Madam Speaker, I sometimes stumble through some of the medicine names which can be tongue twisters and very difficult to pronounce.
I am pleased to have a second opportunity to speak to the bill, in particular to the motions in Group No. 2 that we are referencing here, a specific series of drugs that have been introduced.
I want to first and foremost commend the committee work, as we have heard from several members. The fact that it is coming forward this way is because the committee agreed at that time to review things and make sure that Health Canada could review some of my amendments which could then be introduced at report stage. That is to the credit of the committee, the flexibility that evolved out of that, to ensure that we were doing the right thing.
Hopefully this group of amendments will provide additional resources to assist people around the world who are suffering with different types of conditions. The premise of the bill is to ensure that a distribution of generic drugs at a lower cost can get out to people who really need them. This is why we are doing this at this particular time.
These amendments are representative of a series of amendments that I proposed at the clause by clause stage. These are drugs to which Health Canada raised no objection. I thank those officials for their advice and assistance in my preparation of the list of motions on drug products. They were very professional and courteous, and made sure they were open for questions, especially given the tight timeframes under which we were working. They were very good in terms of getting back to me and my staff. It is important to recognize the work of the Health Canada officials.
Those officials have also circulated a copy of their recommendations to me, which I hope has been of use. Because of the way schedule 1 is worded, members will note that for some of the amendments, like that of amprenavir, it is simply the addition of a capsule formula but the amendment had to read to replace the whole line. It was a procedural issue but I hope the clarification is useful and once again provides for no other obstructions in getting those types of medicines to people who really need them.
This series of drugs presented here are indicated for a variety of different illnesses that affect the developing world, quite tragically. There are solutions and that is what some of these drugs can do, providing the right infrastructures for not only the countries themselves but also the humanitarian groups that are assisting them.
The amendment for amprenavir, Motion No. 12; delavirdine, Motion No. 15; lamivudine, Motion No. 17; and zalcitabine, Motion No. 19, are simple technical additions to include either the capsule or tablet formulation that is not currently in Bill C-9. All of these drugs are indicated for use in the treatment of HIV. We know from a number of speakers how many individuals across the developing worlds are suffering from HIV, and these drugs will provide some additional opportunities for them.
The amendment on ceftriaxone, Motion No. 13, simply adds the 500 milligram dosage to what already exists in schedule 1. It provides another opportunity for a specific case, if it is deemed necessary, for those wishing to assist.
The first of the new drug products which I propose to include is clarithromycin, Motion No.. 14. It is used to treat an AIDS-related infection called mycobacterium avium complex and also has other more general anti-infection uses.
As members of the House may be aware, the World Health Organization, in its attempts to facilitate quality, effective and safe HIV-AIDS, tuberculosis and malaria drugs, regularly updates what are referred to as “pre-qualified” drugs. Essentially it means that international experts appointed by the World Health Organization examine products submitted by companies around the world and assess whether they meet World Health Organization standards of quality, safety and efficacy.
Clarithromycin is on the WHO's pre-qualified list of HIV-AIDS drugs. Therefore it is one that has been vetted through the international process and we feel that that is a good reason to support it. It also apparently is a very expensive drug and, therefore, including it in the bill, which has the ultimate aim of providing access to medicines through cheaper generic versions, especially for the treatment of HIV-AIDS, tuberculosis and malaria, would make the bill even more able to achieve its aims. That is a benefit and a credit to the bill.
The second new drug that I have proposed is the fixed dose combination drug of isoniazid, pyrazinamide and rifampin, Motion No. 16. This combination of the three drugs is an anti-tuberculosis agent that is used for short course treatments of pulmonary tuberculosis in the initial phase.
According to Stop TB, tuberculosis infects one in three people worldwide. Between two million and three million die each year of this curable disease. This combination drug, also known as rifater, is also an expensive drug and could be very advantageous and important in the treatment of tuberculosis, which would, like clarithromycin, meet the aims of the bill.
The third of the new drug products I propose to introduce is moxifloxacin hydrochloride, Motion No. 18. Moxifloxacin is officially indicated for the treatment of what is called community acquired pneumonia, which simply means pneumonia acquired through regular contact as opposed to the complications from HIV-AIDS or a disease like that.
According to the Centre for Disease Control in Atlanta, approximately 5% to 10% of all children under five years old in developing countries develop pneumonia each year and acute respiratory infections like pneumonia cause approximately two million deaths among children under five each year and are the leading cause of death in that age group. In addition to children, approximately 100 of every 100,000 adults are affected yearly and the elderly are at particular risk according to WHO information. I feel the moxifloxacin should be included because of its potential to help treat people affected with pneumonia.
I believe that all these drugs are useful to have available as options to countries wishing to participate. My intent here, of course, is not to indicate that they should be used by anybody but I believe they should be available as options. However those people will decide.
As I mentioned and as the committee heard, there is consensus that the presence of a schedule at all provides further inflexibility in ensuring that countries have access to the drugs that they need. A list by its nature is exclusionary because it does not include all possibilities. If a country wants a drug that is already approved for use and sale here in Canada on the patent register, et cetera, it will still have to start a process for the drug to be included before a generic producer could apply for a voluntary or compulsory licence to supply the country with that drug. It is a bit of a barrier and it is one of the concerns we have with the bill.
I will quote from the testimony of our committee hearings by the representative of Médecins sans frontières about schedule 1:
So our proposal for that is simply to remove the schedule. Neither TRIPS nor the Doha declaration saw any list of medicines, and in fact developing countries fought very hard that there was no such list. It was a big point of discussion during those negotiations.
That is why we believe the list is something that the bill would be better without.
The government representatives have repeatedly testified that the presence of the schedule is intended as a guide and that it is meant to be flexible. I hope the members will consider supporting these amendments, particularly those that would introduce new eligible drugs important for the treatment of HIV-AIDS, tuberculosis and pneumonia to show that schedule 1 of this bill will be flexible as the government has claimed it will be. I am sure that they will be because there has been a lot of goodwill about the bill.
I commend all the parties that were a part of it. In fact, people across Canada are probably wondering why for the first time in a long time members are not shouting back and forth at different points but the fact is that we actually are talking about something that is very beneficial. We may still have differences of opinion about the bill but there is a great consensus for moving it forward rather quickly and also improving it where there are items of consensus. I think that is important to recognize.
These groups of amendments are intended to improve the bill and I hope they will receive the support they merit because they are important for many people throughout the world.
