Health Committee on April 20th, 2023

[The Chair, Liberal, Sean Casey]

I call this meeting to order.

Welcome to meeting number 62 of the House of Commons Standing Committee on Health.

Today, we will consider Bill C-293 during the first hour, before proceeding to committee business in camera during the second hour.

In accordance with our routine motion, I'm informing the committee that all remote participants, specifically Mr. Erskine-Smith, have completed the required connection tests in advance of the meeting.

It's now my pleasure to welcome Mr. Nathaniel Erskine-Smith, member of Parliament for Beaches—East York, who is joining us today via video conference to speak to Bill C-293, an act respecting pandemic prevention and preparedness.

Nathaniel, I know you have a few things going on in your life. It's very good to have you here with us. You know the drill.

You have five minutes for your opening statement. The floor is yours.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Chair, before the witness begins his presentation, to avoid cutting him off, I would like to inform you right away of a small technicality today with respect to the interpretation channel. The French channel is not working; the auxiliary channel is working. When there is a change of interpreter, this may change again. Until now, on the French channel, it was your lovely voice that we heard, Mr. Chair.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Thériault. I know we have to access it differently today, but we still have the interpretation. It's just a little different, compared with the usual way.

[Luc Thériault, Bloc, Montcalm, QC]

Okay, that works, as long as it stays that way throughout the meeting. It's different from the usual way of operating. We hear you in English on the French channel.

[The Chair, Liberal, Sean Casey]

Okay.

We'll go over to you, Mr. Erskine-Smith.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

Thanks, Sean.

Thanks to everyone for the time today. I have to admit that it's a bit odd to be the one presenting instead of the one asking questions, so bear with me.

This bill is really straightforward in many respects. We've all just lived through a devastating pandemic. It upended our lives in so many different ways. It has taken lives. It has damaged businesses. It has undermined livelihoods. It has upset schooling, and on and on and on.

We don't want to live through another one. There are a couple of things we need to do. One is to take every step we can to reduce the risk of a future pandemic, and there are steps we can take, working here domestically and working with international partners. We need to make sure that, when the next one comes, we are the best prepared for it.

I don't propose that I've managed to include every single thing that should be included in this piece of legislation, but the architecture is there. It's an accountability architecture that would require the government every three years—and you could consider changing it to five, but it would be on a regular basis—to say, “Here is our pandemic prevention and preparedness plan” and table it in Parliament. Parliamentarians from all parties, working with experts, could then hold the government to account on its plan.

Is enough being done? Can we take additional steps to reduce risk? What are other countries doing that we aren't doing? What's in their plan that isn't in ours?

It is essential that we have that ongoing accountability, because if you look at the experience with SARS, there was a review, there was a report and there were recommendations. Some were even acted on, but not all were. There wasn't a recurring accountability so it fell off the table. When we came to the COVID pandemic, we weren't as prepared as we ought to have been. Frankly, we didn't take the steps we could have taken to prevent COVID in the first place.

The architecture is there. I almost called it the “one health bill”. It's the pandemic prevention and preparedness act. I almost called it the one health bill because on the prevention side—and we already have a one health framework at Health Canada, working with agriculture—it is incredibly important that we keep in mind, we take to heart and we keep in this bill this idea. It's grounded in science, grounded in international bodies and grounded in science here in Canada that animal health, environmental health and human health are interconnected ideas.

If we don't have a clear-eyed focus on environmental health, that can impact animal health, which can then impact human health. It's especially important when you consider the particular risk posed by zoonosis. If you have other experts who testify in the course of these proceedings on Bill C-293, you will hear over and over again that the core primary risk of another pandemic is a zoonotic disease and spillover risk from animals.

That's on the prevention and one health side.

At a high level, I want to say there is a lot in this bill. I consulted with the United Nations Environment Programme's report about preventing future pandemics. I consulted with the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services' report about preventing future pandemics, including consulting with a Canadian expert involved in that report. I consulted with the independent panel, which has written reports on pandemic prevention and preparedness and worked directly with the researchers who wrote and put those reports together, and consulted with a range of other experts.

That's how this bill came to be.

Again, I don't propose that it's perfect, and I would expect amendments are going to be forthcoming. I want to say that amendments should be forthcoming.

For one, I know the review section in the bill has caused some consternation, because there is some question about whether it should be independent. My view has generally been that there should be some more fulsome, searching independent review. This review is more focused on informing the plan, but I don't want to get into the politics of it. I understand there's an agreement to remove that section of the bill, and I'm comfortable with that. That seems right by me in terms of the conversations that have been had.

The second piece is on specific language in the bill. I would say, in everything that you do, improve it, take certain language out if you don't like it and add other language in if there's language missing. At all times, my ask, and it's how I came to this legislation at all times, is to make sure that everything we do is going to put in place an architecture whereby a future government—this government, the next government and the government 20 or 50 years from now—is going to be required to turn its mind to certain issues that are core to pandemic prevention and preparedness, and follow the science.

I know I've received some questions. I engaged with the Ontario Federation of Agriculture, for example, on the agriculture amendments. They said it could perhaps be even tighter and more specific with the language. That's fair.

I would encourage all of you, as you look at amending the legislation—I know amendments will be warranted—to make sure that we, at all times, focus on what is best in the science when it comes to prevention and preparedness.

I appreciate the time, Sean.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Erskine-Smith.

We're now going to move to rounds of questions, beginning with the Conservatives.

Dr. Kitchen, you have six minutes.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you, Mr. Chair.

Thank you for your presentation. I appreciate that.

In trying to get some understanding of what's going on, I'm going to just throw some things at you and see what we can hear.

I'm going to read something to you and then I'm just going to ask if you believe that this is, basically, what's part of the legislation:

Promote health;

Prevent and control chronic diseases and injuries;

Prevent and control infectious diseases;

Prepare for and respond to public health emergencies;

Serve as a central point for sharing Canada's expertise with the rest of the world;

Apply international research and development to Canada's public health programs; and

Strengthen intergovernmental collaboration on public health and facilitate national approaches to public health policy and planning.

Would you agree that this is what this legislation is about?

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

In many respects, yes, Robert. At the same, though, the legislation is really focused on taking a set of ideas around public health and ensuring that they're embedded in an accountability framework.

I want to emphasize that what the legislation is really about is ensuring there's an accountability framework that would include many of the components that you're talking about. I would liken it to the climate accountability law that we have, where the obligation is on the government to come up with a plan and to table the plan in Parliament on a recurring basis, and there are progress reports associated with it.

This, in a similar, parallel fashion, would require the government to come up with a plan, table the plan on a recurring basis and update the plan every three years.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.

I appreciate that, and I recognize the avenue for three years and five years, as you've indicated.

I will expand a little bit more on that and add some other parts to it, such as the following:

...develops and maintains national emergency response plans for the Public Health Agency of Canada and Health Canada; monitors outbreaks and global disease events; assesses public health risks during emergencies; contributes to keeping Canada's health and emergency policies in line with threats to public health security and general security for Canadians in collaboration with other federal and international health and security agencies; is responsible for the important federal public health rules governing laboratory safety and security, quarantine and similar issues; and is the health authority in the Government of Canada on bioterrorism, emergency health services and emergency response.

Other than putting in the time frame to check on those, would you agree that's part of what this legislation is about?

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

It sounds like you're talking about an authority that has responsibility for some of the measures related to pandemic prevention and preparedness.

If I could, I'll ask a question back, so there's clarity here. From the office that you're suggesting and listing off a set of responsibilities for, where is a public-facing prevention preparedness plan available? Where does it reside and how can experts and third parties weigh in to say whether it's sufficient or it's insufficient?

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

I will clarify that now.

Basically what I was just reading to you was the mandate of the Public Health Agency of Canada, which we already have in place, as well as the mandate for the centre for emergency preparedness and response structure. Those are already in place. The legislation, basically, is repeating those same things, which are already in place today.

We had the president of the Public Health Agency here just a couple of weeks ago. I asked for a plan, which the Auditor General had said should be put in place. She said there was a plan, but we never received it because it can't be found.

To me, the legislation is good if it's going to make certain that the Public Health Agency will put it on paper so that people can see that plan. That part I love about the legislation. It talks about putting...but when we already have it in place.... It was before 2016 that this came forward, and it still hasn't been done.

Why will this piece of legislation make it happen when it hasn't been done when it should have been?

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

The short answer is that there's parliamentary accountability here, and there hasn't been to date.

You can put anything in a mandate letter to a minister. You can put anything in a mandate letter to a government official, but unless there's ongoing accountability.... At law here, what this bill would do is require that kind of accountability to us in Parliament. Where's the plan? What does the plan say? Is the plan sufficient?

Robert, we could go off and consult with our own experts and say, “This is missing. This should be worded differently. Not enough is being done.” That's the very reason we have a climate accountability law. We need a law like this.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.

I hear you, and I see that. You and I have discussed it over time, over the years. Ultimately, how do we get that in place?

I agree. We're repeating things to recreate what we already have when what we need is accountability to have the agencies that are supposed to be doing this for us doing it.

Public Health Agency of Canada came into place in 2003 or 2004, after the SARS epidemic, as you indicated. It was put in place to do these steps, to be prepared for the pandemic and to prepare for it such that we could get it done.

To me, taking this legislation and saying, let's just make sure we have the report.... I think that what you're looking for is, let's just get this done and get a report on what's happened and where we succeeded and where we failed.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

It's not only that. The bill does ask for a report—I've mentioned that—and a review, but the the core accountability architecture here addresses the primary concern you're raising, which is that it's not enough and it wasn't enough to say, “PHAC, here are your obligations. Prepare us for the next pandemic.”

PHAC has a number of responsibilities. Who is the individual person in PHAC who is responsible for coordinating pandemic prevention and preparedness? Someone needs that core accountability, and this legislation sets that down.

It requires the government to table a plan to Parliament. When you ask PHAC for a plan, and they say, “We have a plan; don't worry about it”, that's insufficient. We as the public have just lived through something we never thought we were going to live through and we never want to live through again. We'd better have ongoing accountability from not just this government but all future governments to ensure this never falls off the table and that there's ongoing accountability to Parliament.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Chair, there is no interpretation currently, at least not on the auxiliary channel. The problem I was apprehensive about at the beginning of the meeting just happened, didn't it?

[The Chair, Liberal, Sean Casey]

Indeed, the issue you raised at the beginning has been resolved.

Thank you, all.

We now have Dr. Hanley, please, for six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Chair, the French channel is not working.

[The Chair, Liberal, Sean Casey]

All right, just a moment.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Chair, the French channel has just started working.

[The Chair, Liberal, Sean Casey]

All right. Sometimes time is the best remedy. It's all taken care of.

Mr. Hanley, you have the floor for six minutes.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you very much.

Thanks, Nate, for bringing this forward. You're passionate, articulate and effective in your role as an MP on a wide range of issues.

One of the ways I want to start this off is by saying that, of all the things that you might have taken on as a private member's bill at this time, you've picked this one. You've seen a need to put forward a private member's bill in addition to everything else that should be or is happening in terms of postpandemic reviews, preparedness and external reviews.

Tell me a bit more about what motivated you and what you saw was missing that led you to put this forward. I'm hearing accountability. That may be the key word, but I'll give you a chance to explain briefly some of the rationale.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

There were a few different things, Brendan. I appreciate the question.

First, I came to this idea really out of a lot of work with the climate accountability law. I think that is a really important piece of legislation. The U.K. had legislation like that in 2006 and really led the way. We've more recently caught up to that. I think it's a really important framework to have in place to ensure that, with an existential threat like climate change, we have ongoing accountability, no matter the government. Whether it's a future Conservative government, it doesn't matter. We have a piece of legislation in place that says the government has to continue to table plans and maintain progress reports. We can see whether action is sufficient or insufficient in clearer terms.

Similarly, with an existential threat like a pandemic, especially having gone through one, I wondered whether we needed similar architecture. I pitched it at one point, I think even into the 2021 platform process, and it didn't come to fruition. When I won the private members' bills lottery again, it seemed like a good place to start.

My experience with private members' business has not always been that they become law, when one considers the specific process of a private member's bill through the very arcane process that we live through as individual legislators, but oftentimes they do get picked up by governments. In a perfect world, a bill like this with an architecture like this would be picked up by the government and be part of government legislation.

[Brendan Hanley, Liberal, Yukon, YT]

Thanks.

Another area I was really interested in and that you referred to in your five minutes was the one health framework. I think that would be really interesting to highlight, so I want to give you another chance to highlight the importance of that, whether we talk about antimicrobial resistance, for instance, as a global threat; climate change effects and the effects on animal or human health; or the risk, and I would say the ever-increasing risk, of spillover events from animals to humans to trigger another pandemic.

Could you just talk about the importance of grounding this bill in that one health viewpoint?

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

I appreciate the question. It's absolutely essential that, when we look at prevention in particular, everything runs through a one health lens. This is not my idea. This is an idea that, as I said, is already residing at Health Canada and Agriculture Canada by way of antimicrobial resistance.

I remember sitting through a World Bank briefing many years ago when Minister Philpott was still in that role. The risk of a superbug was highlighted even at that time. It wasn't just the human toll of a superbug but also the economic toll. We've seen first-hand now, having lived through a pandemic, the risk of these spillover events.

I can use a couple of examples. You can look at antimicrobial resistance. The risk of superbugs is brought on by the poor health of animals and the need for an overreliance on antibiotics. Resistance builds, and then there's a huge risk to humans as a result of initially poor animal health. When you look at the spillover risks that we increasingly face as a matter of climate change and deforestation, or when you look at deforestation, you look at the loss of habitat and the increased interaction, as a result, between animals and humans. There is a major spillover risk. Poor environmental health leads to poor human health and great risks to human health.

All of these things are interconnected. That's the primary focus that we have to hold onto here. Human health, animal health and environmental health are interconnected. To prevent the next pandemic, we have to take one health very seriously.