e-4248 (Health)

Since the onset of the pandemic, the Government of Canada has taken concerted actions to boost funding in order to accelerate research and development (R&D) efforts and strengthen the domestic biomanufacturing and life sciences sector. These early efforts across the industry and health portfolios led to the launch of Canada’s Biomanufacturing and Life Sciences Strategy (BLSS) in 2021. The Government’s focus has been to grow the resilience of the life science’s sector, enable the advancement of health innovation and ensure the renewed prioritization for pandemic preparedness and health emergencies.

The Government has taken a holistic approach to strengthening the sector’s growth and pandemic preparedness by supporting Research and Development (R&D) efforts across the full innovation continuum, from early research, translation, commercialisation and manufacturing.

Since 2020, the Government has invested over $2.2 billion in 38 projects to support therapeutics and vaccine development and biomanufacturing facilities. For example, there are projects that include advancing monoclonal antibody treatments as well as building up biomanufacturing capacity, including establishing GMP facilities for the production of vaccines, treatments and critical inputs such as lipids, which are a critical component for mRNA medicines, as well as fill and finish capabilities. Canada is also growing capabilities in a diverse portfolio of technology platforms spanning medium-to-large-scale production in mRNA, cell culture manufacturing for the production of products that could include antibodies, protein-based vaccines, or viral vectors at commercial scale or for later-stage clinical trials, influenza vaccine manufacturing capacity, and medium-to-large scale fill and finish capacity. These include contract manufacturing organizations as well as the Biologics Manufacturing Centre at the National Research Council’s Montreal campus.

In addition to investing in R&D and manufacturing capacity for industry, in May 2024, the Government announced nearly $574 million in funding for 19 research, infrastructure, and talent development projects at 14 research institutions across Canada, through Stage 2 of the integrated Canada Biomedical Research Fund (CBRF) and Biosciences Research Infrastructure Fund (BRIF) competition. The CBRF-BRIF research hubs, centered at six Canadian universities, combine the strengths of academia, industry and the public and not-for-profit sectors. The Hubs also seek to accelerate the research and development of next-generation vaccines and therapeutics and diagnostics, while supporting training and development to expand the pipeline of skilled talent.

The Government is also investing in strengthening capabilities to advance clinical trials in Canada. In June 2022, the federal government also launched the Clinical Trials Fund (CTF) with $250 million earmarked over three years – Canada’s largest-ever investment in clinical trials to strengthen research coordination across Canadian universities. To date, approximately $130 million has been deployed through the CTF to support 22 clinical trial projects across a spectrum of medical areas including COVID-19 and other infectious diseases, oncology, AMR, and cell and gene therapies. In July 2023, the CTF opened its second round of operating grants for clinical trials projects with results yet to be announced.

The end result of the Government’s efforts is that Canada will be better prepared to face future pandemics through investments across the sector that support foundational capabilities in health innovation and biomanufacturing.

RESPONSE TO PART 3 OF THE PETITION

Air Quality Regulations

•         Part II (Occupational Health and Safety) of the Canada Labour Code (Code), and the regulations made under that part, set requirements to protect all persons granted access to federally regulated workplaces by ensuring employers comply with relevant occupational health and safety (OHS) standards through employer and employee cooperation.

•         The Canada Occupational Health and Safety Regulations (COHSR), made under the Code, includes requirements regarding air quality standards. These requirements can be found in Part 2 (Permanent Structures), Division III (HVAC Systems) of the COHSR.

•         It is anticipated that federally regulated employers have dedicated resources to carry out OHS activities, including those outlined in the COHSR. The cost of air quality analysis, the implementation of preventive measures, and the maintenance of ventilation systems are an employer responsibility.

HVAC Systems

•         The employer is responsible for analyzing risks and determining and implementing prevention measures. Employees, for their part, participate in the risk analysis and determination of preventative measures, and are responsible for implementing the employer’s instructions.

•         The Labour Program assesses and applies the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) recommendations published in the ASHRAE Position Document on Airborne Infectious Diseases regarding the use of HVAC systems when a risk of transmission of a biological agent is present in a federally regulated workplace. This publication is updated when knowledge evolves regarding a particular biological agent.

•         The commissioning of a HEPA filtration system is implemented following the assessment of these recommendations, and when possible, depending on the ventilation system in place in the building. If this measure is recommended and is not possible, other precautionary measures are implemented to achieve an equivalent level of protection, to the extent possible.

•         Concerning the monitoring of carbon dioxide levels, the latter is not a sufficient measure to adequately assess the air quality in a building. This approach has been replaced by new approaches set out in the ASHRAE Ventilation for Acceptable Indoor Air Quality publication. The Labour Program uses the most up to date recommendations to assess indoor air quality.

Enforcement

•         The Labour Program provides services related to the administration and enforcement of Part II of the Code and works with employers and employees to help fulfill their responsibilities and obligations under the legislation.

•         Part II of the Code is enforced by a series of escalating actions that depend on the seriousness of the violation and the co-operation of the workplace. Labour Program health and safety officers conduct inspections and investigations. They also follow a compliance policy to ensure fair and consistent application of the Code in all workplaces. For more information, please refer to our website, which provides explanations of a variety of compliance tools.

RESPONSE TO PART 4 OF THE PETITION

As for your request to institute universal mandatory paid sick leave of at least two weeks, the government amended the Canada Labour Code to give employees in the federally regulated private sector access to up to 10 days of medical leave with pay each year. We introduced this initiative to address many workers’ lack of access to paid sick leave, a critical issue that the pandemic brought to light. These amendments, which came into force on December 1, 2022, empower employees to prioritize their health and the health and safety of their workplaces.

This new leave only applies to federally regulated private sector workplaces. Responsibility for the regulation of labour matters is constitutionally divided between the federal and provincial governments. The federal government has exclusive authority to legislate labour standards for the federally regulated private sector. This includes about 1,020,000 employees (or approximately 6% of all Canadian employees) working for approximately 19,150 employers in industries such as banking, telecommunications, broadcasting, and inter-provincial and international transportation (including air, rail, maritime and road transportation), and for federal Crown corporations. The majority of workplaces in Canada fall under provincial or territorial regulation.

Even though our government cannot legislate labour standards in workplaces that fall outside its jurisdiction, we will continue to encourage provinces and territories to introduce or expand paid sick leave because it is good public policy and the right thing to do for both workers and employers. 

Part 7 – Between February 2020 and May 2023, the Government of Canada committed close to $3.5 billion in international assistance in response to the COVID-19 pandemic. As a leading international donor to the global response, Canada contributed over $2.1 billion for the Access to COVID-19 Tools (ACT)-Accelerator and its partners. This included over $1.2 billion to the ACT-Accelerator Vaccines Pillar to promote equitable access to COVID-19 vaccines in low-and lower-middle income countries (LMICs). As part of Canada’s allocation to the ACT-Accelerator Vaccines Pillar, Canada provided $840 million for the COVID-19 Vaccine Global Access (COVAX) Facility to procure, distribute and deliver COVID-19 vaccines for Advance Market Commitment (AMC) countries, all of them LMICs. This included up to $10 million to design and implement COVAX’s dose sharing mechanism, which made it possible for donor countries to share over 922 million doses.

The ACT-Accelerator was a groundbreaking global collaboration to accelerate development, production, and equitable access to COVID-19 tests, treatments, and vaccines. ACT-A brought together governments, scientists, businesses, civil society, and philanthropists and global health organizations, including the Bill and Melinda Gates Foundation, CEPI, FIND, Gavi, The Global Fund, Unitaid, Wellcome, the World Health Organization (WHO), and the World Bank, with UNICEF and the Pan American Health Organization (PAHO) also engaged as delivery partners for COVAX. Through the ACT-A, Canada worked closely with partners and other governments to develop and deliver on effective solutions to tackle the COVID-19 pandemic. This included Ministerial representation as a Co-Chair of the COVAX AMC Engagement Group and Canadian participation within the ACT-Accelerator Facilitation Council and Gavi Board.

In response to global calls for support to enhance COVID-19 vaccine roll-out, Canada launched Canada’s Global Initiative for Vaccine Equity (CanGIVE), a $317 million signature initiative to bolster vaccine delivery, strengthen health systems and increase regional vaccine manufacturing capacity. CanGIVE was delivered in coordination with the COVAX COVID-19 Vaccine Delivery Partnership and other international donors to support critical last-mile delivery in LMICs with particularly low vaccination rates and access barriers. Canada’s ongoing support to scale up regional vaccine production capacity will bring manufacturing closer to populations in LMICs. As the world moves beyond pandemic response, Canada remains committed to strengthening health systems and pandemic preparedness in low- and lower-middle income countries as part of an inclusive and sustainable recovery.

Public Services and Procurement Canada (PSPC) owns and manages 1,491 buildings across Canada, representing 24% of the total federal real property inventory based on floor area. In these buildings, the Heating Ventilation and Air-Conditioning (HVAC) systems are designed, installed, operated and maintained to meet or exceed the requirements of the National Building Code of Canada and the Canadian Occupational Health and Safety Regulations. Federal tenants of these buildings are responsible for implementing the employer requirements of workplace health and safety regulations.

In response to COVID-19, PSPC implemented supplementary HVAC measures that go beyond regular operation and maintenance activities to enhance occupant wellness in our buildings and to address the potential risks posed by respiratory aerosols. These measures include:

• increasing outdoor airflow into buildings to the maximum that can be sustained by building systems without affecting comfort and asset integrity;
• increasing operating hours of ventilation systems to ensure good airflow and dilution;
• installing the highest level of filtration that the HVAC system can accommodate while not impacting building airflow;
• continuing to maintain appropriate temperature and humidity levels; and
• ensuring that there is no potential cross contamination between washroom exhaust air and ventilation airflow.

These measures, which are still in effect, are in accordance with advice and guidance from public health authorities such as the Public Health Agency of Canada and industry organizations such as the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE).

The Canada Health Act, Canada’s federal health care insurance legislation, establishes the criteria and conditions related to medically necessary hospital and physician services (i.e. insured health services) that the provinces and territories must fulfil to receive the full federal cash contribution available under the Canada Health Transfer. These criteria are public administration, comprehensiveness, universality, portability, and accessibility.

The Act ensures that all eligible residents of Canadian provinces and territories have reasonable access insured health services on a prepaid basis, without charges related to the provision of these services. Provinces and territories that allow patient charges for insured health services are subject to dollar-for-dollar deductions to their Canada Health Transfer payment.

The federal government is committed to upholding the Canada Health Act and to working with provinces and territoriesto ensure that Canadians have access to insured health services based on their needs, not their ability to pay. This is why, since 2015, over $266 million has been deducted from the Canada Health Transfer payments to provinces that have permitted patient charges for insured health services. In addition, since the CHA Reimbursement Policy was introduced in 2018, several provinces have received reimbursements totalling over $175 million for taking actions to eliminate patient charges for insured health services. More information about compliance with the Canada Health Act can be found in the Canada Health Act Annual Report 2022-2023.

With regards to mask mandates, the Public Health Agency of Canada (PHAC) encourages individuals to remain aware of their personal risks and make informed decisions on the use of personal protective measures, including mask wearing, to help reduce the spread of respiratory infectious diseases, such as COVID-19.

While PHAC provides advice and develops guidance on public health measures to prevent the spread of respiratory infectious diseases, public health authorities and governments (including federal, provincial/territorial and regional/local) are responsible for implementing those recommendations by making decisions within their jurisdictions regarding when it is necessary to instate, maintain, ease or re-instate public health measures, including measures such as mask mandates. These decisions are usually based on a risk assessment, which considers multiple factors including local epidemiology, enabling jurisdictions to adapt responses to their unique situation. For example, the easing of public health measures, such as masking mandates, was based on factors including, but not limited to, increasing immunity within the population, lower hospitalization and death rates, high vaccination rates, as well as broad availability of vaccines (including new formulations), rapid tests, and treatments.

As such, the Government of Canada does not have the authority to mandate masking in indoor public spaces or other community-based settings (for example, local businesses/workplaces, schools, grocery stores, etc.) that are under provincial/territorial jurisdiction. However, PHAC continues to encourage individuals to wear a well-fitting respirator or mask in public indoor settings any time to help protect themselves and others from getting or spreading a respiratory infectious disease, such as COVID-19. Mask use is especially important in certain situations, including: when an individual is sick and must be around other people; during seasons where respiratory illnesses tend to spread more; in settings and during events where the risk of transmission is greater (for example, crowded and poorly ventilated spaces); and for those who are or spend time around those at risk of more severe disease or complications from respiratory infectious diseases. For more information on PHAC’s advice for mask wearing, please visit: Respiratory infectious diseases: How to reduce the spread with personal protective measures.

In Canada, vaccination is a shared responsibility. The primary responsibility for matters related to the administration and delivery of health care services, including COVID-19 vaccination programs and campaigns, falls within provincial/territorial responsibility. At the federal level, the Government of Canada supports Provinces and Territories with their respective vaccination programs and policies through the development of evidence-based recommendations from the National Advisory Committee on Immunization (NACI), an external advisory body that provides independent, expert advice to PHAC on the optimal use of vaccines authorized in Canada. Provincial and territorial governments consider NACI advice, but ultimately determine their vaccination polices and programs based on their unique circumstances.

The Government of Canada supports sustained and resilient vaccine uptake in numerous ways, including combatting anti-vaccine misinformation and encouraging the public to stay up-to-date with COVID-19 vaccinations. PHAC acts as the focal point for vaccine confidence policy, research, and behavioural analysis to inform the development of evidence-based awareness and outreach campaigns, and tools and training to help healthcare providers communicate credible information about vaccine effectiveness and safety to people in Canada. As a core part of vaccine confidence efforts, the Immunization Partnership Fund is an equity- and evidence-based grants and contributions program that supports public health actors and communities to increase vaccine acceptance and uptake. It supports local, regional, and national organizations, and provinces and territories develop evidence-based approaches designed to improve vaccination coverage rates and combat mis- and dis-information. The Government of Canada also develops and delivers communications campaigns to support vaccine uptake by reminding people in Canada about the importance of vaccination and encouraging people in Canada to remain up-to-date with all vaccinations, including those for COVID-19.  In addition, to further counteract and combat anti-vaccine misinformation, the federal Government encourages people in Canada to verify online information that seems questionable or inaccurate with trustworthy sources, and has developed tips and tools to spot disinformation and how to counter it.