Industry Committee on Oct. 26th, 2010

[Anthony Rota, Liberal, Nipissing—Timiskaming, ON]

So it looks good on the shelf--

[Russell Williams]

I'm perplexed that they're holding off. I am very perplexed. The generic companies are sitting back and telling Canada that unless parliamentarians change this law, they will not use it again. I find that kind of positioning, when we're talking about this kind of humanitarian cause, quite--I'll be careful with my words--inappropriate. I find it inappropriate that we should be pushing ourselves to push harder and apply and make sure this law works. I find it astounding that the companies are sitting back and telling politicians that they're not going to apply until you change the law.

[Anthony Rota, Liberal, Nipissing—Timiskaming, ON]

When we put laws together, I look at something...like, how functional is it? If it just sits on your shelf--it makes us feel good but it doesn't work, and nobody's using it--then the law isn't functional.

I'm trying to make heads or tails out of this, and it comes down to IP, licensing...?

Ms. MacLean, did you have a comment you wanted to make on this?

[Emilou MacLean]

I would just say that in the conversations we have....

I guess I'll start back at the beginning. Normally when we're purchasing drugs, we make an order and we get the drugs. There aren't many other steps in that process. When you have to go through the CAMR process, there are about 30 other steps in that process. There is a stunning diagram that demonstrates what that comparison is.

Countries have told us, “We don't even understand the legislation, so how can we go forward with this?” There are enormous barriers in there. I mean, we can speak about what Apotex would say. We know from the other side that there is another initiation of that process that has to happen also from the countries' perspective. The countries are not going to move forward with it. They're not here to testify. They weren't invited to testify. No criticism to the committee, but Apotex is not here, and was unavailable today.

The countries' perspective, as they told it to us and as they experienced it with us, was this: the system was unworkable and it needed to be changed.

[Anthony Rota, Liberal, Nipissing—Timiskaming, ON]

Okay.

I'd like to go back to the one-licence solution. I'm not going to say it's a cure-all, but it seems to be something that would allow drugs to get out there. It would make it worthwhile for the companies.

Mr. Williams or Mr. Perry, how would this affect your companies?

[Russell Williams]

I think you have seen already, in the one example that's been effective, that when there were terminations of time schedules, the three companies involved on our side voluntarily extended them and supported the principles of CAMR. That was a non-issue. It seems to me that the checks and balances that parliamentarians unanimously put into CAMR are actually there, and they work. Once they go through it, and people have some dialogue.... To my understanding, the renewal was done within a week.

Again, I'm having a hard time buying that there are problems here if people actually want to work this out together.

[Anthony Rota, Liberal, Nipissing—Timiskaming, ON]

You're okay with that, Mr. Perry?

[Grant Perry]

Yes.

[Anthony Rota, Liberal, Nipissing—Timiskaming, ON]

Okay.

I'm going to switch over to something else, something that comes up often, and that's that the infrastructure is non-existent. It's the chicken and the egg: which one comes first?

Mr. Dotto, you were talking about how hospitals are in place in rural areas, and Ms. MacLean, I'm sure you've had a lot of experience. Maybe from the two of you--I believe I'm running probably fairly short on time, so I'll open the question to both of you--how did you see the hospitals develop, and why are they not developing sooner? Does the medication stop or does it help them?

I mean, if we have something that we can use, we want to develop the infrastructure. If we don't have it, we kind of give up hope and walk away. That would be my way of looking at it, or my interpretation of it, but I'll leave that open to the two of you to comment. Maybe just explain to me, first, how infrastructure develops, and second, whether more medication going into a country would help develop that infrastructure.

[The Chair, Conservative, David Sweet]

Madam MacLean first, as briefly as you can, then Mr. Dotto.

[Emilou MacLean]

I'll be as brief as I can.

I would like to give a specific example of a colleague of mine who was working to start an antiretroviral treatment program with MSF in the early days in Mozambique. His wife, a gynecologist who was working on maternal mortality, said, “We don't even get support to be able to do work on maternal mortality. How do you expect to be able to roll out antiretroviral treatment when there are all these burdens and all these barriers and all these arguments about this not working?” And he said, “We're changing the paradigm. There's been recognition of a stunning disease devastating the global south, and we're going to bring that to the fore and change the paradigm.”

We have seen that infrastructure gets built and resources come forward; when there is political will, you can actually respond. Some 5.2 million people who are on treatment today would have died without it. There were 8,000 people on treatment in all of Africa a decade ago.

So the arguments about infrastructure made at that time--they're the exact same arguments that are being made about infrastructure today.

[The Chair, Conservative, David Sweet]

Mr. Dotto.

[Laurence Dotto]

I would just add in terms of infrastructure that I think it's a critical issue. Many times the infrastructure will only change when there is support from partnerships--partnerships with governments, partnerships with NGOs, partnerships with companies like Abbott, Glaxo, and others.

In the countries where you are starting to see significant changes in infrastructure capacity.... Take Malawi, for example, where the HIV rate six years ago was running 13% to 15%. Through a lot of collaboration partnerships, that HIV rate now is down to 12%. They've dropped several points. So in order for that type of thing to happen, I think these are the sorts of partnerships and collaborations that are needed.

In terms of getting access to the medication, six, seven, eight years ago, this was a huge issue, but today many of these countries have moved on. They're now getting source drugs from countries that they weren't six years ago.

I think that's another reason why you're not seeing people asking from Africa. I'm not sure how many people here today are here representing the African community, but I think you have to ask yourselves, “Why are they not here? Why are they not asking for these medications?”

[The Chair, Conservative, David Sweet]

Madam Watson, you have 30 seconds.

[Linda Watson]

Oh, Mr. Sweet.

I want to say that we grandmothers are aware of a different paradigm of infrastructure in Africa. There are places like the Hillcrest AIDS Centre, where there are only six registered nurses, but a whole army of volunteers have been trained to do home-based care and take medicines where they're needed. There is the situation of the Consol Homes in Malawi. One couple went around to try to get help for 63 orphans. They now have 107 centres, over 500 volunteers, and are treating 30,000 African children and getting them medicines. There is an infrastructure that's working now. The people there care enough to put their feet down and make it work.

I want to know that this country cares enough to do its part to make this legislation as effective as possible. I am very distressed, and even outraged, by the rumours we have heard that the decision of this committee was made before these hearings even began, and that when the report comes back this bill will be dismissed on a procedural technicality. That is an insult to this committee and an insult to the champions of this bill.

I ask you, Mr. Sweet, to please guarantee that your clause-by-clause deliberations will be conducted with full account of the merits of this bill and the hearings you've heard, and that members of this committee, at least, are not complicit in trying to dodge the transfer of sponsorship to Mr. Masse when it comes to the House.

[The Chair, Conservative, David Sweet]

Thank you, Madam Watson.

We'll go to Mr. Lake for five minutes, please.

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

I'm going to make a few comments, and then I will direct a question to Ms. Watson and Ms. Rennie.

I want to start by saying that there are a lot of grandmothers here in the room, and in my five years as a parliamentarian I have not met a more compelling or motivated group of witnesses on any issue.

I can assure you that the first question I had when I saw this piece of legislation come before us and I sat with officials to talk about it was whether there was any way at all to modify this bill to achieve something positive, without the negative unintended consequences we've talked about. As far as addressing this issue, we're on the same page.

Ms. Rennie, in your opening statement you said that we need to do something. I think we can all agree that we need to do something.

There are a few other things you talked about in your opening statement. You said the issue is not about patents or intellectual property; it's about people. Part of the problem in dealing with this bill is that while I agree with you that the issue is about people, the bill is entirely about patents, IP, and food and drug regulations. That's where we're going to see unintended consequences. It's our job as parliamentarians to consider the impacts of the legislation we pass on all sorts of things.

You also talked about the need of the Canadian government to step up. We've heard that from witnesses who have come before the committee in the past week. We heard it today when Ms. MacLean talked about the 5.2 million people who are getting treatment today. I think you said there were 8,000 originally. The numbers we have are 400,000 in 2003, and I believe there was a twelve-fold increase to 2010 to get to 5.2 million. It seems that we're well on our way to the 10 million in total that we need to get to.

I would say that something is working. We know that considerable momentum is occurring. We can see that through the investments we've made in the global fund--$540 million for the next three years--a significant contribution is being made by the Canadian government. Let's face it, that contribution is simply being made by Canadians. We're not spending government money, we're spending taxpayers' money, Canadians' money, and we've increased the amount we're spending. So we're seeing some impact.

I have to be honest with you, Ms. Watson. You made some comments about what's going to happen with this bill. I voted against it in the first place when it was before the House, for what I consider to be good reasons. At this point I haven't heard anything that convinces me to not vote against it the second time. But I want to assure you that moving forward I want to focus my attention on addressing the actual issue: that people in Africa who don't need to be dying are dying for want of very simple solutions. We need to find ways to address that.

As we move forward, if this bill doesn't pass, how can we take the momentum and considerable enthusiasm the grandmothers bring to the table and work together to achieve some real results? What other areas could the grandmothers be working on, or are working on currently?

[Elizabeth Rennie]

Thank you, Mr. Lake.

Obviously, some things are working. On the other hand, there are still millions who are dying. As we've said, this is but one solution. I don't know how many times people have to hear from the experts about the intellectual properties being compliant with this bill. I don't know how many times we have to say that and hear that from the experts. I don't know how many times we have to say that the existing CAMR includes a clause about diversion. Diversion is not a problem. I think this is constantly sidetracking us from the real issues of how to make this work.

I can speak for myself; I'll speak for thousands of others: of course we want to make it work, and we will work with anyone who is going to offer a viable solution. We think we have a viable solution with this. What can we lose, Mr. Lake, by trying it? What can we lose?

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

The answer is that there are significant unintended consequences, and of course the experts that came before us from all four departments, experts who are not partisan, who are the people we rely on to give professional advice on these issues--

[Voices]

Oh, oh.

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

No, for clarification, they are people who would be there regardless of who's in government, giving advice on these issues from all four departments involved. They have advised very strongly against unintended consequences of this bill.

[Elizabeth Rennie]

We're not paid lobbyists. We really are multi-partisan.

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

These are departmental officials I'm talking about. I'm not talking about anybody else who has come before the committee. I'm talking about the departmental officials, our professional public service, simply for clarification.

[Linda Watson]

Mr. Lake, to your question about what other sorts of things grandmothers would support to see change and improvement in the lives of those who live in sub-Saharan Africa, particularly the grandmothers and the children orphaned by AIDS in their care, we would like to champion seeing Canada on a timeline to reach the 0.7% commitment to official development assistance, relative to GNI, that we committed to back in 1970 and have recommitted to many times. We would like to see Canada increase its contribution to the global fund, to its true fair share, in fact.

But we are dealing with this bill today, having discussions about infrastructure and other kinds of matters, and whether there's clean water or not are moot to this discussion. This bill has a potential to save lives. You asked, “How will we go forward?” You mentioned that you voted against this in the House of Commons. I don't know if that was a vote of conscience. If it was, I encourage you to vote it again at third reading, but, please, do not put up a procedural block to the transfer of sponsorship that will not allow proper debate and proper use of your vote, one way or the other, at third reading.

[The Chair, Conservative, David Sweet]

Thank you, Madam Watson. I appreciate the passionate response you have on this, but we have only about three minutes left now.

Monsieur Bouchard, any time we go over we're taking from the next panel, so be as brief as you possibly can, please, sir.