In the fall of 2022, pharmacy shelves were empty, respiratory disease cases were high, and Canadian parents everywhere were scrambling to find pain and fever relief medications for their children. Manufacturers couldn’t keep up with the demand.
In Alberta, Premier Danielle Smith had just won the United Conservative Party leadership race and was looking to strike a proactive pose on health care. So in December, she announced she had reached a deal with Turkey’s Atabay Pharmaceuticals and Fine Chemicals to import 5 million bottles of children’s acetaminophen and ibuprofen to the province.
At the time, Ms. Smith’s idea to source from abroad appeared positive, bold, and coming from a place of genuine care. Though it hardly ever agrees with the UCP, especially on anything health care related, even the Alberta NDP spoke optimistically about the plan.
But though the best in politics involves risk, and hopefully good intentions, this bet has not paid off. The downsides of Alberta’s Atabay deal continue to mount.
First, there were the predictable delays in the Health Canada approval process, which included ensuring that the packaging had childproof caps. This pushed the bulk of medication deliveries to the spring of 2023, when the need had quieted down.
In the early months of last year, Albertans also learned the deal carried a $75- to 80-million price tag. The contract included a minimum-purchase order requirement, which exceeded provincial demand. The government’s idea was to recoup some of the money through sales, and to sell stock to other provinces and territories. At least the latter part of the financial plan fizzled out.
Then late last year, it became clear that Alberta was unlikely to receive the majority of the Turkish children’s pain-relief medication because Health Canada said it wouldn’t approve further shipments after resolving the drug shortage.
And finally, this week, The Globe and Mail reported – using documents obtained through an access-to-information request – that the use of acetaminophen from Turkey increased the risk of a life-threatening illness in neonatal patients. This is because the imported medication is thicker than products typically used in Alberta. In some instances, it clogged the feeding tubes used to deliver medicine to these tiny patients. Tubes then had to be flushed with water, and the higher volume of liquid increased the risk of necrotizing enterocolitis, which inflames the intestines of infants.
Staff were ordered to stop using the product in neonatal intensive care units in May, according to Alberta Health Services (AHS). To be clear, AHS said no patients fell ill as a result of the medication. The public health body said this week that the Atabay product was used at AHS sites for two months before staff reverted back to the usual medications.
But the risk had still been there.
AHS still maintains that having this medication stock on hand is a good thing. And Albertans would be inclined to grant the Smith government more grace on this issue – if Ms. Smith was a more normal premier on health care. However, her political rise has been built on tearing the system down.
The Premier was focused on medications for children in part because her government doesn’t like some of the other options. For example, it has done away with crystal-clear messaging around the benefits of vaccines for COVID-19 or influenza, even with childhood respiratory-disease rates being high once again.
It’s necessary to rehash that one of the reasons Ms. Smith is Premier today is because she was so successful at winning support from the Albertans most skeptical about vaccines, public health leaders such as Deena Hinshaw, and the mandates that former premier Jason Kenney reluctantly declared to keep hospitals from being overwhelmed through the pandemic.
Globe reporter Alanna Smith, who has done yeoman’s service covering the twists and turns of this story over the last 13 months, asked the Premier’s office to comment on the Atabay file this week. But she only received answers from AHS – the same AHS, of course, that Ms. Smith is now breaking into separate pieces. Since the original announcement on Atabay came not from AHS, but from the Premier herself, it’s her office that should respond.
The Premier has said she stands by her initial deal with Atabay. But she has also long said her overarching political philosophy is to follow in the footsteps of one of her political heroes, Ralph Klein, in the former Alberta premier’s propensity for acknowledging missteps.
Ms. Smith has built her political career on remaking Alberta’s health care system according to her own mind’s eye, and she owned the original announcement to import children’s medications in 2022, when it seemed like a good idea.
In 2024, the Premier has to acknowledge the plan has been a bust.