Health Committee on July 6th, 2020

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thanks, Mr. Chair.

Hello to staff, colleagues, and witnesses.

My questions will be focused on Innovative Medicines Canada.

It was maybe three or four months ago now that I spoke with one of your team members, Bobby Sutherland, and learned that a number of your clients from start-ups to large companies were involved in researching COVID-19, and specifically vaccine exploration.

Can you give me an idea of how many of these vaccine development projects are still under way, and are there any hopeful candidates? Can you give us a sense of where we are with what you know at this time?

[Dr. Dion Neame]

There are about 150 different companies across the world that have SARS-CoV-2 candidate vaccines. These are distributed into different types. It seems mRNA vaccines and subunit vaccines are the ones people are working on.

It is extremely complicated to make a vaccine, because it's a biologic. Usually, we're looking at 10 to 15 years, as I'm sure you well know, but now we're trying to cram that into approximately one to two years.

Many of the companies have moved very quickly, because they have had previous platforms for different types of viruses, whether it be Ebola or influenza virus vaccines. Those are the ones that are jumping ahead. Most likely, we will see a vaccine within the next year to two years. The question is always, “Is it safe, and is it efficacious?” This is where we must continue to do substantial phase one, phase two and phase three trials. If they work, they'll be ready to come to Canada.

We have to understand that we are dealing with infectious diseases. Although we talk about infectious disease and vaccines hand in hand, some infectious diseases are very amenable to vaccine production, and some are much more difficult. We're dealing with coronavirus, which sits in the middle. It's not HIV, which is very difficult for vaccine development, but it's going to be challenging.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

As a pharmaceutical company, how has your organization benefited from the $1 billion in national medical research strategy monies that were announced earlier in this pandemic? That's for either or both.

[Dr. Dion Neame]

With regard to the research funds, my company Sanofi has not benefited, but other companies have. This is not about one or two different companies. Across the board we have to try to—

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

It's a web.

[Dr. Dion Neame]

—do our best.

I've been in great communication with Health Canada. It has asked me to find small biotechs in Canada that we can introduce to Health Canada, to find the best research possibilities. It's not a guessing game here. This is a science game. We have to find the best opportunities and back those best opportunities with funds. I think we've done a really good job here in Canada.

Again, it's going to be hard. When you look at the therapeutics—I'm jumping away from vaccines for a second—we've been looking at in regard to clinical trials, there have been many indications that some of our already licensed products might have effects with COVID-19, and we've gone through it. We've gone through many trials and lots of money.

Unfortunately, with all that we've done, we're not really seeing many candidates that are actually going to be helping us, and that's just the nature of the business. We have to innovate. We have to invest. We have to study, and then we're hoping we will find some help from therapeutics and vaccines.

[Pamela Fralick]

If I may add one quick comment. It's almost a good news story that I can't give you a list of every company and how many dollars they received and how they benefited, because what it means—to Dr. Neame's point—is that everyone is working in collaboration.

I can point to a company of ours in Quebec, Medicago, which we mentioned in the opening comments. It identified a candidate vaccine in 20 days from the virus first being identified here in Canada. In British Columbia, we have Eli Lilly, one of our member companies working with AbCellera. They have taken advantage of a great deal of funding to work on the antibody side of this particular situation.

We could go on with a list of where our companies have benefited. Our website, actually, keeps a daily and weekly update of all of the projects under way, if you'd like to have a look at those. We're very grateful that the government has really acknowledged the important role that the life sciences play at this particular time, and has put money behind that.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

It's fantastic to see that collaboration, which is obviously important and needed.

I'm wondering if we can go back to a couple of comments that were made just previously. When I'm asking questions to witnesses, I'm doing a deeper dive on some of the questions. I'm really curious about your perspective. I think you touched upon it a little bit, but what influences companies to invest in research in Canada. What would be the top three that you would be looking at? Based on that, would your web of companies, or your network of companies, consider manufacturing or further research investments here in Canada?

I guess my first question is this: What influences companies to do research and to invest in Canada?

[Pamela Fralick]

Let me say first of all that Canada is seen as a very attractive country, so companies want to invest here. We have a good health care system. We have excellent researchers. We have good institutions. We have diverse populations with clinical trials. We are an attractive place.

The CEOs of our member companies spend a lot of their time competing, if you will, and trying to bring investment dollars into this country. We can show you studies done by Ernst and Young that have evidence that 10% of the revenue does go into R and D in this country. That being said, we can do so much more. I think COVID-19.... I hate to look at it as an opportunity for anything, but it is a chance to recalibrate how we're doing business in this country. We need a very supportive regulatory environment. We are out of balance right now. I don't want to harp on that issue—I will if given the opportunity—but we need to balance that out.

We need to address a system that has been constructive in pieces and is very slow to bring products to market. It will take Canada over 900 days to bring an innovative product from initial approval into patients' hands. The OECD medium is down around 500 days, and I can cite many countries that are in the 300-day range. We are out of step. To the government's credit, Health Canada is working on changing this, but we are very far behind. We need to have that faster time to list.

Those are a couple of the key issues. There are others that I could cite, but in the interest of time, perhaps those are the two most important.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Kelloway.

[Peter Hardwick]

I have one comment, if I may.

[The Chair, Liberal, Ron McKinnon]

We will now move to Mr. Desilets.

Mr. Desilets, the floor is yours for six minutes.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Thank you, Mr. Chair.

My thanks to all our guests. Their remarks are very interesting and they will allow us to move forward towards the report that we will be producing in a few months.

Dr. Neame, If I understood correctly, you said that there are about 150 candidate vaccines in the world. First of all, let us stay objective, since we are all from the same country; can you tell us which vaccines are the most promising from those that are being worked on around the world? What is the difference between those vaccines?

[Dr. Dion Neame]

Thank you very much for the question.

“Promising” is an interesting word. It's almost like what is coming first. We have a number of vaccines that are coming first. There's one in particular out of Oxford that is associated with AstraZeneca. It is a vector form of vaccine with an mRNA on the adenovirus. Now, once again, that's wonderful. As a candidate vaccine, it seems that in theory and science it would work, but we have to do clinical trials. To get to the finish line first, with regard to a candidate, doesn't mean it's actually going to be safe and it doesn't mean it's going to be effective.

We have another vaccine in Canada coming from CanSino, and Dr. Halperin can speak to that. This is a vaccine that is in place right now. Dr. Halperin will be in clinical trials phase three fairly soon in the Halifax area.

We have Sanofi and its collaboration with GlaxoSmithKline. They are using an influenza manufacturing system called a baculovirus expression system. Because that has created flu vaccines in the past, we feel confident that we can create COVID proteins with an adjuvant from GSK, and that will come fairly soon. However, once again, we have to do clinical trials to make sure it's safe and efficacious.

There are a number of different vaccines that are called mRNA or RNA vaccines. Moderna—you may have heard of that company—is moving along quite quickly in its trials as well.

Once again, and I hate to keep repeating myself, it has to be safe and it has to be efficacious.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

This is very interesting.

We are all assuming that, once the finish line has been crossed, that is to say, in the fall, one or more of the vaccines will have gone through the three stages and will be ready to be brought to market.

First, I would like to know what difference there will be between the two vaccines that have gone through those stages. You mentioned the effectiveness, and I would like some more details. For example, could we accept one vaccine that is 60% effective and another that is 80% effective?

Then, could you also tell us about prices in the current situation, considering all this competition, the Chinese market, and our friends and enemies all around the world?

[Dr. Dion Neame]

I don't think there's going to be a single vaccine that's going to be the solution. A lot of that has to do with production capacity. We will have, hopefully, many successful safe and efficacious vaccines, and then we will see the manufacturing and production ability.

I understand from our colleagues in Swiftwater, Pennsylvania, that we may be producing 600 million doses if our COVID-19 candidate vaccine is successful, but you can see that 600 million per year is not going to take care of eight billion people.

Multiple vaccines will come into play. It will certainly not be a pharmaceutical company that's going to define how much it can produce, and where it's going to go. That will be decided by governments in regard to the previous agreements they may have had with pharmaceutical companies. There are also organizations that are looking at the ethical distribution of COVID-19 vaccines, and they will be involved.

Pamela, do you have any comments on that?

[Pamela Fralick]

I would emphasize the policy-making decisions that are going to be required by every government to determine who gets these vaccines first. There's a lot of coverage in the media these days about that very question. First of all, once we get the vaccine—and I say “once”, because I'm confident we will—we have to create the supply and the distribution. Every country will likely take a different approach.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Ms. Fralick, apart from the criteria of effectiveness, safety and, I imagine, price, what could influence a government's decision?

[Pamela Fralick]

I think my colleagues, Drs. Halperin and Neame, might be the best to respond to that.

As I say, there's quite a bit of coverage in the press right now in terms of making that decision. Do you provide it to the most vulnerable, the elderly, the marginalized populations, or do we identify the biggest spreaders, young people, etc., who are perhaps asymptomatic but spreading the disease? Do we give it to front-line health professionals? These are big questions for policy decision-makers.

Drs. Halperin or Neame, you may wish to jump in on this one.

[Dr. Dion Neame]

The epidemiology has been fairly clear on this in regard to who are the most vulnerable. Certainly, they are people who are the most frail in our community, and it's quite horrible when you look at Canada and the statistics for Canada. Initially, when you were looking at the mortality rates, particularly, almost 85% of people were from long-term care and seniors homes.

Because they're the most vulnerable, they tended to unfortunately pass quite quickly. You'll see that the numbers now have gone down to about 65%. However, when you look at the reason they have dropped from 85% to 65%, it's that people may be living outside of a long-term care or seniors retirement home. They are also the people who may have multiple comorbidities and tend to be above 65 years of age.

The epidemiology for me is fairly clear. Dr. Halperin, would you like to comment?

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Do I have any time left at all, Mr. Chair?

[The Chair, Liberal, Ron McKinnon]

No, your time is up, sir.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Okay. Thank you very much, everyone.

[The Chair, Liberal, Ron McKinnon]

However, I'll let the witness quickly respond.

[Dr. Scott Halperin]

The other thing will be that there's a process that is taking place by the national advisory committee on immunization, which will be recommending how the vaccines, when they are available, should be used, how they should be rolled out and who should have priority. Those recommendations will be federal recommendations made to the provinces, and then each province will interpret those based on their own population. The vaccine will be rolled out based on that prioritization.

That's very similar to what was done with the H1N1 pandemic. A process will take place. It will take into account bioethics, the epidemiology, the effectiveness of the vaccine on different populations, etc.