BC’s David and Goliath saga

DRUG BUST Alan Cassels

I offer you a parable – perhaps the parable of our time. Pull up a chair and start imagining. Imagine being a big group of very powerful and profitable companies whose main business is the manufacturing of pharmaceuticals. You are so influential that government ministers promptly return your calls. You keep some of the most powerful people within the legal and medical communities on your payroll. You invite yourself to lead government task forces and other agenda-setting activities and are considered so mighty that only fools would dare challenge your decrees. When it comes to leverage, you play a good game. You know how to force governments to have some “skin in the game” when it comes to paying the hefty costs of researching and developing your products. It’s not that you are a bully or anything; you are actually quite polite and congenial. Yet, at the same time, you and your members are very, very angry.

You are angry because not everyone considers the good products you produce and the good works conducted on your behalf by many of your favoured charities to be so special. Some even question whether your products are worth what you charge for them. Some even say they didn’t live up to their claims. Even worse, some believe your products make some people sicker. Those heretics might be small in number, but they are vocal. They constitute an unpleasant obstacle and prevent you from expanding your empire, blocking you from earning higher shareholder profits that are your due. With your great strength and wealth, some say you’re like Goliath because, in contrast to this pesky, nay-saying and ill-equipped David, you could easily overpower and smite him dead.

What makes you really angry is that this David’s skepticism could threaten to destroy other markets around the country. This sort of pesky impertinence could seriously harm your bottom line so you have to act, and act decisively.

This biblical parable is currently being played out right here in BC. Not in the full sheen of media lights, of course, but in the shadows and backrooms and offices of the legislature. In government ministries and universities. In halls redolent with the scent of power, prestige and privilege. The David and Goliath scenario could be an allegory for the forces of science against the forces of commerce, where we know David and his science don’t stand a chance.

It might be more accurate to call this particular BC-based David “evidence-based medicine.” Yet, in the eyes of Goliath, David is best characterized by the pharmaceutical industry’s pesky foe: UBC’s Therapeutics Initiative.

The world renowned Therapeutics Initiative (TI) was established by the BC provincial government in 1994 and planted at the Department of Pharmacology and Therapeutics at UBC. This group of researchers, university professors and experts in clinical research provides valuable analysis and insight into the value of pharmaceuticals. The TI has been involved in educating medical students and practising physicians in BC for nearly 15 years and has developed an international following. While it is often accused of setting BC government drug policy, its role is limited to examining, synthesizing and discussing the evidence around drugs. It has a “just the facts ma’am” approach to clinical research.

Sadly, most physicians, after formal training in medical school, will learn about new drugs mostly from pharmaceutical companies. These doctors urgently need a group like the TI, which can provide balanced and current assessments of new drugs. Drug companies maintain it is their job to convince physicians of the value of new drug products; they spend upwards of $3 billion per year doing just that, an amount larger than the collective budgets of all medical schools in Canada. The fact that TI maintains its distance from the drug companies is one of the true sources of Goliath’s anger: he is unable to influence the key agency that makes drug evidence available to BC physicians.

You can imagine Goliath’s anger when he examines drug expenditures across Canada and finds a huge “missing market” for drugs in BC, worth close to $500 million per year. On a per capita basis, if BC residents spent as much on drugs as people in Quebec and New Brunswick, our provincial drug bill would be about 50 percent higher than it is right now. It currently hovers around $1 billion per year.

In BC, the Therapeutics Initiative has strived to educate doctors about the relative prices (and therapeutic values) of new drugs and while some critics say it tends to favour older, cheaper drugs, its analyses ignore the pharmaceutical industry’s marketing pitches and zero in on what the evidence shows.

Goliaths from the drug world have been trying to slay the Davids of evidence-based medicine for years now, funding political parties, patient groups and specialists in order to build cases for the new drugs they will pitch to governments, physicians and patients. They supply money to universities and research institutes while claiming to politicians they are there to help “grow the knowledge economy.”

Despite how much we love our towers of higher learning, hang out at any of the world’s major universities these days and you will catch the unmistakeable whiff of commercialism, where plenty of Goliaths are cutting deals to divert publicly-funded, high-octane thinking into profitable and patentable products. Discussion of higher purposes and human fulfillment in universities is passé; the dominant theme is the drive for the respect and prestige that comes along with telling everyone we’re “Open for Business.”

If the government does away with the Therapeutics Initiative because of some sweetheart deal provided to UBC by Goliath, we should expect to see a body count. Wasn’t it the TI that sent out early alarm bells, asking physicians to pause before writing new prescriptions for drugs like Celebrex and Vioxx? Vioxx is likely responsible for more than 50,000 deaths in the US alone. I remember when the TI’s researchers were accused of being naysayers when they were asking physicians to be careful about prescribing this particular drug and to question the science behind the intense marketing.

Here in BC, there is growing evidence that Goliath is fortifying its battle with David by enticing UBC with lots of riches. There are rumours of buildings and bigger and well-equipped centres of research and drug discovery. The bribes have to be big because the payoff (half a billion dollars per year) is huge. Any government hoping to kill the TI and expecting a payoff should be asking not for a building worth a miserly $50 million, but rather for half a billion per year, every year to perpetuity. That’s what David is likely saving us.

BC is a strange province where the cosiness – a sort of chequebook diplomacy – between the current Liberal government and the drug companies that fund their election campaigns is well known. Last year, this cosiness translated into a BC government-appointed Pharmaceutical Task Force, staffed with drug industry lobbyists who produced a report so shoddy it’s an embarrassment to anyone involved. The major outcome of the report was the suggestion to scrap the Therapeutics Initiative.

The plot heats up when you recall that back in February of this year the UBC Centre for Drug Research and Development (CDRD) was named as a Centre of Excellence for Commercialization and Research (CECR). The Canadian government plans to kick in $15 million over five years to “accelerate the translation of health research into high value medicines.” Matching funds will come from BC taxpayers, funnelled through groups like the British Columbia Knowledge Development Fund and the British Columbia Innovation Council (BCIC). The latter describes itself as a ?one-stop point of access and support to high tech companies, educational institutions, technology industry awareness groups (including regional technology councils), federal science and technology agencies and university research labs.” Wow – sounds like a full-on marketing machine for BC high tech. Just what the doctor ordered.

Like most universities, UBC certainly has its own objectives and new pools of potential research money must seem awfully tempting. UBC’s president, Stephen Toope, is a world-respected advocate for human rights and the power of international law. He is one serious and uncompromising dude when it comes to speaking truth to power. But you have to ask yourself: Will Dr. Toope be able to speak truth to the Goliath at the gates of UBC?

It’s hard to say. What is certain is that the success of university presidents is usually measured by their ability to increase the university’s prestige, size, influence and wealth. And with large numbers of academics and researchers who measure their success by how much research funds they can absorb, Dr. Toope would certainly face a rabid faculty backlash if he questioned the flow of drug funds to UBC.

What a conundrum, eh?

You might think this biblical parable is too much of a stretch because in the real ‘modern’ world, the Goliaths almost always win. Well, thankfully we have a democracy and there is an election coming up. We can throw out the politics of rule by rude power. We can choose not to support a government that thumbs its nose at evidence-based medicine, one that encourages the drug companies rule the day. OR we could ask for something different. And that difference is something that may mean the choice of life or death for some of us.

Alan Cassels is a drug policy researcher at the University of Victoria a. He served with Stephen Toope as a UN Election Observer in the first all-race elections in South Africa in April, 1994.

cassels@uivic.ca

Health food matters

by Joseph Roberts

 

photo: Luc Santerre Castonguay

Food was always very important, the author said on the radio as she dedicated her new cookbook to her mother “who instilled in her a love of food”.

Food is important, in many ways and for many reasons. In many different delicious cultures there are very distinct eating habits, but we all have something in common: we all eat.

Books abound with food for thought: The Food Revolution, Power of Superfoods, Fields of Plenty, Vegan Delights, Real Foods for a Change, No More Bull, Eating My Words, Chef’s Table, New Ethics of Eating, Feed Your Genes Right, The Joy of Cooking, and even The End of Food.

Yes, we all eat – at least those of us who are fortunate to live in places where food exists. Many just scrape by, and the even less fortunate die of starvation.

Soil, water, and sun are so intertwined with food on this good earth. I hold an almond in my hand: how did it get here where did it come from, who help it grow? So many questions. Each nut is a seed capable of growing into a huge beautiful tree which in turn brings forth the next generation of almond flowers which produce pollen for the bees. The mystery of life to continues.

Humans are not the only animals who cherish nuts and seeds. The branches of the birch tree outside my window are home to many seed-eating birds and squirrels. We are each and all part of a magical natural cycle. As the grey and black squirrels scurry about on autumn’s gold-leafed branches, people scurry about in traffic and in their homes. While the wilder creatures hunt and gather directly from the source of their sustenance, we too search out our foods – but usually in more indirect and complex manners.

What we choose to eat is based on our beliefs, our customs.

Where our foods come from, what soil or water they use, how they are grown and produced makes the difference between life giving or disease making. As we learn and evolve we learn what matters about food.

photo:Chanyut Sribua-rawd

Access to nutritious food from sustainable sources is a primary responsibility of any functional culture. May all beings be fed and may all beings be happy.

A decade ago, at an organic food conference, women from rural India told of their fight to keep their village’s soil and food clean of toxins. A t-shirt message starkly read, “Food without poison is a must for life”. They were in a battle to keep high tech patented genetically altered terminator seeds, and their accompanying chemical herbicides, from displacing hereditary seeds which had, for thousands of years, reproduced life giving free seeds. The gap between the corporate food-for-profit agenda and grassroots sustainable food-for-families was graphic. Monsanto, the same corporation that sued Percy Schmeiser in Canada over copyrighted GMO products, was involved over in India as well.

Health food matters.

When a food product shows up on a store shelf, it is only as good as its ingredients, and the skills and care of its handlers. And the ingredients are only as healthy as the soil it comes from.

We look at food with various levels of understanding. Sometimes companies that manipulate foods intentionally hide the real nature of what they produce. In Canada, for example, labelling genetically modified food is voluntary. Given that most informed eaters would shun GMO products, voluntarily disclosing that their product contain GMOs is not likely to happen. Deceptive labelling can deceive by omission.

Prior to the industrial chemical revolution there were natural methods of preserving certain foods, drying or pickling being two examples. Chemical preservatives now promise longer shelf life so the product can sit around – sometimes for years – and still be sold. These food products get consumed much later than nature would normally allow. Some preservatives are more natural but most modern ones are synthetic and toxic. It gets tricky when natural-sounding additives are used to greenwash or hide other preservatives. A case in point happened in Canada with the combining of ascorbic acid and sodium benzoate in the cheap two litre plastic bottles of orange looking soda pop sold in supermarkets. The synthetic vitamin C in the form of ascorbic acid chemically reacted to the sodium benzoate when the pop was left out of the fridge and in the sunshine on a hot summer afternoon. The ascorbic acid broke down the sodium benzoate into sodium and benzene. Benzene is a known carcinogen. Unwittingly, thirsty people gulped down the sugar-coated poison thinking it was okay.

So as we eat our way through a lifetime of food, we absorb what is in our diet. Like the proverbial frog in hot water we slowly get cooked. If we eat food with carcinogens we toxify our cells, some even to the point of immune collapse where diseases take over the organism.

Food of course is not the only vector of unwanted contaminants, but it is one we do have a some choice over. We can eat the highly refined, sugar, salt, preservative-laden unfresh food, or an apple, avocado or pumpkin seeds for snacks each day.

We make ourselves healthy or unhealthy one bite at a time. And how we chew our food matters too, in whether we assimilate what we consume. Chewing our liquids and drinking our solids engages our mouth saliva to begin the process of digestion. Remember, if our teeth do not chew our foods then our stomach must.

The Canadian Health Food Association selected November as National Natural Food Month in Canada. What a beautiful time of year to be reminded of health with all the lush colour of maple leaves. Colour is an important indicator of how rich in vitamins and minerals certain foods are. May autumn inspire us to choose fruits and vegetables of deep hues for deeper nutrition. Products carefully manufactured from such green, red, blue, purple, orange mineral-laden ingredients form great supplements to augment our diet.

Whole foods are the way nature initially provides humans with abundance. Eat as much fresh raw food as you can. Cook foods in ways that release their nutrients, but avoid overheating and use utensils that are not toxic. Keep food from having contact with aluminum, Teflon or other non-slip plastic compounds. Avoid microwave ovens because they alter the food on an electron level and release free radicals linked to aging and cancer. Don’t be a guinea pig. There are other less intrusive ways to prepare what we eat.

Intention effects what ends up on our plate. Those that link our mouths with the original source of sustenance need to honour and respect natural cycles. Principles are more important than pretty packaging when it comes to health and the quality or goodness shows up in the details.

Think of foods as having benefits or side effects as do drugs. Most people would not take drugs if they understood the harm. But they do, because they are not well informed, or believe in so-called experts who would never take the very same drugs they prescribe. In the UK, adverse drug reactions kill about 10,000 (a nasty “side effect”) every year, whereas car accident kill about 3,000. Drugs, like cigarettes, are profitable but they also make people sick. The costs are sloughed off to the society rather than the manufacturer being held liable for the damage caused. In Canada we do not allow direct-to-consumer prescription drug advertising as they do in the USA. Twenty five per cent of TV ads in the USA are drug commercials. The effect is that Americans spend about 50 per cent more on drugs than Canadians.

Three hundred billion dollars are spent on drugs in North America annually, much of which is advertising induced and unnecessary. Many side effects occur for which yet more drugs are prescribed. The combination of drugs bring unexpected results. How many well intended, obedient elders come to harm following their multiple prescriptions religiously? Their A to Z plastic pill organizers give them a false sense of control in an overly chemicalized world, further numbed by loneliness, alcohol and TV (with its booze and drugs ads).

When in doubt, use natural nutrition and a healthy lifestyle to improve your well-being.

Junk food compromises one’s health to the point of disease because, besides containing toxins, it lacks the basis nutrients needed for bodies to function well. This leads to attempts to rectify the situation with drugs, which can contribute to premature death. These unhealthy faux-foods may make a killing for their producers, but eventually sicken their user. There is an unholy synergy between crappy foods, sedentary lifestyles, pill pushers and pharmaceutical profits.

Nature eventually wins out in the long run. The laws of ecology do not go away. Every thing is connected to everythings else, and, we all live down stream from the source and processing of our food. Likewise, there is no such thing as a free lunch. Bad nutrition and toxic food extract their toll in human suffering. Just as one vitamin can cure so many illnesses, so can the deficiency of a vitamin or mineral cause disease. Vitamins, mineral, fibre, and other nutriments – coupled with rest, fresh air and pH balanced clean water – enable a body to be nourished and heal.

Imagine the social impact of chronic well-being and a highly contagious epidemic of health. Well-informed and inspired people choosing their foods wisely with care, respect and gratitude. The joy of healthy food spreads like wildfire across our land nourishing all in its path. People stop hurting themselves with unconscious habits around food. We honour the land along with the energy required to grow and deliver foods to market. There is an awaking of compassion for all those who hunger to better organize and distribute nature’s abundance so all are fed. Health Canada sees the light, reverses its drug-heavy approach to treating disease, and invests money to prevent disease.

You may say we are dreamers but we are not the only ones.

In 1976 Mother Teresa came to Vancouver’s Habitat for Humanity where she spoke of a hunger that bread cannot satisfy. It is a hunger to be touched, a hunger to be loved and a hunger to belong.

As we celebrate our healthy food choices, let’s remember those who have much less than us. Though most starving people live in countries ruined by geopolitical greed and environmental degradation, there are those in our land who are also hungry. Some are malnourished from junk food or poor eating habits, others from hard emotional, mental and financial times. Some are on drugs, some are not. Some smoke and drink, others don’t. But we all eat, and as challenging as it gets, if it is not us, who will be our brothers or sisters keeper?

By helping others, magically we too are helped. We are related, we belong.

So share some food with a street person or a neighbour you haven’t yet met. Take time to see him or her fully as a person and part of the larger human family, a fellow traveller in this world of wonders. We each have our story to tell and our need to be heard. Break bread with the beggar on the street; share a handful of grapes. This too is a remembrance. Like the almond, we are a human tree capable of spreading comfort and joy. Spice life with compassion so we too can nourish our deep spirit inside.

Go for green

NUTRISPEAK by Vesanto Melina

Green is a big plus when it comes to nutrition. Whether it is a salad or vibrant florets of steamed broccoli, a green juice or a smoothie, the green derives from the chlorophyll molecule, with magnesium right in its centre. Greens are packed with a multitude of minerals and abundant vitamins. (See recipe below.)

Green is also an outstanding choice when it comes to political parties. The Green Party, now rising to well-deserved prominence, recognizes that food choices profoundly affect our health and that of the planet; this fact is reflected in school food policies. The Green Party advocates the labelling of genetically modified ingredients, in line with the desire of many Canadians who prefer GMO-free foods. It also supports the elimination of subsidies for pesticides, thereby permitting organic farming to be more competitive with pesticide-laden foods that are sold at cheaper prices. The Green Party also supports fair trade, ensuring that impoverished farmers receive fair prices.

The Green Party profoundly understands the link between lifestyle and climate change. Taking heed of the thousands of peer reviewed climate scientists who agree that global warming is a real threat, its party platform encourages earth friendly choices for food and transportation. We Canadians want hybrid cars, energy efficient appliances, wind and solar power systems and green building products and the Green Party supports the growth of these industries in Canada.

For Canadians, the issue that has proven to be even more important than driving eco-friendly cars or riding a bike is the food we put into our mouths. Researchers Gidon Eshel and Pamela Martin at the University of Chicago have calculated the carbon intensity of a standard vegan diet and North American carnivorous diet, through production processing, distribution and cooking to consumption. By going vegan, one elects to emit 1.5 tons less CO2 every year than the burger-eater. Choosing a state-of-the-art Prius hybrid over a gas-guzzling vehicle saves just over one ton of CO2 per year.

An average diet that includes meat leads to an annual greenhouse gas production equivalent to driving a mid-sized car a distance of 4,758 kilometres. See below for the correlation between eating various foods and the equivalent distance driven in kilometres. (Source: the Institute for Ecological Economy Research, Germany; study commissioned by independent consumer protection group Foodwatch.) Calculations are based on methane from animals, emissions from food production, manufacturing feed, fertilizer and the use of farmland.

Comparison of dietary choice (for one year) and the equivalent distance driven by a mid-size car:

• Diet that includes meat: 4,758 km
• Vegetarian diet (no meat, fish, poultry): 2,427 km
• Vegan diet (vegetarian with no eggs or dairy): 629 km
• Organic, vegan diet: 281 km.

Vesanto Melina is a dietitian and author of a number of nutrition classics, including The Raw Revolution Diet, co-authored by Cherie Soria and Brenda Davis. Register for the raw FUNdamentals class with Cherie Soria (Sunday, November 23) at www.rawbc.org or call 778-737-8852. For more great, green energy, visit www.greenparty.bc.ca or call 604-687-1199 or 1-888-473-3686.


GARDEN BLEND SOUP

(Makes 2 1/2 cups)

Of all the foods that support health, dark, leafy greens top the list. Kale, a plant that survives Vancouver winters, offers more nutrition per calorie than almost any other food. This recipe provides protein, vitamins A, C, E, most B vitamins, calcium, iron, selenium, zinc, copper, magnesium and manganese. Vary the flavours to suit your taste. In winter months, use hot water for a warming soup. This recipe is a favourite of Patrick Meyer, Langley’s Green Party candidate.

3/4 cup hot water
1/4 cup orange juice, or 1/2 orange, peeled
3 to 4 cups kale, stem removed, chopped
1/2 apple, cored or 1/2 small cucumber, peeled
1/4 cup fresh cilantro, basil leaves or dill weed
1 1/2 tbsp. light miso
1/2 tbsp. lemon juice
1/2 clove garlic
1/4 red jalapeño pepper or a pinch of cayenne
1/2 green onion, optional
1/4 cup sunflower seeds or 1/2 avocado, peeled and seeded

In a blender, process the water, juices, kale, apple, herbs, miso, garlic, jalapeño and green onion (if applicable) until smooth. Add seeds or avocado; blend again until smooth and serve.

Growing a food movement

ON THE GARDEN PATH by Carolyn Herriot

Food security seems to be on everyone’s mind this year. It’s fascinating to see so many local initiatives in response to the concern for more local food, so I thought I’d share what it’s looking like in my part of the world on southern Vancouver Island.

The year began with a public forum on food security in the Westshore community, which launched a “Grow Tomato Challenge” by giving away hundreds of free tomato seedlings and mapping where they were grown for a future tomato festival to track people’s progress. Often, all it takes is one juicy, homegrown tomato to get a person hooked on growing food!

Food markets sprung up in all 13 of the municipalities in Vancouver Island’s Capital Regional District. At the end of Bastion Square’s Thursday market in Victoria, David Mincey from the Island’s Chef Collaborative (an initiative linking chefs with farmers) told me there was not enough food being grown to keep up with the demand. He is astounded by the response to local food at the downtown market. What a great incentive to get more farmers on the land.

Recently, I was bedazzled by the colourful sight of food being grown on the boulevard in the municipality of Fernwood. On Garden Street, not only did one front garden and boulevard overflow with edible plants, but also the vacant lot next door housed several allotment gardens. Around the corner on “Haultain Commons,” they were giving away free potatoes and squash from their boulevard garden. What a great way to build community and share resources.

In September, I spoke to an audience at a meeting for the newly established Farmlands Trust (www.farmlandstrust.ca) in the Mount Newton Valley in Saanich. Since February of 2008, people have raised $2.5 million of the $6.25 million needed to purchase 192 acres of Woodwynn Farm and turn it into a community farm that will become a model of sustainable, organic agriculture, providing education and land tenure to new farmers. Preserving farmland for the next generation is the only way to go when you consider that the average age of a farmer in BC is 56.

In the municipality of Oak Bay, the council changed a bylaw to allow the continuation of SPIN farming (Small Plot Intensive) so that Martin Scaia and Paula Scobie could carry on market gardening in 20 gardens. In Esquimalt, the council changed a bylaw to allow chickens in backyards and two women stepped forward to write a manual called Everything You Need to Know About Backyard Chickens.

At the Victoria Public Library, I sat on a discussion panel in an overflowing room, where MP Denise Savoie invited people to talk about Vancouver Island’s food security. Public forums are the only way to inform all levels of government of our concern for the future food supply, especially when 95 percent of the food we consume on this island comes from off the island.

This past March, I started teaching a 10-month course called Twelve Steps to Sustainable Homegrown Food Production and discovered two amazingly simple ways to build food gardens. Check out “Lasagna Gardening” and “Keyhole Gardening” on the internet. Instead of digging into the ground, you build up from the ground, which means you can grow food with very little effort or expense. These gardening methods turn unproductive spaces into food gardens in a few hours, as they can be planted with food immediately following construction.

“Keyhole” gardens are so easy to build that even children are making them. If you stockpile organic waste materials, such as cardboard, newspaper, leaves, hay, grass clippings, manure or compost, you’ll have the necessary ingredients. These gardens provide the healthiest and most productive food because the medium in which it grows is so fertile and rich in micro-organisms. 

I have often asked myself what it takes to launch a Grow Your Own Food movement, but I now think we may have already launched one. How’s it growing in your part of the world?

Carolyn Herriot is author of A Year on the Garden Path: A 52-Week Organic Gardening Guide. She grows her certified organic “Seeds of Victoria” at The Garden Path Centre where she blogs The New Victory Garden online.

Do the candidates have us covered?

DRUG BUST Alan Cassels

Wanna talk pharmaceutical politics? Then ask yourself these two questions: If a new drug is marketed in Canada, does that mean the government should pay for it? And further, if your doctor prescribes a drug that is deemed essential, should you have to pay for it yourself?

If you’re like me, the answer to the first question is “Of course not.” There are lots of drugs on the market, many of which either do very little to improve the quality of your life or may even be harmful. We shouldn’t expect the public purse to pay for these frivolous drugs, especially when there are already so many other urgent demands for our precious health care bucks. The answer to the second question is the same: “Of course not.” In Canada, we don’t pay out of our pockets for essential health services like doctor or hospital visits so why would we expect to have to pay for an essential drug?

By the time you read this, we’ll be in the final sprint for the election finish line. Even though there have been enough mini-scandals, resignations and apologies to keep a hungry media at bay over the last month, and we have heard a lot about what governments would do about crime, infrastructure and childcare, we’ve heard barely a word about health care. Certainly, almost nothing about the biggest elephant in the room – Canada’s pharmaceuticals budget.

Yet this crazy election season is the most appropriate time to be asking, "How well do Canadian governments, both provincial and federal, provide drug coverage to our populations?” Sadly, we are a pathetic country on that front. A recently released report said that among developed countries, Canada is almost last in terms of its level of public coverage of pharmaceuticals.

It seems that for every dollar that goes towards pharmaceuticals in Canada, about 45 cents come from the government; about 35 cents come from your private insurance plan that you would have as part of your employment if you are lucky (even though you are ultimately paying for it because that money comes off your pay cheque one way or another); and the final 20 cents come out of your pocket. The report stated that we scored a dismal seventeenth out of 18 countries, in terms of public drug spending. In contrast, the UK spend on drugs is more than 80 percent from the public purse.

This is a real shame and obviously an election issue that should have huge prominence, given the fact that, in 2007, spending on drugs in Canada reached $27 billion, a figure that represents almost 17 percent of total health care spending. According to the Canadian Institutes of Health Information, after hospitals, drugs account for the largest share of major health expenditures.

It is criminal if Canadians are doing without life-saving drugs because they can’t afford them (though I’m not convinced this is much of an issue). Suffice to say this study provides some evidence that Canadian politicians lack the political will to enact strong, national legislation to pay for our drug costs.

This is certainly not the vision Tommy Douglas had when he established public health care in Canada. Even the Romanow Commission, which is one of the most extensive examinations of Canada’s health care system ever undertaken, recommended a national, catastrophic pharmacare program.

Have we seen anything in the last five years? Nada.

The second important statistic to emerge from this study, which also slams Canada as miserly and misdirected on drugs, is a dismal score of sixteenth out of 18 countries, in terms of access to new drug treatments. While that may strike most people as pathetic, I’m a lot more understanding about this one. When you consider the dismal batch of drugs coming onto the market that are deemed “new” and which arrive on the scene with massively inflated prices compared to existing treatments, you’re not really missing much.

Let me explain: the study looked at a comparison of 36 new drugs evaluated for public drug plan reimbursement by all developed countries. Canada’s Common Drug Review (CDR) the federal body which decides, based on an assessment of the drug’s safety, effectiveness and cost (and makes recommendations whether a new drug deserves public coverage), recommended only 61 percent of drugs for public drug plan reimbursement. Apparently, this is a lot less than the averages of the European Union (EU: 91 percent) and the US at 88 percent.

Most people are thankful that the government does its part to pay for pharmaceuticals. And yet, whether you get access to “new” drug treatments, Canada is apparently not a good place to live. The study was produced by a Toronto health consulting firm and paid for by Rx&D, the association of Canada’s brand name drug companies, with the claim that it is the first comprehensive study of its kind evaluating Canada’s access to new drug therapies.

LetÅñs talk about the access issue because the drug companies and their surrogate patient groups are always screaming blue murder about the lack of access to new drugs in Canada. We’ve got a situation in which about half the ?new” drugs recently approved for sale in Canada – drugs for HIV, cancer, heart disease – aren’t recommended for coverage. The Common Drug Review, a serious contender in establishing proof of evidence when it comes to making decisions about coverage, apparently issued 78 recommendations between 2003 to the end of 2007, giving a positive recommendation only 46 percent of the time.

Even though this study apparently demonstrates that Canada is not keeping pace with other countries, in terms of new drug coverage, it is the lack of public funding overall that I think is the most serious issue.

Where do the various political parties weigh-in on this issue?

We know, for example, that the NDP supports a National Pharmaceutical Program. On his website, Jack Layton says that he “…hears about the prescription problem in every single province he visits.” He knows the numbers too; he’s aware that between 1992 and 2002, household spending on prescription drugs jumped by more than 70 percent, while over the same period, spending on food, clothing and shelter increased by only 11 percent.

Layton decries the fact that almost 20 percent of Canadians do not have adequate drug coverage and God forbid, if they find themselves in a situation where they cannot afford the medication they need, they would be ?…forced to choose between medications or mortgage payments.

What Mr. Layton doesn’t say is that many of those drugs that Canadians are paying for may not actually be worth the money demanded at the pharmacy counter, when you know what kind of health outcome they will deliver. However, he’s not adverse to a bit of fear mongering when it comes to putting demands on the government. He says access to medication should be based on need. ?Canadians want to know that if they get sick and can’t afford the drugs they need to survive, the federal government will step in to help.” I have to give some credit to the NDP when they say that if they were paying for drugs, they’d at least look at “essential” medicines and ensure that those Canadians who carry a heavy burden of paying for drugs would get some help.

Where do the Liberals stand?

It’s hard to say, but, like a lot of issues, the Liberals are stealing the best parts from the NDP. Liberal Leader Stéphane Dion promised a ?national program to fund high-cost drug treatments for people who suffer from serious and chronic illnesses – a program aimed at extending coverage to provinces in Atlantic Canada that don’t have provincial drug plans.” Dion said the Libs would spend $900 million over four years and ?ensure people in all provinces can afford expensive drugs like kidney cancer treatments that can run as much as $7,000 per month.”

How about the Conservatives? Let’s start by saying that many drug lobbyists are deeply connected with the governing Conservatives. In an article in theNational Post on May 6 of this year, it was revealed that two high profile Conservatives were mired in the muck around the drug companies’ efforts to restrict the availability of generic drugs. Then there was the stinky business about a former communications director for Stephen Harper, who became a lobbyist for the company that owned the vaccine for cervical cancer for which the Conservatives allocated $300 million.

There’s no doubt that the brand name drug industry is one of the most powerful in Canada, and if anyone is keeping drugs out of the hands of Canadians (due to their high prices), it is those folks.

Let me add one final bit. There is a Conservative I’d vote for if he was running in my riding. Terence Young, who is running for the Conservatives in Oakville, is one of Canada’s staunchest supporters of weapons-grade drug safety legislation. He’s spoken publicly in favour of strong legislation supporting the recommendations of the Romanow Commission, especially the one about establishing a new Drug Agency for Canada to ensure Canadians are safer when using prescription drugs.

Alan Cassels is a drug policy researcher at the University of Victoria. He was recently interviewed on CBC Radio’s White Coat, Black Art on the subject of public funding of pharmaceuticals in Canada. You can catch this program at www.cbc.ca/whitecoat.
cassels@uivic.ca

Sample a Taste of Health

NUTRISPEAK by Vesanto Melina

Vancouver’s healthy food festival, Taste of Health, has become a welcome September tradition. It’s a fun, inexpensive way for families to spend a day or weekend. It’s also a great way for vegetarians and non-vegetarians alike to sample healthy foods and discover how small, dietary changes will impact climate change.

Earthsave Canada’s 10th annual food festival includes cooking demonstrations, seminars and a veggie food court. Visitors can hear informative lectures, ask questions of food experts, attend demos, sample tasty foods and browse the book fair.

Speakers include cattle rancher turned vegan activist Howard Lyman (www.madcowboy.com); David Pimentel, professor of ecology and agriculture at Cornell University; Brenda Davis, RD, a dietitian and my co-author (www.brendadavisrd.com) and I’ll be there too so please come by and say hello.

The following authors will give cooking demonstrations: Rose Vasile (www.rawrose.com), Victoria Laine (www.healthbychocolatebook.com), Dreena Burton (www.everydayvegan.com) and Nyala’s restaurateur Assefa Kebede (www.nyala.com).

Here are summaries of my and Brenda Davis’ presentations:

Rx for Healthy Eating
Vesanto Melina

Did your medical doctor give you a prescription for healthy eating? Would you like to live an extra 10 vibrant years? Can food be good for you and also be delicious and easy to prepare? How do you cope when some of your dear ones are vegetarian, vegan or eat raw foods while others can’t imagine a meal without meat? In this presentation, you’ll learn simple tips for preparing meals and snacks throughout the day. You’ll learn to keep your blood sugar level and your energy high. You’ll get ideas for feeding children, grandchildren and spouses food that will tickle their fancies and tingle their taste buds. You’ll discover how to fare well at restaurants and while travelling.

The Raw Revolution Diet
Vesanto Melina

A trend that is sweeping North America is the raw foods movement. Some people are motivated to go raw by a concern about bulging waistlines, others by the abundance of protective antioxidants and phytochemicals in raw plant foods. Are raw diets nutritionally adequate? If so, what does a day’s intake look like? How do we create a raw menu that meets recommended intakes for protein, calcium, iron, zinc, vitamins B12 and D? Is it okay to be partly raw, rather than 100 percent? Can a raw diet be the basis for a successful weight loss plan?

Cutting Edge Vegetarian Nutrition 
Brenda Davis

There is no more powerful tool than your own example of great health. While there is overwhelming evidence that a vegetarian or near-vegetarian diet is as healthy as you can get, plant-based diets are not foolproof. This presentation will guide you through common concerns and questions about plant-based diets and provide you with authoritative answers and detailed information on protein, calcium, vitamin D, vitamin B12 and essential fatty acids. Learn about the far-reaching benefits of a vegetarian diet.

Defeating Diabetes – lessons from the Marshall Islands
Brenda Davis

Type 2 diabetes is sweeping North America. Once primarily a disease affecting people over age 45, it is now common among young adults and increasing numbers of teens and children. Though often believed to follow a downhill spiral, research demonstrates that the disease is highly treatable and, in some cases, completely reversible. The author of the bestsellerDefeating Diabetes will guide you through the reversal diet and lifestyle and provide tools to improve, and possibly defeat, your disease. Brenda Davis brings her experience of working on diabetes reversal in the Marshall Islands, where nearly half of those over 35 years of age are affected. Her story is riveting and inspiring. Don’t miss this presentation.

 

Vesanto Melina is a dietitian and author based in Langley, BC. Call 604-882-6782 for a personal consultation or visit www.nutrispeak.com Also see www.healthyschoolfood.org to get a year’s worth of daily Wakeup Wellness Messages for a $50 donation.


TASTE OF HEALTH
10th Anniversary Sept. 26-28
Croatian Cultural Centre 
3250 Commercial Drive @ 16th Ave.
10th Anniversary Gala: Fri. Sept. 26, 6-9 pm 
Sat. & Sun.: 10:30 am – 6 pm 
Admission: $7/daily (children under 12 free). Free with Earthsave membership 
Info: 604-731-5885, www.earthsave.ca

Seeds – the future of food

ON THE GARDEN PATH by Carolyn Herriot

Since the dawn of agriculture, edible plants that thrive in the bioregion in which they grow have been domesticated through plant breeding. Traditionally, local farmers were the stewards of these seeds, passing them on from harvest to harvest. Knowledge garnered over 10,000 years meant farmers were well qualified to select seeds of plants with the most desirable traits, such as high yield, drought tolerance and disease resistance. These “landrace” varieties were passed on from one generation to the next. At the dawn of the 21st century, the situation looks radically different.

Ninety-eight percent of the world’s food seed sales are now in the hands of six corporations: Monsanto, Syngenta, DuPont, Mitsui, Aventis and Dow. While Monsanto is not in the business of feeding the world, it conducts most of its research in a living laboratory – farmers’ fields throughout the world. This corporation’s business is the genetic modification of seeds, which have to be sold in a package just like their pesticide products, such as Roundup. In order to control these GMOs, Monsanto has patented its seeds and, even more alarmingly, is now trying to sterilize them through proposed terminator technology. Monsanto’s objective is seemingly to control the way the world feeds itself, but it appears that its methods are not sustainable on many fronts. We are now seeing the impact of mass quantities of food being flown around the world, while people working the fields go hungry and the planet warms up. Cheap food is costing the Earth!

Our ancestors recognized food as the staff of life; without seeds there is no agriculture to grow food, and without agriculture, there is no civilization. It’s incredible that across the planet people have become so disconnected to the source of their food, the very essence of their survival.

How can we accept that we are feeding the world with food grown in the absence of nature? There’s no place for wildlife on hundreds of acres of monocultured crops. There’s no habitat, food or water for the birds, bees and butterflies. What happens to the fragile soil-food web of life when the soil is dosed with Roundup? It’s time to reconnect with nature by finding a place for Her in the food production cycle.

Plants are dependent for their nutritional content on the soil in which they grow. Fertile soil is alive with organic matter, which feeds the myriad organisms that dwell within it. What kind of food is being grown through industrialized food production? Is it real food that nourishes us? We are now seeing the consequences of eating food grown in depleted soils, or no soil at all (as with hydroponics): neurological problems such as dementia in the elderly and attention deficit disorder in youth.

When fed empty calories, we always feel hungry. When we eat too much, we create Type 11 diabetes in children and obesity throughout the populations of developed and developing nations. Our healthcare systems will soon be bankrupt through the necessity of caring for a society of undernourished people.

Perhaps it’s time for a resurgence of the ‘60s hippies’ “back to the land” movement. Perhaps if we grow real food where we live, we will reconnect with nature. Perhaps all we need to do is go back to the garden to remember how to feed ourselves and future generations. But we need the seeds to do that.

Around the world, many small groups of seed savers are actively working to safeguard global food security by preserving the genetic diversity of plants. Our capacity to feed ourselves in the future depends on defending our global, agricultural heritage today. Grassroots organizations are saving the seeds in a living laboratory by growing heritage varieties of food plants whose seeds have not been genetically altered or hybridized in the interests of large scale industrialized food production. (See sidebar.)

Carolyn Herriot is author of A Year on the Garden Path: A 52-Week Organic Gardening Guide. She grows her certified organic “Seeds of Victoria” at The Garden Path Centre where she blogs The New Victory Garden online.

 

Grassroots Seed Savers

Salt Spring Seed Sanctuary

Seeds of Diversity Canada Resource List 

Seed Savers Exchange USA

The Heritage Seed Library – UK

Digger’s Club – Australia

Medical scan scam

DRUG BUST Alan Cassels

Seek and ye shall find. We can find disease wherever we look; the question is do we need to be looking? One of the longest-running debates in health care circles involves the dichotomy of “prevention” versus “treatment.” Some people complain that our “health” system has nothing to do with health and basically exists to patch you up once you’re broken. It’s a system that, by design, ignores many of the factors that make us sick in the first place. Many people praise the need for prevention using very compelling arguments, stressing that the bucks need to go towards health promotion and disease prevention in order to save further billions on medical services down the road. This would avoid much needless suffering and engender a healthier, happier society at a fraction of the cost we currently incur.

There’s no doubt that, as a society, we need to do a better job of following the classic triumvirate of health promotion advice: Eat well. Exercise often. Don’t smoke. However, that which passes for prevention is often an exercise in consumerism to get us to part with even more of our dollars. All in the name of health, of course.

We’ve seen many examples of how “prevention” consumerism drives the use of pharmaceutical drugs prescribed to “prevent” all kinds of chronic disease, even when the evidence underlying those treatments really applies to only a small subset of “high risk” people who may benefit. The incessant drumbeat of preventative pharmacology persistently fails to remind us that many of those treatments provide infinitesimally small benefits for relatively healthy people at great costs with unknown risks.

The pharmaceutical industry is not alone in discovering that prevention sells. Others, particularly those that market organ screening with some of the highest tech tools on the planet, such as the CT (computed tomography) or PET (positron emission tomography) scanning machines, have discovered that screening for disease is a cash cow capable of providing a much more lucrative revenue stream than that yielded by simply providing treatments for the sick.

In fact, one way to sell “prevention” is to establish a market for screening for the deadliest diseases lurking in your body – seeking out markers of disease, such as heart disease or cancer, before the disease can get you.

This new generation of scanning devices wouldn’t look out of place in Dr. McCoy’s sickbay on the Starship Enterprise. These space-age devices generate three-dimensional images of your body’s insides and, in terms of diagnosing what is wrong with you, a CT or PET scan might be the best medicine for you. But, at the same time, because these machines are so good at detecting tumours and arterial plaque, entrepreneurs would naturally reason that we should grow that market by expanding the machines’ uses to more and more healthy people. In fact, why not send the whole population to get “screened,” under the guise that it would (like most arguments for prevention) ultimately save the health system money?

It’s not that simple. Population-wide screening of healthy people seems intuitively sound until you look a little closer and realize the costs and potential for harm are considerable, including, in this case, the massive doses of radiation that some of the tests themselves deliver.

What do we really know about the overall screening of the population using these devices? The answer is not much. And it provides no solace that even the screening paradigm about which we know the most – screening mammography for breast cancer – is no slam-dunk. Maryann Napoli, associate director of the Centre for Medical Consumers in Manhattan (www.medicalconsumers.org), has an in-depth consumer’s view of the controversies around mammography. In a recent interview, she shared some of the statistics with me: “For every 2,000 women who have mammography over the course of 10 years, one woman will have her life extended because she was saved from having or dying from breast cancer. Meanwhile, 10 more women will be diagnosed and treated for a cancer that they didn’t need to know about.”

The fact is the more mammography screening you do, the more things you’ll find. And the more stuff you find, the more you will be driven to determine if the lumps are lethal, beginning a cascade of biopsies, surgery, radiation, hormone therapy and so on. Any screening, if pursued too aggressively in well people, will deliver high rates of false positives – the equivalent of crying wolf. One of the surprising findings of mammography screening research, despite our profound belief in its usefulness, is that breast cancer death rates don’t vary, regardless of whether or not you religiously have mammograms or avoid them. The equation tilts in favour of older women being more rigorous about mammography, but then why do we still recommend screening so aggressively for younger women?

Cancers don’t just show up in the breast, and around the world, private entrepreneurs with scanning machines are promoting their high-tech search and destroy missions in hearts, lungs and other organs. In Canada, these scans seem to be currently limited to those who can plunk down the fee of several thousand dollars, unless you’re a CEO and you get the screen as a perk of “executive health” coverage. The promotion of these types of screenings tend to use a predictable technique designed to grab your attention: 1) the hook –sell the size of the problem. 2) the set-up – sell the wonders of the technology. 3) the pitch – and then close the deal by asking the customer to commit to some action.

The following two examples derive from a centre in a large, western Canadian city pitching its screens for lung cancer, heart disease, and other conditions.

Lung cancer screening

1. The hook: “The Lung Scan – The Best Defence is a Good Offence”

2. The setup: The most preventable of all cancers, lung cancer remains the leading cause of cancer death for both men and women.

3. The pitch: After quitting smoking, early detection may be your best defence against lung cancer. Researchers have recently demonstrated that routine CT screening reveals most lung cancers while they are potentially curable.

4. The close: The lung scan is very accurate in detecting small lung cancers before they become symptomatic or before they become visible on standard chest X-rays. Early detection of lung cancers can mean a longer life and, in many cases, a cure.

Heart Disease

1. The hook: “The Heart Scan – Know the Score”

2. The setup: Cardiovascular disease is the single greatest health problem in Canada and the rest of the developed world. Health Canada suggests 37 percent of Canadian men and 41 percent of women will eventually die of some form of cardiovascular disease.

3. The pitch: A heart scan is an “effective, non-invasive way to measure the amount of calcified plaque in blood vessels – your ‘cardiac calcium score.’ Once identified, at-risk patients can be treated for problems such as high blood pressure, cholesterol pathology and borderline diabetes, significantly improving their chances of survival.”

4. The close: “Starting at age 45 for men and 55 for women, individuals should consider a heart scan to determine their calcified plaque levels.”

So there you have it – all the reasons why you should be proactive. There is this disease – lung cancer or heart disease – that is a huge killer. You could be at risk. The technology could save you. And luckily for you, you can act now (and pay the thousands of dollars your scan will cost you). And the narrative flows to the point where you are willing to part with your money.

By now, you would probably like to ask me, “So what’s wrong with paying a few thousand dollars to find out if your body is harbouring any latent disease?” One way to answer this question is by asking yourself what matters to you.

Does it matter that a single CT scan could expose you to as much radiation as 300 chest x-rays, which, statistically, will cause cancer in a small number of patients thus exposed?

Does it matter to you if the World Health Organization, as well as almost every federal agency in Canada and the US and many radiology societies and associations around the world, gives the thumbs down to population screening of asymptomatic (healthy people) for coronary artery disease or lung cancer using CT scans? In other words, for a variety of reasons, the experts don’t recommend it.

Does it matter that the language used to sell many types of population screening is prone to many forms of bias? Three types of bias – lead-time, length time and overdiagnosis bias – collectively conspire to make the screening appear to improve your chances of survival when it actually doesn’t? (Check Wikipedia for a good explanation of the types of possible bias.)

Does it matter that many of us who are healthy are harbouring slow-growing tumours and other moles, lumps and bits inside our bodies that we don’t know about and which may never bother us, yet, if those things were to be discovered, the medical cascade of investigations, biopsies and surgeries (as well as complications arising from hospitalization and surgery) would tend to follow?

Let me conclude by saying that while we all hope that high tech, such as CT or PET screening, saves lives, it’s worth waiting for the evidence to back up that hope. In the meantime, it’s buyer beware; watch for the hook and beware of those ready to “close” the deal.

Alan Cassels is a pharmaceutical policy researcher at the University of Victoria and is the author of The ABCs of Disease Mongering. He is currently studying the marketing and regulation of private scanning in Canada. Have you been scanned? Do you have a story to tell? Contact him:cassels@uivic.ca

Health Canada takes baby steps toward drug safety

DRUG BUST Alan Cassels

If you thought we could get through these lazy days of summer without another major drug warning from Health Canada for a class of drugs taken by thousands of Canadians, think again.

The most recent advisory is among the more mystifying of the “adverse drug reactions” warnings I’ve seen lately; it warns of tendonitis and even tendon rupture linked to a commonly prescribed, relatively new class of antibiotics. And while the warning threatens to make me riff, for the umpteenth time, on the variety of ways in which drug regulators around the world – Health Canada not excepted – seem to go through the motions of monitoring and ensuring drug safety, there was also some good news. In a separate announcement, Health Canada advised it would provide some new seed money to help establish a drug safety research network in Canada.

This is very good news, but first, about the warning. The fluoroquinolone antibiotics, which include ciprofloxacin (Cipro) and other drugs whose generic names end in floxacin, have been under a dark cloud for a while now. More than two years ago, the drug watchdog group Public Citizen petitioned the US FDA to strengthen the warnings, stating, “…tendon ruptures associated with these drugs continue to occur at a disturbing rate, but could be prevented if doctors and patients were more aware of early warning signals.”

Last month, Health Canada was seemingly spurred into action by the US FDA’s ruling that makers of fluoroquinolone drugs had to issue a “black box” warning – the FDA’s strongest safety warning – on these drugs. Black box warnings don’t come along all that frequently and they usually emerge after much negotiation between the manufacturers and the regulator. A “black box” often precedes the removal of a drug from the market and it is a serious signal that the regulators are concerned about the drug’s toxicity.

For all you active individuals out enjoying the summer sunshine, the phrase “tendon rupture” is likely to strike fear in your heart. Tendon damage and perhaps a torn Achilles tendon could wreck anyone’s day. And this due to a drug you took for a simple infection? While the potential effects on your tendons from these drugs have been known for some time, what isn’t entirely clear is why any physician would prescribe the drug, being fully aware of the risk it carries when other antibiotics carry no such risk. As far as I can tell, there is no valid evidence that the fluoroquinolones are any better at treating most infections compared to the alternatives, such as older penicillin-type antibiotics.

My knee-jerk reaction is to suspect that the fluoroquinolone antibiotics have been widely prescribed – both mis-prescribed and over-prescribed – and only a little research confirms those suspicions. There is that perennial, but misapplied, axiom “newer equals better,” which has likely driven much of the marketing and subsequent prescribing of these drugs, and as with any newer treatment, the drug roars onto the scene with bells and whistles while the vital safety signals are spoken in whispers years later.

It is obvious to me that these drugs are marketed as being useful for indications for which they would, at best, be someone’s second choice. At least one manufacturer of this type of antibiotic has been slapped on the wrist by the US FDA for “…making false and misleading statements regarding the safety and efficacy” of the treatment in its advertising.

In terms of how well the drugs are being prescribed, one study involving 100 patients in two academic medical centres in the US found that 81 percent of the patients taking fluoroquinolone antibiotics had been given them for an inappropriate indication. In that same study, 43 percent of the patients received these antibiotics as a first-line treatment and 27 percent of recipients had no evidence of an infection. If this study, which was small and perhaps not applicable to the wider population, comes even close to representing the actual use of these drugs in the “real world,” it is a damning indictment of a serious failure in prescribing, made all the more serious because the drugs have the inconvenient capacity to cause “tendon rupture.”

Should we not expect Health Canada, as our drug regulator, to ensure that proper and timely prescribing information, especially safety information, is made available to guide our physicians? Sadly “too little and too late” seems to characterize the safety signals reaching physicians. After a new drug is approved, the marketers jump into action putting the new drug front and centre of our doctors, our hospitals and health clinics, plying them with free samples and glowing literature.

So what can we do to ensure that new drugs are used properly, rather than inadvertently inflicting tendon damage on the population?

Essentially, we need better “real world” data. It is slowly being recognized that Canada lacks the capacity to properly ensure that “real world” data is generated for new drugs, and that vital safety information about how drugs work in the world in which you and I live must be delivered to physicians in a timely manner. We hope that our physicians are acting in the most prudent manner possible when it comes to treating our infections. We also hope they will reserve newer drugs for patients for whom the older, more established classes of drugs clearly don’t work. Although hope is a pretty frail framework upon which to build a drug safety system.

The demand for “Real World Safety and Effectiveness” research around pharmaceuticals is a topic I’ve written about in the past (Common Ground, August, 2007). This need was initially enshrined in the National Pharmaceutical Strategy (NPS), a federal-provincial initiative boldly launched in September 2004, with the goal of providing Canadians with more equitable, sustainable and safer access to new drugs.

Almost four years later, I’m not the only one to notice that the NPS is largely a dud. Some have said that the “new” Conservative government’s mighty tendency to jettison those Liberal initiatives sounded the death knell for the NPS. Others have noted that provincial-federal wrangling over drug issues – the provinces want help to stanch the bleeding of red ink on the provincial drug file while the feds want to please the drug industry – means the NPS is going nowhere fast.

One of the things buried in the NPS’s objectives was a desire to “strengthen evaluation of real-world drug safety and effectiveness” and this recent announcement seems like it’s about to happen, albeit with baby steps.

With prescription drug spending now in excess of $22 billion per year, and a strong public appetite for more rigorous drug safety in Canada, Health Canada announced in mid-July it would provide the seed money needed to set up an independent research network to study the real world safety and effectiveness of prescription drugs in Canada. The business plan behind this network called for about $20 million per year, but Health Canada announced an immediate five percent of that ($1 million dollars) to get things up and running.

The hope is that the provinces will jump in with their own money and make the network a reality, a network that will likely link researchers in Canada, who are already doing “post-market” surveillance work, and allow them to cooperate in tracking real world drug use issues across the country.

No one can argue that Canadians must be protected from the unanticipated, adverse effects of prescription drugs, as the recent drug safety warning related to the fluoroquinolones has highlighted. Some, however, are insulted with the measly five percent Health Canada is kicking in, as it barely represents a down payment on the initiative.

Some have said that regardless of what form Bill C-51 ultimately takes, if it even survives, any promise of a “cradle-to-grave” surveillance of drugs in Canada will have to be bankrolled by “real world” drug data, and this money will ensure that Canadian researchers are organized and funded to use those data.

I say we give credit where credit is due. Health Canada has anted up so let’s wait and see if the provinces will come on board. Only time will tell if they will do their part to make this network fly. Or perhaps this initiative, like so many other important initiatives in the past, is destined to die from the lack of political will.

My strategy? I’m going to say a little prayer for those who are suffering needless Achilles damage this summer and I’ll feel a little guilty as I continue to enjoy running, jumping, hiking and walking. Because of our collective ignorance about a particular class of drugs, many Canadians won’t be enjoying the summer as I will.

It doesn’t have to be this way. Let’s make drug safety a priority this year and put the money behind that decision.

Alan Cassels is a pharmaceutical policy researcher at the University of Victoria and can be reached at; cassels@uivic.ca

If you think you have been injured by a prescription drug, you should call the Canada Vigilance Program at 1-866-234-2345. You can also submit an adverse reaction report on the Med Effect Canada website (www.hc-sc.gc.ca/dhp-mps/medeff/index_e.html).

Higher education just got higher

by Naseem Salila Gulamhusein

As human beings, our greatness lies not so much in being able to remake the world, as in being able to remake ourselves.

– Mohandas Gandhi

While finishing a degree at UBC, I dreamed of a curriculum that included yoga and wellness. I had already completed a degree at Langara College and I was well aware of the stress and pressure placed on students to succeed. I also questioned the logic of having to take some of the classes deemed “mandatory” to obtain a degree and I thought colleges and universities would be wise to include a six-credit course in yoga and holistic health. This way, when students got into the “real world,” they would have some valuable tools to deal with the changes and challenges of life.

In 1999, I was heading down the path to depression; life was taking its toll on me and sadness consumed my heart. I remember leaving campus one day after seeing a psychologist who had recommended I go on Prozac. I knew this was not an answer to my problems. Walking away from the institution, I was aware that I needed to make a choice between a path of suffering (where I was getting great marks) or embracing a path towards peace. In that moment, I remembered a quote my uncle had written in a yoga book: “When you surrender to emptiness, you will find happiness.”

The Centre for Holistic Health Studies at Langara College states its purpose as follows: “…to re-evaluate how health is created in the mind, body and spirit by expanding a client centred healthcare model that awakens the body’s innate healing potential and opens the path of the Heart.” After selecting the centre from a long list of potential workplaces that would be a good fit for my skills and passions, I was called in for an interview for the position of program coordinator.

During the interview, we talked about a number of things in relation to the programs. I spoke about wanting to share my passion for teaching yoga, and the interview changed into a larger discussion about creating a yoga teacher-training program at Langara. It would be vital to create a balance between the art and science of yoga and program development; and conversations with the Dean and others helped clarify how we could accomplish this in a college setting.

Spirituality and religion have always been a part of my life. Growing up, I was exposed to a diverse cultural and religious background. My father is Ismaili Muslim, born is East Africa, and my mother is Catholic, born in Northern Ireland. As a little girl, on Friday nights I would accompany my father when he went to the mosque. On Sundays, I attended church with my mother. Hearing the words of God, Allah, Jesus and Mohamed, I would think to myself how similar they all sounded; the meaning and message were about living by one’s virtues and helping those in need.

My mother and father struggled to find a balance and I soon came to understand why people fight over religion. Because of their interracial marriage, my parents were on the fringe of their own religions, providing me with a rich, cultural experience. In my teenage years, my father took me to my first yoga class, where I met my first teacher, a woman named Joy who suggested that one day I teach yoga. In saying that, she sealed my destiny.

My yoga-training journey brought me many blessings and the honour of studying with four great teachers: the first of which are my parents, who have taught me patience; the second, Yogi Bhajan (Kundalini yoga), taught me courage; the third, Gurumayi (Siddha yoga), taught me to follow my heart, and, to this day, Baba Hari Dass (classical Ashtanga and Raja Yoga) teaches me selfless service and devotion.

In 2001, I ended up in New Mexico with a backpack and a small tent, which would be my only possessions for the next six months. I couldn’t help but ask myself, “What am I doing?” but I knew there was no turning back. I had a strong desire to burn off the karma of sadness and suffering and my days consisted of chanting every morning at 4 AM, yoga, meditation and working in the gardens and the office. On the first day of our yoga teacher-training, Yogi Bhajan advised, “You are going to work through your stuff now!” and he made us hold our arms in the air for what seems like hours. After I completed my stay there, he admonished me to go and teach the world.

After travelling and teaching yoga full time for several years, my life took a dramatic turn. Having just spent more than a year in service at the Mount Madonna Center in Northern California and the Salt Spring Centre of Yoga in BC, I received news that my beloved mother in Ottawa had breast cancer. The prognosis was not good – she had three to six months to live. My reality crashed around me as I fell to the ground in deep sadness. Only a few days before, I had talked with a close friend about what it would be like to lose a parent. I was not prepared, but bolstered with the support of community, I headed home to do my duty. Initially, my duty to my family took me to Ottawa, but it was my love for my mother that kept me there. Hospitals, chemotherapy, painkillers, nausea, cooking, laughter, forgiveness and tears became our day-to-day reality. Having lived independently for so many years, I was once again a daughter, living at home.

I have heard that the greatest test of anyone’s practice is to move back home with parents and continue to remain in a state of shanti (peace). Three to six months turned into 18 months and I was honoured to be by my mother’s side during the process. In the summer of 2006, the cancer consumed my mother’s body, the battle was over and all that remained was to surrender. In the face of death, all I knew to do was chant. Both the Catholic priest and the Mukhi Kamadia from the mosque gave the Last Rights and I chanted the shanti mantra so that peace would prevail.

I was graced by watching my mother live and die without fear. She offered all of her suffering to God and forgave those who had trespassed against her. In her final hours, I watched the true meaning of life unfold. We come into this world on an inhale and we literally leave on an exhale. Everything in between is an experience that brings us closer to our inner truth and divine consciousness. Life is pairs of opposites seeking balance and union (yoga). Balance arises when we give up suffering, negativity and fear.

In the face of fear, there is always love and this is what guides me to live in the world. I choose to live and love through the path of devotion and action. After my mother’s death, I travelled with my beloved teacher Baba Hari Dass to India. For two months, I lived at Sri Ram Ashram, an orphanage for 68 destitute and orphaned children and school for 500 children. It is also a charitable medical clinic. It was there that my feelings of gratitude for having the love of a mother became more than I can ever express.

All these experiences brought me back to Vancouver in the fall of 2007, where I was led to Langara College to follow my dream at the Centre for Holistic Health Studies. Langara College is the first college in Canada to offer a 250-hour, experiential yoga teacher-training certificate program, which offers students the opportunity to study and practice these ancient teachings, which can bring about personal transformation, as well as allowing them to develop a daily at-home yoga and meditation practice.

One of the foundations of yoga is a regular daily practice (sadhana). Through meditation, self-affirming thinking and developing a positive approach to life, students learn how to solve personal challenges and promote peaceful change in society. They also gain the knowledge and skills to effectively teach mindful yoga classes and deliver workshops to diverse groups.

It is our life experiences that make us great teachers. We can only teach people from where we have gone before. Teaching yoga is a life journey, which begins with cultivating awareness of one’s mind, body and soul and a strong desire to free oneself from the bondage of suffering. When we are free, life becomes a joyous dance with the divine. The heart opens and blossoms, providing beauty and light to all.

Naseem Salila Gulamhusein is the Yoga Teacher Training Program Coordinator and Teacher Trainer at Langara College. She has taught all levels of students internationally and has instructed for yoga teacher training programs in Canada and the US. ngulamhusein@langara.bc.ca,
www.holistichealthstudies.com