Health Committee on Dec. 11th, 2023

[Luc Thériault, Bloc, Montcalm, QC]

In the same Le Devoir article by Jessica Nadeau from December 9, which is quite recent, Dr. Goyer spoke to the journalist about what is on the illicit drug market. She referred to the elephant in the room, stating in particular that the illicit market is creating increasingly complex and dangerous substances, at a phenomenal rate.

Here is part of what Dr. Goyer said, in translation:

I had never seen this in my career: the illicit market is producing substances that do not exist in medicine. Before, one person made fentanyl patches, while someone else made fentanyl powder. One person made Ativan, someone else made Ativan and added a bit of sugar and caffeine to make it cheaper. But things have changed now. The illicit market has begun producing things itself and mixing substances. It has become a very intense Russian roulette that we have never seen before, and we are faced with the complex task of managing overdoses, withdrawals and treatments when we no longer really know what we are actually treating.

What do you think of that statement? Have you seen that?

[Dr. Dan Werb]

Yes. Look, the evolution of the unregulated drug market is predictably unpredictable. I think we need to trace this back to the late 19th century. We had opium, then laudanum, then heroin, then fentanyl, then carfentanil and then nitazene-class opioids. Every step of the way, as there's been more pressure placed on drug markets, unregulated drug markets have adapted and evolved.

It's like any other market. I think of the smart phone market. There's pressure for evolution in markets. That's why we started with giant phones that couldn't do anything, and now we have smaller and smaller phones with incredible computing power.

Unfortunately, what we have right now is pressure from law enforcement and seizures that are incentivizing innovation on the part of drug trafficking organizations. If we want to address overdose in a meaningful, structural, long-term and sustainable way, I think we need to look at the source of the innovation that's happening in the unregulated drug market and think about structural ways that we can apply some stasis to the market.

I'll leave it there.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Werb.

The last round of questions for this panel will come from Mr. Johns. Mr. Johns, you have the next two and a half minutes.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Thank you, Mr. Chair.

Dr. Humphreys, are you aware of the data showing that overdoses and infections increased exponentially in 2013 or so with the introduction of fentanyl, and are you aware that the overdoses and infections that occurred with OxyContin occurred at a fraction of the rate that occurred with fentanyl?

[Dr. Keith Humphreys]

Fentanyl is definitely more likely to cause an overdose than OxyContin.

Since we're also concerned about addiction, far more people got addicted to OxyContin than to fentanyl. Both things are desirable to avoid.

[Gord Johns, NDP, Courtenay—Alberni, BC]

In terms of the protocols and structures, they are wildly different. In terms of safe supply, in the case of OxyContin they are daily dispensed and monitored weekly. I am wondering how you can compare the two in terms of safe supply protocols and structure.

I'll just state that methadone retention rates are 50% at six months and buprenorphine is at 40%. Safe supply retention is greater than 90%. Are you aware of these impacts? You stated that there are no protocols to monitor diversion earlier, that you hadn't seen any, and I know the safe supply clinics have a heavy amount of monitoring for diversion, so I'm just concerned about your knowledge around safe supply and if that's complete or not.

[Dr. Keith Humphreys]

What I said—and there's no evidence to contradict it—is that when people test negative for the drugs that they're provided, what no one has done is to go find the person to whom those drugs went and assess their well-being. That's the kind of monitoring you would need to do to determine whether or not these are doing community harm or not. That has not been done. There is no study like that in the literature. That's why I call attention to it as an area for audit.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Can you talk about how many times it takes people to go through recovery treatment before they stay sober in the long term? What is the success rate of people staying sober after one year and five years? After treatment, what happens? What are people supposed to do if there's no housing?

That's for Dr. Werb.

[Dr. Dan Werb]

I can say there is good evidence suggesting that people on average engage in, say, a methadone program five to seven times before they're able to manage their substance use long term.

There is evidence on the recovery side. For example, there was a randomized clinical trial of buprenorphine and some counselling, versus just counselling and no pharmacotherapies. It found that the mean abstinence rate for the counselling group was 5%, compared with 43% in the buprenorphine group. Again, there is really good evidence to suggest that pharmacotherapies can provide more effective abstinence compared to recovery-oriented non-pharmacotherapy treatments.

Again, I would reiterate that the catch-22 that happens where people can't find housing because they're using substances but can't access treatment because they don't have housing is a major issue that is going to prolong the life cycle of this overdose epidemic.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Werb.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Mr. Werb talked earlier about a study from the Office of the Chief Coroner for Ontario to map out overdose mortality in the radius around supervised consumption sites. Would it be the will of the committee to ask him to table that report to the committee within two weeks? Would that be possible??

[Some hon. members]

Agreed.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Johns. You took the words right out of my mouth.

Go ahead, Dr. Powlowski.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Could I ask both witnesses to please submit any studies that they think are particularly relevant to this study?

[The Chair, Liberal, Sean Casey]

I'm redundant here now, so let me just say thank you.

This has been a fascinating discussion. We very much appreciate your being here with us and sharing your expertise. There was easily enough interest and enough questions to keep you here longer, and that's probably the reason that we'd like to see a follow-up in writing.

Once again, thank you, and I wish you all the best for the holiday season.

Colleagues, we're going to suspend to allow the next panel to get set up. We are suspended for five minutes.

[The Chair, Liberal, Sean Casey]

I call the meeting back to order.

Pursuant to Standing Order 108(2) and the motion adopted on November 8, 2023, the committee is resuming its study of the government's advance purchase agreement for vaccines with Medicago.

I would like to welcome our witnesses. Representing Medicago Inc., we have Toshifumi Tada, president and chief executive officer, and Sarah Marquis, vice-president for legal affairs and corporate secretary.

I thank you both for taking the time to appear today. You have up to five minutes for an opening statement. You have the floor.

[Toshifumi Tada, President and Chief Executive Officer, Medicago Inc.]

Thank you, Mr. Chair.

First of all, ladies and gentlemen, I appreciate this invitation to attend the House of Commons Standing Committee on Health today.

My name is Toshifumi Tada. I am president and CEO of Medicago. I'm accompanied today by Sarah Marquis, who is vice-president for legal affairs and a corporate secretary of Medicago.

Medicago was a Canadian biotechnology and biopharmaceutical company specialized in the discovery, development and commercialization of virus-like particles that we call VLPs, using plants as bioreactors to produce protein-based vaccine candidates. Medicago's VLP technology was born out of a research partnership between Laval University and Agriculture Canada in 1997.

Medicago's technology evolved from research and development to having its first VLP vaccine approved by Health Canada in February 2022. It was the first plant-based VLP vaccine approved for human use in the world.

In the clinical trials, our vaccine was found to be 71% effective against symptomatic infection and 100% effective against severe disease caused by the coronavirus. These studies were conducted while there were multiple variants in circulation. I will be clear that these results could only be achieved with the tireless dedication of our employees and the scientific achievement and expertise developed in Canada. Medicago was very proud of this scientific achievement.

Although the science was a success, we experienced challenges in transforming to commercial, scaled-up production. Our experts believed we could fix the issues, but it would take time. At the same time, however, the vaccine landscape was evolving very rapidly, with more and more variants arising. We assessed that significant additional research and development investment would be needed.

This is why our shareholder, Mitsubishi Chemical Group, made the business decision to cease the operations of Medicago. This was a very difficult decision to make, both on a business and human level.

Medicago had been in Quebec for more than 20 years, and at the time of Mitsubishi Chemical's announcement, we had nearly 600 employees, both in Canada and the United States, with 378 employees in Quebec City. The company had strong ties to the local community, and our employees believed in Medicago's technology and its public health mission.

As part of the windup activities at Medicago, we ensured that all employees received the full amount of compensation they were entitled to. In addition, we provided full support and outplacement services, including organizing job fairs for our employees, in collaboration with the Quebec government, to help our employees find their next employer.

We also worked with financial and legal advisers to terminate our agreements with our service providers, to settle our debts and to sell our business operations and assets. This led to several transactions, two of which were with the Government of Canada.

The first one was the advance purchase agreement between Medicago and PSPC, signed in November 2020. Under this agreement, Medicago had received a non-refundable advance payment of $150 million for initiating the manufacturing of its COVID-19 vaccine. This agreement was terminated by mutual consent in June 2023. Medicago was released of its obligations, as it met all the terms under the agreement.

The second transaction was the strategic innovation fund—or SIF—agreement with ISED. This was recently terminated. Under this agreement, Medicago was awarded contribution offers for the development of our COVID-19 vaccine and the establishment of a large-scale manufacturing facility in Quebec.

As part of the termination agreement, we reimbursed the amounts owed to the Canadian government, which included $40 million in cash, and we transferred our key research and development assets, such as our manufacturing pilot plant, intellectual property assets, and equipment to Aramis Biotechnologies, a new local company established by former employees of Medicago.

I would be happy to answer any questions the committee may have at this point in time. It is possible that I may ask Sarah Marquis, my colleague, to answer certain questions that fall within her field of expertise.

Mr. Chairman, that concludes my opening statement. Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Tada.

We'll begin our round of questions with the Conservatives. Mr. Perkins, you have six minutes, please.

[Rick Perkins, Conservative, South Shore—St. Margarets, NS]

Thank you, Mr. Chair.

Thank you to the witnesses.

Mr. Tada, how many contracts were signed with the government? There was the one for $200 million initially, for both the development of the vaccine and some plant improvements. What other contracts were signed?

[Toshifumi Tada]

We had two contracts. We had the APA, or advance purchase agreement, with PSPC. Second, we had the SIF agreement with ISED. Those are the two contracts we had with the federal Government of Canada.

[Rick Perkins, Conservative, South Shore—St. Margarets, NS]

First, on the SIF program from ISED, that was for $200 million. I believe, from the reports I've read, that in the end only $173 million was used. Is that correct, or was the full $200 million used?

[Toshifumi Tada]

That contract contributed up to $200 million to Medicago to support our development of the COVID-19 vaccine and the establishment of a manufacturing facility.

[Rick Perkins, Conservative, South Shore—St. Margarets, NS]

I understand that. How much of that was used—all of it? Did you receive all $200 million?

[Toshifumi Tada]

I don't comment on the details, but the agreement is up to $200 million.

[Rick Perkins, Conservative, South Shore—St. Margarets, NS]

You won't tell this committee of Parliament how much money the Government of Canada actually in the end transferred to you?