:
Good morning, everybody. Welcome to the committee.
I'm so pleased to have the Honourable Leona Aglukkaq, Minister of Health, join us today.
Pursuant to Standing Order 81(5), supplementary estimates (B) 2010-2011, votes 1b, 5b, 10b, 20b, 25b, and 40b, under Health, are referred to the committee on Thursday, November 4, 2010.
Joining the minister is our very well-known friend from the Public Health Agency of Canada who keeps joining us on a regular basis, Dr. Butler-Jones. Welcome.
From the Canadian Institutes of Health Research we have Dr. Alain Beaudet, president. Welcome, Dr. Beaudet.
From the Department of Health we have Deputy Minister Glenda Yeates.
Minister, please begin your presentation. We look forward to hearing from you.
Good morning, everyone.
Madam Chair and members of the committee, it's a pleasure to be here to discuss supplementary estimates (B).
Before we get into the details of today's discussion, I would like to thank you for the hard work on Bill , which is now before the Senate. The piece of legislation, once it comes into force, will provide us with the tools needed to recall dangerous consumer products.
Canada's Consumer Product Safety Act will have a profound effect on the marketplace. It will give consumers greater confidence in the safety of the products they find on the shelves of stores everywhere in this country.
We know that the discovery of things like lead in toys has rightly caused parents to be concerned. They know that young children put objects in their mouths as a form of discovery. The new limits on lead content that I announced this week indicate, not only to our industry but to those around the world, that we mean business.
Bill will give us new powers to deal with those kinds of problems more effectively. The new inspector powers in Bill C-36 are both fair and consistent with those of other federal laws. They are also consistent with the Supreme Court of Canada's decisions on the acceptable scope of inspection powers.
The safety of consumer products is something from which we can all benefit. We are working with industry to enhance consumer product safety and we are developing new tools to help us take corrective actions where problems arise.
While we have given a great deal of attention to that legislation and other safety measures, Health Canada has also continued to focus on the business of funding and administering other programs that protect and improve the health of Canadians.
Health Canada's 2010-11 supplementary estimates (B) include a net increase of $48.1 million, which brings its total budget to $3.731 billion for the current fiscal year.
We recognize the important part that research plays in ensuring the continued health of Canadians. This is why we have provided ongoing support and additional investments to Canadian Institutes of Health Research to support innovative and patient-oriented research that could have an impact on the health of Canadians.
Another important funding initiative supported by our government is an international initiative on Alzheimer's, and $5 million has been added for this purpose. Our government has invested more than $88 million in research regarding Alzheimer's disease and related dementia since 2006, and we are funding a four-year national population study on neurological diseases. In addition, important international MOUs have been signed with our partners from France, Germany, and the U.K. on Alzheimer's research.
I am particularly proud of the accomplishments we have made in the fight against HIV/AIDS. The Canadian HIV vaccine initiative, led by our government, along with the Bill and Melinda Gates Foundation, highlights Canada's world-class HIV and vaccine research expertise.
CIHR is investing approximately $40 million per year in support of HIV/AIDS research. Canadian investigators, supported by this funding, are at the forefront of discovery, improving the health of those infected, and are working toward a vaccine. CIHR continues to invest strategically in HIV research and is actively implementing the CIHR HIV/AIDS research initiative strategic plan. This will ensure continued knowledge development and research capacity-building, as well as the application of new findings in HIV/AIDS research in Canada.
The landscape for health services on population health research in HIV/AIDS is changing in Canada through the support for two centres for research development in HIV/AIDS. These centres are building research networks, addressing high-priority research questions, and building knowledge translation capacity in Canada.
The Public Health Agency's national HIV laboratories and their surveillance and risk assessment divisions are active members of the World Health Organization's advisory network of experts that support the development and implementation of the HIV drug resistance, prevention, and assessment strategy.
The lab is designed as one of the very few specialized HIV drug resistance laboratories in the world. It will also provide training and technical support to laboratory staff in resource-poor countries, and will continue to lead the way in developing new technologies that will facilitate testing worldwide.
This past summer I travelled to Vienna, where I met with international leaders, and particularly with Bill Gates. As a result, our government will help advance the science for the development of a safe and effective HIV vaccine that will benefit those who need it most, and that's all Canadians.
I would also like to take the opportunity to inform members of this committee of the announcement I made yesterday, along with the Bill and Melinda Gates Foundation, on the appointment of Dr. Singh and Dr. Esparza as co-chairs of the advisory board that will oversee the renewed Canadian HIV vaccine initiatives and its research development alliance.
Addressing the health concerns of Canada's aboriginal people comprises a portion of the funding under the supplementary estimates. It is targeted for programs that are helping aboriginal people, especially those living on reserve. One of the commitments in the supplementary estimates is our contribution to the Indian residential school resolution health support program. The Government of Canada is committed to supporting former students of residential schools and their families throughout the implementation of the Indian residential school settlement agreement. Health Canada is responsible for the resolution health support program that is part of the agreement, and we hope this will continue to have a positive impact on the health of first nations people.
We are committed to offering support services that take into account the culture and heritage of aboriginal people. Community-based healing programs, such as those for mental health and addictions, will assist these communities by addressing the health and social challenges they face. These investments represent a total of $5 million.
Additional funds have also been required to help in the transition from the outdated food mail system, which had been in place for more than 40 years. It is being replaced with Nutrition North Canada, a new retail-based subsidy program that will ensure northerners benefit from improved access to healthy and nutritious food throughout the year. Health Canada is allocating $1.5 million this fiscal year and $2.9 million annually beginning in 2011-12 for nutrition and education initiatives under Nutrition North Canada.
We also recognize that the availability of nutritious food and access to it is a starting point for a nutritious diet. These education initiatives will help northern Canadians put nutritious meals on their plates. Nutrition North Canada will be more efficient, more accountable, and more transparent. It will help make sure that northerners get the maximum benefit from the government subsidy for healthy foods. It will give retailers more control over their supply chain and therefore create more competition. That means there will be more incentives for greater quality control.
Fresh foods will get to the shelves sooner, making them more attractive to consumers. Our government is particularly proud of the efforts that have been made in the health promotion. Encouraging a healthy lifestyle is instrumental in maintaining a healthy body. It also means an overall improved quality of life and a healthier Canadian population, while being less onerous on our health care system. This cannot be truer than for young Canadians. Our intention is to encourage them to lead a healthier lifestyle right from the beginning.
For example, we have recently launched a bold new education campaign aimed at 13- to 15-year-olds to teach them about the dangers of illicit drugs. The centrepiece of this campaign is a commercial called “Mirror”, which dramatizes the harmful effects of drugs. It shows a young woman looking into the mirror and seeing what her life would be like if she experimented with drugs. The commercial began running two weeks ago and will be airing until March. During that time, we expect two-thirds of all Canadian teens between the ages of 13 and 15 to see it. This campaign is designed to be a powerful deterrent. Deterrence is an essential component of the government's national anti-drug strategy.
Last week I had the pleasure of meeting Gil Kerlikowske, an important figure in the battle against illicit drugs in the United States. We discussed many issues of common interest that have a bearing on the health of young Canadians and Americans. The most effective way to help Canadians is to give them the information they need to make informed choices. In fact, we have made many announcements in the past and there are more to come in the future about sources of information for parents with regard to the health and safety of their children.
Information and education are also playing an important role in our efforts to curb childhood obesity. Obesity rates among children and youth have nearly tripled over the last 25 years. Obesity increases the risk of developing some chronic diseases, including type 2 diabetes, cancer, and heart disease.
The federal, provincial, and territorial governments recently agreed to a framework for coordinating their approaches to promoting healthy weights among children under the age of 18. We have agreed to focus on making the environment where children live, learn, and play more supportive of physical activity and healthy eating. We will also try to identify the risk factors that can lead to obesity in children and address those issues early in a child's life. We agreed to find ways to increase access to nutritious food and decrease the marketing to children of foods and drink that are high in fat, sugar, or sodium.
An equally essential part of the plan to reduce obesity is the need to promote more physical activity. All levels of government need to be involved in finding more ways for kids to be active, both indoors and outdoors throughout the season.
The campaigns we are currently leading are designed to have an impact on the long-term health of many Canadians. By helping them change their lifestyles or avoid dangerous substances, we can prevent a wide variety of health problems in the future.
Through our nutrition facts education campaign, we are helping Canadians understand more about the foods they eat.
Our children's health and safety campaign strives to help parents protect their children from many potential hazards, and our national anti-drug strategy is helping to prevent young people from experimenting with illicit drugs and becoming addicted in the first place.
In the year ahead, we will continue to develop initiatives that support our long-term vision for health care in Canada, while tending to the short-term needs of Canadians.
I will be pleased to take questions from the committee.
Thank you.
:
Thank you very much, Madam Chair.
Welcome, Minister.
Madam, Sir, it’s always a pleasure to have you with us to discuss supplementary estimates (B).
Madam Minister, I will not be asking all of the questions on cigarette package warnings that were raised by my Liberal colleagues, but I must say that this announcement floored us. We knew that for many years now, the Department of Health has been reassessing the need for warning labels and, we believed, and I am sure you agree, that this was necessary as businesses tend to avoid repeating the same ad campaign over and over. Businesses well know the importance of changing their ads often, very often, so that they may continue to have an impact. Otherwise, people just don’t notice them anymore.
However, one of the things you mentioned in your response to the Liberal members sticks in my mind. Essentially, you haven’t abandoned but merely suspended the renewing of warnings so as to permit you to study the question as a whole and to present, rapidly I hope, a global plan to ensure that the number of people addicted to tobacco will continue to fall. Indeed, as we all know, cigarettes are harmful.
My question is quite simple. When will you clearly announce your intentions and when will you present, as you say you will, a global intervention plan that will have sufficient clout to address the problems related to tobacco use?
Our government recognizes the burden neurological conditions place on individuals, families, and caregivers. This will, I think, increase as our population ages.
Our government has committed $15 million to conduct a four-year study of persons with neurological conditions. The study will fill gaps in information about the state of neurological conditions among Canadians. It will also increase our understanding of the number of people affected by neurological conditions; the impact on individuals, their families, and their caregivers; the health services used and required; and the factors that increase the risk of developing neurological conditions.
As well, a conference will be held at the conclusion of this study to provide information for developing policies and programs to improve the lives of those individuals living with neurological conditions.
Through the Canadian Institutes of Health Research our government has also invested $88 million in neurological research. Canada is taking a leadership role in working with other countries to accelerate research on Alzheimer's prevention and on the development of new therapies to address the public health challenges. In fact, we have signed international memoranda of understanding with France, Germany, and the United Kingdom on Alzheimer's research. They all recognize, as well, that they are facing the same challenges we are. But Canada was able to pull those important partners together to accelerate our research in that area.
Our government has also invested $30 million over five years, with the support of the Rick Hansen Foundation, to support the programs and operations of the related Rick Hansen Institute.
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Thank you, Madam Chairperson.
Thank you for having me here today. My name is Jennifer Heatley and I'm the executive director of the Atlantic Collaborative on Injury Prevention, or ACIP as we call it for short. ACIP is an NGO based out of Halifax and works to reduce the burden of injury in the four Atlantic Canadian provinces.
After several years of working in the area of injury prevention, I continue to be surprised at its contradictory profile as a public health issue. On any given day, the media often leads with stories of injury in all its forms, but despite the high profile of individual incidents, there is a striking difference between injury and the other leading killers of Canadians.
Research dollars, surveillance systems, and strategies are pale compared to those of other major diseases such as cancer and heart disease. The public's concern about injury, although sincere, has not translated into "movembers" or "walks for the cure". Injuries are still considered bad luck or fate.
What we do know is that preventable injuries, both those that are intentional and unintentional, present a significant social and economic burden in Atlantic Canada and across the country. Over 1,000 Atlantic Canadians die annually as a result of injuries and another 16,000 are injured severely enough that they need to be hospitalized. Overall, this costs Atlantic Canada over $1 billion per year in direct and indirect costs.
Furthermore, injury is an issue that highly impacts our youth. Although injury is the leading cause of death across all ages, up to the age of 44 it is the number one cause of death. For children and teenagers, it is responsible for more deaths than all other causes combined.
Injuries that kill and disable so many Canadians are preventable through healthy public policy and evidence-based strategies. The issue of injury would benefit from a coordinated national injury prevention strategy. National strategies and coordinated efforts have been integral to other high-profile health issues. We need to move beyond attempting to change individual behaviours and work to create safer environments through broader social change.
There is a need for federal leadership to coordinate across sectors, so that injury prevention efforts are comprehensive and take into account the many factors that put individuals at risk for injury. Continuing to create divisions between issue areas or between intentional and unintentional injury is artificial and unnecessary, as the root causes are the same for all.
Although the federal government has recently indicated a planned focus on injury prevention for children, ACIP would encourage an approach that will address injury across ages, population groups, and injury issues. The socio-economic conditions that increase injury risk for children are the same as those that increase risk for other populations and age groups at higher risk, such as seniors and aboriginals. Furthermore, children are heavily influenced by the adults in their lives and their surrounding environments. Safe and healthy children cannot exist without safe and healthy adults, and communities.
Our communities won't be safe until they're equitable. Canada has the capacity to be as healthy and safe as other countries who are leaders in the health field, but we need to make some big changes. We know what the cure for this disease is. If we can come together as a country on a coordinated injury prevention strategy and a series of healthy public policies that address the role that poverty plays in injury, we can address billions of dollars in avoidable health care costs, and, more importantly, an enormous personal burden to millions of Canadians.
Thank you.
:
Thank you, Madam Chairperson, and thank you to the rest of the committee.
My name is Philip Groff, and I thank you all for the opportunity to speak with you today and to share some information on injury and its prevention.
I'm here today representing SMARTRISK, a national charitable organization dedicated to preventing injury and saving lives. Our mission is to empower you through education, programming, and policy change to recognize and manage the risks of injury in the smartest way possible. We focus most of our programming efforts on young people, as they are at peak risk for injury and are prone to take risks without thinking them through. We believe if we can reach young people, traditionally a tough group to get through to with safety messaging, we could help make them smart risk-takers for life.
Our organization began 19 years ago when our founder, Dr. Robert Conn, a pediatric heart surgeon, became interested in precisely where the donor hearts he was harvesting as a member of a transplant team were coming from. He did some research and discovered they were coming from people like you and me, like our children, our nieces and nephews, people who were healthy and happy one moment, but then due to a bad decision on someone's part, or a poorly engineered piece of the environment, or a moment of inattention were fatally injured and eligible to donate their organs. Dr. Conn realized he could save many more lives by preventing injuries before they happen, rather than trying to repair them in the operating room afterwards. He left surgery and founded SMARTRISK.
Since that initial research of Dr. Conn, the data has not lost its impact. In 2009 SMARTRISK released our second national report on the economic burden of injury in Canada, a report that we have tabled with the clerk of this committee. You will see that in any given year, injury claims more than 13,000 Canadian lives and necessitates more than three million emergency department visits and more than 200,000 overnight hospital stays. It leaves more than 60,000 citizens with some form of personal disability and another 5,000 permanently and totally disabled. The annual cost to all Canadians is more than $19.8 billion, all for events that the research literature indicates are largely predictable and preventable.
At SMARTRISK we've spent the majority of our efforts in trying to protect the youth of this country from death and serious injury. As you've already heard, injury is the leading cause of death from ages one to 44, and between the ages of 10 and 35 a Canadian is more likely to die from a predictable and preventable injury than from all other causes of death combined. Getting youth to manage their risk of injury is not impossible, but neither is it easy. We've invested a great deal of time and research investigating what works and what doesn't when trying to persuade teens to make smarter choices. We've learned through research and talking to teens to avoid negative messages, with an emphasis on consequences that push our audience into denial that these events could ever affect them. We've learned to emphasize the positive benefits of making healthier choices rather than trying to scare teens straight, and we've learned to harness the enormous power of positive peer influence so that life-saving messages are spoken in a language that is native to our young listeners, which no adult remembers fully how to speak. We've also learned the importance of building supportive environments so that the healthy choices are also the easy, popular, and fun choices.
We and our partners at the other national injury organizations have learned a lot about how to prevent injuries and save lives. We have the vaccine; what we lack is the infrastructure and supports to deliver it as widely as necessary.
A number of years ago we facilitated a national consultation with stakeholders representing the domains of surveillance, research, knowledge translation, and community programming to develop a draft framework for a national injury prevention strategy. The resulting document, Ending Canada's Invisible Epidemic, called for a pan-Canadian strategy based on six pillars: national leadership and coordination, an effective surveillance system, research, community supports and resources, policy analysis and development, and public information and education.
There has been some development of each of these pillars in the subsequent years, most vividly the leadership shown by CIHR in the development and launching of the strategic teams in applied injury research grants last year, a landmark achievement, as it represents the first time that many researchers in this country will be able to devote themselves to injury prevention research as their primary vocation rather than as a sideline they pursued with passion but little support or recognition.
However, much of the development that has occurred in these areas has been led from outside government, through the dedication of various NGOs. We are still looking for national leadership and coordination on this issue and a commitment to address this epidemic that is commensurate with the magnitude of the burden.
On March 3, 2010, in the Speech from the Throne, then Governor General Michaëlle Jean read the following statement: “To prevent accidents that harm our children and youth, our Government will also work in partnership with non-governmental organizations to launch a national strategy on childhood injury prevention.”
SMARTRISK, along with the other national injury prevention organizations--Safe Communities Canada, Safe Kids Canada, and ThinkFirst Canada--stands ready to partner with the government on this national strategy.
Thank you again for the opportunity to speak today. I'd be happy to answer any questions.
It is an honour to be here on behalf of the ThinkFirst Foundation of Canada.
Injury affects all of us. It affects the injured person; it affects the person's family; it affects our health care system profoundly. Injury is a huge public health issue in this country. On average in Canada, 500 children a year die from injuries. That's more than one child a day. These are your children, your grandchildren, your nieces, your nephews. We're all affected.
Every 30 seconds in Ontario, somebody walks into an emergency department for treatment resulting from an injury, so it's really important. It affects our wait times, our hospitalizations, everything.
The impact of injury is lifelong. Having a spinal cord injury can result in paraplegia, decreased mobility for the rest of your life. Having a brain injury, as I'm sure Tyler will share with us, can change your life forever.
The leading causes of injury include drowning, motor vehicle and pedestrian injuries, and falls. All of these have evidence-based strategies that can reduce their incidence or their causes in our population. If we just did what we know works, we'd already make a huge impact. Things like bicycle helmet laws, four-sided pool fencing, playground standards that meet the CSA standards developed here in Canada, rule changes in sports, can all lead to healthier and safer kids in Canada. We know that some populations are particularly vulnerable. Poor children are at increased risk. Our first nations and Inuit children are much more likely to die of injury than our other Canadian children. Children who live in rural and remote areas on places such as farms are also at increased risk.
We rank 32nd among OECD countries in injury prevention, and for a country like Canada, that is not good enough. We can and must do better for our children and for our communities in injury prevention.
Rebecca's going to talk a bit about some suggestions for strategies, which I think are similar to what the other speakers have mentioned.
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My name is Rebecca Nesdale-Tucker and I'm with ThinkFirst Canada.
I would very much echo what my colleagues have said at the table.
Number one is that we'd like to see strategic action. It has worked on the international scene in other countries. It simply makes sense to figure out what the priorities are and focus our attention there collaboratively.
As Alison said, whatever we're approaching we want to have a three-Es perspective, so consider the education, the enforcement, and the engineering. Absolutely, we want helmets whenever your head is vulnerable. Whether it's sports and recreation, if you're on wheeled activity, have a helmet on. Have enforcement of appropriate rules across injury cause, and make sure the engineering is appropriate as well. That goes to product safety and to regulation.
Almost every type of child injury requires this kind of multi-faceted approach. We have the solutions; we simply need to implement them.
Similarly with road safety crashes, we want kids in the appropriate child restraints, in the car seat, in the booster seat. We want to lower speeds. That helps pedestrians, helps all different types of vulnerable road users. Then again, the education piece: educate adults, but I also think we first favour educating kids from a young age so they're self--