Health Committee on Dec. 4th, 2025

[Dan Mazier, Conservative, Riding Mountain, MB]

Ms. Buckley, can you explain Health Canada's special access program and the impact it has on obtaining pharmaceuticals?

[Jennifer Buckley]

I can't speak to it in granular detail, having never used it, but I can give you a general overview.

Essentially, what it means is that a treating physician has to go through Health Canada to be able to access a medication that's been approved in another country but isn't available here.

Oftentimes it happens that we'd be accessing medications from the U.S., so a physician or a pharmacist or whoever the health care provider is would fill out the form. They would essentially have to fill out paperwork to say that they needed access for patient X for these conditions. Then somebody at Health Canada would approve that request, and then they would have the ability to import it. That's the high-level overview of what an SAP looks like.

[Dan Mazier, Conservative, Riding Mountain, MB]

Would you know of any issues with the special access program?

[Jennifer Buckley]

Again, having never used it myself, I can't speak in great detail to it, but we can follow up with more information.

[Dan Mazier, Conservative, Riding Mountain, MB]

I just have one quick question here.

The Auditor General's report states that “the Public Health Agency of Canada, in collaboration with Health Canada, had not finalized an approach to coordinate federal, provincial, and territorial activities to preserve the effectiveness of antimicrobials.”

Has this coordination been finalized, to your knowledge?

[Jennifer Buckley]

My understanding is that there is a pull incentive in development. It has not yet been finalized. As Dr. Salama mentioned earlier, there is an AMR action plan, and I think there will be an update on that shortly as well.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

We'll now go to the Liberals and Ms. Chi for five minutes, please.

[Maggie Chi, Liberal, Don Valley North, ON]

Thank you, Madam Chair.

My first question is for Dr. Fafard.

In your testimony, you spoke a lot about surveillance in Quebec. I want to get a sense from you of which resistant organisms or strains are rising the fastest in Quebec right now, and whether you are aware of trends in other provinces. Do you even have data on that?

[Judith Fafard]

Carbapenemase-producing Enterobacteriaceae are among the most concerning bacteria on the rise in Quebec and elsewhere in Canada. These bacteria are resistant to last-line beta-lactams. They often acquire other genes that confer resistance to other antibiotics. The number of these bacteria is increasing in Quebec and elsewhere.

However, as I explained, detection protocols are not necessarily standardized from one location to another. Comparisons therefore remain difficult, but these are the most worrisome and resistant bacteria at this time. They represent a therapeutic dead end.

[Maggie Chi, Liberal, Don Valley North, ON]

Thank you for that.

You mentioned that it's not harmonized. Have you been seeing advances in genomic sequencing or any other approaches to allow us to detect them earlier by maybe having a more harmonized approach?

[Judith Fafard]

Networks of researchers are conducting research and development to detect and predict antimicrobial resistance. In addition, the National Microbiology Laboratory, in collaboration with the provinces, is conducting work to predict antimicrobial resistance. Progress is being made.

[Maggie Chi, Liberal, Don Valley North, ON]

That's fantastic. I'm looking forward to seeing more of that collaborative work across the country. Thank you, Dr. Fafard.

Ms. Buckley, you talked a lot about the regulatory process. I want to pick your brain on current antibiotics development. Why is it so different from the generic traditional drug market, and what do you see as the current challenges to support AMR innovations globally, not just in Canada?

[Jennifer Buckley]

I think there are a couple of things.

It's different from the traditional market just because of the market size. It would be similar if you looked at a rare disease medication, for example, for a small population size. In this case, it's by design from the stewardship perspective for rare diseases, because there's a small population.

I think there is a lot of great work going on internationally. Global programs that have been around for a number of years have supported that development and innovation.

Canada has some of the best scientists in the world who look at some of these things. The challenge is really from the access perspective in the Canadian context, as I said earlier. From both the market question and from the numerous steps in the approval process in this country, there's a real disincentive to do that. I'll leave it at that.

[Maggie Chi, Liberal, Don Valley North, ON]

No, I appreciate it.

Can you also help us understand the APIs from a global supply chain perspective?

[Jennifer Buckley]

That would probably be a question I would need to follow up on. I can speak generically to APIs, but I think it would probably be better for us to have an answer from one of our member companies that would deal more directly with the supply chain question.

[Maggie Chi, Liberal, Don Valley North, ON]

If you can send us a little more information on that to include in the study, it would be much appreciated.

I think that ends my round. Thank you so much.

[The Chair, Liberal, Hedy Fry]

Yes, your time is up, Ms. Chi.

I now go to Madame Larouche.

Ms. Larouche, you have the floor for two minutes and 30 seconds.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Madam Chair.

It is unfortunate that we have one less witness because he did not receive the equipment on time. We lost another one due to connection issues. I would like to thank the two witnesses who are still with us to conclude today's meeting.

I had a question for Mr. Salama, but perhaps you can answer it one after the other, Ms. Buckley and Ms. Fafard.

In one of his answers, Mr. Salama mentioned our dependence on China for certain medications that are manufactured there. We ask a lot of questions about how we should be less dependent on other countries. At the last meeting, when China was discussed, the discussion focused mainly on PPE, and I will come back to that.

I would like to address the issue of vaccines manufactured in China. At the last meeting, witnesses spoke about the importance of not purchasing products that may have been manufactured using modern slavery. One of them mentioned China and the Uyghurs.

How do you view this supply of vaccines from China?

How important is it to ensure that we are less dependent on countries that practise modern slavery and that we are able to purchase quality products?

[The Chair, Liberal, Hedy Fry]

Who would like to take that?

[Judith Fafard]

Thank you for that question.

Unfortunately, I cannot answer that question as I do not have any information about vaccine manufacturing methods abroad.

[Andréanne Larouche, Bloc, Shefford, QC]

Ms. Buckley, can you answer that?

[Jennifer Buckley]

I think also it would be something that I would need to follow up with in terms of an answer. Given that I'm not a supply chain expert, it would probably be best for us to follow up with an answer once we've spoken to the supply chain folks in our membership, if that's okay.

[The Chair, Liberal, Hedy Fry]

Thank you.

There is 10 seconds left.

[Andréanne Larouche, Bloc, Shefford, QC]

I will conclude by saying that my question mainly concerned the doubts that might exist about the quality of these vaccines, but I may have the opportunity to return to this subject during a future round of questions when discussing personal protective equipment.

[The Chair, Liberal, Hedy Fry]

I now go to Ms. Konanz from the Conservatives for five minutes.