Health Committee on March 26th, 2026

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Has Health Canada not seen it?

[Mary Hughes]

Madam Chair, I don't have the answer to that.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Okay. You can table that also.

Mr. Mazier, do you have anything?

[The Chair, Liberal, Hedy Fry]

You have 12 seconds. I'm sorry, Mr. Mazier, but I don't think you can ask a question and get an answer in 12 seconds.

[Dan Mazier, Conservative, Riding Mountain, MB]

No, I can't do it in 12 seconds.

[The Chair, Liberal, Hedy Fry]

I now move to the final person in this round.

Ms. Jaczek, you have five minutes, please.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Thank you so much, Madam Chair.

It's good to see you again, Dr. Burnell.

The goal of this particular study, of course, is for the committee to ultimately draft recommendations based on expert testimony. It is important that the report be practical and focused on areas in which the federal government can make a real difference. If you were advising this committee on one or two priority actions the federal government should take to improve access to drugs, attract investment and strengthen pharmaceutical sovereignty, what would they be? I know this is difficult, but...one or two real priorities.

[Dr. Margot Burnell]

I think the main priorities are, really, to invest in drug production and to study the opportunities with respect to that. Supporting the task force to do that will be critically important because they will then be able to do a very complete analysis and bring forth recommendations. Creating the task force and providing the financial and human resources support for that are critical, as is having the ability for data to flow across this country—what the various medications are, what the stockpiles are and what is available to Canadians in times of crisis. My other recommendation is that pharmaceutical companies should be able to create capacity within their procedures and to be resilient in times of crisis.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

During a previous study that this committee engaged in, we looked at antimicrobial resistance. We heard from a number of pharmaceutical companies that they were loath to invest in looking at potentially new antimicrobials, because the market was relatively small and so on.

Do you see antimicrobial resistance as a major issue? Should we be investing in some way in ensuring that we have supplies of new antimicrobials?

[Dr. Margot Burnell]

Organisms are very smart. They will develop resistance to drug medications. Regulatory bodies such as Health Canada—and the CDC previously in the States—track these organisms with respect to resistance across the world. When you see a particular organism becoming resistant to what is considered standard of care within developed nations, there is an onus and a reason to look at a drug to combat this.

We've seen in several of our organisms that rarely, but not insignificantly, we have had to go to a less-common drug to fight it. With respect to resistant Staphylococcus aureus, for example, this is a common organism that can become resistant. We have to stay ahead of the resistance pathway. This won't be a large percentage of any drug development or consumption, but there can be potentially life-threatening illnesses, and we need to be ready to combat them.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Thank you, Madam Chair. That's all.

[The Chair, Liberal, Hedy Fry]

You have one more minute.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Oh, how generous. Thank you so much.

Those are practical suggestions in terms of areas to focus on. In terms of some of the things you may have seen in your own practice, are there some particular areas you're aware of in which pharmaceutical sovereignty might help your patients or in which you have personally seen shortages of potential medications for them?

[Dr. Margot Burnell]

We have seen shortages of medications when production pathways change. When cork was used to seal some vials, for example, the whole industry really had to revolutionize around that. We will see that particular pharmaceutical manufacturing plants cannot accommodate demand or that, for some reason, they've had to shut down part of their production. Then we are looking for other sources of medication to accomplish the same goal with respect to our patients.

[The Chair, Liberal, Hedy Fry]

Thank you very much. Time is up, Ms. Jaczek.

I want to thank the witnesses for coming and sharing their expertise with us and for answering questions so honestly and up front.

I want to ask one question about the CDC, which Ms. Jaczek referred to and you did as well, Dr. Burnell, and about the vaccine policies in the United States. They are now not looking at vaccines as important elements of prevention. We get a lot of our vaccines and a lot of our pharmaceuticals from the United States. Do you think this means it's almost a necessity for us to create our own pharmaceutical sector?

[Dr. Margot Burnell]

I would separate the recommendations that come from those organizations from the production standards. The CDC, until recently in the current geopolitical...had very strong and reputable guidelines. From a Canadian perspective, we have the opportunity to fill the gap and to provide guidelines for our physicians and our communities.

With respect to drug production, we'd like as much done in Canada as possible, but I am not aware of anything that has affected the quality of drug production within the States.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

I want to remind the witnesses before they leave that there have been some requests for written documentation. Please send those to the clerk. She will distribute them. Thank you very much.

I now—

[Dan Mazier, Conservative, Riding Mountain, MB]

Chair...?

[The Chair, Liberal, Hedy Fry]

Yes?

[Dan Mazier, Conservative, Riding Mountain, MB]

Thank you.

I'm seeking unanimous consent for this motion: That the committee order the complete and fully unredacted agreements between Canadian Blood Services and Grifols announced on September 7, 2022, and that this be deposited with the clerk of the committee no later than April 10, 2026.

I'm asking for unanimous consent.

[The Chair, Liberal, Hedy Fry]

Do we have unanimous consent? We do.

(Motion agreed to [See Minutes of Proceedings])

I thank the witnesses.

We will suspend so that the witnesses can leave and the new witnesses can come in for the second hour.

Thank you.

[The Chair, Liberal, Hedy Fry]

The meeting is resumed.

I want to welcome the witnesses joining us for this second hour on the study of pharmaceutical sovereignty in Canada.

I'd like to introduce our witnesses.

As individuals, we have Dr. Martyn Judson, who is an addictions specialist, and Dr. Mina Tadrous, associate professor, University of Toronto. From the Canadian Pharmacists Association, we have Dr. Sadaf Faisal, interim vice-president, public and professional affairs.

I will give you a quick rundown. Each of you has five minutes to speak. I will give you a one-minute shout-out so you can start wrapping up and then a 30-second shout-out so you can finish wrapping up. We will then go to a question and answer period. I will time everybody for that period, giving people a few seconds here and there to finish their thoughts. I want to suggest that if you wish to respond, you should speak only when the chair recognizes you.

Dr. Tadrous, you know that you have a “raise hand” function. Please mute your microphone when you're not speaking. When the question and answer period comes up, if a question is directed to you, go ahead and unmute and answer it. There is an interpretation service designated by a little globe at the bottom. You can get English or French or floor. You can use that if you wish to.

Once again, all questions and comments should be made through the chair.

I want to begin by welcoming Dr. Judson.

You have five minutes, please, Dr. Judson.

[Dr. Martyn Judson, Addictionist, As an Individual]

Thank you, Madam Chair, for this opportunity to speak before the committee.

I, Martyn Judson, was licensed by the College of Physicians and Surgeons of Ontario to practise medicine for over 50 years, until I retired in April 2025. I engaged in general practice for 10 years and then specialized full time in addiction medicine in 1984.

Over the last 40 years, I've studied the theories of addiction and attended numerous educational seminars pertaining to the management of substance misuse. I achieved certification in the management of substance misuse from the Royal College of General Practitioners in the U.K. and from the International Society of Addiction Medicine. I remain familiar with current suggestions and recommendations for addiction management and continue to teach students at Western University.

In 1991, I was the first physician to prescribe methadone for the management of opioid dependence or addiction west of Toronto. The introduction of methadone was in part a harm reduction strategy intended to minimize the spread of HIV and hepatitis C by contaminated injection equipment. It also combatted the overuse of prescription opioids such as Percocet and OxyContin. Methadone and, latterly, Suboxone are well-recognized opioid replacement therapies that have been significant influences in stabilizing the neurochemistry and neurophysiology of the addicted brain. The consequences achieved are the almost complete eradication of withdrawal symptoms, curbing cravings to use opioids and, most importantly, blocking the access of other opioids, such as hydromorphone and fentanyl, to brain receptors. These receptors, when stimulated, cause damage and harm, which are experienced by the user and society.

It is well known that the pharmaceutical industry, particularly Purdue Pharma, deliberately promoted the use of short-acting opioids in an attempt to induce addiction for those recipients, all the time denying that such a disorder would develop. Opioid agonist therapy had significant success in London until what is best viewed as the introduction of an abundance of short-acting, destabilizing opioids into the community. It is the result of poorly educated, misinformed physicians who do not fully understand the neurochemistry of addiction and therefore over-prescribe. This surfeit of over-prescribing has been aggravated by seemingly substandard medical care, which has not been adequately reviewed by the appropriate licensing authorities.

It is recognized that opioid replacement therapies, such as methadone and Suboxone, do not meet every patient need. Alternative opiate prescribing is acceptable, necessary and sometimes indicated, but this should be in the format of a long-acting opioid. The use of short-acting opioid preparations that do not comprehensively block the opioid receptors significantly increases the risk for patient destabilization, overdosing, homelessness and crime.

Physicians working in safe supply clinics are seemingly unaware of the harm caused to the majority of their patients and the community, not to mention the contribution to drug trafficking. Perhaps they choose to deny it—and this is understandable, considering the lamentable absence of education about addiction in most medical schools, which is limited to about one hour over a four-year course.

In London, there are five safe supply clinics located within pharmacies, in which physicians interview patients and prescribe short-acting addictive opioids by video link. There is infrequent interpersonal contact. The patients then visit the attached pharmacy to collect their prescriptions. The ingestion of medications such as hydromorphone is not appropriately witnessed. This is a recipe for diversion. The more patients attend these clinics, the greater the profits for the physicians, pharmacists, pharmaceutical companies and drug traffickers. All the while, the regulatory colleges, such as the Ontario Ministry of Health and Health Canada, take seemingly little or no action.

My 40 years of experience and accrued knowledge attained by listening to those who successfully became healthy have taught me that the essential components of recovery are the development of responsibility and supportive psychosocial connections to other humans. Many addicted persons have difficulty assuming these prerequisites for recovery, but they must be encouraged to try. The government must stop focusing on the short-term solutions. Physicians need to be better educated about addiction management and academics must move on from putting so much emphasis on harm reduction strategies, which are only part of the management. We must promote holistic well-being by moving away from the disease model of addiction and we must, as a society, not ignore those other components of treatment, prevention and enforcement.

The comments provided in this summary can be well encapsulated in the vernacular by stating that we should adopt a policy of providing a hand-up, not a handout.

I'll attempt to answer any questions you may have.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

I will now go to Dr. Tadrous for five minutes.

[Dr. Mina Tadrous, Associate Professor, University of Toronto, As an Individual]

Thank you, Madam Chair and honourable members of the committee, for the invitation to appear before you today and for bringing focus to this important topic of pharmaceutical sovereignty.

My name is Mina Tadrous. I'm an associate professor at the Leslie Dan faculty of pharmacy at the University of Toronto. I hold the inaugural Canada research chairship in pharmaceutical policy and real-world evidence. I'm also the founding director of the Toronto Centre for Real World Evidence, and I am co-director of the Ontario Drug Policy Research Network.

My research largely focuses on using data to support pharmaceutical policy decision-making in Canada and globally. A large portion of the work I've been doing has examined Canadian and global drug supply chains to better understand the causes and consequences of drug shortages and how to build systems that can help predict and prevent them.

My team has developed world-class tools and technologies that are already being used to help make decisions across Canada today. Our research has been published in some of the world’s top scientific journals and has been commercialized by the university to maximize our impact. Most importantly, our work is actively being used today by decision-makers and health system leaders in Canada and around the world.

Today, I would like to communicate to the committee one central message: True pharmaceutical sovereignty begins with precision and data. We cannot secure what we do not measure, and we cannot secure every medicine in the same way, nor should we try to.

In my view, the core issue is not whether a policy exists; it's whether we know how, when and where to apply it. This is the challenge before us as Canadians.

When it comes to pharmaceutical development, we live in what I describe as an era of abundance. This is both a blessing and a curse. We have thousands of medicines, sourced through deeply interconnected global supply chains, that save and improve Canadian lives every single day, but this abundance also means no country can secure and make every drug themselves. It's simply not possible. Thus, we are forced to choose and prioritize.

The fundamental lesson from my work is not simply that shortages are common and growing, which they are. The fundamental lesson is that shortages are not all the same. Our work has found that not every drug has the same chance of having a shortage. We've also found that not every drug carries the same degree of clinical consequence. To be very direct, not having some drugs will kill patients, while not having others won’t.

For example, a shortage of epinephrine, a life-saving medicine used in hospitals daily, happened a few years ago. This was associated with increased mortality when it was not available. In contrast, a shortage of valsartan, a common blood pressure medication, didn't show any mortality signals.

That doesn't mean those shortages don't matter; it means they don't all demand an equal response, and this is why we need a targeted, data-driven approach to pharmaceutical sovereignty.

The potential policy responses are numerous. Many witnesses will propose some very smart options today and in future meetings, as they have in past ones—things like strategic stockpiles, domestic production, procurement reform, essential medicines lists and even friendshoring. They can all play an important role, but no system can, nor can it afford to, apply every policy to every product when managing thousands of medicines.

That's why a one-size-fits-all approach will fail. This is too complex a problem. What we need to help bolster Canada's pharmaceutical sovereignty is a framework.

Here's a thought experiment to illustrate this. If Canada could build one factory today to manufacture only one drug, what drug should it make? In my view, we should ask ourselves four critical questions: First, which medicines are most critical for Canadians' lives? Second, which are at the highest risk of shortages, and what do we already produce? Third, where can Canada gain economic value? Fourth, what can or should Canada do well?

We must also be honest that this is not just a domestic issue. Canada sits within a complex global market.

It's not only the price a country pays that affects resilience; it's also how its market and regulators function and where it sits in this broader supply chain. For this reason, I urge the committee to think beyond crisis response and towards proactive resilience using evidence and data to identify the medicines that are clinically critical, structurally vulnerable and most likely to fail.

Pharmaceutical sovereignty does not mean making everything in Canada, which is neither realistic nor necessary. If Canada is serious about pharmaceutical sovereignty, it must build a precision-based national resilience strategy, which would position Canada to contribute where it can lead globally.

Thank you very much.