Health Committee on Oct. 2nd, 2025

[The Chair, Liberal, Hedy Fry]

We'll suspend your time for a second while we find out what's wrong.

[Burton Bailey, Conservative, Red Deer, AB]

Thank you.

[The Chair, Liberal, Hedy Fry]

Is your volume up?

[Burton Bailey, Conservative, Red Deer, AB]

Okay, I'll try again.

Why did the former minister of health, Mark Holland, unilaterally restrict nicotine replacement pouch sales to behind the counter in pharmacies, making it significantly more difficult for those who wish to find alternatives to cigarettes?

[Greg Orencsak]

In August 2024, Health Canada did publish a ministerial order that introduced new measures around nicotine replacement therapies. That was done, in large measure, as a result of concerns that had been expressed by health care professionals about youth using nicotine replacement therapies like pouches recreationally.

[Burton Bailey, Conservative, Red Deer, AB]

In order to help Canadians quit smoking and achieve Health Canada's target of 5% or less tobacco use by 2035, would it not make sense to give Canadians access to nicotine pouches?

[Greg Orencsak]

Nicotine pouches continue to be accessible to Canadians. They're available in pharmacies behind the pharmacy counters. Canadians who choose to use that kind of nicotine replacement therapy continue to be able to access it.

The measures that were taken by the former minister were, in large measure, to protect youth from the harms of the recreational use of these pouches.

[Burton Bailey, Conservative, Red Deer, AB]

Will Health Canada give Canadians the freedom to choose to stop smoking by reversing the former Liberal health minister's order and regulating the sales of nicotine pouches in the same way that cigarettes are sold, which is with valid, government-issued ID to legal adults only, to protect against youth access while supporting Canadians who wish to stop smoking?

[Greg Orencsak]

We will continue to review and consider many sources of evidence to inform these new rules, including data on the flavour appeal to youth, for example, as well as any feedback that we get through consultations. We'll continue to consider the risk factors going forward in terms of measures that may be appropriate to mitigate harms, especially as they relate to youth, while continuing to strike the right balance to maintain access to smoking cessation tools for those who need them.

[The Chair, Liberal, Hedy Fry]

Thank you. The time is up, Mr. Bailey.

I now go to Mr. Powlowski for five minutes, please.

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

A number of us here were on the committee at the outbreak of COVID-19, including Monsieur Thériault and Sonia. I see Todd Doherty sitting over there; I think he was on the health committee at the time.

In the weeks leading up to COVID-19, we had Dr. Tam here, and Dr. Njoo, I think. We asked about the assessment of the risk. We were repeatedly told in the weeks preceding the actual shutdown of our society that the risk was low. This was despite the fact that I think you could have gone into any locker room or hockey arena in Thunder Bay and asked a beer hockey team what they thought the risk was, and the majority of people would have said, “Yeah, it's coming.”

I think the Public Health Agency of Canada and Health Canada underestimated the risk. I think our response to the initial outbreak was suboptimal. I think there have been a number of inquiries looking at why that was.

The Globe and Mail had an article in which it investigated and talked to a lot of people about what the problem was with PHAC. I know the Auditor General also came out with a report. I certainly know that one of the things The Globe and Mail criticized was the fact that, in their assessment, the Public Health Agency of Canada and Health Canada had become heavily dominated by bureaucrats rather than medical people. That is something that has taken place over a number of years. That made it feel as though this was one of the factors that contributed to our suboptimal response.

I would note that Madam Hamzawi, the new leader of the Public Health Agency of Canada, is not a doctor. Dr. Tam, who was a doctor, was previously there.

I do not think that you need to be a doctor to be the head of the Public Health Agency of Canada, but what can you do to reassure people like me and the Canadian public that our government has addressed the concern about the lack of medical people?

I'm glad Dr. Sharma showed up here, because she is a medical person.

How can you assure us that in fact you are getting the medical input and the best medical evidence in making your decisions?

[Nancy Hamzawi]

First off, I should clarify that the Public Health Agency of Canada Act is very clear. There is a president of the agency, and that is me. Essentially, I act as the chief executive officer of the organization. There is also a chief public health officer, who also is part of the leadership of the agency. Those are two distinct positions. In fact, in the act, there are four more provisions associated with the chief public health officer than there are with the president, in recognition of the very important role of the chief public health officer.

Currently, the interim chief public health officer is Dr. Howard Njoo. There is a competitive appointment process that is under way, and we look forward to the conclusion of that process soon.

What I can assure you is that the agency continues to have science and medical advice at the core of its work, and we're continuing to ensure that we bolster that to the fullest extent possible. As I noted earlier in terms of the reductions, we have been very careful to minimize the reductions in those areas. For example, the lab is the least impacted by the changes.

Perhaps I might note—and this goes back to an earlier question, Madam Chair—that, in terms of the COVID-19 pandemic, without public health measures or vaccines, there would have been up to 800,000 deaths. The observed number of deaths, as of April 24, 2022, was 38,783. Without public health measures or vaccines during the pandemic, up to two million hospitalizations were expected, and there were 150,602. Without public health measures or vaccines, there would have been up to 34 million cases, but there were 3.3 million reported cases. Those are the facts in terms of what happened during the pandemic and what the modelling shows.

[The Chair, Liberal, Hedy Fry]

Thank you, Dr. Powlowski.

I will now go to the third round. I'll begin with the Conservatives.

Mr. Strauss.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Thank you, Chair.

Thank you to all the officials who have come. I used to be a public health official, and I had to present myself to the board of health. It is always stressful, so I appreciate what you're doing, being here today.

My questions are for Ms. Hamzawi.

I want to say before I start that I noted when you were appointed that there was a lot of unfair and, frankly, ugly and inappropriate criticism of your appointment. I thought you handled that with a lot of grace and composure, so thank you for your service.

I reviewed this document, the Public Health Agency of Canada science strategy. I know it was prepared before your tenure. I don't know if you've had time to review it, but there are parts of it that I found very interesting, and I want to ask you some questions about it.

With respect to this document, several references are made to decolonization and science. In your view, is the Public Health Agency of Canada science strategy currently colonized?

[Nancy Hamzawi]

That essentially reflects the importance of health equity in the work that we do. I would interpret that as making sure that we reflect the importance of reaching all Canadians and having an anti-racist lens to the work that we do.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

I take that as a yes then, that the science currently being pursued is colonized.

Do you have an example of colonization in the science that the agency is currently doing?

[Nancy Hamzawi]

I would say that a key priority for the agency is health equity, ensuring that we reach all populations. There are some populations that are more impacted than others. There are our indigenous populations. We have specific programs for Black Canadians. There are a number of populations that need additional supports to ensure that they receive supports for access to health care.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Health equity is very important, and “health equity” is in the document many times. It seems like you have a preference for the term “health equity” over the term “decolonization”. I wonder if you would commit to, if that's what the term means, using the term “health equity” more often in these documents when they are prepared.

[Nancy Hamzawi]

Thank you for that. I'll take a look at that.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Thank you.

Similarly, the report says that the Public Health Agency of Canada “recognizes that taking meaningful action against racism in science...is crucial for achieving science excellence.”

Is science, in fact, currently racist, and what racist science will you be taking action against?

[Nancy Hamzawi]

That statement essentially reinforces that we take an anti-racist lens to our work. An example I can think of is from when I was at Health Canada, and it was around the issue of sunscreen in terms of the requirements. An assumption of a lighter tone of skin rather than a darker tone of skin has an impact in terms of the kind of advice that comes forward. That's an indicative example of what we're looking at trying to avoid in the advice, the best possible scientific advice, that we can give to you.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

I will say that it's a terrific example. I remember it from when I was in medical school in 2004, and I was thinking exactly that.

The report says that PHAC wants to diversify its science workforce. Does this mean that PHAC will strive to have scientists from diverse academic disciplines working on diverse problems with diverse methods, or does it mean something rather cruder about racial quotas in hiring scientists?

[Nancy Hamzawi]

We have employment equity obligations enshrined in law, so I would say that it's both ensuring that we meet our obligations for employment equity but also ensuring that we have multidisciplinary streams of thoughts that support our work. We're looking at multidisciplinary and interdisciplinary aspects as well as meeting our obligations for employment equity.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Are these employment equity outcomes quotas?

[Nancy Hamzawi]

They are not quotas. They ensure that we engage at a rate similar to workforce availability in each of these areas.