Health care is more than treatment—it’s time to get serious about disease prevention

The big news in health care these days is national pharmacare. This is surely welcome news for those of us living with any chronic illness. National pharmacare offers a dream—perhaps unrealistically, given the cost—that one day Canada might have a universal program covering all drugs for all diseases. Yet despite this hope, the proposed framework is still a post-onset, pharmacological approach to treating disease. Is there another way? Dr. Pamela Valentine is president and CEO of MS Canada. Photograph courtesy of Pamela Valentine Pharmacare would provide access to drugs for those who are already sick. It’s a pathology approach to health. Yes, this is critically important—access to new multiple sclerosis (MS) therapies reduces disability, and saves both pain and lives. And we must continue to develop better therapies to lessen the disease’s impacts. We also must strengthen health and social supports for those affected. And that means doing better than offering a disappointing $6/day to lower-income Canadians with disabilities, as proposed in the recent federal budget. But access to drugs is also just one half of a true health system. The other side of the coin is health promotion and disease prevention. And we are not focusing sufficiently on preventing people from becoming sick in the first place. We are all familiar with the adage that an ounce of prevention is worth a pound of cure. Take the case of MS. A chronic neurological disease of the central nervous system, it affects vision, memory, balance, and mobility. Canada has one of the highest rates in the world, with 12 people in this country diagnosed every day; that’s one person every two hours being told “you have MS.” MS costs Canada $3.4-billion annually and climbing—a staggering statistic recently distilled by Deloitte Access Economics. That $3.4-billion per year is more than twice the projected annual cost of the new pharmacare plan before Parliament. Now imagine for a moment a future without MS: no new cases of what is called “Canada’s disease” that hits women at three times the rate of men, and tends to afflict people in their prime. Imagine also being able to eliminate the $3.4-billion cost of MS annually, and reinvesting that into other things: more prevention research, heart disease, cancer research, better support for other chronic illness, the list goes on. A generation ago, we couldn’t really—credibly—talk about a future without MS other than in wishful thinking. Today we can. Recent research breakthroughs have isolated what appears to be a critical antecedent or “necessary condition” to the onset of MS: the Epstein-Barr virus, or EBV. It follows, then, that a combination of an EBV vaccine and antivirals could block the future development of MS. This is a phenomenal breakthrough, given the leaps and bounds by which both vaccine and anti-viral development have been progressing. Let’s lean into disease prevention strategies wherever the opportunity presents itself. We know that just six per cent of the MS research investments in Canada and around the globe are focused on prevention. By investing our health-research dollars in a laser-focused way, we could actually be able to prevent future MS cases. If we get this right, we could be in a situation where, within two generations, there could be no new cases of MS. For the first time ever, this appears doable, and in our lifetime. Many countries do a better job than we are in promoting healthy living and health hazard avoidance. We are coming to know more and more about the “perfect storm” scenarios of disease expression—the set of circumstances that allows a disease to take hold. We know that time matters, that what you do in your 20s and 30s determines the health of your nervous system for the rest of your life. This is part of the behaviour-modification approach to early health promotion. And when a door opens to disease prevention, we have to go through it. Australia is investing $18-million to unpack the EBV-MS connection, and is about to deploy an antiviral clinical trial while additional work is done on potential vaccines. Given the prominence of MS in Canada, there is no excuse for us to not get on board. While the recently tabled budget gives significant new research funds to the Canadian Institute for Health Research, less than one per cent is being earmarked for MS research—a disease that could potentially be prevented. Our MS researchers are among the best in the world. Let’s invest in them like Australia is doing, and focus those dollars in the right direction. We need to work with the growing global team on this breakthrough opportunity that just presented itself. We found this opening for disease prevention by investing in research. Let’s keep going and see it through. Dr. Pamela Valentine is president and CEO of MS Canada. The Hill Times

Health care is more than treatment—it’s time to get serious about disease prevention

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Health care is more than treatment—it’s time to get serious about disease prevention

Pharmacare would provide access to drugs for those who are already sick. We are not focusing sufficiently on preventing people from becoming sick in the first place.

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