Veterans Affairs Committee on May 6th, 2019

[Col Rakesh Jetly]

Yes

[Phil McColeman, Conservative, Brantford—Brant, ON]

Okay.

Homewood Health bills itself as Canada's leader in mental health and addiction services, with a national network of over 4,500 employees and clinical experts. In addition to the agreements, Veterans Affairs Canada also has agreements with provincial health authorities, and the department claims it funds “a well-established network of over 4,000 mental health professionals across Canada”.

Is Homewood the “well-established network” that Veterans Affairs Canada is funding?

[Col Rakesh Jetly]

Again, you're asking a military person about Veterans Affairs Canada, so would you like me to continue answering it?

[Phil McColeman, Conservative, Brantford—Brant, ON]

Yes, if you could.

[Col Rakesh Jetly]

It's up to Veterans Affairs to decide what their network is.

[Phil McColeman, Conservative, Brantford—Brant, ON]

So you're not aware of whether that well-established network is Homewood?

[Col Rakesh Jetly]

I'm a military member. I focus on military matters.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Okay.

The research being done by Homewood is delving into PTSD in military personnel and veterans. Does the research address mefloquine exposure in any way?

[Col Rakesh Jetly]

I don't think so. I'm not positive though.

[Phil McColeman, Conservative, Brantford—Brant, ON]

You're not sure.

You may have been able to look at the testimony of our previous witnesses who were here. We had Dr. Nevin and the chief psychiatrist who were here from the United States. In both cases, in their testimony, they came to a point that I would describe as somewhat outraged by the response of the Minister of Veterans Affairs to their request to assist in the study of mefloquine by screening military members on whether they took mefloquine, which would be step one. It would be an acknowledgement of “Did you take mefloquine, yes or no?”

From your positions within your departments, would you be opposed to a screening of military members as to whether they took mefloquine, yes or no?

We can just go across the table, unless one of you wants to take that on in a more fulsome way.

[BGen Andrew Downes]

Thank you.

I'll start by trying to provide an answer to the question prior to passing it on to my colleagues.

One of the purposes of doing screening is to be able to do something about it. The current situation is that, although we could ask questions about what people did or did not take, as far as the understanding or the science around actually conducting a test is concerned, there is no specific test to be conducted.

[Phil McColeman, Conservative, Brantford—Brant, ON]

I'm going to have to end it there. I didn't know I was that far down the line on my time.

I will take that as a no, because you were elaborating as to perhaps why you are not doing it.

Chair, I'd like to ask for unanimous consent to distribute the actual monogram that is on the product that was described in our last meeting by the experts that we have. I have copies of that monogram, and just for your information, it describes what is put on the packaging of the product.

Could I have unanimous consent for that?

[The Chair, Liberal, Neil Ellis]

Is there unanimous consent?

[Some hon. members]

Agreed.

[An hon. member]

[Inaudible—Editor]

[Phil McColeman, Conservative, Brantford—Brant, ON]

No, we only have it in one....

[The Chair, Liberal, Neil Ellis]

Okay, we will get it translated and give it to the committee at the next meeting, then.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Do we have unanimous consent?

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

They gave unanimous consent to give it out, but in the future,

it needs to be in both official languages, please.

[The Chair, Liberal, Neil Ellis]

Okay.

Mr. Eyolfson.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you, Mr. Chair.

Thank you, all, for coming.

Dr. Downes, I was reading your testimony. You stated that there are a number of military members and veterans who are concerned that they have long-term psychiatric symptoms, and they are concerned whether mefloquine could have contributed to their illness. You then go on to say the concern is understandable given the level of discussion and debate in the media and in the scientific and medical communities.

One of the things we deal with in medicine, and in research as well as medicine, is confirmation bias. Do you think there's any role of confirmation bias in some of the claims being made by certain investigators and certain advocates of this point of view as to whether certain individuals may or may not have so-called toxicity to mefloquine?

[BGen Andrew Downes]

I would say that humans all have bias. On the issue of confirmation bias, I'm not quite sure what you're referring to there. I presume you're referring to the fact that we have a hypothesis on the table and that people are looking to confirm their hypothesis. Is that what you're referring to?

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Yes.

[BGen Andrew Downes]

I can't really answer that question. It's quite possible that this is the case. I think when you look at all the studies that are being done and reports that are being generated, there are biases, a number of different kinds of biases. I do think there is a desire among some to prove a theory, prove a hypothesis, but the real evidence for it is not strong. I sense that this discussion has sort of reached an unhealthy level where there are accusations going on back and forth within the scientific community, which I don't believe has been helpful. I think we need to be having mature discussions on this very important subject and working together to find solutions.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Okay. Thank you.

I have another question. We talked about screening. When you're screening for a disease, if we have a group of people who came back from a certain area with a disease, you're screening for it. You look for, let's say, malaria, if they've been to a malaria.... I'm just using that as an example of what you might be screening for in a population. You have evidence to believe that the screening you're going to do is going to confirm the diagnosis. You do a blood test for malaria, and these sorts of things. Now, as to this request for screening for mefloquine toxicity, in the letter from Dr. Nevin, which I have here, the screening tool that he talks about—and I'm obviously condensing this: Do you have neuropsychiatric symptoms and did you take mefloquine—is there any science supporting the contention that this series of questions would in any way, shape or form support the diagnosis of mefloquine toxicity?