help me understand things a bit better. Essentially, right now, we have four sources of stem cells: bone marrow, embryonic, umbilical, and iPSC. Is that right?

[Dr. Michael Rudnicki]

There exist in every tissue resident stem cells. There are probably over 300 different cell types in our bodies. I think the exact number of stem cells is unclear. There's a large number of different types of stem cells.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

I meant in terms of sources we're using for either clinical trials or for therapeutic uses.

[Dr. Michael Rudnicki]

Well, there are also brain stem cells that have been isolated for transplantation. Skin stem cells are being used for burn victims. Islets transfers perhaps can be thought of as stem cell. The Edmonton Protocol might be another type of stem cell transplantation.

So that exact list, I don't know what it would be, but....

[The Chair, Conservative, Joy Smith]

Go ahead, Dr. Lyall.

[Drew Lyall]

In broad terms, though, in terms of where you're going there, the types of cells Dr. Rudnicki is describing are adult stem cells. Then there are embryonic stem cells, sourced from embryos, and then these new iPS cells. You have kind of these three broad categories.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

So adult stem cells are mostly through the OneMatch process? Those are either from individuals' families or through the OneMatch process?

[The Chair, Conservative, Joy Smith]

Dr. Wall and then Dr. Rossant.

[Dr. Donna Wall]

We're talking about two things at the same time, and that's where it gets a little bit confusing.

There are adult donors and cord blood donors for hematopoietic stem cells for use in blood and marrow transplantation. So that's the OneMatch part, only for blood and marrow transplantation indication at this point.

The discussion for most of this discussion today has been a much broader discussion about the use of stem cells that actually may be taken from yourself and enriched and expanded to treat yourself or modified to treat yourself, and this is actually the more exciting and the bigger part of the discussion.

[The Chair, Conservative, Joy Smith]

Dr. Rossant.

[Dr. Janet Rossant]

That's fine.

[The Chair, Conservative, Joy Smith]

Okay.

Ms. McLeod.