Health committee  It's important to realize that some drugs are very important, and we should get those on the market. However, they don't necessarily have to come on to the market at the prices that are being demanded by the drug companies. There's an independent organization in the United States that looks at the cost-effectiveness of medications and decides what is a reasonable price.

Health committee  In one word, yes. We paid for part of the cost of developing that. We should make sure that the intellectual property rights are public, so that those drugs can not only be produced in Canada or other rich countries but also be shared with the rest of the world to increase vaccine production.

Health committee  Let me emphasize your point about companies trying to blackmail Canada. This goes back to the early 1970s with the Manitoba government, when they were introducing public payment for drugs. They were saying that if there is a generic on the market, they would cover only the cost of the generic.

Health committee  As to why it's refused, you'd have to ask the people in government who are in charge of that kind of decision-making. If you look at the history of Canada, the Canadian government has had to make a choice between supporting improved access to medications in low- and middle-income countries versus supporting intellectual property rights, and we go back to 1999.

Health committee  The government is putting money into a number of facilities. There's the NRC plant that's being built in Montreal, and there's Medicago in Quebec City. They're investing money in Sanofi in northern Toronto, but none of these are Canadian-controlled companies. What we've seen is that, when companies are controlled internationally, those decisions are not necessarily made with the best interests of Canada in mind, so we've got a COVID vaccine being developed by Sanofi and GlaxoSmithKline.

Health committee  There are a number of things that you have to consider. First of all, it's that drug companies, by and large, look at established markets. They see that there's a drug on the market and it has good sales, and they want to get a piece of that pie. They develop their own version of that product.

Health committee  Primarily it comes down to economics. Even the large drug companies have limits on resources, and they are going to submit to get a drug on the market in places where they can get the largest return on those drugs, and that's the United States. The United States prices for brand name drugs are two to three times higher than virtually any other country around.

Health committee  Thank you for the opportunity to appear before the committee. I work as an emergency physician in downtown Toronto. Between 2001 and 2016, I taught health policy at York University. Over the past 40 years, I've been involved in researching and writing about pharmaceutical policy issues.

Health committee  In my view, what we want is a global strategy for this, so that the most vulnerable people in all countries get immunized to decrease the rate of spread. One of the things we know is that the faster the virus spreads and the more people it infects, the higher the likelihood that it's going to mutate.

Health committee  I think the problem is that the vaccines are being treated as commercial products subject to commercial contracts. The vaccines are not a normal commercial good in the sense that computers might be. They're essential to health, and because they're essential to health, we need to understand the terms of the contracts so that everybody is aware of what the delivery schedule is going to be, the numbers and how quickly those doses are going to arrive.

Health committee  That's certainly a significant problem, that lack of transparency. One of the things we've been faced with over the entire period of the pandemic is that we need public trust in what is happening and what the health community and the government are doing in terms of trying to protect us from COVID-19, but without transparency in terms of what's happening on the task force, that trust is being eroded.

Health committee  First of all, I think what we're dealing with is a lack of domestic capacity to produce vaccine, which leaves us vulnerable to what's going on in other countries. We're seeing now threats, or moves, by the European Union to possibly restrict the export of vaccines from those countries.

Health committee  Thank you very much for the opportunity to speak to the committee. I am an emergency physician and have been one since 1982. I taught health policy at York University from 2001 to 2016, and I've been researching pharmaceutical policy for about 40 years. I'm going to go into four different areas.