Search

Unlike other high-income countries, Canada has no national policy for drugs treating rare diseases (orphan drugs). Nevertheless, in 2022, the Canadian government committed to creating a national strategy to make access to these drugs more consistent. Our aim was to study whether recommendations made by the Canadian Agency for Drugs and Technology in Health (CADTH) translated into coverage decisions for orphan drugs in Ontario, the largest Canadian province. This study is the first to look at this question for orphan drugs, which are at the center of policy attention. We included 155 orphan drug-indication pairs approved and marketed in Canada between October 2002 and April 2022. Cohen's kappa was used to test the agreement across health technology assessment (HTA) recommendations and coverage decisions in Ontario. Logistic regression was used to test which factors, relevant to decision-makers, might be associated with funding in Ontario. We found only fair agreement between CADTH's recommendations and coverage decisions in Ontario. Although a positive and statistically significant association between favorable HTA recommendations and coverage was found, more than half of the drugs with a negative HTA recommendation were available in Ontario, predominately through specialized funds. Successful pan-Canadian pricing negotiations were a strong predictor of coverage in Ontario. Despite efforts to harmonize access to drugs across Canada, considerable room for improvement remains. Introducing a national strategy for orphan drugs could help increase transparency, consistency, promote collaborations, and make access to orphan drugs a national priority. • Recommendations by the Canadian Agency for Drugs and Technology in Health do not always translate to provincial coverage decisions for new drugs. • We explored whether Canadian Agency for Drugs and Technology in Health's recommendations are aligned with coverage decisions for orphan drugs in Ontario. • Negative health technology assessment recommendations did not necessarily translate to no pan-Canadian pricing negotiations. • More than half the drugs with negative health technology assessment recommendations were available in Ontario through specialized funds. • A national strategy for orphan drugs could prioritize access to these treatments at a national level and harmonize access, at least to some extent, across Canada. [ABSTRACT FROM AUTHOR]

The present study empirically investigates whether targeted government spending and environmental policies promote green growth, as measured by greenhouse gas productivity. Government spending for pollution abatement (GEPA) represents non-market environmental policies encompassing both enforcement regulations and stakeholder incentives, while policy dummy represents province specific targeted environmental policies. Using panel data from 1995 to 2020 across ten provinces of Canada, an empirical model based on STIRPAT has been developed and estimated, addressing various econometric issues to ensure the robustness and consistency of the results. The findings confirm that both GEPA and targeted environmental policies are crucial determinants in achieving green growth. Additionally, variables such as business sector expenditures for R&D, the share of renewable energy, per capita GDP, and population also contribute to green growth. These results highlight the importance of the stick-and-carrot approach as a key strategy and policy tool for sustainable development. The implications of these findings extend beyond Canada and hold valuable lessons for emerging and developing countries that predominantly rely on command-and-control regulations without adequate support. To effectively address the challenge of achieving green growth, a coordinated approach that combines targeted government spending and environmental policies, supported by innovation and renewable energy exploration, is essential. Overall, this study's findings have significant implications for environmental sustainability on a global scale. [Display omitted] • Examines the effect of targeted government spending and environmental policies on green growth in Canada. • Uses greenhouse gas productivity as an index of green growth. • Estimates the empirical model developed addressing advanced econometric issues related to panel data for 1995–2020. • Controls renewable energy, innovation, per capita income, population. • Have significant implications for environmental sustainability on a global scale. [ABSTRACT FROM AUTHOR]

An updated national ammonia (NH3) emissions inventory was employed to study the relationship between NH3 emissions and livestock industries in Canada. Emissions from animal agriculture accounted for 322kilotonnes (kt) or 64% of Canadian NH3 emissions in 2002. Cattle and swine accounted for the bulk of livestock emissions. The provinces of Alberta, Ontario, Quebec, and Saskatchewan accounted for 28.1%, 22.0%, 18.7%, and 13.1% of total livestock emissions, respectively. Emissions from Ontario and Quebec were attributed to the intensive production of dairy, hogs and poultry. Dairy cattle emissions per hectolitre of milk were higher in Ontario and Québec than in other provinces, while swine emissions per livestock unit were higher than either beef or dairy cattle. A review of the abatement literature indicated diet manipulation to improve N efficiency and land spreading methods are very effective techniques to lower NH3 emissions. Future research is required to evaluate the feasibility of biofilters and feces/urine separation methods. [Copyright &y& Elsevier]

Summary: In order to successfully conduct integrated management of land, water and living resources the Convention on Biological Diversity (CBD) has developed a strategy called the Ecosystem Approach (EA). This paper analyses the obstacles preventing the implementation of the EA in two case study countries, Canada and Germany. We briefly describe the EA, followed by the results of literature research of protected area management and the EA, as well as structured telephone interviews conducted with managers of large protected areas in Germany and expert interviews in the Canadian Provinces of Manitoba and Ontario, in addition to the German Federal State of Brandenburg all conducted in 2005-2006. Results reveal that the EA is faced with a wide range of barriers and its implementation seems to be stuck in the political arena, not reaching the practical level. Most notable were issues concerning general knowledge of the EA, top-down information sharing, both administrative and cross-sectoral cooperation and stakeholder involvement. Major outcomes are the need for more cooperation and knowledge sharing, as well as for a correct combination of both top-down and bottom-up approaches to ecosystem management. The results partially reflect eight general obstacles considered in a Strategic Plan of the CBD, with the exception of socio-economic factors and natural phenomena and environmental change. We rather see these as issues demonstrating the urgent need for implementing the EA. In particular, climate change increases the need of the implementation of the EA and actually could lead to a broader acceptance of its principles. [Copyright &y& Elsevier]