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.
Chair, Board of Directors, Canadian Stem Cell Foundation
By that I mean that maybe Canadian Blood Services, who've been kind of managing that process, would be a better group to talk to.
Conservative
The Chair Conservative Joy Smith
I think Dr. Wall has raised her hand.
Dr. Wall, would you like to comment on that?
Dr. Donna Wall Physician, Pediatric Hematology and Oncology, CancerCare Manitoba
Sure.
I've had the pleasure of working with Canadian Blood Services on this project, and have been involved with several cord blood banks in the U.S. over the last several years. The proposal has been approved across the provinces and territories, but there was no funding in the past year allocated to it. At issue, I believe, is that the Canadian Blood Services charter works through the provinces, and making any commitment to a Canadian Blood Services project needs 100% buy-in from the provinces and territories. That was received last year, but there were no funding dollars attached to that.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Thank you.
Thanks to all of you for being here to discuss regenerative medicine and the future of medicine. Thank you for your world-leading research.
I think you've raised a really good point: if Canada doesn't step up to the plate, people will go overseas. They are going now. They are going for help with multiple sclerosis, for adult mesenchymal stem cells.
Could you please compare and contrast the utility of cord blood stem cells, iPS cells, adult mesenchymal stem cells, and others from the research stage through to therapeutics? Do we need all types of stem cells? Will iPSCs replace the other types?
Scientific Director, Stem Cell Network
I can speak to that.
Without question, researchers are working with all of these cell types. We need to compare and contrast them. And they're being used for different types of therapies. So iPSC will not replace everything else, and neither will embryonic stem cells be used for all possible trials. We're talking about hundreds of different diseases with multiple solutions. The best solution for each disease may well come from using different types of cells.
These drug screens that I talked about are making using iPSC cells. The Geron trial is making use of human embryonic stem cells. Cancer stem cells are being derived from tumours to develop cancer treatments. Mesenchymal cells are being used to modulate the immune system.
So there's no one solution, and one particular cell type doesn't fit all sizes.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Thank you.
What specific recommendations would you make to this committee—Dr. Rossant talked to some of the legal challenges—to address all of the legal, ethical, and scientific issues, so that we can move forward to getting more treatments here in Canada?
Scientific Director, Stem Cell Network
Perhaps I can address that.
Certainly the system is very bureaucratic, and we have overlapping jurisdictions and we have contradictory aspects for the different instruments.
Chief of Research, Hospital for Sick Children
I think we are in a situation in which the regulatory environment is a little confused. The CIHR has jurisdiction over all aspects of research, and I think the stem cell oversight committee of CIHR does a very good job. That is the number one thing we should focus on, making sure that we have one system for the research.
But it is more complicated than that, because there are legal aspects as well. Our overriding goal is that whatever regulatory frameworks are set up, they should be harmonized. So if we have to have—and we probably will have—multiple regulations on different aspects of stem cell research and of course their application, there needs to be harmonization across all of those. That's the one thing I think I would really make a plea for.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Okay.
What do cord blood stem cells offer? At this time, we may be able to treat small-sized adults. Over time, will we be able to treat full-sized adults, or will iPS cells replace that? The question I'm asking is what need there is for cord blood stem cell banks.
Chief of Research, Hospital for Sick Children
Can I try that one?
Actually, let Dr. Wall take it.
Conservative
The Chair Conservative Joy Smith
Excuse me, could you pay attention to the chair so that we don't get chaos in here?
Conservative
The Chair Conservative Joy Smith
Dr. Young, could you address that...?
I'm sorry, I meant to say Dr. Wall.
Physician, Pediatric Hematology and Oncology, CancerCare Manitoba
I'll take Dr. “Young”.
Conservative
Physician, Pediatric Hematology and Oncology, CancerCare Manitoba
We have to be a little bit careful here, because we're using stem cells in a very wide application. When we're talking about a Canadian public cord blood bank, at this point the application is specifically for what we used to call bone marrow transplantation, or blood and marrow transplantation.
Looking at that very small focus, cord blood offers a tremendous opportunity to offer transplantation to people who have rare immune types and thus are on wait lists for transplant and may not be able to have a transplant to treat their blood disorder, immune disorder, or cancer.
The issue with cord blood that you alluded to was that when you collect cord blood at the time of delivery, you collect roughly a cup of blood, and that amount of blood is used to “transplant” a baby or an adult. The cell dose is low. There is active research in the area to expand cord blood. We have now found out that we can use two cord blood units at once, and this has largely overcome our size issue. We in Manitoba and other Canadian transplant centres are using cord blood as a transplant option for adults now.
Conservative
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
Thank you, Madam Chair. Thank you as well to our witnesses for their presence here with us this morning.
Dr. Rossant, allow me to put my first question to you. In your presentation, you stated that research is directed via three professional bodies or in accordance with the recommendations of three instruments, namely the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans, CIHR and the Assisted Human Reproduction Act.
I would simply like to come back to the Assisted Human Reproduction Act, because, as you know, it is presently being challenged before the Supreme Court. I was wondering what impacts, if any, this legal challenge is having on your work.
Chief of Research, Hospital for Sick Children
I'll answer in English, if you don't mind.
The fact that the act is not able to move forward because of the judicial challenge means that the regulations that the act requires to be set in place are not in place. Currently, the act that should apply to the derivation of human embryonic stem cells or any use of human reproductive material would require a licence through the regulations of the act. The regulations are not in place, so there in fact is no means, for the act, of actually looking over stem cell research and the use of human reproductive material.
It's a big issue, not just for stem cell research but for human reproductive technologies. IVF programs are supposed to be regulated under the act, and they are currently not because the act is in limbo and the regulations are not in place.
So it has actually a broad impact on the use of human reproductive materials.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
But if, for example, the regulatory framework is not there, does this prevent you from pursuing your research work?
Chief of Research, Hospital for Sick Children
No, it's not affecting our ability to do research, but it's affecting the confidence scientists have that we have a clear regulatory environment. I think it affects the public's confidence in the same thing: that research in Canada is moving forward in a clear environment.
We are in a very competitive international environment. We need to be sure that in Canada we can be clear with scientists coming in about what they can do and what they can't do. So it's really about clarity and openness and transparency at all levels: to the public, to the scientists, to the regulators, and indeed to Parliament.
