Health Committee on Dec. 7th, 2017

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

Thank you, Minister.

Health Canada, Canadian Institutes of Health Research, and the Public Health Agency of Canada are requesting approximately $11.8 million in supplementary estimates (B) to support the Canadian drugs and substances strategy, which will support harm reduction activities, public education, expansion of drug science, monitoring activities, and research.

Can you explain why there is a need to expand drug science and how it will be expanded as a result of these funds?

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

Absolutely. I'm very pleased to take this question.

Having been in Alberta not that long ago, we were able to meet with many individuals, especially individuals with lived experience. They shared with us their personal stories and their challenges, but also what worked and what didn't work for them. With respect to the investments that we're making in health research, we really want to look at pilot projects or programs that are happening on the ground and from there, to find out what the best practices are. If we can learn from those best practices, we may be able to adapt them in other parts of the country.

It's truly important to ensure that we get the data because if we don't have a scope of the situation, we're certainly not going to be able to effectively deal with it. Investing in research is paramount and it's certainly a priority of our government.

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

Thank you.

Under the Canadian drugs and substances strategy, what proportion of these funds will be made available to support increased availability of treatment options?

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

For the strategy itself, $100 million has been earmarked. With respect to the actual breakdown, I may defer that to Mr. Kennedy.

[Simon Kennedy]

Regarding the additional funding coming in this year for the drugs and substances strategy, we have a program called the substance use and addictions program, which has funding of about $28 million a year. There is additional funding that comes in over the next number of years, as part of the strategy, to top up that program.

On top of the existing dollars, which are permanent this year, the additional funding is $2 million, with another $2 million next year, and then an additional $3 million ongoing. Through that program, that's extra money that we'll be putting out for piloting innovative treatment projects.

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

Thank you.

[The Chair, Liberal, Bill Casey]

Your time's up.

Minister, are you good for another round of questions?

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

I've just been told I have another—

[The Chair, Liberal, Bill Casey]

You were to be here until 4:30. That was our understanding. It is 4:30.

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

If I receive another invitation, I'm more than happy to come again.

[The Chair, Liberal, Bill Casey]

All right.

Thanks very much for coming. We appreciated your answers.

We'll go to Mr. Van Kesteren, for five minutes.

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

Thank you, Chair.

I'm sorry to see the Minister go because I had some really important questions for her.

I wanted to talk about Bill S-5 and the plain packaging. I sometimes wonder who would want to smoke when they see the proposed new packaging. It's a great approach. I think it has been effective. I think we have done a great job as a society to reduce the harm in smoking.

In light of that, I'm wondering if Health Canada is going to do the same thing with the marijuana packaging. One of your own Health Canada reports states quite emphatically that no one under the age of 25 should use this product.

Would that be part of the new packaging we will be seeing when marijuana is put out for public sale on July 1, 2018?

[Simon Kennedy]

This is one of the areas where we are out for consultation right now. We put out for discussion a fairly detailed regulatory consultation paper about two weeks ago, and the consultations will proceed until late January. There's a lot of detail in there about what the government has suggested as the restrictions that would be placed on marketing and advertising.

Generally the intention and the scheme that's laid out in the proposed paper is to take a fairly strict approach to marketing and branding and so on with cannabis. Certainly there would be extraordinarily strict provisions for people who are not of legal age to consume it.

The details are in the paper. At this point, obviously, we haven't gone out with final regulations, but that's part of what we're talking about to Canadians and the industry and others.

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

Will some of that packaging warn about driving once somebody has smoked marijuana?

[Simon Kennedy]

I don't want to get out in front of the government, but the intention is to have appropriate warning labelling, if you like, health information and so on. That would be a requirement that would accompany the sales of these products.

Again, there is going to have to be consultation, sir, before that's finalized, but the idea would be to make those kinds of warning messages available as part of the packaging.

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

Will there be a direct effort to get this out of the hands of teenagers or younger people because that same report that came from Health Canada states that the younger the smokers, the more likely they are to become addicted to it?

Will that be part of the packaging as well?

[Simon Kennedy]

I think the general intent of the regulatory scheme and the work that Health Canada is certainly doing in partnership with other departments to get ready for the legalization of cannabis is that all of this is being undertaken with a public health approach in mind. Our organization is certainly well aware of and seized with the research around the potentially deleterious effects on young people.

If you take tobacco as a good example, there has been very good success over the last 20 years through a strict regulatory approach of driving down usage rates quite substantially to the point where you see instances with young people where the usage rates of things like cannabis are now higher than the usage rates of tobacco.

To be quite frank, our hope would be that a very strict regulatory approach, with the kinds of restrictions we're talking about, would render it more difficult for children and youth to get access to it, with the objective of driving down usage rates.

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

Will you disallow cannabis marketers to target younger users as has been done, and rightfully so, with cigarettes as well? Will that be part of your focus as well?

[Simon Kennedy]

It might be prudent to offer the committee that we could provide a more detailed written response to your questions. It's not to dodge the question, but I think it almost merits a more detailed response than I feel confident to give.

The very clear objective here is to strictly prohibit and avoid directing this kind of stuff at people who are not of legal age. Where that age—19, 18—has been fixed by law by a provincial jurisdiction, below that there would be very strict prohibitions and efforts made to ensure that product does not make it into the hands of those young people.

It might be useful to come back with a little more verbiage than I could give in this discussion.

[The Chair, Liberal, Bill Casey]

Your time is up.

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

You're very strict with me, Mr. Chair.

[The Chair, Liberal, Bill Casey]

You're beyond, but not as far as some others.

Now we'll go to Mr. Oliver.

[John Oliver, Liberal, Oakville, ON]

Thank you very much.

My first question is around health research and whether we are making adequate investments in health research and support to CIHR. We've heard from virtually every study we've done that research is required. On antimicrobials, we heard how important it was. Because the pharma companies were not investing in that, there had to be investments made for antimicrobial research. On the cannabis bill, we heard about the need for research now around cannabis, its health effects, and the longer-term consequences of it. On the opioid study, we heard from virtually every person that there was a need for treatment, and research into treatment protocols and directions, yet I didn't see where you sit on research, Mr. Kennedy and Mr. Perron.

Do you feel that CIHR is adequately funded? I have to say that the majority of groups that come to see me do not feel that there are sufficient funds through CIHR and the other granting bodies to cover the degree of research that's needed.

[Michel Perron, Executive Vice-President, Canadian Institutes of Health Research]

Thank you, Mr. Oliver, for the question.

Clearly, with regard to the supplementary estimates that this committee is examining, we were delighted to receive an additional $5 million, which has gone to some of the items that you indicated. One is the funding for the Canadian drugs and substances strategy, which the deputy referred to earlier. This is very much to address many of the issues specific to the opioid crisis.

This is in addition to our annual grant funding level of approximately $1.1 billion in available authorities. This is a significant amount of money that we try to invest as wisely as possible, given the very significant expectations and pressure on health research generally in the area of antimicrobial resistance that you referred to. For instance, in the past five years, we've spent well over $100 million in AMR research, an average of $22 million a year. We work very closely with the Public Health Agency and the like.

With regard to opioids, I would just indicate that many of the investments recently—whether through the Canadian drug strategy or our funding more generally—are to provide clear evidence of what works best in what setting and to provide the direct kind of clinical guidance required for clinicians and first-line providers to ensure that those efforts are well done. For instance, there's a study under way right now to evaluate models of care. Is it methadone or—

[John Oliver, Liberal, Oakville, ON]

I understand that some research has been done.

Correct me if I'm wrong, but I think the overall transfer to CIHR is about $1 billion, and you had a $5-million increase. Is that about right?