Health Committee on Nov. 25th, 2013

[Libby Davies, NDP, Vancouver East, BC]

Okay.

I'd just like to ask some questions about the very major changes that are going to take place to the medical marijuana program, which are going to come in next March.

I don't know about you, but we've had lots of emails from people. There are a number of concerns, but the ones that hit the top of the list are these: first of all, the new program will eliminate personal production; second, there is a lot of concern about the cost going from $1.80 a gram to $5 a gram and up to $8.80 per gram; and third, what have commonly been referred to as the compassion clubs or the community-based dispensaries are completely knocked out of the new system.

I just wonder if any of the officials here today can comment on why the decision was made to eliminate personal production, particularly for low-income people. As well, why was the decision made to, in effect, eliminate the community-based dispensaries that do have their own association, they have quality control, and they're very professional about what they do? It seems a shame to waste the expertise, the knowledge, and the local access they've developed, basically putting patients first. We're going to lose that under this new system.

[George Da Pont]

Again, let me offer a few comments on that.

The reason that a new approach was taken and a new program was put in place is because the existing model of personal production had very significant diversion from its intended purpose. And both municipalities and law enforcement were raising significant issues.

We very much realize the importance of having access. We believe that with the new system, which will be based on licensed producers, which will also have strong quality control processes in place that will be subject to regular inspection and will have careful tracking, we'll find that appropriate balance between ensuring that people have access to marijuana for medical purposes, but also taking into account the legitimate public safety and community concerns that were raised.

In terms of your question on price, it remains to be seen how that works out in terms of the marketplace. But what I can say is that the existing program right now is very heavily subsidized.

We believe the new program will be a significant improvement.

[Libby Davies, NDP, Vancouver East, BC]

Could I interrupt? Apparently there was an application made in Canada for the RU-486. There was an application made, so maybe you could check that.

[George Da Pont]

I will double-check that, because the information I received was the opposite.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

If there is, there is, and if there isn't, there isn't. But if there is, please forward it to us.

Thank you, Ms. Davies—

[Libby Davies, NDP, Vancouver East, BC]

Could we ask Mr. Da Pont if he would get back to the committee about whether or not there is an application? Thank you.

[The Chair, Conservative, Ben Lobb]

Yes, I'm sure he will.

[George Da Pont]

Yes, I certainly will.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

Next up for our next round is Mr. Dreeshen, please.

[Earl Dreeshen, Conservative, Red Deer, AB]

Thank you very much, Mr. Chair.

I welcome our guests today.

As a food producer, I'm extremely proud of what we've done as far as ensuring food safety goes. Certainly, we're world renowned for what we do. We've been involved with ParlAmericas and in discussions with Central America and South America in talking about food security and food safety. Of course, they look to Canada as a model.

But we still need to remain vigilant. Of course, food safety is important to all Canadians, and just as it's important that Canadian consumers remember their lessons from home economics class on proper food preparation, it's also important that those companies that handle our food prioritize food safety as well. So the fact that the Canadian Food Inspection Agency has been transferred from the agriculture department to Health is truly a logical statement. I know that Ms. Fry spoke about that earlier.

Could you comment on the work that has been done so far to improve food safety even further?

[Dr. Bruce Archibald, President, Canadian Food Inspection Agency]

Thank you for the question. There are a number of areas in which I think the government has made some significant investments in terms of improving Canada's overall food safety system, which, as you mentioned, is already highly regarded throughout the world.

I think some of the more recent investments that have been announced, coming out of a review of various programs, include the establishment of inspection verification teams that are going to help us improve the overall performance of Canada's entire food inspection system. This allows us to establish various teams across the country to move in and work on evaluation and ensure that the system is actually meeting its various objectives, and to continue to make investments to look at Canada's overall prevention and detection of food-borne diseases through our listeria response to the Weatherill report in terms of inspection in various areas.

We've also continued to make investments in the meat area, with a daily presence of inspectors in all our federally inspected meat facilities, to ensure that we comply not only with our own requirements, but also with international requirements that facilitate trade.

As well, we continue to work with Health Canada and the Public Health Agency of Canada to improve detection of and response to food-borne outbreaks.

As you mentioned, I think there has always been good cooperation between the agency and the department and the Public Health Agency. I think these new reporting relationships actually allow us to strengthen that going forward in terms of our cooperation and working together.

Those are just a couple of examples of areas where we continue to make investments to further strengthen the system.

[Earl Dreeshen, Conservative, Red Deer, AB]

We've heard comments about some dollars coming out of CFIA when they were talking about food inspectors, but of course it had nothing to do with that. There was actually an increase in food inspectors and millions of dollars in new funding in order to help and prepare, so some of the things we heard from other sides have perhaps confused the issue.

Could you expand somewhat on the Safe Food for Canadians Act and the things that are happening there? I see a lot of that included in this brochure the minister presented to us, and of course this is something that many Canadians should take a look at. As I say, it's going back to what you should have learned in your home economics classes about how much you cook your food and the cleaning of the food and so on. I think that's important.

Could you expand upon that a little and give us a bit of an idea about what this brochure is and what it does to help Canadians?

[Dr. Bruce Archibald]

Yes, absolutely. I'm going to ask my colleague Paul Mayers, who is our associate vice-president in policy and programs, to expand a bit on that.

[Paul Mayers, Associate Vice-President, Programs, Canadian Food Inspection Agency]

Thank you very much for the question.

As the minister noted in her remarks, the framework focuses on promotion, prevention, and protection. Those three elements together reflect the work of not just the Canadian Food Inspection Agency but our colleagues in Health Canada and the Public Health Agency of Canada, in terms of an overall focus on strengthening Canada's already excellent food safety system.

In the context of the Canadian Food Inspection Agency, as we look across that framework, one particular area that I'll draw attention to is the Safe Food for Canadians Act and the work we're doing currently under the action plan to bring the legislation into force.

We've undertaken a significant consultative effort with Canadians around improvement, and a centrepiece to that is an improved food inspection system. Even though the food inspection system in Canada is strong, we recognize that there are opportunities to further strengthen that system to enhance the tools available to our front-line inspection staff, to ensure we have an integrated approach to information, to strengthen the support for our front-line staff in terms of decision-making, and to strengthen the risk basis for our system.

We're very proud of founding our decisions on science. We're building on that by introducing a strengthened focus on risk to guide the application of our inspection resources, so they have the greatest impact as we undertake our business in order to provide that protection for Canadians.

[The Chair, Conservative, Ben Lobb]

Thank you, Mr. Mayers. Thank you, Mr. Dreeshen.

Next up we have Mr. Aspin, for five minutes, please.

[Jay Aspin, Conservative, Nipissing—Timiskaming, ON]

Thank you, Mr. Chair.

Welcome to our guests today.

I'd like to pursue a few questions with regard to CFIA, so I guess they would be addressed to Mr. Archibald and/or Mr. Mayers.

CFIA's authorities to date are just under $720 million, and it has requested almost $40 million in transfers and adjustments in these two supplementary estimates. There is about one-quarter of the requested funds, according to the supplementary estimates document pages 2 to 9, that are to go to maintaining an increased frequency of food inspections in meat processing establishments.

When and how did the frequency of inspections of meat processing establishments increase?

[Dr. Bruce Archibald]

There was an international audit done in 2009 that identified a number of areas where Canada was doing inspection in various meat processing facilities for both domestic and international use. One of the audit findings concluded that there needed to be more presence in terms of the facilities to ensure we were meeting all our domestic and international requirements.

As a result of that, there was an initial investment in budget 2010 of $26 million over two years to deal with a daily presence of inspection at all federally inspected meat processing establishments, both export and domestic. We expanded the number of inspectors and supervisors of program specialists and the training related to that. The request in supplementary estimates that you see for this is a continuation of that work, a continuing daily presence for 2012-13, as well as going forward in 2013 and 2014.

The original work was a result of an audit that was done. The government made investments, and part of the supplementary estimates request is to continue that work.

[Jay Aspin, Conservative, Nipissing—Timiskaming, ON]

CFIA is a partner with Health Canada and PHAC in two initiatives listed in these supplementary estimates: enhancing the ability to prevent, detect, and respond to food-borne illnesses; and streamlining government import regulations and border processes for commercial trade. Approximately $15 million is requested in these supplementary estimates for the two initiatives combined.

Could you please describe CFIA's role in these two initiatives?

[Dr. Bruce Archibald]

I'm going to ask Paul to respond to this one.

[Paul Mayers]

Thank you.

Let me start with the second in terms of import control. The focus on strengthening Canada's import controls stems from the interests that Canadians have expressed in greater assurance that foods imported into Canada meet Canadian requirements. So the Canadian Food Inspection Agency has been enhancing its activities in terms of import control as a direct response to that interest expressed by Canadians.

The Government of Canada has invested in CFIA in order to enable that activity, and again, as noted in other areas, the supplementary estimates reflect our ability to continue that work. What we have done with that investment focuses on carrying out blitzes in collaboration with our colleagues at the Canada Border Services Agency, in carrying out targeted activities in response to where we've identified potential areas of risk associated with foods, particularly foods imported from countries whose food safety systems are weaker than our own. Canadians have indicated their interest in this and the agency has responded.

The other aspect that you note, in terms of our investigative capacity in collaboration with our colleagues in the Public Health Agency...it allows us to respond to food-borne illness events in terms of investigation, leading ultimately to the withdrawal from the market of suspect products demonstrated to be associated with such events. These actions, again consistent with the framework the minister has announced, enabled the protection element the minister noted.

[Jay Aspin, Conservative, Nipissing—Timiskaming, ON]

Thank you, Mr. Chair.

[The Chair, Conservative, Ben Lobb]

Thank you, Mr. Aspin and Mr. Mayers.

Next up for five minutes is Ms. Fry.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you very much, Mr. Chair.

I want to go back to a question I had asked earlier. I gather that you didn't have the time to answer it because my time was up.

I don't think I would get disagreement from any one of the officials around the table that in fact if you are going to make good public policy, or if you are going to make any kind of good health decisions, then you have to look at evidence. Evidence drives it all. Outcome drives everything.

I had asked earlier about HAART, the active antiretroviral programs that go on in British Columbia. British Columbia is the only province in Canada that has this program.

It has caused a decrease. If we're talking about outcomes, then, what is it we're seeing in terms of evidence? The evidence is that British Columbia, since it adopted this program, is the only place—the only province, place, anywhere in North America—where the number of new cases of HIV is going down dramatically. Everywhere else, in every other province in Canada, and in the United States, it is going up, remarkably up.

In fact, I would like to tell you that in 1995 there were 18 cases per 100,000 in British Columbia. Now there are six cases per 100,000. That's a huge drop.

In Saskatchewan, for example, there were two per 100,000 in 1995. There were 16 per 100,000 in 2011.

Everywhere, in every jurisdiction, this has been proven to be important. We know that the medication stops the transmission of the virus because the virus is gone. It is not present in the blood.

I would hope that given the cost of taking care of every patient with new HIV, this would become a really important thing for the Canadian government to adopt, or for anyone to keep looking at, when this has been going on now for quite a while in British Columbia.

In fact, Brazil has adopted this policy wholeheartedly. The United Kingdom has adopted this treatment wholeheartedly. France has adopted the treatment wholeheartedly. We also see that the U.S. is already onside to adopt it wholeheartedly.

This should be, as I said, a triumph for Canada. This is a Canadian initiative, done here, built here. We should be proud of this.

No one wants to even speak to the people from the BC Centre for Excellence in HIV/AIDS. Well, no one at the political level; I'm sure bureaucrats have been speaking. What is it that prevents, with such remarkable outcomes, Health Canada from even looking at this in a way that...?

You can say that we're continuing to assess it, but it's been assessed. It's been assessed internationally. Peer reviews have shown that it works. The World Health Organization is saying that everyone should adopt it. China has adopted it, for crying out loud.

I just want to know why, when we could save lives and save costs in the health care system for every new case that we don't get, we are doing this. We could take that money and put it elsewhere in the system.

I just want to understand what is driving the decision to completely ignore and not adopt this when British Columbia is now being asked to international conferences. British Columbia is not Canada, but British Columbia is being asked to come and sit at the table with other nation-states.

Can someone explain this to me?

[Krista Outhwaite]

I'll perhaps just add to my previous response. It's an important question that you're raising.

I would also like to introduce our deputy chief public health officer, Dr. Greg Taylor, who may also wish to make a few comments.

There is no doubt that the work in British Columbia, the work of Dr. Montaner, is very interesting, promising, and is delivering results in that particular context.

I would say to the committee and to the member that we are not ignoring that work, not at all. In fact, it is a topic of discussion not only with our partners in the HIV/AIDS sector, the ministerial advisory committee on the federal initiative, as well as the national partners that we engage with on HIV/AIDS, but also with our provincial and territorial partners.

British Columbia is bringing the concept to the table, and it forms part of the discussion of our public health network council in terms of how to best place this, how to look at this, in the array of responses to HIV/AIDS that this country is undertaking.

As I mentioned in my previous comments, this is also a topic of conversation, as the member has pointed out, at the World Health Organization, the World Health Assembly, and we also looked at it at the International AIDS Conference.

There have been advancements in the area of HIV/AIDS. People who have this disease are living much longer than they used to, and we are encouraged by that. Also, there has been huge progress made in terms of maternal transmission. Fewer and fewer children are contracting the disease.

[Hedy Fry, Liberal, Vancouver Centre, BC]

I'm sorry, Ms. Outhwaite, but I know all this, and I think most of us know that.

I'm saying that this is not simply treatment that keeps people living longer with the disease; this prevents the disease from being transmitted. It would seem to me to be the first thing one would want to do. British Columbia has done it, with the success that I'm showing you here. They have brought down the rate of new cases by 60%. We have 4,000 new cases a year here in Canada. If we can bring that down by 60%, it would be a remarkable thing.