The Hon. Marilou McPhedran: Therefore, honourable senators, in amendment, I move:

That Bill C-29, as amended, be not now read a third time, but that it be further amended in the preamble, on page 1, by replacing lines 1 and 2 with the following:

“Whereas, since time immemorial, First Nations and Inuit peoples — and, post-contact, the Métis Nation — have thrived on and managed and governed”.

Thank you, meegwetch.

Some Hon. Senators: Hear, hear.

[Translation]

The Hon. the Speaker: Senator McCallum, I’m sorry, your time for debate has expired.

The Hon. the Speaker: Is leave granted, senators?

The Hon. the Speaker: Is leave granted, honourable senators?

Hon. David M. Arnot: Honourable senators, I rise today to speak to Bill S-232, An Act respecting the development of a national strategy for the decriminalization of illegal substances, to amend the Controlled Drugs and Substances Act and to make consequential amendments to other Acts.

Colleagues, I ask you the following: What is one of the greatest moral failures of the 21st century? My answer today is the opioid crisis. I believe I can safely predict that 50 years from now, Canadians will look back on this era and ask how legislators and policy-makers could have been so blind. How could they have steadfastly carried down a road that was so clearly leading to a dead end? I commend our colleague the Honourable Senator Boniface for putting forward this bill, as she has succinctly and convincingly argued that a national crisis deserves a national response.

Fundamentally, the impact of this national crisis on Canada is clear. The war on drugs is lost, and the cost is the lives of our fellow Canadian citizens.

Between January 1 and November 2 of this year, in my home province of Saskatchewan, the coroner’s office recorded 395 confirmed or suspected drug toxicity deaths. Over 90% of those deaths were related to fentanyl or fentanyl-like substances. As with most provinces, coroners only investigate under specific circumstances and at specific locations. Also, that data doesn’t show any of the people who were thankfully revived by naloxone, or who required an ambulance to an emergency room or hospital stay.

It has been reported that a single overdose can cost as much as hundreds of thousands of dollars, but it can be even more: A long stay in an intensive care unit for an overdose can cost millions of dollars. The costs also say nothing of the personal, familial and community impacts of substance use disorders and drug toxicity deaths. Those impacts reverberate and persist.

Data suggests this assertion. For instance, the 2019 Canadian Alcohol and Drugs Survey — released at the end of 2021 — found that in 2019, 4% of Canadians reported having used at least one illegal drug. Other research found that an estimated 3% of Canadians have used one of five illegal drugs, including cocaine, or crack; ecstasy; speed, or methamphetamine; and hallucinogens. Further, almost 18% of Canadians report that they have used an illegal drug at some point in their lifetime, with hallucinogens being the most used. In 2019, 14% of Canadians reported being harmed in the past year due to someone else’s alcohol use, and 2% reported being harmed due to someone else’s drug use.

While illegal drug use is remarkably indiscriminate as to the lives it touches, some in our country are affected disproportionately through the criminalization of illegal drug use. Earlier this year, I had a discussion with two young doctors — Dr. Shayan Shirazi and Dr. Ryan Krochak — both who are students at the University of Saskatchewan. They spoke of the increased vulnerability to substance use disorders of Indigenous peoples being framed by trauma related to colonization.

Simple possession has led to over-policing and high rates of incarceration of Indigenous peoples. Over 30% of the Canadian federal inmate population is Indigenous, despite comprising approximately 5% of the Canadian population. In 2003, the Aboriginal Healing Foundation reported:

. . . the residential school system contributed to the central risk factor involved, substance abuse, but also to factors shown to be linked to alcohol abuse, such as child and adult physical, emotional and sexual abuse, mental health problems and family dysfunction. The impact of residential schools can also be linked to risk factors for poor pregnancy outcomes among women who abuse alcohol, such as poor overall health, low levels of education and chronic poverty.

I thank Senator Boniface and Senator Pate for exploring this ongoing impact and the disproportionate incarceration of Indigenous peoples, particularly Indigenous women.

I reached out to two women from my home province of Saskatchewan this year. These women — both of them mothers — share a bond forged in tragedy. They both lost sons because of tainted drugs. Marie Agioritis lost her son Kelly Best due to a counterfeit OxyContin pill laced with fentanyl in 2015. He was described as living “a life full of fun, love, laughter, plans, dreams, friends, and family . . . .” and had aspirations of becoming an electrician. Kelly was only 19 years of age. Ms. Agioritis pointed out to me that, in war, the first objective of peacekeepers is to deal with trauma. She also told me that there are too many talking points and not enough actions. One all-too-common and painful talking point that she hears about those substance abuse disorders is the old saw, “If you mess with the bull, you’ll get the horns.”

I am told that the youth of today do not believe this and that their perspective is different. I believe that youth are a source of hope; at the same time, they are the low-hanging fruit in a national strategy for education that is evidence-based and not driven by misinformed public opinion or tainted by the “if you mess with the bull, you get the horns” ideology.

Like Ms. Agioritis, Jenny Churchill is a tireless advocate for public education, supports and a medical-model view of substance use disorder. Ms. Churchill lost her son Jordan in 2018 due to a fentanyl overdose.

For her, a successful national strategy will be responsive primarily to the needs of three groups of Canadians: those with substance use disorders, people who use substances recreationally and the youth cohort.

Both Marie and Jenny are members of the Moms Stop the Harm group, a Canada-wide network of moms and families advocating for evidence-based treatment and policy change. They want policies and a national strategy that would do three things effectively: one, save lives; two, reduce health care costs; and three, reduce criminal behaviour on the streets.

A partnership research project with Moms Stop the Harm reported that over 19,355 Canadians died from opiate overdose between January 2016 and September 2020. A unique aspect of this research is that it involved those who had lost a loved one to an opioid overdose, mostly moms, almost half of whom experienced stigma or judgment from their peers after the death of their loved one.

Decriminalization is not a cure-all for that kind of pain or for drug supplies that are increasingly adulterated and contaminated by fentanyl and its analogues.

What decriminalization does is provide a venue for an individual — a person, a Canadian citizen — who uses or may be addicted to illegal drugs to be seen first as an individual, a person and a Canadian citizen.

The Canadian state has a vested interest in the health and well-being of all its citizens. The federal government has a duty and moral obligation to every one of its citizens. This is evident when government agencies work hard to repatriate Canadians stranded because of a global pandemic or conflict and war.

The war on drugs, by most accounts, is either an abject failure or a losing battle. We are losing because the war on drugs is most often a war on people whose lives hang in the balance. A recent study by Scher et al. found that “. . . Canada’s drug laws may shape public attitudes toward people who use drugs . . .” and create the resulting “. . . structural, social and self-stigma experienced by people who use drugs.”

As Dr. Harry Rakowski, a senior cardiologist at the Peter Munk Cardiac Centre and Professor of Medicine, University of Toronto, asserted, “We keep losing the war on drugs because we are fighting the wrong enemy.” He argues that Canada needs to address the antecedent issues, harms, traumas and root causes. I agree that this is a necessary step. However, without a national conversation and strategy, we will not be able to address the root causes or challenge the concerns of those who argue for continued criminalization — concerns such as an increase in drug use; impacts on public safety, youth and international relations; and limited treatment infrastructure.

A truism about the justice system is that it is inherently reactive and only rarely proactive. I believe that Bill S-232 will create a national strategy for the decriminalization of illegal substances and will be an opportunity to be proactive in stopping the harm created by failed drug policies.

Dr. Shirazi and Dr. Krochak provided me with a well-researched brief in which they stated:

Canada’s drug toxicity crisis is a complex issue with no single or immediate solution; however, it is well established that substance abuse disorders are a medical issue, not a criminal one. Canada is not going to arrest its way out of its drug toxicity crisis. Ultimately, decriminalization is a policy that will save the taxpayer money, fight the drug toxicity crisis and, most importantly, save lives.

Experts have been clear, however, that decriminalization is not an ultimate solution, but may be a necessary step. This bill takes an important and necessary step toward finding solutions. It recognizes that substance abuse disorder is a public health issue and not a criminal justice matter.

Canada has a moral obligation to help individuals and our society through legislation and law, including in regard to offences under the Controlled Drugs and Substances Act.

Five years ago, the Canadian Association of Chiefs of Police released a statement supporting:

. . . decriminalization strategies such as increasing diversionary opportunities, alternate sanctions and health partnerships, while exploring the evolution of harm-reduction techniques such as safe supply and supervised drug consumption sites.

The national conversation Bill S-232 proposes must consider the research and data that finds decriminalization is a means of harm reduction and, in turn, of enabling positive health outcomes.

Dr. Rebecca Seliga, a member of the University of Ottawa Department of Emergency Medicine, summarized this by stating:

While some may argue that decriminalization is just a buzzword alone, we already know that its counterpart, criminalization, does not work.

Colleagues, it is time for the conversation to begin in earnest; it is time for a national response to a national crisis. I support Bill S-232 and hope it will be sent to the committee as soon as possible. Thank you.

[Translation]

Hon. Pierre-Hugues Boisvenu: I rise today as the critic for Bill S-232, An Act respecting the development of a national strategy for the decriminalization of illegal substances, to amend the Controlled Drugs and Substances Act and to make consequential amendments to other Acts, which was introduced by the Honourable Gwen Boniface.

Honourable colleagues, Bill S-232 addresses an alarming and worrisome public health issue in our country. Drug use continues to kill many Canadians every day, and it impacts the health of thousands more. Some of the deadliest psychoactive substances are the notorious opioid analgesics, such as heroin and fentanyl.

According to the Canadian Alcohol and Drugs Survey, CADS, 4.4 million Canadians aged 15 and up reported having used opioid pain relievers in 2019, up 12% from 2017. Of those 4.4 million people, 269,000 reported problematic use of those drugs. According to the Government of Canada, there were 3,556 opioid-related deaths from January to June 2022, an average of 20 per day. Of those deaths, 76% were caused by fentanyl overdose.

Yes, the opioid crisis in Canada is raging, but we must not lose sight of the impact of other types of illegal drugs on many Canadians. According to CADS, in 2019, 1.1 million Canadians reported having consumed drugs in one of the following six categories: cocaine and crack, speed and methamphetamine, ecstasy, hallucinogens, heroin and salvia. In Quebec, those drugs killed seven times more users than fentanyl from January to April 2022.

Drug use not only kills people, it also has major impacts on the lives and health of drug users. In addition to their harmful mental and physical effects, drugs can insidiously compromise the user’s social, professional, intimate and financial life. For some, life spirals out of control and, sadly, they end up homeless. In 2019, over one million Canadians reported that drugs had negatively impacted their own lives.

Drug use also affects crime rates linked to family violence, theft and sexual assault. Honourable senators, drug use is a serious public health problem in Canada. It deserves more of our attention so that we can come up with constructive solutions to help people struggling with hard drugs and to effectively fight traffickers, who exploit human misery for profit and must be held accountable for the many lives lost.

In Canada, we may need to consider the sale of deadly drugs as nothing less than premeditated murder. Bill S-232 is a legislative response to the substance abuse problem that I just described; according to the critic, it has two objectives.

The first objective is to require the federal government to consult with the provinces and territories in order to present Parliament with a national strategy for the decriminalization of all drugs. The second objective is to amend the Controlled Drugs and Substances Act, to repeal the provisions that make possession of certain substances an offence. In other words, we are talking about decriminalization from a purely legal point of view.

In my view, a third objective is missing from Bill S-232. It should include a provision requiring the government to develop a concrete public health strategy that provides for detox before decriminalization.

While I applaud Senator Boniface’s useful work and the laudable objectives of her bill, I believe that the approach of outright decriminalization of drugs is premature and that it only partially addresses the problem.

In her speech at second reading, the senator indicated that the part of the bill seeking the total decriminalization of simple possession through the repeal of drug law sections would be done by an order-in-council issued by the Governor in Council, and according to their wishes, after the strategy is finalized so it can be put in place, if this bill passes.

When it comes to public health, it is rare to see anyone want to decriminalize anything while waiting to see what happens later. That is this government’s strategy. Decriminalization for the Trudeau government is not a public health strategy; it is dogma.

The senator’s approach is certainly prudent. However, I would like to state an important caveat on this point: Nothing in the bill states that this strategy, which is apparently complete and takes all challenges and perspectives into account, has to be implemented and analyzed first before the possibility of decriminalizing all drugs can be considered.

I think it is premature and even dangerous to consider passing a bill that proposes repealing sections of the law that criminalize simple drug possession at this stage of the process, when no complete strategy has been implemented, which might well take years to happen.

This is an important point, colleagues, because the bill we are studying does not set any legislative framework to decriminalize drugs. As a result, any possession of any illicit drug for personal use will no longer be considered criminal, regardless of the nature of the substance and the quantity in possession.

It is important to keep in mind that the purpose of the bill is to prevent drug overdose deaths, which are largely attributable to a bad supply that is extremely dangerous.

People use illicit drugs without knowing what is in them or where they came from. Often the user is not aware that those drugs may contain all sorts of harmful or deadly substances, such as fentanyl-type opioids or fentanyl analogues. That is especially true of crack.

I would like to share with you a sad incident that occurred last Friday in Laval to demonstrate how dangerous Bill S-232 is and how it could give drug users and the population in general a false sense of security.

I am talking about the murder of 61-year-old Mireille Martin. I want to take this opportunity to express my deepest condolences to her family and friends. Mireille Martin led a quiet life in an apartment building near her nephew, Jérôme Frigault, an ordinary young man in his 30s. According to his best friend, Jérôme regularly took methamphetamine tablets, commonly known as speed. Late last Thursday, the Laval police went to Ms. Martin’s address after receiving a complaint about excessive noise coming from her apartment. They left without taking any action. Two hours later, Mireille stumbled out of her apartment bleeding and died on the sidewalk after being stabbed to death by her nephew, who was in a psychotic state.

She was yet another victim, another case of femicide. To date, 2023 has been a record year in Quebec for this type of criminal death. Was this murder preventable? Possibly, given that the police who arrived at the scene two hours prior to the tragedy would have likely noticed the murderer’s agitated state. Why did they not remove him from the building or take him to hospital until he calmed down? The investigation will undoubtedly shed light on this horrible tragedy, or at least I hope it will.

This is a compelling example of why I fear decriminalizing all drugs, especially the deadliest ones. This bill gives drug users and politicians alike a false sense of security. What is more, it throws the door wide open to drug dealers.

It is all the more disturbing to note that the more lethal the drug, the smaller the quantity consumed. Therefore, most of the time, it is difficult to prove that the quantity of drugs seized was for the purpose of trafficking.

I would like to give you another example of how young people interpret the decriminalization of dangerous drugs as normalization. According to today’s edition of La Presse, the number of Quebec teens using illegal vapes to consume cannabis has exploded over the past four years, tripling since 2019. According to doctors, vaping cannabis increases the risk of addiction and mental illness.

According to a 2023 survey of approximately 24,000 adolescents, 12% said they use cannabis, compared to 15% in 2019. However, 66% said they vape cannabis, compared to 20% in 2019. Teens acquire cannabis vapes on the black market because it is illegal to sell them to anyone in Quebec, even adults.

Some of these devices are rechargeable, while others, called wax pens, are disposable. Some schools report students fainting after using them. The fact is, the vape juice these young people are consuming can contain as much as 90% THC, compared to the 30% maximum in products sold by the Société québécoise du cannabis.

This desired decriminalization, regardless of its potentially deadly risks, will undoubtedly lead to the same outcome as the legalization of cannabis, a drug with an illegal market that still controls 50% of sales today. This means that 50% of consumers buy cannabis of uncontrolled quality and origin.

This highly touted decriminalization will have little impact on death tolls or lethal drug trafficking, because, for the past eight years, the federal government has failed to implement any kind of strategy to guide consumers to public health services for detox support, like Portugal did when it introduced a detox strategy prior to decriminalization. Portugal’s strategy was a success. To do otherwise and believe we could achieve the same result is totally irresponsible.

Bill S-232 takes a somewhat simplistic and especially dangerous view of Canada’s illegal drug market. We have a duty to do better. Most importantly, we have an obligation to avoid making the situation worse by putting more lives in danger.

Bill S-232 in no way addresses the issue of minors. I would remind my colleagues that the Controlled Drugs and Substances Act and the Criminal Code apply to anyone aged 12 or over, and that the Youth Criminal Justice Act does not contain a specific provision criminalizing drug possession. Without important clarifications, Bill S-232 will allow adolescents to possess any type of psychoactive substance in undefined quantities, without giving the police or judicial authorities any powers to prevent or dissuade teens from using them. This important aspect must not be overlooked, in order to avoid any unintended consequences to Senator Boniface’s desired objective.

Honourable senators, I will quote another passage from Bill S-232, but first I would like to point out that I’m opposed to the very principle of this bill.

In my opinion, the decriminalization of all drugs runs contrary to the balance that is needed between the problem of drug addiction and criminal justice objectives.

Now I’d like to talk about how the justice system has already adopted diversion measures for drug possession over the past 10 years.

Currently, our justice system is adapting more and more to the drug addiction issue. You will recall that Bill C-5, which we passed on November 17, 2022, provides diversion measures for simple drug possession in the Controlled Drugs and Substances Act.

Three new paragraphs that came into effect with the passage of Bill C-5 read as follows:

I would also remind senators that the Criminal Code and the Controlled Drugs and Substances Act already contain provisions granting discretionary power to the justice system to delay sentencing so that a person who has been found guilty of an offence can participate in a drug treatment court program. If that program is successful, the offender may receive a reduced sentence. What is more, if the offence is punishable by a minimum term of imprisonment, the court is not required to impose that minimum prison sentence.

I would like to quote subsection 10(4) of the Controlled Drugs and Substances Act, which states the following:

Finally, the Public Prosecution Service of Canada Deskbook already contains directives on how to deal with the opioid overdose issue. Here is one of them:

The Guideline seeks to avoid short durations of incarceration for violation of bail conditions by accused with a substance abuse disorder. This Guideline was created in order to address the epidemic of opioid overdoses through a targeted focus upon the risk of opioid-related overdoses by those with a substance use disorder.

The examples I have just cited demonstrate the pragmatism currently being shown by the Canadian justice system. The balance it has subtly attempted to strike over the years between the problem of drug addiction and the objectives of criminal justice shows a willingness to adapt to the addiction situations experienced by drug users. In my opinion, it is inappropriate to remove the important role played by the justice system and to treat the problem of drug addiction as a public health issue. In fact, this bill is almost a decade behind the Canadian justice system.

Honourable senators, possible exemptions under the current law already exist. These exemptions allow the Minister of Health to identify cases and conditions under which possession of narcotics for personal use can be acceptable in our society. These exemptions help ensure some degree of control, with an opportunity to set guidelines for drug possession, while recognizing specific needs and authorizing the tools and means to support harm reduction among certain populations, for example, by establishing safe injection sites.

These injection sites exist almost everywhere in major Canadian cities. People can show up to these sites and consume narcotics. These centres provide people with a safe place, with sterile consumption equipment, where health professionals are on hand to respond to emergency situations.

The exemption set out in section 56 of the Controlled Drugs and Substances Act allows the staff to possess small amounts of controlled drugs in the course of their professional activities. Analyses to test the composition of a drug can also be performed before clients of these centres consume their drugs, thus preventing accidental deaths due to the presence of undesirable substances. Some users can also obtain medical prescriptions for the consumption of controlled substances under medical supervision, under this exemption to the law.

That is the approach taken by British Columbia, which requested and obtained an exemption to be able to experiment with the decriminalization of drugs at the provincial level. That exemption is valid until January 31, 2026.

British Columbia is being hard hit by fatal opioid overdoses. Thanks to this exemption, in British Columbia, any adult can possess 2.5 grams of four types of illegal drugs: opioids, cocaine, methamphetamine, and MDMA. Moreover, this exemption does not apply in certain locations, such as elementary and secondary schools, child care facilities, airports and aboard Canadian Coast Guard ships and helicopters.

Honourable senators, given that exemptions already exist in the Controlled Drugs and Substances Act and that the justice system is adapting each and every year to the problem of addictions, I do not consider it either useful or responsible to remove the role the justice system plays in addressing this problem.

I agree with Senator Boniface that we need a national strategy that provides better social services and more support to users, who should also be offered medical treatment.

Decriminalization could never be the ultimate solution to the drug addiction problem for the reasons I have already outlined.

In my analysis, Bill S-232 in its current form is a far too simple a response to a very complex problematic situation.

Most importantly, it does not include plans for a real public health strategy to combat drug addiction. This bill risks creating even bigger problems if a comprehensive strategy is not developed before we think about decriminalizing drugs.

Decriminalization should only happen if it is truly a desirable solution, after comprehensive studies and analyses have been conducted. That is not yet the case.

Let’s hope we will have the opportunity to address these issues in committee soon. Thank you very much.

[English]

The Hon. the Speaker: Would you take a question, Senator Boisvenu?

The Hon. the Speaker: Would you take a supplementary question, Senator Boisvenu?

Hon. Andrew Cardozo: Honourable senators, this item is adjourned in the name of Senator Martin. I ask for leave of the Senate that, following my intervention, the balance of her time to speak to this item be reserved.

The Hon. the Speaker: Is leave granted?

An Hon. Senator: Leo Housakos.

Hon. Senators: Hear, hear!

[English]

Hon. Michael L. MacDonald: Honourable senators, I am pleased to join the discussion today on Bill S-273, Chignecto Isthmus Dykeland System act, tabled by our Maritime colleague Senator Quinn. I rise as the critic of this legislation.

For those less familiar with topographical terminology, an isthmus is a narrow strip of land separating two expansive bodies of water and connecting two larger landmasses. As Senator Cotter accurately pointed out in his speech, “isthmus” certainly qualifies as one of the most difficult words to pronounce in the English language, at least for those of us who speak English as our first language. It is no wonder Maritimers have always euphemistically referred to the general area as the Tantramar Marshes. It’s so much easier to pronounce.

There are four distinct and significant isthmus formations in Canada: the Isthmus of Avalon, connecting the Avalon Peninsula with the main portion of the island of Newfoundland; the Sechelt Isthmus, on B.C.’s Sunshine Coast; the Niagara Isthmus, separating Lakes Erie and Ontario; and, in this case, the Isthmus of Chignecto. The Chignecto Isthmus separates the Northumberland Strait in the Gulf of St. Lawrence from the Bay of Fundy to the southwest, and it connects the provinces of Nova Scotia and New Brunswick.

But this 13-mile-wide strip of land connecting Nova Scotia to the North American continent exists in unique circumstances. As the only land link between Nova Scotia and the mainland of Canada, it serves a vital role to industry and our economy, with over $35 billion in trade transiting the corridor annually, as well as 15,000 vehicles daily and millions of people annually.

All roads and rail service, fibre optic telecommunications and pipelines depend on this corridor. It should also be remembered that this highway access is almost as important to Newfoundland as it is to Nova Scotia. What makes the area of immediate structural concern, however, is that it sits on land only slightly above sea level, and that land, while very fertile, is also very flat. This vulnerability presents a particular risk that must be mitigated, especially with the Bay of Fundy subjecting the area to the highest and strongest tides in the world.

I’ve heard repeated references to climate change, but I remind honourable senators that the rising nature of the Atlantic Ocean has been around long before the term “climate change” was coined, and the practical necessity of diking this land and protecting this unique coastline has been evident for well over three centuries.

Senator Quinn provided this chamber with a useful overview of the history of the dike land systems established by the Acadians beginning in the late 17th century. They built a series of earthen dikes to protect agricultural lands from the ever-active tides of the Bay of Fundy. Many of these earthen dikes remain, although they are only a couple of feet high for the most part.

When the New England planters arrived to farm the vacated land beginning in 1759, they revived and expanded the existing agricultural dike lands over the ensuing decades, building bigger dikes, culminating in the building of the Wellington dike between 1817 and 1825, which protects over 3,000 acres of prime farmland and is over 50 feet high and 120 feet at the base.

In 1948, after persistent pressure from Maritimers who recognized that the dike lands required significant enhancements, Parliament passed the Maritime Marshland Rehabilitation Act, which obligated the federal government to pay 100% for the construction and reconstruction of dikes and dams in the area. Now, 75 years later, these are the same dikes that need to be replaced, upgraded or reinforced at an estimated cost of $650 million. I think all my Maritime colleagues would agree that we have been experiencing severe weather events in our region at an alarming frequency — certainly more frequently than I can remember in my lifetime. As you recall, this summer Nova Scotia experienced record-shattering rainfall during a 24-hour period in July with some areas receiving nearly 10 inches of rain. That’s 250 millimetres. This is rainfall of historic proportions.

Atlantic Canadians have also been experiencing increased threats from hurricanes in recent years. With ocean surface temperatures rising along the eastern seaboard, scientists have noted the Atlantic coast is becoming a breeding ground for tropical storms and hurricanes sweeping north. They are increasing in intensity and they are increasing in frequency, bringing with them heavy wind, rain, dangerous ocean swells and leaving a trail of destruction behind for Atlantic Canadians.

Colleagues, when you add the severity and frequency of these weather events to the reality of rising sea levels, it’s understandable that the governments of New Brunswick and Nova Scotia and the residents have increased anxieties about the adequacy of the dike system at Chignecto.

What would happen if there was a failure of the dated infrastructure? What if, suddenly, that narrow piece of land — vital for trade, a utility corridor for this country and a lifeline for Nova Scotia and Newfoundland — became compromised and impassable? We can only imagine the result would be devastating for our national economy, our industries as well as the people and businesses of Nova Scotia and Atlantic Canada.

Since the federal government has the responsibility for interprovincial trade, the New Brunswick and Nova Scotia governments believe that Ottawa should take on 100% of the cost. But the federal government is only offering to cover 50% through the Disaster Mitigation and Adaptation Fund. This is not only unfair, it is unjust and it is unequal. What Senator Quinn has proposed with this bill is to declare the dike land systems at Chignecto to be for the general advantage of Canada, a policy principle that has its foundation in our Constitution and which allows for the federal government to assume jurisdiction over works which it deems to be in the national interest.

Senator Quinn rightly points out that the Fathers of Confederation provided Parliament with a declaratory power to determine works that are in the national interest, transferring jurisdiction for those works to the federal level. And what Senator Quinn is proposing is not unprecedented.

For years, the American-Canadian border at Windsor and Detroit has served as Canada’s single business and commercial land corridor between our two countries, but the privately and American-owned Ambassador Bridge was the sole access for road traffic, and it could often be congested to the detriment of both commerce and the movement of people.

In 2012, the Harper government resolved to fix the problem with the decision to build the Gordie Howe International Bridge, which will open in 2025. It wasn’t required to adopt any declaration to build the bridge as all international crossings are the responsibility of the federal government and the demand for a new bridge had been around for a long time. The $4-billion structure would be paid for through its tolls, a user-pay approach that I have always supported in principle where and when it makes sense.

Then in 2014, the Harper government enacted the New Bridge for the St. Lawrence Act, in which it declared the Champlain Bridge in Montreal and related works to be for the general advantage of Canada. The very busy original Champlain Bridge was found to be structurally unsound, but the Government of Quebec and the City of Montreal said they couldn’t afford to pay for the new bridge. However, unlike the Gordie Howe International Bridge, this is unquestionably a provincial matter. Municipalities are creatures of the provinces, and municipal bridges are simply not the responsibility of the federal authority in this country. But the need was urgent, hence the decision of the Harper government to assist in the construction of the new Champlain Bridge.

However, the federal government also declared that its commitment came with the understanding that the bridge would be tolled and that the federal taxpayer would be reimbursed for the upfront costs of the new Champlain Bridge. I agree wholeheartedly with that economically responsible approach, which solves an immediate problem but also respects divisions of power under the Constitution.

After the election of the Trudeau government, they dropped the reasonable and financially responsible decision to toll the new bridge. Instead, the new Trudeau government gifted to Montreal an expensive and important piece of infrastructure that is unquestionably a municipal and provincial responsibility. The new bridge is to be paid for exclusively by the Canadian taxpayer with the considerable price tag of $4.2 billion.

Colleagues, I think the Champlain Bridge is of vital importance to our economy and that it was a sound initiative by the federal government to replace the aging original structure. However, I also believe the Trudeau government should have done the fair, equitable, honourable and financially responsible thing and kept the tolls on the bridge. Since they established this precedent, all regions, provinces and Canadians should be treated equally in matters of this nature.

For reference, compare the issue of management regarding the new Champlain Bridge to that applied towards the Confederation Bridge connecting Prince Edward Island to the mainland. I remember that project very well. The late Stewart McInnes was the then-minister of public works, and I was the executive assistant when the decision was made to build the Confederation Bridge. The government had a foundational obligation going back to 1873 to provide transportation infrastructure to Prince Edward Island, which traditionally meant a ferry service.

Why is it fair today for Prince Edward Islanders and those who visit the Island to continue to pay tolls while other bridges paid for by the federal government are exempt, especially when infrastructure like the Confederation Bridge is actually the responsibility of the federal authority? These are reasonable questions.

Canadians today are finally realizing that financial responsibility and the Trudeau government repel each other like the same poles of a magnet, and their latest scheme regarding selective tax exemptions for home heating illustrates that fair and equal treatment of Canadians appears to be something beyond their capacity.

I would be remiss if I did not note that the Nova Scotia capital has two bridges spanning Halifax Harbour, funded by the provincial and municipal governments, paid for and maintained by the tolls charged to those who use the bridges — no federal money for these bridges and no removal of our tolls. I don’t begrudge any municipality, any province or anyone in this country anything if it makes life a little better for all concerned, but it’s time we return to a government that didn’t treat Canadians differently in different parts of the country. Canadians deserve better than this.

Given that the $4.2-billion Champlain Bridge serves as a vital economic corridor with approximately $20 billion worth of goods crossing from the island of Montreal to the south shore of the St. Lawrence, I share the view that this is a justifiable federal investment, but the precedent has been set. In the interests of regional fairness, the same logic should be applied to vital infrastructure of national interest in the Maritimes. The Isthmus of Chignecto is a critical choke point with $35 billion of annual business, and the cost of the proposed solution is merely one seventh of the cost of the Champlain Bridge. The federal government should step up and do its job and stop prevaricating.

It’s not uncommon for Maritimers to be forgotten or treated like second-class citizens by governments in Ottawa. In fact, it was foreseen by our Fathers of Confederation. When John A. Macdonald and the Fathers of Confederation met for two weeks in Charlottetown, a full six days were spent solely on the creation of the Senate and its composition. They established a Senate that is formed on the basis of regional representation. Although we are appointed by province, our representation is regional, and we have to remind ourselves that one of our duties is to ensure regional fairness.

I have no doubt that the protection of this vital corridor is in the national interest, and I commend Senator Quinn for taking the initiative with this bill and supporting its advancement. So let’s get it to committee so we can ask the important questions. Let’s ask about the vulnerability of the dike system to weather events and the consequences of this land link being washed out.

Let’s ask how it would affect interprovincial trade and the industries that rely on the railway and highway or how international trade would be affected if the Port of Halifax could not import and export as usual. Let’s ask how Newfoundland would handle being cut off from its major supply line.

Senator Cormier indicated in his speech that he has some concerns about the federal use of the declaratory power of the federal government, and quoted our esteemed former colleague André Pratte as a source for his uncertainty. I don’t recall hearing these reservations being expressed when it was announced that the federal taxpayers would pay for the new Champlain Bridge, so perhaps his views have been modified in the meantime. However, I submit these reservations are esoteric concerns, and the real issue now is one of equal treatment for regions of this country, something which should be top of mind for every senator.

Colleagues, let’s send this bill as soon as possible to committee for further study. Canada has an isthmus to protect and preserve. Thank you.

Hon. Jim Quinn: Would the senator take a question?

An Hon. Senator: No.

The Hon. the Speaker: Is leave granted?

Hon. Marie-Françoise Mégie moved second reading of Bill S-280, An Act respecting a national framework on sickle cell disease.

She said: Honourable senators, I rise today to speak to Bill S-280, An Act respecting a national framework on sickle cell disease.

This has already been discussed in Parliament. In 2011, in the other place, MP Kirsty Duncan tabled Bill C-221, meant to implement a comprehensive national strategy for sickle cell disease and thalassemic disorders.

Unfortunately, that bill never made it past first reading. Building on MP Duncan’s commitment, our colleague Senator Cordy introduced Bill S-211 in this chamber, designating June 19 as National Sickle Cell Awareness Day. That bill received Royal Assent in December 2017.

Thank you, Senator Cordy.

[English]

This disease has several names.

[Translation]

In French, it is known as “drépanocytose,” from the Greek word drepanon, meaning “sickle” or “crescent.” In English, the name used is “sickle cell disease” or “sickle cell anemia.” All these diverse terms are commonly used, but for the purposes of my speech, I will use the term “sickle cell disease.”

[English]

What exactly is this disease?

[Translation]

To help you understand it, allow me to make a brief foray into the world of medicine. Don’t worry, I’ll make sure that my remarks don’t wear you down too much at this late hour.

This disease has been around since time immemorial. It was described for the first time in medical literature in 1910 by American doctor James Herrick, and its genetic basis was established in 1949 by James Neel.

[English]

It is: enetic, rare, chronic and multisystemic. It affects the quality of life, and it decreases life expectancy. It’s a death sentence.

[Translation]

It is a hereditary disease. It can’t be caught like a cold. It is passed down by the parents when the child inherits genes from both parents. Roughly 5% of the world’s population carries the gene, also called a trait. In some parts of the world, that percentage rises to 25% or more.

With respect to prevalence, the disease affects roughly 6,000 Canadians. Dr. Yves Giguère, director of Quebec’s newborn screening program, says it is a rare disease, occurring in one in every 2,000 births in Quebec.

Sickle cell disease is prevalent among persons with ancestors from Africa, the Caribbean, the Middle East, Central and South America, some regions of India and the Mediterranean. According to a study published in 2023 by Jacob Pendergrast and his colleagues at the Toronto General Hospital Research Institute, “The estimated prevalence of patients with sickle cell disease in Ontario [between 2007 and] 2016/17 was 1 in 4200,” and affected patients’ need for hospital-based care is substantial.

This is a chronic and multisystemic disease: It is present at birth, it lasts a lifetime and it affects every organ in the body.

Sickle cell disease is a genetic disorder that affects hemoglobin, the protein in red blood cells that transports oxygen. Abnormal hemoglobin results in abnormally shaped red blood cells. Red blood cells are usually disc-shaped and flexible, but in people with sickle cell disease they become crescent- or sickle-shaped, thus the name of the disease. These sickle-shaped red blood cells are rigid and can block small blood vessels, a condition known as vaso-occlusion. Normal red blood cells can live up to 120 days, but sickle cells live only for about 20 days, which can cause severe anemia. Every organ in the body can be affected because they all require adequate blood flow. They are not getting the oxygen they need, which is what causes the various symptoms and complications that I am going to tell you about.

The most common clinical symptoms of sickle cell disease are vaso-occlusive crises, which can cause medium-intensity to intolerable chest, bone and joint pain that often requires frequent hospitalization. The person affected can also get infections that can lead to sepsis or death, if they are not treated immediately. That is all I will say about that.

One of the most common complications of sickle cell disease is stroke. One in ten sickle cell disease patients under the age of 20 have a stroke. They also suffer from pulmonary hypertension, which means that they need daily oxygen for the rest of their lives. Another complication is kidney failure, which means the patient will need dialysis and so on.

In terms of reducing life expectancy, the treatment of sickle cell disease has evolved over the years, and life expectancy has improved. In the 1970s, life expectancy was estimated at five to 10 years. These days, many patients who receive appropriate treatment can live into their sixties, which is still markedly shorter than the general population.

This is just an estimate because we don’t have the evidence.

Ismaël, a 35-year-old man who expects to live to about 50, said, “I have already lived half my life, if nothing changes.”

[English]

Why talk about sickle cell disease today? It’s unknown, underdiagnosed, lacks research funding and causes premature death.

[Translation]

According to the Sickle Cell Disease Association of Canada, this disease is the most common of all genetic diseases. Nonetheless, it remains relatively unknown to the public and even to health care professionals. Only the health care teams at specialized centres in Canada’s major cities have professionals who are familiar with the disease and can provide adequate care to patients. This lack of knowledge has many consequences, including the name of the disease. Some francophone families who only know the disease by the French name “drépanocytose” have had a hard time making themselves understood in English-speaking hospital environments.

Even when families use the correct terms, care providers do not always give them the attention they need, blaming everything on parental anxiety. Ignorance of the disease’s manifestations also leads to limited access to appropriate care.

As soon as their children develop a fever, parents are instructed to take them to hospital immediately, as they are at risk of developing life-threatening sepsis. However, it’s not easy to make this clear to the professionals who receive them in the emergency room. Excruciating chest, bone and joint pain cannot always be alleviated by regular painkillers, so the use of narcotics may be required. These adolescents are often labelled as “drug addicts” in the emergency room, and pain treatment is then delayed, with the risk of serious complications. For many of our suffering young patients, inadequate care and stigma is their lot in life.

Along with the physical symptoms, their mental wellness is considerably compromised. Repeated hospitalizations and difficulty holding down steady employment take a heavy toll on patients’ self-esteem. Parents are forced to stand by, powerless, as their child experiences angry outbursts and sadness that can morph into depression.

The emotional challenges lead patients like Mamadou to wonder why they are not normal and why they are always in bed, why their legs and arms hurt so much, why they spend 18 hours a day crying on and off, why they wake up every morning feeling like there is a cloud hanging over their heads and not knowing what is going to happen to them today or tomorrow.

Ismaël says, “It’s hard to plan long term because my life has an all-but-definite expiration date.”

Then, a parent speaking from his own experience testified about the devastating effects this disease can have on daily life and family well-being. He said the following:

The hospital has become our second home, which hinders our ability to plan our work schedule, our vacations, in short, to enjoy a certain quality of life.

Some families have to choose a different career path in order to live near centres where health care professionals know the disease.

I will now talk about the lack of research funding.

The Interdisciplinary Centre for Black Health in Ottawa is studying the mental health of patients and their families. Applications for research grants from hemato-oncologists and other specialists in the field keep being turned down by funding agencies. Although sickle cell disease was the first genetic disorder to be identified, advances in treatment have been slow to follow. This is largely due to a lack of research funding.

Many specialists compare sickle cell disease and its associated challenges to other genetic disorders, particularly cystic fibrosis. These two disease have some similarities. They are both rare, chronic, multisystemic disorders that reduce life expectancy. However, there are major differences between the two when it comes to the funding allocated for research, a registry and therapeutic advances.

The Cystic Fibrosis Canada website shows that scientists receive many research grants, some valued at up to $100,000 a year. However, the Sickle Cell Disease Association of Canada website shows that only two small grants are available: two individual grants in the amount of $20,000 per year for up to two years, and two additional grants in the amount of up to $5,000 each, also for two years.

When will a research chair be created for sickle cell disease in Canada?

This lack of knowledge about the disease also delayed the development of a diagnosis. The key to diagnosis is universal newborn screening involving a simple heel prick. The test is one of several screens administered to identify other metabolic and genetic diseases already part of the screening program.

Lillie Johnson, a nurse and founder of the Sickle Cell Association of Ontario, had to fight for universal newborn screening before it was introduced in her province in 2006. In November 2009, British Columbia followed suit, along with Nova Scotia in 2014. In November 2013, the screen was partially implemented in Quebec and later extended to include the entire province in 2016. The sheer determination of Wilson Sanon, president of Quebec’s sickle cell disease association, deserves credit for this accomplishment.

Later, several other provinces signed on. Yet, the disease easily meets the eligibility criteria for this diagnostic test. The test can detect the disease within 24 to 48 hours after birth. It is specific and sensitive to the medical condition targeted. Early screening allows care providers to intervene and create an effective treatment plan with the family. When this kind of response starts in the first few months of life, it helps reduce the frequency of hospitalization, prevents complications and improves the quality of life for these children and their families.

After this test was introduced, hematologist Dr. Yves Pastore and his team observed that the cohort of babies diagnosed with sickle cell disease had almost doubled, from 250 cases to 475, at Montreal’s Centre hospitalier universitaire Sainte-Justine between 2013 and June 2023. Despite the fact that over 100 years have passed since sickle cell disease was first identified, we’re still very far behind when it comes to treatments. We now know that healthy living and certain preventive measures, such as avoiding exposure to extreme temperatures and staying hydrated, can help stave off complications.

In terms of medications, hydroxyurea, a drug first used in the treatment of cancer, has been administered for over 15 years to treat sickle cell disease. It has proven helpful by reducing the frequency and severity of acute pain episodes. Unfortunately, the drug isn’t suitable for every patient.

There are other treatment options, such as blood transfusions, apheresis, a complex technique, and bone marrow transplants, which have been available in Quebec since 1980 and are the only cure we know of. According to Dr. Yvette Bonny, a national pioneer in this particular medical intervention, this treatment can’t be offered to everyone because of the risk of complications. All of these interventions, combined with monitoring by a multidisciplinary team, help improve patients’ quality of life.

Three new drugs have been approved by the Food and Drug Administration, or FDA. I will spare you their complicated names. The research that went into these drugs showed that two of them reduce the number of vaso-occlusive crises and therefore reduce pain. The third improves hemoglobin levels, which clears the anemia. These drugs have proven to be effective if used alone or in combination with hydroxyurea. That’s why it’s necessary to explore new paths of innovation for developing drugs adapted to a wider range of affected patients. This really rings true when we hear a grieving mother say, “we bury our children at a very young age. It is unfair and unjustifiable in 2023 in a country like ours.”

[English]

Here is why you should care about this framework. It will benefit health care professional awareness; the implementation of a research network; the creation of a national registry; full access to newborn screening; public awareness and needed financial support.

[Translation]

In 1971, President Richard Nixon promised research credits and patient care. The following year, in 1972, he signed a new act into law, the National Sickle Cell Anemia Control Act. In later years, a direct correlation was established between funds allocated by the National Institutes of Health and improvements in the quality and lifespan of patients living with sickle cell disease.

Canada must take action too.

Under this national framework, Bill S-280 will provide a six-point plan.

First, it will help mobilize medical regulatory bodies, nurses and other health care professions to encourage their members to learn more about sickle cell disease. It will also help enlist their participation in launching concrete initiatives that meet the training needs of health care providers to strengthen their skills. The development of clear guidelines will also help align practices to ensure a holistic, consistent and effective approach. In the words of one person we interviewed, this framework would fill “the gap in knowledge about the disease among some doctors, who often choose to simply treat symptoms rather than tackle the underlying causes.”

Second, the framework will provide for the creation of a national research network dedicated to advancing the understanding of sickle cell disease. This is a fundamental part of the framework. For example, the Sickle Cell Association of Canada is actively collaborating with the Canadian Hemoglobinopathy Association to promote research and facilitate data collection. This exemplary partnership demonstrates the importance of close collaboration between organizations, researchers and funders.

COVID-19 was a wonderful example of international collaboration that led to the creation of vaccines that are indispensable today. Some will say it was an emergency. However, it can happen again. There is a recent publication concerning gene therapy. It discusses molecular scissors known as CRISPR-Cas9, which will hopefully lead to a curative treatment. It partially restores normal blood formation and reduces, but does not completely eliminate, complications associated with the disease. It has been approved in the UK and is in the process of being approved by the FDA. Canada could also carve out an enviable place for itself in this rapidly developing field, while contributing to the well-being of its people.

Third, implementing this framework will help establish a national registry aimed at reducing existing disparities in the knowledge, diagnosis and management of sickle cell disease.

Dr. Smita Pakhalé, Chair in Equity and Patient Engagement in Vulnerable Populations, couldn’t agree more. In addition, Dr. Giguère says that one of the many advantages of a registry is that it would make it easier to contact people suffering from the disease, in the event of a cure being discovered.

Fourth, implementing this national framework will guarantee equal access to universal newborn screening and sickle cell disease diagnosis across Canada. This would ensure that appropriate care can be administered to all newborns immediately after birth and throughout their life.

Fifth, the framework will serve as a lever supporting national campaigns to increase awareness and understanding of sickle cell disease among the general public, and to better support the well-being of families and caregivers of people living with the disease. These public education efforts by community organizations will reduce the stigmatization of those suffering from the disease and create a supportive, inclusive environment for them and their loved ones.

Sixth, beyond exploring the feasibility of offering a tax credit to the families of people suffering from sickle cell disease, this framework will also look into the possibility of including these individuals in programs for people with disabilities.

This consideration is especially relevant, since many young adults stricken with the disease have a hard time keeping a job due to repeated hospitalizations and the debilitating chronic fatigue caused by the disease.

By integrating all of these aspects, we are seeking to develop a comprehensive framework that takes into account not only medical needs, but also the socio-economic challenges faced by individuals and their families.

Honourable senators, establishing a national framework for sickle cell disease responds to a UNESCO resolution adopted in 2007 and a resolution adopted by the UN General Assembly in 2008. These resolutions were adopted unanimously and recognized sickle cell disease as a public health issue.

In light of everything I’ve just said, it’s imperative to support the passage of this bill to fill the gaps that exist in terms of awareness, research and the national registry. In response to these challenges, we need to move Bill S-280 quickly through committee. I encourage you to head to YouTube and watch a 15-minute clip from an upcoming documentary called Silent Suffering — Sickle cell disease by Mamoudou Camara, which tells the story of a young man suffering from this disease. My office can send you the link, if you wish. Just as we did with cystic fibrosis, Canada can also show global leadership on all aspects of sickle cell disease.

I would like to thank a few people. I want to thank the specialists, Dr. Auray, Dr. Bonny, Dr. Pakhalé, Dr. Cénat, Dr. Giguère, Dr. Pastore and Dr. Soulières for their insightful comments. I also want to thank the presidents of the Canadian and Quebec sickle cell disease associations, Ms. Tinga and Mr. Sanon, for the work they do in that capacity and as parents, as well as for their enthusiasm and contagious perseverance in supporting my initiative when I decided to introduce Bill S-280. I want to thank Ms. Mouscardy, Mamoudou and Ismaël, who gave me a glimpse into their home life to help me understand what it is like to be a parent and a young person living with this disease.

It is your turn, honourable senators, to lend your support to Bill S-280 and send it to committee as quickly as possible. Thank you.

The Hon. the Speaker: Is it your pleasure, honourable senators, to adopt the motion?