Evidence of meeting #30 for Health in the 43rd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was countries.
A recording is available from Parliament.
11:55 a.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mr. Davies. That ends our first round.
We will now start our second round with Mr. Webber. You have five minutes.
11:55 a.m.
Conservative
Len Webber Conservative Calgary Confederation, AB
Thank you, Mr. Chair. I have a point of order.
MP Davies took all these fantastic questions of mine and asked them, so now I'm scrambling. My questions may not be as fantastic as Mr. Davies' were, so bear with me.
My first question is for Mr. Konyndyk.
You mentioned that you served in the government and led the Obama administration's response to the 2014 Ebola outbreak. In a recent Frontline documentary, you speak about the political pressures public health officials are subject to and the pressure to downplay the bad news.
Canada is a country that is highly integrated and dependent on a close relationship with the United States. What words of advice do you have for us? Can we trust the U.S. government to provide accurate and thorough information to us when we need to make key decisions, such as reopening the border to non-essential travel?
11:55 a.m.
Senior Policy Fellow, Centre for Global Development
Maybe we could go back to the other questions you had. That's a hard question. It's a very important question for Canada and, frankly, it's an important question for the United States.
It is abundantly clear that political pressure is curtailing public health advice from the U.S. government. There's no question. The President himself has effectively admitted it.
The President was asked earlier today if he was kidding when he said the government should slow down COVID testing; and his response was that he doesn't kid.
There is clearly intense political pressure on U.S. public health officials. I still have great confidence in the people of the CDC and the people of the NIH. I think we're not hearing nearly enough from them. I trust what I hear from the CDC, from people like Tony Fauci, but I think you have to triangulate. The CDC is clearly not being allowed to speak in an unfettered way. The last time we heard from the CDC in an unfettered way was late February, when Dr. Nancy Messonnier said there was going to be a lot of disruption to American lives. That so upset the White House that they spent days walking back that comment, but she was of course completely correct.
I would very much like to get back to a point when we can hear that kind of unfettered truth from the CDC again. We haven't heard it in a long time, and they clearly feel very curtailed politically, so I think it's best to triangulate on it. Just to complete the point, you have to triangulate between that and what you're hearing from public health commentators in the U.S. more broadly, and I think that's what the U.S. public is doing right now.
11:55 a.m.
O'Neill Professor of Global Health Law, Georgetown University, and Director, WHO Collaborating Center on National and Global Health Law, As an Individual
Obviously you can see that both Jeremy and I have deep concerns about our own government and how it has handled the situation and how it has muzzled science. There's no question about that, but on the other hand, we also need to express the strengths of the United States. It's not in the White House; it's in civil society, in whistle-blowers, in the CDC, in the NIH, in our community action. I believe we have robust institutions, a robust civil society. We need to remember that President Trump doesn't speak for all America, and there are many sane voices in the United States that we can listen to.
11:55 a.m.
Conservative
Len Webber Conservative Calgary Confederation, AB
Thank you for that.
Mr. Konyndyk, in your closing remarks you talked a bit about international monies not getting to the front lines. Of $2.5 billion, $2 million is going to the front-line organizations. Where is 99% of that money going? Can you give us some clarification, please?
Noon
Senior Policy Fellow, Centre for Global Development
Yes, certainly. It's not to say that the $2.5 billion is not being well spent. It is going to really important work being done by large UN agencies, and some of that gets to front-line local organizations second- or third-hand. The problem is that this shouldn't be the main thing or the only thing. This is a broader critique that I have of the way that humanitarian work is financed, and that's the background I come out of.
The UN agencies do vitally important work, and they're doing vitally important work on this, but they're not the only ones. Making them the principal, almost sole, recipient of humanitarian financing for COVID, which is the habit that the humanitarian system has had for many years and is now being applied to this crisis, is not going to serve us well here.
Usually there's a comfort blanket in giving a lot of money to the UN, knowing it will look after it well. I think it is very important for donors like Canada and the United States to find creative ways and to take some risks they're not used to taking to get money not just to the UN but also to those front-line community organizations that don't normally get direct donor money, that usually have a lot of intermediary layers among them. Those front-line community organizations are going to do really vital work.
In the lesson we saw in Ebola in west Africa, those organizations were some of the most credible, the most persuasive and the most engaged in their local communities. We need to make sure they're getting the support they need from the big, familiar international groups.
Noon
Liberal
The Chair Liberal Ron McKinnon
We go now to Mr. Fisher.
Mr. Fisher, please go ahead. You have five minutes.
Noon
Liberal
Darren Fisher Liberal Dartmouth—Cole Harbour, NS
Thank you very much, Mr. Chair.
Mr. Konyndyk and Professor Gostin, you both said it was a great honour to be here in front of our committee today. I will tell you that the honour is all ours. I thank you for being here today.
When I think of this pandemic, when I think of COVID-19, I think of the faces of public health. I think specifically of the importance of Dr. Tam, of the importance of Canada's relationship with the World Health Organization and of the absolute importance of trusting our experts. With regard to a novel virus, of course we are learning along the way as citizens, as the public and as health experts. I think of the importance of following science and data rather than politics. Personally, I feel that Canadians are very lucky to have Dr. Tam as Canada's chief public health officer.
Professor Gostin, I believe it was you who spoke of public trust and solidarity. How important is it that we continue to trust in science and experts through this pandemic and into the future, assuming there will be more?
Noon
O'Neill Professor of Global Health Law, Georgetown University, and Director, WHO Collaborating Center on National and Global Health Law, As an Individual
I think that's really important. For me, trust in science and public health experts begins with really good health communication. I've been in close touch with the WHO about health communication, because we all know about their advice on masks, asymptomatic transmission and things like that. We're in an evolving science. This is a virus we've rarely confronted. It's really pernicious. It's hard to fully understand.
This is how good public health communication should be: We should, honestly, trust the public. We should be honest with them, tell them what we know and be clear and consistent on that without a political undermining of the science that we know. Tell them what we don't know, because there's a lot that we still don't quite understand. Then tell them what we're doing to find out what we don't know. If every politician and every scientist did that, we would be in such great shape.
You know, the White House at one point in this pandemic asked the CDC, the NIH and others to clear public health messaging with the White House. I would say it should be the exact opposite: Politicians should clear what they say with the scientists. Science is so important, and it's so easy to do.
The media have conspiracy theories. On social media, on one day something is said and the next day something different is said, but we have to rely on science and the objectives of science. Otherwise, we're lost.
12:05 p.m.
Senior Policy Fellow, Centre for Global Development
Can I add something quickly on that?
12:05 p.m.
Senior Policy Fellow, Centre for Global Development
I think communicating uncertainty has been a weakness of virtually all public health authorities in this response. It's a really core part of good public health communication. I think the WHO has not done well enough in proactively communicating uncertainty.
With a novel virus, we don't know everything. At the beginning, we're working from the closest parallels we see. What do we know about influenza? What do we know about SARS? What do we know about MERS? Those are the closest things to this virus, so we'll recommend what we know about those viruses, and then, as we learn more about this one, we can refine it.
I don't think that process was well explained or well communicated. It's really important—this is written into the CDC communications guidelines—to communicate up front the uncertainty, to say that the guidance will change, so bear with us. You will know what we know as we know it.
12:05 p.m.
Liberal
Darren Fisher Liberal Dartmouth—Cole Harbour, NS
Yes. Thank you very much. I couldn't agree more.
So much has been said by both witnesses and members of Parliament about the World Health Organization. I expect that when this is all over, we can have a post-mortem. We can evaluate how we did as a country. You both mentioned how well Canada has done compared with some countries.
Professor Gostin, you said, and I quote, “The WHO director-general must have freedom to act in the best interest of public health and science without political interference.” Do you want to add anything else on that, or to elaborate on that quote?
12:05 p.m.
O'Neill Professor of Global Health Law, Georgetown University, and Director, WHO Collaborating Center on National and Global Health Law, As an Individual
Yes. I said at the beginning I worked with the World Health Organization for a long time. I think a good friend of the World Health Organization is a good friend. A good friend will tell you when you're wrong, but they won't try to blame you, tear you down, defund you, withdraw their membership or get you in the middle of geopolitical struggles between superpowers. That's not what the world needs right now.
We need constructive engagement with the World Health Organization. It's not perfect. We can make it better, but we don't want to tear it down. Anybody who thinks that the solution is to say, “My country would have done great if the WHO had only done this”.... That can't be the real world. Anybody who says we don't need a world health organization.... When you think of not just COVID-19, but polio eradication, safe childbirth, mental health, injury prevention and non-communicable diseases, you see these diseases are still there. We need a WHO to be more robust when we come out of it, not weakened.
12:05 p.m.
Liberal
12:05 p.m.
Conservative
Tamara Jansen Conservative Cloverdale—Langley City, BC
Thank you. It's been very fascinating so far this morning.
I'm going to be sharing my time with MP Webber.
First, what I've heard so far is that we should trust the experts. Regular citizens are kind of like anti-science bumpkins, and they're going to weaken the global order. I really question that premise.
I would like to read to you an email that I received on January 29 from a regular constituent in my riding. He said, “MP Jansen, I'm hoping you can urge the government to have a more serious approach to raising the threat level assessment of coronavirus. I'm a screening officer at YVR. Most of the employees at YVR feel strongly we are not prepared to fight or prevent the spread of the virus. Since Health Canada determines the threat level is low, there are no face masks provided to the employees, and the official language is “not recommended but respected” towards staff's personal choice to wear the mask. We are only told to wash our hands more than 20 seconds but a lot of passengers and some employees don't wash their hands or the soap runs out during peak hours in some of the popular washrooms. Health Canada ensures the public that a healthy person will be safe from the virus by washing their hands and staying two metres away from others.
“Currently that's impossible. Our searches do not allow officers to keep two metres distance when conducting searches nor do we have space needed at checkpoints. I know for a fact that a lot of movement flow from YVR staff and inbound and outbound travellers are mixed together in certain areas. While China has gone so far to lock down cities and other countries like Britain - they've stopped flights to and from Beijing, it worries me and other YVR staff to see that the Canadian government is taking such an optimistic approach for something so contagious and dangerous. We're concerned and even if we want to help ourselves by wearing our own masks, they're sold out and I've even gotten teased on my choice of using my own mask by upper management.”
Again, you need to understand that this was a regular Canadian sending me an email on January 29 asking me to beg that we take this more seriously. Who do I...?
You tell us we have to trust the experts, but I'm concerned that the experts were giving us the wrong information.
12:10 p.m.
O'Neill Professor of Global Health Law, Georgetown University, and Director, WHO Collaborating Center on National and Global Health Law, As an Individual
Jeremy, do you want me to answer that or would you prefer to?
12:10 p.m.
Senior Policy Fellow, Centre for Global Development
I have some thoughts, but if you want, you can go first.
12:10 p.m.
O'Neill Professor of Global Health Law, Georgetown University, and Director, WHO Collaborating Center on National and Global Health Law, As an Individual
Okay, thanks.
I don't think any of us said quite what you suggested we said. I don't think that experts come down from on high and almighty and know all the answers. This is a process that we need to learn together and understand. You and all the members of this committee, and all Canadians, really have the same objectives. We really want to find the best way of doing this.
I don't know all the details of what Health Canada is saying. If they're saying, “You can be absolutely safe”, I'd be very surprised. If they said you'd be safe by doing x, y and z, then that would not be right. What they can say is, “This is what we know: If there's universal mask use, if there's social distancing, if there's really good hand hygiene, we will have a reduced risk.”
Right now I'm—
12:10 p.m.
Conservative
Tamara Jansen Conservative Cloverdale—Langley City, BC
Sorry, but my time is a bit limited. I just want to point out that universal mask usage was not recommended by the WHO or by Health Canada until far past January 29, and that is the concern. If a regular fellow in my constituency wants to wear a mask, he should be able to wear a mask, and it would have made a whole lot more sense.
I want to make sure that Mr. Webber has time, and so if I could, I'll pass it on to him.
12:10 p.m.
Conservative
Len Webber Conservative Calgary Confederation, AB
That's fine, MP Jansen.
Mr. Konyndyk, you had some comments to make on that.
12:10 p.m.
Senior Policy Fellow, Centre for Global Development
Yes. The mask thing, probably more than anything else, is an area where the guidance has shifted, and I think it's important to understand why.
In the early phases of this virus, we knew almost nothing about it, and the public health guidance coming out at that point was based on the closest parallels that were available. It was also guided by the fact that there was not, in public perception, a distinction between medical and non-medical masks. There was a—
12:10 p.m.
Conservative
Tamara Jansen Conservative Cloverdale—Langley City, BC
But under the circumstances, would it not have been wise out of an abundance of caution to use a mask? Why were we not able to?