Health Committee on June 7th, 2018

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

We certainly recognize that Lyme disease is a public health concern in Canada, and we are taking action on it. You perhaps don't want me to mention the steps that we've taken thus far—

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

—but I want to reiterate that there certainly has been some work done, and there continues to be research in this area. If we look at the infectious diseases and climate change fund, we'll see that it is a $21 million fund that's been set aside over the next 11 years to address the impact of vector-borne, water-borne, and food-borne infectious diseases like Lyme disease. So far, out of that fund, $1.4 million has supported seven research projects in the area.

[Len Webber, Conservative, Calgary Confederation, AB]

I understand that, Minister.

I understand the research and the money that's been put into research, the $4 million. You've indicated that to me in question period.

Minister, as you know, Lyme disease is a growing problem here in Canada; a full 20% of the ticks out there right now are carrying Lyme disease. There are now 10 times as many known cases of Lyme disease as there were back in 2009. Minister, your own Public Health Agency says that known Lyme cases are up 50% from last summer. A 50% increase in one year is a cause for great concern. With Lyme cases up 50% in one year, one would expect that funding would also increase by at least that much, if not more. With the problem up 50%, how much has government spending increased on treatment for patients of Lyme disease?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

As you're very well aware, the direct treatment delivery model is provided by provinces and territories. We provide funding through our health transfer payments with respect to that. With respect to the work that is being done, we are absolutely supporting provinces and territories through our federal laboratories to make sure that the detection of Lyme disease does occur. As well, we want to make sure that we have public information and awareness campaigns. We certainly have a huge role to play in that area

[Len Webber, Conservative, Calgary Confederation, AB]

I understand that.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

I am very pleased to say that the 2018 campaign to promote awareness and information about Lyme disease was launched last month. We recognize that spring is here now and we certainly want to make sure Canadians have access to the information. A lot of information has been distributed online and also through Service Canada and Parks Canada.

I may ask my public health officer if there's any more information that she wanted to add, if you would permit her to.

[Len Webber, Conservative, Calgary Confederation, AB]

I would just like to know what we are doing for the Lyme patients who are suffering right now, who have been forgotten in this country. There is no treatment for them and we need to address their huge problem. We've met with you numerous times and the Lyme groups have met with your staff. There just doesn't seem to be anything that you are doing for these patients.

I have a quick question. Of this $4 million that you allocated last year for Lyme disease research, how much remains unspent? Could you answer that?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

I'm going to refer that to my public health officer.

[Dr. Theresa Tam, Chief Public Health Officer, Public Health Agency of Canada]

There are different pockets of funding, if you like.

The $4 million for the research network is still at play, so the discussion on how that spending is going to be done is currently being reviewed and evaluated. That's for our research network. Of the funding that we received under the pan-Canadian framework on clean growth and climate change, there was $20.8 million over 11 years for specific projects that can be played out in the community. We have actually just gone through phase 1 of that funding approach, and we'll be launching more requests for proposals in the future.

As the minister mentioned, of the 13 projects that we've already considered, seven are focused on Lyme disease.

[Len Webber, Conservative, Calgary Confederation, AB]

Is there anything focused on the patient?

[The Chair, Liberal, Bill Casey]

I'm sorry. The time's up. We're beyond now.

We'll move on to Mr. Ayoub.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Thank you, Mr. Chair.

Thank you for being here today, Madam Minister.

You head up an outstanding department and we form a committee that is equally remarkable. Every day we talk about issues that are very important to Canadians. We have conducted many studies and produced various reports pertaining to the health of Canadians.

This morning, I would like to hear more from you about organ donation, an issue that is very important to me. In recent months, I have had the opportunity to become involved in this issue. I have even asked my fellow citizens what concerns they have about organ donation. Their response was incredible and immediate: 90% of people support organ donation. Unfortunately, only about 20% of people have signed the organ donation consent form.

There are major challenges to improve the situation of people waiting for an organ. Every year, there are 4,500 names on the waiting list of people hoping for a better quality of life, and 250 of them die before receiving an organ.

The provinces have a role to play in this regard, but so does the federal government. What nationwide initiatives are there on this issue? What does Canada intend to do to improve the health of Canadians?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Thank you very much, Mr. Ayoub.

Our government certainly understands and recognizes the importance of organ donation in Canada. Personally, I am very interested in the issue. One of our good friends recently had an organ transplant. He now has a new lease on life. It is heartwarming.

Since 2008, provincial and territorial governments have made major investments in this area. For our part, we have invested over $69 million to support Canadian Blood Services. We want to help coordinate interprovincial organ and tissue donations. Further, we invested $100 million in research between 2012 and 2017 to better understand the situation, the issues, and the challenges.

Finally, to coordinate our approach on this file, we continue to work with the provinces and territories. We know we have to work very closely with them in order to be in a better position to develop our strategy and move forward.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Thank you.

Clearly, efforts have been made and measures have been taken, but there is still a lot of room for improvement. We can do more. That is why I will be tabling motion M-189, to help people who are suffering and whose quality of life could be improved through organ donation. Thank you for your answer. We are expecting a bit more. Perhaps this motion will lead to additional measures.

On another important matter, something happened in Quebec recently that has had a major impact on the rest of Canada. I am referring to the young Athéna Gervais, who unfortunately lost her life. We have considered the issues related to beverages with a high sugar and alcohol content. We heard from witnesses at this committee. The availability of these beverages appears to be a major problem. In many cases, they are available and in full view. These young people were simply able to take them, or steal them in this case, without any monitoring.

What is the federal government doing to reassure the public and, in this case, to keep young people safe?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Thank you for your question.

Once again, I want to thank the Standing Committee on Health for your work on this issue. What the family of Athéna Gervais went through is clearly serious and one death is one too many. This raises serious concerns. That is why we took immediate action. We asked for a notice of intent to be published, which was done in March, to amend the act in order to limit the amount of alcohol in these sweetened beverages. Further, we are working closely with the provinces and territories on the regulation of alcohol. We have already held a teleconference with those officials to continue the discussion.

Be that as it may, let me clearly state that these beverages, which were in stores and were consumed, will no longer exist in the same form. We want the alcohol level to be reduced or, at least, for the containers to be changed to prevent this kind of thing from happening again.

[The Chair, Liberal, Bill Casey]

Thanks very much.

We have to move on to Ms. Gladu.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Thank you, Chair.

My first question has to do with the new drug approval process.

I was at a forum at the Macdonald-Laurier Institute where there were a lot of stakeholders—industry, academia, policy people—talking about the PMPRB changes. They indicated that these will have huge unintended consequences. These will likely eliminate clinical trials in Canada, and companies will decide not to market new medicines to Canada. With this process, the changes are going to make it longer and more expensive for people to bring drugs here.

I see that there is money allocated in the estimates for changing this process.

Will the minister consider abandoning these changes based on the input from the industry, academia, policy, and other stakeholders?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

As I've indicated a few times today, we certainly need to do all we can to bring down the prices of drugs. That's why we're in the process of modernizing the PMPRB. Our officials have met with several individuals in this area, and they've shared their points of view with us.

We recognize that there are different ways we can fund research as well. We are looking at all options. However, at the the end of the day, we certainly want to make sure, as government, that we update the regulations, and we certainly have to look at doing things differently. PMPRB has not been updated, I believe, in 20 years or even longer, so we certainly recognize that we have to do some work in that area. We're looking forward to consultations, and we continue to have an open dialogue with those involved.

Perhaps my deputy minister would like to add a few comments on that.

[Simon Kennedy]

One thing that has perhaps received a little less attention than the proposed regulatory reforms to the Patented Medicine Prices Review Board is the significant changes that are happening in the health portfolio around how drugs are reviewed and approved. A key objective is to streamline and make it faster for valuable new medicines to get to market. We're working quite closely with the industry on that. I'll just give you an example.

We want to provide new pathways to market that might rely more extensively on reviews that take place in other jurisdictions. If a new drug comes out, and it's clear it has tremendous benefits for patients—maybe it saves the health system money—if our major partners abroad have already reviewed and approved it, we're looking at whether we could use that as a basis to expedite getting it to market. Industry is very interested in some of these new regulatory pathways. While pricing, obviously and understandably, is getting a lot of attention, we're doing a lot of other things to try to make it easier and faster for valuable medication to make it onto the Canadian market.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

I think it needs to be faster, and we need to make sure we're continuing to have access to new medications.

I heard the same concern about the medical devices special access program, especially the regulatory burden this will put on smaller entrepreneurs that are introducing medical devices into Canada. It might limit the number of new devices we would see. Could you comment on how you might be able to change that process to not put such a regulatory burden on small companies?

[Simon Kennedy]

Very briefly, Mr. Chair, there has been a little confusion around the medical device single audit process. Canada has a mandatory system for these kinds of audits. The updated process will be mandatory, but the old process was mandatory as well. The government is not imposing something that was not a requirement all along. The new system is one where the audit process is going to mimic those in a number of our trading partners. Larger manufacturers of medical devices have said that they value this because, once they get an approval in Canada, that approval will be valid in a number of other jurisdictions. We're taking a process that used to be Canada-specific, and are now making it such that if you get an approval, you can use it in other jurisdictions. For certain firms it results in a reduction in red tape.

We have heard concerns from SMEs and others that the new process is more complex. Health Canada is very sympathetic to those concerns. We are quite keen on addressing them. The intention here is to introduce a program that will be of value, and so we're in active conversation with SMEs and others to see how we might make adjustments.

[The Chair, Liberal, Bill Casey]

We'll go to Mr. McKinnon now.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Thank you, Minister, for being here.

I'm going to switch gears and talk about antimicrobial resistance.

As you may recall, this committee did a study on antimicrobial resistance and released a report quite recently.

The prevalence of microbes that are becoming resistant to our pharmaceuticals, our antibiotics, is a major issue. It's an emerging issue around the world. Effective antibiotics are critical to much of modern medicine, such as major surgeries. One of our recommendations was for a national surveillance system. I recently had a delegation in my office from some health care agencies who were asking specifically for that.

I'm wondering if you can speak to any actions that might be under way toward a national surveillance system for antimicrobial resistance.

Also, I'm interested in whether incentives and perhaps research money are available for the development of new vaccines, which is becoming ever more critical as we go forward.

Thank you.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

I also want to again thank the committee for the work that you've done on the issue of AMR, and we certainly look forward to responding to your recommendations very soon.

We recognize that antimicrobial resistance is an absolute global health issue. I can say that at every international meeting I have attended, the issue of AMR has come up with all health ministers. It's certainly an area of top priority for all levels of government, both here in Canada and abroad.

We've made some investments with respect to the global health issue. To support global efforts in the area of antimicrobial resistance, $9 million has been set aside or invested. We're also investing approximately $107 million for research and innovation in Canada on this very important issue. It's really important that we understand the challenges, but we also want to look at how we can address these challenges, so significant monies have been put aside in that area, as well.

The federal government is taking a leadership role in working with provinces and territories in this area. Presently work is under way to develop an action plan to identify concrete deliverables on how to effectively deal with AMR in Canada and abroad.

It is certainly a very active file and one that is absolutely a priority for our government. I know that for Dr. Tam and her colleagues internationally, it's at the top of the agenda at every health meeting we attend.