Anne McLellan

[Health, September 17th, 2003]

Mr. Speaker, the hon. member raises an important issue, one that should concern all levels of government and non-governmental organizations that work with those who are mentally ill.

Indeed, Health Canada participated in a fact finding project which resulted in the first ever statistical overview of mental illness in Canada. We are now working with other government departments to ensure that its recommendations are implemented. In addition, the CIHR has funded over $60 million worth of research in relation to mental health, neurosciences and addiction across our country.

This is a very important issue and one which we need to work on together.

[Question No. 232, September 15th, 2003]

With respect to (a), Health Canada and external partners have developed the testing methodology for detecting SV40 in cells and tissues from patients with non-Hodgkin lymphoma, NHL, and are currently developing blood tests to detect antibody to simian virus 40 (SV40) to permit our planned studies of the correlation of SV40 infection and certain cancers.

With respect to (b), “A review of relevant literature on Simian Virus 40 published between July 2000 and November 2002: Update to July 2000 Simian Virus 40 paper presenting recent knowledge on the zoonotic aspects of SV40 and any identified relationship to blood safety” was completed in early 2003. The review was aimed to identify research priorities and concluded: No firm link has established SV40 as a cause of human cancer. As in the July 2000 report, more recently published studies continue to show no evidence of a significant increase in rates of cancer linked to SV40. Continued research into SV40 will be important as SV40 may yet prove to be a cofactor in the development of certain types of cancers.

With respect to (c), risk assessment of SV40 for human diseases associated with blood is being done through two approaches:

One, the risk of SV40 for the Canadian blood supply is being assessed through Health Canada’s Rapid Response Surveillance System for Emerging Bloodborne Pathogens, RRSS; RRSS has in place a system which has been activated in response to this issue.

Two the Canadian Blood and Marrow Transplant Group, CBMTG, approach: has stored blood specimens of patients with non-Hodgkin’s lymphomas, NHL, and other conditions who are being studied both retrospectively and prospectively and compared to assess the clinical implications of SV40 in NHL and possibly other malignant conditions, as well as, its transmissibility through blood and blood product transfusion, and organ and tissue transplantation.

Blood specimens from a sample of the general Canadian population and from patients at risk of multiple blood transfusion will be tested for SV40 infection with consent to assess: one, the level of SV40 infection in the general population; two, the risk of SV40 transmission through blood transfusion. The research is expected to be completed in 2004 upon the completion of an ethical review.

With respect to (d), it is presumed that SV40 is being transmitted among humans, but it is not known if this transmission occurred prior to the use of polio vaccine in the late 1950s and early 1960s, or was a result of its use. No study has satisfactorily confirmed whether SV40 found in the human population is from contaminated polio vaccine, or from some other source, and epidemiological studies to date have not determine whether SV40 contaminated polio vaccine did or did not cause cancer in the recipients of vaccine.

Research shows a remarkable rise in incidence of NHL over the last 30 years, double from 1973 to 1998; the incidence rate estimated for 2002 is 14.9/20.7 (female/male) per 100,000 (age standardized). However, it is not known if the doubling of NHL in Canada is related to the presence of SV40.

On November 22, 2002, Health Canada sponsored a meeting of our partners at the National Microbiology Laboratory, NML, in Winnipeg to discuss progress on the various research projects. Health Canada informed the group that it had developed the testing methodology for detecting SV40 in cells and tissues from patients with non-Hodgkin lymphoma and was in the process of developing blood tests to detect antibody to SV40 to permit our planned seroprevalence studies. A proposal is being prepared to conduct relevant study.

With respect to (e), it is not known how many Canadians may have been exposed to contaminated vaccine in Canada, nor is it currently known if the virus is detectable in cancers in the Canadian population. The evidence to date is inadequate to accept or reject a causal relationship between SV40-contaminated polio vaccine and cancer in humans.

Health Canada and external partners including the BC Cancer Agency, the Canadian Blood and Marrow Transplant Group CBMTG, the BC Transplant Society, hospitals, provincial laboratories, as well as, academics are currently undertaking a risk assessment of SV40. This risk assessment involves a number of independent research studies which collectively aim to address several research questions, including: one, is there an any evidence of SV40 infection in the Canadian population? Two, is SV40 associated with non-Hodgkin lymphoma or other human cancers? Three, is SV40 transmissible through blood? and four, what is the risk of SV40 for the Canadian blood supply?

A proposal is being prepared to determine the relative incidence of markers indicating viral infection with lymphotropic viruses in tissues of patients with NHL and other diseases. The proposal is also aimed to corelate findings of viral infection of SV40 in tissue with clinical parameters and diagnostic subsets of NHL, and to compare prevalence of SV40 infection in tissues among NHL patients born between 1955 and 1963, before and after that period.

With respect to (f), since 1995, only approximately $20,000 for the FY 2002/03 is for testing and approximately $50,000 from the Blood Safety Surveillance and Health Care Acquired Infections Division to support the CBMTG and other groups.

[Question No. 231, September 15th, 2003]

With respect to (a), Health Canada considers all forms of smoking harmful to health. Many of the potential long term health risks of cannabis use, such as respiratory damage and disease, are due to smoking as a means of ingestion. Heavy cannabis smoking during pregnancy has been associated with low birth weight babies. Smoking cannabis interferes with the ability to concentrate and impairs learning processes. Cannabis users can become dependent. Research indicates that cannabis smoking may trigger psychotic episodes among users who already have or are at high risk for schizophrenia or depression.

With respect to (b), Health Canada has not established estimates of public health impact of smoking marijuana. However, under the renewed drug strategy, research on this topic will be considered.

With respect to (c), there have been no specific Health Canada initiatives. However, under the renewed drug strategy, a public education program targeted at youth will be launched in the fall of 2003, on the health risks of smoking marijuana.

With respect to (d), no research has been conducted, but under the renewed drug strategy, research is underway and a survey is scheduled to start in November 2003. Thereafter, surveys on this subject will be conducted every four to five years.

With respect to (e), ( i) and ( ii) an medical marijuana, in 1999, Health Canada developed a strategy to determine the risks and benefits associated with the use of marijuana and cannabinoids for the treatment of the symptoms of targeted serious diseases in patients unresponsive to usual treatment modalities. This strategy now includes the medical marijuana research program MMRP, a partnership with the Canadian Institutes of Health Research, a contribution agreement with the Community Research Initiative of Toronto CRIT, a community based HIV-AIDS non-profit research organization, and the Marijuana Open Label Safety Initiative MOLSI, another partnership with the Canadian Institutes of Health Research. An undertaking with Public Works and Government Services Canada PWGSC to award contracts to the private sector to conduct clinical trials, is currently under consideration. These initiatives aim at developing new knowledge concerning the risks and benefits associated to the medical use of marijuana. This knowledge will allow Canadians suffering from some serious and chronic conditions and diseases and their physicians to make better informed choices of proven therapies and further inform Health Canada’s policy making capacity in formulating sound science based decisions regarding access and use of marijuana for medical purposes.

Health Canada is dedicating $7.5 million over five years to marijuana clinical research through its MMRP. The first study granted under this program will be conducted by the Pain Centre of McGill University. It is a short term study, involving 32 clinical subjects to evaluate the effects of smoked marijuana for chronic neuropathic pain. In addition, through a contribution, Health Canada is funding CRIT to conduct a pilot study on the efficacy of smoked marijuana on appetite stimulation in persons living with HIV-AIDS. In total, since 1999, not including in-house human resources and administrative costs, Health Canada has invested $1,292,385 in its marijuana clinical research strategy. This amount includes contribution and grant payments for the conduct of clinical studies, the holding of three workshops to assist the Canadian medical community in addressing specific issues related to conducting of clinical studies on marijuana for medical purposes, and contracts with consultants to develop two information documents for distribution to patients and clinicians. These documents describe the current scientific knowledge on marijuana and the risks and benefits associated with its use for medical purposes.

The Canadian Institutes of Health Research CIHR, has supported 13 projects related to marijuana use since 2000, with a total investment of approximately $2,832,902.

With respect to (iii), see (c) above. Final costs of the program have yet to be determined, as the scope of work is under development.

With respect to (iv), The salary and operating costs of the Office of Cannabis Medical Access, for fiscal year 2002-03, were approximately $3.5 million. These costs include the administration of the medical marijuana access regulations and related regulatory and policy work.

With respect to (f), see (c) above. The medical marijuana research program described in (e) (i) and ( ii) will continue. Costs for research will depend on projects approved for funding by CIHR.

With respect to (g), during the development of the proposed cannabis reform legislation, Health Canada provided the Department of Justice and the Department of the Solicitor General summary documents on the health effects of marijuana. These summaries were based on published literature.

On May 27, 2003 the Government of Canada announced the renewal of Canada’s drug strategy and the investment of $245 million over five years. The renewed strategy will take a balanced approach to reducing both the demand for, and the supply of drugs. Health Canada, in close collaboration with its partners, including the provinces, territories, communities and stakeholders, will take the lead on implementing and coordinating this renewed strategy by investing in: increased government and stakeholder coordination and funds to support community-based prevention, treatment and harm reduction initiatives; enhanced partnerships, education programs and interventions designed to discourage and treat substance abuse, particularly among youth; new research activities, including funding for statistical analysis of drug trends to enable more effective decision-making; new enforcement resources to address marijuana grow operations and clandestine chemical laboratories.

Health Canada has stressed that any move towards decriminalization must be done in tandem with a renewed and fully funded drug strategy in order to provide the necessary emphasis on public education, prevention programs, enforcement resources and new research activities.

[Montreal Grand Prix, September 15th, 2003]

Mr. Speaker, we have said throughout this episode that Health Canada has no intention of changing our law, which in fact is a very effective law in relation to tobacco reduction. In fact, recently over the summer I had the opportunity to sign, on behalf of this country and all Canadians, the global convention on tobacco reduction. I can inform the House that indeed we are viewed as a world leader in relation to dealing with a habit that kills approximately 42,000 Canadians every year.

[Health, June 12th, 2003]

Mr. Speaker, I think it is fair to say and I have said in this House on a number of occasions that there is no evidence to suggest that for profit health care provides either better health care or more cost effective health care.

Delivery of health care is a matter for the individual provinces and territories. Our obligation on behalf of all Canadians is to ensure that in the delivery of that health care, they respect the five principles of the Canada Health Act. If they do not, we will take action against them.

[Health, June 12th, 2003]

Mr. Speaker, as I have said many times in this House, the question of health delivery is one that is left up to the provinces. In delivering health care they must abide by and respect the five principles of the Canada Health Act.

We are well aware of the situation in British Columbia. My officials are in contact with B.C. officials. We have been in contact with them over other issues in relation to private delivery of health care. We try to make sure that if there are problems, that they are worked out through negotiation and discussion. If that is not possible, then we can take action under the Canada Health Act to withhold transfer payments.

[Canada Elections Act, June 11th, 2003]

moved that Bill C-24, an act to amend the Canada Elections Act and the Income Tax Act (political financing), be read the third time and passed.

[Motions for Papers, June 11th, 2003]

Mr. Speaker, I ask that this Motion for the Production of Papers be transferred for debate.

[Health, June 11th, 2003]

Mr. Speaker, the WHO official indicated that he was concerned about the SARS situation in the City of Toronto. Obviously we are all concerned about that. I hope the hon. member is concerned as well.

Let me go back to the question of the gentleman who went to North Carolina. Dr. Megan Davies went on to say:

--the man was healthy when he flew out of Toronto...I don't think of this as Canada exporting a case. I think we have a worldwide epidemic of an emerging pathogen that none of us understands completely...

[Health, June 11th, 2003]

Mr. Speaker, as I indicated yesterday, appropriate screening measures are in place. We are in regular contact with the WHO. As I said yesterday and as has been confirmed by Dr. Megan Davies of the North Carolina department of health, when this person left Canada and entered the United States, he showed no symptoms of SARS.