Evidence of meeting #35 for Health in the 40th Parliament, 3rd session. (The original version is on Parliament’s site, as are the minutes.) The winning word was bank.
A recording is available from Parliament.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
I would like to know what proportion of the stem cells being used today are imported, and what controls these stem cells are subject to. Are they the same procedures as those used for stem cells retrieved from Canadian citizens, for example?
Chief of Research, Hospital for Sick Children
I'm not sure; maybe Dr. Wall is going to try to answer.
Physician, Pediatric Hematology and Oncology, CancerCare Manitoba
I can answer that from the field of blood and marrow transplantation. There is a robust sharing across countries of the best-matched cell products. This includes cord blood. When importing cells, we follow Health Canada regulations that would apply to Canadian products.
To date, a vast majority of the cord blood units that have been used for transplantation in Canada have been sourced internationally.
Chief of Research, Hospital for Sick Children
I would address this on the embryonic stem cell side.
Embryonic stem cell lines have been generated around the world, and some of them are imported into Canada. They have to be approved by the CIHR stem cell oversight committee, which reviews their derivation and the informed consent. They have to be approved under the same regulations as occur in Canada, and then they can be used.
It's very important, again, to be able to share expertise internationally and to share and cross-compare research across different jurisdictions.
Chair, Board of Directors, Canadian Stem Cell Foundation
Just to give some sense of numbers, in Canada, four human embryonic stem cell lines have been derived by scientists who were grandfathered under the provisions of the bill when it came in in 2004, but around the world there are probably a couple of hundred stem cell lines now.
Conservative
The Chair Conservative Joy Smith
Mr. Malo, you have one more minute, if you'd like another question.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
Thank you very much.
I would like to come back to a statement made by Dr. Dhaliwal with regard to medical tourism for stem cell transplantation. I would simply like to have an idea of the scope of this phenomenon.
President and Chief Executive Officer, Provincial Clinical Director of Oncology, CancerCare Manitoba
It varies from province to province, but at this moment we know that every province has had applications to the provincial health ministries for support of the funding necessary to access. But I must point out that at the moment, there are not well-established studies that have gone through the test of rigorous clinical testing. So it is in that early phase at which the patients hear of advances or processes or procedures that are available outside Canada and then undertake to go there.
I think this is going to increase dramatically if we do not support the research and the clinical application infrastructure across the country. I believe we will need before that a rigorous process of testing the utility of these therapies and their cost-effectiveness and the long-term impacts.
Conservative
Carol Hughes NDP Algoma—Manitoulin—Kapuskasing, ON
Thank you.
I want to touch base on the issue of cord blood. I'm just trying to get some sense of it, because obviously there's a demand out there for that. Basically, from what I can gather from the information you've provided, there's not really a bank out there that could easily provide that information and how to collect it all.
I'm just wondering what could be put in place with respect to ensuring that there's access to cord blood. How do we go about collecting all of that?
Physician, Pediatric Hematology and Oncology, CancerCare Manitoba
Yes. It's a good question, but it's hard to answer that in a sound bite.
The issue is that we in the blood and marrow transplant community are networked worldwide with donors for cord blood, and for adult volunteer donors, good Samaritans, who are willing to donate bone marrow for patients in need. That is an established network.
The focus of a Canadian cord blood bank would be, in my opinion, to enrich the number of units that represent our ethnic minorities, our mixed-heritage families, which is an increasing number of families, because your immune type goes along with your ethnic background. The patients we have a hard time finding donors for are first nations families, new immigrants, patients of mixed heritage, so the needs we have in the transplant community are to get cord blood units banked specifically in this area.
Chief of Research, Hospital for Sick Children
I want to make it clear, in case people haven't twigged, that there are cord blood banks in Canada, but they are largely private. There's a very different rationale in a private cord blood bank, where a cord from a baby is stored for the use of that baby. Those are commercial undertakings with a fee.
What Dr. Wall is talking about is a very different undertaking, a much more open and publicly available bank, where, again, people would be asked to donate their baby's cord blood, but it's like putting it in a bank and you can pull out not necessarily that blood again but any blood that you need later on.
So I think it's a very different concept and it's really one that we need to embrace in Canada.
NDP
Carol Hughes NDP Algoma—Manitoulin—Kapuskasing, ON
I'd like to follow up on a comment that Dr. Wall has actually indicated with respect to first nations as well.
I come from a mostly rural riding, and the difficulties there...so I'm trying to figure this out. I'm assuming that one of the suggestions would probably be that we educate people so that when someone becomes pregnant, there's an opportunity to educate--i.e., if you want, you can actually make a donation.
I'm simply trying to get some sense as to what we need to do here federally in that respect.
Physician, Pediatric Hematology and Oncology, CancerCare Manitoba
I've done this for many years now--so I'm not Dr. “Young” in this--and the issue--
Conservative
The Chair Conservative Joy Smith
Dr. Wall, there is a rule here at my committee, you know.
Do you want to hear it?
Physician, Pediatric Hematology and Oncology, CancerCare Manitoba
The issue here is not, in my past experience, the willingness of parents and obstetricians and hospitals in participating in cord collections. It's very easy to get the word out, and Canadians have big hearts. I don't anticipate problems in that early phase of donation. The difficulty is that in order to bank cord blood units for use in clinical transplantation, we need to meet manufacturing standards, and we need to have the infrastructure support for high-quality banking. That would include rigours on the collection, the transportation, the processing, the storage, the characterization.
So it's a big effort, all of which is doable, but it needs to be well funded.
NDP
Carol Hughes NDP Algoma—Manitoulin—Kapuskasing, ON
Just on that note, I'm trying to get some sense as well....
This is something that Dr. Dhaliwal has mentioned on a number of occasions, and we've from some other speakers here, with respect to financial and infrastructure support and capacity building.
I don't know if anybody wants to add to that. I know that as you're making your presentations and you're hearing others, you may have other things to say, and sometimes you don't have time to say it.
So if you had to get your message out to us, what would it be?