Family’s scramble to find COVID drug Paxlovid for their ailing dad highlights challenges with access

From the Toronto Star article

When Derek McGivern’s dad tested positive for COVID-19, he knew the clock was ticking.

Due to multiple medical issues, his 70-something father was at risk, and McGivern knew the antiviral pill Paxlovid — which must be taken within five days of the first symptoms — could help keep him out of the hospital.

“Every hour that goes by, you’re closer to that limit,” said McGivern over the phone from Wallaceburg, Ont., near Chatham. “And that’s extremely frustrating — because no one knew how to get him what he needed.”

With COVID cases soaring in Ontario — reaching an estimated 100,000 new infections a day, according to wastewater readings — Paxlovid is being touted by medical experts as a game changer in the province’s pandemic response, a key tool to help protect those most at risk.

But in recent weeks, physicians and vulnerable patients have been struggling to access the medication and are urging the province to ramp up education and outreach efforts and to make Paxlovid more widely available.

“What strikes me is how many people don’t realize they would qualify for these medications if they had COVID. And, even if they did realize they were eligible, what to do and where to go is not clear … And it varies by region,” said Dr. Tara Kiran, a family physician at Toronto’s St. Michael’s Hospital.

“It is a big problem. We need a public education campaign.”

As of March 31, about 400 courses of Paxlovid had been given out in Ontario, with an additional 755 distributed to hospitals. The province, which had previously stated it had about 40,000 courses from the federal government, would not provide the Star with updated figures Friday.

Ontario government launching independent review into WSIB process for toxic workplaces

From the Hamilton Spectator

The Ontario government says it’s launching a new independent review of the system that helps people who get sick following exposure to workplace toxins.

“There have been injustices that need to be fixed — and no one should be waiting decades for compensation,” said Labour Minister Monte McNaughton in an interview.

McNaughton announced Tuesday that the MAP Centre for Urban Health Solutions at St. Michael’s Hospital in Toronto will begin work immediately on a review for release in December.

MAP scientists study complex health issues, according to their website, including the effects of social inequality on human health.

For years many local advocates have asked the provincial government to overhaul the way the Workplace Safety and Insurance Board (WSIB) makes decisions on which cases get benefits and which ones are rejected.

After a rash of cancer cases emerged in Peterborough among General Electric plant workers beginning in the 1990s, many applied for WSIB benefits — though some cases have been accepted for compensation, many more have not been.

MAP scientists will look at how occupational illnesses are identified, monitored and prevented, McNaughton said.

No strangers to pandemics, HIV and infectious diseases researchers study new ways to treat and prevent viruses

From Unity Health Toronto

Diseases don’t stop in a pandemic. Neither do our researchers. In this series, we highlight Unity Health research projects that have persisted despite lockdowns, work-from-home arrangements and a global focus on another disease entirely. Here are their stories.

Research goals: To treat and prevent infectious diseases such as HIV and sexually-transmitted infections

Project lead: Dr. Darrell Tan, scientist at the MAP Centre for Urban Health Solutions

Dr. Tan and his research team at the Options Collaboratory for HIV/STI Treatment and Prevention Science are no strangers to pandemics: long before COVID-19 became a reality, their team had been studying HIV and other sexually transmitted diseases that have caused global pandemics and public health concerns for decades.

“We aim to find more ways to treat and prevent these conditions and expand the menu of options available to people, recognizing that different people have different needs,” Dr. Tan says.

Many of their studies continued throughout the COVID-19 pandemic, both in the hospital and in community clinics, hoping to reach as many people as possible to help accomplish this goal.

A study evaluating implementation of pre-exposure prophylaxis (PrEP), a medicine people at risk of HIV take to prevent the disease, is one example. Working with sexual health, public health, hospital-based and family medicine clinics, the team has tried to ensure that whenever folks at risk of HIV come into contact with health care, they are linked to PrEP services.

Ontario launches first review of occupational illnesses

From the Canadian Occupational Safety article, featuring research by Dr. Linn Holness

Ontario’s Ministry of Labour, Training and Skills Development is launching its first-ever review of the province’s occupational illness system.

The review will be conducted by the MAP Centre for Urban Health Solutions at St. Michael’s Hospital in Toronto, the Ontario government revealed in a statement on Tuesday. The hospital is an independent research center with expertise in studying complex community health issues.  In partnership with the provincial government, it will evaluate how these illnesses are identified, monitored and prevented in Ontario.

“Ontario has one of the strongest health and safety records in the country, but we need to make sure our system works for everyone. I have tasked this team of independent experts to find a clear path forward that improves supports for injured workers and their families. Change is coming to the system, and we are going to get it done,” says Monte McNaughton, Minister of Labour, Training and Skills Development in the statement.

Quebec Project Removes Barriers to Health Care for Racialized and Migrant Populations Who Are LGBTQI+

Lire cet article en français

April 12, 2022 – Université de Montréal and the Centre de Recherche en Santé Publique (CReSP), supported by MAP and Staples Canada/Bureau en Gros through their Even the Odds initiative, is launching a research project to study an innovative health clinic specifically designed to meet the needs of racialized and migrant communities who identify as LGBTQI+.

The first of its kind in Quebec, ‘Clinic Mauve’ was launched in Montréal in 2020 through an initial grant from the Foundation for Advancing Family Medicine of the College of Family Physicians of Canada. Led by Dr. Vania Jimenez, Dr. Pierre-Paul Tellier and Dr. Edward Lee, in close collaboration with community partner AGIR (a by and for LGBTQI+ migrant community organization), Clinic Mauve operates within a family medicine group at the Health and Social Service Centres of Côte-des-Neiges and Parc-Extension, and the Actuel medical clinic.

Despite Canada’s universal health care system, migrant and racialized people who are LGBTQI+ face multiple structural and intersecting barriers to accessing and benefiting from health care. These inequities were highlighted and exacerbated by the sudden arrival of COVID-19 in the spring of 2020.

Clinic Mauve delivers integrated medical care and psycho-social services (including social workers, therapists, and peer navigators) that engage in trauma-informed, anti-oppressive, and intersectional approaches tailored to meet the health needs of migrant and racialized populations who are LGBTQI+.

“We know that the Clinic Mauve is a very promising model of integrated care,” said Dr. Edward Lee, Associate Professor in the School of Social Work at Université de Montréal, a member of CReSP and the study’s lead researcher. “We’re launching this study to help us understand the aspects of the clinic that are most effective, and how we can scale up and share successful strategies with other care providers and communities across Canada.”

As part of the research project, the Université de Montréal team is collaborating with ongoing ‘Trans Indigenous Youth Social Action Research Sharing Circle’, a project led by Dr. Annie Pullen Sansfaçon and funded by SSHRC and in partnership with the organization P10, to explore the best ways to tailor the clinic’s services to serve Two-Spirit and/or trans Indigenous people, especially youth.

The research is funded by Even the Odds, a partnership between Staples Canada/Bureau en Gros and MAP (Unity Health Toronto) to raise awareness of inequity in Canada and help build vibrant, healthy communities. To date, the initiative has raised more than $1.2 million with the generous support of Staples/Bureau en Gros customers, vendors and corporate donations.

“We’re proud to support this exciting innovation to take on structural challenges that migrant and racialized people who are LGBTQI+ face accessing health care in Quebec,” said David Boone, CEO, Staples Canada/Bureau en Gros. “It’s a great model with the potential to scale and help ‘Even the Odds’ across Canada.”

Université de Montréal

Deeply rooted in Montreal and dedicated to its international mission, Université de Montréal ranks among the world’s top universities, placing 73rd in the Times Higher Education rankings. Founded in 1878, UdeM and its two affiliated schools, HEC Montréal and Polytechnique Montréal, constitute the largest centre of higher education and research in Quebec and one of the most important in North America. It has more than 2,300 professors and researchers, and nearly 70,000 students. For more information, visit


The Centre for Public Health Research (CReSP) is the result of a partnership between the Université de Montréal and the CIUSSS du Centre-Sud-de-l’Île-de-Montréal, an integrated university health and social services centre. The CReSP is funded by the Fonds de recherche du Québec – Santé, and it brings together more than 60 researchers from six faculties of the University of Montréal and Polytechnique Montréal. Its mission is to generate relevant cutting-edge knowledge to provide insight into population health issues and support evidence-based public health initiatives to promote health and reduce the burden of illness. For more information, visit


MAP is a world-leading research centre dedicated to creating a healthier future for all. Through big-picture research and street-level solutions, MAP scientists tackle complex community health issues—many at the intersection of health and equity. MAP’s 32 scientists and over 120 staff and students work in partnership with communities, researchers, and government leaders across Canada to address issues such as homelessness, unequal access to health care and medicine, and the lifelong effects of childhood poverty. MAP is part of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Unity Health Toronto. For more information, visit

Staples Canada

Staples Canada/Bureau en Gros is The Working and Learning Company. With a focus on community, inspiration and services, the privately-owned company is committed to being a dynamic, inspiring partner to customers who visit its over 300 locations and The company has two brands that support business customers, Staples Preferred for small businesses and Staples Professional for medium to large-sized enterprises, as well as five co-working facilities in Toronto, Kelowna, Oakville and Ottawa under the banner Staples Studio. Staples Canada is a proud partner of MAP through its Even the Odds campaign, which aims to tackle inequities in communities across Canada and helps make a future that’s fair for everyone. Visit for more information or get social with @StaplesCanada on Facebook, Twitter, Instagram and LinkedIn.


Jeff Heinrich
Press attaché – Foreign & English
Université de Montréal,
Tel.: 514-343-7593

Kathleen Stelmach
Manager, PR and Communications
Staples Canada/Bureau en Gros
Tel. : 905 737-1147 Ext. 578

Un projet québécois fait tomber les obstacles aux soins de santé pour les populations LGBTQI+ migrantes et racisées

12 avril 2022 – L’Université de Montréal et le Centre de recherche en santé publique (CReSP), soutenus par le MAP et par Staples Canada/Bureau en Gros dans le cadre de leur initiative À chance égale, lancent un projet de recherche qui évaluera une clinique de santé novatrice spécialement conçue pour répondre aux besoins des communautés migrantes et racisées qui s’identifient comme étant membres des communautés LGBTQI+.

Première du genre au Québec, la « Clinique Mauve » a été lancée à Montréal en 2020 grâce à une subvention originale de la Fondation pour l’avancement de la médecine familiale du Collège des médecins de famille du Canada. Dirigée par les professeur.e.s Vania Jimenez, Pierre-Paul Tellier et Edward Lee, en étroite collaboration avec le partenaire communautaire AGIR (un organisme communautaire par et pour les personnes LGBTQI+ migrantes) la Clinique Mauve fonctionne au sein d’un groupe de médecine familiale des Centres de santé et de services sociaux de Côte-des-Neiges et Parc-Extension, et de la clinique médicale l’Actuel.

En dépit de la couverture universelle du système de santé canadien, les personnes migrantes et racisées membres des communautés LGBTQI+ font face à de multiples obstacles structurels et intersectionnels lorsqu’il s’agit d’accéder aux soins de santé et d’en bénéficier. Ces inégalités ont été mises en évidence et accentuées par l’arrivée soudaine de la COVID-19 au printemps 2020.

La Clinique Mauve propose des soins médicaux intégrés et des services psychosociaux (notamment au moyen d’équipes de travail social, de services en santé mentale et de paire navigation) qui adoptent des approches anti-oppressives, intersectionnelles et sensibles aux traumatismes. Ces approches visent à mieux répondre aux besoins de santé des populations migrantes et racisées qui sont membres des communautés LGBTQI+.

« Nous savons que la Clinique Mauve représente un modèle très prometteur de soins intégrés », a déclaré Edward Lee, professeur agrégé à l’École de travail social de l’Université de Montréal, membre du CReSP et chercheur principal de l’étude. « Nous lançons cette étude pour nous aider à comprendre les éléments de la clinique qui sont les plus efficaces, et comment nous pouvons les transposer à plus grande échelle et partager les stratégies efficaces avec d’autres milieux de pratique et communautés à l’échelle du Canada. »

Dans le cadre du projet de recherche, l’équipe de l’Université de Montréal collabore avec le « Trans Indigenous Youth Social Action Research Sharing Circle », un projet dirigé par la professeure Annie Pullen Sansfaçon, financé par le CRSH et en partenariat avec l’organisme P10, afin d’explorer les meilleures façons d’adapter les services de la clinique pour servir les personnes Autochtones bispirituelles et/ou trans, en particulier les jeunes.

Cette recherche est financée par À chance égale, un partenariat entre Staples Canada/Bureau en Gros et le MAP (Unity Health Toronto) visant à sensibiliser la population aux inégalités au Canada et à contribuer à la création de communautés dynamiques et saines. À ce jour, l’initiative a permis de recueillir plus de 1,2 million de dollars grâce au soutien généreux des client.e.s, des vendeur.euse.s de Staples/Bureau en Gros, et de dons d’entreprises.

« Nous sommes fiers de soutenir cette formidable initiative visant à relever les défis structurels pour accéder aux soins de santé au Québec auxquels font face les personnes migrantes et les personnes racisées LGBTQI+ », a déclaré David Boone, PDG de Staples Canada/Bureau en Gros. « Il s’agit d’un excellent modèle qui a le potentiel de s’étendre et de donner à toutes et à tous une chance égale de s’épanouir ».

Université de Montréal

Montréalaise par ses racines, internationale par vocation, l’Université de Montréal compte parmi les meilleures universités au monde. Elle se classe au 73e rang du classement du Times Higher Education. Elle a été fondée en 1878 et forme aujourd’hui avec ses deux écoles affiliées, HEC Montréal et Polytechnique Montréal, le premier pôle d’enseignement supérieur et de recherche du Québec et l’un des plus importants en Amérique du Nord. L’Université de Montréal réunit plus de 2300 professeur.e.s et chercheur.e.s et accueille près de 70 000 étudiant.e.s. Pour en savoir plus, visitez

Centre de recherche en santé publique (CReSP)

Issu d’un partenariat entre le CIUSSS du Centre-Sud-de-l’Île-de-Montréal (CCSMTL) et l’Université de Montréal, le Centre de recherche en santé publique (CReSP) est la première et la seule infrastructure majeure de recherche québécoise entièrement dédiée à la santé publique et opérant dans le cadre de liens structurels privilégiés avec un établissement responsable de la santé d’une population, le CCSMTL. Le CReSP est un regroupement de recherche financé par le Fonds de recherche du Québec – Santé (FRQS) qui compte plus de 60 membres chercheur.e.s régulier.e.s et des expert.e.s provenant d’organisations partenaires. Pour en savoir plus, visitez


Le MAP est un centre de recherche de premier plan au niveau mondial, qui se consacre à la création d’un avenir plus sain pour tous. Grâce à des recherches d’envergure et à des solutions concrètes, les scientifiques du MAP s’attaquent à des enjeux complexes de santé communautaire, souvent à la croisée de la santé et de l’équité. Les 32 scientifiques et plus de 120 employé.e.s et étudiant.e.s du MAP travaillent en partenariat avec des communautés, des chercheur.e.s et des dirigeant.e.s gouvernementaux.ales dans tout le Canada pour s’attaquer à des problèmes tels que l’itinérance, l’accès inégal aux soins de santé et à la médecine, et les effets permanents dus à la pauvreté des enfants. Le MAP relève de l’Institut du savoir Li Ka Shing de l’hôpital St. Michael, Unity Health Toronto. Pour en savoir plus, visitez

Staples Canada/Bureau en Gros

Staples Canada/Bureau en Gros est l’Entreprise du travail et de l’apprentissage. En mettant l’accent sur la collectivité, l’inspiration et les services, la société privée est déterminée à jouer le rôle de partenaire dynamique et inspirant pour tous les clients qui visitent ses quelque 300 succursales et le site L’entreprise possède deux sous-marques qui soutiennent ses clients commerciaux – Bureau en Gros Privilège pour les petites entreprises et Staples Professionnel pour les moyennes et grandes entreprises – ainsi que cinq studios de travail partagé à Toronto, Kelowna, Oakville et Ottawa sous la bannière Staples Studio. Staples Canada/Bureau en Gros est fier de travailler en partenariat avec le Centre MAP dans le cadre de sa campagne À chance égale, qui vise à s’attaquer aux inégalités dans les collectivités partout au Canada et à créer un avenir équitable pour tous. Consultez pour en savoir plus ou suivez @BureauenGros sur Facebook, Twitter et Instagram.

Médias :

Julie Gazaille
Attachée de presse – médias francophones
Université de Montréal
514-343-6796 |

Kathleen Stelmach
Manager, PR and Communications
Staples Canada/Bureau en Gros
Tel. : 905 737-1147 Ext. 578

The Landlord and Tenant Board must resume in-person hearings

Op-ed in the Toronto Star, Hamilton Spectator by Dr. Nav Persaud and Dr. Stephen Hwang

Related: Housing lawyer Douglas Kwan discusses virtual hearings in the MAPmaking episode, ‘Evictions & Access to Justice

As malls and coffee shops reopened after a long COVID winter, the doors have remained locked on an institution that keeps people housed: Ontario’s Landlord and Tenant Board.

The board has not returned to in-person hearings. Tenants trying to stave off eviction no longer have access to supports that were available in person, or even the reliability of being able to make their case in person.

Imagine calling into a hearing to decide whether you will be able to keep your apartment, and then getting disconnected. The stakes are extremely high for tenants appearing before the board — decisions can mean the difference between sleeping in your own bed, and scanning a list of emergency shelters to find out which ones take kids. Landlords may be seeking to secure their incomes, but they are not at risk of being on the street when a hearing concludes.

Virtual attendance can tilt hearings toward landlords. Tenants often have poorer access to high-speed internet connections and thus join by phone, especially when they need to be logged on for hours waiting for their hearing. In contrast, landlords are able to see and be seen by board staff and members. Prior to COVID, tenants were supported by board staff when they arrived at hearings, and had access to duty counsel or lawyers on site who provided timely advice and support. Tenants could easily submit pictures of mouldy or poorly maintained basements to support their claims.

Open letter: Health care providers and MAP scientists call for Ontario’s Landlord and Tenant Board to reopen in-person hearings

Attention: Sean Weir, Executive Chair, Tribunals Ontario

April 6, 2022

Dear Executive Chair Sean Weir,

Related: Housing lawyer Douglas Kwan discusses virtual hearings in the MAPmaking episode, ‘Evictions & Access to Justice

We are writing to draw your attention to the urgent need to offer the option of in-person hearings at Ontario’s Landlord and Tenant Board (LTB). Indoor settings are now open across Ontario. This includes public buildings such as libraries, community centres, universities and government offices. It also includes private sector venues such as gyms, restaurants and sports stadiums.

We are an interdisciplinary team of epidemiologists; public health specialists; primary care providers and internal medicine and family physicians. We work at or collaborate with the MAP Centre for Urban Health Solutions at St. Michael’s Hospital in Toronto, but we have affiliations and practices in a variety of settings. 

Together, we have expertise in: COVID-19 treatment and vaccination; tracking or modeling infectious disease outbreaks; housing and homelessness; and working to ensure a wide variety of environments are as safe as possible from COVID-19.

Many of us have seen the devastating effect of remote hearings for our patients. And, as a group, we want Tribunals Ontario to know that it is entirely possible to open in-person hearing spaces that meet or exceed the COVID-19 safety standards applied to the types of venues listed above.

We know the LTB used both dedicated hearing spaces in large cities and temporary venues such as church halls or hotels in smaller jurisdictions. Simple and often cost-effective measures can ensure these sites meet or exceed the COVID-19 safety standards in place across the province.

These measures are well-known and implementation is straightforward. In addition, in many public venues, they should already be in place. These measures include: the provision of well-fitted, high-quality masks; physical distancing; limiting occupancy (including in waiting areas); limiting wait times; use of portable air filters appropriate for room size; opening windows where possible; optimizing ventilation and filtration provided by HVAC systems; use of well-maintained bathroom fans that exhaust to the outside; and, hand hygiene measures. For people with cell phones, they could also be given the option to wait outside for a call until their hearing begins.

The problems with an exclusively digital approach are well known. More than a year ago, in October, 2020, legal clinics across Ontario released a report to your attention and to the Attorney General, “Ontario legal clinics’ concerns: Landlord and Tenant Board’s operations during the COVID-19 pandemic.” This report demonstrates the advantage that remote hearings often give to landlords over tenants. For example, some tenants do not have access to the necessary technology and resources such as “computers, printers, internet, phone minutes, or even a private space from which to participate in remote hearings.”

In addition, remote hearings have meant a reduction in supports for tenants, such as those provided by onsite staff such as LTB staff mediators, Legal Aid Ontario-funded tenant duty counsel, and LTB counter staff.  Although these resources remain present in the digital format, their ability to help is reduced and in some specific hearing blocks they are simply unavailable. Finally, some tenants with disabilities (visual, auditory, cognitive impairments, etc.) have difficulty participating in remote hearings as they are presently configured by the LTB.

These are just a few examples. A recent report explores tenant experiences in remote hearings from March to May 2021, and details a range of hardships caused by the current format. We encourage you to read it carefully, and consider the consequences of the current situation for people’s lives. As the report makes clear, “…a tenant’s inability to participate in a hearing has potentially dire consequences – the loss of their home.”

The stakes are high for tenants at the LTB. Losing housing can directly harm health, for example, by making it difficult for people to take medications and manage diabetes. Stressors such as being evicted can directly impact mental health. Unstable housing can also make it difficult for under-housed individuals to engage in health and mental health supports.

The importance of secure housing to health and mental health outcomes is well-supported by scientific evidence. A recent study in the Canadian Medical Association Journal explores policies with the greatest capacity to improve health in the wake of the COVID-19 pandemic. Eviction prevention is one of the measures at the top of the list. Ending tenancies that might otherwise be preserved will, simply put, make people sick.

It is time to ensure that in-person hearings are made available for Ontario tenants. At many sites, this can be done very quickly. To assist, we are providing our contact information to Tribunals Ontario.

As Ontario continues to re-open in the weeks to come, we look forward to seeing the reopening of in-person LTB hearings as well. We are prepared to offer our expertise and experience to assist with this, and hope you will contact us to that end.


Dr. Stephen Hwang, Staff Physician, General Internal Medicine, St. Michael’s Hospital
Research Scientist and Director, MAP Centre for Urban Health Solutions
Professor of Medicine, University of Toronto
Chair in Homelessness, Housing and Health, University of Toronto and St. Michael’s Hospital

Dr. Nav Persaud, Canada Research Chair in Health Justice
Associate Professor, University of Toronto
Staff Physician, St. Michael’s Hospital
Research Scientist, MAP Centre for Urban Health Solutions

Dr. Sean B. Rourke, Scientist, MAP Centre for Urban Health Solutions
Director, CIHR Centre for REACH Nexus
Professor of Psychiatry, University of Toronto

Dan Werb, PhD, Director, Centre on Drug Policy Evaluation
Assistant Professor, Division of Infectious Diseases & Global Public Health, UC San Diego
Scientist, MAP Centre for Urban Health Solutions

Naomi Thulien, NP-PHC, PhD, Research Scientist, MAP Centre for Urban Health Solutions
Assistant Professor, Dalla Lana School of Public Health, University of Toronto
Nurse Practitioner, Covenant House Toronto

Rosane Nisenbaum, Biostatistician, MAP Centre for Urban Health Solutions
Division of Biostatistics, Dalla Lana School of Public Health

Dr. Andrew Pinto, CIHR Applied Public Health Chair in Upstream Prevention
Director, Upstream Lab
Research Scientist, MAP Centre for Urban Health Solutions
Associate Professor, University of Toronto
Staff Physician, St. Michael’s Hospital

Dr. Ahmed Bayoumi, Staff Physician, General Internal Medicine, St. Michael’s Hospital
Professor of Medicine and Health Policy, Management and Evaluation, University of Toronto
Research Scientist, MAP Centre for Urban Health Solutions
Fondation Baxter and Alma Ricard Chair in Inner City Health, University of Toronto and
St. Michael’s Hospital

Patricia O’Campo, PhD, Executive Director, Li Ka Shing Knowledge Institute, Unity Health Toronto
Research Scientist, MAP Centre for Urban Health Solutions
Tier 1 Canada Research Chair, Population Health Interventions
Professor, Dalla Lana School of Public Health, University of Toronto

Dr. Rami Shoucri, Family Physician, St. Michael’s Hospital Academic Family Health Team
Assistant Professor, University of Toronto, Department of Family and Community Medicine
Clinical Champion, Health Justice Program

Dr. Danyaal Raza, Family Physician, St. Michael’s Hospital Academic Family Health Team
Social Accountability Faculty Lead & Assistant Professor, University of Toronto, Department of Family and Community Medicine

Dr. Kathryn Dorman, Family Physician, Addictions Medicine Program, St. Michael’s Hospital Academic Family Health Team
Assistant Professor, University of Toronto, Department of Family and Community Medicine

Why pharmacare plans keep stalling in Canada — even as research suggests billions in savings

From the CBC News article

While the federal Liberals have pledged to make progress toward a national pharmacare program through a recent deal with the NDP, health care advocates warn those efforts are moving too slowly — putting people’s health at risk and taking a financial toll on Canada’s hospital system.

The government recently announced a “supply-and-confidence” agreement that could see the Liberals stay in power until 2025 in exchange for action on several NDP priorities, including dental care and pharmacare programs.

But there’s little to suggest drug access will be a major focus in the latest federal budget expected on Thursday.

The Liberals intend to pass a Canada Pharmacare Act by the end of 2023, then task the National Drug Agency with developing a national formulary of essential medicines and a bulk purchasing plan by the end of their agreement with the NDP.

It’s “concerning” that such an open-ended timeline means building a national pharmacare program likely won’t happen until the next election cycle, said Dr. Nav Persaud, Canada research chair in health justice and a staff physician at St. Michael’s Hospital in Toronto.

“Multiple reports have detailed how including medicines in our publicly funded system would improve access, improve health, reduce the need for hospitalizations, emergency room visits, and also save billions of dollars both through direct savings, through lowering prices and through the need for health care,” he said.

“But much more important than that saved money would be the improved health, and avoided death.”

As some countries roll out fourth doses of COVID vaccine, Canada is struggling to get citizens to take a third

From the Toronto Star article

The days of the two-shot COVID vaccine regime appear all but over, with countries such as Israel and now the United States opening up widespread access to not just a third shot to bolster waning protection against infection, but a fourth. It’s left some experts wondering whether Canada, which worked hard to get those first two shots into arms, is now falling behind in the push to vaccinate its citizens.

The American Food and Drug Administration this week approved a fourth shot for people 50 and older in the U.S. While at least Pfizer says it has begun conversations with Health Canada, the regulatory body has yet to see an official application for that cohort to get a fourth dose from anyone.

Meanwhile, a sub-variant of highly infectious Omicron has upended what we knew about the virus — again — meaning that, at least for high-risk people, vaccination is looking less like a milestone to be achieved, and more like a process to be maintained.

That’s a message that may not yet have widespread acceptance in Canada, where 85 per cent of people have two doses but just under half have rolled up their sleeves for a third.

“I think people feel like they did their part,” says Dr. Tara Kiran, a family doctor at St. Michael’s Hospital and the Fidani Chair in Improvement and Innovation at the University of Toronto.

“They got their first and second doses, and maybe they were even on the fence, but they were like, ‘I’m going to roll up my sleeves and do it, because it’s important.’”

But when it comes to a third, or even fourth dose, that enthusiasm has tapered off, especially after a concerted push from health-care workers when Omicron landed in December, Kiran said.

Liberal-NDP deal promises nothing more than a pharmacare pantomime

Op-ed by Dr. Nav Persaud in The Hill Times

NDP Leader Jagmeet Singh and Prime Minister Justin Trudeau have each got a lot of political mileage out of past pharmacare announcements. Last week’s vague joint announcement continued the positive coverage, writes Nav Persaud.

NDP Leader Jagmeet Singh stepped over broken promises about pharmacare walking down the aisle to join Prime Minister Justin Trudeau in a confidence and supply agreement. The “marriage” vows included a new promise—not to implement pharmacare, but about “continuing progress” toward a national program by passing legislation next year and making a plan to bulk purchase essential medicines.

…This is one of two ways we will be able to see if the NDP-Liberal will really yield pharmacare. The public subsidy for private insurance plans should be rolled back or cancelled. Back in 2017, the Trudeau government indicated it would re-examine that regressive subsidy that was estimated to be worth $2.9-billion at the time. That’s right, although some naively ask how we can afford pharmacare, the current private insurance system for medicines receives a public subsidy worth well over $3-billion today.

The other test of this commitment to including medicines in our publicly funded system will be by reforming regulations patented drug pricing. Bulk purchasing will not necessarily lower the prices of patented medicines, so price ceilings need to be set and enforced with fines. Currently price ceilings in Canada are set using comparator countries like the United States that pay high prices. Plans to adopt prices paid in countries that do a better job of reigning in drug pricing were postponed in 2018 due to pressure from the pharmaceutical industry and private insurance companies.

How can we tell if industry lobbying is succeeding? Our elected leaders will wave around pharmacare blueprints but never put their work boots on. The status quo will persist and we will keep paying the price.