Thank you very much, Mr. Chair.

Heart and Stroke appreciates the opportunity to appear before this committee to discuss Bill C-69, the budget implementation act.

I would like to address four measures today that were included in budget 2024, namely the school nutrition program funding, tobacco and vaping taxes, measures to address nicotine pouches, and pharmacare funding.

First, the $1-billion investment over the next five years to implement a national school nutrition program will greatly benefit the health and well-being of children in Canada. This investment is important to the one-third of students in elementary schools and two-thirds of students in secondary schools who do not eat a nutritious breakfast before school, leaving them at risk for learning, behavioural and health challenges at school.

The reality is that food insecurity puts people at risk for various chronic diseases, including heart disease and stroke. The annual economic burden to Canadians of chronic diseases, which is attributed to unhealthy eating and other modifiable risk factors, has been estimated at a staggering $28.2 billion. Canada is seeing increases in the rates of illnesses, such as type 2 diabetes, heart disease and cancer, much of it stemming from poor diets. In 2019, dietary risk factors contributed to an estimated 36,000 deaths in Canada.

Evidence shows that school food programs help to produce better health and education outcomes, including a reduction in the risk of chronic disease and improved mental health, as well as improved concentration and learning, which are associated with improved graduation rates.

School food programs can have significant positive economic impacts. A preliminary University of Guelph study suggested that a national program could stimulate the development of over 200,000 jobs. Also, a national school nutrition program can help to educate our kids on the value of local agriculture and the important role that local farmers play in supporting healthy diets. It will be key for this measure to be implemented, given that Canada is the only G7 country without a national school food program.

Heart and Stroke is also pleased to see strong action on tobacco and vaping control by way of increased taxation. Smoking remains the leading risk for premature death and disability in Canada. It places a burden on our economy, with over $11 billion in lost productivity and health care costs in 2020.

Also, Canada has some of the highest youth vaping rates in the world. The reality is that increased taxes on tobacco and vaping products are one of the most effective strategies to reduce consumption, especially among price-sensitive youth and young adults. Young people have lower disposable incomes, and research shows that they are more sensitive to e-cigarette and tobacco price increases.

Heart and Stroke is also pleased to see the federal government's resolve to move towards a healthier nicotine-free generation. The budget includes a proposed amendment to the Food and Drugs Act that will help address the alarming uptake of nicotine pouches amongst our youth. The reality is that the unregulated sale of nicotine pouches, such as Zonnic, is a real danger to young people in Canada. With attractive flavours, such as Tropic Breeze, Chill Mint and Berry Frost, and colourful small packages, these packages entice youth to try nicotine pouches. The devastating result is that youth will become trapped in a cycle of nicotine addiction.

This proposed amendment will restrict the marketing, restrict the use of attractive flavours, impose a minimum age for sale, require placement of these products behind the counters at pharmacies, and impose warning labels and other measures. These are key to helping to protect our youth from these harmful products.

Finally, as a last point, the allocation of $1.5 billion in funding over five years to support the launch of the national pharmacare program is critical in order to improve drug coverage among the seven and a half million people in Canada with no insurance or inadequate insurance. The current patchwork of public and private plans in Canada has created fragmented drug access, leaving millions struggling to afford their prescription medications.

While many people in Canada have some form of drug coverage, it is often not sufficient and poses affordability issues for some. A 2024 poll commissioned by Heart and Stroke and the Canadian Cancer Society found that one in five people in Canada do not have sufficient prescription drug coverage. Over one in four Canadians had to make difficult choices in order to afford prescription drugs, such as cutting back on groceries; delaying paying rent, mortgage or utility bills; and/or incurring debt.

One in 10 people in Canada diagnosed with a chronic health condition were more likely to visit an emergency room due to a worsening health issue because they were not able to afford their prescription medications.

People with diabetes are more likely to develop heart conditions at a younger age and are three times more likely to die of heart disease. As such, the budget 2024 investment in pharmacare will support 3.7 million people in Canada living with diabetes in managing their condition at home. It will also reduce their risk of developing heart conditions, among other complications.

We hope to see the coverage expanded to cover heart disease and stroke drugs in the near future.

I'll be happy to address any comments or questions. Thank you very much.