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Friday, December 9, 2011 3:37 PM | CCSVI in MS Toronto Volg link

Mr. Speaker, it is my pleasure to rise in the House today to talk about the actions being undertaken by our government with regard to multiple sclerosis.

As a chiropractor practising in Oshawa for many years, I have had the privilege of treating patients who have suffered from this terrible disease. As such, I recognize, and our government recognizes, how difficult it is for people with MS and their families to live with this devastating disease.

This is why we are committed to advancing our understanding of this complex disease in order to develop the most effective treatments and, ultimately, a cure.

As members are well aware, Dr. Zamboni from Italy has proposed a new surgical procedure to treat MS called chronic cerebrospinal venous insufficiency, or the CCSVI procedure. The CCSVI procedure consists of opening veins in the necks of patients to relieve their MS symptoms.

The member for Etobicoke North has introduced Bill C-280 to legislate government action to establish, in collaboration with the provinces and territories, a national strategy on the CCSVI procedure. I need to stress that our government has already acted on a number of the initiatives proposed in the bill.

This past summer, the Minister of Health announced the establishment of a clinical trial on the CCSVI procedure. The Canadian Institutes of Health Research, or CIHR, is leading this federal initiative. In the coming weeks, CIHR will implement a rigorous and internationally peer-reviewed competition to select the team that will conduct this important research.

Our government has also been pleased to see the great interest that several provinces and territories have expressed in working with our government on this very important clinical trial. On that note, key stakeholders such as the Canadian and U.S. MS societies have also confirmed their commitment to collaborate on the proposed trial.

It is important to understand that the decision to move forward with a clinical trial must be based on scientific evidence. The CIHR scientific experts have recommended moving forward cautiously with a small clinical trial that would test the safety of the CCSVI procedure. Some people argue that the CCSVI procedure is a safe medical procedure. They have called on our government to move faster with a clinical trial on larger groups of patients.

We have to listen to what the experts have said on this matter. Experts from around the world are advising us to move cautiously. Researchers, including Dr. Zamboni himself, have called for further research on the safety and efficacy of the CCSVI procedure. A multidisciplinary panel of experts concluded at the June meeting of the United States Society of Interventional Radiology that there was not enough evidence on the specific parameters required to run a large-scale trial on the proposed procedure.

This panel recommended that “prospective safety and efficacy trials should be conducted in well defined and potentially smaller controlled populations”.

We also have to keep in mind that many Canadians have experienced complications following the CCSVI procedure. As indicated in a recent publication by Dr. Cal Gutkin from the College of Family Physicians of Canada, “Endovascular treatment is not without risk.” Hemorrhage and other complications have been reported.

Two Canadians who underwent the CCSVI procedure abroad died following the medical intervention. For all these reasons it is necessary to move cautiously with a well defined clinical trial on the safety of the CCSVI procedure. This trial will increase our understanding of the proposed treatment without putting the lives of Canadians at risk.

In this regard, I am very pleased that last month the Minister of Health and Dr. Alain Beaudet, president of CIHR, announced that CIHR is ready to accept research proposals for the phase I and II clinical trials on CCSVI. The request for research proposals is available on CIHR's website.

The second requirement outlined in Bill C-280 is to track MS patients who undergo the CCSVI procedure.

Our government, in collaboration with the provinces and territories, CIHR, the Canadian Network of MS Clinics and the MS Society of Canada, is already developing a Canadian MS monitoring system. This important initiative will provide individuals living with MS and their doctors with information to better understand this horrible disease.

As I already mentioned, Bill C-280 is also calling on the federal government to establish an advisory panel to advise the Minister of Health on the medical procedure proposed by Dr. Zamboni. Our government has already established such a panel.

Over the last 18 months a scientific expert working group established by CIHR has been reviewing research evidence from around the world on the CCSVI issue. The working group has made valuable recommendations to our government on the CCSVI issue. CIHRs scientific expert working group will continue to monitor and analyze new research evidence as it becomes available.

Bill C-280 also raises the issue of ensuring proper health care for MS patients who undergo the CCSVI procedure.

As members know, health care delivery is a provincial and territorial responsibility. Some provinces have developed guidelines to ensure that MS patients who undergo the CCSVI procedure abroad receive proper follow-up care here in Canada.

As an example, Ontario's minister of health and long-term care recently mandated an MS expert advisory group to produce guidelines on the follow-up care of MS patients. These guidelines are now available to all health care practitioners in the province of Ontario.

Our government has also worked in close collaboration with the provinces, territories and health professional associations to ensure that MS patients and their caregivers receive the most up-to-date research evidence.

For example, CIHR has been sharing research information related to CCSVI with health professional organizations, such as the College of Family Physicians, which has posted this information on its website and distributed it to all of its members.

A hotline service has also been established by our government to ensure that MS patients have access to the most recent information on MS.

Let me assure the House that we have already established strategic initiatives that will allow us to better understand the new procedure proposed by Dr. Zamboni to treat MS and MS patients.

These initiatives, along with other important MS-related research projects funded by the federal government, will increase our understanding of this devastating disease, and will lead to a more effective diagnosis, treatment, and hopefully, ultimately a cure.

Speaking for myself, I hope that this procedure is a cure for MS. But we all have to understand that it is up to us as legislators to work with the research community, not put unreasonable constraints on the research community and try to force research by legislation.

I think I speak for everyone in the House when I say that we would all like to work together to see what we can do to end this devastating disease. I want to thank the member for bringing up this issue again. She has done a lot of work to bring this issue forward to Canadians and Canadian families.

Colin Carrie, Parliamentary Secretary to the Minister of Health - November 8 2011