THE SENATE

LEGAL AND CONSTITUTIONAL AFFAIRS LEGISLATION COMMITTEE

Dear Mr Wachtel,

Inquiry into the Regulator of Medicinal Cannabis Bill 2014

Hi Boaz, As requested, here is a rough transcript of your talk to Australia’s Senate hearing into medical marijuana .

April 1, 2015. Inquiry chair: Welcome. Boaz Wachtel (BZ) : Gooday, everyone. Chair: We have your submission, thank you very much. I am required to advise you that this is a parliamentary committee and, in Australia, parliamentary privilege applies and gives protection to witnesses and evidence provided. However, you are not in Australia and parliamentary privilege does not extend outside of Australia. Australian law cannot protect individuals giving evidence in another country. That is probably completely irrelevant to you in Israel and I do not think it means much, but I am required to provide you with that. I invite you to make a short opening statement and then we will ask you some questions. We do very much appreciate your assistance and the time you are taking to talk to us because I understand it is very early in the morning for you. Unfortunately, we have limited time so we are all try to be brief. BZ: PhytoTech Medical Ltd is an Australian listed public company. It is the first medical cannabis company listed on the Australian Stock Exchange. I was chosen for my position with Phytotech due to my 20 years of work in the area of cannabis medicalisation in Israel and in other countries. I am the initiator of the medical cannabis efforts in Israel. In 1995, I was a public representative in the committee in the Israeli parliament to study the issue of cannabis, the legal status and the access to medical cannabis. The committee recommended allowing access to cannabis for seriously ill individuals. I worked vis-a-vis with the ministry of health in Israel, formulating the strategy. Today in Israel, there are 20-plus thousand patients receiving medical cannabis in different forms, which we will discuss later, with their doctor's prescription from eight legal growers. Thus far until recently, until August, I was doing it pro bono. This is the first time in my life I have been asked to serve on a public company as a managing

director, and due to my experience and knowledge of the subject matter to help achieve the company's goals, which are the pharmaceutical development of some delivery methods of cannabis and cooperation in various countries. I am here to help and share the experience that we have and I have with the Australian parliamentary committee, so mistakes can be avoided and access to cannabis by Australian patients can be accelerated. Regarding an overview, there are three countries with national medical cannabis programs now in place and operating. The three countries are the Netherlands, which was the first country in 2003 to launch such a program, in line with Canada, and Israel was the third. The UN drug conventions allow governments to use prohibited drugs for medicinal use such as opium in Australia. Australia is a producer of medicinal opium and an exporter of finished products. Uruguay has recently also launched a program that is in its infancy. The Czech Republic is the fifth country to come on board, so there is no need for any government in any location to reinvent the wheel that wants to launch a national medical cannabis program. There are many lessons to be learnt from the previous experience of these governments, and all it needs is the political will to launch a national medical cannabis agency, which is required by the UN drug conventions. A national medical cannabis agency may have a long name or sound a little bureaucratic , but in Israel the Ministry of Health took an office and nominated a certain individual to run the program. It runs the national program. It sets the rules for cultivation, use, safeguards and any other rules applying to the national medical cannabis program. It issues a tender to choose growers. The national agency takes possession within four months of harvesting the produced cannabis. It distributes it through pharmacists, and the patients come to the pharmacies or some other arrangement and show the prescription and receive the cannabis. In Israel a 30-gram monthly supply costs about $US100 regardless of the quantity the individual receives. There are a number of indications in Israel that are approved for patients. Currently, it is chronic pain due to proven organic etiology, orphan diseases, HIV, inflammatory bowel disease, multiple sclerosis, Parkinson's, malignant tumours in various stages and PTSD. In Israel, as you may have heard—I am sure you have—there are a lot of war veterans with PTSD, and the Israeli Ministry of Defense, in collaboration with the Ministry of Health, conducted a number of studies on the effects of smoked cannabis on chronic PTSD patients. There were tremendously positive results from that study. Current medications do not work for PTSD war veterans. I can share all this information with this distinguished panel and senators in Australia. The indications in the different countries—Israel, Canada, the United States and the Netherlands—are different. The Canadians are the most liberal, if you like. In Canada, it does not have to be a doctor's prescription; it could be a doctor's opinion. There are maybe 30 or 40 conditions that it is possible to receive medical cannabis for in Canada. There are a number of lessons that I wish to share with you, if you are formulating now the medical cannabis program in Australia. One is that there is a danger that the number of available strains, or genetics as they are called, for patients will be too limited. Every patient reacts differently and, therefore, they have to be exposed to

medical cannabis: a few strains are given to them, they take them home and they see how they react to each strain and which reaction is better. In the Netherlands, they have made a mistake of choosing only one supplier with a limited number of strains, and as a result—also in Holland they have an option to go to coffee shops. As a result, we see a very low attendance rate among Dutch patients in the Netherlands. In Israel, the rise in the number of patients is explained by the fact that they have access to a large variety of strains and they can choose which one is best for them. The other issue that I want to share with you is the Israeli Ministry of Health recently issued a chart choosing basically nine categories with different ratios between THC and CBD that will be available to the patients, and all of the growers of the different strains—there may be 100 strains now—would have to comply with this list, which gives it a variation of about 20 per cent to 30 per cent from each category. Let us say you have a 90 per cent THC content and one per cent CBD, so it can vary by 20 per cent to 30 per cent. I cannot remember exactly if it is 20 per cent or 30 per cent. The key is that the medical cannabis has to be grown under controlled conditions. It can be grown in greenhouses; it does not necessarily have to be grown indoors. Growing cannabis indoors costs a lot of money and if, as a result, cannabis becomes too expensive then it becomes cannabis for the rich. It has to be priced so that it does not burden the economics of the patient and his or her family, because many people who become seriously ill also suffer economic catastrophes. In some cases it is covered or subsidised—for example, by the ministry of defence in the case of war veterans. There are some national insurance companies in Israel—not all of them—that also participate in the cost, which is really not very high. It is $100 a month. It seems like not a lot, but it is still burdensome for some patients. It has to be grown in organic matter and in an organic way, with no chemicals added to it or chemical additives. It has to be checked before it reaches the patients because many of them have weakened immune systems. So for the whole chain, from growing to production to distribution, there has to be testing along the way to make sure that the patients receive a product, a herbal medicine, cannabis, that is free from pathogens and contaminations. Chair: I do not want to interrupt you, but we are running out of time and we have a couple of questions. Are there any other major points you want to make? We do have your written submission, of course. BZ: I would like to state that the pharmaceutical industry are very much opposed to medical cannabis because it is outside of their paradigm of existence. Also, we see in Israel, usually among the elderly, that, if a patient is on five or six medications, once they go on cannabis they reduce their other medication intake, so they are left with cannabis and maybe one other medication. So, in many instances, the pharmaceutical industry resistance to medical cabinet stems from the fact that it lowers their profit margins. The other problem is the doctors. There is a prevalent ignorance among doctors as to what cannabis is. They are not being taught about it in medical schools or nursing schools and so on, and therefore they are afraid of it and they cannot think to recommend cannabis in a smoking form. But we see again and again in Israel and Canada and the Netherlands that smoking has to be an option on the table—

Chair: In Australia the medical profession are against it because it is illegal, of course—or they are not against it, but they are cautious about it. Can I ask you: what is an Australian company doing Israel? I ask that in relation to the bill that we are looking at, which is trying to get a regime in Australia that allows the beneficial use of the drug. Why are you in Israel? BZ: Because the research and development that we are doing on the development of a pill with a very unique bioavailability that will be almost as effective as smoking is done here with the Hebrew University and we also do a buccal patch inside the mouth for slow release. The No. 1 problem is the reluctance of doctors to recommend cannabis in its smoking form. They are more familiar or they feel more comfortable with pills, patches and so on. So the company is developing these delivery technologies in Israel in the form of a pill and a buccal patch with the Hebrew University, which is a leader in medical cannabis research and development in the world. I am here as the managing director and the Australian company has a daughter company in Israel that is doing the research and development. They are utilising my experience in the field. I also a certified clinical research manager, so I am happy to help the Australian people. Again, historically, the Australians have helped us fight a number of wars and adversaries—against the Nazis and so on—so I feel obliged. I want to help the Australian people to have a compassionate program for sick people to access medical cannabis, which is really a wonderful plant— Chair: Have you had a chance to read the draft legislation that this Senate inquiry is investigating? BZ : Yes, I did. I think the time is too short right now to react on it— Chair: My question was going to be that, if this bill were passed so that a lot of the things that are now not possible in Australia might perhaps be possible, do you think that would attract your Australian company to do some of the research work it is now doing in Israel in Australia? Mr Wachtel: Absolutely. The fact that the research is so difficult to conduct in Australia, and in the United States for that matter, made Israel a leader in the field—maybe by default, but we would very much like to share our experiences and do further research in Australia, collaborating with Australian doctors and hospitals. There is a huge amount of data available in research regarding cannabis and more research should not be used as an excuse to delay access for patients. We can research cannabis for the next 50 years but access to medical cannabis needs to be as soon as possible. Like the lady who appeared before the committee prior to me, many patients use medical cannabis illegally. The criminalisation of patients under the current control regime has to cease. As I see it, you have to take the next step and make it available to patients as soon as possible. Chair: I regret this very greatly but we really have run out of time. Perhaps we can arrange with the secretary of our committee to get back to you at another time. I am sorry to do this to you but we have run out of time. BZ : I appreciate the opportunity to be able to have input. I am here to help in any way, shape or form if you wish to continue the dialogue at another time.

Chair: Thank you very much. We are very interested in what you have had to say and in your written submission. We did all want to ask you questions but we have simply run out of time. With our very great thanks and appreciation for what you have given us so far, we will say goodbye. But we will get the secretariat of to be in touch with you and perhaps we will catch up with you again. BZ : I look forward to it. Good luck with your mission of compassion and justice for the people of Australia. I support it wholeheartedly.