Health Committee on Oct. 29th, 2024

[The Chair, Liberal, Sean Casey]

I'm sorry, Mr. Julian; that's your time.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

I still have 30 seconds, Mr. Chair. We have six-minute rounds.

[The Chair, Liberal, Sean Casey]

Did we start late? Okay.

The clock I was looking at had you at time, obviously.

You have 30 seconds. Go ahead.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

I'll take the 30 seconds. Thank you.

In the 772 cases of adverse reactions in natural health products, how many of them would you attribute to those 31 public warnings?

[Linsey Hollett]

We do track the origins of what leads to compliance action, whether it's a trade complaint or an adverse drug reaction report. Specific to those 31, I will need to confirm the number. We do track that information, and I'll be happy to share it.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Julian.

Next is Mr. Doherty, please, for five minutes.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Thank you, Mr. Chair.

I want to give our witnesses another opportunity. I want to ask Ms. Hollett and Dr. Sharma again on the record: Was the Canadian Health Food Association consulted, either for Bill C-368 or for Vanessa's Law?

[Dr. Supriya Sharma]

Yes, it was for both.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

I'd like to introduce Aaron Skelton, the CEO of the Canadian Health Food Association, as well as two executives, Sonia Parmar and Jules Gorham, who will provide testimony later this week. They were not consulted. They are in the audience. Perhaps after this meeting, I can introduce our witnesses to them, because they were not consulted on either Bill C-368 or Vanessa's Law.

With that, I'll cede the floor to my colleague, Mrs. Goodridge.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Mr. Chair, and thanks to the witnesses.

To follow up on what Mr. Julian was bringing forward, out of the 31 that were found to have public advisories notices, three were uncooperative. Of those three that were uncooperative, how many led to negative health outcomes?

[Linsey Hollett]

I would not have a line of sight to be able to give you a 100% accurate answer. Of those, was there a potential that, despite our risk communication and despite a recall, there were negative outcomes? We would need 100% assurance that all negative outcomes are reported to Health Canada, which unfortunately we do not receive.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

I fully understand that you're not going to be able to gather all this data, because there are imperfect circumstances. Is there anywhere in the behemoth that is Health Canada any data on how many negative health outcomes there were from the 350 that were flagged as problematic, the 31 that had public advisories issued, and the three that were uncooperative?

This is germane to the conversation we're having. The fact that you don't have these statistics readily available for us says, to me, that there was a failure in preparing to come to this committee today.

Can you send this information to us as soon as possible, regarding the information that Health Canada knows? I understand that it's not going to be complete and that not every negative interaction will be reported to Health Canada, but we need to know what Health Canada knows, because right now we're basically being told, “Just trust us.”

[Linsey Hollett]

As I mentioned in response to MP Julian, we will table the information that we have. It will include the adverse drug reactions that were reported to us that were linked to the 31 products we're talking about, for which we publicly communicated.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

This becomes part of this complicated space. I had asked the minister earlier about the gender-based analysis that was done in the budget implementation act. Could you table that information with us, or share more information about the specific findings of your gender-based analysis?

[Dr. Supriya Sharma]

Certainly, we can table it. I will just note that there are different aspects of the GBA. One is, obviously, the impact on the companies, but also, with respect to Vanessa's Law, when you look at natural health products, the users of natural health products are disproportionately women, indigenous populations, people of the LGBTQI population, and ethnic groups. In part of that assessment, Vanessa's Law provisions also contribute to the safety of those products and benefit those groups. It's both, on both sides.

Certainly, we can table the analysis with the committee.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

This goes back to the fact that the minister went on at length talking about possibly the most egregious circumstance that was found, which, from the testimony we've heard throughout the rest of this meeting, sounded like a one-off, a very rare circumstance, not the standard that you guys see. However, he painted it like that was a regular occurrence with which you guys were dealing.

Canadians need to know, how often are you seeing those exceptionally egregious circumstances that were described by the minister as if that was the common practice?

[Linsey Hollett]

Again, we commit to share information with this committee on those most serious incidents.

What I would add is that although not all rat urine and feces.... What you can tell from the stats we've already provided is that, in the last five years, there were at least 31 where, whatever the circumstances were, whether it was contamination or sanitary conditions, we believed the bar was met to warn Canadians about products, conditions and risks. That's 31 in five years.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Hollett.

Next, we have Dr. Hanley, please, for five minutes.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you.

Thank you for being here, and thank you for your service.

Dr. Sharma, the 2021 Auditor General's report said:

Overall, Health Canada's oversight of natural health products available for sale in Canada fell short of ensuring that products were safe and effective. The department did approve products on the basis of evidence that they were safe and effective. However, gaps in the oversight of manufacturing sites and in the monitoring of products once on the market left consumers exposed to potential health and safety risks because products were not always manufactured or marketed according to licence conditions.

Do you feel that now, with applying Vanessa's Law to natural health products, the regulatory gaps referred to in the Auditor General's report will be addressed?

[Dr. Supriya Sharma]

Certainly, the Auditor General did take a comprehensive look at the system with respect to natural health products and raised a number of issues. We've accepted all of those and have endeavoured to make improvements.

Vanessa's Law goes part of the way to improving the system. I think the ability to mandate a recall in exceptional circumstances for serious and imminent threats and the ability to compel a change to a label, again, if it's serious, are very important. Having fines and penalties without having regulatory requirements, without having that regulatory backstop of appropriate fines and penalties, which before Vanessa's Law were only $5,000, makes the system rather toothless. There are also other provisions that we haven't yet put into force with respect to reporting adverse drug reactions, terms and conditions, and other tools.

With those tools, it does go a certain way to improving the system. I think there are still other modifications and improvements that can be made. We've talked to the committee about some of those other initiatives. That's separate from what we're talking about today.

Certainly, Vanessa's Law does move the bar in terms of bringing the regulation of natural health products up to a minimum standard that we would expect for all therapeutic products in Canada.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you.

I recall Mr. Calkins saying, if I can paraphrase him, that we already have everything we need in place with existing regulations to address non-compliance or to remove contaminated or high-risk products. What are your thoughts on the potential consequences if Bill C-368 were to pass and we were to revert to existing mechanisms?

[Linsey Hollett]

In essence, this is not even a theoretical question, because we lived it prior to adding Vanessa's Law authorities to NHPs. There are many consequences, but maybe I can highlight three that are top of mind for me.

Number one—and there's been a lot of discussion about this today—when we have the most serious of situations and we do not have a co-operative entity, a co-operative company—again, I will stress that this is the minority of cases—we will not have a way to remove products from retail shelves. I firmly believe that Canadians think their health regulator has that ability, but we would not.

Two, if someone were to disobey a mandatory recall or in some other way be in strong non-compliance with the regulations and the act, and we wanted, after we had mitigated the risk, to move to punitive measures, our stick would be very small—you heard, $5,000 in fines. In Vanessa's Law, we also have injunction authority, which hasn't gotten much attention today. If someone was willfully non-compliant, we would be very hard-pressed to follow that up with the tools we have in a meaningful way.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you.

I think we all agree that natural health products are at the heart of an important and I would say cherished industry for Canadians. We all recognize the value of small businesses that are the front line of natural health products. What would you say about the projected impact of Vanessa's Law on small businesses that sell natural health products?

[Dr. Supriya Sharma]

It depends on which study you look at, but, definitely, more than 60% of the natural health product companies are small or medium-sized. Overall, with respect to Vanessa's Law, there would be minimal impact because, again, these are only circumstances where you have a serious safety risk and you have a company that's not complying with that safety risk.

The example that was used in the Auditor General's report was actually a tea extract. It was contaminated with something called mycophenolate, which is a pharmaceutical product that's used for immunosuppression in people who have had organ transplants. It was first noted in 2017. By 2018, the company still hadn't recalled it. By 2020, it was back on the market online, selling these products. Exposure to mycophenolate for women who are pregnant can cause miscarriages and birth defects. That was the example in the Auditor General's report.

I think a company that is small or medium-sized in this environment would want companies that are not compliant and not abiding by the rules to have some corrective action and to have circumstances whereby we can create a level playing field.

Again, if you're making a quality product, you're abiding by the regulations. This would not have an impact. Actually, there are provisions in Vanessa's Law that get into the technicalities for the corporations I referenced, which would actually be advantageous for businesses to help them in terms of standards and—

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Sharma.

Mr. Thériault, you have two and a half minutes.