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Order Paper questions
Q-233 — May 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to chronic cerebrospinal venous insufficiency (CCSVI), the “liberation” procedure, and multiple sclerosis (MS): (a) does Health Canada recognize the International Union of Phebology (IUP), and is Canada a member; (b) does Health Canada recognize the IUP’s Consensus Document on the diagnosis and treatment of venous malformations; (c) will Health Canada be respecting the IUP’s standards regarding diagnosis and treatment of venous malformations; (d) will the government work with the provinces and territories to establish imaging and treatment guidelines for CCSVI and, if so, over what timeline and, if not, why not, (i) what are the benefits and risks associated with imaging and treatment techniques, (ii) what are the costs for each of the identified methods; (e) will the government, in collaboration with the provinces and territories, commit to imaging MS patients for venous malformations, and treating those patients who require interventions and, if not, why not and, if so, (i) over what timeline, (ii) what barriers would have to be overcome; (f) is CCSVI recognized as an official diagnosis and, if so, by what professional medical organizations and how is it defined; (g) what is the cause of narrow veins in the neck or thorax and what methods could possibly be undertaken to reduce their occurrence either in utero, in childhood, or in adulthood; (h) with what medical conditions is CCSVI associated; (i) what are the potential health impacts of CCSVI in the short-term, medium-term and long-term, both with and without treatment; (j) what percentage of MS patients show one or more blocked veins; (k) what veins, other than the jugular veins, are commonly blocked, damaged, or twisted in the human body, (i) what imaging procedures are used to identify the problems, (ii) what interventions are required to address the problems and why, (iii) what are the possible health impacts if left untreated, (iv) are interventions time sensitive, (v) what are the costs of imaging procedures and treatment; (l) what specific methods are used to investigate CCSVI, what costs are associated with each method, and what are the benefits and risks associated with these techniques; (m) where in Canada are these imaging methods available and, for each location, what procedures are offered and how much do they cost; (n) where in the world are private clinics emerging, what are their efficacy and safety records, and what are the imaging and treatment costs; (o) what percentage of MS patients show a reduction in MS attacks and brain lesions following the liberation procedure; (p) what percentage of MS patients with little or mild blockage show improvement following the liberation procedure; (q) what discussions is the government having regarding CCSVI, its imaging, and the possible link with MS; (r) what studies are government scientists conducting to assess the reliability and validity of imaging techniques, the possible association between CCSVI and MS, and to follow-up on patients who have undergone the liberation procedure; (s) how much money has the government allocated to research related to CCSVI, the liberation procedure and MS; (t) what is the estimated number of MS patients in Canada, and what is (i) the percentage who can no longer work, (ii) the percentage who depend on family caregivers, (iii) the percentage who require around-the-clock care from professional caregivers; (u) what is the estimated national annual economic impact of MS on families and healthcare plans; (v) what is the estimated national annual cost of disease-modifying therapies, including Copaxone and Interfon, for families and healthcare plans; (w) what are the projected imaging costs for CCSVI and treatment costs for MS patients who show a vascular abnormality; (x) what are the projected imaging costs for CCSVI and treatment costs for all MS patients; (y) what recommendations regarding CCSVI and imaging are being provided by the government to MS patients, particularly regarding (i) reputable imaging and treatment clinics, (ii) the pros and cons regarding venoplasty and stents, (iii) the need for continuing treatment regimes following any liberation procedure; (z) what steps is the government taking to educate MS patients about blogger patients and sham imaging and treatment centres; and (aa) what is the estimated number of Canadians who have gone overseas for imaging and treatment, and what tracking is being undertaken of their condition following such trips?
Q-2342 — May 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to nutrition in Canada: (a) does the government recognize good nutrition as a basic human right; (b) how is food insecurity defined by the government, and what factors are responsible for it in Canada; (c) what action, if any, has the government taken to address each of the factors as identified in the answer to (b); (d) what action, if any, has the government taken to promote nutrition in Canada and which specific populations have been targeted; (f) does Canada have a comprehensive initiative that aims to reduce undernutrition and hunger at the national scale and, if so, (i) what is it, and if not, (ii) why not; (g) what successes has the current government had in building on effective programs to reduce food insecurity, undernutrition and hunger, and what barriers has it had to overcome; (h) has the government facilitated communications between the provinces and territories concerning the best methods of improving infant, child and adolescent nutrition in Canada and, if so, (i) on what dates and what were the recommendations and, if not, (ii) why not; (i) what are the names of all food security, nutrition, hunger prevention, etc. stakeholders with whom the government meets; (j) what percentage of Canadian families seeks assistance from food banks, and how has this changed over the last 20 years; (k) what percentage of Canadian infants, children and adolescents require assistance from food banks to meet their nutritional needs, and are all their needs met; (l) what action, if any, has the government taken to address in particular the nutrition of pregnant women and children through two years of age; (m) what percentage of Canadian children and adolescents experience food insecurity or hunger, and how does this translate into numbers, how have these data changed over the last 20 years, and for what reasons; (n) has the government considered a national breakfast, lunch or snack program to help ensure that children and adolescents meet their nutritional needs; (o) how does the government define the categories overweight and obese, and what percentage of Canadian infants, children, and adolescents are overweight and obese; (p) how does socio-economic level impact overweight and obesity in Canadian infants, children, and adolescents; (q) what are the medical and psychological complications of child and adolescent overweight and obesity; (r) how has childhood overweight and obesity increased in Canada over the last 20 years, and what action, if any, has the current government taken to address the situation; (s) how has type 2 diabetes increased in Canadian children and adolescents over the last 20 years; (t) how many treatment centres for childhood and adolescent obesity exist in Canada, and has the government increased or decreased funding to these, and by what percentage; (u) what action, if any, has the government taken to expand the number of child obesity treatment centres; (v) what action, if any has the government taken to facilitate communications between the provinces and territories concerning successful overweight and obesity prevention and treatment programs, and replication of what is working well; (w) what action, if any, has the government taken to support research and evaluation of childhood overweight and obesity prevention, including behavioural, dietary, environmental, pharmacological, and physical activity approaches, and treatment initiatives; (x) what analysis, if any, has the government undertaken of nutrition programs in other jurisdictions, such as the United Kingdom and the United States; and (y) what consideration, if any, has been given to the Pennsylvania program that has led to more than 80 supermarkets being set up in unserved areas in the last five years?
Q-65 — March 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to the climate summit in Copenhagen and climate change: (a) what criteria needed to be met in order to be part of the Canadian delegation; (b) what were the name and position of each member of the Canadian delegation, what expertise and skills did each bring to the table, and for what time period were each in Copenhagen; (c) what was the total budget for the delegation, from flights to accommodation and living expenses; (d) what, if any, offsets were purchased for the delegation; (e) what was the description, in detail, of the Canadian climate change plan, and when will it be revealed to Canadians; (f) who were all the stakeholders consulted in the development of the plan, and how does each goal/target reflect or does not reflect each stakeholder's views; (g) did the government include the voice of Canadians who are on the “front line of climate change”, and were those who will be impacted by climate change meaningfully involved, and, if so, how; (h) what accountability measures, if any, were in place to ensure that the Canadian delegation would be responsible to those Canadians who will be particularly impacted (e.g., those living in low-lying areas and Aboriginal peoples); (i) what has been the stakeholder response to the plan, particularly from business, NGOs, scientists, and all stakeholders, and if available, what is the actual response of stakeholders' consulted; (j) what were the specific goals of the Canadian delegation, and how do they compare (in advance and afterward) with those of the G-20 or OECD in terms of baseline, absolute reductions, and target date; (k) did the Canadian delegation support the notion that climate change is not just an environmental issue, but rather a human rights issue and a justice issue and, if so, what is the description, in detail, of Canada's position; (l) did the Canadian delegation listen to the world's “frontline voice”, such as Bangladesh's and the Maldives', and act upon scientific and humanitarian evidence; (m) what were the projected costs of mitigating acid precipitation and reducing chemicals that destroyed stratospheric ozone, the costs of inaction, and what were the actual costs required; (n) what are the projected costs of adapting to and mitigating climate change in Canada today, and what are the costs of inaction for each year, five years, and decade delayed; (o) will the government commit new research dollars to support global climate research and services; (p) in detail, what percentage of 2009's stimulus was “green”, and how was it a “triple win” for the economy, jobs, and the atmosphere, and going forward, what specific targets in Canada's climate change plan will be a “triple win”; and (q) what are the costs the government is willing to pay to mitigate climate change, and how do these costs compare with the projected economic, environmental and social costs of climate change?
Q-66 — March 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to armed conflicts where Canada is both directly and indirectly involved: (a) what are the sites and in detail, Canada’s involvement; (b) how are civilians, and particularly, children, minorities, and women impacted for each identified site; (c) which identified areas have refugees and refugee camps, with the numbers of civilians, and particularly, children and minorities affected, and what are the living conditions in refugee camps if applicable; (d) what is the process for determining whether Canada becomes either directly or indirectly involved or not in a conflict, and how does Canada become involved; (e) how does the process ensure that good verifiable information is obtained from the field, particularly in areas where there is poor communication; (f) how does Canada obtain information from civilians who might be afraid to speak out, as well as NGOs, who need to have their work protected; (g) what is the process for ensuring that good information is acted upon, and what is the demonstration, if applicable, of where Canada has acted upon such evidence with regard to identified sites; (h) does Canada invest in development and reintegration in areas to ensure alternative lifestyles for civilians and, if so, in which areas specifically; and (i) what are the other sites, by countries, where Canada is aware of an armed conflict but is not involved?
Q-672 — March 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to humanitarian issues and crisis and Canada’s involvement: (a) how does Canada increase awareness around the world that abuse of children, minorities, women, etc. will be punished; (b) how often is humanitarian evidence examined in Canada, and by whom; (c) what accountability measures are in place to demonstrate Canada’s commitments with respect to human rights internationally; (d) what processes are in place to give Canadian family members information, and to give information on how to help; (e) what processes are in place or can be put in place to allow Canadians to sponsor family members more quickly if required; (f) what, if any, audit process follows Canada’s direct or indirect involvement during a humanitarian crisis; (g) what, if any, process follows the resolution of a humanitarian crisis, and how Canada performed with respect to it; (h) what opportunity, if any, is there for Canadians to have their input in such an audit process; and (i) with respect to Canada’s involvement during last year's crisis in Sri Lanka, (i) what, if any, audit will follow Canada’s involvement, (ii) what, if any, evidence is Canada receiving that might suggest violations against children, minorities, and women, (iii) what steps, if
applicable, is Canada taking to address such evidence?
Q-682 — March 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to the Canadian HIV Vaccine Initiative (CHVI) and the Level 5 Laboratory (L5L): (a) what are the details of the initial request for proposals for the CHVI; (b) what amount were the government and the Gates Foundation planning to invest in the CHVI and what were the scheduled dates for investment; (c) how many bids for the CHVI were submitted and by which organizations; (d) what are the details of the CHVI process for determining suitable award winners; (e) what were the selection criteria for awarding the CHVI bid and who was responsible for identifying the criteria; (f) how many people made up the independent evaluation committee for the CHVI bids, how were they selected, and from which disciplines and geographic areas were they drawn; (g) were representatives from the pharmaceutical industry invited to be part of the independent evaluation committee for the CHVI bids and, if so, on what date did each representative serve and, if not, why not; (h) what were the results for each of the selection criterion for each of the organizations bidding on the CHVI and how were the bids ranked; (i) did the independent evaluation committee for the CHVI bids reach a recommendation, and, if so, on what date, and to whom was the information conveyed in the government; (j) was there a steering committee for the CHVI bids and, if so, who were the members, who was the chair and what was its mandate; (k) were there changes to the steering committee for the CHVI bids and, if so, on what dates and for what reasons; (l) was any organization bidding on the CHVI informed, formally or otherwise, that it had been chosen to host the facility and, if so, how and on what date; (m) did the federal government put up a notice on its Web site to announce that the CHVI project had been cancelled or would not proceed and, if so, on what date; (n) was the notice in (m) removed from the Web site and, if so, on what date and for what reason; (o) have each of the organizations bidding on the CHVI seen the results of the peer-review process and, if so, on what date and, if not, why not; (p) what constructive criticism was given to each of the organizations bidding on the CHVI; (q) what specific problems were identified that prevented each of the organizations bidding on the CHVI from being selected; (r) why were bidding organizations not encouraged to redevelop their CHVI bid; (s) why and by whom was the CHVI cancelled; (t) on what dates was the CHVI project cancelled, were the submitting organizations formally informed and was the Canadian public informed; (u) what do “changing needs” and “reallocation of resources” mean in relation to the cancellation of the CHVI project; (v) what post-mortem audit does the government plan to undertake to investigate how Canadian investigators and research centres failed to meet the selection criteria for the CHVI bid; (w) how will the planned CHVI investment monies be spent; (x) what are the details of both the CHVI’s and the L5L’s history from January 2009; (y) what are the organizations involved in the L5L, and what, if any, overlap (e.g., goals, funds, personnel, etc.) exists between the International Centre for Infectious Diseases, which was bidding for the CHVI, and the L5L; (z) what, if any, involvement does the government have in the L5L; and (aa) what, if any, review process is in place for the L5L?
September 24, 2009 — Ms. Duncan (Etobicoke North) — With regard to the current pandemic of new influenza A (H1N1) virus in Aboriginal (First Nations, Inuit, Metis) communities in Canada: (a) what were the containment measures taken to slow the spread of the virus within households, between households, and among communities; (b) what were the control measures taken in more remote areas to flatten the epidemiological peak; (c) what was the average length of time from symptoms to treatment for those Aboriginal peoples who required a stay in intensive care unit (ICU); (d) what percentage of hospitalizations, ICU cases, and deaths were among Aboriginal peoples, and how do these compare with the Canadian population at large; (e) what was the average length of time on a ventilator and the mean length of stay in an ICU for Aboriginal peoples; (f) what specific measures are being planned to reduce the time to treatment, hospitalizations, ICU, and deaths; (g) when will the results of the preliminary investigation in First Nations communities be available, specifically, (i) how many Aboriginal communities in Canada have a revised H1N1 pandemic influenza plan, (ii) how many have tested their plan, (iii) how many have necessary supplies in place; (h) what specific actions have been undertaken to address the fact that only two of 30 communities in northern Manitoba had a pandemic plan, and none had been tested; (i) where did the Minister of Health obtain the 90 percent figure she used in her August 28 response letter to Drs Bennett and Duncan; (j) what funding have Aboriginal communities requested, and what additional funds have been made available to Aboriginal communities for pandemic planning and response in 2009; (k) is there any encouragement to identify vulnerable people, such as pregnant women and those with underlying medical conditions, to take additional precautions, specifically, (i) how many communities lack necessary clean water for infection control measures, (ii) what funding and progress has been made to address this situation; (l) what measures are being put into place to decrease transmission in households where there is overcrowding; (m) are all Aboriginal people on the priority list for vaccine, or just communities in remote and isolated settings; (n) are anti-virals pre-positioned in all Aboriginal communities, should they be required urgently, and are there provisions for communities without registered nurses; and (o) what measures exist to ensure that remote and isolated communities will have the necessary human resources to ensure appropriate and timely treatment, particularly in communities where weather may impact help?
September 24, 2009 — Ms. Duncan (Etobicoke North) — With respect to the current pandemic of new influenza A (H1N1): (a) who is at the top of the pandemic organizational chart for the country; (b) what gaps still exist in the government’s overarching plan, recognizing that it is an ever-evolving plan, and by what date will identified gaps be addressed; (c) what money remains from the $400 million contained in the budget of 2006 as ‘to be set aside as a contingency to be accessed on an as-needed basis’; (d) what funds have been spent since the start of the pandemic in Canada to address response, specifically, (i) what government departments have tested their pandemic plan, (ii) what departments operationalized their plans or part of their plans in the spring, and updated their plans since the lessons learned from the spring; (e) should there be an election, what is the pandemic preparedness plan for Elections Canada, both to protect the health and well-being of its employees and Canadians; (f) what are the outstanding issues among medical personnel in terms of preparedness, and how are these issues being addressed; (g) what was the process for monitoring swine herds prior to April 24, 2009, and how has it increased since that date; (h) what is the purpose behind the absence of a Canadian notifiable swine influenza surveillance system; (i) what is known of the clinical spectrum of the disease at this time, and what are the possible long-term impacts on lungs, and other organs, and potential long-term costs to the healthcare system; (j) by what date are provincial and territorial vaccine distribution plans to be in place, what oversight exists to ensure they are in place, and will they be made public; (k) what contingency plans are being put in place should Canadian distributors run out of stock of N95 masks; (l) will there be a compensation package should there be challenges with the vaccine; (m) what recommendations are being made to those with chronic conditions, such as cardiovascular disease, diabetes, and immunocompromised patients, and how is this information being relayed to these groups to see their doctor now; (n) what are the details of the “alternative strategies” being developed by provinces and territories; (o) what are the details of adding a “small amount of amantadine” to the National Emergency Stockpile System, and is its use in combination thought to be effective when the virus is resistant to amantadines; (p) are there any other alternative therapies being explored to address antiviral resistance and, if so, what funds are being allocated to the effort; (q) will 500 ventilators meet the potential intensive care unit (ICU) burden considering Canada’s ICU cases were around 20% of its hospitalized, compared to 15% in heavily impacted communities in the southern hemisphere; and (r) what do recent modelling studies show?
October 1, 2009 — Ms. Duncan (Etobicoke North) — With respect to the current pandemic of new influenza A (H1N1): (a) what is the key leadership shown by the organizational reporting chart, from the two lead ministries, the Public Health Agency of Canada and Public Safety Canada, through to the deputy ministers; (b) what is the decision-making process to determine which of the two ministries leads on issues; (c) what, if any, funding requests have been made by government departments for pandemic planning since the beginning of the pandemic in Canada; (d) what, if any, additional funding is required to ensure all government departments have tested their H1N1 plans and rolled them out to their employees; (e) what, if any, specific agreements have been signed with the provinces and territories, and which, if any, agreements still need to be signed; (f) what are the government’s identified critical services, what is the decision-making process to reduce services if required, and who has responsibility for these decisions; (g) how will the government acquire and distribute medical countermeasures if required; (h) what guidance is being provided to foreign missions, including consulates, embassies, high commissions and trade offices, and what is the decision-making process to reduce services, or repatriate staff; (i) what guidance is being provided to the Canadian Forces, including the army, the air force and the navy, and what recommendations are being made for military personnel; (j) with regard to recommendations being made to the Canadian Forces and military personnel concerning vaccinations, what processes are in place to (i) re-evaluate policies as required, (ii) ensure legal compliance and respect ethical considerations, (iii) ensure protection of our troops in Afghanistan; (k) on what date was the pandemic vaccine ordered, and what, if any, effect did having only one supplier, or the decision to use adjuvant, had on the delivery date for the H1N1 vaccine; (l) what, if any, actions is the government taking to investigate claims of unpublished Canadian data regarding vaccination, and what updates are available in Canada and internationally; (m) what, if any, recommendations will the government make in terms of timing of seasonal and H1N1 vaccines, why was priority setting or sequencing different from that of the World Health Organization, and what considerations have been given to possible impacts of varying provincial and territorial vaccination plans on short-term and long-term trust in public health officials and vaccination rates; (n) what, if any, oversight exists to ensure Canadian communities have H1N1 pandemic plans in place, and what specific recommendations are being made for those who live in poverty or in crowded housing conditions, including prisons and shelters; (o) what, if any, gaps exist in medical surge capacity; (p) what, if any, monitoring is being undertaken for influenza-like illness in daycares, schools, colleges, and universities, and, if so, what patterns are occurring; (q) what percentage of people who died of H1N1 during the last four months had secondary bacterial infection, and what, if any, underlying health conditions did they have, and how might possible secondary bacterial infections be reduced in at-risk populations; (r) what, if any, ethical guidelines are in place to allow for consistent decision-making regarding ventilators; (s) what research, if any, has been undertaken to determine what percentage of healthcare workers might be concerned to work during a possible second wave, and what mitigating efforts have been taken to address this possible challenge; (t) what, if any, recommendations exist regarding “duty to care” and institutional supports to healthcare workers during a pandemic; (u) what efforts are being taken to boost vaccination rates among pregnant women, and how is this information being conveyed to medical practitioners and expectant mothers; (v) what, if any, consideration has been given to the construction of field hospitals in remote and isolated areas; (w) with historical hindsight, and knowledge of increased vulnerability to H1N1 of Aboriginal communities due to underlying health conditions and socio-economic problems, what, if any, containment measures were taken to slow the spread of the H1N1 virus in the spring; (x) what preventive and treatment measures are being implemented to reduce the percentage of Aboriginal people who will be hospitalized, who will stay in intensive care units, and who will die, compared to the whole of the Canadian population; and (y) what, if any, consideration has been given to share a portion of Canada’s antiviral medication, vaccine allotments, and flu management kits with developing countries?
October 7, 2009 — Ms. Duncan (Etobicoke North) — With respect to the current pandemic of new influenza A (H1N1): (a) what specific healthcare professional stakeholder groups have been consulted since the beginning of the H1N1 pandemic, what was the consultation process, and what concerns were raised; (b) what concerns from the consultation process have been addressed, what concerns are remaining, and by what date will they be addressed; (c) what, if any, additional funding was requested to address identified challenges; (d) do identified stakeholder groups report there are sufficient human resources and supplies to meet the need during a second wave of H1N1 and, if not, what are the identified gaps; (e) what, if any, additional education and training was requested by stakeholder groups; (f) what procedures are in place to ensure applicability, consistency and clarity of protocols to healthcare professional organizations, and do stakeholders report that they are receiving clear, concise, timely messaging; (g) what, if any, differences exist in how healthcare professionals will be protected among provinces and territories; (h) what specific agreements have been made in respect to assuring sufficient human resources during a second wave; (i) what, if any, differences exist between the national guidelines and those of the provinces and territories, with respect to antivirals, N-95 masks, vaccines, and other personal protective measures, and how should healthcare professionals address any discrepancies; (j) what are the known and suspected benefits and risks of the H1N1 vaccine; (k) what non-clinical and clinical trials have been or are being undertaken regarding the H1N1 vaccine, on what dates were they completed, and what are the outcomes of these trials; (l) what possible side effects, including rare events, might be expected with the H1N1 vaccine; (m) what are the possible legal risks associated with an H1N1 vaccination programme, and what efforts have been taken to reduce these risks; (n) what, if any, plans exist for rapid distribution and administration of vaccines for the first mass vaccination effort; (o) what special efforts are being made to reach out to young adults, minorities, and other at-risk groups to get vaccinated, and what languages and media outlets are being used; (p) for how long will vaccination campaigns continue past the fall in case of a possible third wave; (q) how do hospitals across the nation vary in their ability to bear the burden of H1N1 cases; (r) what percentage of hospitals are operating at their limit today; (s) what percentage of hospitals will be able to accommodate the predicted surge capacity if 15%, 35% and 50% of the population is impacted by H1N1; (t) what percentage of hospitals will be expected to meet intensive care unit (ICU) and ventilator surge capacity if the above percentages of people are affected; (u) do any hospitals or provinces and territories had difficulty meeting surge capacity in the spring and summer; (v) what, if any, surge capacity challenges existed in the spring and summer in terms of hospitalizations, ICU stays, and ventilator use, and what measures have since been taken to address these challenges; (w) what, if any, funding has been given to address surge capacity challenges; (x) what specific efforts are being taken to help reduce the burden on hospitals by distributing high profile messages about when to seek medical care for pandemic H1N1 infections; and (y) what is being undertaken to reduce the risk of resistance (i) in patients with severely compromised or suppressed immune systems who have prolonged illness, have received oseltamivir treatment, but still have evidence of persistent viral replication, (ii) in people who receive oseltamivir for post-exposure prophylaxis, and who then develop illness despite taking oseltamivir?
June 4, 2009 — Ms. Duncan (Etobicoke North) — With regard to funding for pandemic response in the 2006-2007, 2007-2008 and 2008-2009 fiscal years: (a) what is the detailed breakdown of the (i) total funding allocated, (ii) total funding spent; (b) what are the official criteria required to access the pandemic response funding; and (c) what funding amounts have been distributed, on what date and towards what project?
— June 4, 2009 — Ms. Duncan (Etobicoke North) — With regard to the current outbreak of new influenza A (H1N1) virus, including its potential global spread, and including the probability that it will become widely established: (a) seeing as swine is an important reservoir for the new virus, what specific measures are being undertaken by animal and human health experts in Canada to monitor swine; (b) what, if any, funding has been made available for a coordinated surveillance effort; (c) how does the new H1N1 compare with the 1918 H1N1 virus and H5N1, particularly regarding the adaptation markers and virulence, and are the current human cases of H1N1 similar (in pattern) to the possible cases of influenza between the spring and fall of 1918 and, if so, what lessons can be learnt; (d) what planning is being undertaken for a worse-case scenario, especially if a more virulent virus emerges during the course of a pandemic; (e) what specific measures are being taken to reduce the spread of H1N1 in local communities (and particularly in low resource areas) and institutions, and in the future, at what point should affected provinces consider activating aggressive containment or mitigation efforts for affected communities; (f) what new surveillance is taking place in the southern hemisphere, particularly in respect to the Americas’ flyways, humans, and pig populations; (g) has the source of H5N1 infection in the Fraser Valley of British Columbia been established and, if so, what is the source, and is it endemic; (h) what steps are being taken to address the source of H5N1 infections in the Fraser Valley, particularly with the approach of the Vancouver Olympic Games; (i) what specific preventive and treatment recommendations, if any, will be provided to young adults and pregnant women; (j) what are the predicted impacts on the Canadian economy and society should a pandemic occur if illnesses and deaths are concentrated in a young, economically productive age group, and what specific measures can be implemented to reduce these effects; (k) what underlying medical conditions may make individuals more at risk of complications or more likely to experience severe or lethal infections, and how will this information be related to at-risk groups; (l) how might our current disease burden influence the impacts of a possible H1N1 pandemic, and how might these impacts be reduced; (m) what is the known full clinical spectrum of the disease caused by H1N1, does it impact multiple organs and, if so, which ones, what specific supportive therapies might be given, and will there be resources to provide these; (n) what specific steps have been taken to engage the private and voluntary sector in Canada, what percentage of organizations are prepared for the economic and social impacts of a possible pandemic, and what measures are being taken to better prepare these sectors; (o) what percentage of Canadian companies activated their pandemic response plans because of the H1N1 epidemic, and what are the learnings from these companies; (p) since the emergence of the H1N1 epidemic, what steps have been taken to evaluate the effectiveness of communications among all stakeholders, including the levels of public awareness, degree of concern, and complacency; (q) what, if any, steps could have been taken to contain the spread of H1N1 infection in Canada, and going forward, what is the decision framework to move from a policy of containment to mitigation; (r) what will be the decision process for deciding whether to produce and stock seasonal or new influenza A (H1N1) vaccines for Canada; (s) what specific measures will be taken to avoid complacency about the H1N1 virus and keep the public engaged; (t) what steps are being taken to monitor antiviral resistance in Canada, (i) what alternative therapies, including, new antiviral agents for flexibility in developing prophylaxis treatment, benefits of combination therapies and novel therapies, including, monoclonal antibodies, are being explored to deal with this possibility, (ii) what resources are being provided for these efforts, (iii) how will it be decided who has been exposed and requires treatment, (iv) how will antivirals be distributed in the event of a pandemic; (u) what specific funding is being provided for clinical vaccine studies for commercial-scale production of both antigen and adjuvant for a novel H1N1 influenza vaccine; (v) how quickly will influenza A (H1N1) vaccines be available, (i) what regulatory processes would need to be modified, (ii) what delays might occur in production, (iii) how could these be overcome; (w) will vaccines being developed now be effective if the virus causes a mild pandemic in the warmer months and changes into something more severe in the fall; (x) who specifically is likely to receive priority for vaccination with a future pandemic vaccine, and how can decision makers engage citizens regarding ethical choices in order that the public understand the decisions that will have to be made during a pandemic; (y) what advice is being given to medical personnel and community members regarding masks, (i) what is the Canadian stockpile of N-95 and surgical masks, (ii) could Canadian companies supply enough of the required masks for a serious outbreak, (iii) what is the Canadian supply of respirators and does it meet the needs of the government’s estimate; and (z) what is the possibility of a wider clinical spectrum of H1N1, and a longer medical legacy (i.e. long-term sequelae)?
— June 11, 2009 — Ms. Duncan (Etobicoke North) — With respect to genocide: (a) does the government define the term according to the 1951 Convention on the Prevention and Punishment of the Crime of Genocide; (b) how does the government qualify and quantify “acts committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group” (e.g. is there a critical threshold that must be surpassed in terms of numbers of people killed, extent of physical destruction), and how does the government distinguish among domestic conflict, genocide and war; (c) what are the government’s legal and ethical responsibilities to intervene and protect as a signatory to the 1951 Convention; (d) what is the decision-making process that the government takes in determining whether killing is genocide or not, whether Canada takes action or not, and what possible action might look like; (e) how does the government ensure that it does not use the wording of the convention, namely the lack of numbers of dead or displaced to constitute genocide, to avoid enforcing it; (f) does the government have any measures in place to ensure that national sovereignty is not used as an excuse to prevent Canada from enforcing United Nations regulations; (g) what is the decision-making process that ensures that Canada has multiple viewpoints before making a decision on a possible genocide, and does not just take the viewpoint of a main party while ignoring the opposing side and third-parties; (h) has the government examined past genocides, and identified early warnings, where Canada might have taken action earlier, what the savings would have been in terms of human life, society, and the economy, and how such lessons might be applied to current conflicts, such as Pakistan and Sudan; (i) what factors has the government identified as potentially leading to genocide, and has it developed an early-warning system or response centre / institution; (j) what specific tactics has the government established to stop genocide; (k) does the government have a special representative for genocide prevention, as well as access to people who are experts in genocide early warning and, if so, to what departments do they belong, and do they have sufficient funding to properly do their jobs; and (l) what legislation is in place to allow Canada to take action, and to hold aggressors to account?
— June 11, 2009 — Ms. Duncan (Etobicoke North) — With respect to Sri Lanka, what is the government doing: (a) to accelerate the processing of visas and refugee claims for those living in refugee camps, and specifically, how many applications have been made, and how many processed; (b) to help Canadian citizens of Tamil heritage locate their family members; (c) to increase humanitarian assistance and medical aid to those living in refugee camps, and specifically, how much aid is being sent, in what form, how is it being tracked, and how is delivery ensured for those in need; (d) to assure full access to the camps by the international community and journalists; (e) to ensure a comprehensive effort at national reconciliation with full recognition of the rights of all communities and respect for the rule of law; and (f) to determine whether there is classification, dehumanization, or extermination of the Tamil people?
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Q-92 — January 26, 2009 — Ms. Duncan (Etobicoke North) — With respect to mitigating the impacts of the next pandemic influenza: (a) have provincial pandemic plans been tested during the last twelve months and, if so, which ones were tested, and what revisions were made based on lessons learned; and (b) what legislative and logistical steps has the government taken regarding social distancing measures? |
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Q-102 — January 26, 2009 — Ms. Duncan (Etobicoke North) — With regards to the risk of a pandemic influenza: (a) what steps has the government taken to protect the health of Canadians during the initial delay in the availability of a specific influenza vaccine for the pandemic strain; (b) what human health and economic costs have been identified for Canada for the delay period, and what steps has the government taken to reduce these costs; (c) what is the government stockpile of Tamiflu, and has the government achieved the stockpile target for antivirals and, if not, when will it be reached; and (d) what specific steps has the government taken to address the limited shelf life of Tamiflu, and the development of resistance to the drug? |
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Q-112 — January 26, 2009 — Ms. Duncan (Etobicoke North) — With regards to the stockpiling of Tamiflu for an influenza pandemic: (a) how does Canada rank among other G7 countries in terms of the number of antiviral treatments the government has stockpiled or intends to stockpile; (b) how do the steps of the government compare to the actions of other G7 countries in terms of using Tamiflu for prophylaxis and treatment; (c) what is the ethical framework for identifying priority groups during a pandemic, and what priority groups have been identified by the government for prophylaxis and treatment; and (d) what priority age groups in order of ranking for prophylaxis and treatment during an influenza pandemic have been identified? |
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Q-402 — January 29, 2009 — Ms. Duncan (Etobicoke North) — With respect to caffeinated energy drinks: (a) what does the term energy drink mean, and what Canadian regulatory agencies recognize the term; (b) what are the brands sold in Canada, what is the caffeine, guarana, and taurine content and concentration, if applicable, for each, and what regulations the brands passed; (c) what is the content and warning labels for each of the brands, and how do they compare with international standards, such as the European Union and the United States; (d) what are the pre-mixed caffeine-alcohol drinks, the caffeine and alcohol content and concentration, and the regulations passed; (e) what is the scientific evidence for the positive benefit claims; (f) what pre-existing health conditions might make adolescents more susceptible or more at risk to caffeinated energy drinks; (g) what are the acute and long-term effects resulting from chronic and excessive consumption of energy drinks; (h) what are the acute and chronic long-term effects of consumption of caffeine in combination with other substances, such as alcohol, B vitamins, herbal derivatives, nicotinamide, pyridoxine, riboflavin, and taurine; (i) what is the safe daily amount of caffeine, and caffeine and taurine, for adolescents, aged 12-18 years; (j) were there any deaths that have been, in part, linked to consumption of energy drinks in Australia, Canada, the European Union, and the United States and, is so, in each case, what was the drink, the content and the concentration of caffeine and the number of drinks consumed; (k) what are the top-selling brands as well as pre-mixed caffeine-alcohol drinks, and what is the total retail market value for each in Canada; (l) what studies have been undertaken regarding adolescent use, adverse effects, and mixing with alcohol; (m) what are the impacts of caffeine-alcohol interactions, and what might this mean for abuse, drunk-driving, or injury; (n) has caffeine overdose been increasing among caffeine abstainers as well as habitual users in Canada; (o) what, if any, cases of caffeine abuse from caffeinated energy drinks have been reported to Canadian poison centres, and how do these data compare to the European Union and the United States; (p) what measures have been taken to warn the public regarding the adverse health effects, including caffeine intoxification, caffeine dependence and withdrawal; (q) what measures have been taken to warn children and adolescents, who do not use caffeine regularly, regarding possible adverse health effects; (r) what restrictions have been placed on aggressive marketing to youth and inexperienced users, and what mechanisms are in place to ensure compliance; and (s) what measures have been taken to inform medical practitioners regarding the potential health consequences of consumption of energy drinks? |
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