Canadian Health Minister Ujjal Dosanjh

"It is a matter of common sense that Canada cannot be the drug store of the United States,’’ Dosanjh said. The lecture was part of the World Health Forum Series, organized by the Office for Diversity and Community Partnership at HMS and co-sponsored by the HSPH Division of Public Health Practice and the Office for Professional Education, among others.

Right now, prescription drug exports to the U.S. have plateaued at about $600 million per year. If the figure continues to grow, however, Canada may be forced to take steps to curb sales to the U.S., which are mostly transacted over the Internet, warned Dosanjh, a former premier of British Columbia who was named Canada’s top health official in July.

Just how Canada might intervene is uncertain, he said, because the regulation of doctors and pharmacists is up to the individual provinces and the various colleges of physicians and pharmacists. The federal government might be able to enact rules that prohibit doctors from writing prescriptions for patients they have not actually seen.

Prescription drug prices are sharply lower in Canada because of government price controls. As a result, many U.S. citizens, and a growing number of states and municipalities, including Boston, have programs to buy drugs from Canada for their city workers and others.

Dosanjh said he remains committed to price controls, even though some in the U.S. have suggested prices in Canada are too low and should be increased. "The system we have works well for us,’’ he said.

He spoke glowingly of Canada’s universal health care system. "It allows every single one of us to pursue our dreams without worrying about losing our homes or farms or businesses because of illness,’’ said Dosanjh.

He conceded that there are problems, including waiting lists for non-emergency services, shortages of doctors and other professionals, and no prescription drug coverage in some provinces. However, he said, the federal government has recently invested $41 billion across the country to reduce wait times, expand home care, and establish at least catastrophic drug coverage for all citizens.

Public health is an issue of growing importance in Canada, particularly since the SARS epidemic struck hard in Ontario last year. Cooperation with other nations on public health issues in general is critical, said Dosanjh, noting that Canada has developed and operates the Global Public Health Intelligence Network, or GPHIN, an Internet-based early warning system that gathers preliminary reports of public health significance in six languages on a real-time, 24/7 basis. The system has been credited by the World Health Organization for its role in the early detection of SARS, he said.

Canada announced a second-generation GPHIN system–GPHIN2–on November 17 that will be more effective at helping to identify and mobilize responses to emergency global public health threats.

--ML