Health Committee on Nov. 25th, 2010

[Patrick Brown, Conservative, Barrie, ON]

Dave, I think you have another point.

[Dr. David Butler-Jones]

Very briefly, I thought I mentioned it, but in case I didn't, we've invested $15 million over four years to do the first ever neurological study, to have a better understanding of it. If I didn't specifically say that, I meant to.

[Patrick Brown, Conservative, Barrie, ON]

The Alzheimer Society had that report last year, Rising Tide, and it said that health care costs for the country are going to be $40 billion in the years ahead. Are the measures we're taking today going toward attempting to mitigate some of those costs?

[Dr. Alain Beaudet]

Well, we're certainly hoping it's going to mitigate. Obviously we're funding a lot of research to understand causes of the disease and to treat it at its roots. We realize this can take time, so in parallel we're really focusing research efforts on early diagnosis, early biomarkers, early imaging markers, which would allow us to treat the disease before substantial neuro-degeneration has occurred.

We believe that if the clinical trials on Alzheimer's disease have not been successful so far, it's because they were carried out on patients who were in stages of the disease that were too far advanced. We believe if we can diagnosis the disease earlier and carry out clinical trials earlier, we will see drugs that allow us to delay the onset of the disease.

Our objective is fairly modest; it is to delay the onset of the disease by five years. But we're talking about huge, huge impacts, both economic and social, if we succeed in doing that.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Beaudet.

We'll now go on to Monsieur Malo.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Madam Chair, Ms. Yeates, I would just like to go back to what was said a little earlier.

What deadline have you set for yourselves to get back to your standard 8- to 10-week processing time?

[Glenda Yeates]

If I understand correctly, we were talking about marihuana earlier. We hope to be able to get there in a few months, though we thought we could do so by December. That was our internal target. At the moment, we are still trying to get it done. It will also depend on the number of applications we receive.

At the moment, we are saying a few months so that we can keep up with the applications, but we hope that it will be sooner. I would say by the start of 2011. We hope to be there for the first quarter, maybe sooner.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you.

Dr. Butler-Jones, vote 50 is a transfer to Health Canada for the Canadian HIV vaccine initiative.

Can you tell us why the Public Health Agency of Canada is transferring that amount to Health Canada, what impact it will have on your work on the initiative and what specifically Health Canada will do with the funds?

[Dr. David Butler-Jones]

Health Canada has the expertise in regulations. Internationally, medium-sized countries do not have enough capacity to conduct research and clinical trials, and so on. It's about expertise—

It's really important to ensure that. The countries that have the highest rates of HIV, where clinical trials will be most able to demonstrate a benefit, or not, also do not have much in the way of regulatory capacity. The ability to assist them to have more uniform standards—that the kinds of standards in these countries and our country are more similar across countries—to facilitate the research, and then ultimately facilitate the ability to provide vaccines is a very important component. It fits very well with the initiative itself.

Glenda may want to add to that.

[Glenda Yeates]

As Dr. Butler-Jones said, it's for training. We think it is important to have regulations.

and the oversight of these clinical trials. We have expertise in that area on the regulatory side, so we will be using that money to build capacity through mentoring and training. We can share the regulatory expertise in the management of these trials, expertise we have in the health products and food branch of Health Canada.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you very much.

Thank you, Madam Chair. I have no further questions.

[The Chair, Conservative, Joy Smith]

Thank you very much.

Ms. McLeod.

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

Thank you, Madam Chair.

I guess I first have a quick comment. To me, this is such an unusual process, because of course as the municipal politics or health authorities you do really careful planning around your budget. You have your budget set for a year, and then of course you live within your budget. The federal government process with supplementary estimates that sort of pop up throughout the year is quite unusual. So can you talk in general about your budgeting process at the start of the year, and then how you really determine what's going to get added as you go?

[Glenda Yeates]

I'll perhaps start with that, Madam Chair.

My background, as I think I've mentioned before at the committee, is as a provincial deputy minister. This process is a little bit different from the provincial process as well, but essentially departments build most of their A-base, the known expenditures that they will have year to year, into the regular budget process, and that's what gets tabled early in the year. But then as we go through, for example, in a budget, we would often be involved with the budget discussions. For example, one of the items in our supplementary estimates this year is to recognize increased demands for programs under the Indian residential school support program. That would have become apparent to us, that the base we had in the budget we didn't feel was going to be sufficient to meet the demands we were seeing, and that's a requirement, that we'd be able to provide those supports for everyone who comes forward. So with that, we would have gone with the revision, essentially, to say that we are seeing greater numbers, and if that then is approved in the budget, then we hear often in a budget announcement a number of those programs, and indeed most of the ones that I mentioned in my opening remarks were things you would have heard as part of the budget. Then the process for regularizing and finalizing the details and getting them before Parliament occurs later in the year through the Treasury Board process in here.

Essentially it's a staged process, partly because of a difference between what things are fundamentally in an A-base that we can deal with at one point in time versus other things that arise later either because they're new or because we have revised estimates, for example.

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

Thank you.

[Dr. David Butler-Jones]

Just to supplement, I've worked at all three levels of government, and this level of government is the most parliamentarily transparent. Generally you'd have a budget, you work it out, you might transfer it between departments, etc., you'd just work it out, whereas here, all of that comes forward.

In our case, most of it is transfers, where, for example, CIHR is in a better position to manage this program than we are because of their expertise. Normally, at the municipal-provincial level, you just transfer it, but here it is part of a process that you have the opportunity to see.

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

Thank you.

I read an article, and I will perhaps brag slightly about my own community. In this community, because we were talking about chronic disease, Kamloops has one of three of what they call a strategic alliance, and it is a partnership between the health authority and the city where they've trained people who are specialists in exercising and supporting exercise for chronic disease. Again, there are only three across the country. I think they are probably doing amazing work.

If you're not affiliated with a university, how does that ever connect through? If you have some things that are happening that are absolutely fantastic, how does it ever connect through to the CIHR process or the Public Health Agency of Canada's process if it's sort of not formalized, not connected with the university, in terms of you saying “Wow, those are great ideas, let's do a more formal evaluation”? How are we going to not only formally evaluate but look at embedding and ensuring that knowledge?

[Dr. Alain Beaudet]

I think it's an excellent question, and it's something we're looking at, particularly as we're increasing our investments in primary health care research, where we're starting to look at community-based research, community-based researchers. I think for certain aspects of research, and certainly under the patient-oriented research strategy, we will need to look not only into the large academic health centres but also into community centres that provide the types of services for which research is actually needed.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Beaudet.

Dr. Dhalla.

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

Thank you for coming.

I want to go back to a comment that Dr. Butler-Jones made earlier. You had said that no one had met the standards of the HIV vaccine facility. Was that correct?

[Dr. David Butler-Jones]

Correct.

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

Could you elaborate on why no one met the requirements? Were the requirements too stringent, or was there not a will to invest in something like this? Did other priorities override this effort?

[Dr. David Butler-Jones]

No, it was an independent process. It was peer-reviewed. None of the bids met the minimum standard. At the same time, the Gates Foundation had done a review of international capacity. In the intervening year and a half or two years, there was increasing capacity available in Canada and elsewhere.

So we didn't have any proposals that we could fund, because none of them met the standard. At the same time, we realized that there was new capacity out there that could be made use of. So why put money into bricks and mortar when you can further research that will speed up the development of a vaccine?

It became redundant. None were successful because none met the standard. So it became a redundant program—not a wise use of investment dollars.

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

We've formed something here in Parliament called an HIV/AIDS and TB caucus, otherwise known as HAT. It's a non-partisan group that has come together from all political parties. We held a forum with Dignitas on some of the ideas for innovation and investing in HIV/AIDS and TB research. We had a number of individuals and stakeholders from the Canadian HIV/AIDS Legal Network as well. It's an important issue and we had a tremendous turnout.

You've said that you're transferring $152,000 from your department into the initiative. Is that going to affect the department? What types of initiatives is that money going to be used for? Health Canada, I believe, has also reallocated $200,000. Can you elaborate on what you're going to be using that money for?

[Glenda Yeates]

The $152,000 is the same money I was speaking of earlier, the transfer from the Public Health Agency. We have recognized a need for mentoring and training on the regulatory side.

There are areas in which Health Canada, rather than the Public Health Agency, has the expertise to help people run clinical trials in Africa, say, where they need the clinical trials but may not have the technical expertise to get some of the regulatory clinical trial approvals. We're offering to help and to bring some people here for training. That is what the $152,000 will be spent for.