World Health Day 2011: Thoughts on Drug Resistance and Health Privacy

Matt Lonsdale is a JD candidate at Dalhousie University.

April 7th, 2011, will be the 11th annual World Health Day. This year the World Health Organization (WHO) is encouraging organizations to host events focusing on the increasing threat of antimicrobial resistance. The improper use of medicines can create conditions where viruses, bacteria and parasites develop resistance to the drugs used to treat them.

These “superbugs” can have a devastating effect: according to the WHO, there are 150,000 deaths a year from multidrug-resistant tuberculosis. There are concerns that the increased use of retroviral medicines to treat HIV may lead to the development of similarly resistant strains of that virus. On April 11th, the WHO will release a six-point policy package and encourage politicians, healthcare providers and individuals around the world to adopt these policies in order to help curtail the spread of drug-resistant diseases. In Canada, a number of organizations, including the National Collaborating Centre for Infectious Diseases and the Public Health Agency of Canada, had previously partnered together to mark November 18, 2010 as Antibiotics Awareness Day. The partnership is now working to increase awareness of World Health Day.

Among the factors cited by the WHO for the rise of these resistant strains are insufficient monitoring and surveillance and inadequate research efforts. By their very nature, medical records contain deeply personal information. Surveillance efforts involving increased scrutiny of these records may raise privacy concerns. Provinces across Canada have enacted legislation defining how medical information may be collected and used by healthcare providers. Among the most recent of these laws is Nova Scotia’s Personal Health Information Act (PHIA), which received Royal Assent in December of 2010, but has not yet come into force. The Act requires “custodians” of medical records to obtain informed consent from individuals regarding the uses that will be made of their information and to take steps to protect the confidentiality of information under their control. A recent blog post by David Fraser suggests that in certain contexts, there may be concurrent jurisdiction between the PHIA and the federal Personal Information Protection and Electronic Documents Act, requiring researchers to satisfy the demands of both laws.

However, the focus of the PHIA, and other similar privacy legislation, is typically on personally identifiable information. Section 5(2)(a) of the PHIA states that “This Act does not apply to… statistical, aggregate or de-identified health information”. Information regarding the incidence of a virus within a large group of anonymized individuals would therefore not be covered by the Act, and so could be disclosed as part of an effort to monitor the rise of drug-resistant diseases.

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