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Opinion: A national pharmacare plan could rein in soaring drug prices

Lack of prescription drug coverage has led to some of the highest costs in the world

Opinion: A national pharmacare plan could rein in soaring drug prices

Canada has one of the highest prices for prescriptions drugs in the world. Prescription drug spending has become the second-largest cost to the Canadian health care system, ranking only behind hospital expenditures.

That cost is only rising.

A number of factors, such as demographics and prescription volume, are responsible for this increase. However, the main factor driving up overall spending is the ballooning cost of prescribed medications itself.

The drug development process

The pharmaceutical industry has made incredible advances in recent years. There are now medications that can help manage and even cure diseases that were once untreatable. However, these medications often come with hefty charges. For example, the cost of hepatitis C treatment can well exceed $100,000 per patient.

It is estimated that these high-cost drugs will account for 42 per cent of prescription drug expenditure by 2020, a figure that is well above its 17.5 per cent share in 2010.

According to pharmaceutical companies, the steep price is needed, in part, to finance the extensive drug development process. This process takes well over a decade and includes preclinical testing, clinical trials for safety and efficacy, as well as the federal drug application review.

For every 5000 compounds discovered, five drugs enter clinical trials and just one new drug receives federal approval. Although most firms decline to disclose the cost of research and development, it can vary from several hundred million dollars to over $12 billion.

Once the drug is approved for sale in Canada, the Patented Medicine Prices Review Board (PMPRB) — a federal agency — sets the maximum price of the drug based on the price of similar medications on the market.

Prescription drug coverage in the Canadian health care system

Canada is the only high-income economy — nations with at least $12,056 USD in gross national income per capita — with a public health care system that does not include prescription drug coverage. Although drugs administered in hospitals are provided to patients at no cost, patients out of hospitals must purchase prescription medications either through insurance plans, whether public or private, or from their own pocket.

Public insurance plans are offered by provincial and territorial governments to special populations, such as the elderly, individuals with disabilities, and unemployed individuals. Private insurance plans may be available as a benefit to individuals through their employer.

The number and type of medications covered by public and private insurance plans vary significantly. Patients who have neither a public nor a private insurance plan must pay for their prescriptions themselves.

Furthermore, due to the presence of multiple public and private insurance plans in Canada, there is no single agent for pharmaceutical companies to bargain with when setting drug prices.

“When you have a single agent, [that agent has a] much stronger ability to drive down what [Canadians are] going to pay,” said Dr. Jodel Lexchin, an associate professor at U of T’s Institute of Health Policy, Management and Evaluation, in an interview with The Varsity.

“Drug companies know that if they cannot reach a suitable price with that bargaining body, then they may still be able to sell the drug in the country.”

However, Lexchin noted that companies are disincentivized from selling prescription drugs directly to the public. The firms would receive less revenue, as insurance providers can afford to pay higher prices for prescription drugs as opposed to patients who are paying out of pocket.

The role of the Patented Medicine Prices Review Board

The PMPRB attempts to mitigate the lack of a single payer health care system in Canada by controlling the prices of patented drugs. The organization can challenge the price of patented drugs sold in Canada and demand pharmaceutical companies to repay some revenue.

While the number of investigations into high-cost drugs has been rising, regulations proposed by Health Canada would allow the PMPRB to assess the value of new drugs by reviewing cost-effectiveness analyses, which may lower maximum drug prices.

However, these individual successes are unlikely to have a significant impact on the pricing war between pharmaceutical companies and bargaining agents. The PMPRB can control the price of a single high-cost drug on the market, but subsequent drugs may also be priced outrageously upon entering the market.

Considering it is not feasible for federal agencies to open investigations into all emerging high-cost drugs, Lexchin believes that a system-level change to address drug prices is needed.

Drug prices in the global pharmaceutical market

“The only group that really benefits [from high drug prices] are the companies that are making the products,” explained Lexchin. These are multinational companies that have substantial power in the United States. For this reason, the US has the highest drug prices in the world and a considerably larger market than Canada.

Pharmaceutical companies worry that similar prices could spread into the US, if Canada attempts to lower our drug prices. Therefore, these companies lobby the American government to put pressure on Canadian officials and prevent regulation that would result in lower drug prices.

Despite having lower prices than the US, drug prices in Canada are already greater than the global average. Drug prices in other high-income countries, such as Denmark, can be less than half of those in Canada.

Many of these high-income countries have a universal health care system that includes prescription drug coverage. Having a single payer system for prescription drugs gives them greater bargaining power and effectively reduces drug prices. Other countries may have profit controls.

Either way, pharmaceutical companies must control drug prices such that their profits are within the designated margin.

Next steps for Canada

There have been growing efforts within the federal government to establish a national “pharmacare” program. This means that prescription drugs would be covered as part of the universal health care system.

A national drug plan requires a national formulary, explained Lexchin, which is a list of medications covered by public insurance. Drugs on this formulary would be selected based on evidence of cost effectiveness.

For example, if five drugs in a class of medications are equally effective and safe, but vary in price, the government may only elect to pay for two of the five medications. The plan would only pay for the most cost effective medications in that group, without compromising safety or efficacy.

Patients may still be able to use private insurance plans or out-of-pocket payments to purchase the other, more expensive medications.

But without effective reforms, such as national pharmacare, drug prices in Canada will continue to rise. Several drugs already have an annual cost exceeding hundreds of thousands of dollars,  which can mean a difference between life and death.

For most Canadians to be able to afford these life-saving medications, however, reform must take place to rein in these current drug prices.

Asbestos is scary, how we deal with it shouldn’t be

The contention shines light on larger issues of safety and feasibility

Asbestos is scary, how we deal with it shouldn’t be

For anyone still unaware, asbestos exposure is not good for you. For much of the twentieth century, asbestos materials were installed almost everywhere as cheap fireproofing. Now, it is now effectively banned in Canada and for good reason. 

Health Canada warns that breathing in even microscopic amounts of asbestos can cause severe long-term health problems. These include aggressive cancers and asbestosis, a disease that scars the lungs and impairs breathing. 

Often, people only experience the effects of inhaling asbestos fibres decades after the fact. 

Any potential exposure to asbestos is a big deal. This explains why in 2017, when “unusual dust” was discovered in the Medical Sciences Building, rooms were cordoned off for days. It is also why the University of Toronto Faculty Association (UFTA), along with other labour groups, are doubting the clean bill of health U of T has given to its air quality.

At the centre of this dispute is who and what determines the acceptable amount of asbestos in the air. 

The national occupational standard exposure limit for asbestos concentration in construction sites is 0.1 fibres per cubic centimetre (0.1 f/cc), which poses a very small risk on exposure. U of T’s report decided that the acceptable amount is 0.5 f/cc. However, the provincial government’s guideline, while not legally enforceable, is 0.4 f/cc. The UFTA wants U of T’s asbestos level to be closer to Queen’s Park recommendation, and preferably around a limit of 0.1 f/cc.

If those differences sound a bit trivial and pedantic, it is because they might be. Even the Vice-President of Operations and Real Estate Partnerships Scott Mabury, who is responsible for U of T buildings and their safety, admitted that it’s very hard to tell the difference between U of T’s and Queen’s Park’s limits. Mabury is also the former Chair of the Chemistry Department. 

U of T contends that it has reached its limit based on what is tangible, achievable, and legal. But the UFTA is also right to demand more. The university must do everything it can to ensure that our community is not exposed to asbestos. That not everything is being done to protect its members from exposure to asbestos is troubling.

However, what should really worry us is the UFTA’s allegations of how U of T decided upon its asbestos exposure limitation. The UFTA has made allegations of a “democratic deficit” in the process, meaning that the union was only informed of feedback sessions at the last minute and that the panel responsible for making the decision was overly close to U of T officials. The union also claims the panel did not include enough asbestos experts.

The implications of these allegations are serious and troubling. If the culture and formal process for deciding how to go about safety are being compromised and rushed in order for U of T to get what it wants, then this issue goes beyond how many fractions of particles are in the air. It affects every aspect of safety at U of T: the buildings, the people inside them, and whether the administration will do everything possible to ensure the safety of our community.

Ideally, there would be no asbestos fibres in the air at all, but past architects and engineers made choices that decided otherwise. All that can be done now is to minimize fibres to the point that the risk becomes negligible. 

Instating a limit lower than where U of T has placed so far may prove very tricky. But when it comes to breathing in potentially lethal industrial fibres, having the university only reach a legally-sound common denominator is hardly reassuring. It is definitely not the standard by which U of T came to be recognized as one of the best employers and schools in the country. This does not leave us breathing easy.

Martin Concagh is a second-year Political Science student at New College.

Doug Ford doesn’t deserve to march at Pride

Premier has a record of disregarding the needs of minority communities

Doug Ford doesn’t deserve to march at Pride

Earlier this month, Ontario Premier Doug Ford announced that he would not be marching at Toronto’s Pride Parade on June 23 as long as uniformed police officers remained banned from the event. Uniformed police officers will not march at Pride for the third year in a row, following a Black Lives Matter (BLM) protest at the 2016 Pride Parade.

BLM successfully demanded the removal of police floats from future parades and voiced the need for Pride to better include communities of colour. Since then, criticism over perceived police inaction and mishandling of several disappearances in the Church and Wellesley Village has also underlined the continuation of the ban. 

Ford’s decision not to march — calculated and political — is not surprising, considering his history of exclusionary policy-making, some of which reduced funding for healthcare, education, and social services.

These changes will impact the most vulnerable of our community and blatantly express a disregard for constituents who are unable to access these resources independently. His choice to march in the York Pride Festival on June 15 alongside the York Regional Police is just another reminder of Ford’s disregard for the marginalized in Toronto and raises the question of whether the premier was marching in support of Pride or in support of police.

Ford breaks six-year tradition set by Wynne in 2013

By contrast, Kathleen Wynne became the first sitting Premier to march in the Parade in 2013. Wynne, who led Ontario’s previous Liberal government, was unaware of this historical first, and said of her attendance, “Every year I take part in the Pride events. Jane and I go to the Pride and Remembrance run on Saturday morning. I go to the church service, which is always very, very moving, on Sunday morning, and of course I walk in the Parade.”

Wynne, who was the first Premier in Canada to openly identify as a member of the LGBTQ+ community, noted at the time that many of her constituents told her that Pride was like an annual family gathering, given that many of their own families had excluded them from important events.

On the other hand, in 2014, while running for the mayor of Toronto, Ford — alongside his brother, former Mayor Rob Ford — declined to march in the parade, infamously saying, “Do I condone men running down the middle of Yonge Street buck naked? Absolutely not.” He continued, “Maybe there are some people in this city that approve of that, and maybe they can bring their kids down to watch this.”

The Fords have long been criticized for their absence at the parade, and it is unreasonable to expect Ford to attend the parade now. Since taking office last summer, Ford reintroduced a regressive sexual education curriculum which, as discussed in a previous Varsity editorial, greatly threatened the ability for LGBTQ+ students to learn in an inclusive space.

After much backlash from Ontarians, including legal challenges by the Canadian Civil Liberties Association (CCLA) and the Elementary Teachers’ Federation of Ontario, Ford’s government backtracked on its plans, instead opting for a new sex ed curriculum that appears similar to Wynne’s 2015 version. However, though sexual orientation and gender identity are still in the curriculum, they will now be taught much later, and parents will also have the ability to opt-out their children from the curriculum.

Absence at Parade follows legally-challenged move to revise Ontario’s sex ed curriculum

In truth, Ford’s appearance at Toronto’s Pride Parade would be a farce, as his policies do not reflect the needs of the community. In practice, his reversal of Wynne’s sex ed policies is regressive and detrimental to students’ health education. A 2015 comparison by Global News revealed that the previous government’s policies brought Ontario’s sex ed curriculum closer to that of Canada’s other provinces and territories. 

By reverting Ontario’s sex ed curriculum this year, he instigated a harmful discourse questioning the importance of LGBTQ+ identities. Eliminating references to sexual orientation, gender identity, and same-sex relationships — as Ford planned to do before the reversal — threatens efforts to normalize different gender and sexual identities through the public school system.

Not only did the previous curriculum aim to foster a community of inclusivity, but it also strived to eliminate gender and sexuality-based persecution and bullying in and outside of schools. In many situations, this curriculum may have been the first time many students below grade eight encountered issues related to the LGBTQ+ community.

The Ford government claimed that Wynne’s curriculum was too detailed in its description of certain elements of sexual health and reproduction and introduced certain concepts too early in students’ education. Rather than rewriting and introducing an alternative curriculum that would specifically remedy these issues, Ford wanted to roll back Wynne’s 2015 curriculum, a decision which the CCLA says “stigmatizes, degrades, and alienates” LGBTQ+ students and parents.

In addition, his cuts to public education threaten the livelihoods of teachers, parents, and students as schools will be forced to make cuts to specialized programs, elective courses, and classroom supplies. It also grossly increased class sizes, reducing face-to-face time between students and teachers. These disproportionately affect students who are not able to access programs outside of school due to financial, physical, or environmental factors.

Ford’s Student Choice Initiative has also threatened funding of LGBTQ+ student advocacy groups

Similarly, Ford’s highly controversial Student Choice Initiative (SCI) allows students to opt out of non-essential fees. Institutions must rationalize “essential” services according to the framework set out by the Ontario government. Student groups, such as The Varsity, will need to provide a fee opt-out option. The Canadian Federation of Students–Ontario and the York Federation of Students subsequently launched a legal challenge against the initiative in May.

The opt-out policy has the potential to defund or severely restrict funding for groups and services whose members may be otherwise without a community to depend upon for social support. Particularly at U of T, an institution that has been criticized for failing to foster a positive collegiate atmosphere, students rely on clubs and group activities to transform our university into a place of emotional and social growth and support. Minority students, many of whom may not be able to express themselves in their communities and homes — whether through their gender identity, sexual orientation, or cultural and ethnic heritage — will be without these support systems.

The SCI will potentially cut the ability of levy-funded student organizations, like LGBTOUT, Rainbow Trinity, and Woodsworth Inclusive, all of which advocate for LGBTQ+ students.

University is meant to be a place of growth and of self-discovery, and Ford’s SCI limits individuals’ and clubs’ ability to fully support this element of postsecondary education.

Ford’s funding cuts do not stop at the SCI. His reductions of OSAP funding threaten lower- and middle-income students’ ability to access postsecondary education. In particular, the decrease in grants for loans, the consideration of parents’ incomes up to six years after being in school, and the fact that the loans will accumulate interest immediately after graduation have detrimental effects on students’ ability to access funding. Just this week, many students took to social media to show how much funding they stand to lose in comparison to previous years.

According to Higher Education Today, a blog by the American Council on Education, “higher education has historically been and remains a positive location for students’ identity development.” Gender and sexual identity development should not be bound to an economic bracket.

Placing an increased pressure on lower-income students to find funding for school not only places these students in a compromising position, but uniquely challenges LGBTQ+ identifying students by limiting their access to a historically supportive space — and especially considering that LGBTQ+ people are more likely to be in lower socio-economic brackets. According to the Canadian Mental Health Association, “Bisexual and trans people are over-represented among low-income Canadians… An Ontario-based study found that half of trans people were living on less than $15,000 a year.”

Doug Ford has never been for the people, and there is no reason to believe he has a place at Toronto Pride. His policies have increased financial and systemic pressures on the province in general and on the LGBTQ+ community specifically.

Ford continues to tout his adherence to his campaign base while ignoring and flagrantly opposing much of the social and financial support systems which aim to benefit marginalized communities and individuals. By limiting access to student groups, financial aid, and modern sexual health education, Ford is unduly challenging members of the LGBTQ+ community who rely on these services.

Ford’s last-minute decision to participate in York Pride was his opportunity to assure his base of his support of the police force, and, in the process, his prioritization of the needs of institutions over vulnerable communities and individuals. Supporting the LGBTQ+ community was never the nexus of his appearance. If it were, he would have attended the Parade during his time as a city councillor. Doug Ford chose not to go to Pride, but the truth is, Pride is better off without him.

The Varsity’s editorial board is elected by the masthead at the beginning of each semester. For more information about the editorial policy, email editorial@thevarsity.ca.

Opinion: Public Health needs a better political strategy

Chronic underfunding fetters life-saving public health efforts in Canada

Opinion: Public Health needs a better political strategy

Cuts to public health funding by the Ontario government announced in April have taken the media by storm, leading a tripartisan group of previous Ontario Health Ministers to urge the government to reverse its decision.

But is this political treatment of public health a new phenomenon, or is this appended to a long history of budgetary cuts and perceived underfunding of its practice and research?

Another event in a long-lasting pattern

Dr. Steven J. Hoffman — the Scientific Director of the Canadian Institutes of Health Research’s Institute of Population & Public Health — and his colleagues would agree with the latter. In a timely paper published in May, the authors argue that public health in Canada is underfunded.

They assert that the 5.5 per cent of total Canadian health spending allocated to public health practice fails to sufficiently fund the range of work that public health practitioners are expected to undertake — from food and drug safety, to occupational health, to health inspection, and more.

More importantly, Hoffman and his colleagues point out that the current rise in the frequency of chronic disease, mood disorders, and anxiety disorders in Canada has failed to garner a “significant” increase in budget allocation to the appropriate venues of public health.

They say that this results from the public health community lacking an appreciation for the process of policymaking, which causes them to fail to account for the reasons why public health isn’t a clear win from a political perspective.

As a solution, the authors propose developing knowledge of political tools and processes among public health officials.

Public health saves lives

Public health efforts are focused on long-term goals, such as preventing, rather than curing, illnesses, or on analyses of statistical trends within the field. Often, its work seems intangible to the public, and is not exploitable by politicians.

Attempts to pull down the 28.1 per cent Canadian adult obesity rate, for example, would require public health officials to target multiple industries. They may need to advocate for businesses to change food labelling, health care providers to provide more expansive training programs, or ask municipalities to adjust local regulations, according to the 2011 Obesity in Canada federal report.

Such efforts aim to change individual behaviour on a large scale through multiple forms of societal intervention. However, it is difficult for non-experts to trace their effects back to conscious public health efforts.

The more these efforts are hidden from voters, the less clout they gather on the political agenda of politicians, who are already wary of being unable to reap rewards from these efforts within the timeframe of the election cycle.

Solutions to the lack of political will for public health funding

To solve this problem, the authors ask for members of the public health community to better appreciate the policy-making process and the actors involved in it, so that public health agencies can adapt strategies to the kind of policy-making network relevant to specific healthcare issues.

They similarly argued for improved understanding of policy instruments — regulation, communication, taxing, and spending — so that the regulatory tools used for public health can be better used. Increased efforts to spread awareness of public health efforts may counter its lack of priority in the voter base.

In the wake of the opioid overdose crisis, mental health crisis, and spread of preventable chronic diseases forming the leading causes of death in the province, public health cannot be more vital in addressing our most urgent needs. Whether the output of a work is deemed tangible or not by some individuals should not make the verdict over the survival of that field of work.

Nonetheless, concerted effort to engage with the political system in the push for improved funding and policy can ultimately win over politicians and policymakers.

Who is fighting for our future?

Youth protests reveal the lifeless reality of on-campus climate activism

Who is fighting for our future?

Fridays for Future is a movement started by 15 year old Greta Thunberg, who sat for three weeks outside of the Swedish parliament to challenge their inaction on climate change. Her courage and determination sparked an international student activism movement.

In Toronto, the Fridays for Future school strike for climate change action began on May 3 at Queen’s Park. It coincided with Doug Ford’s meeting with the recently-elected Alberta Premier, Jason Kenney, as they discussed their objections to the recently-enacted federal carbon tax. The strike concluded at Nathan Phillips Square, in front of City Hall.

These protesters highlighted the fact that even if they collectively decided to recycle, stop using straws, and go vegan, it would not be enough to contest the amount of damage that large-scale carbon emissions have done to the earth. Just 100 businesses alone have contributed to 71 per cent of our world’s global emissions since 1988.

Statistics like this can leave some feeling hopeless, but it ignited a movement among thousands of students around the world. These students refused to let the world decide their future. They refused to be left with the scraps of a dying planet. The march on May 3 was just a glimpse of their potential for enacting change. This is a continuous fight on all fronts, and it is being led by those who will be affected the most.

In 11 years, the damage to the Earth caused by climate change will be irreversible. It is the terrifying end to a story that began with the birth of the industrial age. From the early eighteenth century to now, generations have witnessed the development of what the National Centre for Climate Restoration calls a “near- to mid-term existential threat to human civilization.”

It may seem excessive to phrase it that way, but it is the unfortunate, daunting truth. Scientists around the world have made it clear that if we do not stop the current trajectory of greenhouse gas emissions there will be permanently detrimental consequences.

We already see some of these consequences today, with frequent wildfires on the west coast, record-breaking hurricanes, floods with tolls on thousands of lives, and a severe lack of crops, a major instigator behind the modern refugee crisis.

As reported by the Intergovernmental Panel on Climate Change, the international goal is to reduce warming to under two degrees Celsius and afterward to not allow warming to rise above 1.5 degrees Celsius. It seems impossible, but in order to even begin the process, “every sector of the economy needs to get to zero emissions if we are to stabilize our climate” according to Akshat Rathi, reporting for Quartz.  

It is an intimidating task laid before all of humanity, and yet the response in political spaces has been lackluster.

U of T has witnessed a small protest campaign centred around divesting from fossil fuel companies led by the climate activist group Leap UofT. However, the scale and reach of the movement, unfortunately, does not compare to that of Fridays for Future and is only the second campaign of its kind on campus, following the UofT350 campaign. The truth is, we are nowhere near leading the charge. We are not doing enough.

Just before the march began, the voices that spoke from the microphone placed at the top of Queen’s Park were young, innocent, and enraged. They screamed, they begged, they chastised, and they joked at all those who claimed to work for the betterment of their future.

They spoke on a range of issues in quick, concise speeches. Topics included fast fashion, the effect of the meat industry on global emissions, the Green New Deal, and why divesting from the corporations leading in greenhouse gas emissions was vital for the fight against climate change. All this, when they should have been busy being kids.

Signs are one of the most important parts of a protest, and at the Friday for Future protests it was no different. One replaced the faces on the popular ‘distracted boyfriend’ meme with Doug Ford, money, and our dying earth. Another displayed earth imagined as an ice cream cone with the caption “Noo, I’m melting.” Then there were those with simple, heartbreaking messages, such as “I want to meet my grandchildren.”

That is the core message of Fridays for Future: to let the world see who would be left to deal with the ramifications of a dying earth. At the heart of protest signs covered in memes and the innocence of various misspelled words were children, standing in front of adults who have determined their future, begging for their lives.

As the world faces the consequences of negligent production and selfish policies, children, armed with seemingly more knowledge and worldly understanding than our public servants, are rallying. The question to be asked is where do we, the students who should be empowered by the privilege to learn more, question more, and fight for more, stand. We, as fellow students, must follow in the footsteps of the brave, impassioned students at Fridays for Future in combating climate change. This movement is for all of us, and we must do a better job.

It can be comforting to see youth rising against the injustices of the world. It can make you feel hopeful that the future will be filled with bright minds ready to challenge any obstacle that comes their way. You must not forget that this is not what they should be doing. At the end of the day, it is upsetting to see so many children forced to protest in the streets, because instead, as dozens of signs read, they should be at school.

Nadine Waiganjo is a second-year Social Sciences student at University College.

Opinion: What counts as fairness in sports?

Caster Semenya and the extent to which sporting will go to exclude athletes who are different

Opinion: What counts as fairness in sports?

The Court of Arbitration for Sport (CAS) has erred by failing to overturn a series of discriminatory rules that target female athletes who are transgender or have intersex traits.  

By ruling in favour of the International Association of Athletics Federation (IAAF), the CAS has authorized regulations that require female athletes with naturally high testosterone levels — typically found in intersex women — to suppress their hormone levels if they wish to compete in races between 400 metres and a mile.

At the centre of this controversy is South African runner Caster Semenya. Semenya, who issued an appeal against the IAAF rules, has dominated the women’s track and field scene for the past decade. As a two-time Olympic gold medalist and a three-time World Champion in the women’s 800-metre race, Semenya has faced unrelenting scrutiny. Like several other intersex women who will be penalized by the new rules, Semenya identifies and competes as a woman.

In order to race, she has four options: either take hormonal contraceptives up to six months before competing; compete alongside men; compete in other events not subject to the regulations; or cease competing entirely. Even if Semenya gives in and undergoes hormonal treatment to lower her testosterone levels to the IAAF requirements, the possible side effects of the treatment may negatively impact her health and further prevent her from racing against other women in the events of her choosing.

The IAAF has argued that their new rules — which came into effect on May 8 — are intended to ensure fairness in women’s track and field. This argument is supported by the perceived correlation between testosterone and enhanced athletic performance.

It is commonly believed that an increased amount of testosterone can improve strength and speed levels. The IAAF and supporters of this ruling have relied heavily on this perceived correlation to argue that Semenya holds an “unfair advantage” over other women in her sport because of her naturally elevated levels of testosterone.

However, wouldn’t it be fair to argue that many successful athletes possess natural advantages that give them an upper hand in their respective sports? It’s no secret that height is beneficial in sports such as volleyball and basketball. Should the IAAF ban tall women from competing in basketball and volleyball matches to ensure fairness in these sports?

Take 23-time Olympic gold medalist Michael Phelps. Phelps not only possesses an exceptionally long arm span and reportedly double-jointed ankles, but also produces significantly smaller amounts of lactic acid compared to his competitors. Lactic acid build-up contributes to muscle fatigue, and because Phelps produces less while competing, he holds an advantage over his competitors. Yet, Phelps is not required to undergo treatment to elevate his lactic acid. We still continue to praise him for his athletic achievements while discounting Semenya for hers.

The natural testosterone that Semenya produces differs from the exogenous testosterone which has been prohibited in the Olympics since 1976. The correlation between testosterone and enhanced performance is believed to be linked to the use of synthetic testosterone.

It has yet to be proven whether the same correlation exists for its natural counterpart in female sports. There is a possibility that natural testosterone improves performance, but this prospect is offset by the likelihood that it is unrelated to athletic capabilities. As reported by the Journal of Clinical Endocrinology & Metabolism, there is “no clear scientific evidence”  of a relationship between the two in female sports.

The argument that women with higher testosterone levels hold an unfair advantage is also based on the outdated association of testosterone with masculinity. Traditionally, it has been understood that there is a crucial distinction between men and women in terms of athletic ability, since it was assumed that men typically have more testosterone than women.

Categorizing testosterone as the sex hormone that exclusively belongs to men not only falsely categorizes women with naturally high levels of testosterone as somehow unwomanly, but also neglects the fact that women produce and rely on testosterone to survive as well.

The preoccupation with the role that testosterone plays in fuelling athletic performance also underestimates the importance of external factors, such as income, which play as much of a role in contributing to athletic success as do physical capabilities alone.

Large income disparities across the globe disadvantage athletes who are the product of lower-income environments. These athletes do not have access to the same quality facilities, coaching staff, treatment, or even the support system that are generally present for athletes living in more affluent areas.

U of T Professor of Kinesiology and Physical Education Bruce Kidd reflects similar sentiments in his article. There, he remarks: “Would Canadians who support the IAAF against Semenya like it if they were required to train under the same conditions as their competitors from the Global South? Of course not.”

The new IAAF rules also draw criticism because it seems to unfairly and unnecessarily target Semenya and other female runners from the Global South. An IAAF study on the effects of natural testosterone reveals that it has a greater influence on performance in events such as the hammer throw and the pole vault.

On the contrary, there is a much weaker correlation between natural testosterone and athletic capabilities in the 1500-metre race. Yet women with higher testosterone levels have not been barred from competing in the hammer throw and the pole vault, but have been banned from competing in the 1500-metre race.

This finding is especially daunting considering the fact that events, such as the hammer throw and the pole vault, have historically been dominated by white women from the West. Black women from the global South have typically been victorious in long-distance running events, thus leading some to believe that the IAAF’s policy may be racially motivated.

In response to the CAS’s rejection of Semenya’s challenge to the IAAF rules, the South African Sports Ministry has declared that their track federation, Athletics South Africa, will appeal the decision. Canadian Minister of Science and Sport, Kirsty Duncan, has condemned the ruling, saying that it exhibits “a total disregard for human dignity.” Furthermore, Semenya has vowed to continue running, even stating that she will not give in to the new rules and take hormone suppressants.  

The unjust IAAF rules call for society to re-examine our traditional beliefs about fairness in sports. Is it fair to publicly humiliate intersex women on the unfounded belief that their genetics give them an unfair advantage over other women? If the goal is to ensure an equal playing field for female athletes, the IAAF should focus on securing equal access to adequate training facilities, coaching staff, and athletic gear, instead of resorting to inhumane measures that single out certain athletes because they are different.

Comment in Briefs: Month of April

Students react to some of Volume 139’s final News stories

Comment in Briefs: Month of April

Who are we missing?

Re: “Accessibility is inaccessible, Innis students host mental health forum”

When Oliver Daniel, Annie Liu, Kathy Sun, and Jehan Vakharia first proposed the idea of hosting a mental health forum at Innis College in response to the death in the Bahen Centre for Information Technology, I was impressed and delighted. Four first-year students coming together to take action within days of the news spreading gives me hope about the strength of our campus community.

I love the spirited proposition of initiatives, like the implementation of a Mental Health Director and mental health training within Innis, as well as the acknowledgement that there is only so much students can do without the full force of administration and professional resources to back us up.

But there are still important questions to be asked: what will happen to the students who don’t make themselves visible to us, who don’t come to events, who don’t speak out about campus issues, who don’t engage with student groups, and who may not live on or near campus? These are questions fellow student leaders and I deal with on a daily basis.

These students are often not even on the radar of student clubs, unions, and publications. Student leaders may not have the tools or the vocabulary to identify the communities that are missing from their programming. At the same time, these students are often the ones who most need support.

Student leaders and administration at Innis have worked hard this year to push the boundaries of the Innis community farther to encompass more students of diverse backgrounds and interests. But it is not certain if it is enough. If we aren’t even fully aware of who we are missing, it is not clear what our next step should be to ensure that essential services like mental health support reach the students who need it most.

Michelle Zhang is a second-year Peace, Conflict and Justice Studies, Urban Studies, and Political Science student at Innis College.

Disclosure: Zhang served as the 2018—2019 Equity & Outreach Director at the Innis College Student Society.


In defence of the recent provincial changes to education

Re: “Thousands protest Ford’s proposed education cuts at Queen’s Park”

Since the Ontario government backtracked on controversial changes to its autism programs by making significant concessions and pursuing consultations with parents, I will focus on the recently protested changes to the general public education system. Rather than succumb to the fear-mongering antics of some protesters, we must recognize the benefit of proposed changes to the Ontario public education system, namely the increases to class sizes and mandatory online education.

We’ve come far since the pioneer society of Upper Canada with non-uniform textbooks and uncertified, often transient, pseudo-educators to today’s Ontario public education system.

Still, the system is not without faults. Most concerningly, it fails to prepare students to meet the unique challenges and unprecedented scale and rate of socio-economic changes of the age of information technology.

Overloading if not overburdening the public system by hiring too many teachers misses the forest for the trees. This ineffective hiring policy has diminishing returns on investment and limits the capacity of public coffers to address the many other systemic and infrastructural problems.

It’s been my experience, from primary through postsecondary education, that the quality of the teachers not class size makes for a good or bad learning environment. Increasing classroom size in order to better optimize cost-effectiveness will hopefully maximize use of limited space and resources. At the very least, it will encourage students to be independent and to self-advocate.

Furthermore, mandatory online learning isn’t something to be feared. It is long overdue and must be embraced, especially in a year that marks the 30th anniversary of the World Wide Web. Online learning promotes student independence and responsibility, and holds our province’s limited public resources more accountable.

These changes will maximize the potential of our society’s public education system and better prepare them for an economy that requires more versatile and adaptable lifelong learners.

Oscar Starschild is a second-year Mathematics, Philosophy, and Computer Science student at Woodsworth College.

How can students get involved in science policy?

Fighting for science and the decisions it informs

How can students get involved in science policy?

With the recent anniversary of Toronto’s March for Science, it’s hard to ignore changes rolled out by the Ford government this past year.

Not only has the government scrapped initiatives such as Ontario’s cap and trade carbon tax program and energy efficiency programs, it eliminated the position of Environmental Commissioner and fired Ontario’s Chief Scientist. Many of us who disagree with these changes are wondering where and how we can have our voices heard, especially since the march — which sought to encourage science that works for all — did not take place this year.

Having a seat at the table is the first step toward the inclusion of scientific evidence in policy. This means showing up to city hall meetings and contacting local representatives about science issues that matter to you.

“There are many competing voices [in policy], and there will be trade-offs and balances. Our job is to help people understand what those trade-offs really mean,” said Dr. Dan Weaver, Assistant Professor in UTSC’s Department of Physical & Environmental Sciences.

Each year at U of T and across the world, research yields mountains of new scientific data. Weaver noted that we must continue to incorporate this new data, see if our goals should shift, and ask ourselves if policy and the public are still informed. For researchers, this means communicating findings effectively to those drafting policy.

Weaver pointed to the 2015 United Nations Climate Change Conference in Paris as an example of effective communication. Initially, limiting global warming to two degrees Celsius was set as a policy goal, but further scientific evidence showed that the outcomes would be less costly and far more manageable if capped at 1.5 degrees Celsius instead. This informed policymakers and inspired stronger initiatives for more aggressive emission reductions.

Let’s Talk Science and U of T’s Science Communication Club, both organizations that focus on science communication and outreach, are outlets for students to advocate for science. According to UTM PhD candidate Sasha Weiditch, students can also create their own blogs or participate in activities with groups such as Soapbox Science.

For those interested in policy, Toronto Science Policy Network (TSPN), co-founded by U of T PhD candidate Ellen Gute, regularly organizes workshops on science advocacy, communication, and policy, in addition to hosting panel discussions. These workshops teach students and researchers how to translate their knowledge into an accessible format for the public and for political representatives.

Initiatives outside of campus, such as Citizen Science, allow people to assist in the collection of important data, work on environmental monitoring, or get involved with public science education and awareness.

There are many ways to fight for science as citizens, students, and whoever we will be in the future.

Instead of showing up en masse to march in the streets this year, we must show up in equally great numbers to our campuses, city halls, and voting booths, to communicate the critical importance of science for our democracy and the world at large.