Mr. Speaker, when I was first elected in 1993 and when the 35th Parliament opened in January 1994, one of the issues was our health care system. It continues to be the top priority of Canadians today. At the time there was a commitment of the party that formed the government to establish a national forum on health, because there was this looming concern about whether or not our health care system was prepared to meet the challenges that we were facing. Some of the signals were already showing.
I had served for about nine years on the hospital board in Mississauga, so I was quite interested in the health files. After nine years on the board I had learned a little about our health system, how complicated it is and how extremely important it is to deal with prioritization. Therefore, when I came to Parliament, I asked to be on the health committee.
I raise this because the first meeting I ever attended as a parliamentarian was a meeting of the health committee. The officials gave us a presentation on the state of the health care system in Canada. What I will never forget, and it still continues to be reflected in what we are talking about in Bill C-5, is they said that 75% of what we spend in the health care system is for the remediation of problems and only 25% is for prevention. Their conclusion was that that model was unsustainable. They were right.
Even back in 1993 there were the same concerns about whether or not we had the right balance between prevention and dealing with problems after they had occurred. That is why since 1993 there have been significant programs with regard to the responsible use of alcohol, smoking cessation, and the like. These are directly related to a conscious decision by Health Canada to get the balance a little better and shift from dealing with problems after they have occurred to prevention.
As we go through all of this, it is extremely important that we do not abandon those who are ill. At the same time, while stabilizing the problems that are there already, as economic circumstances will permit, we still have to make those investments.
The genesis of this bill goes back to even before I became a member of Parliament. Sometimes things in this place take a long time to ultimately happen. There are linkages. Everything has a history. There certainly is a history here and rather than repeat a lot of the information that was given by members already, I wanted to add a little perspective. I wanted to provide some information to members and to Canadians about one of the principal areas of the mandate of this new agency, which actually started to operate in September 2004. This bill will give some parliamentary foundation to it. Its mandate is to strengthen Canada's public health and emergency response capacity.
Many members have talked about the SARS outbreak in 2003. In some areas of our country that was a very difficult time. Particularly in Scarborough, Ontario, there was some localization. In the Chinese community, the restaurants and some of the seniors' centres, all of a sudden there were problems. We could see that it was there. We received a failing grade on the report card on how we responded to that crisis. People were not sure what they were dealing with, how to deal with it, how to protect the health of Canadians.
Since that time, more and more people are becoming better informed about things like bird flu and pandemics. They are still a bit unsure about what these things are. Part of the principal mandate of the agency headed up by Dr. David Butler-Jones is to deal with preparedness for the big hit, for those things that really could impact.
I am told that if a pandemic of a certain viral strain or flu strain were to hit, in theory it could spread throughout the world in a matter of weeks. Those who have health difficulties may be the most vulnerable.
What do we do about all the caregivers, the doctors, nurses, paramedics and first responders who are exposed to all these things? What happens when they get sick and suddenly there is nobody to help? This could be very devastating. It has been a long time since Canada has had a pandemic.
I thought I would share with the House something which I wrote about a month ago on what is a pandemic. I received feedback from some constituents who thought it was helpful.
I wrote that there are three types of influenza currently in the news, the human influenza, the avian influenza and the pandemic influenza. Now all of a sudden, there is something new here.
Human influenza, the flu as we would typically know it, is a respiratory infection caused by an influenza virus. We are familiar with that. The strains circulate every year and make people sick. Most people will recover from the influenza within a week or 10 days. However, people generally over the age of 65 and children with chronic conditions, and chronic conditions are an important element, or weaknesses and deficiencies in the immune system, such as diabetes or cancer, are at greater risk of serious complications from some other diseases like influenza or flu. Pneumonia would probably be the most prevalent. Between 4,000 and 8,000 Canadians die annually of influenza. It is not an insignificant number, 4,000 to 8,000 Canadians, and we somehow take the flu for granted.
There is also the avian influenza. The media refers to it as the bird flu because birds seem to be the most prevalent transmitters of this strain of influenza. Birds and other animals, including pigs which are also very prevalent carriers of these viruses, also contact and transmit influenza. Wild birds in particular are natural carriers. They have carried animal influenza viruses with no apparent harm for centuries.
This is not something that was just created because of something else that we have done. This has been with us for a long time and is rearing its ugly head. How many times have we heard about medical problems which have been latent for many years and suddenly they crop up again? HIV-AIDS is another similar example of where people may have the virus but will not have full-blown AIDS for 10 years or even longer. There are latent problems.
Wildlife have carried animal influenza viruses with no apparent harm to themselves. Migratory fowl, ducks and geese carry viruses known as the H5 or H7 strain or some other subtypes. Currently there is an avian influenza called H5N1. We hear about H5N1 a lot. I wish it would be given a name that people could remember. That virus is circulating in southeast Asia and parts of Europe and is infecting many poultry populations and some humans.
We now have evidence that there is transmission to humans. This strain is highly pathogenic or highly deadly to birds and has infected a limited number of people, but still, it has infected people. There is no evidence that this virus has been transmitted from person to person. That would be the big step. Going from a bird to a human, yes, there has been some limited transmission, but when human to human transmission happens, it will be a whole different kettle of fish.
Why is it of concern? People are exposed to several different strains of influenza many times during their lives. Even though the virus changes, their previous bouts of influenza may offer some protection through the development of their own immune systems. However, three or four times each century, for some unknown reason and it was a surprise to me, a radical change takes place in the influenza A virus causing a new strain to emerge to which nobody will have immunity. It will be new. It will have morphed itself into something brand new.
One way that this radical change could happen is that a person sick with a human influenza virus also becomes infected with the avian influenza virus and the two viruses mix. This means that the avian influenza virus acquires some of the human influenza genes, potentially creating a new type of influenza. Now it is getting complicated. It is just like the human population. As families marry, it kind of spreads itself out. We are sharing and creating all kinds of uniqueness in terms of the degree of immunities that we have built up in our gene system and our gene pool.
There is no pandemic influenza in the world right now. That is good news. However, there were three influenza pandemics in the last century and scientists are preparing for another influenza pandemic. That is part of the responsibility of this agency.
We know it is coming. This agency has an enormous responsibility to ensure that we are absolutely prepared, as prepared as we possibly can be.
I did however learn a couple of other facts that I was not aware of that Canadians should also know. The Canadian pandemic influenza plan was released in 2004. It outlines the actions to be taken at various levels of government so that we have a coordinated response. This is a good thing.
The Public Health Agency of Canada continually monitors the influenza viruses. Obviously, we want to ensure that we are players in this game. We will adapt and revise that plan as more information becomes available and as the knowledge of pandemic preparedness globally becomes greater in terms of the risks associated with it.
There are vaccines and antivirals which are two components of our approach. There are two ways to deal with this. A pandemic vaccine cannot be developed until a new virus emerges. That means we have to wait until it happens before we can actually develop the medicine that is going to be necessary to treat it.
People have asked me if they should be stockpiling some of this stuff that they can get at the drugstore and they can get from their doctor who will give them a prescription. That is fine for a particular strain of a virus, but it is not going to do very much unless it is the same strain that actually becomes the pandemic virus. After the strain has emerged and has been identified, it actually is going to take about six months before the influenza vaccine can be developed.
We can imagine that in the six month period in the middle of a pandemic there are going to be some serious problems. In fact, we could not possibly develop enough of that vaccine to treat all Canadians at the same time, which means that all of a sudden some choices have to be made.
I mentioned earlier the caregivers, nurses, doctors, first responders and paramedics. These people need to be treated first because if we do not have them, we do not have the linkage to the medicines that we need. Therefore, the vaccine would not be available at the start of the pandemic and may be in short supply for some time. All of a sudden we begin to appreciate that this is a complicated issue. If this is all the agency has to do, it would be worth doing.
Canada has a contract with domestic suppliers to develop these vaccines at that point in time. Until that is available there are antivirals which will be an important part of the response. An antiviral is a medicine that destroys a virus or interferes with its ability to grow, but it is not a cure. Antivirals do not provide immunity. Antivirals are used for prevention, but the dose is much higher and has to be taken for as long as people are exposed to the virus. It is an interim measure. It is the best we could do without having the vaccine itself.
The combined federal, provincial and territorial governments currently own about 35 million capsules of an antiviral with 5 million additional capsules on order. The antivirals however are limited in their effectiveness and are therefore only part of the overall strategy.
People ask if we are ready for the pandemic. I suppose, in terms of the pills that we can take to ensure that, should it break, we will have something that will either prevent us from getting the virus, or if we have it, the pills will ensure that we do not have serious complications and maybe even die. All of a sudden, when we start talking in this context, we are talking about a major catastrophe. We are talking about a lot of people who will be impacted.
The final thing is, what can Canadians do themselves? At this time, if people are travelling to a foreign destination, they should check Health Canada's website and find out the risk elements and risk conditions that may exist there and what happens should they get sick abroad, et cetera. From country to country, particularly in some undeveloped countries, there are some risks.
Prevention is obviously the best defence. Besides getting an annual flu vaccine, personal basic hygiene will help to ward off sickness. We know that. I would refer members to the Health Canada website simply to get a little information about preparedness in terms of a pandemic possibility. It is really important.
Since the agency was established in September 2004 and the Chief Public Health Officer was appointed by order in council in September 2004, the bill is simply giving it a parliamentary foundation, which will allow it to continue. I do not think we will see any changes, other than it will have the ability to issue a report on its own through the Minister of Health. It still reports. It is actually a former department of the Ministry of Health that will now be an agency within Health Canada.
It is important to understand that there is a designated mandate. As I indicated, the first part of the mandate was to strengthen Canada's public health system and emergency response capacity; second, to develop national strategies for managing infectious diseases and chronic diseases; and third, to develop an integrated pan-Canadian public health plan that address chronic diseases, including cancer and heart disease.
In the brief time that I have remaining, I want to mention something else that did come up in some of my work as a member of that health committee and as a parliamentarian since.
One of the private member's bills that I introduced about five years ago called on the Government of Canada to establish the position of physician general of Canada. It was intended to be modelled somewhat after the surgeon general of the United States.
Canadians need some information about personal health. Seniors want to know about seniors issues and seniors illnesses. Youth may have questions about a disease or whatever. Women need information on things like hormones and have questions on whether or not breast self-examination is still useful. People have questions about health. I found it extremely difficult to get information out of Health Canada's website or through making direct enquiries to the Health Canada office.
However, if we were ever to visit the surgeon general's website in the United States, we would see that there is a portal or a link to cancer, if we want information on it . Whether a person is a youth, a senior, or a pregnant woman, if they are suffering from depression or there is a mental health issue, the website is set up so nicely to communicate with people. Too often governments do not have communications formats which are informative to people who just want some basic reassurance.
When there are emerging issues, such as something that has been with us for a long time like fetal alcohol spectrum of disorders, or FAS, should not someone be there pronouncing on the risk associated with doing this or not doing that, someone who has some credibility from within the health profession to assist Canadians with their health needs?
It would be complementary to what the health agency is doing. I hope we can find that portal for all of the other things that we have to care for in the best interests of the health of Canadians.
