Bill C-398 and the Essential Medicines Debate | By Nikita-Kiran Singh

As Canadians, our universal health care system is often a source of national pride.  Although our health care system is not perfect, we are typically able to access the medication we need.  Nevertheless, we do not always realize just how lucky we are, particularly in a global context.

One in three people around the globe cannot access essential medicines, which are medications deemed necessary for basic health care by the World Health Organization.  The result is ten million people annually succumbing to perfectly treatable diseases.  As a developed nation, we have the opportunity to encourage humanitarianism.  Thus, Bill C-398, proposed legislation to increase the availability of essential medicines to the developing world, is incredibly relevant and truly significant.

The idea behind Bill C-398 can be traced back to the Jean Chrétien Pledge to Africa Act, which intended to increase the global availability of medicine by allowing generic manufacturers, such as Apotex, to produce patented medicines for poorer nations.  From this proposed act, Canada’s Access to Medicines Regime (CAMR) was established in 2004.  However, due to problematic red tape, CAMR has only been used once in its eight years of existence – to ship antiretroviral medications produced by Apotex to Rwanda.  In order to address the flaws inherent to CAMR, Bill C-393 was introduced, debated and eventually passed by the House of Commons in March 2011.  Members of Parliament from all political parties, including 26 Conservatives, voted for the bill.

In a twist of events, the bill would not receive the same support from the Senate.  It was revealed that Tony Clement, President of the Treasury Board, had sent an e-mail to Conservative senators, urging them to block Bill C-393.  Prior to becoming a cabinet minister, Mr. Clement was a pharmaceutical company stakeholder, and his e-mail suggested a clear conflict of interest, given that 80% of Canadians supported the proposed repairing of CAMR.  The leaked e-mail fuelled the allegation that the bill was stalled intentionally in the Senate prior to the 2011 federal election.  Celebrities including K’naan and Margaret Atwood endorsed the bill, in an attempt to encourage its movement in the Senate.  However, at the time of the election, the Senate had “failed” to reach a conclusion, and the bill was thrown out.  This outcome infuriated many Canadians, who believed that the Conservative Party was using the Senate as a means of undermining the principles of democracy.

Fortunately, NDP MP Hélène Laverdière was inspired to propose similar legislation, now entitled Bill C-398.  The opposition parties fear that many Conservatives who voted for Bill C-393 last year are now under substantial pressure to vote against Bill C-398.  The bill is currently at second reading; a vote will take place on November 28th.  Laverdière stated in the House of Commons on November 21st, “This bill would save lives. It should not be voted upon on the basis of hearsay and misinformation.”

Conversely, Conservatives continue to suggest that Bill C-398 would not amend the global health issues it seeks to address.  Mike Lake, Conservative MP for Millwoods, stated “This bill would in fact do nothing to save lives.  Less costly alternatives will always be available from emerging markets.  India supplies over 80% of donor-funded antiretrovirals to developing countries.”  Mr. Lake’s suggestion – if people are sick, we do not need to provide them further assistance because someone else will – is alarming to say the least, epitomizing the concepts of social loafing and the bystander effect.  Is this what we would want individuals to say if we could not afford medication?  Analogously, if 80% of a group project is being completed by one individual, does it make more sense for the other group members to do their fair share, or to dump the remaining 20% onto the other worker as well?

It has been suggested that the bill could compromise the quality of the medicine.  It is important to note, however, that the medicine would be produced by Canadian generic manufacturers; therefore the quality would not be substandard.  Furthermore, Bill C-398 would regulate the administration of drugs in order to avoid misdirected use; require generic manufacturers to report their production and shipment of medicines; and would not cost any taxpayer dollars.  In addressing the Conservative Party’s qualms, Liberal MP Wayne Easter quite rationally suggested, “If the government has concerns about this private member’s bill, then it could bring forward some sensible amendments that might fix some of the problems.”

The Grandmothers Advocacy Network (GRAN) has accumulated over 23 000 signatures in support of Bill C-398.  The University of Alberta chapter of Universities Allied for Essential Medicines (UAEM) has passionately supported the bill, administering petitions on campus to deliver to regional Members of Parliament.  Eighty international NGOs and 250 Canadian NGOs have endorsed the bill, including Médecins sans Frontières (Doctors without Borders), the United Church of Canada, and UNICEF Canada.

It is ineffably imperative to tackle the unfortunate trend of the sick becoming sicker.  Bill C-398 would not only mark significant progression in addressing issues plaguing global health today, but would also further the humanitarian facet of our identity as Canadians.  An issue like essential medicine should surpass mere political boundaries – so why isn’t it?  The politicization of this issue is utterly shameful.

A video summarizing the Bill C-398 issue can be found here.

To sign a petition in support of Bill C-398, visit here.





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