Mark Holland

[Questions on the Order Paper, January 29th, 2024]

Mr. Speaker, with regard to part (a) of the question, yes, the Minister of Health requires a manufacturer to submit an application for approval of a new indication for a drug that is already approved for a different indication. However, health care practitioners may choose to prescribe a drug outside of its approved indication, also called off-label use. Off-label use falls under the “practice of medicine” and is regulated at the provincial and territorial level.

Regarding parts (b) and (c), Health Canada’s bureau of gastroenterology, infection and viral diseases, which is part of the pharmaceutical drugs directorate, received 17 inquiries in its inquiries mailbox related to the use of ivermectin for the prophylaxis and treatment of COVID-19. All inquiries received were from the general public.

In general, inquiries made to Health Canada, or HC, and the Public Health Agency of Canada, or PHAC, about ivermectin for the prophylaxis and treatment of COVID-19 are not systematically tracked in a centralized database. HC and PHAC concluded that producing and validating a comprehensive response to this question would require a manual collection of information that is not possible in the time allotted and could lead to the disclosure of incomplete and misleading information.

However, ministerial correspondence is tracked centrally. Based on the question, 123 pieces of ministerial correspondence were identified and are broken down as follows: 115 pieces from the general public; four from health care professionals; one from a member of provincial, territorial or federal Parliament; and three from organizations.

Regarding part (d), Health Canada and the Public Health Agency of Canada do not track this information.

[Questions on the Order Paper, January 29th, 2024]

Mr. Speaker, with regard to part (a), Health Canada’s regulatory evaluation of vaccines includes the review of randomized control studies if there are indications for pregnant and lactating women. Observational studies may be required as part of the risk management plan that is reviewed by Health Canada prior to authorization. In addition, after authorization, Canada has a robust and well-established vaccine safety surveillance system involving Health Canada, Public Health Agency of Canada, PHAC, provinces and territories, and vaccine manufacturers. Health Canada monitors the safety of COVID-19 vaccines through monitoring and risk minimization measures, including requiring manufacturers to regularly submit safety reports and reports of adverse events following immunization, AEFIs, and regularly assessing whether there is any new safety information that may affect the benefit-risk profile of the product. Health Canada has been actively monitoring and reviewing safety data submitted by the manufacturers of the COVID-19 vaccines. Health Canada also monitors and considers information from the scientific literature and international regulators.

With regard to part (b), none of the COVID-19 vaccine manufacturers sought indications for use in pregnant or lactating women or submitted RCTs in pregnant/lactating women for regulatory evaluation. The product monographs included statements about the uncertainties related to pregnancy and lactation. The product monographs can be accessed using the following link: COVID-19 vaccines and treatments portal (canada.ca).

With regard to part (c), as indicated above, there were no RCTs in pregnant/lactating women submitted for regulatory evaluation as the vaccine sponsors did not seek an indication for use in pregnant and lactating women.

With regard to parts (d) and (g), the regulatory basis for the decision taken by Health Canada is publicly available at https://covid-vaccine.canada.ca/ for each specific vaccine. Please see Regulatory Decision Summary and Summary Basis of Decision documents.

As indicated in the specific product monographs, it is noted that the safety and efficacy of these vaccines in pregnant women have not yet been established. No indication for use in pregnant or lactating women was sought by the vaccine sponsors or authorized by Health Canada.

It is important to note that evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing from real-world use. No safety concerns were identified in a study of more than 35,000 pregnant persons who received an mRNA COVID-19 vaccine during pregnancy or in the immediate period prior to conception. More information about COVID-19 vaccination and pregnancy is available here https://www.canada.ca/en/public-health/services/immunization-vaccines/vaccination-pregnancy-covid-19.html

Health Canada has been actively monitoring and reviewing safety data submitted by the manufacturers as well as adverse events following immunization, AEFI, reported to the Canada vigilance program, CVP, of Health Canada while also considering information from Canadian Adverse Events Following Immunization Surveillance System, CAEFISS, of the Public Health Agency of Canada, PHAC, and foreign data from international partners. Should there be new safety issues identified, Health Canada takes actions, as appropriate.

With regard part (e), Health Canada publishes the product monographs on its website https://covid-vaccine.canada.ca/ in order to inform the public, health care professionals and the research community. As noted in the product monograph, the safety and efficacy of Comirnaty in pregnant women have not yet been established. In addition, Health Canada also publishes the summary basis of decision that provides information about the authorization of the Comirnaty Omicron XBB.1.5. Please see https://covid-vaccine.canada.ca/info/SBD1700495075939-comirnaty-omicron-xbb-1-5-en.html

The National Advisory Committee on Immunization, NACI, is an external advisory body that provides independent, expert advice to PHAC on the optimal use of authorized vaccines in Canada. When making recommendations, NACI considers the benefits and potential risks of a vaccine and any unknowns at the time. NACI has made recommendations for the use of COVID-19 vaccine in pregnant and lactating women based on the totality of evidence available across all authorized COVID-19 vaccines. Considerations specific for pregnant and/or lactating women are included in the Canadian Immunization Guide COVID-19 chapter, which is based on the NACI recommendations. Links to the product monographs for authorized XBB.1.5 vaccines are included in the latest advice from NACI.

With regard to part (f), Health Canada publishes the product monographs on its website https://covid-vaccine.canada.ca/ in order to inform the public, health care professionals and the research community.

With regard to part (h), Health Canada has not approved any safety claims with regard to pregnant and lactating women.

[Questions on the Order Paper, January 29th, 2024]

Mr. Speaker, with regard to part (a), yes, the non-clinical studies submitted to Health Canada to support the approval of the COVID-19 vaccines were conducted in accordance with the ICH standards. In particular, the ICH safety guideline S5(R3), detection of reproductive and developmental toxicity for human pharmaceuticals, has specific requirements for the design and conduct of developmental and reproductive toxicity studies for vaccines. This guideline provides information on animal species selection as well as dose selection and study design for vaccines against infectious diseases.

Health Canada is responsible for the regulatory authorization of vaccines, which encompasses the review and assessment of various studies to ensure the safety and efficacy of vaccines. The National Advisory Committee on Immunization, NACI, primarily focuses on analyzing data from human clinical trials to provide vaccine safety recommendations. NACI's role is not directly involved in the regulatory authorization process or in the initial review of safety and efficacy studies.

With regard to part (b), yes, DART studies were required as part of the regulatory evaluation of COVID-19 vaccines. These studies were conducted in accordance with ICH guidelines in S5(R3). These studies were submitted for regulatory review and supported the approval of the COVID-19 vaccines. The outcomes of these studies were included in the relevant documents prepared and published by Health Canada to inform the public, health care professionals and researchers. This information can be found under each specific product. For Comirnaty, from Pfizer-BioNTech, the product monograph is at https://covid-vaccine.canada.ca/info/pdf/pfizer-biontech-covid-19-vaccine-pm1-en.pdf and the summary basis of decision is at https://covid-vaccine.canada.ca/info/SBD00510-comirnaty-en.html. For Spikevax, from Moderna, the product monograph is at https://covid-vaccine.canada.ca/info/pdf/covid-19-vaccine-moderna-pm-en.pdf and the summary basis of decision is at https://covid-vaccine.canada.ca/info/SBD00511-spikevax-en.html.

It should be noted that the vaccine manufacturers did not seek an indication for use in pregnant and lactating women and that the product monographs included statements about the uncertainty regarding safety and efficacy in pregnancy and lactation. At the time of approval, there was limited experience with the use of COVID-19 vaccines in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryo or fetal development, parturition or postnatal development, and human randomized clinical trials were not submitted for regulatory evaluation.

With regard to part (c), as indicated above, DART studies were required as part of the regulatory evaluation of COVID-19 vaccines. DART studies are required to detect any effects of the vaccine within a complete reproductive cycle as relevant to humans, from initial conception to reproductive capacity. No vaccine-related adverse effects on female fertility, fetal development or postnatal development were reported in the studies for the vaccines. Excerpts from the product monographs are included below.

As to Comirnaty’s reproductive and developmental toxicology, in a reproductive and developmental toxicity study, 30 micrograms per animal, or 0.06 millilitres of a vaccine formulation containing the same quantity of nucleoside-modified messenger ribonucleic acid, mRNA, and other ingredients included in a single human dose, of Comirnaty was administered to female rats by the intramuscular route on four occasions: 21 and 14 days prior to mating and on gestation days nine and 20. No vaccine-related adverse effects on female fertility, fetal development or postnatal development were reported in the study.

As to Spikevax’s reproductive and developmental toxicology, in a pre- and postnatal developmental toxicity study, 0.2 millilitres of a vaccine formulation containing the same quantity of mRNA, 100 micrograms, and other ingredients included in a single human dose of Spikevax was administered to female rats by the intramuscular route on four occasions: 28 and 14 days prior to mating and on gestation days one and 13. No vaccine-related adverse effects on female fertility, fetal development or postnatal development were reported in the study.

Part (d) is not applicable. Please see response to part (b).

[Questions on the Order Paper, January 29th, 2024]

Mr. Speaker, with regard to part (a), Health Canada did not receive the above-mentioned report. With regard to part (b), the answer is nil, as per (a). With regard to part (c), the answer is nil, as per (a).

With regard to part (d), Health Canada has a robust vaccine safety surveillance system in place that engages health care professionals, vaccine manufacturers, the Public Health Agency of Canada, PHAC, and the provincial and territorial health authorities. Through these measures, manufacturers are required to submit safety data from real-world use and results related to safety and effectiveness from ongoing and planned studies as they become available.

In addition, Health Canada and the Public Health Agency of Canada have been actively monitoring and reviewing reports of adverse events following immunization, AEFI, reported to the Canada vigilance program, at https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/canada-vigilance-program.html, and the Canadian adverse events following immunization surveillance system, at https://www.canada.ca/en/public-health/services/immunization/canadian-adverse-events-following-immunization-surveillance-system-caefiss.html. This information is published on the Government of Canada’s website at https://health-infobase.canada.ca/covid-19/vaccine-safety/. As noted on this website, there were 95 reports of spontaneous abortion up to and including September 15, 2023. It is important to note that these reports do not necessarily imply that a relationship between the adverse event and the vaccine has been established. However, they are an important source of information supporting ongoing safety monitoring. Health Canada also monitors and considers information from the scientific literature and international regulators.

Health Canada will not request the above-mentioned report separately since the report is now outdated. However, on October 22, 2022, Health Canada published a summary of the review on the use of the mRNA COVID-19 vaccines Comirnaty and Spikevax during pregnancy and breastfeeding, which included adverse events reported to Health Canada. Information about the summary of the review is available by clinking on this website: https://www.canada.ca/content/dam/hc-sc/documents/services/drugs-health-products/medeffect-canada/health-product-infowatch/october-2022/health-product-infowatch-october-2022.pdf.

Health Canada continues to monitor the safety of COVID-19 vaccines approved in Canada to help ensure that the benefits continue to outweigh the risks for all groups of individuals, including pregnant and lactating women. Should there be new safety issues identified, Health Canada will take action, as appropriate.

From the National Advisory Committee on Immunization, NACI, the summary of evidence and rationale for NACI’s pregnancy and breastfeeding recommendations was updated to reference developmental and reproductive toxicity, DART, animal studies for COVID-19 vaccines as those became available throughout 2020 and 2021. The relevant evidence was summarized in each update to NACI COVID 19 recommendations. In September 2022, as more evidence accumulated, NACI revised public health advice to strongly recommend that COVID-19 vaccines should be offered to those who are pregnant or breastfeeding, based on a review of global vaccine safety surveillance, vaccine effectiveness, vaccine safety studies and Canadian epidemiology. This included information from the Canadian National Vaccine Safety Network study, which started in December 2020, and the COVID-19 vaccine registry for pregnant and lactating individuals, which was launched in July 2021.

With regard to part (e), none of the COVID-19 vaccine manufacturers sought indications for use in pregnant or lactating women or submitted randomized clinical trial data in pregnant or lactating women for regulatory evaluation. The product monographs included statements about the uncertainties related to pregnancy and lactation. A change to the approved conditions of use for a drug, including vaccines, or removal of a drug from the market is based upon the available evidence regarding the risks and benefits of the drug. There is no specific threshold but rather a scientific evaluation of the balance of risks and benefits. If the available evidence, including data obtained through passive surveillance, indicates that the risks outweigh the benefits, Health Canada will take appropriate action. This action may include changes to the conditions of use of a drug, such as contraindicating use for some groups, or complete removal of the drug from the market. Should such action be taken, Health Canada would also communicate the risk to Canadians and health care providers.

With regard to part (f), while Health Canada has no information on institutions that met continuous review of the global vaccine safety surveillance rule, we understand that vaccine safety is monitored worldwide by health authorities. This information can be found on the official websites of international health authorities.

[Questions on the Order Paper, January 29th, 2024]

Mr. Speaker, Ivermectin for use in humans is an oral drug approved in Canada for the treatment of certain parasitic worm infections, such as strongyloidiasis and onchocerciasis. This is based on evidence from clinical studies that were included by the manufacturer as part of its submission for review by Health Canada: https://dhpp.hpfb-dgpsa.ca/review-documents/resource/RDS00498. However, Ivermectin is not approved for the prevention or treatment of coronavirus disease 2019, or COVID-19.

Health Canada was made aware of reports in media related to issues with the use of Ivermectin for COVID-19. Subsequently, the department communicated on this issue in a public advisory in August 2021 and October 2021: https://recalls-rappels.canada.ca/en/alert-recall/ivermectin-not-authorized-prevent-or-treat-covid-19-may-cause-serious-health-problems.

With regard to part (b), emerging information from sources such as literature publications and poison control centres was screened for signal detection purposes as part of our surveillance activities for products authorized to prevent or treat COVID-19. This specific publication was not reviewed by Health Canada as part of these activities given that it did not provide new risk or safety information with the use of Ivermectin as authorized and reflected in the product monograph for the drug.

With regard to part (c), Health Canada did not perform a risk-harm analysis for the use of Ivermectin to prevent or treat COVID 19. Health Canada only performs this type of analysis if a marketing application for a drug has been submitted by a manufacturer. Health Canada has not received an application seeking the authorization of Ivermectin for the treatment of COVID-19. Therefore, the department has not received nor reviewed any scientific evidence for the purpose of determining a benefits, harms and uncertainties profile on such use.

[Questions on the Order Paper, January 29th, 2024]

Mr. Speaker, with regard to part (a), the Canadian Institutes of Health Research, CIHR, does not systematically track intellectual property created by grants awarded by CIHR. As such, producing and validating a comprehensive response to this question would not be possible in the time allotted and could lead to the disclosure of incomplete and misleading information.

With regard to part (b), as per the Tri-agency Guide on Financial Administration, CIHR does not pass judgment on the eventual commercial success of research, nor does it retain or claim any ownership of, or exploitation or proprietary rights to intellectual property, copyright or inventions developed/resulting from research supported with agency grant funds. Administering institutions are required to disclose to grant recipients their policy on intellectual property rights and ownership arising from supported research. Grant recipients that decide to pursue commercialization of any results of the research are required to adhere to applicable institutional policies governing the assignment of intellectual property.

As per the Canadian Institutes of Health Research (CIHR) Application Administration Guide, the onus is on the nominated principal investigator, or the institution or both, depending on the institution's policy on ownership of intellectual property, to seek patent protection, in collaboration with the partner where applicable, for inventions or developments arising from CIHR-supported research. Grant recipients that pursue commercialization of any results of the research are required to adhere to institutional and agency policies governing the assignment of intellectual property.

[Questions on the Order Paper, January 29th, 2024]

Mr. Speaker, with regard to part (i), non-clinical biodistribution studies in animals were submitted to Health Canada for regulatory evaluation in the original COVID-19 vaccine submissions, with the following exceptions: Covishield vaccine, for which information was cross-referenced to AstraZeneca’s COVID-19 vaccine given that they are both based on the same viral vector technology; and Covifenz, which uses an adjuvant already approved for influenza vaccines and cross-referenced biodistribution studies that were conducted with the influenza vaccine.

Details of these studies are included in the Summary Basis of Decisions, SBDs. The SBDs can be accessed through this link: COVID-19 vaccines and treatments portal (canada.ca)

With regard to part (ii), non-clinical pharmacokinetic studies that were provided evaluated the biodistribution of the lipid nanoparticle, LNP, formulated with a model mRNA. These studies also evaluated the metabolism and excretion of the novel lipid excipients.

The biodistribution data identified no cause for concern as the spike protein is expressed transiently. For Comirnaty, for example, it peaks at six hours post-injection with signals at the injection site and the liver, then declines over time. Less than 1% of signal was detected in other tissues and it becomes undetectable within 24 hours.

The results of the non-clinical studies as well as the potential risks to humans have been included in the specific product monographs: Spikevax PM, Comirnaty PM and Vaxzevria PM. In addition, specific non-clinical information regarding biodistribution data can be found in the Summary Basis of Decision of Spikevax SBD, Comirnaty SBD and Vaxzevria SBD.

With regard to parts (iii) and (iv), please see the response to part (ii).

With regard to part (v), please see the response to part (ii). All toxicity and biodistribution studies were conducted in line with international standards of WHO Guideline: Non-clinical evaluation of vaccines.

With regard to part (vi), repeat-dose toxicity studies were conducted in accordance with international guidelines of WHO Guideline: Non-clinical evaluation of vaccines.

With regard to part (vii), metabolism studies demonstrated that components of the LNP are slowly metabolized and excreted via the fecal route, and evidence of urinary excretion for some of the lipids. Studies have shown that intravenous and intramuscular injection of mRNA-encoded spike protein is only expressed transiently and at the injection site and the liver, then declines over time. Vaccine produced spike protein is rapidly broken down and does not persist in the body. Many studies have demonstrated that the mRNA remains in the cytoplasm of cells and does not come in contact with human DNA, which resides in the nucleus.

The potential toxic effects of vaccine present in milk are evaluated in reproductive and developmental toxicity studies. No vaccine-related maternal toxicity or overt adverse effects on pre- and post-natal development were observed.

Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing from real-world use. The data show that mRNA COVID-19 vaccines are safe for people who are pregnant or breastfeeding. No safety concerns were identified in a study of more than 35,000 pregnant people who received an mRNA COVID-19 vaccine within 30 days of conception. More information about COVID-19 Vaccination and pregnancy is available here: https://bit.ly/3E5bytJ.

With regard to parts (viii) and (ix), please see the response to part (vii).

With regard to part (x), Health Canada is responsible for the regulatory authorization of vaccines, which encompasses the review and assessment of various studies, including biodistribution studies, to ensure the safety and efficacy of vaccines. The National Advisory Committee on Immunization, NACI, primarily focuses on analyzing data from human clinical trials to provide vaccine safety recommendations. NACI's role is not directly involved in the regulatory authorization process or in the initial review of biodistribution studies. The question regarding the timing and manner of informing the Canadian public and medical community about the biodistribution of COVID-19 vaccine components is outside the scope of NACI's mandate, as NACI focuses on analyzing clinical trial data for vaccine safety recommendations rather than regulatory communications.

[Questions on the Order Paper, January 29th, 2024]

Mr. Speaker, in December 2011, the Government of Canada announced that the Canada health transfer, or CHT, would continue to grow at 6% annually from 2014-15 to 2016-17, and beginning in 2017-18, the CHT would grow in line with a three-year moving average of nominal gross domestic product, or GDP, growth with funding guaranteed to increase by at least 3% per year.

The December 2011 announcement effectively extended the 6% CHT escalator for three additional years beyond the legislated time frame set out in the September 2004 10-year plan to strengthen health care, which was to end in 2013-14. This resulted in the CHT continuing to grow at 6% annually for 2014-15 to 2016-17, thereby providing provinces and territories with additional CHT growth in those years. Since then, the CHT has grown at an average annual rate of 4.9% under the current GDP-based escalator, which provided provinces and territories with ongoing and predictable funding for health care. In addition, budget 2017 included a targeted investment of $11 billion in federal funding over 10 years to improve home and community care and mental health and addiction services.

Looking forward, the government's working together to improve health care for Canadians plan, first announced in February 2023, includes $25 billion through new tailored bilateral agreements and billions more through top-ups to the CHT and other funding. In total, the Government of Canada is investing over $200 billion over the next 10 years to support provinces and territories to strengthen Canada’s universal public health care system.

Historical data for the Canada health transfer and other major federal transfers to provinces and territories can be found at the following link: https://open.canada.ca/data/en/dataset/4eee1558-45b7-4484-9336-e692897d393f

[Questions on the Order Paper, January 29th, 2024]

Mr. Speaker, with regard to (a) and (b), the incidence rate of tuberculosis, or TB, in Canada is broken down by province and by territory and by Indigenous group, namely First Nations, Inuit and Métis, for the 2008-2018 time period and can be found at https://opencanada.blob.core.windows.net/opengovprod/resources/1ff8f1b6-02a8-425a-bd0b-af9495d2e53c/tb-in-canada_2008-2018_eng_march24-2022.pdf?sr=b&sp=r&sig=D6d5ljkzoXi4CwVF9%2BMAAxZrPYJN2tG8/yQBAvKkhzA%3D&sv=2019-07-07&se=2024-01-30T02%3A27%3A38Z.

Surveillance data for the 2012-2021 reporting period will be published on the Government of Canada website in winter 2024 in a new report entitled “Tuberculosis in Canada: 2012-2021 Expanded report.” The report will include updated data broken down by province and by territory, as well as descriptive statistics on a wide range of variables related to TB. A summary of TB data for the 2012 to 2021 time period was recently published and can be found at https://www.canada.ca/en/public-health/services/publications/diseases-conditions/tuberculosis-surveillance-canada-summary-2012-2021.html. With regard to the incidence rate of TB in 2021, the data showed 135.1 cases per 100,000 among Inuit people, 16.1 cases per 100,000 among First Nations people and 2.1 per 100,000 among Métis people.

Additionally, an infographic with surveillance highlights entitled “Tuberculosis in Canada: Infographic (2021),” is available at https://www.canada.ca/en/public-health/services/publications/diseases-conditions/tuberculosis-canada-2021-infographic.html. It is expected that an infographic presenting 2022 data will be released by March 2024.

With regard to (c), the Public Health Agency of Canada, or PHAC, Health Canada, and other federal departments such as Indigenous Services Canada and Immigration, Refugees and Citizenship Canada meet regularly to discuss national TB surveillance trends and interventions to support TB elimination such as support for outbreaks, access to TB medications, capacity building, and other activities. These departments and other partners, such as the provinces, territories, Indigenous groups and TB experts, use national TB surveillance reports to measure Canada’s progress towards TB elimination targets and commitments which in turn help to inform TB policy and program decision making, research initiatives and innovation related to TB. TB surveillance reports are also used by provincial and territorial partners for benchmarking and to inform decision-making.

With regard to (d), demographic data collected through Canada’s TB surveillance system originate from the provinces and territories. The data includes province or territory of residence, population group, namely the country of birth, immigration status, the year of arrival in Canada and Indigenous groups, age and sex. A complete list of variables can be found on our case report form available at https://www.canada.ca/content/dam/phac-aspc/documents/services/diseases/tuberculosis/active-tuberculosis-reporting-form-eng.pdf.

The national surveillance system consists of TB related data submitted from provincial and territorial public health departments but does not include specific information on health care.

With regard to (e), the TB surveillance program at PHAC has a total funding of $1,222,030 for fiscal year 2023-2024, which includes employee salaries, program operations and maintenance. Furthermore, the dissemination of the infographic and surveillance report have an estimated cost of $6,500.

With regard to (f), active TB cases are reported to the National Tuberculosis Surveillance system on an annual basis in the summer months following the calendar year in which they were diagnosed. A national report is then produced usually in the fall and published in the winter. The time period between when data are submitted to PHAC and published include requirements for cleaning data, verifying quality, analyzing, reporting, and publishing.

With regard to (g), guided by recommendations from an Expert Advisory Group, there was significant collaboration between the federal, provincial, and territorial governments towards a pan-Canadian health data strategy, focused on common priorities such as modernizing and aligning health data standards, policies and governance, and building public trust. This work set the stage for enhanced collaboration across the country, under the Government of Canada’s “Working Together to Improve Health Care for Canadians” Plan, announced in February 2023, and a Federal, Provincial, and Territorial Joint Action Plan on Health Data and Digital Health, which was endorsed by Ministers of Health on October 12, 2023. More information on the “Working Together to Improve Health Care for Canadians” Plan is available at https://www.canada.ca/en/health-canada/news/2023/02/working-together-to-improve-health-care-for-canadians.html.

The Pan-Canadian Health Data Strategy, or PCHDS, led to the release of a final report in May 2022 led by an Expert Advisory Group which includes recommendations for health data partners from all jurisdictions, namely federal, provincial and territorial, which can be found at https://www.canada.ca/content/dam/phac-aspc/documents/corporate/mandate/about-agency/external-advisory-bodies/list/pan-canadian-health-data-strategy-reports-summaries/expert-advisory-group-report-03-toward-world-class-health-data-system/expert-advisory-group-report-03-toward-world-class-health-data-system.pdf.

Some of these recommendations align with the work being undertaken by PHAC’s TB surveillance program. The program works collaboratively with federal, provincial and territorial surveillance stakeholders to collect common indicators for TB. In addition, to better understand data needs, gaps and expectations, bilateral discussions with provincial and territorial TB partners took place in the summer and fall 2023. This aligns with recommendation #5 from the PCHDS: Establish meaningful and ongoing engagement with the public and stakeholders to understand their health data needs and expectations.

Furthermore, the PHAC TB surveillance program is exploring the development of a new surveillance infrastructure to modernize the storage, management and analysis of data. This is expected to improve timeliness and data quality and aligns with recommendation #9: Establish common integrated health data standards and data architecture and drive and monitor their roll out.

[Questions on the Order Paper, January 29th, 2024]

Mr. Speaker,the precise origin of COVID-19 remains unknown. The first report of an unknown pneumonia outbreak in China, later called COVID-19, was detected by the Global Public Health Intelligence Network or GPHIN on December 30, 2019. The information was then distributed to Canadian public health practitioners on December 31, 2019, via the GPHIN Daily Report. The Public Health Agency of Canada orPHAC actively monitored the situation and initiated regular and ongoing communications with federal, provincial and territorial partners.

The Government of Canada is supportive of all efforts that will contribute to a clear understanding of the origins of the virus. Canada continues to work with international partners to better understand the origins of COVID-19.