Industry Committee on Oct. 7th, 2010

[The Chair, Conservative, David Sweet]

Thank you, Madam Zirger.

Thank you, Mr. Masse.

Now we go on to Mr. Van Kesteren for five minutes.

[Dave Van Kesteren, Conservative, Chatham-Kent—Essex, ON]

Thank you, Chair.

Thank you for coming.

I, like Mr. McTeague, have been on this committee...not quite as long as he has, but I remember that we did a study in which we looked at this same issue.

Dan, was it in 2006?

[Dan McTeague, Liberal, Pickering—Scarborough East, ON]

Or was it 2005?

[Dave Van Kesteren, Conservative, Chatham-Kent—Essex, ON]

But this was prior to the success we've seen with at least one drug coming to Africa.

I get a feeling, though—and I don't think it's just a feeling, but the elephant in the room—that it's rather like trying to give infrastructure to a country, saying “these people need trains”, and you send them a bunch of trains and there are no tracks. We're talking about all these things and we're asking the question, is it efficient? Are there things we can change? Would that change anything?

Some of you have stated in your opening statements that there are other serious problems. Before we administer these drugs, before we can bring them to market, before we can give the people that which they're in need of, there have to be some other things that line up.

I think we have to bring this home. There's no one here who doesn't look at Africa without our hearts just aching. I saw a program the other night on TV Ontario about the Congo. It's a different issue, but we all wish we could do something, that we could be more effective.

But I want to bring us home, and I'm going to give you the opportunity just to talk about what else is necessary. Before we can administer these drugs, what is the prerequisite for all of that?

Maybe you could elaborate on this.

[Louise Clément]

As I mentioned in my opening statement, providing health services and accessing the population is a complex issue. It's multifaceted, and yes, it requires a number of elements; medicine is one. It also involves being able to plan effectively for the medicine you need, having the health care workers to do the diagnosis and provide the treatment that is needed, having the facilities available so that the people can access health care. It means governments having the capacity to procure. It means having the financing to be able to plan your health system.

There are other elements; these are a few major elements. And as I've mentioned, CIDA and its partners have a number of programs that work to address this continuum, the whole of the health challenge. I've mentioned a few examples in my statement. I don't think it's worth repeating those examples.

Perhaps I can share some results. I have some information here; maybe that would be helpful.

[Dave Van Kesteren, Conservative, Chatham-Kent—Essex, ON]

Please do.

[Louise Clément]

Through the Global Fund, for example, to which Canada announced an increased contribution recently, 2.8 million individuals living with HIV/AIDS currently receive treatment; 7 million people have received treatment for TB; and 142.4 million malaria drug treatments have been delivered.

Through the WHO “3 by 5” initiative, to which Canada contributes as well, we helped facilitate three million people receiving treatment for HIV by the end of 2007. Through the global polio eradication initiative, another one to which Canada contributes, they've succeeded in reducing the number of annual polio cases by 99%. Through the GAVI Alliance, between 2000 and 2001, immunization programs have averted an estimated 4.4 million deaths in developing countries.

I have one last one, the Global Drug Facility. This has supplied more than 60 million patients in 100 countries with TB treatment.

These are examples of areas in which the types of intervention that are supported are producing results.

[Dave Van Kesteren, Conservative, Chatham-Kent—Essex, ON]

So we do have some good news stories, and the effort....

I see, Ms. Reissmann, that maybe you want to jump in as well.

There are some areas that we are being successful in. I think what I'm hearing from you is that we need to concentrate our efforts on those areas. Is that correct?

[The Chair, Conservative, David Sweet]

Be brief, Ms. Reissmann.

[Christine Reissmann]

That's correct.

I wanted to add to my colleague's answer a few other issues related to your earlier question.

There are also issues or gaps in laboratory and diagnostic services. In some of these countries, people are misdiagnosed—quite badly misdiagnosed—for a long period of time while their real illness flourishes. Distribution and delivery networks are in some cases non-existent. Vaccines requiring a cold chain are not always there. In the end, you can have—and we have experienced—situations in which large shipments languish somewhere and expire and then create another problem of disposing of those products when they have expired.

[The Chair, Conservative, David Sweet]

Thank you, Madam Reissmann. I'm sorry to interrupt. I am always at the mercy of the clock.

Now on to Mr. McTeague for five minutes.

[Dan McTeague, Liberal, Pickering—Scarborough East, ON]

I just want to follow up Mr. Van Kesteren's questions.

I thank you for those answers. It's my understanding that WHO is taking a rather different tack now and has begun the process of identifying children's AIDS as being a priority. If that's the case, and in terms of what you've given as far as therapeutic outcomes are concerned, what has Canada done to address that more recent priority, if you will, of the WHO?

[Christine Reissmann]

Canada has just recently committed an additional $30 million to the prevention of mother-to-child transmission of HIV as part of the Canadian HIV vaccine initiative. That is one example. We have other funding with various multilateral organizations, UNICEF and the WHO, whose considerable and significant treatment programs for mothers and children in the field we have also supported.

[Dan McTeague, Liberal, Pickering—Scarborough East, ON]

The vaccine of choice in this case would be produced by whom and under what regulatory regime? It would not necessarily be within Canada, but another country I presume would.... We'd be purchasing or contributing to a global fund, and one company that has the vaccine would then distribute at a particular rate.

[Christine Reissmann]

The HIV vaccine at this point, unhappily, doesn't yet exist. The initiative is about providing incentives to the development of such a vaccine.

[Dan McTeague, Liberal, Pickering—Scarborough East, ON]

Oh, okay.

[Christine Reissmann]

The prevention of the mother-to-child transmission component of that initiative was put in place. We insisted on it as a stop-gap measure while a vaccine was still under development, and we hope it will be soon, but we don't know how long that process will take. The infection rate is still approximately three million new infections every year, so CIDA felt it was important to put something in place to address the ongoing infections at the moment.

[Dan McTeague, Liberal, Pickering—Scarborough East, ON]

Could I just shift back to a piece of legislation that may have been a precursor to this or that happened at the same time, Bill S-232? The senator has now retired. I did speak to him at one point.

With reference to streamlining the applications process within CAMR, I wonder if the following has been considered by the departments involved, where one obtains a licence in order to renew that licence and they have to go through the same process. I think part of the legislation was to minimize that period of time and to have one licence for one particular product for one particular case.

Is that something that's been considered by the Department of Industry as being acceptable if we were to continue down the road of trying to gain momentum? As we all know, Apotex has made it very clear that it no longer intends to produce or supply under the current regime as it stands.

[Colette Downie]

Every time the government considers a bill, a private member's bill or otherwise, of course it goes back and looks again at the processes and the proposals to change them. I don't think I can go into the consideration, obviously, by cabinet of what might or might not be done. I will say, though, that one of the things about the Apotex example was that it actually did allow for multiple shipments, in that the authorization was for a total amount, a large amount, which was then shipped as individual shipments. So that is actually possible under the regime.

[Dan McTeague, Liberal, Pickering—Scarborough East, ON]

Am I correct in assuming that what was shipped over the period of time was two shipments, 17 million tablets targeting 22,000 patients over a three-year period? Does that jive with your...?

[Colette Downie]

I don't have those exact numbers. About 15,600,000 tablets were authorized. About that in total was sent. A first shipment of about 6.7 million tablets was sent, and then another 7.6 million.

[Dan McTeague, Liberal, Pickering—Scarborough East, ON]

Can anyone tell this committee if anyone had attempted to do any other country, such as the Congo and Botswana? There's a whole list of countries considered hot spots. Was there ever any approach to the Canadian government or to the use of CAMR other than Rwanda in the case of Apotex?

[Colette Downie]

I'm aware of that, but it's second-hand information and concerns some of Rob's predecessors. There have been lots of discussions in the past, I understand, of other possibilities. But again, it's second-hand information. These didn't come to fruition for various reasons, which I'm not actually aware of.

[Dan McTeague, Liberal, Pickering—Scarborough East, ON]

And I think we're here because of that.

Thank you, Chair.

Thank you, witnesses.

[The Chair, Conservative, David Sweet]

Thank you, Mr. McTeague.

Actually, you were right on time, Ms. Downie.

Now, on to Mr. Lake for five minutes.