Health Committee on April 26th, 2012

[Dr. Edward Fon]

Sort of. You said it much better.

[Prof. Daniel Krewski]

I thought you said it better.

[The Chair, Conservative, Joy Smith]

Your time is up. Thank you, Mr. Lizon.

Now we'll go to Dr. Duncan.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I get to go again?

[The Chair, Conservative, Joy Smith]

You do. Now be good and stay in the federal jurisdiction.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I'm always good, and it's okay to bring ideas to committee after you've talked—

[The Chair, Conservative, Joy Smith]

Do you have a question, Dr. Duncan?

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I do. I'm just saying it's okay to bring ideas to committee after talking to researchers across the country.

We have an aging population. We're talking about Parkinson's today, and another concern is dementia. One person is diagnosed with dementia every five minutes. The cost is $15 billion a year. The human costs are horrific, but in 30 years that's going to be once every two minutes and the cost will be $153 billion.

The World Health Organization has called for countries to produce a national dementia strategy. Five of the G-7 nations have done so, and Canada is lagging behind.

What are the Parkinson's impacts? We've talked about the human impacts. Can we talk about the economics?

[The Chair, Conservative, Joy Smith]

Who would like to take that?

[Dr. Bin Hu]

I can talk about the costs to patients and their family members. Sometimes you can't measure the economic and emotional burdens just by numbers. For example, many patients' spouses told us it drained them every day to take care of their husband or their wife.

In addition, I think what you look at is the cost to the entire family in extra worry. Children are constantly worrying about their parents and disrupting their work and their lives. The quality of life declines. And then there are the falls. Actually, these are the biggest costs to society. I think the cost of falls by itself is around $3 billion a year, taking into account the cost of fractures and hospitalizations.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Dr. Hu, for bringing out the human costs, which are what profoundly matters.

Dr. Krewski, you wanted to pick up on that?

[Prof. Daniel Krewski]

I liked your characterization of the magnitude of the problem that's facing us now and a decade or two from now.

If we're spending $15 billion a year to treat neurological disorders in the broad sense, and $5 billion of that is due to Alzheimer's alone, and if that multiplies by a factor of ten over the next two decades, can we afford it?

[Kirsty Duncan, Liberal, Etobicoke North, ON]

You're absolutely right, and worldwide this is a major concern. Governments around the world are preparing for this. The Rising Tide report came out a year ago, but the WHO released a report at the end of March saying we can't afford it.

[Prof. Daniel Krewski]

It's the same story everywhere. Everybody is coming to the same conclusion. What we have here is a disaster in slow motion. Imagine if you were to invest $10 million a year for five or ten years, $50 million to $100 million, and you could reduce a significant chunk of this neurological public health burden. What a huge success. What a huge return on investment. What a huge trade-off in benefit and risk.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Dr. Krewski, I agree wholeheartedly.

What would be your recommendation to the committee? What would you like to see in the report?

[Prof. Daniel Krewski]

I like your suggestion of trying to stimulate the research community to help find new ways to address this public health problem. You had asked us for some ballpark figures. I threw out a figure of $5 million. I'd rather see that at $10 million a year for five to ten years.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

On the centre of excellence, is it $200 million or $300 million that we need in research? If we're looking at costs of $15 billion now, then $153 billion, what is the amount that we need to invest?

[Prof. Daniel Krewski]

Probably anybody who's an active researcher will say more is better, but we have to be practical and compare it with other major crises that we're facing.

Ted, would $10 million a year for five to ten years help you make a difference?

[Dr. Edward Fon]

I think that would be a start. If you look at funding in Canada for basic research, we're really lagging. Per researcher, per capita, the National Institutes of Health spends about five times more for basic research than the equivalent in Canada, than the CIHR.

We make up for it by having these different streams, for instance these networks of centres of excellence. Given what you've just said, which is that—

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Fon.

We have time for one more now. Do you have one, Ms. Davies?

[Libby Davies, NDP, Vancouver East, BC]

Just very quickly, in terms of this massive study that's being undertaken looking at all the different research—I think you said globally, Dr. Krewski, and I think you said it would be completed in March 2013, and I don't know how long your funding goes—what is anticipated after that, in terms of follow-through, particularly from a funding point of view? How does that keep up to date?

I have the sense that things are moving quickly, that there are new developments, although I don't know that because I don't have it relative to any other either neurological or other diseases. You gave the impression that things are moving quickly.

How do we actually keep up that data? Maybe by next year there will be a whole bunch of things, and by the time you've caught up there will be new things happening. So could you tell us what the follow-through is?

[Prof. Daniel Krewski]

I'm going to say something very brief, and then I'd like Joyce to maybe expand on that.

This is part of a very well thought through initiative started jointly by the NHCC and the Public Health Agency of Canada. We had three years of funding for 18 projects. Mine is just one. Another was how the incidence and prevalence of these diseases vary by geographic area. Others focus on the delivery of health services.

The idea was that at the end of that period to collectively take stock of what we've learned and then take some steps towards trying to develop an evidence-based strategy to deal with neurological disease in Canada.

That is where I would like to pass the ball to you, Joyce.

[Joyce Gordon]

I just wanted to clarify some of the timeframe. The reports will all be completed by March 13, 2013, but there will be a synthesis event where we will bring together all the researchers to share their findings and to look at commonalities, and what key findings may be.

Then there will be a consensus conference, which will engage stakeholders. The anticipation is that the report will be tabled with the minister in March 2014. That will be the final report.

That in itself will be extremely helpful. I just want to confirm what you've said, that the intent then would be.... Well, not then; we need to have that planning now. We need a strategy in place that would be based upon the evidence and facts presented in that report, and should have some very clear directions about where the best investments could be.

The challenge with it is that if we wait until then, it may be too late and we may have a report that may sit and not have implementation. We would like to see a concept around a national brain strategy being thought about now, and plans starting to be put in place on what would be the legacy. The second part would be to ensure that neurological diseases are included in the surveillance system within the Public Health Agency. It's started on that path, but that would ensure the continuity of gathering some of this information on an ongoing basis. That would be one legacy that would be quite incredible, if we could ensure that would happen.

[Libby Davies, NDP, Vancouver East, BC]

Is there more time?

[The Chair, Conservative, Joy Smith]

You have one minute.