Evidence of meeting #42 for Health in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was know.
A video is available from Parliament.
November 20th, 2014 / 11:05 a.m.
Conservative
The Chair Conservative Ben Lobb
Good morning, ladies and gentlemen. Thank you for all being here today.
We're looking at the supplementary estimates (B).
We're happy to have the minister here today and all of her officials. I thank the minister for taking the time out of her schedule today.
Do you have your prepared statement ready, Minister?
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
Thank you, Mr. Chair.
It's great to be here in front of the health committee.
I want to start off by thanking you for all of the good work that you're doing. Thank you for the invitation to discuss supplementary estimates for the health portfolio.
We have a number of officials here that many of you know already: Alain Beaudet, from the Canadian Institutes of Health Research; of course, Bruce Archibald, who's here from CFIA; George Da Pont, our deputy minister from Health Canada; Gregory Taylor, our chief public health officer; and Krista Outhwaite, our newly appointed deputy minister for the Public Health Agency.
I'm going to provide just a short update to committee members on Canada's response to the Ebola outbreak in West Africa, as that I believe would prove helpful to all of you.
As many of you know, this outbreak is the most severe and complex the world has seen in 40 years of combatting the virus. The humanitarian, social, and economic impacts will be felt long after the virus is contained. Canada has been at the forefront of the international response to this outbreak, and has been since April. We are contributing funds, expertise, and equipment. To date we have committed over $65 million in health, humanitarian support, and security interventions. I'm pleased to report to the committee that 57 million dollars' worth of this funding has now been disbursed. This funding has gone to support the United Nations, the World Health Organization, UNICEF, and many others to improve treatment and prevention, improve health capacity, save lives, and support the basics such as nutrition.
Our efforts are directed at bringing an end to this outbreak, treating patients, assuring the availability of essential services, preserving stability, and preventing outbreaks in surrounding countries.
We've also now donated and delivered over 2.5 million dollars' worth of personal protective equipment to West Africa that was requested by the WHO, including 1.5 million pairs of gloves, two million masks, over 480,000 respirators, and over 1,000 beds and blankets. The Public Health Agency also has deployed our mobile laboratory again to Sierra Leone to provide rapid diagnostic support and infection control testing, and we're currently awaiting further direction from the WHO on where our second mobile lab can be deployed.
In addition to Canada's invention of an experimental Ebola vaccine, which is currently undergoing clinical trials, we've generously donated the Canadian Ebola vaccine, in the amount of 800 vials, to the World Health Organization in Geneva. This vaccine is a fine example of Canadian scientific innovation. It's our hope that if found to be safe and effective, it will be used in West Africa to help stop this outbreak.
To support this goal, we've recently launched a Canadian phase one clinical trial for the vaccine, led by the Canadian Immunization Research Network in Halifax at the Canadian Centre for Vaccinology in the IWK Health Centre. This trial will support concurrent trials elsewhere in the world by determining if lower dosages could be just as effective as higher ones, potentially multiplying the amount of doses in each vial. While there has never been a case of Ebola in Canada, we must of course continue to be prepared and take every precaution necessary.
I've now spoken with health ministers from across the country several times and we've held, I think, three meetings. Our chief public health officer is in regular contact with medical officers in provinces and territories, I think now meeting almost twice a week for a number of months. In the event of an Ebola case, the Public Health Agency is ready to support the provinces and territories by deploying our Ebola rapid response teams. These five teams are made up of a team lead, a field epidemiologist, an infection control expert, a biosafety expert, a laboratory expert, a communications expert, and a logistics expert, and they would be deployed immediately to support any local public health systems that would need our support.
Transport Canada is also supporting the Public Health Agency by having planes readily available to deploy at a moment's notice. These planes are also stocked with emergency supplies, including protective equipment, like masks, gloves, and gowns. Our government is also providing additional funding to support Ebola preparedness and response capacity here in Canada to further support the provinces. This includes, of course, the $27.5 million that will be directed towards domestic preparedness. This amount includes just under $25 million to support further research and development of Ebola medical countermeasures. This means more money for research of the Canadian Ebola vaccine and monoclonal antibodies.
Funding has also been set aside to support infection control training and equipment, and to deploy additional quarantine officers at Canadian airports.
We've also launched an online Ebola information campaign designed to help raise public awareness about the disease and its risks, through social media such as Facebook and Twitter. As we combat the disease, we need to fight the stigma around it. Canadians need to know the facts about Ebola, how the virus is transmitted, its symptoms, and any other information that will help them manage their fears of contracting this disease.
Of course, we are making a strong contribution to international efforts abroad and working together to prepare here at home. We are strengthening coordination across the federal, provincial, and territorial governments, and other important agencies, and doing everything possible to protect Canadians and fight the disease.
On a different subject, I'd like to commend and thank all of you for your thoughtful study of Bill C-17, Vanessa's Law. In addition to the many months of consultations—
Conservative
The Chair Conservative Ben Lobb
Excuse me, Minister, I've just had a request that you slow down a bit.
Conservative
Conservative
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
In addition to the many months of consultations that we held with Canadians, this committee's careful review of this bill contributed to the successful passage of Vanessa's Law. I feel that we've made very real progress in the last year on improving public health and safety, and nowhere is this more apparent than with the royal assent of Vanessa's Law. Vanessa's Law contains some of the most profound changes to the Food and Drugs Act in more than 50 years. It's truly an historic step in our government's continuous improvements to patient safety, especially over the past several years.
Thanks to the hard work of this committee, and Vanessa's Law, Canadians can have renewed confidence that the medicines they are using are safe. As Minister of Health I now have the powers to recall a drug and take it off store shelves when it's not safe. For the very first time, serious adverse drug reactions and medical device incidents will have to be reported by health care institutions. As well, as you know full well, courts can now impose penalties on drug companies that include up to $5 million per day or jail time for distributing unsafe products. Also, we can compel drug companies to revise labels so that they clearly reflect health risk information, including updates for health warnings for children. We can direct companies to do further testing on a product, including when issues are identified with specific at-risk populations such as children.
Many of these new powers came into effect with the royal assent of Vanessa's Law, and we are moving quickly to put regulations in place to support other powers, such as the requirement for all authorized clinical trials to be registered, and some elements of mandatory adverse reaction reporting for health care institutions.
Canadians need access to information, especially when it comes to their health, and beyond Vanessa's Law we've made great progress in increasing transparency through Health Canada's regulatory transparency and openness framework and action plan. For example, Health Canada has begun to post summaries of drug safety reviews that both patients and medical professionals can use to make informed decisions. Patients can also check the clinical trials database to determine if a clinical trial they are interested in has met regulatory requirements. These concrete initiatives are making more information on departmental decision-making and results available to Canadians in an easy-to-understand format. More can always be done. I have asked my officials to accelerate the implementation of the transparency initiative.
I would also like to congratulate this committee on your report on the serious health risks and harms of marijuana. As this committee noted, smoking marijuana has serious health risks for youth. As many of you know, Health Canada launched an awareness campaign aimed at educating parents on how to talk with their teenage children about the dangers associated with prescription drug abuse and smoking marijuana, in line with recommendations included in your report. Television ads began airing in October focusing on the developing brains and bodies of teenagers and how marijuana use, as well as prescription drug abuse, can cause permanent damage to their development and put educational achievement and long-term mental health at serious risk.
The department developed web and social media content as well on the dangers associated with marijuana and prescription drug abuse in order to encourage parents to get the facts, and tips on how to speak with their children on drug use and abuse. As this committee will know, our government has also committed almost $45 million over five years to expand the national anti-drug strategy to now also include prescription drug abuse. The many dangerous and unpredictable consequences of drug abuse make this a very real and widespread public health issue, and no one feels that more acutely than Canadian families.
Over the past year I've met with health officials, physicians, pharmacists, first nations representatives, law enforcement, addiction specialists and medical associations to discuss how we can collectively tackle prescription drug abuse. I've issued a call for proposals to seek new ways to improve prescribing practices for opioids and other drugs that pose a high risk of abuse or addiction. Additionally, we are now providing funding to build on initiatives to support research on new clinical and community-based interventions for preventing and treating prescription drug abuse.
I'd like now to turn to innovation in health care, Mr. Chair.
As you know, Canadians benefit from a system that provides access to high-quality care and supports good health outcomes, but with Canada's aging population and a growing burden of chronic disease, we know we need to accelerate the pace of change. That's why I launched the advisory panel on health care innovation back in June. It's headed by Dr. David Naylor and this panel has truly hit the ground running.
The panel is consulting broadly across Canada, identifying promising areas for innovation, and determining how the federal government can help accelerate that progress. In fact, the panel is eager to hear from Canadians from across the country in an online consultation that runs until December 5. I anticipate the arrival of the final report by the end of May and I look forward to sharing this information with members of this committee.
Mr. Chair, Canadians expect their federal government to play a major role in sustaining our high-quality health care system. Today, I want to reinforce that our government is at the table and we want to make sure Canadians have the highest level of care.
Once again, thank you for inviting me to be here today to speak with you. My officials and I are pleased to take any questions that you may have.
Conservative
The Chair Conservative Ben Lobb
Thank you very much, Minister.
The first round of questioning will start with Ms. Davies. You have seven minutes. Go ahead.
NDP
Libby Davies NDP Vancouver East, BC
Thank you very much, Chairperson.
Thank you to Minister Ambrose for appearing before our committee today as we deal with the estimates.
Thank you to the officials who will be here.
Minister, I know you're here only for an hour so obviously we want to ask as many questions as possible. I'm glad that you began your comments with an update on the Ebola situation because I do think that has been a very urgent matter and as you know, we've raised it in the House a number of times with you and also with the parliamentary secretary. There have been a lot of concerns about delays from Canada, both in terms of getting equipment and protective gear out the door, and there have certainly been significant concerns around the vaccine. So I'm glad to hear you say today that now $57 million of the federal commitment has actually been disbursed.
I do want to come to a question, though, on the vaccine itself. You're probably aware that the contract with NewLink, which is the company in Iowa that received a contract from the federal government in 2010. That's four years ago, and that contract requires the company to commercialize the made-in-Canada vaccine, and within that contract there are specifics that outline that any parking, shelving, or lack of diligently and aggressively commercializing the vaccine is considered to be a fundamental breach of contract.
The question that I have is whether or not you as the minister, or the federal government, have given notice to NewLink Genetics outlining the concerns that many Canadians have—certainly we have—with the apparent parking of the vaccine development over the last four years, and the lack of urgency this summer to conduct the clinical trials. The contract says that 90 days' notice has to be given for required inactivity to be considered a sufficient cause for termination. Basically we want to know, have you given notice of breach of contract? Have you been seeking alternate sources to ensure that this vaccine is commercialized, given that now we're looking at four years since this contract was initiated?
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
First of all, I think we're all very proud that Canadians and Canadian taxpayer money has paid for the research over 10 years to develop this vaccine. As you know, this outbreak has become urgent in the last year. I have absolutely no evidence that there is any lack of urgency around commercializing this vaccine. In fact it's the opposite. I've asked many times. I received very clear reassurances—and I'll be happy to allow Dr. Taylor and Krista Outhwaite to speak to this—that this process is moving at an unprecedented pace.
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
The words that have been shared with me are that the international community has been brought to bear to support the rapid commercialization. Let's remember this is an experimental vaccine. We are in phase one clinical trials. We're still testing for safety and efficacy. Let's hope that it is safe and that it is able to be deployed quickly once we do know that it is safe to be used.
NDP
Libby Davies NDP Vancouver East, BC
Minister, I think we all share your concerns about safety, so I want to ask you again. You have no concerns whatsoever that this company has been parking or shelving or has lacked any diligence in terms of aggressively commercializing this very desperately needed vaccine, no concerns with the company whatsoever.
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
I'll allow Dr. Taylor to give you as much detail as we're able to give you.
Dr. Gregory Taylor Chief Public Health Officer, Public Health Agency of Canada
I don't think we have concerns with this company. They've been working diligently. Some of the delays have to do with a production process to produce a large amount of vaccine for clinical grade. That took some time. We placed our order with them initially so we would have some vaccine. We just received that batch early this year. I think it was around February, so it took a long time for the production to get going.
As for the clinical trials, I think it's worth remembering that typically this process takes five years or more from the beginning. Prior to this outbreak there had been only 2,500 cases in the world—
NDP
Libby Davies NDP Vancouver East, BC
But they did have the contract since 2010, so that's four years.
Chief Public Health Officer, Public Health Agency of Canada
That's 2010. So it took a long time to get the production facility in place. Once the vaccine was produced and we had some of that early this year, there have been no less than six clinical trials they've engaged with.
They have another manufacturing system on line. They've produced some for this year and there will be some in early March 2015, which could be as many as 100 million doses. We don't know that. We go by vials. We purchased initially 1,400 vials, but with some of the testing in the Canadian clinical trials using a very low dose, as the minister suggested, it could be much longer.
They've invested well over $10 million, and they've leveraged as much as $42 million. million from the U.S. Department of Defense, National Institute of Allergy and Infectious Diseases, etc.
NDP
Libby Davies NDP Vancouver East, BC
Dr. Taylor, perhaps I could just do a quick follow-up to you. As you know, we have the visa ban that was initiated by Canada from affected Ebola countries, and I'd like to ask you as the chief medical health officer for Canada, do you support the visa ban from affected Ebola countries? What evidence supports the decision that was made?
Chief Public Health Officer, Public Health Agency of Canada
The balance we have to take between protecting Canadians and trying to assist and trying to deal with the outbreak is always very difficult to do. It's not an outright ban. It's a pause in issuing new visas. In my understanding there are about 1,700 to 1,800 existing visas that will continue to be valid.
It's very difficult to get exactly the right balance. It's not like it's a border closure; it's a pause in issuing that. My understanding as well is that the—
Chief Public Health Officer, Public Health Agency of Canada
—minister can issue them on an exceptional basis.
NDP
Chief Public Health Officer, Public Health Agency of Canada
Personally I think it's the appropriate balance to take, and yes, I support a very measured approach like this.