:
I call this meeting to order.
Welcome to meeting number 93 of the House of Commons Standing Committee on Health.
Today's meeting is taking place in a hybrid format, pursuant to the Standing Orders. I understand that we have one witness and one member participating virtually, so in accordance with our routine motion, I'm informing the committee that all remote participants have completed the required connection tests in advance of the meeting.
For the one witness we have by video conference, you're probably already aware of this, but you have translation available at the bottom of your screen. You have a choice of floor, English or French. Close the mic when you're not speaking, and avoid taking screenshots of the screen, please.
Today, from 11 a.m. to 1 p.m., we have a panel on the opioid epidemic and the toxic drug crisis. Pursuant to Standing Order 108(2) and the motion adopted on November 8, we're going to begin that study today.
Before we begin, I'd like to introduce the officials we have with us.
From the Canadian Institutes of Health Research, we have Dr. Samuel Weiss, scientific director of the Institute of Neurosciences, Mental Health and Addiction. Dr. Weiss is the gentleman who is participating by video conference. The other witnesses are here in person.
From the Department of Health, we have Jennifer Saxe, associate assistant deputy minister, controlled substances and cannabis branch; Carol Anne Chénard, acting director general, office of controlled substances; and Kelly Robinson, director general, marketed health products directorate.
From the Department of Indigenous Services, we welcome Jennifer Novak, director general, mental wellness, first nations and Inuit health branch. From the Department of Public Safety and Emergency Preparedness, we have Marie-Hélène Lévesque, director general, law enforcement policy directorate. From the Public Health Agency of Canada, we have Shannon Hurley, associate director general, centre for mental health and well-being.
Thank you all for taking the time to appear today.
Before I hand the floor over to Ms. Saxe, I understand that there is a possibility of bells before we complete this panel. If and when that happens, I'll be asking for unanimous consent to continue.
Also, we have heard from the , who has indicated her willingness to come before the committee on this study, probably in the new year.
With that, I'm going to turn the floor over to Jennifer Saxe from the Department of Health for her five-minute opening statement.
[Translation]
Good afternoon.
Thank you for providing my colleagues and I with the opportunity to address this crucial issue.
In my comments today, I would like to share some information about what we know about the crisis, based on the data we collect at the federal level, and to outline some of the measures we have been advancing to reduce harm, prevent overdoses and related deaths, and to expand access to treatment and support recovery and wellbeing.
The overdose crisis we face today is a profound public health emergency, reaching into the lives of individuals across diverse demographics. This public health crisis is having a tragic impact on people who use substances, their families, and communities across the country, and is shaped by a wide range of factors.
[English]
Based on the latest available data, there have been 38,514 opioid overdose deaths since January 2016. While 90% of these deaths in Canada occurred in British Columbia, Alberta and Ontario, it is important to note that elevated rates have also been observed in other areas with smaller population sizes, including Saskatchewan and Yukon.
Most apparent opioid toxicity deaths are among young to middle-aged males. In fact, males accounted for 73% of accidental apparent opioid toxicity deaths.
Indigenous peoples are disproportionately impacted. For example, while first nations make up 3% of British Columbia's total population, 16% of those who died of an overdose identified as first nations. Also, according to data from the Alberta First Nations Information Governance Centre, the rate of opioid poisoning deaths is seven times higher for first nations people compared to non-first nations people in the province.
The data also confirmed that very high rates of overdose deaths are the direct result of increasing street drug toxicity. Of all reported overdose deaths, 81% involved fentanyl. Multi-drug toxicity is a contributing factor to the crisis. Increasingly, people are using a mix of drugs, which is significantly increasing risk.
[Translation]
This crisis is widespread and pervasive. Understanding why people turn to substances engages the full range of social determinants of health, as well as adverse childhood experiences, trauma, poverty, mental illness and chronic pain.
[English]
We have worked with experts to ensure we are pursuing evidence-based strategies to comprehensively and compassionately address this crisis. It is within this context that the Government of Canada has been actively working for many years, mobilizing efforts across a continuum of interventions that span prevention, harm reduction, treatment and enforcement, and working together to reduce harmful stigmatizing attitudes and behaviours.
Substance use prevention initiatives are tailored to reach people most at risk. For example, the “ease the burden” campaign is a targeted effort to reach men in the trades, a demographic disproportionately affected by the overdose crisis. This campaign, with over 26 million views, shows how we are raising awareness and reducing stigma in these populations.
Recognizing how important timely access to quality treatment services is, we have made significant investments to expand access, including specialized services for youth and much-needed withdrawal management, commonly referred to as detox.
The government has also made efforts to expand access to services that reduce harms and prevent overdose deaths. This includes the distribution of naloxone and widespread training. We have made it easier for communities to establish and provide consumption sites. There are currently 39 sites across the country, which have seen over 4.3 million visits, responding to nearly 50,000 overdoses. For many, these sites are the only direct experience people will have with health providers. As a result, there have been over 257,000 referrals to health and social services.
Simultaneously, our law enforcement and border officials are actively countering illegal drug production, diversion, trafficking and related crimes.
As part of the response to this crisis, the government also continues to support research that is helping us to better understand substance use in Canada and that allows for the development of evidence-based policies and programs.
[Translation]
Before I close, I wanted to mention that on October 30, 2023, the Minister of Mental Health and Addictions and Associate Minister of Health launched a renewed Canadian drugs and substances strategy. This strategy presents a compassionate, equitable, collaborative, and comprehensive federal approach to this crisis and may be of interest as you conduct your study.
In conclusion, it is essential to understand that federal actions alone will not end the overdose crisis. We stand committed to ongoing collaboration with provinces and territories, indigenous communities, families and people with lived or living experience.
We welcome the opportunity to inform your important study and are prepared to respond to any questions you may have.
Before I ask questions, I wanted to provide some opening remarks, given that this is a study that I initiated with a motion passed by committee earlier this year.
Mr. Chair, we have eight meetings, I believe, most of which will be taking place in the new year, in 2024.
We know that 2023 will be another tragic year for Canadians. In 2022, we saw 7,328 deaths. The current death rate is estimated to be 21 Canadians dying daily. Isn't it shocking that we can actually predict with more or less confidence that 600 or more Canadians will die of an opioid or mixed drug overdose between now and the end of the year? Despite this having been recognized as an emergency seven years ago, the death toll continues to be the same or to rise.
When I was CMOH in the Yukon, we witnessed the first fentanyl death occurring in April 2016, the same month that British Columbia's chief public health officer at the time, Dr. Kendall, declared a public health emergency due to a shocking rise in deaths in that province. That's continued to increase since.
Since those earlier days of the epidemic, governments have responded. Many wonderful things have happened. Naloxone kits, for instance, are everywhere in our territory and widespread around the country. We have had the first supervised consumption site in Yukon, north of 60, including one of the first sites in the country with an inhalation room. We've scaled up efforts and treatment in clinical opioid substitution, in harm reduction, and to some degree in prevention.
The Yukon declared a substance use emergency in January 2022, and recently revised its substance use health emergency strategy, just a few months ago, based on the four-pillar approach that we all know so well.
Yet the deaths go on. Lives and families are torn apart with overdose fatalities or injuries. We've done so much, yet the scale of our response has not yet matched the need.
As we take on this study, I plead with all committee members around the table to have one aim—one single aim in mind. I know I'll be thinking of my own two teenagers and their friends, and what more we can do to protect them. Let this be about saving Canadians' lives. Let's not make this about personal attacks or takedowns, or scoring political points. Let's take a hard look at what is working and what is not, and if something is not working, then let us examine why, learn and adapt.
To my colleague Dr. Ellis, “experiment” is really a word for taking a new approach. To your question about a “null hypothesis”, I think we could answer that our current model is clearly not working, so we need to take new directions.
Let us look at models of innovation and success that have shown promise or have been shown to work, either within our country or elsewhere. Let us be able to come up at the end of this study with urgent, thoughtful, evidence-based, compassionate, bold and intelligent recommendations as to what all of us can do to get this epidemic under control—as individuals, as communities, as governments at all levels.
I know that each one of us cares. Please, for the sake of Canadians, let's work together on this with respect, with humility, with urgency, and with the decency that Canadians expect of us.
I know I have only about two minutes left, but I'd like to bring back my questions.
Thank you all for being here.
Budget 2023 proposes an additional $359 million over five years to support a renewed strategy. Ms. Saxe, I wonder if you could describe some of the directions you intend to take with this renewed funding.
I'd like to save time for Ms. Hurley from the Public Health Agency to comment as well on that same question.
:
I will absolutely make sure to save some time for Shannon Hurley.
Thank you for that question and for your remarks.
The renewed strategy really builds on the previous strategy by ensuring that we have holistic, integrated action that cuts across prevention education and looks at the whole suite of substance use services, including harm reduction, treatment and recovery. It looks at making sure we're building on the evidence and taking a range of actions in terms of substance controls. It looks at law enforcement and at ensuring the appropriate controls are there for the misuse of substances.
Some of the key actions we're taking include a call for proposals for substance use and addictions programs to make sure we can invest in community-based programs. The call for proposals went out at the end of September. We received just over 600 applications at the end of November. We'll be reviewing those to make sure we can invest in promising, evidence-building, innovative projects at the community level.
I'll turn it over to Shannon Hurley in a minute to talk about some of the prevention work, building on the Icelandic prevention model-based program we have.
We're continuing to take action in terms of authorization and making sure people have access to harm reduction services, whether that's supervised consumption sites, access to naloxone, or drug-checking services so people can know what's in their drugs and health workers also can know what's in substances people are consuming.
There are a range of actions. I can turn it over to my colleague after, in terms of the public safety and law enforcement. There are a suite of surveillance activities, and targeted research and evidence we are looking to build up, including on innovative models, so we can learn and adjust as we are doing that.
For prescribed pharmaceutical alternatives and supervised consumption sites, we are looking at what the evidence is showing and we're monitoring those programs so we can learn, adapt and put in best practices.
Maybe I'll turn it over to Shannon on prevention.
:
Thank you very much for the question.
Harm reduction continues to be a key element in the strategy, which was launched by the Government of Canada to address the overdose crisis and substance abuse. To be clear, let's say that harm reduction is part of a continuum of measures and care. It is based on accurate data, and it reduces harm and saves lives.
It's important to make every effort to reduce harm because of the growing toxicity and unpredictability of illicit drugs currently in circulation.
We are continuing our focus on harm reduction because not everyone has access to treatment services. Such services may not be available in some regions. Private treatment can be expensive or inaccessible. Harm reduction can help connect people and services.
Harm reduction is a medical and a health service.
Ms. Lévesque, in the government's response to the committee, the emphasis was on tightening up the borders and the act. The example it gave was Bill , which would give border officers more latitude to intercept fentanyl, because they would be able to inspect baggage weighing less than 30 grams.
Seven years on, it's perfectly clear that the illicit production of fentanyl has not changed since the passage of that bill.
What's missing? What's needed to tighten up border controls?
What could be done to make this action plan more effective, given that it is not currently producing the desired results?
:
Thank you for being here and for the work that you're doing.
I want to reiterate what Dr. Hanley said about what's working and what's not working. Clearly, what we're doing isn't working. I like the idea of not only talking about models of innovation and success, but also using sound data so that we have evidence-based decision-making and policies that are going to respond to this crisis.
One thing we heard from doctors at the beginning, in 2016, when B.C. declared a public health emergency, was that they were calling for the federal government to also declare a national public health emergency. Can you explain why that hasn't happened?
The reason, and you've heard me talk about this many times—I met with all of you on this panel—is the need for a plan and a timeline, and that is not in the renewed Canadian drugs and substances strategy. It was something I outlined in Bill , which was defeated by the Conservatives and most Liberals. That would have provided a timeline. That bill directed government to provide a timeline and a plan.
Why has no national public health emergency been declared?
:
I love all the buzzwords around a compassionate approach and an integrated, coordinated approach, but that requires a timeline and resources. I'm sorry, but $1 billion isn't even 1% of what we spent in response to the COVID-19 health emergency.
That's why we need to declare a national public health emergency, so that we can force everyone to the table and actually develop a plan with provinces, with municipalities and with indigenous nations so that it's a coordinated and cohesive strategy.
When I look at the expert task force on substance use, the Canadian Association of Chiefs of Police, which put out a policy platform a few years ago with what they were recommending, the chief coroner of B.C., B.C.'s First Nations Health Authority and now the death review panel in B.C.—it's unbelievable that we have a death review panel on this issue—they all have something in common. They've all cited that we need treatment on demand, recovery, prevention, education and a safer supply of substances. They've all been unequivocally clear.
Have any of them changed their position when it comes to safer supply—since that was brought up earlier in this conversation—that you're aware of?
There are a few things I could start off with. I could reply to Dr. Hanley's comment. This is deeply personal for me. I'm not here for sound bites, but I'm angry and I am frustrated. I've been very vocal and upfront about my family's struggles with this horrible epidemic. I've sat with family members of children who are now addicted and in the grips of addictions and also with families that have lost loved ones—young children, teens—to this horrible epidemic. This is deeply personal.
To our guests, thank you for being here. Thank you for the work that you're doing, but I have to say, whatever it is that we're doing is not working. Ms. Saxe, you even said so yourself: Since 2016, there have been 38,000 deaths. Whatever it is that we're doing is not enough. I get that you're one team and our provinces and others have to pitch in as well. It's not working.
My colleague talked about the experiment. An experiment is to see what works and what doesn't work. Throwing a billion dollars at it...and the leading cause of death for 10- to 18-year-olds in my province is overdose. It is not working.
What are the rates of diversion from government-funded safe supply?
In 2016, at hearings of the committee, Dr. Bonnie Henry, the provincial health officer for British Columbia, said that detoxification programs for users of opioids were not working, because the physiological dependence created by opioids required opioid substitution therapy, based on products like Suboxone. There was also discussion of Vivitrol at the hearings.
All of that led to recommendation 21 in a committee report, which I believe was adopted unanimously.
The recommendation reads as follows:
That the Government of Canada improve access to medications for opioid addiction treatment such as Suboxone® and other effective medications not currently available in Canada, especially for people at high risk of complication and death.
In British Columbia, do you have data on the number of substitution therapies, access to these substitution therapies, and their efficacy in terms of medium-term recovery?
:
I'm going to go back to the need for a national public health emergency.
During COVID, we were able to work through jurisdictional barriers constantly, and within hours, with provinces, municipalities and territories, and with indigenous communities. We haven't been able to do that when it comes to the toxic drug crisis because of this lack of action.
I want to talk about jurisdiction, because there is a lot of politics going on here. We have had record amounts of deaths in B.C. under an NDP government, in Alberta, Ontario and Saskatchewan under Conservative governments, and in the Yukon under a Liberal government. In the U.S., 30 states have doubled in overdoses in the last two years, and in the top 10, the majority of them are Republican. This isn't a Republican-Democrat issue. It's not an NDP-Conservative-Liberal issue. This is a societal issue. This is a failure in terms of ideology within society. That's what I believe.
We went to Portugal this summer, my colleague MP Hanley and I, on our own dime. We learned what a response to a public health emergency looked like. They scaled up methadone delivery from 250 people to 35,000 in two years. They engaged the military to create labs, scale it up, and get it out to people.
Is this government looking at an emergency-type response? We haven't seen it yet. I really want to encourage everybody around the table here to work collectively, because that's.... The big win in Portugal was that the politicians took off their gloves, let the experts lead and supported them with the resources. That's how they actually got things done.
:
We have funded an arms-length study, through the Canadian Research Initiative in Substance Misuse, on safe supply programs in 11 sites across the country.
The early research results coming out suggest that for highly marginalized clients—those who have limited access to health services—safe supply is helpful and effective in reducing cravings, time on the streets and deaths. However, it has also been shown that it works best when wraparound services are also there. The critical element is that with wraparound services, clients are expected to attend and participate in allied health and social services. That's when safe supply is most effective.
I will also mention, of course, that safe supply really is part of prescribing practices overall, which started in the 1990s and led to the situation we're in today. The term “diversion” is also not new. It's been around since the 1990s because of prescribing practices.
When prescribing practices were curtailed, more people went to the streets. The second wave of the opioid crisis was when people could no longer receive prescribed opioids, so they went to the streets and started to overdose on heroin. The heroin, which was the second wave of the toxic drug crisis, was then supplanted in approximately 2010-13, when fentanyl arrived for the first time. It took over from heroin and became the drug of choice on the streets, where very small amounts lead to overdose deaths.
I think it's important to note that when we speak about safe supply, we're talking about part of a range of prescribing practices—good and bad—that have been part of how this crisis began in the first place. These would have to be considered scientifically as part of the go-forward regardless, because prescribing opioids is one of the few approaches we have right now for treating chronic pain and cancer pain.
:
Yes, I'm happy to do so.
It is clear that indigenous people in this country are disproportionately impacted by this crisis. In B.C. and Alberta, you're looking at an impact of five to seven times the rate of non-indigenous people.
For us at Indigenous Services Canada, we're really trying to connect people to services and to harm reduction products. That includes naloxone, but specifically opioid agonists, which we've been talking about today. We've been trying to access wraparound sites. Basically, 82 sites across the country are delivering opioid agonist treatment in over 100 communities.
We're also trying to get mental wellness teams. Jennifer Saxe mentioned that continuum of services. Those mental wellness teams are there. There are 75 of them serving 385 communities across the country.
What we're trying to do there is to get people to go through withdrawal management first, to stabilize people first, and then move them through opioid agonist treatment. It's also on-the-land training, healing centres, connecting them with culture and, really, what comes after. After they've gone through their treatment, what can we do to support people in a more longitudinal way?
We're really looking at innovative systems. We have an interesting pilot happening right now in Ontario. Most indigenous populations are in rural and remote areas, so we are trying to connect them with new virtual supports. The Oculus headset is one of them, where people can have access to wraparound services.
Before my questions, I want to give a notice of motion. The intent of the motion is to have the appear as part of this study. The motion is:
That, as part of its study of the opioid epidemic and toxic drug crisis in Canada, the committee invite the Minister of Mental Health and Addictions and Associate Minister of Health for one hour, and that the meeting take place no later than Monday, February 19, 2024.
I'm presenting that as a notice of motion.
First of all, I wanted to make a couple of comments.
Again, we're hearing a lot of focus on safe supply and on the assumption that safe supply is a concept that doesn't work. We know that there has been diversion of safe supply that certainly has been documented, at least anecdotally, by some of the experts who have written letters. We also know that diversion has always been an issue—for many years—with prescription drugs as well. I just want to make the point that diversion of safe supply does not mean that safe supply does not have an important role in the spectrum of approaches. Where there is diversion, we need to do our best to prevent it.
I did want to point out that the B.C. coroner has said, “We know for a fact that people are not dying (from safer supply), including children. The rates of death amongst those under 19 have not increased at all since safer supply was introduced”. That's within the B.C. context and is a quote from Lisa Lapointe.
I also think it's important to talk about some misconceptions about fentanyl and the issue of tolerance and the thresholds. The thresholds for decriminalization in B.C. were based on expert recommendations. There was a lot of back-and-forth, as we know, over a period of probably about a year, to agree on thresholds. The thresholds are really based on the concept of tolerance to fentanyl. People who are addicted to drugs become tolerant to incredibly high doses very rapidly. That is the rationale for the concept of using thresholds to determine decriminalization.
In Portugal—and Mr. Johns referred to the fact that we had an incredibly educational trip to Portugal together—the concept of personal possession in their decriminalization is 10 days of supply of whatever drug is determined. The threshold is based on a 10-day supply.
We forget in this discourse that criminalizing drug use is not only not working but actually causing harm, because the market is being flooded with ever more dangerous and toxic drugs. Criminalization adds to the stigmatization that prevents people from accessing care.
For my Conservative colleagues, I would ask, why would we or should we keep pursuing policies that are clearly not working?
How much time do I have?
:
Thanks very much, Mr. Chair.
Thanks to my colleague for the motion.
I certainly think February 19 is a long way from now. I would suggest to you that a friendly amendment might be something in the order of January 15. We have some time available to us, and this is an important study. I think my colleagues all recognize this.
I suggest that continuing to delay this important study by not having the appear until February creates a significant time delay, in terms of allowing policies that we know are not working—as my colleagues have clearly mentioned—to continue. Allowing the minister to not, as suggested, meet with physicians who have a significant difference of opinion related to safe supply is, I think, dangerous to Canadians. Obviously, we know that no official from Health Canada, including the minister, has met with physicians with a contrary point of view. We also know the government doesn't have data, and it doesn't have a plan, either. It didn't have one from the very beginning.
I think waiting until February 19 will continue to put Canadian lives in danger and jeopardy. For that reason, I suggest we need to change the date to January 15 as an amendment, Mr. Chair.
Thank you.
:
The amendment is in order.
The debate is on the amendment.
If there is no debate, are we ready for the question? The question is that the motion be amended by deleting “February 19” and replacing it with “February 2”.
(Amendment agreed to)
The Chair: It's unanimous.
The debate is now on the main motion as amended.
(Motion as amended agreed to [See Minutes of Proceedings])
The Chair: It's unanimous. The motion is adopted.
Thank you, Dr. Hanley. That's your time.
We'll go over to the Conservatives.
Mr. Majumdar, you have the floor for the next five minutes.
:
We've been working with our counterparts in the provinces and territories. The Minister of Health, the deputy minister and senior officials like me, sit on various committees. We work closely with our counterparts in the provinces and territories to discuss our best practices and a wide range of measures.
For instance, we introduced the substance use and addictions program, the SUAP, under which some effective projects were implemented in the provinces. We organized some forums to exchange information on best practices. We believe it is extremely important to continue this collaboration, because others can learn from these exchanges.
That being said, some things could definitely be improved. For instance, we could improve data gathering, standardize indices, and improve the range of services and supports across Canada.
As we just said, it's truly important to work together. This collaborative effort ought not to come from just one partner, but all the partners, including the federal government, the provinces, the territories, and the communities. Work needs to be done with indigenous groups and health experts. Also required are assessments and data to allow us to track the impact of the programs we implement on an ongoing basis.
Colleagues, that concludes the first panel. We're going to suspend briefly for the second one. Before we do, on the opioid study, we have not yet set a deadline for witness lists. May I suggest that the witness lists be in by the time the House rises, say, Friday, December 15, at 4 o'clock? Is everyone okay to have all their witnesses in by then?
Some hon. members: Agreed.
The Chair: Thank you. That will allow the analysts time to prepare a work plan over the winter.
To all of our witnesses, thank you so much for your patience and your professionalism, as always. We very much appreciate your being with us. This is the first step in a fairly long journey and study, and it has laid the foundation for all of us to be able to do our work. We're grateful to you for what you do and for your assistance to us in connection with this study.
With that, we're going to suspend while the next panel gets situated, so probably about five minutes.
:
I call the meeting back to order.
Pursuant to Standing Order 108(2) and the motion adopted on November 8, 2023, the committee is beginning its study of the government's advance purchase agreement for vaccines with Medicago.
I would like to welcome the officials who are with us today.
From the Department of Public Works and Government Services, we have Andrea Andrachuk, director general.
[Translation]
Also with us today is Ms. Joëlle Paquette, the director general of the procurement support services sector.
[English]
From the Office of the Auditor General, we have Andrew Hayes, deputy auditor general, and Susan Gomez, principal.
Colleagues, we received notice during this meeting that the Auditor General herself wasn't able to be here. I don't have any explanation for you except that it was a development that was very recent.
First of all, to all of our witnesses who are here, thank you.
We have two opening statements, the first from the Auditor General.
I presume that will be you, Mr. Hayes. You have the floor for the next five minutes. Welcome to the committee.
:
Mr. Chair, thank you for giving us this opportunity to discuss our report on COVID‑19 vaccines in connection with the review of the planned vaccine purchase agreement signed by the government with Medicago. Our report was tabled in the House of Commons in December 2022.
I'll begin by acknowledging that this meeting is taking place on the traditional unceded territory of the Algonquin Anishinaabe nation.
With me today is the principal, Ms. Susan Gomez. She was in charge of the audit. The audit examined how the federal government purchased and authorized COVID‑19 vaccines, and also how they were distributed to the provinces and territories to ensure that Canadians could be vaccinated.
In our meeting today, we will focus on the part of the audit concerning procurement. Overall, we determined that Public Services and Procurement Canada had supplied solid support to the Public Health Agency of Canada, enabling it to obtain enough doses of COVID‑19 vaccines to vaccinate everyone in Canada. Between December 2020 and May 2022, the federal government purchased 169 million vaccine doses. Over 84 million of these were administered to the population.
[English]
Public Services and Procurement Canada used its emergency contracting authority. This provided the department with flexibility on a number of fronts, including using a non-competitive approach to procure vaccines from companies recommended by the COVID-19 vaccine task force.
The department established advance purchase agreements with seven companies that showed the potential to develop viable vaccines. We found that the department exercised due diligence on the seven vaccine companies. For example, the department examined whether the companies had the financial capability to meet the contractual requirements and were eligible to do business with the federal government. The department reached an agreement with Medicago on November 13, 2020.
The government's strategy was to secure agreements with several vaccine companies, in case Health Canada authorized only one vaccine. While this approach meant Canada could end up with a surplus if all seven vaccines were eventually approved, it also increased the chances of securing enough doses to support the largest vaccination program in the country's history.
Mr. Chair, we are happy to answer the committee's questions where possible. However, given the confidentiality of the agreements, we are unable to discuss details relating to contracting costs or fulfilment for any of the specific agreements.
This concludes my opening remarks.
Thank you.
:
Good afternoon, Mr. Chair.
I'm pleased to be appearing before the Standing Committee on Health to discuss the work of Public Services and Procurement Canada on the advance purchase agreement for COVID‑19 vaccines with Medicago.
I wish to acknowledge that this meeting is being held on the traditional unceded territory of the Algonquin Anishinaabe nation.
I am accompanied today by Ms. Joëlle Paquette, the director general of the procurement support services sector.
From the earliest days of the pandemic, the Government of Canada’s objective was to secure safe and effective vaccines as rapidly as possible. Early in the pandemic, there were many uncertainties and it was unclear whether developing safe and effective vaccines was even possible. This uncertainty created high global demand and Canada made every effort to secure advance purchase agreements with vaccine companies for future promising vaccines.
Scientific and industry experts on the COVID‑19 Vaccine Task Force advised that the quickest route for the government to get vaccines was to pursue a diverse portfolio of potential vaccines as early as possible.
Public Services and Procurement Canada, on behalf of the Public Health Agency of Canada, established seven advance purchase agreements with promising vaccine manufacturers, including Medicago, a Canadian supplier. The advance purchase agreement with Medicago was signed in November 2020 and included a firm commitment of 20 million doses, to be delivered before the end of December 2021, with options for up to an additional 56 million doses.
The contract was approved by the then Minister of Public Services and Procurement, following the approval of the Public Health Agency of Canada, and following approval by a Deputy Minister Committee for COVID‑19 vaccines.
As Medicago had received authorization from Health Canada for its Covifenz vaccine in February 2022, the contract was amended to allow the delivery of doses before the end of December 2022.
As part of overall supply management in mid-2022, the Public Health Agency of Canada expressed an interest to reduce or eliminate Medicago dose deliveries, in an effort to right-size inventories, and prevent wastage and logistics costs.
Also at that time, Medicago was experiencing production challenges, which caused some delivery delays. Discussions were undertaken with Medicago to terminate the contract.
In February 2023, Mitsubishi, the parent company of Medicago, announced intentions to proceed with an orderly wind‑up of Medicago operations in Canada and the United States and not to pursue the commercialization of the Covifenz vaccine.
[English]
The government recently shared that a $150-million non-refundable advance payment was made to Medicago in accordance with the advance purchase agreement, that Medicago met all terms for the payment, that the contract was terminated by mutual consent, that Medicago was released of its obligations under the advance purchase agreement and that no doses of Covifenz were delivered.
This advance payment was agreed to in negotiations in order to fund at-risk production of the vaccine prior to Health Canada authorization. In the termination by mutual consent, the government had no contractual right to request a return of the payment.
The government is committed to being as transparent as possible while respecting the confidentiality clauses in these vaccine purchase agreements. Significantly, this agreement with Medicago, along with the six others, was the subject of the Auditor General's report in December 2022. In April 2023, the government shared unredacted copies of the seven advance purchase agreements with the parliamentary Standing Committee on Public Accounts. Senior officials from Public Services and Procurement Canada appeared in two in camera sessions with the committee.
Mr. Chair, Public Services and Procurement Canada played a key role in supporting the Public Health Agency of Canada's efforts to ensure the delivery of COVID-19 vaccines as soon as we could acquire them, helping save Canadian lives.
Thank you. I'm happy to take your questions.
First of all, good morning and welcome to our committee.
I have a preamble. It was during a very difficult time. Our government chose to take a multipronged approach. We signed, as you highlighted, seven advance purchase agreements. That's the purchase part of the vaccine. It was both international and, in the case of Medicago, domestic. We invested a lot of money into R and D, both domestically and internationally. We also realized that we really needed to build a domestic capacity.
When we look at Medicago, this is a cross between the very well-thought-out strategy of purchasing, which is hedging bets; focusing on R and D, both domestically and internationally; and building domestic capacity.
Was it a sound strategy? I would say yes. Did we execute it? I believe, when we look at the $172 million that was spent.... Did it generate the result? I would say, yes, it did, because we managed to get a vaccine approved by Health Canada. Did we know that the World Health Organization was not going to approve this vaccine because of its affiliation with a cigarette-manufacturing company? I don't know, and we are not 100% sure. That might be an area that's worth diving into a bit deeper.
On the issue of IP, the federal government, through various programs, invests in the work of many companies, and the IP remains with the company. I just finished making an announcement on Friday about a company, Visual Defence, into which the Government of Canada, through Scale AI, invested about a million dollars, and the IP belongs to the company. I'm not sure that who owns the IP should be the focus of this.
I think what we need clarification on...and this leads to the question I'm about to ask you. What did the Government of Canada pay $150 million for, aside from the $172 million, which we can justify? What did we pay the $150 million for, and what did we get as a result of that?
Anyone can answer that question.
:
Thank you very much, Mr. Chair.
Ladies and gentlemen, welcome to the House of Commons.
It gives me no pleasure, Mr. Chair, to be here today.
I'm a guy from Quebec City. I was a journalist and I'm very familiar with Medicago, because I used to write about the company.
I find everything about this saga very troubling, because it's clear that it's been contaminated by a virus—not a medical virus, but an ownership virus.
On February 27, 2005, Canada and 181 other countries around the world signed the WHO Framework Convention on Tobacco Control, which specifically says in point 3 of article 5 of the convention that “Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry”.
Since 2005, it has been clear that when the tobacco industry applies for funding, it cannot, according to the WHO, move forward. The application would not be recognized.
In 2008, Philip Morris International became a 21% shareholder in Medicago.
In March 2020, in the middle of the pandemic, it's understandable that everyone should want to find a solution. On March 23, the government announced that it would help companies conduct scientific research. The press release states that: “The funding will enable Medicago to rapidly advance their clinical trials and then expand production to respond to the pandemic”.
Did you know at the time, Ms. Andrachuk and Ms. Paquette, that the Medicago company had a tobacco corporation as a shareholder and that it would accordingly never be recognized by the WHO?
A yes or a no will do.
In November 2023, just a month ago, a former Parliamentary Budget Officer, Kevin Page, was quoted in the National Post saying, “It seems wrong that the PHAC refuses to answer your questions about how money has been spent or written off”.
Similarly, the current Parliamentary Budget Officer, Yves Giroux, commented that the government's initial refusal to disclose details about the $150 million lost due to the unfulfilled contract with the vendor was “highly unusual”.
Do you agree with that assessment?
Thank you to all of our witnesses.
That concludes the round of questions.
Colleagues, I remind you that we're meeting on Wednesday evening from 6:30 to 9:30. There's one hour on this study and two hours on women's health.
To all of our witnesses today, thank you so much for your service to Canadians. Thank you so much for being available to come to committee and for answering our questions so patiently. This is our first hour on this topic, and there will be several others, so, once again, it's a good foundation for us to work from. We really appreciate your being here.
Is it the will of the committee to adjourn the meeting?
Some hon. members: Agreed.
The Chair: We're adjourned.