Health Committee on March 26th, 2026

[Dr. Mina Tadrous]

Thanks again for the opportunity to be here.

This area of work is something that I've been thinking about for a very long time. Canada is not the only one grappling with this. You heard Dr. Faisal speak eloquently about the different components and how every country is largely dependent on somebody else. For drugs to end up in Canada, some of them will go through four or five or even eight different countries before they end up on a shelf in a pharmacy here. This is true for the United States, the world's largest consumer of pharmaceuticals. This is true for Europe and many of our allies that do this work.

What they're all grappling with is that, let's say you want to invest in and build a factory. One factory can cost anywhere between half a billion dollars and $1 billion, depending on what you want to do, and it can take many years. It's a large investment, but it may produce only a small number of products. I'm not saying it's not very important, because domestic production is critical, but the issue becomes this: If you have thousands of drugs, which ones are you going to pick to do this for? Even the United States has admitted they cannot produce all of their own drugs. However, we know that we want to produce some of them.

In terms of what we have produced, what we've proposed in a lot of our research and our work is that, to think about what the most important drugs are, you need to think about two factors.

First, which drugs are at the highest risk of a shortage? We can predict this based on a variety of different factors. How much domestic production do we have? How many products are in it? Is it an IV? What kind of drug is it?

Second, what is critical for an acute clinical situation? I laid out two examples in my opening statement. You have epinephrine, a medication that is needed when someone has an anaphylactic shock or they're in the hospital and they need it at that moment, versus a blood pressure medication for which we have other options. It's preventative. It's important, but you can do with other options there.

That's the kind of thing you can think about. It can help you fine-tune and bring it down from thousands. You can probably pick your top 50 or top 100, depending on which policy you want to implement.

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

As a follow-up to that, how do you see putting this into practice? When we're looking at frontline physicians, pharmacists and nurse practitioners, will it be immediate, or do you see more training happening in between?

[Dr. Mina Tadrous]

That's a really great question. Some of these proposed frameworks are more about what is preventative. When we think about drug shortages and supply chains, there are preventative and there are reactive things. We want to minimize anything reactive, because this is when things go awry. For the preventative, there are things like building factories and developing stockpiles, but that means an investment from the Canadian government.

If you have a limited amount of funds and you want to put it towards a certain place, you would implement the list and think about, “Okay, let's pick the 50 drugs that we want to make sure we control the supply of.” We ensure that they're made in Canada, and that's what we're going to invest in. We can then apply the same list and use it slightly differently to say, “Let's make sure we get the next 50 important ones from friendly allies.” You can imagine that this helps prevent future shortages, because we know that, even by going from one manufacturer active in the market to two, it can reduce shortages with a 20% probability. This is a big deal when you have hundreds of shortages happening within a single year.

Reactively, at the ground level, there are a lot of different policies that I want to flag. We need to empower pharmacists to respond, and we need to empower ourselves to respond quickly. I will note that we've done research in this space, in which we compared a shortage that hits Canada versus one that hits the United States. What we found, and it is something I am pretty proud of, is that Canada responds better—40% better, actually. The reason for this is that we empower some responses: We have tables and task forces. When you have policies that help you respond, you can do better in the way you respond to these shortages.

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

Thank you so much.

[The Chair, Liberal, Hedy Fry]

You have one minute.

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

Maybe I'll wrap up by asking, if you were to make a recommendation to the federal government—you talked about the supply incentivizing side—are there any actions...? Within the short 30 seconds you have, do you have anything to add to what you just said?

[Dr. Mina Tadrous]

I think that domestic production, friendshoring, supply chain resiliency and regulatory agility in responding are essential. However, again, all of those policies need to be backed up by data.

One last point I'll make is that we have a data scarcity. We don't even know how much of a drug is inside our country at a single time, and we need to fill that gap immediately.

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

The ability to track and have the real-time data would help.

[Dr. Mina Tadrous]

It would help incredibly, yes.

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

That's really great. Thanks so much.

[The Chair, Liberal, Hedy Fry]

Thank you very much, Ms. Chi.

I now go to Mr. Blanchette-Joncas for six minutes, please.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Thank you, Madam Chair.

I would like to extend my greetings to the witnesses here for the second hour of the study.

My first question is for Ms. Faisal.

Is Canada still heavily dependent on imports for essential drugs?

[Dr. Sadaf Faisal]

Yes. As I mentioned in my remarks, we rely heavily on a lot of pharmaceutical.... Active pharmaceutical ingredients are required to produce any drugs, and only 2% of them are domestically produced in Canada. Most of them we import from other countries.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

According to your analyses, despite the lessons learned from the COVID‑19 pandemic, why does Canada still not have the capacity to produce certain critical drugs in the event of a crisis?

[Dr. Sadaf Faisal]

That's a really good question. There are many factors. Manufacturing a drug is not easy. We need to have the manufacturing plants, the workers to work in those plants, the active pharmaceutical ingredients and the machinery. This is a good time for Canada to consider domestic manufacturing, but as I said, domestic manufacturing is not the only solution, because it will take time. There could be some preventive strategies for drug shortages. There are many other things that we need to consider when we are talking about pharmaceutical sovereignty at this stage.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Can we really talk about pharmaceutical sovereignty if Canada doesn't have enough local capacity to produce essential drugs?

[Dr. Sadaf Faisal]

As I said, producing essential medicine is just one part of pharmaceutical sovereignty. It is one part of the whole approach. The other approach is that we need to have a critical list of medications that we really need. Right now there are more than 9,000 prescription medications that are Health Canada-approved, 2,000 non-prescription medications and more than 30,000 medical devices and parts. We can't just start producing everything together, so we really need to come down to making an important critical list of medications. We can then look into the feasibility for us to produce them.

However, during that time—because you can't just start a manufacturing plant overnight—we need to look at other resources. We may try to expedite some of the review processes for drug manufacturers so that they can bring their products into Canada.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Thank you.

In terms of feasibility, is there a formal and up‑to‑date assessment of the risks posed by our dependence, for example, on major foreign supply chains?

[Dr. Sadaf Faisal]

Not that I'm aware of. I haven't come across any for supply chain feasibility.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Do you think that the government should carry out a risk assessment of our dependence on foreign supply chains?

[Dr. Sadaf Faisal]

It would be a really good start to look at the supply chain. It would give us some information and data to look at what points we need to invest in if we really want Canada to be resilient when it comes to drug supply chains.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Do you know whether other comparable countries in the G7, the G20 or the Organisation for Economic Co‑operation and Development, or OECD, carry out this type of analysis?

[Dr. Sadaf Faisal]

Not that I'm aware of, but I can check it for you.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

In your opinion, is Canada currently a real match for the United States, for example, when it comes to attracting pharmaceutical investment?

[Dr. Sadaf Faisal]

I'm not aware of that landscape, so I don't think I can talk about it.

We are in a really good position to explain that there is an opportunity for people to come and invest in Canada, but as I said, that's not the only solution for pharmaceutical sovereignty.