Health Committee on Nov. 25th, 2010

[Dr. David Butler-Jones]

As to the money that the Gates Foundation and several departments contributed, it's in the initiative. Not having to build a structure means that we're able to do a number of other things to support the process, and that's what some of these transfers represent. But they're still in that broad initiative.

[Dr. Alain Beaudet]

Thirty-four million of this money is actually for AIDS research, particularly research focused on the discovery of a new vaccine. It's also for preparing the low- and middle-income countries for clinical trials, once we have a vaccine. It will ensure that we have trained people to carry out these trials.

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

HIV/AIDS awareness week is coming up next week. Could you table for the committee some of the initiatives that are currently under way? I think it would be helpful.

I had another question for Ms. Yeates on a topic that I believe Mr. Malo touched upon in regard to the natural health products directorate. As a chiropractor in my previous life, prior to becoming an MP, I know that it's an important issue for many people within my network.

You mentioned that with the new regulations, 87% of the backlog has been completed. How many applications do you currently have within the directorate, and how quickly do you see those being processed? The delay in getting them approved has been a huge area of concern for many stakeholders.

[Glenda Yeates]

We've had many discussions with the committee about the challenge of moving these products on to market, while assuring Canadians of their safety. This is the reason we went with the changed regulations. We do a safety review, and then we have a 180-day process. Unless we see something very new or unusual that needs to be thoroughly assessed, we can let it on the market in this 180-day—

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

How many applications have you had so far?

[The Chair, Conservative, Joy Smith]

Thank you very much.

We'll now go to Ms. Davidson.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thanks very much to each of you for being with us again today.

I just want to change the questioning a bit. I know that we've all been hearing a lot lately about the cholera outbreak in Haiti. I think well over 1,200 people have died from it, and certainly thousands more are very ill because of it. I know that Canada has certainly stepped up to the plate and has contributed greatly to relief efforts and ongoing assistance to the Haitian people, but is the Public Health Agency involved in this effort to assist Haiti? Are we doing anything through the microbiology labs?

[Dr. David Butler-Jones]

There are actually a number of areas we're involved with, in close contact with departments across government not only here but also with our colleagues in other countries.

In terms of the laboratory, the genetic sequencing or genome sequencing of the cholera bacteria is actually something that we did, which helps to identify exactly the potential sources, etc. So we're very much involved in that, working jointly with the CDC in the U.S. on that.

There has not been a request for assistance, in the sense of a team of epidemiologists and others going down, but if we are asked, we are available to go.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Okay, thank you.

I want to ask Ms. Yeates, if I could, please, if there is any additional funding in the estimates this year for the impact of environmental conditions on human health. If there is, does it support other efforts designed to address health concerns related to the environment?

[Glenda Yeates]

Thank you very much for the question.

Yes, Health Canada partners in a number of ways with Environment Canada and others on the environmental file, because there's often a concern on both the environmental and human health sides. Environment tends to be the lead department, but we are very much, we think, an important partner in a number of environmental activities. Certainly one of the ones that's in these estimates is something that's very specific to air quality.

There is a need for additional research to support the development and refinement of an indicator that would help us measure the connection between air quality and health, because I think that understanding which conditions are linked in the epidemiological research to which air quality indices or air quality findings is critical to taking action. So the research function of a new health air indicator we think is quite important. It would allow us to track changes over time in air pollution levels, for example, and to see what links those might have to the health of Canadians.

So there is actually $240,000 in supplementary estimates (B) for the expansion of this indicator to include other pollutants. It's an ongoing piece of work that we are doing. Currently, we have an air quality indicator for ozone and for particulate matter, but we are working to expand that as part of our overall clean air agenda in terms of the work we do with Environment Canada under the chemicals management plan and the work we do on the environmental and health files generally.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you.

That's the end of my questions. Thank you.

[The Chair, Conservative, Joy Smith]

Thanks, Ms. Davidson.

Now, Ms. Chow, you had another question.

[Olivia Chow, NDP, Trinity—Spadina, ON]

Thank you.

It's really about your excellent northern health initiative for accessible and nutritious food.

Have you considered rolling that out to other parts of Canada that need access to healthy nutritious meals, and especially to children, given that boys are now 16 pounds heavier than they were 20 years ago and girls 11 or 12 pounds heavier? That's substantial. So access to nutritious, affordable, local food is really important.

Is there any movement on this, or are there any learnings from your food mail program on this? Is it community-based? Maybe you could describe it somewhat.

[Glenda Yeates]

Thank you for that question.

I'll speak to the Nutrition North program, specifically. In answer to the broader question of the consideration, when health ministers met this past September, there was a real joint coming together on the issues. There was a declaration on prevention and promotion and a focus on childhood obesity and a specific initiative in terms of a framework on childhood obesity.

Now, we have been tasked with coming forward with strategies and with collectively bringing back to the ministers of provinces and territories and the federal government strategies and options. One of the things they particularly asked us to look at, for example, is the marketing of unhealthy foods to children.

Ministers are seized of the issue. I think everyone realizes that this is all levels of government. Everyone is working together at the health minister level. So there may be further things there.

[Olivia Chow, NDP, Trinity—Spadina, ON]

Would any of it include helping some of the local communities provide food in schools, community centres, and child care centres? Child care centres already have food. Kids have to go to school. They show up in community centres, and if they actually got a decent meal in a day, that would be wonderful.

You said any kind of partnership. I know that CAPC is very small. Is there any discussion of expanding it or changing the mandate?

[Glenda Yeates]

It's early days, so I don't think we're at that stage. But certainly the partners are looking to understand best practices. I know that some jurisdictions do some of those programs now, and others may wish to learn from them and work on them.

To make the link to Nutrition North, which is obviously a program that is within the Government of Canada's remit and focus, there was a real sense that we should be focusing on this program to try to improve the availability of nutritious food. Our colleague department, INAC, is actually the lead on this program. On moving the subsidies, we had to make some choices about trying to focus the resources on healthy foods. We had an expert panel that looked at, for example, removing food that had high levels of salt or sugar and focusing the supports on other foods.

The Health Canada portion I think is quite important, because in addition to simply making foods available, I think all the best research has told us that it's also about making sure that people have the understanding and the skills, in terms of how to prepare these foods, that might lead people to choose them.

The money in supplementaries is for us to actually work with communities and work with the existing programs to try to build nutrition supports for communities. It may be cooking classes. It may be displays right in retail establishments. It may be community freezers.

[The Chair, Conservative, Joy Smith]

I think Dr. Butler-Jones has some comments on that as well.

[Dr. David Butler-Jones]

We actually fund the CAPC and CPNP programs as well as the aboriginal head start program off reserve.

It's back to public health being local and local community initiatives, whether it's community kitchens or different agencies coming together.

[Olivia Chow, NDP, Trinity—Spadina, ON]

[Inaudible--Editor]

[Dr. David Butler-Jones]

Well, there are both. We provide a lot of money, actually, to support those things. But it's not just a federal issue. It is about different levels of government working together and different agencies working together.

In my life as a local medical officer, one of the things we found was that kids were recognized as coming to school hungry, and parents' groups and teachers wanted to come together and put together a program, such as a muffin program or whatever. What I observed is that there were all these regulatory things, and by the time they worked through all the regulations and having kitchens and all this, they ran out of energy. So what we did was bring the inspectors, the nurses, and the schools together and said “Okay, how can we make this easy so that all the energy of the volunteers and the parents can go into actually delivering the program?”

There are a number of things to do. From the agency's perspective, in addition to the kinds of programs we fund, one of the things that's really key, which goes back to, in a way, a previous question, is how you get that information out there. We have the Canadian best practices portal and the chronic disease portal. We're very much focused on evaluations and understanding what works and what doesn't. It is why my annual report is not just a list of the problems but has ways in which communities and organizations can actually address them.

We're seized with the idea that every public health nurse in this country, every inspector, every nurse, and every nutritionist should not have to rediscover what's been learned and what is a good program in Kamloops or whatever.

That is a strong focus. We've reinstituted the preventive practices group. We've done a number of things that I think over the next few years will help so that practitioners, whether they're teachers or public health workers or whatever, have access to the tools that will assist them in actually getting the work done, as opposed to waiting for somebody to get something to happen.

[The Chair, Conservative, Joy Smith]

We'll now go to Dr. Carrie. You have four minutes, because at 12:30 we will have to go into our business portion.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you, Madam Chair.

I wonder if you could indulge me a bit.

When I was first elected I was on the health committee, and we did some really good work together. One of the issues we addressed at the time was fetal alcohol spectrum disorder. It is a very important issue. It's something I learned a lot about and took on as a bit of a cause. I was wondering if you could update the committee. I believe we might have made recommendations in 2004-05. Could you let us know what the Government of Canada is doing to help prevent fetal alcohol spectrum disorder, and how do we help people who are actually affected by it?

[Dr. David Butler-Jones]

Perhaps I'll just start, in terms of the agency's role in this, and then Glenda could speak to the extensive programs that have developed for first nations communities.

This is a huge challenge, obviously. And unfortunately for kids born with fetal alcohol, it is a life challenge; it's not just an event. Some of the things that were recognized were awareness, understanding, guidelines, standards in terms of diagnosis, and what are appropriate therapies and approaches, etc.

A lot of our resources have been focused on ensuring that practitioners, physicians, and others have the tools they need to actually address that. Then we're also seeing the development in the provinces, who actually deliver these services, at not only an increased understanding but an increased focus on how best to do that. Our job is to make sure they have the best tools possible to both understand the condition but also to address it.

[Glenda Yeates]

Madam Chair, perhaps I could speak specifically to our efforts as part of our participation in the Inuit health branch. As David has mentioned, all jurisdictions—provinces, territories, and the federal government—are very much aware of the challenge. So we, as part of the first nations and Inuit health branch, have some specific focus here as well.

We invest $16 million annually, as part of an FASD prevention program. We're working on trying to improve awareness. We've done some public opinion research, which tells us that we are actually increasing the awareness in our first nations communities of some of the challenges.

We are working to develop actual support programs that give us culturally appropriate and evidence-based prevention, and early intervention programs. So we're working with some mentoring projects, for example, in certain areas to provide women who are pregnant with some supports. We're also supporting community coordinator positions to increase access for families to multidisciplinary teams in certain areas.

We're continuing to work with communities. Again, much like other issues, this isn't something the Government of Canada can do for people. It is working with communities, providing them with the support, the knowledge, the information, and the assistance to deal with what is obviously a very challenging and important issue.

[Colin Carrie, Conservative, Oshawa, ON]

I do want to thank you and commend you, because in this committee we did some really good work. We visited the north and we did look at some of the specific issues there, particularly fetal alcohol spectrum disorder. But I also commend you in moving forward with Nutrition North Canada, because when we were up there, I couldn't believe the amount of junk food and things like that.

My next question follows up with Madam Chow.