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Canada is currently plagued by an opioid crisis. Opioids such as fentanyl are drugs that are commonly used to relieve pain. These drugs, however, can be extremely addictive and their misuse has led to thousands of overdoses and deaths.

In 2017, 88 Hamilton residents died from opioid overdoses. So far into this year, Hamilton Paramedic Services has already responded to 161 incidents of suspected opioid overdoses. In comparison to other cities within the province, Hamilton has the highest opioid-related death rate.

While there is no publicly available data on the demographics of opioid use in Hamilton, in general, young adults aged 18 to 25 are the most vulnerable to opioid misuse. As the rate of opioid misuse increases annually, it is imperative that students are aware of the availability of naloxone.

Naloxone is a fast-acting drug that temporarily reverses the effects of opioid overdoses until medical emergency services can arrive. As of March 2019, Public Health and the Naloxone Expansion Sites in Hamilton have distributed 2496 doses of naloxone, with 285 people reported as being revived by the drug.  

McMaster University’s student-led Emergency First Response Team and McMaster University security officers carry and are trained to use naloxone nasal kits in case of emergency situations. While Mac’s security officers only recently began to carry the kits, EFRT responders have been carrying them since August 2017.

Fortunately, EFRT has not had to use any of their kits since they began carrying them. While this may imply that opioid-related overdoses have not occurred on campus, this does not guarantee that students are not at risk at opioid misuse.

As EFRT responders and McMaster security cannot always be available to respond to students’ needs off-campus, students should be more aware of their ability to carry and be trained to use naloxone kits.

While the Student Wellness Centre does not carry the free naloxone kit, the McMaster University Centre Pharmasave located within the McMaster University Student Centre does, in addition to the Shoppers Drug Mart pharmacies located near campus. To obtain a kit, all students must do is show their Ontario health card.

The fact that this life-saving drug is so readily available to students on and near campus is amazing. It is disappointing then that the university hasn’t done a sufficient job in advertising this information to students.

Students should be given naloxone kits and mandatory opioid information and response training at the beginning of the academic term. At the very least, this information can be distributed during Welcome Week along with other orientation events.

The opioid crisis is one that affects us all, especially here in Hamilton. McMaster University should help fight this crisis by ensuring that their students are equipped with the knowledge to recognize an opioid overdose and have the necessary tools to help reverse them.


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Shloka Jetha is a woman who has always been on the move. After growing up in seven countries, the 23-year old has finally settled in Toronto and is pursuing her dream of working with at-risk youth. Part of what appealed to her about the new Professional Addiction Studies program at McMaster Continuing Education is that it’s online, which means she can set her own schedule and study on-the-go when she’s away from home.

But of course the biggest draw is the way Jetha feels the program will complement and expand upon what she learned in her McMaster degree in sociology, as well as what she is currently learning in a Child and Youth Care program at another school. With the goal of someday working in a clinical setting like the Sick Kids Centre for Brain and Mental Health, Jetha believes the more practical information she has about addiction and mental health, the better.

“I’m learning a lot in my current Child and Youth program,” Jetha enthuses, “but for me there is a bit of a knowledge gap that the McMaster Professional Addiction Studies program will help to close. It’s an incredibly complex field, every situation is new, and you need to be able read between the lines and understand the difference between what a troubled kid is saying and what’s actually going on in their life.”

Jetha believes that having the rich background knowledge the Professional Addiction Studies program will provide, and being able to link that information to her work in the field, will help her excel faster. Most importantly, she feels it will make her better and more effective at helping and healing kids in crisis.

“I’m specifically looking forward to gaining more knowledge about pharmacology, but also about other things as it’s difficult to learn on the job,” Jetha says. “I can learn a tremendous amount from the kids I work with, and that’s invaluable experience, but coming to them with a deeper knowledge base will allow me to talk with them about drugs and alcohol in a way I otherwise couldn’t.”

Jetha has been fortunate not to be personally touched by addiction, but has lost friends and people in her community from overdose. She is also familiar with the impact of this complex issue through the volunteer work she has done.

Even though this is an incredibly demanding career path, it’s one Jetha is proud and honoured to walk. She feels the good outweighs the bad and is determined to continue learning and helping as much as she can. The Professional Addiction Studies program at McMaster Continuing Education is uniquely designed to help her achieve that goal.

Applications for Spring term are open until April 29, 2019. Learn more at


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"Carrying over 50 personal health and care products, these touch-screen vending machines have been placed in Mary Keyes Residence and the Commons Building."

Read the full article here:

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Opioid abuse has become a more pressing problem in Hamilton than anywhere else in Ontario. In Aug. 2017 alone, 26 overdose calls were made to 911. Despite these statistics, Hamilton police officers have been barred from administering naloxone, a life-saving anti-opioid drug that counteracts the effects of opioids in the event of an overdose.

The McMaster Students Union, however, has embraced naloxone. In the wake of the opioid crisis gripping Hamilton and campuses across Canada, the MSU Emergency First Response Team has stocked up on the opioid treatment.

On Aug. 25, EFRT was trained to administer naloxone injections to prepare for potential overdoses during Welcome Week.

“Naloxone is a drug that isn’t incredibly dangerous if you’re injected with it when you’re not in an opioid overdose situation, and that’s another reason why our medical director said it would be beneficial to have,” said Samantha Aung, EFRT program director.

On Sept. 15, EFRT obtained the nasal spray version of naloxone. In the event of an overdose, EFRT may administer two nasal spray doses in addition to four injections. EFRT may therefore administer four more doses than the average bystander equipped with a naloxone kit from a pharamacy.

Joining a few other institutions, including Mount Allison University, the University of Alberta and the University of King’s College (Halifax), McMaster has become one of the first Canadian universities to carry naloxone.

At Dalhousie University and the University of British Columbia, students can seek out their own naloxone kit for free. When asked if McMaster should implement this initiative and do more to protect students from the growing opioid crisis, Dunavan Morris-Janzen, EFRT public relations coordinator, said he cannot directly comment on whether or not the university should have naloxone available to students for free pick-up.

EFRT may therefore administer four more doses than the average bystander equipped with a naloxone kit from a pharamacy.

“Students with an Ontario health card can acquire free naloxone kits and the necessary training to administer the drug from Shoppers Drug Mart located across Main Street West.”

Although several other Canadian universities and colleges are considering obtaining naloxone, some have opted not to carry it, primarily because of liability concerns or a lack of demand.

At the University of Ottawa, student leaders were barred from carrying naloxone kits during the university’s frosh week as a result of a liability issue that could emerge in the event of an improper injection.

“Obviously, [treatments with] needles always contain some sort of danger, but I think having the drug in general is a great thing because it does truly help people,” said Aung.

When asked if the University of Ottawa’s liability concern applies to McMaster, Aung stated that since naloxone injections are exclusively administered by EFRT, the university would not be held liable in the event of an improper injection.

“The concern at the University of Ottawa was that, as a civilian population using naloxone, there’s a chance that it’s less safe, and the university assumes that liability if student leaders are administering the drug,” she explained. “For EFRT, we were trained on how to use the needles a little more intensively than you would if you just picked up your own kit at the pharmacy. As well, because we have medical directive behind us, our medical director, in teaching us how to use the drug, assumes that we know how to properly administer it, and when we administer it, it is safe,” Aung said.

As the opioid crisis continues, both the McMaster and Hamilton community continue to develop strategies to combat overdoses and death.

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By: Michal Coret/ SHEC

University students are recommended to sleep seven to nine hours a night. Ha! That’s funny. Thanks, science. With increasing sleep debts due to schoolwork, social life and other obligations, many of us turn to caffeine as a solution to stay awake. Caffeine is the most popular substance on university campuses, and also worldwide, with approximately 70 percent of university students addicted.

So how much is too much? The maximum daily caffeine intake is often cited as 400 mg. An eight-ounce cup of coffee, depending on its intensity, can contain 40-200 mg of caffeine. When consumed within this margin, caffeine improves attention, memory, wakefulness, reaction time and athletic performance for some. Additional evidence suggests that that caffeine, in moderation, has positive effects on mood, and may play a role in weight loss. Sounds great, right?

Unfortunately, many coffee drinkers exceed this safety margin. Two cups is just with breakfast. Almost unconsciously, another three or four may be consumed to stay awake during lectures, meetings and assignments. But what are the consequences? Most of the detrimental effects of caffeine are long-term. These include heart problems, deteriorated bone health and even diabetes.

Caffeine may also have effects on the dopaminergic reward system of the brain. This is a pathway involved in drug addiction and a possible explanation for why coffee is so addictive. Withdrawal symptoms (which might appear all too familiar) include sleepiness, poor concentration, headaches and nausea. Studies done specifically on undergraduate students showed that those who drink over six cups of coffee a day sleep significantly fewer hours than their peers. It seems to be a vicious cycle.

Another consideration is that brain development related to planning and emotional control is also critical in the early 20s. Caffeine may have an adverse impact on how these brain functions develop and lead to long-term cognitive changes.

If one were to try the daunting task of leaving coffee behind, the best way to start is a gradual reduction in daily amounts of coffee. This, combined with caffeine alternatives may effectively promote long-term caffeine reduction. If you’re going for a cleanse, cold water and stretching are also good options.

But let’s not paint such a dark (roast) picture of coffee consumption. The bottom line is that caffeine — like most things in life — is best in moderation. If you are drinking three or more cups of coffee a day, running to the washroom frequently and/or wanting to reduce caffeine, there may be merit in evaluating your daily schedule and priorities to see what can be changed. Also, stress is a major hindrance to sleep. In days when sleep seems far away, considering various outlets for stress can improve your nighttime zzzs.

Caffeine alternatives

Green Tea

The most well known alternative has less caffeine than coffee and contains catechin, an antioxidant and disease fighter.

Licorice Tea

This caffeine free tea also replenishes adrenal glands, organs that respond to stress.

Prune Juice

Need something sweet? Prunes replenish your electrolytes, which can lead to increased stamina.

Chai Tea

A creamy chai tea latte will trick your body into thinking that you’re drinking coffee.

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By: Sunanna Bhasin/Opinions Columnist

I remember heading to a sports tournament with friends a few years ago and having our taxi driver educate us on what drunk driving looked like. He pointed out one car in particular, just a few metres ahead of us. It was weaving in and out of its lane in an unpredictable pattern, travelling at relatively high speeds and the driver never signalled when switching lanes. I was shocked that the driver was drunk or severely impaired, but I was sure that he or she would be pulled over as soon as a cop caught sight of the sign of reckless driving. What would follow would be a brief interrogation and a breathalyser test. If the blood alcohol content was found to be greater than 0.08 mg/ml, then it would be goodbye to the offender’s driver’s license.

It was that simple. However with the election of the Liberal government, it is a possibility that marijuana may be legalized in the near future. With legalization and easier access to the drug, there is the chance of an increase in driving under the influence involving pot. Yet, how can police monitor driving high when there is no efficient test currently available?

The interesting thing about cannabis is that its main ingredient, tetrahydrocannabinol — responsible for its psychological effects — can stay in the blood and urine days after ingestion. Unlike alcohol, which leaves the body before sobriety sets in, marijuana’s THC remains in the blood long after its effects have worn off. While taking a blood test can identify levels of active, or recently ingested THC, roadside blood tests are inefficient and time-consuming, not to mention expensive. In the time that it would take to conclude whether a driver is high, police could be missing those driving drunk. The question is should we be prioritizing one over the other?

The typical drunk driver exhibits three warning signs on the road: weaving within one lane weaving in and out of the lane and speeding. A high driver may weave within his or her lane but is less likely to display as extreme behaviour as a drunk driver. One may find reassurance in the fact that cannabis users are often aware of their impairment, and make conscious efforts to compensate for that on the road by keeping greater distances between themselves and other cars and driving more slowly. Drunk drivers, on the other hand, are often unaware of their inability to drive and do so anyway because of a false sense of confidence.

This does not make driving high less dangerous. Reaction time is affected in both cases, which can result in collisions and serious accidents. Because a stoned driver may not be displaying warning signs, the drivers around them might not realize that they should be concerned. The legalization of marijuana could add to the invisible threats drivers face daily. Surely, wrongly believing one is in control is worse than making the conscious effort to battle the impairment one is aware of being under when high.

The reality is that while both drunk and stoned drivers are a threat to road safety, so are distracted and tired drivers, and there are no tests to determine if someone is too overwhelmed with fatigue to be behind the wheel. The only way to prevent impaired driving is to continue advocating against it and educating the public on the risks. Given the research available, drunk drivers tend to do much more damage than stoned drivers, as there isn’t a clear positive correlation between traffic accidents and cannabis use, while there is a significant amount of evidence in regards to the risks of driving under the influence of alcohol. Finding a means to test for marijuana consumption would be wise nonetheless, but focusing on drunk drivers should remain the priority.

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To suggest that university students are buying into the culture of partying and binge drinking as an expected part of campus life is an all too clichéd and patronizing generalization. The myth of the “party campus” does not exaggerate the existence of large-scale frosh and homecoming house parties, but it does exaggerate their occurrences and popularity.

In popular media, post-secondary institutions are still synonymous with Hollywood depictions of young people, enjoying their newfound freedom through excessive partying, cheap beer, drugs and sexual liberation.

There’s some truth in these depictions, but they are mostly stories told about a minority of students. While this myth has not influenced the behaviour of the vast majority of students, it has created a perceived norm among undergraduates. More significantly, it has skewed measurements of how much alcohol is too much.

Binge drinking — five or more drinks for men, and four or more for women in one sitting — is inevitably part of not just university life, but young adulthood as a whole. The Canadian Campus Survey in 2004 reported that 28 percent of students across Canada are heavy drinkers, and 32 percent of undergraduates meet the criteria for “drinking hazardously.”

Even underage drinking, while clearly frowned upon, is widely accepted as an essential part of the coming-of-age university experience, and few university students would argue for strict, effective steps to be taken to end this practice.

The danger of this drinking culture does not lie in an inability to see one-time excessive drinking as a threat, but in the way its complacency prevents students who regularly drink unhealthy amounts of alcohol to recognize their behaviour as problematic.

The Reality:

McMaster participated in the National College Health Assessment (NCHA) in 2013. The study ultimately concluded that students overestimate the norm for alcohol consumption levels on campus.

When asked about the amount of drinks participants consumed the last time they “partied,” 24 percent said they didn’t drink, 29 percent of students consumed three to five drinks, and 24 percent of students consumed six to ten drinks. When asked what they thought the “typical student at Mac” drank, students estimated that 45 percent of students consumed three to five drinks and 43 percent of students consumed six to ten drinks. This data indicates that most students drink a limited amount, but many believe the majority of McMaster students drink heavier, thus promoting a larger acceptance of binge drinking, and possibly leading to a perceived need to drink more.

The vast majority of students said that they experienced at least one of the negative consequences associated with binge drinking: getting in trouble with police, non-consensual sex, unprotected sex, physically injuring someone else, or contemplating suicide. About 25 percent of students experienced other minor, negative effects associated with drinking, such as feeling some kind of regret about something they did while drinking.

Arrive and Thrive:

Raising awareness about student behaviour, substance-based or otherwise, is an important part of many campus initiatives. Arrive and Thrive is a comprehensive McMaster project that has been funded through the Mental Health Innovation Fund provided by the Ontario Ministry of Training, Colleges and Universities. The focus of the project is to help students develop approaches to deal with mental health and addiction issues, with a focus on students who are transitioning into university.

The campaign, due for a fall launch, consists of three parts. First, Arrive and Thrive Online will launch as a questionnaire designed to help students identify their current habits and coping strategies, offer immediate feedback about how their habits compare to their peers’, and suggest further resources both online and on campus if they feel that they are experiencing difficulty. The second portion, titled Pause, will allow students to meet with a professional counsellor trained in the area of substance use and addiction on a self-referred basis. The final part of the service will introduce a series of interventions and courses to support healthy habits and coping with problematic ones.

“It’s tough because you have this perception that it’s a rampant problem and if I don’t do it, I’m not conforming to the norm. But then, you don’t want to minimize those people that are in the far side of dangerous drinking,” says Arrive and Thrive Project and Research Coordinator Allan Fein.

“Most people will have a positive and fun experience associated with drinking and alcohol, and it’s the few that we really need to focus on. How do we target those people in a way that’s not demeaning to them and not putting them down and not victimizing them or blaming them, but is helping them?” added Fein.

“It’s really about a harm reduction approach, trying to take the person and say, you know, you’re a whole person, you’re not just an alcoholic, you’re not just someone who is dealing with mental health but you are a whole person and let’s deal with you as a whole person and figure out the best way for you to be most successful.”

Dr. Catherine Munn, who is also heading the project, stresses that “people drink for a reason and the reasons are unique to each individual who drinks … It’s really about educating everyone about what is healthy drinking and what is risky or problematic drinking.”

Problematic drinking habits are linked to the motivations behind the habits. Alternatives for Youth is an organization that provides services for youth with addictions. Their Executive Director, Penny Burley, referred to the 2004 Canadian Campus survey that asked students to identify the reasons they drank.

“Largely the reasons youth identify were to be social and to celebrate … when we look at the youth that we work with, often those are the initial reasons for engaging in drinking or other substance use, but overtime, for some people, it can become about anxiety, mood issues. It can become about various mental health concerns, it can be about stress, about coping. So while in the survey there are fewer people who tend to identify that’s the reason they drink. It often becomes the reason why they continue to drink.”

Burley believes that there is a need for a widespread approach that aims to educate and raise awareness about low-risk drinking guidelines and offers alternatives. “I think there’s a responsibility as a community, as a society, to work on changing that culture somewhat. And so when I look, there are university campuses that have policies and protocols to try and shift that culture — things like having dry frosh weeks. It won’t eliminate alcohol use by any means, but it gives youth an alternative.”

An Alcoholics Anonymous volunteer, who shall remain nameless due to AA policy, shared her story with The Silhouette, and the concerns she has about young people lacking the resources to recognize problematic alcohol consumption. She described what she felt separated her personal experience with alcohol from that of others around her. “If I was partying and drinking, there would be people who come to a point and they’d say ‘I’m going to bed, or I’m going home, or I’ve had enough,’ but not me. I was always looking for that next drink, always thinking about that next drink.”

“I used to come home and I’d think I was going to the bar on Friday night and even before I got there — I remember one time I was sitting there — and I was thinking about the night and I remember saying, ‘oh, I could just feel the rush of that drink and what it was going to do for me and I could talk to people and you know, be more friendly and open and not be an introvert,’ … it was a high for me even before I got the drink.”

She further stressed the importance of recognizing a problem, “It’s physical, it’s mental, it’s spiritual for us, you know. We don’t have anything left because alcohol takes everything away. And if you’re younger you have to think you’re going to save yourself all those years, all that pain, but you can’t force it on anyone. If they’re not ready, they’re not ready.”

When Arrive and Thrive makes its official launch this fall season, it will come as an invitation for students to be conscious about the choices they make. Its aim isn’t to tell students that the decisions they are making are wrong, or that there is something inherently shameful about these decisions. It will offer online questionnaires, professional help, courses and extended services in an attempt to reach parts of the student population that may be otherwise left without the outlets to ask the right questions, and seek help if they need to.

For additional information and guidelines for safe drinking, this brochure by the Canadian Centre on Substance Abuse is a good starting point. Additional information about the CSAA is available on their website.

By: Grace Kennedy

The Conservative government launched a new anti-marijuana television ad campaign that aims to warn parents about the harms of recreational marijuana use. The ad really tries to convey "science." A woman speaks in a serious warning tone accompanied by imagery of smoke funnelling through what appears to be a clear tube, which I naturally assumed was part of a bong. When the picture zooms out it turns out to be an image of the brain composed of a clear tube-like material, i.e. a really cool looking bong. I really hope the marketing firm responsible for the ad sold this idea to a head shop after.

Bong jokes aside, the ad is entirely aimed at parents, urging them to "talk to their teens" about the side effects of marijuana and visit their website.

After doing so, all I can think is, thank God I don't have a teenager with a marijuana "addiction" that I'm trying to convince to stop blazing. The website has very little useful information. However, it does have a Pinterest account with a picture of an alarm clock that reads, "Do you know what 'four-twenty' means?”

The television ad may as well say, "Hey voters, who are considering voting Conservative," because of its narrow target audience of "traditional" families and complete incompetence in providing compelling information that could alter anyone's opinion on marijuana use.

If this ad by the chance of a Hail Mary causes any teen to visit this website for help, there is no way they will spend more than 18 seconds on this brutal, uninformative page. The site is so poorly constructed that I think it's actually condescending toward parents or teens who actually want help.

Of course, the reason for this could be because there is no specific treatment for marijuana addiction and methods such as behavioural cognitive therapy have had modest success at best.

The ad is part of a $5-million campaign that has been controversial because critics have viewed it as a partisan attack on Liberal leader Justin Trudeau's stance in favour of the legalization of marijuana.

The Huffington Post reported this summer that the government spends $500 million per year on anti-drug campaigning and enforcement, and that 475,000 people have been criminally convicted in relation to the "drug" since Harper was elected. Furthermore, the main bodies representing physicians in Canada did not co-sponsor the ad, stating it was a "political football."

Health Canada's website currently states that "dried marijuana is not an approved drug or medicine in Canada," but on the same page, gives instructions for how to obtain it with the support of a physician.

I write "drug" because I think that the stigma behind criminalizing drugs, especially a softer substance like marijuana, is the real harm to society. Criminalizing drugs requires policing and judicial costs that are a burden to taxpayers, but it also poses horrible consequences to people who are criminalized as "addicts" or depend on trafficking, and then face sentences that drastically jeopardize their lives, for a substance that is arguably pretty widely-accepted.

In the U.S., 46 percent of the population will have tried marijuana by the time they graduate from high school. I couldn’t find comparable Canadian statistics perhaps because the government doesn't want to publicize that throwing money on these campaigns is like combating Facebook usage.

The war against drugs hasn't paid off, hasn't decreased drug use, and only makes life harder and dangerous for addicts and participants in its black market economy. The Conservative government's obsession with drug prevention is archaic and severely out of touch with Canadian needs.

Rachel Faber
The Silhouette

On the first day of class, the course outline for Health Sciences 4ZZ3 was thrown away. Instead of learning about advocacy, students would be practicing it.

Though the course has been running for four years at McMaster, this is the first year that experiential education has been a part of the curriculum.

Lead by professor Steven Hoffman, this class takes a problem based learning approach and applies it to global health advocacy. Hoffman explained that this benefits students by pushing them out of their comfort zones and into “doing things they have never done and probably didn’t think they ever would be doing.”

Through this hands-on approach, students have been speaking to Members of Parliament, civil society leaders, and key stakeholders about the policy options that they have been formulating. In prednisone 100 mg order to make their ideas effective and politically feasible, the students have formed an organization called Global Access to Medicines, to advocate for change and engage in global health policy issues.

Their mission is to facilitate Canada’s role in access to medicine, introducing an initiative into the existing “Orphan Drug Framework”, which regulates drugs for rare diseases.

The students saw a policy window in Canada, which has created an opportunity for them to actually make a difference. The students are proposing to give more incentive to pharmaceutical companies with something called “Priority Review Vouchers”, which will allow companies to release drugs onto the market 12 months earlier than they would normally be able to.

Orphan Drugs are expensive to invest in, and this new idea would mean huge revenue for the drug companies and large strides in the research of these important drugs for rare diseases.

Some students from the class attended a conference on Nov. 11 and 12, to which they were invited by the Canadian Organization for Rare Disorders. The goal of this conference was to make any last minute changes to the Orphan Drug Framework that CORD will be presenting to the House of Commons this winter.

The students had the opportunity to present their idea about Priority Review Vouchers in Canada, which has already been a success in the United States. They were the youngest people at the conference by a landslide, and they had a lot of great responses from academics and pharmaceutical companies who attended.

This opportunity to attend the conference has given the students “a real seat at the table,” according to fourth-year Arts and Science student Sarah Silverberg.

The students feel that the most valuable thing they are learning from this course is how to advocate, reach out and talk to stakeholders who can help them reach their policy goals. The students expressed that the process is long and tedious, and are learning just how difficult it is to form policies.

“I’ve been so excited to see my students get more confident in themselves as advocates…this is very much their campaign, not mine,” said Hoffman. The students have been surprised at the positive reactions that they are getting from MPs, Industry Canada and Health Canada.

In December, three students will be heading to Ottawa to meet with more lobbyists from Industry Canada to further discuss their ideas. These important individuals have given the students advice to shape their campaign moving forward.

Hoffman notes that this allows his students to become a part of the public discourse, “their voice is a legitimate voice.” Overwhelmingly, the students in the class admit that this course was not what they were expecting.

“I think we’ve all been surprised at how seriously everyone takes us, if we take ourselves seriously,” said Silverberg.

Hoffman explained that experiential education still remains an experiment, about whether this is the best way to deliver a course on global health advocacy, but the results have been extremely promising.

Said Hoffman, “It’s amazing to be at McMaster where this type of really innovative and wacky educational experiment is not only supported but celebrated.”


Initiative for Global Access to Medicines
Global Health Advocacy 4ZZ3


Ten years ago this week, the Canadian Access to Medicines Regime was created. Its purpose was to improve global access to medicines by allowing Canadian generic pharmaceutical companies to reproduce patented medicines at a lower cost, which could then be distributed to countries where these medicines are inaccessible.

In doing this, Canada was a global leader and tried to set an international precedent to use inexpensive generic drug manufacturing to improve access to lifesaving drugs worldwide.

Unfortunately, Canada’s leadership was short-lived. In its ten-year existence, CAMR has only been used once, highlighting its failure. CAMR procedures were found to be too cumbersome, and the only generic pharmaceutical company to ever use CAMR vowed never to try it again.

Last year, Canada had a chance to plug the holes in the original legislation. Although petty politics got in the way of the Canadian government’s chance to where to get azithromycin fix CAMR, there is still hope for improving global access to medicines. There is another option for Canada to use its strong pharmaceutical sector for the global good.

The Orphan Drug Regulatory Framework, a set of incentives meant to encourage research and development for rare and neglected diseases, is being brought to Parliament in Winter 2014. Rare diseases are those that affect less than five in 10,000 Canadians, while neglected diseases are those that disproportionately affect low- and middle-income countries, but receive little research funding. The ODRF legislation is a key opportunity for Canada to address the global disease burden.

Right now, Canadian pharmaceutical companies are not motivated to perform research on drugs for the diseases that most affect the developing world. The ODRF does not do enough to help stimulate such interest, particularly in the case for ultra-rare and neglected diseases. An additional incentive is needed so that researching these drugs is profitable for Canadian companies.

Canada should look to the United States’ in its innovative creation of Priority Review Vouchers. To provide further incentives to the ODRF, priority review vouchers can be awarded to pharmaceutical companies that develop rare and neglected disease therapies. In the regular review process, it takes Health Canada an average of 18 months to review and approve a new drug. Most of this time is spent waiting in line to begin the testing process. But under the priority review, certain drugs, such as those that target life-threatening diseases, are reviewed in just 3 months.

Priority review ensures that drugs complete the same approval processes and pass the same safety and quality testing, but without waiting in line. Priority review vouchers — which would allow companies to redeem these priority reviews for any drug — could be worth up to $300 million dollars in profits for pharmaceutical companies, since they allow for earlier market introduction of drugs.

This is a low-cost solution for the Canadian government that will increase profits for pharmaceutical companies, thus making it a financially sustainable enterprise.

Priority review vouchers will have a significant impact not only for Canadians living with rare and ultra-rare diseases, but can also have implications on global access to medicines. By incentivizing research and development on treatments for neglected diseases in addition to rare disorders, Canadian pharmaceutical companies will also be targeting the issue of availability of essential drugs to people in the developing world.

Canada has come a long way, but it still has a ways to go to fulfill its global commitments. Although the ODRF is an important step forward, but Canada needs to include priority review vouchers if it is to improve global drug access.

Canada was once a leader in access to medicines, and Canada can re-establish this role on the world stage once again.


Contributors: Asha Behdinan, Justina Ellery, Anna Foster, Esaba Kashem, Jennifer Romano, Sarah Silverberg.

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