Public Health Agency of Canada 2004–2005 Departmental Performance Report Ujjal Dosanjh

Public Health Agency of Canada
2004–2005
Departmental Performance Report
Ujjal Dosanjh
Minister of Health
Table of Contents
Section I – Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Minister’s Message . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
Minister of State’s Message . . . . . . . . . . . . . . . . . . . . . .
4
Chief Public Health Officer’s Message . . . . . . . . . . . . . . . .
6
Management Representation Statement . . . . . . . . . . . . . . .
8
Summary Information . . . . . . . . . . . . . . . . . . . . . . . . .
9
Agency’s Raison d’Être . . . . . . . . . . . . . . . . . . . . . . . .
9
Total Financial Resources . . . . . . . . . . . . . . . . . . . . . .
11
Total Human Resources . . . . . . . . . . . . . . . . . . . . . . .
11
Summary of Performance in Relationship to Departmental
Strategic Outcomes, Priorities and Commitments . . . . . . . . .
12
Overall Agency Performance . . . . . . . . . . . . . . . . . . . . . .
13
Summary of Agency Performance . . . . . . . . . . . . . . . . . .
13
Overall Agency Performance. . . . . . . . . . . . . . . . . . . . .
14
Priority 1: Contribute towards the development of a
seamless and comprehensive public health system . . . . . . . .
16
Priority 2: Enhance federal capacity in public health . . . . . . .
17
Organizing for Results . . . . . . . . . . . . . . . . . . . . . . . .
18
Emergency Preparedness and Response . . . . . . . . . . . . . .
18
Total Financial Resources – Emergency Preparedness
and Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
Health Promotion and Chronic Disease Prevention and Control . .
21
Total Financial Resources – Health Promotion and
Chronic Disease Prevention and Control . . . . . . . . . . . . . .
21
Infectious Disease Prevention and Control . . . . . . . . . . . . . .
26
Total Financial Resources – Infectious Disease
Prevention and Control . . . . . . . . . . . . . . . . . . . . . . .
26
Public Health Tools and Practice . . . . . . . . . . . . . . . . . . .
30
Total Financial Resources – Public Health Tools
and Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30
Other Programs and Services . . . . . . . . . . . . . . . . . . . . .
31
Total Financial Resources – Other Programs and Services . . . .
31
Organizing for Results Sumary . . . . . . . . . . . . . . . . . . . .
32
Total Financial Resources – Public Health Agency . . . . . . . .
32
Section II – Analysis of Performance by Strategic Outcome . . . . .
33
Performance Summary for Priority 1: Contribute Towards the
Development of a Seamless and Comprehensive
Public Health System . . . . . . . . . . . . . . . . . . . . . . . . . .
37
Performance Summary for Priority 2: Enhance the Federal
Government’s Capacity in Public Health . . . . . . . . . . . . . . .
52
Section III – Supplementary Information . . . . . . . . . . . . . . . .
65
Organizational Information . . . . . . . . . . . . . . . . . . . . . .
66
Table 1:
Comparison of Planned Spending and
Full Time Equivalents . . . . . . . . . . . . . . . . . . .
69
Table 2:
Use of Resources by Business Line . . . . . . . . . . . .
70
Table 3:
Voted and Statutory Items . . . . . . . . . . . . . . . . .
71
Table 4:
Net Cost of Department . . . . . . . . . . . . . . . . . .
71
Table 5:
Contingent Liabilities . . . . . . . . . . . . . . . . . . . .
72
Table 6:
Details on Transfer Payments Programs
(TPPs) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
72
Table 7:
Conditional Grants (Foundations) . . . . . . . . . . . . .
86
Table 8:
Response to Parliamentary Committees,
Audits and Evaluations for FY2004–2005 . . . . . . . .
88
Sustainable Development Strategies (SDS) . . . . . . . .
89
Table 10: Procurement and Contracting . . . . . . . . . . . . . . .
93
Table 11: Service Improvement Initiative (SII) . . . . . . . . . . .
94
Table 12: Horizontal Initiatives . . . . . . . . . . . . . . . . . . . .
97
Table 13: Travel Policies . . . . . . . . . . . . . . . . . . . . . . . .
98
Table 9:
Section 1 – Overview
Minister’s Message
I am pleased to present to Parliament the
2004–2005 Departmental Performance Report for
the Public Health Agency of Canada. This is the
Agency’s
first
performance
report
and
demonstrates that much has been accomplished
since its inception on September 24, 2004.
The creation of the Public Health Agency of Canada
and appointment of the country’s first Chief Public
Health Officer last September represented an
important addition to the federal health portfolio.
The Agency, in conjunction with Health Canada
and the rest of the health portfolio, is already
making a vital contribution towards meeting the country’s public health challenges.
The establishment of the Agency allows us to continue building the best health
system in the world, as well as to move towards the ultimate goal of helping make
Canadians the healthiest people in the world.
In Budget 2004 the government announced an additional investment of $100
million to support the development of a pan-Canadian health surveillance system
with particular focus on infectious disease.
The Agency supported health emergency preparedness and response activities for
the entire health portfolio and launched the National Emergency Management
System in collaboration with Public Safety and Emergency Preparedness Canada
and all provinces and territories.
These components are critical to fulfilling the Agency’s mission to promote and
protect the health of Canadians through leadership, partnership, innovation and
action in public health, and to realizing its vision of creating healthy communities in
a healthier world.
The Agency has also acted to enhance partnerships with the provinces and
territories through the establishment of the pan-Canadian Public Health Network
and has advanced international collaboration within the World Health
Organization and with other countries around the world.
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Public Health Agency of Canada
Because disease knows no boundaries, the Agency collaborated with the World
Health Organization on relief efforts for victims of the tsunami emergency in
Southeast Asia, on the Marburg virus outbreak in Angola, and on response to the
Avian flu threat in Southeast Asia. It has been active in developing international
chronic disease and laboratory networks and has developed candidate vaccines for
Ebola and Marburg viruses, two often-deadly diseases.
The 2004–2005 Departmental Performance Report shows the Public Health
Agency of Canada is meeting its responsibility in providing federal leadership in the
area of public health, building alliances with domestic and international partners to
improve health outcomes, and rising to new challenges that threaten the health of
Canadians. The Report demonstrates that the new Agency has made an excellent
start and will continue to make an important contribution to improving a health
system that is already the envy of the world.
Ujjal Dosanjh
Minister of Health
Section I – Overview
3
Minister of State’s Message
The creation of the Public Health Agency of
Canada and the appointment of Canada’s first
Chief Public Health Officer last September
signalled the federal government’s renewed
emphasis on health promotion, disease prevention, and emergency preparedness and response
as a means of improving the health outcomes of
Canadians.
The Agency’s vision statement – “Healthy
Canadians and communities in a healthier
world” – reflects the government’s commitment
to expand the traditional approach to health care
to include the upstream model of exploring the determinants of good health and
taking action to prevent disease.
To that end, I am proud of my involvement as co-leader of the federal-provincial
public consultations to develop pan-Canadian public health goals. This exercise,
which was initiated in 2004-05, will produce when completed Canada’s first
national health goals, endorsed by federal, provincial and territorial governments,
which will serve as the foundation for establishing targets to improve the health of
Canadians.
The public health goals process is one collaborating initiative along with the
creation of the pan-Canadian Public Health Network, a consultative body that is
engaged in knowledge sharing and collaboration between federal, provincial and
territorial partners for the advancement of public health across the country.
The Agency continues to fulfill its mandate to support innovative internal and
external research, and to support the transfer of research into public health practice
and programming. This was highlighted by our support in the creation of six
National Collaborating Centres focussing on infectious diseases, determinants of
health, public policy and risk assessment, infrastructure, infostructure and new
tools development, environmental health, and Aboriginal health.
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Public Health Agency of Canada
The 2004–2005 Departmental Performance Report shows the Public Health
Agency of Canada responding across the spectrum of public health issues facing
Canadians. From meeting the challenges of protecting Canadians against infectious
diseases such as a possible pandemic outbreak, to supporting research that will help
advance our knowledge, to promoting healthy living to improve health outcomes
and reduce the incidence and severity of chronic diseases, the Agency is providing
leadership that will continue to produce long-term improvements in the health and
lives of Canadians for years to come.
Dr. Carolyn Bennett
Minister of State (Public Health)
Section I – Overview
5
Chief Public Health Officer’s Message
As Canada’s first Chief Public Health Officer, I
am proud to have been part of the launch of the
Public Health Agency of Canada in 2004 and of
this public accounting to Parliament of the
Agency’s work in the past twelve months, both as
a branch of Health Canada and then as the
Public Health Agency of Canada in the last six
months.
The Agency was established to provide a national
focal point to lead efforts in the promotion and
advancement of public health nationally and
internationally through the widest possible
collaboration. However, the creation of the Agency has posed a number of
challenges as a result of transition to a new departmental entity which has two
domestic pillars and an international role. Despite this ongoing process, the Agency
continued to deliver on its mandate and it has taken important steps over the last
six months towards improving health outcomes for Canadians.
The Agency accomplished a number of goals during its initial year. It launched the
second phase of the Global Public Health Intelligence Network (GPHIN-II), an
early warning system for public health issues; developed the new Quarantine Act;
and completed the establishment of the Emergency Operations Centres in the
Agency’s twin pillars of Ottawa and Winnipeg. In 2004–05, the Agency also worked
with the provinces and territories to update the Canadian Pandemic Influenza Plan.
To enhance pandemic preparedness, the Government of Canada made a $24 million
contribution (9.6 million doses) towards the creation of a national stockpile of
16 million doses of antivirals for the prevention and treatment of influenza.
The Agency has met many unexpected challenges during its first year of operation.
It helped secure additional influenza vaccine supplies last fall to meet public
concern over shortages, and worked with the World Health Organization (WHO)
and our United States counterparts to detect and trace the source of an accidental
release of H2N2 influenza virus.
6
Public Health Agency of Canada
The Agency welcomed the announcement of the Integrated Strategy on Healthy
Living and Chronic Disease that will combat major chronic diseases such as
diabetes, cancer and cardiovascular disease, which impose a huge burden of
premature death and disability on Canadians. The Agency will lead the
implementation of this Strategy to link public health approaches to health
promotion and to disease prevention and control.
Through these measures, and others, the Agency has lived up to its mandate. It has
anticipated and prepared for threats to public health, carried out surveillance and
reported on diseases and preventable health risks, and used the best tools available
to inform and advise Canadians on matters that will improve their health.
The Agency’s first Departmental Performance Report shows that the Agency,
through its dedicated staff across the country, is meeting the challenges and critical
responsibilities we have been given by the Government of Canada. We are moving
forward on fulfilling our vision of healthy Canadians and communities in a healthier
world.
Dr. David Butler-Jones
Chief Public Health Officer
Section I – Overview
7
Management Representation Statement
I submit for tabling in Parliament, the 2004–2005 Departmental Performance
Report (DPR) for the Public Health Agency of Canada.
This document has been prepared based on the reporting principles contained in
the Treasury Board of Canada Secretariat’s Guide for the preparation of 2004–2005
Departmental Performance Reports:
• It adheres to the specific reporting requirements;
• It uses an approved Business Lines structure;
• It presents consistent, comprehensive, balanced and accurate information;
• It provides a basis of accountability for the results pursued or achieved with
the resources and authorities entrusted to it; and
• It reports finances based on approved numbers from the Estimates and the
Public Accounts of Canada.
Dr. David Butler-Jones
Chief Public Health Officer
8
Public Health Agency of Canada
Summary Information
Agency’s Raison d’être
Canadians are among the healthiest people in the world. Two factors which
contribute to Canadians’ high quality of life are their access to a strong and
sustainable publicly funded health care system, and the existence of a strong public
health system.
Public health involves a range of players and partners engaging in initiatives that
reflect a comprehensive and integrated approach to promoting health, preventing
and controlling both infectious and chronic diseases, protecting people from the
consequences of health emergencies as well as engaging in public health research
and surveillance activities. In Canada, public health is a responsibility shared by the
three levels of government, the private sector, the not-for-profit sector and health
professionals such as family physicians.
An increasingly global economy, the convergence of people in large urban areas, the
ease with which people and goods travel around the world, rapid advances in science
and technology, and the changing nature of our environment are but some of the
factors exerting strong pressures on and posing challenges to Canada’s public
health system. Canada must be prepared to respond to public health threats that
impact on the health of Canadians.
The actions of the public health community are often not as apparent as those
relating to the conventional health care system, because public health focusses on
the promotion of health and the prevention of health problems that could become,
or are, widespread. Events like the emergence of severe acute respiratory syndrome
(SARS) in 2003, however, brought the activities of Canada’s public health
professionals to the public’s attention.
The occurrence of SARS, and subsequent reports by public health experts,
reinforced the need for Canada to have a national focal point to deal with public
health issues. The existence since 1946 of such an organization in the United States
(the Centers for Disease Control and Prevention) and the need to coordinate our
efforts with those of our southern neighbour also encouraged the creation of a lead
agency for Canada. In response to these pressures, the Cabinet established, on
September 24, 2004, the Public Health Agency of Canada (the Agency), and
appointed Dr. David Butler-Jones as the country’s first Chief Public Health Officer.
The creation of the Agency marks the beginning of a new approach to federal
leadership and to collaboration with provinces and territories toward efforts to
renew the public health system in Canada and support a sustainable health care
system.
Section I – Overview
9
When the Agency was created, it inherited the base of activities and commitments
of the former Population and Public Health Branch of Health Canada. Thus, fiscal
year 2004–05 was one of transition from a branch of Health Canada to an agency.
This Departmental Performance Report reports on the Population and Public
Health Branch until September 24, 2004, and the Agency after that date.
One of the accomplishments of the Agency was the identification of its mission: “To
promote and protect the health of Canadians through leadership, partnership,
innovation and action in public health.” To assist Canadians in moving towards its
vision of “healthy Canadians and communities in a healthier world,” the Agency is
mandated to work in collaboration with its partners, to lead federal efforts and to
mobilize pan-Canadian action in preventing disease and injury, and to promote and
protect national and international public health through the following:
• Anticipating, preparing for, responding to and recovering from threats to
public health;
• Carrying out surveillance of, monitoring, researching, investigating and
reporting on diseases, injuries, other preventable health risks and their
determinants, and the general state of public health in Canada and
internationally;
• Using the best available evidence and tools to advise and support public
health stakeholders nationally and internationally as they work to enhance
the health of their communities;
• Providing public health information, advice and leadership to Canadians and
stakeholders; and
• Building and sustaining a public health network with stakeholders.
In addition to setting its long-term focus and direction, the Agency launched several
new initiatives in 2004–05. These new activities follow up on commitments made at
the September 2004 First Ministers’ Meeting as well as on some of the recommendations presented by experts’ reports on the public health system. For example,
• The Minister of State engaged individuals, public health experts, volunteer
organizations and elected officials in a consultation process to establish
health goals for Canada by the fall of 2005. The second phase of this process,
beginning in the fall of 2005, will consist of establishing targets and
indicators so that progress against those health goals can be measured. More
information on this process is accessible on the Healthy Canadians Web site
at http://healthycanadians.ca/home.html.
10
Public Health Agency of Canada
• Pan-Canadian Public Health Strategy and Network: To build on the future
health goals, the Agency took a leadership role in putting in place the initial
components of a pan-Canadian Public Health Strategy and a pan-Canadian
Public Health Network that will improve collaboration and informationsharing among governments on public health issues.
• The Agency supported the establishment of six National Collaborating
Centres for Public Health to provide national focal points for the study of key
priority areas in public health and to contribute to the development of a panCanadian public health capacity. The Centres will emphasize collaboration
and translation of knowledge into practical public health strategies. They
will focus on the determinants of health; public policy and risk assessment;
infrastructure, infostructure (systems of information and communications
technologies), and new tools development; infectious diseases; environmental health; and Aboriginal health. Additional details are available at
http://www.phac-aspc.gc.ca/media/nr-rp/2004/2004_01bk2_e.html.
• In the February 2005 Budget, the Government announced that it would
provide $300 million over five years for the Integrated Strategy on Healthy
Living and Chronic Disease. The pan-Canadian Healthy Living Strategy, a
federal/provincial/territorial effort comprising one of the key components of
the Integrated Strategy, reflects the Agency’s integrated approach to health
promotion and chronic disease prevention. The Integrated Strategy has
three pillars: promoting health by addressing the conditions that lead to
unhealthy eating, physical inactivity and unhealthy weights; preventing
chronic diseases through focussed action on risk factors; and creating
platforms for the early detection and management of chronic diseases such
as diabetes, cancer and cardiovascular disease. Additional details are available at http://www.phac-aspc.gc.ca/hl-vs-strat/index.html and at http://www.
phac-aspc.gc.ca/ccdpc-cpcmc/topics/integrated_e.html.
Total Financial Resources
Planned
Authorities ($ millions)
Actual ($ millions)
This agency’s business line was
the Population and Public Health
Branch as well as other parts of
other branches of Health Canada.
605.2
586.7
Total Human Resources (full-time equivalents)
Planned
Actual
Difference
1,671
1,666
5
Section I – Overview
11
Summary of Performance in Relationship to Departmental Strategic
Outcomes, Priorities and Commitments
Strategic
Outcome
2004–2005
Priorities/
Commitments
Actual
Authorities Spending
Type ($ millions) ($ millions)
Expected
Results
and
Current Status
1. Contribute
A healthier
towards the
population
development
by promoting
of a seamless
health and
and comprepreventing
hensive public
illness
health system
New
428.4
419.7
The Agency
would work
collaboratively with provincial/
territorial governments and other
partners to bring
together public
health authorities
for the development of a
seamless and
comprehensive
public health
system.
Successfully
met.
2. Enhance the
federal
government’s
capacity in
public health
New
176.8
167.0
The Agency would
be up and running,
and delivering on
its mandate and
commitments to
develop and
implement national
policies and
programs that
promote and
protect the health
of Canadians.
Successfully
met.
12
Public Health Agency of Canada
Overall Agency Performance
Summary of Agency Performance
Operating Environment and Context
Public health consists of a range of efforts to keep the Canadian population healthy
and safe. A key component of Canada’s health system, it seeks to prevent disease, to
prolong life and to promote health through the organized efforts of society.
Promoting healthy living and reducing health disparities, preventing and
controlling infectious and chronic diseases and injuries, as well as being ready to
respond to threats to public health are critical components of the Government of
Canada’s responsibilities to help the people of Canada maintain and improve their
health.
The role of the Public Health Agency of Canada can be summed up as follows:
• It will take a lead role in the prevention of disease and injury and the
promotion of health;
• It will provide a clear focal point for federal leadership and accountability in
managing public health emergencies;
• It will serve as a centralized point for sharing Canada’s expertise with the
rest of the world and applying international research and development to
Canada’s public health programs; and
• It will strengthen intergovernmental collaboration on public health and
facilitate national approaches to public health policy and planning.
Most of the activities of the Agency – indeed, most public health activities in general
– involve collaboration and partnership with the provinces and territories, other
federal departments, health organizations, professional organizations, academia,
the private and not-for-profit sectors and/or other stakeholders. This creates
challenges for performance measurement, as positive health outcomes and trends
invariably reflect the success of joint efforts.
The context for the new Agency was very clearly stated by the Honourable Ralph
Goodale, in Budget 2004, on March 23, 2004:
…events such as the SARS outbreak and the spread of the avian flu
have reminded all of us that we now live in a more vulnerable world,
where disease can be spread from one end of the globe to the other in
just a matter of hours. As a result, we face new challenges to our public
health systems, requiring new approaches and new responses. With this
budget, we begin to provide the resources for a new Canada Public
Health Agency, to be able to spot outbreaks earlier and mobilize
emergency resources to control them sooner. …
Section I – Overview
13
…Once the agency and its new CEO have developed a long-term
strategic plan, we will be in a position to make further investments to
ensure that Canadians receive the national public health agency they
deserve…
Fiscal year 2004–05 was a year of transition for the new Public Health Agency of
Canada. On September 24, 2004 the Agency was created, its backbone consisting of
Health Canada’s the Population and Public Health Branch.
In this report, the Agency’s performance and financial tables are presented
according to the framework provided under the Strategic Outcome and Business
Line. This Departmental Performance Report is based on the approved Program
Activity Architecture for the Population and Public Health Branch. The PAA used
by the agency will be further developed in order to provide a stronger performance
measurement framework.
Overall Agency Performance
Canada’s Performance
The Public Health Agency of Canada’s strategic outcome “A healthier population by
promoting health and preventing illness” is aligned with Canada’s Performance 2005
under several themes:
! The Agency’s focus on health promotion and on minimizing the extent and
impact of infectious and chronic diseases, injuries and emergencies
contributes to the outcome “Healthy Canadians,” which supports the
Government of Canada’s outcome “Healthy Canadians with access to quality
health care” under the theme “Canada’s Social Foundations.”
! The Agency’s activities to promote healthy living, to minimize the extent and
impact of infectious and chronic diseases, and to strengthen Canada’s public
health system contribute to the high quality of life in Canada. Together with
the Agency’s collaboration with foreign and multilateral organizations and
public health officials, and especially its support of other countries’ efforts
related to its key program areas, these activities support the outcome “Global
poverty reduction through sustainable development” under the theme
“Canada’s Place in the World”. Under the same theme, the Agency also
supports the outcomes “A strong and mutually beneficial North American
partnership” and “A safe and secure world,” primarily within the key program
area of Emergency Preparedness and Response, by activities including
those falling within the Government’s Smart Border Initiative and National
Security Policy.
In its first year of operation, the Agency delivered on its two key priorities (to
contribute towards the development of a seamless and comprehensive public health
system, and to enhance the federal government’s capacity in public health), as
14
Public Health Agency of Canada
identified in the 2004-2005 Health Canada Report on Plans and Priorities. In addition
to developing public health goals, the Agency established the pan-Canadian Public
Health Strategy and the pan-Canadian Public Health Network, and augmented its
capacity for information sharing, surveillance of diseases and emergency response.
A Healthy Living Task group, comprised of representatives from the Agency and
the provinces and territories led the development of the pan-Canadian Healthy
Living Strategy. Intersectoral working groups provided a vehicle for input from other
governments, other federal departments and other stakeholders (including nonThe Public Health Agency of Canada’s Role in Aboriginal Health
In her cross-country series of roundtable discussions surrounding the development
of the Public Health Agency of Canada, the Minister of State (Public Health)
emphasized that the Agency would have a role in Aboriginal public health issues.
All work on Aboriginal people’s issues is done in consultation with the Agency’s
partners in the First Nations and Inuit Health Branch (FNIHB) of Health Canada,
which has responsibility for on-reserve populations and Inuit peoples, while the
Agency offers programs that target Aboriginal populations living off-reserve and
in urban settings. Its Aboriginal Head Start in Urban and Northern Communities
program is designed specifically for Aboriginal people other programs, such as the
Community Action Program for Children and the Canada Prenatal Nutrition
Program, have large numbers of Aboriginal participants. As part of the development
of the Pan-Canadian Healthy Living Strategy, a dialogue was held with national
Aboriginal organizations. In addition the National Collaborating Centre for
Aboriginal Health will bring forward best practices and help move new knowledge
into public health policy and practice as they relate specifically to Aboriginal health.
! Aboriginal Head Start (AHS), in both its Urban and Northern
Communities (off-reserve) components, is an early intervention strategy
for First Nations, Inuit and Métis children and their families living in urban
centres and large northern communities.
! Initiatives to prevent HIV/AIDS among Aboriginal populations during
2004–05 included the provision of funding to the Battlefords Family
Health Centre in North Battleford, Saskatchewan, which sought to
increase knowledge of HIV/AIDS, hepatitis C and other sexually
transmitted infections among at-risk Aboriginal youth. In addition, 25 other
projects were funded under the Non-Reserve First Nations, Inuit and
Métis Communities HIV/AIDS Project Fund (see http://www.phacaspc.gc.ca/aids-sida/hiv_aids/federal_initiative/community/fund_04_06.
html).
! The independent National Collaborating Centre for Aboriginal Health will
develop priorities for research and knowledge translation in consultation
with the Aboriginal community, researchers, practitioners and other levels
of government. Priorities are to take into account the health status of
Aboriginal people in urban settings as well as those who live in rural and
remote communities. This initiative is being delivered through a grant to
the University of Northern British Columbia in Prince George.
Section I – Overview
15
governmental organizations and some private sector agencies), and assisted the
Agency in the development of a policy framework for the Budget 2005 announcement
of funding for the Integrated Strategy on Healthy Living and Chronic Disease. These
initiatives will continue to build strong partnerships with provincial and territorial
governments, other federal departments and other stakeholders, strengthened
federal and national capacity in public health, and enabled the Agency to demonstrate
effective leadership in meeting public health challenges.
Priority 1: Contribute towards the development of a seamless and
comprehensive public health system
The Agency worked with provinces and territories to set in place the initial
components of the pan-Canadian Public Health Strategy that will move toward the
new public health goals being developed through the federal/provincial/territorial
(F/P/T) public consultative process. The Agency took a leadership role in
establishing the new pan-Canadian Public Health Network that will significantly
enhance data sharing and collaboration between F/P/T partners.
New funding programs have been put in place to counter infectious and chronic
disease and to improve emergency preparedness. Concrete steps have been taken to
strengthen information sharing and laboratory capacity dealing with infectious
disease, to enhance access to advanced technologies, and to foster collaborative
research. Significant progress has been made in integrating surveillance networks,
expanding both geographical coverage and content. Activities are underway, in
partnership with provinces and territories, academia, and other health and
professional organizations, to address public health human resource planning
issues, and the Agency has augmented its epidemiology training programs.
The Agency, which has the federal lead for HIV/AIDS, worked with its federal
partners to implement the new Federal Initiative to Address HIV/AIDS in Canada.
Besides the Agency’s work on infectious disease during 2004–05, a major initiative
to promote healthy living and prevent chronic diseases was announced. The
Integrated Strategy on Healthy Living and Chronic Disease was announced in
Budget 2005. It provides a framework for health promotion, with an initial focus on
healthy eating, physical activity and healthy weight as well as complementary
disease-specific prevention and control efforts related to major chronic diseases
such as diabetes, cancer and cardiovascular disease. Its implementation will be
informed by lessons learned from the Canadian Diabetes Strategy (non-Aboriginal
components), which Budget 2005 renewed and enhanced with the Integrated
Strategy.
While the Agency filled gaps in infectious and chronic disease programs, it also
augmented emergency preparedness and response. During 2004–05, it
16
Public Health Agency of Canada
• Launched the Canadian Global Public Health Intelligence Network II,
providing 24-hour global monitoring and surveillance for potential global
health threats;
• Has been laying the foundations, through its regional offices, for Regional
All-Hazards Emergency Plans and Policies, working in coordination with
provincial and territorial partners; and
• Provided emergency supplies, equipment and medicines to survivors of the
December 2004 tsunami, thus playing a significant role in Canada’s response
to that disaster.
Priority 2: Enhance the federal government’s capacity in public health
The creation of the Public Health Agency of Canada and the appointment of Canada’s
first Chief Public Health Officer may be considered the key achievements of 2004–05
in terms of the federal capacity in public health. However, the Agency also swiftly
moved to increase capacity, particularly with regard to information generation and
sharing, healthy living and chronic disease, and emergency response.
The creation of federal systems to support pan-Canadian networks for the collection
and use of infectious disease information were important priorities in 2004-05. The
Canadian Network for Public Health Intelligence (CNPHI) is a three-year project
funded by the Chemical, Biological, Radiological and Nuclear (CBRN) Research and
Technology and Initiative (CTRI) through Defense Research and Development
Canada, to create a robust information technology backbone to strengthen the
public health system. It was in its second year of development, and began supporting
the Canadian Public Health Laboratory Network during 2004-05. An adequate
technological base is making possible effective communication among those
researching infectious diseases, bioterrorism and other health emergencies. Now
used by 99 percent of health units across Canada, the Canadian Integrated Outbreak
Surveillance Centre (CIOSC), which is a part of CNPHI, also played an integral role
in information sharing. In combination, the Integrated Public Health Information
System and the Canadian Integrated Outbreak Surveillance Centre have improved
the federal government’s capacity for diagnostic research, surveillance, and
information sharing. This in turn allows for timely outbreak detection and
response to outbreaks of emerging and re-emerging infectious diseases.
A major goal underlying the creation of the Agency was to ensure that the federal
government would be able to deal effectively with public health emergencies. Key
achievements for 2004–05 in this respect include:
• Re-establishment of front-line quarantine services at Canada’s eight major
international airports; and
• A strategic review of the National Emergency Stockpile System (NESS), to
ensure readiness to respond to all types of emergency hazards.
Section I – Overview
17
Organizing for Results
During 2004–05, the Public Health Agency of Canada’s programming fell into four
broad categories:
• Emergency Preparedness and Response;
• Health Promotion and Chronic Disease Prevention and Control;
• Infectious Disease Prevention and Control; and
• Public Health Tools and Practice.
The Agency’s programming is supported by community grant and contribution
programs, the largest of which are the Community Action Program for Children
(CAPC), the Canada Prenatal Nutrition Program (CPNP), Aboriginal Head Start
(AHS), AIDS – COMMUNITY ACTION, the Population Health Program, the
hepatitis C support program and the Canadian Diabetes Strategy (CDS).
While the Agency’s policy development, research and information management
activities are largely carried out in the Agency’s headquarters offices in Winnipeg
and the National Capital Region, many of its programs are delivered from both
headquarters and regional offices. To achieve the Agency’s mandate, its regional
staff collaborated with the provinces, municipalities, for-profit and non-profit
organizations and delivered funding to community-based organizations.
The following sections provide more detailed information, including actual and
planned spending for key programs and services relating to the Agency’s four broad
categories of programming.
Emergency Preparedness and Response
The public’s health can be threatened by emergencies resulting from events such as
natural disasters, major releases of pollutants and outbreaks of infectious diseases.
The Agency played a role in 2004–05 in assuring adequate preparation for such
events. In December 2004, the World Health Organization (WHO) conducted an
assessment of Canada’s national health emergency preparedness programs. It
found the Canadian system to respond to events with public health consequences to
be, in general, complex, well integrated and capable of responding to such events.
Because emergency response must be a collaborative effort, the Agency worked and
continues to work closely with governmental partners, such as other federal
departments, provinces and territories, as well as non-governmental partners to
develop emergency response plans, the key tool for adequate preparation. For
example, the Agency supported training for emergency preparedness by providing the
services of professionals skilled in course design, adult education and course delivery.
These professionals participated in developing the training courses necessary to
enable Canada’s health sector to respond effectively to emergency situations.
18
Public Health Agency of Canada
New Emergency Operations Centre – Winnipeg
A new Emergency Operations Centre opened at headquarters in Winnipeg in
the spring of 2005. The Agency’s two emergency response centres, in Winnipeg
and in Ottawa, will serve to coordinate the Agency’s response to public health
emergencies. They can be linked, in real time, to other centres and agencies
including those of the World Health Organization and the Pan American Health
Organization.
The Agency also provided accurate and timely information to both Canadians and
World Health Organization officials on national and global public health events. It
played a coordinating role for public health security both domestically and
internationally, and provided essential emergency planning and infectious disease
resources to front-line public health workers across Canada. It provided up-to-date
information on international disease outbreaks, immunization recommendations
for international travel, general health advice for international travellers and
treatment and prevention guidelines for specific diseases. In addition, the Agency
provided expert advice and information to all levels of government in Canada, and
collaborated with international agencies to share intelligence and other information
and to mitigate chemical, biological and radiological/nuclear threats.
Public Health and National Security
In recognition of the close relationship between public health and national
security, Canada’s first National Security Policy, published in April 2004,
included measures to fill priority gaps in public health emergency readiness and
reaffirmed the action taken to modernize the public health emergencies system.
At the international level, Canadian public health officials worked closely with
their United States counterparts on biosecurity aspects of the Smart Border
Declaration and Smart Border Action Plan. The Agency was also a participant in
the Global Health Security Action Group, which works to strengthen the
international public health response to the threat of international biological,
chemical and radiological/nuclear terrorism.
But public health crises do not come only in the form of emergencies – public health
is also threatened by disease. The outbreak of any infectious disease could result in
significant socio-economic difficulties throughout Canada. The Agency is working
to ensure Canada’s preparedness in the event of a pandemic influenza outbreak by
working with provinces and territories to update the Canadian Pandemic Influenza
Section I – Overview
19
Plan. Specifically, the Government of Canada made an investment of $24 million
(9.6 million doses) towards the creation of a national stockpile of 16 million doses of
antivirals.
Total Financial Resources – Emergency Preparedness and Response
Key Program Area
Authorities ($ millions)
Actual ($ millions)
Emergency Preparedness
Capacity
19.1
7.2
Emergency Response
Capacity
30.7
32.6
Total
49.8
49.8
The Agency inspected and licensed high-risk level 3 and 4 biocontainment facilities,
and issued permits for the importation of human pathogens. It applied its national
expertise on biosafety-related issues to the development and application of the
national biosafety policies and guidelines. The Agency played a leading role in the
development of national plans for responses to suspicious packages and other
situations that may involve pathogens including potential threats of bioterrorism. It
also provided access to its extensive resources on biosafety, including training
courses, videos, up-to-date bibliographic references and quick references in the form
of safety data sheets.
Regional Emergency Preparedness
Collectively with the Agency’s other regional offices and Centre for Emergency
Preparedness and Response (CEPR) in Ottawa, the British Columbia-Yukon
Regional Office continued to develop and revise emergency management
plans, capacity and infrastructure. This was done in order to create sufficient
consistency among plans, to ensure that there are elements of interoperability
across regional plans and to support optimum use of relatively scarce human
resources. The regional coordinators of emergency preparedness and response
routinely work as a group with the CEPR and other federal and provincial
partners to address a broad range of strategic and tactical issues related to
emergency management.
When emergencies occurred, the Agency provided emergency health and social
services. This involved assessing and restoring stockpiles of emergency supplies as
well as distributing medical and pharmaceutical supplies to provincial/territorial
governments at their request. Supplies were provided, for example, in response to
the South Asian tsunami in January 2005; the avian influenza outbreak in British
Columbia, when Tamiflu was issued to the Canadian Food Inspection Agency for
20
Public Health Agency of Canada
federal workers involved in the farm cleanup; an Ottawa apartment fire in
September 2004; and a request by the Ministry of Social Services of Ontario for
supplies to be sent to the Public Works and Government Services Canada yard in
Fort Erie, Ontario, in preparation of the set-up of Reception Centre Kits for the Fort
Erie Reception Centre for asylum seekers, in December 2004.
An emergency preparedness forum of provincial and territorial emergency health
and social services officials and Chief Medical Officers of Health was coordinated
through the Agency, in order to discuss the scope of federal/provincial/territorial
emergency preparedness health planning, training and arrangements. Expertise
and services provided by the Agency included business planning, strategic policy
advice, performance measurement and legislative support.
While responding to health emergencies is a crucial public health function,
preventing health problems is as well.
Health Promotion and Chronic Disease Prevention and Control
Total Financial Resources – Health Promotion and
Chronic Disease Prevention and Control
Key Program Area
Health Promotion/Integrated
Healthy Living Strategy
Strategies for Specific Chronic
Diseases
Total
Authorities ($ millions)
Actual ($ millions)
177.3
179.6
33.1
27.7
210.4
207.3
In order to contribute to the health of Canada’s population, the Agency promoted
healthy human development, developed partnerships and introduced integrated
strategies for promoting health and preventing chronic diseases. During 2004–05,
the Agency helped Canadians in this endeavour through the delivery or funding of a
range of programs using integrated healthy living strategies and prevention
strategies for specific chronic diseases.
The Agency developed policy, carried out research and delivered programs related
to childhood and adolescence during 2004–05. These included programs to support
early childhood development such as the Canada Prenatal Nutrition Program, the
Community Action Program for Children (CAPC) and Aboriginal Head Start, as
well as smaller support programs to individual communities and groups. It also
maintained partnerships and networks with a wide range of domestic and
international organizations, other federal departments and provincial/territorial
governments to address issues pertaining to the life stages of childhood and
adolescence.
Section I – Overview
21
Canada Prenatal Nutrition Program (CPNP) – Edmonton
The “Health for Two” program is a unique partnership that involves over 30
community agencies. Community partners and public health centres provide
convenient access to over 50 Edmonton area sites, and deliver services in
“safe” community environments to clients, specifically women exposed to social
and economic risk factors. Partner agencies integrate prenatal information,
support and distribution of nutrition supplements into their ongoing programs.
The “Health for Two” program reaches over 1000 women at any one time and
over 24,000 women annually.
The Agency likewise served as a centre of expertise related to adults, healthy aging
and seniors. It delivered enhanced physical activity programs for adults and healthy
and active aging information for seniors. It also participated in updating Canada’s
Combined Food Guide to Physical Activity and Healthy Eating.
Working with its partners and stakeholders, the Agency developed policy
frameworks and national action plans that allowed for coordinated efforts on health
promotion-related issues such as improving the health of citizens in rural and
isolated areas of Canada and disseminating information to the public and to health
professionals. It provided information directly to professionals and the public
during 2004–05 through the Canadian Health Network, which it manages. This
national, internet-based, bilingual information portal provided easy access to
trustworthy, timely and relevant information on maintaining good health and
preventing disease.
Nunavik Mentoring Project
Directors of childcare centres funded by Aboriginal Head Start (AHS) in
Kuujjuaq (Tumiapiit and Iqitauvik centres) and Ouaqtaq, which provide 160 and
30 day-care spaces respectively for Inuit children, have been able to benefit
from a mentoring program. In this learning and professional development
project, two directors of childcare centres from the greater Montréal region
spent a month in the northern Québec communities, following the local directors
as they carried out their daily tasks. Later, the directors of the Kuujjuaq and
Ouaqtaq centres made a working visit to southern childcare centres to increase
their understanding of practices used in the Montréal region. Another centre, in
Kuujjuaraapik, will benefit from this mentoring experience in the fall of 2005,
completing the initial program which was highly appreciated and considered
beneficial by both the Nunavik region childcare centre directors and their
mentors.
22
Public Health Agency of Canada
Besides this work with professional organizations, the Agency strengthened its
relationship with the voluntary sector through the Voluntary Sector Initiative, with
the goal of increasing that sector’s capacity to deliver public health programs and to
contribute to public health policy development.
Integrated approaches are at the forefront of health promotion and disease
prevention and control both in Canada and internationally. Scientific evidence
demonstrates that healthy eating and physical activity protect people against many
chronic diseases, including cancer, heart disease and stroke as well as diabetes.
These approaches offer opportunities for greater effectiveness by bringing health
promotion and disease prevention efforts together. Given that major chronic
diseases share common risk factors such as unhealthy diet and physical inactivity,
concerted effort across jurisdictions and across sectors, to respond to a combination
of risk factors and diseases, can achieve greater impacts. Integration does not rule
out employing specific approaches to address challenges particular to individual
diseases. In fact, integrated approaches mandate a balance between integrated and
disease-specific efforts.
Expert reviews of the Canadian public health system following the SARS crisis
recommended investments and a coherent national strategy for chronic disease
prevention as part of a necessary growth in public health capacity. All First
Ministers endorsed this approach in the September 2004 health accord, stating that
the pan-Canadian Public Health Strategy “will include efforts to address common
risk factors, such as physical inactivity, and integrated disease strategies.”
Over this reporting year, the Agency responded to these calls for federal leadership
in the establishment of a public health response to chronic disease by developing a
policy framework for an Integrated Strategy on Healthy Living and Chronic
Disease. This initiative, announced in Budget 2005, builds on the initial
investments in the Public Health Agency made in 2004–05. The Budget proposes an
investment of $300 million over five years for the Integrated Strategy. It includes a
series of activities that will promote healthy eating and encourage physical activity
and healthy weight factors that can help to prevent and control chronic diseases.
This would allow a series of complementary, disease-specific activities in the areas
of diabetes, cancer and cardiovascular disease. The Integrated Strategy includes a
renewal of the Canadian Diabetes Strategy (non-Aboriginal components), with
annual funding for the latter enhanced to $18 million from $15 million.
The pan-Canadian Healthy Living Strategy is another key component of the
Integrated Strategy. In 2004–05, in partnership with its provincial and territorial
partners, the Agency carried out developmental work toward a long-term
integrated pan-Canadian Healthy Living Strategy that would include policy and
programming initiatives on healthy eating and physical activity and their
relationship to healthy weights. This developmental work also focussed on mental
Section I – Overview
23
health promotion. The Healthy Living Strategy will function in an inter-sectoral
manner, engaging provincial and territorial governments, other federal departments and non-governmental organizations.
While developing the Integrated Strategy on Healthy Living and Chronic Disease,
during 2004–05 the Agency continued to deliver existing programs on specific
chronic diseases, including the Canadian Diabetes Strategy (non-Aboriginal
components) and the Canadian Breast Cancer Initiative.
Funding for several regional projects under the Canadian Diabetes Strategy (CDS)
was extended as part of a one-year extension of the CDS prior to its incorporation
into the Integrated Strategy on Healthy Living and Chronic Disease. An evaluation
of the CDS validated the direction taken in developing the Integrated Strategy. This
evaluation will be made available in 2005–06.
A National Strategy for Comprehensive Workplace Health Promotion:
Health Works
Funding was provided, through the Canadian Diabetes Strategy, to the Heart
and Stroke Foundation of Nova Scotia to develop workplace health promotion
models for the prevention of chronic diseases, including type 2 diabetes.
Research demonstrates that workplace health promotion can improve
employee health, enhance employee relations, raise morale and productivity
and reduce health care costs and absenteeism. Outcomes of this project
included refined models for comprehensive workplace health promotion and
identification of required support; increased knowledge, skills and abilities
within organizations which are critical to dissemination and sustainability; and
tools to support comprehensive workplace health promotion and evaluation.
Nine multi-year grant and contribution projects were approved in 2004–05 under
the Community Capacity Building Fund component of the Canadian Breast Cancer
Initiative. The nine projects show stronger links to and integration with cancer
strategies whose scope extends beyond breast cancer, and touch on determinants of
health outside personal and systemic health care.
The Agency worked with stakeholders and partners to develop disease-specific
policy frameworks for the prevention and control of the leading chronic diseases in
Canada. It supported the development of pan-Canadian policies on diabetes and
cancer, explored improved surveillance capacity, supported identification and
dissemination of best practices in prevention, and raised awareness of the need for
approaches to chronic disease prevention and control through a range of projects
and activities.
24
Public Health Agency of Canada
It also continued its work towards an integrated and intelligent approach to chronic
disease surveillance, undertaking a number of key activities related to the
enhancement of surveillance of cardiovascular disease, arthritis and other
musculoskeletal diseases, mental health/illness and cancer (staging). Several
workshops were organized to support current forays in these areas. National and
international experts were invited to provide valuable input regarding the
feasibility of creating new initiatives and expanding on current initiatives. In
addition, an internet-based application to assist in national childhood cancer data
collection was launched; this will facilitate remote data submission by paediatric
oncology centres across the country.
In addition, working with other federal government agencies, provinces and
territories, national health professional associations and other non-governmental
organizations, university-based researchers and international experts, the Agency
monitored and reported on the determinants of health and the health outcomes of
foetuses and babies around the time of birth (during the perinatal period), and
injury and child maltreatment.
Work with national and international experts also took place on best practice
guidelines for breast cancer; economic modelling, including of cost-effectiveness of
preventing type 2 diabetes among high-risk groups; and estimation of the
prevalence of pre-diabetes in Canada. In addition, an inventory of best practice
interventions for chronic disease prevention and control was conducted that will
serve as a starting point for the establishment of a searchable database of best
practice interventions.
As a complement to its work within Canada, the Agency was active in fulfilling
Canada’s role as an international partner in the global prevention and control of
chronic disease. It worked with national and international partners and
stakeholders, including the World Health Organization (WHO) and the Chronic
Disease Prevention Alliance of Canada (CDPAC), on national and international
action planning on chronic disease prevention and control. As the only collaborating
centre on non-communicable disease policy in the Americas and Europe, the
Agency’s WHO Collaborating Centre (WHOCC) supported the WHO Network of
Countries (CARMEN and CINDI programs) in all aspects of chronic disease policy
development, from analysis to implementation and development of an
evidence-based framework. In this regard, a demonstration site on the integrated
approach to chronic disease prevention and control, which contributes to the
international model, has been established in Alberta.
Over the last year, the WHOCC led the establishment and technical development of
a Non-Communicable Disease Policy Observatory in the Americas, jointly working
with the Pan American Health Organization. Several countries have begun
conducting case studies on policy formulation processes in the area of nutrition
Section I – Overview
25
policy, and the WHOCC has played an integral role in the development and signing
of a Framework for Cooperation on Chronic Diseases between the WHO and
Canada. The Public Health Agency of Canada also manages WHO Collaborating
Centre on Surveillance of Cardiovascular Diseases in Developing Countries.
First National Conference on Integrated Chronic Disease Prevention
In November 2004, the Agency organized, in partnership with the Chronic
Disease Prevention Alliance of Canada, the first national conference on
integrated chronic disease prevention in Ottawa, under the theme “Getting It
Together,” the conference was a national call for action to mobilize and to build
on vital knowledge across sectors, to strengthen key relationships among
disciplines and to create the future of an integrated system for chronic disease
prevention and control in Canada.
Canada also hosted the fourth meeting of the WHO Global Forum on Chronic
Disease in November 2004, which resulted in a renewed commitment to support
policy activities among countries and within WHO regions. The WHOCC provided
secretariat support for this meeting.
In summary, during 2004–05, the health promotion and chronic disease prevention
and control program addressed populations, high-risk groups and specific diseases
through health promotion and disease prevention, using integrated strategies and
disease-specific strategies.
Infectious Disease Prevention and Control
Total Financial Resources – Infectious Disease Prevention and Control
Key Program Area
Authorities ($ millions)
Actual ($ millions)
31.0
32.5
Pandemic Influenza
Preparedness
4.7
4.7
Immunization and Respiratory
Disease
6.7
6.5
Health Care-/HospitalAcquired Infections
6.6
6.8
Animal-to-Human Diseases
30.1
29.7
Other
89.1
82.4
Total
168.2
162.6
HIV/AIDS
26
Public Health Agency of Canada
Emergency preparedness and response, health promotion and chronic diseases are
not the only concerns of public health. The increased speed and volume of global
travel and trade place Canadians within 24 hours’ transport of almost any other
location in the world – a shorter time frame than the incubation period of many
communicable diseases. The emergence of a new infectious disease anywhere in the
world can have a dramatic impact on Canada and on Canadians abroad. Therefore,
the Agency is involved in many activities aimed at reducing and preventing the
spread of infectious diseases.
In its leadership capacity, the Agency collaborated in investigations of disease
outbreaks in Canada and, when requested, abroad. The National Microbiology
Laboratory, for example, played an instrumental role in containing and controlling
an outbreak of Marburg virus in Angola. Several two-person teams and a portable
laboratory began work in Angola in late 2004 to enhance the capabilities of field
diagnostic tests and work to expedite the identification of cases in the affected
region.
The Agency continued to provide Canada with a national capacity to detect a range
of infectious diseases, and conducted, supported and coordinated applied public
health research on infectious disease threats to Canadians, for example respiratory
disease. It also facilitated and coordinated risk analysis and risk management
activities with international, federal, provincial and local partner organizations.
The areas of concern include waterborne and foodborne diseases, diseases of animal
origin (zoonotic), vaccine preventable diseases, bloodborne pathogens, sexually
transmitted infections and health care-acquired infections.
The Agency provided expert microbiological reference testing, surveillance and
outbreak investigation to the public health networks both in Canada and abroad,
through its Level 4 National Microbiology Laboratory in Winnipeg. In addition, the
Laboratory for Foodborne Zoonoses in Guelph provided policy makers and other
stakeholders with scientific information and advice on minimizing the risk of
human illnesses arising from contact between humans, animals and the
environment, with special emphasis on infections due to enteric (gastro-intestinal)
pathogens. For example, in 2004–05, Agency scientists were involved in work in the
tsunami area for many weeks, in Vietnam on avian influenza, in Hong Kong doing
environmental sampling for the SARS coronavirus, and in Mexico on enteric
pathogens.
Section I – Overview
27
Avian Influenza
The outbreak of avian influenza H7N3 in the Fraser Valley region of British
Columbia damaged the local poultry industry, leading to the culling of nearly 20
million birds. Staff from the Agency’s British Columbia-Yukon Regional Office,
in collaboration with headquarters experts in infectious disease prevention and
control, were actively engaged with partners from Health Canada, the Canadian
Food Inspection Agency, Public Safety and Emergency Preparedness Canada,
the provincial Ministry of Health, the Fraser Health Authority and many others in
a sustained response to this serious outbreak. For the duration of the response
effort, the regional office partially activated its emergency management plan to
help focus resources and activities on the outbreak. Coordination of the
regional response activities within the health portfolio and provision of central
experts for public risk communication were central to the maintenance of public
calm during the response period.
The Agency also took action to prevent infectious diseases. With regard to
bloodborne diseases, bloodborne pathogen infections and sexually transmitted
diseases, it designed, developed and implemented programs that will help prevent
hepatitis C infection, supported people infected with or affected by this bloodborne
disease and increased public awareness about hepatitis C. The Agency also provided
national leadership in the development and promotion of a national
management/policy structure to reduce the risk of bloodborne pathogen infections,
transfusion-transmitted injuries and infections resulting from the transplantation
of cells, tissues and organs.
The Agency worked with provinces, non-governmental organizations and health
care providers to improve and maintain the sexual health of the Canadian
population by preventing and controlling sexually transmitted diseases and their
complications, which include infertility and cancer. It coordinated, implemented
and monitored the Canadian Strategy on HIV/AIDS and helped move the Strategy
towards a nationally shared vision through improved collaboration among all levels
of government, communities, non-governmental organizations, professional
groups, researchers, institutions and the private sector. This led to the creation of
the Federal Initiative to Address HIV/AIDS in Canada, announced in January 2005.
28
Public Health Agency of Canada
AIDS Community Action Program (ACAP)
Funded by the AIDS Community Action Program (ACAP) with the financial
support of the Hepatitis C Program and Health Canada’s First Nations and Inuit
Health Branch, this First Nations of Quebec and Labrador Health and Social
Services Commission (FNQLHSSC) project is intended to improve accessibility
and services for Aboriginals at high risk of contracting HIV/AIDS and hepatitis
C. The project is divided into two components: creating a network linking onand off-reserve Aboriginal organizations and community organizations working
in HIV/AIDS and hepatitis C; and developing and validating a guide and
workshops entitled HIV/AIDS and Hepatitis C Among Natives, An Adapted
Training, for use by Aboriginal stakeholders, and a guide and workshops
entitled Adapting Our Interventions to Native Reality, for use by non-Aboriginal
stakeholders.
This project has been so successful that it has been extended for a third year in
order to consolidate the network developed over the first two years and to
respond to the high demand for the workshops. Extension of the project will
allow the adaptation of the workshop tools and contents for delivery in federal
correctional institutions, in partnership with Correctional Service Canada. It will
also permit the completion of a guide to the specific cultural traits of Quebec’s
eleven Aboriginal nations, to better equip non-Aboriginal stakeholders who
work with Aboriginal clients. The Adapting Our Interventions to Native Reality
component has proved to be particularly interesting, because in addition to its
original purpose it could be applied to any issue linking the Aboriginal and
non-Aboriginal communities.
In addition to its activities addressing specific diseases, the Agency focussed on risks
incurred by the population while undergoing health care. For example, it played a
role in ongoing surveillance for emerging pathogens in high-risk individuals. A
surveillance system was established with the Canadian Blood and Bone Marrow
Transplant Group in hopes of reducing the incidence rates for West Nile virus in
patients undergoing bone marrow transplants. The objective of this activity is to
ensure that no new cases are found in recipients.
Section I – Overview
29
Preparing to Deal With Cross-Border Infectious Disease Outbreaks
In partnership with the Province of British Columbia and the State of
Washington, the Agency’s British Columbia-Yukon Regional Office
co-sponsored a seminar on a range of emergency management issues that
would arise from an infectious disease outbreak crossing the borders of
jurisdictions in the Pacific Northwest. Envisioned as part of an intended series
of regional events, the seminar supported the development of interjurisdictional relationships among officials occupying similar functions, and
enhanced the participants’ understanding of the capacities and capabilities of
their counterparts, within a longer-term objective of raising vital regional issues
to the national level. Ultimately, the goal is to create a national, provincial and
state-supported framework that will facilitate the provision of aid across
jurisdictional boundaries during public health-related emergencies.
Public Health Tools and Practice
Total Financial Resources – Public Health Tools and Practice
Key Program Area
Authorities ($ millions)
Actual ($ millions)
Public Health Tools and
Application Development
9.4
7.0
Building Public Health Human
Resource Capacity
5.2
5.6
14.6
12.6
Total
The variance between authorities and actual spending were mainly caused by work
that was not completed before the end of the fiscal year in Canadian Integrated
Public Health Surveillance ($1.5 million) and Skills Enhancement for Public
Health ($0.4 million).
The programs and approaches described above in this report were primarily
concerned with the content of public health programs. The federal government has
also recognized that to improve the effectiveness of public health practice in
Canada, it must strengthen the core elements of the country’s public health
infrastructure.
As part of the process of creating the new Public Health Agency of Canada, the new
organization built and strengthened its internal capacity to assume a leadership
position and to take an active role in ensuring that public health legislation is
relevant, responsive, effective, accessible and equitable across jurisdictions. To this
end, for example, the Quarantine Act was updated. At the same time, the Agency
worked to harmonize public health legislative and regulatory frameworks across
30
Public Health Agency of Canada
jurisdictions and to develop policies and guidelines for managing health information
relevant to key aspects of infectious disease reporting and management. Among
other examples, the Agency led the development, of common definitions in support
of the Canadian Public Health Laboratory Network and the Canadian Integrated
Outbreak Surveillance Centre.
The Agency also fostered community practices by bringing together key
stakeholders on issues related to public health infostructure. In conjunction with
stakeholders and partners, it worked to develop pan-Canadian strategies on chronic
diseases, chronic disease risk factors, and injuries. It supported the creation of six
National Collaborating Centres for Public Health to improve knowledge translation
and the availability of public health human resources, and supported the
development of more robust regional and national public health emergency
response capacities.
In addition, the Agency provided access to data and information necessary for
evidence-based decision making. It developed managing data policies to ensure that
the data are used in a consistent fashion and in accordance with privacy and
disclosure standards.
Manitoba/Saskatchewan – Comprehensive Evaluation
A Manitoba/Saskatchewan Regional initiative was undertaken to streamline the
administration of financial and evaluation reporting for early childhood
development groups having multiple sources of funding.
With respect to professional development, the Agency provided an internet-based
training service for health professionals in local public health departments and
regional health authorities across Canada, to increase their skills in the areas of
epidemiology, surveillance and information management. This service enabled
professionals to use and understand information by using very specific skills. It
involved development, administration, and management of online learning
modules. The Agency also developed partnerships with the public health
community.
Other Programs and Services
Total Financial Resources – Other Programs and Services
Financial Resources
Authorities ($ millions)
Actual ($ millions)
162.2
154.4
Other Programs and Services include $100 million for the Canada Health Infoway Inc.
Section I – Overview
31
Organizing for Results Summary:
Through the programming areas discussed above, the Public Health Agency of
Canada delivered an effective public health program. As the new Agency continues
to expand the federal government’s capacity in public health, to enhance emergency
preparedness and response capability, to promote healthy living, to address chronic
and infectious diseases and to contribute towards the development of a seamless
and comprehensive public health system, it works to create an even better public
health system in Canada and to contribute to an improved international public
health environment.
Total Financial Resources – Public Health Agency of Canada
Key Program Area
Authorities ($ millions)
Actual ($ millions)
49.8
49.8
Health Promotion and
Chronic Disease Prevention
and Control
210.4
207.3
Infectious Disease Prevention
and Control
168.2
162.6
14.6
12.6
Other Agency Programs and
Services
162.2
154.4
Total
605.2
586.7
Emergency Preparedness
and Response
Public Health Tools and
Practices
32
Public Health Agency of Canada
Section II – Analysis of Performance by
Strategic Outcome
Strategic Outcome: A healthier population by promoting
health and preventing illness
Objective: Promote health and prevent and control injury and disease
Total Financial Resources ($ millions)
Planned
Authorities
Actual
N/A
605.2
586.7
Total Human Resources (full-time equivalents)
Planned
Actual
Difference
1,671
1,666
5
Expected Results:
Intermediate Outcomes
! Informed choices and adoption of safe, healthy and sustainable health
practices.
! Strengthened public health policies and actions within the health system.
! Development of an evidence base to shape population and public health
policy and practice.
! Improved access to health and social services for target populations.
! Enhanced involvement, participation and partnership of individuals and
stakeholders in health promotion and protection policy and program
development.
! Development of a comprehensive, integrated and sustainable health
promotion system.
! Enhanced protection during emergencies.
Immediate Outcomes
! Increased public awareness of key public health issues.
! Enhanced public health research capacity, information sharing, and
uptake of evidence among key partners and stakeholders.
! Strengthened national and international networks and coordination.
! Increased awareness and use of reliable promotion of population health
evidence.
! Increased awareness of information, community and health system
supports.
! Implementation of strategies and policies to support public health.
! Improved community capacity
! A better national health emergency management system.
34
Public Health Agency of Canada
Priorities and Commitments for 2004–05
Priority 1: Contribute Towards the Development of a Seamless and
Comprehensive Public Health System
Commitments
! Develop a Pan-Canadian Public Health System
! Develop Integrated Strategies for Communicable and Non-Communicable
Diseases
! Foster Increased Collaboration in Public Health
Priority 2: Enhance the Federal Government’s Capacity in Public Health
Commitments
! Establish the New Public Health Agency of Canada
! Enhance Federal Capacities in Its Laboratories, Health Surveillance and
Emergency Response
Note: In the performance analysis that follows, references to Health Canada in
specific commitments and undertakings have been replaced by references to the
Agency, where appropriate.
Section II – Analysis of Performance by Strategic Outcome
35
Program, Resources, and Results Linkages
The following Program Structure is based on the Program Activity Architecture (PAA)
of Health Canada’s former Population and Public Health Branch, which now forms
the new Public Health Agency of Canada. It reflects the Program Sub-Activities of
the agency and is provided here for information purposes. The PAA will be revised in
order to improve its alignment to the agency’s objectives.
Programs
Results Linkages
Emergency Preparedness
and Response
The Agency works closely with partners in Health
Canada, other federal departments, and the provinces
and territories to identify and implement emergency
preparedness planning priorities and to develop public
health emergency response plans.
Health Promotion and
Chronic Disease
Prevention and Control
(HHD & CDPC)
The Agency works closely with health portfolio
departments
and
agencies,
provincial/territorial
governments, voluntary organizations and private sector
partners to identify emerging areas of concern, develop
pan-Canadian action plans for health promotion,
disseminate information to the public and health
professionals, integrate multiple and diverse interests
and perspectives, and furnish a critical link between
citizens and government policy and decision-makers.
(This combines the previous Health Canada programs of
Healthy Human Development and Chronic Disease
Prevention and Control).
Infectious Disease
Prevention and Control
The Agency provides an enhanced pan-Canadian
capacity to conduct policy development, surveillance,
investigation, research and program response to foodand water-borne diseases, sexually-transmitted infections, hepatitis C and HIV/AIDS, respiratory infections
such as tuberculosis, vaccine-preventable diseases and
bloodborne pathogens.
Public Health Tools and
Practice
(Surveillance Coordination)
The Agency contributes towards the development and
implementation of a public health surveillance system and
enhancement of public health capacity at the provincial
and territorial levels through: the development and
provision of tools and applications that support front-line
health care professionals; tools and data access to
support evidence-based decision making; and training to
enhance public health human resource capacity. (This
program was previously identified as Surveillance
Coordination by Health Canada).
36
Public Health Agency of Canada
Performance Summary for Priority 1: Contribute Towards
the Development of a Seamless and Comprehensive
Public Health System
Canada needs a seamless and comprehensive pan-Canadian public health system
that is able to identify, respond to and prevent communicable and noncommunicable diseases, injuries, and public health emergencies in a timely, coordinated and effective manner to promote the overall good health of Canadians.
The threats posed by severe acute respiratory syndrome (SARS), West Nile virus
and bovine spongiform encephalopathy (BSE) pointed to the need for Canada to
strengthen its public health system. The creation of the Public Health Agency of
Canada, and the appointment of the Chief Public Health Officer to lead it,
demonstrated the Government of Canada’s commitment to meeting this challenge.
The development of a seamless and comprehensive public health system will
require sustained leadership and hard work over many years, with the Agency
undertaking collaborative efforts with provincial and territorial governments, other
federal departments, and stakeholder groups. Work will be required to develop and
strengthen collaborative policies and working frameworks, to develop and elaborate
integrated strategies for dealing with infectious and non-infectious diseases, to
manage public health human resource requirements, and to prepare and deliver
effective health promotion strategies and programs.
During 2004–05, the Agency worked with the provinces and territories to set in
place the initial components of a new pan-Canadian Public Health Strategy. It
provided input and support to the Federal/Provincial/Territorial Special Task Force
on Public Health, which recommended the creation of a Public Health Network.
The Agency also provided policy and communication support for the creation of the
Network. It continues to provide full support to the Network’s secretariat and is
ensuring communication among all Network components in order to facilitate
federal/provincial/territorial collaboration on public health issues.
In 2004–05, the Agency delivered on one of its key commitments by supporting and
facilitating the creation of six new National Collaborating Centres for Public
Health. To this end, the Agency provided both start-up money and facilitation for
the development of key structures and activities needed to evolve the program in its
initial year. These Centres, whose purpose is to increase collaboration and to
facilitate the translation of knowledge into practical public health tools and
methodologies, will contribute an important component of the pan-Canadian Public
Health Strategy.
Section II – Analysis of Performance by Strategic Outcome
37
National consultations were undertaken to develop a pan-Canadian agreement on
mutual assistance to facilitate the timely transfer of equipment, personnel and
other resources across jurisdictions during health emergencies.
A policy framework for an Integrated Strategy on Healthy Living and Chronic
Disease was developed, and funding for its activities was announced in Budget 2005.
A planned allocation of $300 million over five years for the Integrated Strategy, will
include a series of activities to promote healthy eating and encourage physical
activity and healthy weight – which can help to prevent and control chronic diseases
– as well as a series of complementary, disease-specific activities in the areas of
diabetes, cancer and cardiovascular disease.
As part of the Integrated Strategy, funding was provided for a comprehensive
multiple-partner pan-Canadian Healthy Living Strategy whose first areas of
emphasis are healthy eating, physical activity and their relationships to healthy
weights. The Agency also provides other funding support to increase the physical
activity levels of Canadians, for example through the Agency’s sustainable
development commitment. Funding in 2004–05 supported performance
measurement, research to better understand public opinions, barriers and
motivators influencing transportation decisions, and community workshops on
Active Transportation.
In 2004–05, the Canadian Diabetes Strategy (CDS) was extended for one year, to
March 31, 2005, to enable the Agency to continue its work with community-based
projects, to raise awareness and to engage in joint disease prevention initiatives. It
will now be included in the new Integrated Strategy on Healthy Living and Chronic
Disease.
Mechanisms to incorporate input from youth were established through a new
national youth planning committee for symposium development and a national
youth network for collaborative planning on hepatitis C virus and other infectious
diseases. A surveillance system called the Canadian Blood and Bone Marrow
Transplant Group was established in hopes of seeing results such as a reduction in
the incidence rates for West Nile virus in patients undergoing bone marrow
transplantation. The objective of this activity is to ensure no new cases are found in
recipients.
The Agency has the federal lead on matters relating to HIV/AIDS. The Federal
Initiative to Address HIV/AIDS in Canada was launched in January 2005,
continuing the work of the Canadian Strategy on HIV/AIDS while refocussing
efforts on populations already infected or at risk. In 2004–05, through the AIDS
Community Action Program, the Agency enhanced the capacity of 83 local
community-based organizations to deliver front-line HIV/AIDS prevention
programs. The Agency increased access to more effective HIV/AIDS prevention,
care, treatment and support, through support for 46 projects funded under national
38
Public Health Agency of Canada
HIV/AIDS grants and contribution programs including the Non-Reserve First
Nations, Inuit and Métis HIV/AIDS Communities Project Fund, the National
HIV/AIDS Capacity Building Fund, the HIV/AIDS Information Service Initiative,
the HIV/AIDS Community-Based Social Marketing Fund and the National
HIV/AIDS Non-Government Organization Operational Fund.
The regional offices of the Agency continue to develop strategies to address chronic
disease prevention. Innovative programs are developing best practices, enhancing
collaboration and knowledge transfer.
The Agency has developed an international strategic framework, clarified roles and
responsibilities, built organizational capacity and provided federal leadership in
global activities, including those relating to the World Health Organization, the Pan
American Health Organization and the International Union for Health Promotion
and Education. A Framework for Cooperation was signed by the Agency, Health
Canada, and the World Health Organization in Davos, Switzerland, on January 27,
2005, strengthening Canada’s engagement in the international response to chronic
disease prevention and control.
A critical component in the strengthening of the public health system involves the
need for accurate, comprehensive and current information to allow sound scientific
evidence-based decision making. Agreements in principle have been, and continue
to be, put in place to strengthen laboratory capacity, to enhance access to advanced
technologies and expertise, to permit collaborative projects and to share
information on public health problems. Significant progress has been made in
integrating surveillance and laboratory networks and expanding both geographical
coverage and content.
Effective public health human resource planning is another critical component of
the public health system. The Agency is working in collaboration with its federal
partners to plan a coordinated approach with the provinces and territories,
academia, professional and public health associations to address public health
human resource issues. The Agency has added new modules to its on-line training
program, in order to enhance the capacity of front-line public health professionals to
do their jobs effectively and efficiently. The intake level for both internal and
external candidates to the Canadian Field Epidemiology Program has doubled.
Together, these efforts contributed substantially to the development of a seamless
and comprehensive public health system.
Section II – Analysis of Performance by Strategic Outcome
39
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status
RPP Commitments
Status
Develop a Pan-Canadian Public
Health Strategy
1. In 2004–05, the Agency will work
with the provinces and territories to
develop the initial components of a
pan-Canadian public health strategy,
by:
mClarifying roles, responsibilities and
relationships regarding public
health, especially with respect to
emergency response;
MET (Ongoing)
All levels of government, together with the
private and not-for-profit sectors, are now
engaged in clarifying roles and
responsibilities regarding public health. This
task is scheduled for completion in 2005, and
is expected to build on the work of federal/
provincial/territorial public consultations now
underway to develop the Public Health Goals.
The Ministers of Health have accepted the
National Framework for Health Emergency
Management, developed by the federal/
provincial/territorial Network on Emergency
Preparedness and Response as a guiding
document for the development of an
integrated and comprehensive National
Health Emergency Management System. A
national consultation process is underway to
develop a pan-Canadian Agreement on Mutual
Assistance to facilitate the timely transfer of
equipment, personnel and other resources
across jurisdictions during health emergencies.
mEnhancing laboratory networks;
MET (Ongoing)
Agreements in Principle have been reached
on three collaborative initiatives with
academia and provincial laboratories. These
agreements are designed to enhance laboratory capacity, and access advanced
technologies and expertise, collaborative
projects, and information sharing on public
health problems. Progress is slower than
anticipated, due to the complexity of the
negotiating process.
40
Public Health Agency of Canada
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
Status
The Agency developed an interim
Intellectual Property Management Strategy
that will facilitate future collaborative and
integration efforts and help ensure optimal
use of scientific research.
mIntegrating surveillance networks.
MET
The Agency has over 40 surveillance systems
that produce annual reports, trend analysis,
scientific publications and presentations.
To enhance the integration of surveillance
systems, the Agency is working with
provincial partners to standardize epidemiological case definitions.
Among other chronic disease surveillance
activities, the Agency supported the work of
the Advisory Committee on Population
Health and Health Security’s Task Group on
Enhancing Capacity for Chronic Disease
Risk Factor Surveillance.
Surveillance: The report of the Task Group,
which outlined a comprehensive approach to
enhancing surveillance, was approved by the
Conference of Deputy Ministers of Health.
The Auditor General indicated satisfaction
with progress made in filling identified gaps
in the surveillance of chronic disease.
2. The Agency will develop a national,
coordinated collaborative approach
to public health human resource
planning, addressing issues such as
recruitment, retention and professional development.
MET
As part of the overall pan-Canadian Public
Health Strategy, the Agency worked in
collaboration with federal partners to plan a
coordinated approach with the provinces and
territories, academia, and professional and
public health associations to address public
health human resource planning. This
planning addressed the findings of the Joint
Task Group on Public Health Human
Resources, set up by the Committee of
Deputy Ministers to identify gaps in the
system and to make recommendations for
closing them.
Section II – Analysis of Performance by Strategic Outcome
41
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
Status
Provinces and territories and professional
associations worked with the Agency to
develop core competencies for public health
practice and discipline-specific competencies. The design of the Scholarships in
Public Health Program is underway, as is
collaborative work with the Canadian
Institutes of Health Research (CIHR) to
implement a scholarship program that will
create more partnerships with the provinces,
territories and academia across the country
and to foster excellence in public health
professional development.
mAdditional training modules will be
added to the Agency’s Skills
Enhancement Program.
MET
mThe Agency will continue to provide
professional development to 10
public health professionals through
the Canadian Field Epidemiology
Program.
MET
42
Two additional on-line modules
(”Epidemiology of Chronic Diseases” and
”Outbreak Investigation”) have been added,
further enhancing the capacity of front-line
public health professionals to do their jobs
effectively and efficiently. Over 1000 frontline public health practitioners have received
training under the program, and there are
now over 70 on-line trained facilitators.
In 2004–05, four (4) public health
professionals successfully completed the
program and 9 were in training, enhancing
their capability to undertake field investigations of public health threats and manage
outbreaks, both domestically and internationally. Over 100 health professionals
have so far graduated from this program and
are working at all levels of government or in
other professional settings. Another 15
participated in the intensive specialized
training modules offered by the program,
bringing the total number of external
participants to over 100 in the past 15 years.
The program will double its intake in
September 2005.
Public Health Agency of Canada
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
Status
Develop Integrated Strategies for
Communicable and NonCommunicable Diseases
3. As part of the integrated panCanadian Healthy Living Strategy,
the Agency, in collaboration with
our partners, will continue to
develop and begin to implement a
comprehensive multiple-partner
action plan whose first areas of
emphasis are healthy eating,
physical activity and their
relationships to healthy weights.
MET
In Budget 2005, the Government announced
that it would provide $300 million over five
years for the Integrated Strategy on Healthy
Living and Chronic Disease. The panCanadian Healthy Living Strategy is a key
component of the Integrated Strategy.
The Integrated Strategy is a collaborative
federal/provincial/territorial effort that
reflects the Agency’s approach to health
promotion and the prevention of chronic
diseases. It has three pillars: promoting
health by addressing the conditions that lead
to unhealthy eating, physical inactivity and
unhealthy weights; preventing chronic
diseases through focussed action on risk
factors; and creating platforms for the early
detection and management of chronic
diseases such as diabetes, cancer and
cardiovascular disease. The latter share
several common risk factors.
The Healthy Living Strategy (HLS) is intersectoral, engaging provincial and territorial
governments and non-governmental organizations. Its initial areas of focus are healthy
eating and physical activity and their
relationship to healthy weights.
4. As part of our Sustainable
Development Strategy, the Agency
will promote an active transportation initiative to increase physical
activity levels associated with
actions such as walking or bicycling,
which would improve the health of
Canadians. This initiative is
expected to contribute to the
federal, provincial and territorial
governments’ joint target of
increasing the physical activity
MET
The Agency has supported the initiative to
increase the physical activity levels of
Canadians through specific funding programs,
including:
mActive Transportation Survey 2005, to
assess active transportation knowledge,
attitude and behaviours against a benchmark 1998 survey. (Results will be
available in 2005–06)
Section II – Analysis of Performance by Strategic Outcome
43
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
levels of Canadians by 10 percentage points in each province and
territory by 2010.
Status
mEight focus groups held in Vancouver,
Winnipeg, Ottawa and Halifax, to better
understand public opinions, barriers and
motivators influencing transportation
decisions; and
mSupport for community workshops on
Active Transportation, to assist
communities in developing an active
transportation vision. There has been high
demand for these workshops from other
communities, and for use of the Active
Transportation Tool Kit that assesses the
quality of a community’s active
transportation environment.
5. Final evaluation of the Canadian
Diabetes Strategy will be initiated
and completed.
MET
mThe Agency will build on lessons
learned from the Canadian Diabetes
Strategy and will put emphasis on
the needs of the population groups
at highest risk of developing diabetes
and those who already have the
disease.
MET
The Canadian Diabetes Strategy (CDS)
focusses on health promotion and disease
prevention, national coordination and
surveillance. It was extended for one year to
March 31, 2005, to enable the Agency to
continue its work with community-based
projects, to raise awareness and to engage in
joint disease prevention initiatives. The
NDSS was evaluated in 2004–05; the
associated report will be finalized and the
findings made available in 2005–06.
The Agency has incorporated lessons
learned from the CDS in the development of
the Integrated Strategy on Healthy Living
and Chronic Disease. The Integrated
Strategy will address the needs of those at
greatest risk of developing diabetes and
other chronic diseases along with the needs
of persons trying to maintain their health or
manage an existing disease.
MET
6. The Agency will pursue the
development of integrated strategies
for common populations in common Over the last year the agency developed a
settings.
policy framework for the Integrated Strategy
on Healthy Living and Chronic Disease that
was announced in Budget 2005. The
44
Public Health Agency of Canada
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
Status
Budget’s announcement provides $300
million over five years for the Integrated
Strategy that will include a series of activities
to promote healthy eating, physical activity
and healthy weight – factors that can help
prevent and control chronic diseases – as well
as a series of complementary disease-specific
activities in the areas of diabetes, cancer and
cardiovascular disease.
As part of the Strategy, funding was
provided for a comprehensive
multiple-partner pan- Canadian Healthy
Living Strategy whose first areas of
emphasis are healthy eating and physical
activity and their relationship to healthy
weights. The Agency also provides funding
support to increase the physical activity
levels of Canadians, for example through the
Agency’s sustainable development
commitment. Funding in 2004– 05
supported performance measurement,
research to better understand public
opinions, barriers and motivators
influencing transportation decisions, and
community workshops on Active
Transportation.
The Healthy Living Strategy (HLS) is
inter-sectoral, engaging provincial and
territorial governments and nongovernmental organizations. Its initial areas
of focus are healthy eating and physical
activity and their relationship to healthy
weights.
Implementation work is well underway.
Funding for the HLS was included in the
Integrated Strategy announced in Budget
2005.
An overall framework for an Integrated
Infectious Disease Strategy is under
development and slated for completion in
2005–06.
Section II – Analysis of Performance by Strategic Outcome
45
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
Status
Fiscal year 2004–05 saw the establishment of a
national youth planning committee for
symposium development, and of a national
youth network for collaborative planning and
programming on hepatitis C virus and other
infectious diseases. Both of these events enable
results such as the Best Practice Model for
Youth Involvement in hepatitis C virus and
other infectious disease programming.
Enhanced surveillance programs for street
youth were set up, and data were analyzed
from seven sites across Canada. The
investigation of an outbreak in Alberta led to
recommendations for preventative strategies
and better educational materials for HIV
prevention.
The integration into current programs of
infectious disease information for
populations at risk of, or living with,
HIV/AIDS is being evaluated. Improved
access to more effective prevention, care,
treatment and support was achieved in part
by combining the Canadian Hepatitis C
Information Centre with the Canadian
HIV/AIDS Information Centre. This is a
pilot project to test the efficiencies of
creating a single window for information on
these conditions. Another project with the
Battlefords Family Health Centre in North
Battleford, Saskatchewan, aims to increase
knowledge of HIV/AIDS, hepatitis C and
other sexually transmitted infections among
at-risk Aboriginal youth.
mThe Agency will continue to monitor
emerging and re-emerging infectious
diseases in Canada and to work with
partners to protect Canadians from
these disease risks.
46
MET
The surveillance network for West Nile
virus was extended from four to six sites,
and procedures were set up for collaborating
with the US Centres for Disease Control and
Prevention (CDC). A surveillance system for
West Nile virus was established with the
Canadian Blood and Bone Marrow
Transplant Group, to protect those
undergoing bone marrow transplants.
Public Health Agency of Canada
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
Status
The Agency coordinated an investigation
across provinces of an outbreak of tularemia
among hamsters. The coordinated response
resulted in effective control and prevention
of the disease. The Agency worked collaboratively with public health authorities in
British Columbia, Alberta, Saskatchewan,
Manitoba, Ontario and the CDC to assess
the situation, and to develop required
investigation tools and guidelines and a
public advisory that was disseminated on the
Agency’s Web site.
Due to concerns over the possible emergence
of a new strain of influenza in 2004–05, the
Government of Canada enhanced its
pandemic preparedness by announcing, on
February 4, 2005, a $24 million federal
investment towards the creation of a
national antiviral stockpile (9.6 million doses
of oseltamivir) for possible use during an
influenza pandemic. Provinces and
territories have purchased an additional 6.4
million doses, as recommended by the
Pandemic Influenza Committee.
7. Focussing its attention on key
population groups and improved
public education awareness.
MET
The Federal Initiative to Address HIV/AIDS
in Canada was launched in January 2005,
continuing the work of the Canadian
Strategy on HIV/AIDS while refocussing
efforts on populations already infected or at
risk. In 2004–05, the Agency enhanced the
front-line response capacity of 83
community-based organizations.
The Agency increased access to more effective
HIV/AIDS prevention, care, treatment and
support through 46 projects funded under
national HIV/AIDS grants and contribution
programs including the Non-Reserve First
Nations, Inuit and Métis HIV/AIDS
Communities Project Fund, the National
HIV/AIDS Capacity Building Fund, the
HIV/AIDS Information Service Initiative,
Section II – Analysis of Performance by Strategic Outcome
47
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
Status
the HIV/AIDS Community-Based Social
Marketing Fund and the National HIV/AIDS
Non-Government Organization Operational
Fund.
Two new sites were added to the list for
sentinel HIV surveillance among injection
drug users, and a pilot project was completed
for HIV surveillance among men who have
sex with men.
maddressing determinants of health
related to the disease.
MET
This work is being reinforced under the new
Federal Initiative to Address HIV/AIDS
which will allow for a more strategic
approach to the determinants of health.
The determinants of health related to
HIV/AIDS were addressed in two projects.
With support from grants and contribution
funding under the Federal Initiative to
Address HIV/AIDS in Canada, the
Battlefords Family Heath Centre in
Saskatchewan implemented “Mobilizing
Community Supports for the Prevention of
HIV/AIDS,” a two-year project to increase
knowledge of HIV/AIDS, hepatitis C and
other sexually transmitted infections among
at-risk Aboriginal youth in North Battleford
as well as among their health, social services
and education providers.
Support was provided to St. Michael’s
Hospital in Toronto for a project called
“Adding Life to Years: Building the
Community’s Capacity to Identify and Treat
Depression in People Living With
HIV/AIDS.” This project worked with AIDS
service organizations and other
organizations across Canada to develop
training, tools and resources that will
increase their capacity to identify clients
who are depressed, and to provide
appropriate interventions and referrals.
48
Public Health Agency of Canada
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
Status
Funding programs are being redesigned to
address infectious diseases and determinants of health in an integrated manner
for populations living with, or at risk of,
HIV/AIDS.
mStrengthening Canada’s
international response to the
disease.
MET
The Agency provided technical support for
the design and implementation of a
second-generation surveillance program, and
provided enhanced training for Pakistani
scientists in the area of laboratory expertise.
This was done in collaboration with the
Government of Pakistan, the University of
Manitoba, the Canadian International
Development Agency (CIDA), ProAction
Consulting and Agriteam Consulting.
The Public Health Agency of Canada has
also provided technical assistance to the
Bulgarian Ministry of Health on the
assessment of HIV/AIDS surveillance
reporting and second-generation
surveillance. Partners include the Bulgarian
Ministry of Health; the Global Fund to Fight
AIDS, TB and Malaria; United Nations
agencies, and CIDA. These projects
demonstrate a commitment to provide
technical assistance and are part of a larger
global response to act where need is
identified.
8. The Agency’s regional offices will
focus on the burden of chronic
disease and develop integrated
strategies to address chronic
disease prevention. For example,
the Agency’s Alberta/Northwest
Territories Region is a partner in
the Alberta Healthy Living Network.
This initiative will provide leadership
for integrated action to promote
health and to prevent chronic
disease.
MET
The Agency has supported the Alberta
Healthy Living Initiative in its mission of
providing leadership for collaborative action
to promote health and prevent chronic
disease in Alberta. This has facilitated the
development of local and regional networks
and a Best Practices Framework, and the
promotion of healthy eating and active
living.
Section II – Analysis of Performance by Strategic Outcome
49
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
Status
The Agency has supported the development
of the Ontario Chronic Disease Prevention
Alliance, involving collaboration among over
20 partners, to increase the integration of
efforts on chronic disease prevention, to
enhance knowledge transfer between
partners, and to develop sound financial
analysis to support chronic disease
prevention activities.
mBuilding on the joint process
involving the Agency and the
Government of Nova Scotia, which
led to the report The Cost of
Chronic Disease in Nova Scotia, the
Agency will, in partnership with the
governments of other Atlantic
provinces, complete similar
provincially focussed reports on the
costs related to chronic disease.
These reports will complement
existing work and will serve as an
evidence base to plan appropriate
strategies for local chronic disease
prevention.
MET
Based on previous work with the Province of
Nova Scotia to investigate the costs of
chronic disease, the Agency undertook 12
workshops to provide input to the Turning
the Tides document to be published in
September 2005. Work will continue to
explore the relationship between mental
health, infectious chronic disease and health
disparities.
Foster Increased Collaboration in
Public Health
9. The pan-Canadian Public Health
Network, an intergovernmental
approach to integrating the public
health system in Canada, will be
established. It will be built on
existing strengths and provide the
structures for federal/provincial/
territorial discussions at all levels,
allowing the effective development
and delivery of pan-Canadian public
health strategies across
jurisdictions.
50
MET
The Agency provided input and support to
the Federal/Provincial/Territorial Special
Task Force on Public Health that resulted in
the recommendation to create the Public
Health Network. The Agency also provided
policy and communication support during
the creation of the Network. The Agency
continues to provide full support to the
Network’s Secretariat, and is ensuring
collaboration among all Network
components, in order to facilitate
federal/provincial/territorial collaboration on
public health issues.
Public Health Agency of Canada
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status (continued)
RPP Commitments
Status
As part of this larger network strategy, the
Agency provided support in the development
of six new National Collaborating Centres
for Public Health, each specializing in a
priority issue area. This has included
assisting in the development of a call for
proposals to support the work of the Centres
and the establishment of an external
Advisory Committee which includes senior
public health experts who are recognized
both nationally and internationally as
experts in their fields. Through these efforts,
the Agency has evolved the scope and
contextual parameters of a new approach to
collaboration among Canada’s research
community.
10. The Agency will explore the
international dimensions of public
health to help clarify our roles and
responsibilities, as well as to guide
our relationships with our international partners.
MET
The Agency has developed an international
strategic framework, clarified roles and
responsibilities, built organizational capacity
and provided federal leadership in activities
relating to the World Health Organization,
the Pan American Health Organization and
the International Union for Health
Promotion and Education. A Framework for
Cooperation was signed by the Agency,
Health Canada and the World Health
Organization in Davos, Switzerland, on
January 27, 2005, strengthening Canada’s
engagement in international collaboration
for chronic disease prevention and control.
Section II – Analysis of Performance by Strategic Outcome
51
Performance Summary for Priority 2: Enhance the
Federal Government’s Capacity in Public Health
In response to the outbreak of severe acute respiratory syndrome (SARS) in Canada
and to the subsequent reports by public health professionals, on September 24,
2004, the Prime Minister formally established the Public Health Agency of Canada
and appointed Dr. David Butler-Jones as the country’s first Chief Public Health
Officer. These actions demonstrate the Government’s commitment to provide
Canada with a federal focal point to deal with public health issues. Additional
background information on the Agency is accessible at http://www.
phac-aspc.gc.ca/media/nr-rp/2004/phac_e.html.
Since its creation, the Agency has worked, under the leadership of the Chief Public
Health Officer and in consultation with its employees and external stakeholders, to
set its long-term focus. In March 2005, the Agency revealed its vision, mission and
mandate.
Vision – Healthy Canadians and communities in a healthier world.
Mission – To promote and protect the health of Canadians through leadership,
partnership, innovation and action in public health.
Mandate – In collaboration with our partners, to lead federal efforts and mobilize
pan-Canadian action in preventing disease and injury, and promoting and
protecting national and international public health through the following:
• Anticipate, prepare for, respond to and recover from threats to public health;
• Carry out surveillance, monitor, research, investigate and report on diseases,
injuries, other preventable health risks and their determinants, and the
general state of public health in Canada and internationally;
• Use the best available evidence and tools to advise and support public health
stakeholders nationally and internationally as they work to enhance the
health of their communities;
• Provide public health information, advice and leadership to Canadians and
stakeholders; and
• Build and sustain a public health network with stakeholders.
The Agency is focussed on effective efforts to promote health, to prevent chronic
diseases such as diabetes, cancer and cardiovascular, to prevent injuries, to monitor
infectious disease outbreaks and to respond to public health emergencies. It will also
continue to work closely with the provinces and territories to keep Canadians
healthy and to help reduce pressures on the health care system. One of its chief tools
in accomplishing these goals is information sharing.
52
Public Health Agency of Canada
In keeping with the identified need to enhance the federal government’s capacity in
public health, the Agency moved swiftly during its first year to enhance information
sharing on infectious diseases, immunization, chronic diseases and public health
emergencies.
The agency continues the work on its three-year project to create the
Canadian Network for Public Health Intelligence. Now in its second
year, it was adopted as a business and communication platform for the
Canadian Public Health Laboratory Network. More than 95 percent of
federal and provincial public health laboratories are now connected to
it, including Héma-Québec, Canadian Blood Services and the Canadian
Food Inspection Agency National Centre for Foreign Animal Heath. A
breakthrough in information sharing, this network is significantly
improving communications among those involved in laboratory
diagnosis, mitigation and response to emerging and re-emerging
infectious diseases, bioterrorism and other public health emergencies.
Work is also underway to develop national standards for reporting
diagnoses, and to improve upon diagnostic reference centre testing, and
nation-wide proficiency testing, all necessary steps if the benefits of the
Laboratory Network are to be realized, and to expand the list of diseases
monitored (e.g. hospital ”super bug” infections, pandemic influenza,
etc).
The Canadian Integrated Outbreak Surveillance Centre (CIOSC) also plays an
integral role in information sharing. It is now used by 99 percent of health units
across Canada. Improved outbreak detection and response has also been created
through FluWatch, a collaborative effort between the Agency, provinces and
territories, laboratories and sentinel physicians. FluWatch provides weekly reports
summarizing influenza prevalence in Canada. In addition, the first sentinel site for
surveillance of enteric diseases and exposure to pathogens has been set up with
Region of Waterloo Public Health.
Work is also underway, in collaboration with all stakeholders, to investigate the
surveillance of chronic diseases such as arthritis and mental illness.
In a final step to improve information sharing, as the Public Health Information
System (PHIS) moved into its operational phase, the Agency successfully partnered
with Ontario and British Columbia to develop new modules (Outbreak and Primary
Assessment and Care modules). These provide credible, timely, accessible and
secure public health information and practices, enhancing the ability of health
professionals to make better-informed decisions that benefit Canadians.
Section II – Analysis of Performance by Strategic Outcome
53
In addition to improving the gathering and sharing of information on infectious
diseases, the Government also moved to prevent them. The federal/provincial/
territorial Canadian Immunization Committee was established to provide
leadership in advancing the National Immunization Strategy. Activities carried out
in 2004–05 included the establishment of the federal/provincial/territorial Vaccine
Supply Working Group, and management of the repercussions of supply shortfalls
in the United States, in collaboration with the provincial and territorial
governments. Promising research took place, at the Agency’s National
Microbiological Laboratory, on the development of experimental vaccines for the
deadly Ebola and Marburg hemorrhagic fevers. Through the Integrated Strategy on
Healthy Living and Chronic Disease (described under Priority 1), the Government
made a commitment to preventing chronic disease.
A major goal underlying the creation of the Agency was to ensure that Canada
would be able to deal effectively with public health emergencies. Key achievements
for 2004–05 include
• The re-establishment of front-line quarantine services at Canada’s eight
major international airports;
• The launch of the Canadian Global Public Health Intelligence Network II,
which provides 24-hour global monitoring and surveillance of potential
global health threats;
• A strategic review of the National Emergency Stockpile System (NESS), to
ensure readiness to respond to all types of emergency hazards;
• The setting of the foundation of Regional All-Hazards Emergency Plans and
Policies, by the Agency’s regional offices, who worked in coordination with
provincial and territorial partners;
• The continued development of national surge capacity for large-scale health
emergencies – National Office of Health Emergency Response Teams
(NOHERT); and
• Ongoing emergency preparedness exercises and training, for example
Vigilant Courier, Exercise Constant Vigil and the World Health Organization
assessment of their draft framework “to assess national health emergency
preparedness and response programs.”
NESS was activated at the request of the Canadian International Development
Agency to respond to the need for medicines, supplies and equipment in Southeast
Asia after the devastating tsunami of December 2004. Over $1.6 million in
materials such as blankets, generators and drugs from NESS were used in the
response effort.
54
Public Health Agency of Canada
The Agency co-hosted with Public Safety and Emergency Preparedness Canada
(PSEPC) the fourth National Forum on Emergency Preparedness and Response,
during which significant progress was made toward the development of an
integrated pan-Canadian emergency management system based on the principles
and guidelines of the National Health Emergency Management Framework.
Through these steps taken during 2004–05 on information sharing, infectious and
chronic disease prevention, and emergency preparedness and response, the federal
government increased its capacity to act on public health issues.
Section II – Analysis of Performance by Strategic Outcome
55
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status
RPP Commitments
Status
Establish the new Public Health
Agency of Canada
11. Health Canada will establish the
proposed Canada Public Health
Agency by exploring organizational
options that will enable the
Government of Canada to more
effectively protect and promote the
health of Canadians. The new
agency will be responsible for
leading the federal government’s
response on a range of threats to
health, such as communicable and
non-communicable diseases and
injuries. The Government of
Canada will also appoint a new
Chief Public Health Officer for
Canada who will head the new
agency.
MET
On September 24, 2004, the Prime Minister
announced the creation of the Public Health
Agency of Canada and the appointment of
Dr. David Butler-Jones, as the country’s
first Chief Public Health Officer.
Since the coming into effect of the associated
Orders in Council, the Public Health Agency
of Canada has been working in collaboration
with Health Canada, the Privy Council
Office and Justice Canada to develop
enabling legislation for the Agency. This
activity has included consultations with key
stakeholder groups to hear their
perspectives. Work is continuing on Public
Health Agency legislation.
Enhance Federal Capacities in Its Laboratories,
Health Surveillance and Emergency Response
12. The Canadian Public Health
Laboratory Network will improve
the communications among those
researching infectious diseases,
bioterrorism and other health
emergencies.
MET
The technological backbone of the
Laboratory Network is a combination of
Web-based applications and resources
provided by the Canadian Network for
Public Health Intelligence. It has been
delivered, and over 95% of public health
laboratories are on board. The system is in
place, but 100% national surveillance has
not yet been achieved due to funding
pressures at both the federal and provincial
levels of government.
Work has begun to enhance cross-border
collaboration with the Association of Public
Health Laboratories, the American
counterpart of the Canadian Public Health
Laboratory Network. Priority areas for
additional activities include workforce
development training, communication and
technical partnerships.
56
Public Health Agency of Canada
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status
RPP Commitments
Status
National approaches to laboratory diagnoses
are required in order to fully exploit the
benefits of enhanced communication within
the Canadian Public Health Laboratory
Network. This is a long-term project. The
greatest challenge remains the creation and
distribution of proficiency panels for the 40
national notifiable diseases, along with the
testing and reporting of data.
Significant effort has been expended on
external quality assurance for Agency
laboratories to retain or obtain International
Standardization Organization (ISO)
accreditation. The Laboratory for Foodborne
Zoonoses, in Guelph, and the National
Laboratory for Enteric Pathogens have
received or are close to receiving ISO 17025
certification, while Central Services of the
National Microbiology Laboratory is seeking
ISO 9001:2000 certification. Plans are
underway to share documentation and/or
lessons learned with the laboratory network
on ISO accreditation for certain tests.
Surveillance of E. coli and salmonella has
continued, but the creation of groups to
provide surveillance of CA-MRSA
(community-associated methicillin-resistant
Staphylococcus aureus) and of hospitalacquired infections such as C. difficile and of
influenza, were still under development.
Objectives, discussion support tools and
terms of reference documents were prepared;
however, the coordination of existing teams
and ongoing surveillance through a national
platform are still required.
13. The Agency will facilitate the
integration of surveillance systems
for both communicable and
non-communicable diseases to
enable timely access to critical,
real-time clinical and laboratory
data.
MET
The Canadian Integrated Outbreak
Surveillance Centre (CIOSC) was created in
2004. Providing integrated public health
information to local, regional and national
decision-makers, it is in use by 99% of health
units in Canada, resulting in improved
outbreak detection and response.
Section II – Analysis of Performance by Strategic Outcome
57
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status
RPP Commitments
Status
Through a collaborative effort among the
Agency, provinces and territories,
laboratories and sentinel physicians,
FluWatch provides weekly reports
summarizing influenza prevalence in
Canada.
The Agency developed protocols for
federal/provincial/territorial governments
that provide general principles and
operating procedures to coordinate
investigations and to control severe
respiratory outbreaks. An example is the
Respiratory Illness Outbreak Response
Protocol.
The Canadian Integrated Program for
Antimicrobial Resistance Surveillance
(CIPARS) annual report for 2003 was
released on February 28, 2005 (see
http://www. phac-aspc.gc.ca/cipars-picra/
2003_e. html).
That annual report indicated high levels of
resistance in salmonella strains from human
and poultry sources, prompting a voluntary
ban on a Class 1 antimicrobial used in the
hatching egg industry.
The Agency supports the work of the
Advisory Committee on Population Health
and Health Security’s Task Group on
Enhancing Capacity for Chronic Disease
Risk Factor Surveillance. The report of the
Task Group, which outlines a comprehensive approach to enhancing
surveillance, has been approved by the
Conference of Deputy Ministers of Health.
The Auditor General has indicated
satisfaction with progress made in filling
identified gaps in the surveillance of chronic
disease.
58
Public Health Agency of Canada
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status
RPP Commitments
Status
The National Diabetes Surveillance System
(NDSS) represents the first example of a
coordinated, national use of administrative
data for public health surveillance purposes.
The NDSS can compare data on use of
health services and health outcomes of
people with and without diabetes. With
these features, the NDSS is a prototype of
enhanced capacity and infrastructure to
support surveillance of other diseases that
can be tracked through the health care
system. The NDSS was evaluated in
2004–05, and the report will be finalized and
the findings made available in 2005–06.
Three workshops have been held with
provincial and territorial partners, other
federal departments, academia and
non-governmental organizations to explore
the inclusion of arthritis, mental illness and
cardiovascular disease in an integrated
surveillance system. Work is underway to
study incorporating other chronic diseases
into the National Diabetes System, and to
include cancer staging and palliative care
data in the National Cancer Registry.
The Agency supported the active
surveillance of enteric disease in humans
and their exposure to pathogens through
food, water and animals in sentinel
communities across Canada. This activity
requires collaboration and data sharing
agreements between public health units and
the Agency; it is supported by the
Agriculture Policy Framework. The
Surveillance Framework and negotiations
with the first C-EnterNet sentinel site
(Region of Waterloo Public Health Unit)
have been completed.
mFor West Nile virus and other
animal-to-human transferable
diseases, the Agency will continue
to develop the surveillance and
research capacities to address
these new threats.
MET
Ongoing surveillance information is now
provided on-line.
Section II – Analysis of Performance by Strategic Outcome
59
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status
RPP Commitments
Status
Research was designed to establish the most
relevant mosquito species that act as
transmitters of the disease. The
establishment of mosquito species in a
laboratory setting has been slower than
anticipated, although some important
species are slowly adapting.
Memorandums of Agreement and research
protocols have been developed with the
Government of Cuba for studies on West
Nile virus infection rates.
Reference laboratory services for diagnostic
testing of West Nile virus are provided to
client laboratories in Canada and
internationally.
14. In 2003, Health Canada received
$45 million over five years to
develop and strengthen
immunization capacity and reduce
the incidence of specific vaccinepreventable diseases. This new
funding, now transferred to the
Agency, will be invested in
initiatives to: strengthen federal
program activities; ensure equitable
and timely access to recommended
vaccines for all Canadians; fulfill
federal responsibilities for vaccine
preventable diseases and immunization; and provide a forum for
inter-jurisdictional collaboration on
immunization issues and programs.
MET
The federal/provincial/territorial Canadian
Immunization Committee was established to
provide leadership in advancing the National
Immunization Strategy (NIS) through
analysis, development of national goals, and
effective and efficient immunization
programs, policies, practices, guidelines and
standards.
Funding in 2004–05 was used to develop
various components and activities of the
NIS, including the following:
mA federal/provincial/territorial Vaccine
Supply Working Group was established;
mSupply shortfalls were managed in
collaboration with provincial and
territorial governments, as a result of a
flu vaccine shortage in the United States;
mA task group was established to study
approaches to publicly funded influenza
immunization; and
mThe Canadian Immunization Registry
Network carried out activities.
60
Public Health Agency of Canada
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status
RPP Commitments
Status
15. Based on successful pilots of the
Public Health Information System
(PHIS), the Agency will work with
provincial, territorial and local
partners to further pilot, evaluate
and develop additional PHIS
modules.
MET
In a final step to improve information
sharing, the Agency successfully partnered
with Ontario and British Columbia to
develop new modules (Outbreak and
Primary Assessment and Care modules), as
PHIS moved into its operational phase This
provides credible, timely, accessible and
secure public health information and
practices, enhancing the ability of health
professionals to make better-informed
decisions that benefit Canadians.
Opportunities to collaborate with the Canada
Health Infoway project are also being explored.
16. The Agency will continue to
exchange information through the
Global Public Health Network. Six
regional emergency preparedness
coordinators will focus their
energies on planning, coordinating
and implementing an effective
regional emergency preparedness
response system that supports the
National Departmental Emergency
Preparedness Policy and Plan.
MET
The Agency, through the Global Health
Security Action Group Laboratory Network,
has sponsored workshops covering the
laboratory detection of anthrax, smallpox
and plague, with more to follow on
hemorrhagic fevers and tularemia. At these
gatherings, best practices for laboratory
diagnostics are shared, especially on agents
of bioterrorism. Enhanced communication
protocols have been developed to share best
practices on influenza virus H2N2, Marburg
hemorrhagic fever and avian influenza.
An international transportation workshop
was also held; participants included
representatives of the United Nations, the
World Health Organization, the
International Air Transport Association, the
International Civil Aviation Organization,
the International Airline Pilots Association
and courier corporations. As an additional
part of these international efforts, the
National Microbiology Laboratory conducted
research on vaccines for Ebola and Marburg
hemorrhagic fever viruses, two highly
contagious pathogens endemic to parts of
Africa. Candidate vaccines for both viruses
have been developed.
Section II – Analysis of Performance by Strategic Outcome
61
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status
RPP Commitments
Status
17. The Agency will engage in activities
that will coordinate our response to
public health emergencies and
improve the day-to-day management of broader public health
issues within the federal
jurisdiction.
MET
A major goal underlying the creation of the
Agency was to ensure that Canada would be
able to deal effectively with public health
emergencies. To this end, the Agency has
re-established front-line quarantine services
at Canada’s eight major international
airports, to control the entry of diseases such
as severe acute respiratory syndrome
(SARS). The Canadian Global Public Health
Intelligence Network II was launched in
New York in November 2004; it provides
24-hour global monitoring and surveillance
of potential global health threats, including
potential pandemic communicable disease
outbreaks. New collaborative software
acquisitions provide 24-hour operational
readiness. The Agency is undertaking a
strategic review of the National Emergency
Stockpile System (NESS) to ensure
readiness to respond to all types of
emergency hazards.
NESS was activated at the request of the
Canadian International Development
Agency to respond to the need for medicines,
supplies and equipment in Southeast Asia
after the devastating tsunami of December
2004. The Public Health Agency of Canada
was concerned about the threats to public
health caused by the disaster. Senior
officials of the Public Health Agency
participated in reconnaissance and
evaluation efforts, leading to a more
effective Canadian response.
The Agency co-hosted with Public Safety
and Emergency Preparedness Canada
(PSEPC) the fourth National Forum on
Emergency Preparedness and Response,
during which significant progress was made
toward the development of an integrated
pan-Canadian emergency management
system based on the principles and
guidelines of the National Health
62
Public Health Agency of Canada
2004–05 Health Canada Report on Plans and Priorities (RPP)
Commitments and Status
RPP Commitments
Status
Emergency Management Framework. A
permanent liaison post has been established
to ensure essential links with PSEPC in
inter-sectoral public health safety and
security policies and procedures.
The Quarantine Act was updated, granting
new powers to prevent the introduction and
spread of communicable diseases, and was
subsequently passed by Parliament in May
2005.
The National Office of Health Emergency
Response Teams has completed preparatory
work leading to the creation, training and
exercising of the first Health Emergency
Response Teams. The teams will create a
multi-level, rapidly deployable surge capacity
using an all-hazards approach.
mThe Agency regions will continue
to refine, test and evaluate their
regional all-hazards emergency
response plans as they continue to
participate, plan and execute
emergency exercises and manage
actual emergencies.
MET
A technical working group on emerging
infectious diseases has been established to
develop standards, methods and processes
for the rapid launch of research during an
infectious outbreak. Roles and
responsibilities have been defined in the
event of a pandemic influenza outbreak.
Regional Coordinator positions were
established in all Agency regional offices.
Five positions have been staffed, and the
sixth staffing action is in progress.
Regional offices are laying the foundations
for Regional All-Hazards Emergency Plans
and Policies, working in coordination with
provincial and territorial partners.
Section II – Analysis of Performance by Strategic Outcome
63
Laboratory Security
http://www.phac-aspc.gc.ca/ols-bsl/index.html
Childhood and Adolescence
http://www.phac-aspc.gc.ca/dca-dea/
Aging and Seniors
http://www.phac-aspc.gc.ca/seniors-aines/index_pages/whatsnew_e.htm
Canadian Health Network
http://www.canadian-health-network.ca
Health Surveillance and Epidemiology
http://www.phac-aspc.gc.ca/hsed-dsse/index.html
Voluntary Sector
http://www.phac-aspc.gc.ca/vs-sb/voluntarysector/
Chronic Disease Surveillance
http://www.phac-aspc.gc.ca/ccdpc-cpcmc/surveil_e.html
Countrywide Integrated Noncommunicable Disease Intervention (CINDI)
http://www.phac-aspc.gc.ca/ccdpc-cpcmc/cindi/index_e.html
World Health Organization Collaborating Centre for Non-Communicable
Disease Policy
http://www.phac-aspc.gc.ca/ccdpc-cpcmc/international_e.html
Hepatitis C
http://www.phac-aspc.gc.ca/hepc/hepatitis_c/index.html
Blood Safety Surveillance
http://www.phac-aspc.gc.ca/hcai-iamss/index.html
Immunization and Respiratory Infections
http://www.phac-aspc.gc.ca/dird-dimr/index.html
Network for Health Surveillance
http://www.phac-aspc.gc.ca/csc-ccs/network_e.html
64
Public Health Agency of Canada
Section III – Supplementary Information
Organizational Information
About the Public Health Agency of Canada
The creation of the Public Health Agency of Canada on September 24, 2004,
marked the beginning of a new approach to federal leadership and collaboration
with provinces and territories on efforts to renew the public health system in
Canada and to support a sustainable health care system.
Under the leadership of the Chief Public Health Officer, the Agency continues to
work closely with Health Canada to promote and protect the health of Canadians
through leadership, partnership, innovation and action.
The Agency’s focus remains on the capability to respond to public health
emergencies and infectious disease outbreaks, the prevention of chronic diseases
such as diabetes, cancer and cardiovascular disease, and the prevention of injuries.
Organizing for Effect
The structure of the Public
Health Agency of Canada is
based on creating an Agency
presence in strategic locations across the country in
order to effectively deliver
services and programs which
promote and protect national
and international public
health. Two strategic pillars,
located in Ottawa and
Winnipeg, support a national
team working in satellite
offices and laboratories in six
This map indicates where the Agency has significant presence.
designated regions.
Each region is led by a Regional Director responsible for delivering Agency
programs and services which respond to region-specific demands and national
requirements. Regional staff play an essential role in anticipating, preparing for,
responding to and recovering from public health emergencies.
The interim organizational structure of the Public Health Agency as of March 2005
is outlined below. The Infectious Disease Branch includes the Centre for Infectious
Disease Prevention and Control (with the HIV/AIDs laboratory) located in Ottawa
and Guelph, the National Microbiology Laboratory located in the Canadian Science
66
Public Health Agency of Canada
Centre for Human and Animal Health in Winnipeg, the Laboratory for Foodborne
Zoonoses located in Guelph and the Centre for Emergency Preparedness and
Response. The Health Promotion and Chronic Disease Prevention Branch includes
the Centre for Health Promotion (formerly the Centre for Healthy Human
Development), the Center for Chronic Disease Prevention and Control and the
Transfer Payments Services and Accountability Division. The Office of Public
Health Practice is the former Centre for Surveillance Coordination. Seven regional
offices support program delivery and are located in Halifax, Montréal, Toronto,
Winnipeg, Regina, Edmonton, and Vancouver. The Corporate Services Branch
includes directorates for Strategic policy, Communications, Finance and Planning,
Human Resources and Information Management and Information Technology.
Through extensive partnerships and collaboration, our centres, directorates,
regional offices and laboratories use the best available evidence and tools to advise
and support public health stakeholders nationally and internationally as they work
to enhance the health of their communities. The Agency’s goal is to provide accurate
and timely public health information, advice and leadership to Canadians while
building and sustaining an inclusive public health network with stakeholders.
Through surveillance, research, investigations and reports on diseases, injuries and
other preventable health risks and their determinants, Agency employees are key in
assessing the general state of public health in Canada and abroad.
This transitional organizational structure allowed the Public Health Agency of
Canada to achieve its global mandate while maintaining its national focus on
ensuring healthy Canadians and communities in a healthier world.
Section III – Supplementary Information
67
68
Public Health Agency of Canada
Infectious Disease
(3 labs)
Health Promotion &
Chronic Disease
Prevention
Emergency
Preparedness and
Response
Minister of State
(Public Health)
Interim Organization chart as of March 2005
Office of Public
Health Practice
Chief Public Health
Officer
Minister of Health
Regional Ops
(6 regions)
Corporate Services
Table 1: Comparison of Planned Spending and Full-Time Equivalents ($ millions)
2004–2005
2002–03 2003–04
Main
Actual
Actual Estimates
Planned
Spending
Total
Authorities
Actual
Population and
Public Health
605.2
586.7
Total
605.2
586.7
Total
605.2
586.7
0.0
11.4
Net cost of
Department
605.2
598.1
Full-time
equivalents
1,671.0
1,666.0
Plus: Cost of
services
received
without charge*
This table compares the Total Authorities with Actual Spending for the 2004–05
fiscal year for the Public Health Agency of Canada and its predecessor. Before the
Agency was created on September 24, 2004, this business line included the
Population and Public Health Branch as well as parts of other branches of Health
Canada. Health Canada’s Main Estimates and Planned Spending include the
Population and Public Health Branch figures.
* Services received without charge include accommodation provided by Public
Works and Government Services Canada, the employer’s share of employees’
insurance premiums, expenditures paid by the Treasury Board Secretariat
(excluding revolving funds), and services received from the Department of Justice
Canada (see Table 4).
Section III – Supplementary Information
69
Table 2: Use of Resources by Business Line ($ millions)
2004–05 Budgetary
Operating
Grants and
Contributions
Total: Gross
Budgetary
Expenditures
Total: Net
Budgetary
Expenditures
Main Estimates
N/A
N/A
N/A
N/A
Planned Spending
N/A
N/A
N/A
N/A
Total Authorities
282.1
323.2
605.2
605.2
Actual Spending
264.9
321.8
586.7
586.7
Business Line
Population and
Public Health
This table reflects how resources are used within the Public Health Agency of
Canada and its predecessor by appropriation for the 2004–05 fiscal year. Before the
Agency was created on September 24, 2004, this business line included the
Population and Public Health Branch as well as parts of other branches of Health
Canada. Health Canada’s Main Estimates and Planned Spending include the
Population and Public Health Branch figures.
70
Public Health Agency of Canada
Table 3: Voted and Statutory Items ($ millions)
2004–05
Vote or
Statutory
Item
Truncated Vote or
Statutory Wording
30
Operating expenditures
262.1
245.0
35
Grants and
Contributions
223.2
221.8
(S)
Contributions to
employee benefit plans
19.9
19.9
(S)
Canada Health Infoway
Inc.
100.0
100.0
Total
605.2
586.7
Main
Estimates
Planned
Spending
Total
Authorities Actual
This table compares the Total Authorities with Actual Spending by Vote for the
2004–05 fiscal year for the Public Health Agency of Canada and its predecessor.
Before the Agency was created on September 24, 2004, this business line included
the Population and Public Health Branch as well as parts of other branches of
Health Canada. Health Canada’s Main Estimates and Planned Spending include
the Population and Public Health Branch figures.
Link to TBS Estimates site:
2004–2005 Part III – Departmental Performance Reports (DPR)
http://www.tbs-sct.gc.ca/rma/dpr1/04-05/index_e.asp (English)
http://www.tbs-sct.gc.ca/rma/dpr1/04-05/index_f.asp (French)
Table 4: Net Cost of Department ($ millions)
2004–05
Total Actual Spending
586.7
Plus: Services Received Without Charge
Accommodation provided by Public Works and Government Services
Canada (PWGSC)
2.3
Contributions covering employers’ share of employees’ insurance
premiums and expenditures paid by TBS (excluding revolving funds)
9.0
Salary and associated expenditures of legal services provided by Justice
Canada
0.1
2004–2005 Net cost of Department
Section III – Supplementary Information
598.1
71
Table 5: Contingent Liabilities
** The Agency is involved in individual and class action suits against the Government. In
light of the fact that these cases are the subject of ongoing settlement negotiations, and
given the complexity of the issues, it is not possible to provide a reasoned assessment
of contingent liability at this time.
Table 6: Details on Transfer Payments Programs (TPPs) ($ millions)
GENERAL EXPLANATIONS:
mThis is a summary of the Transfer Payment Programs for the Public Health Agency
that are in excess of $5,000,000.
mAll of the Transfer Payments shown in this Table are voted programs.
mDue to the long-standing history and evolution of some programs, the Total Funding
is not meaningful and/or cannot be determined without extraordinary effort. In such
cases the Total Funding is left blank.
Table 6: Details on Transfer Payments Programs (TPPs
1) Name of Transfer Payment Program: Contributions to persons and agencies to
support health promotion projects in the areas of community health, resource
development, training and skill development, and research
2) Start Date: 1999–2000
3) End Date: Ongoing
4) Total Funding:
5) Description of Transfer Payment Program: Population Health
6) Objective(s), Expected Result(s) and Outcomes: To expand the knowledge base for
program and policy development, to build more partnerships and develop inter-sectoral
collaboration. Evidence-based policies and programs that promote healthy activities and
create a larger cadre of trained community members. Increased number of
community-based initiatives that foster evidence-based healthy living practices, healthy
environments, safe products and strong support systems. Greater number of
organizations and networks acting collaboratively to help Canadians make physical
activity a part of their daily lives. Also included in the Population Health program is the
Canadian Health Network (CHN): To provide Canadian consumers with expert reviewed
information/resources focussing on how to stay healthy and to prevent disease and
injury so that Canadians can be better informed and empowered to have more control
over their health and improve their health literacy.
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Public Health Agency of Canada
7) Achieved Results or Progress Made: The Population Health Fund continued to be active
with 35 national projects completed following the 2002 solicitation. The Fund also
supported the establishment of the National Collaborating Centres and the development
of the 2007 International Conference on Health Promotion in Vancouver. A new
solicitation for national projects resulted in 27 projects being recommended to the
Minister for approval. Funding of regional projects reflecting regional priorities has
continued. The Dissemination and Evaluation component of various approved projects
was also increased.
9) Actual 10) Planned 11) Total 12) Actual 13) Variance(s)
8) Actual
between 10
Spending Spending Spending Authorities Spending
and 12
2002–2003 2003–2004 2004–2005 2004–2005 2004–2005
14) Business
Lines (BL)
Health
Promotion
and
Protection
- Total Grants
- Total
Contributions
18.8
18.2
11.6
10.9
10.4
1.2
15) Total for
BL (or PA)
18.8
18.2
11.6
10.9
10.4
1.2
16) Total TPP
18.8
18.2
11.6
10.9
10.4
1.2
- Total Other
Transfer
Payments
17) Comments on Variances: The CHN provided $1.0 million to address departmental
priorities; negotiations on three content areas were still being conducted ($900,000) to
ensure appropriate fit and value for money before agreements were put into place.
18) Significant Evaluation Findings and URL to Last Evaluation: The CHN is currently
undergoing a comprehensive evaluation that is due to the Treasury Board Secretariat in
December 2005. Initial findings from public opinion research (which feeds into the
evaluation) indicate that the CHN has been steadily growing in usage since its 1999
launch, with an monthly average of 185,439 unique visitors in 2005 (an increase from
123,593 visitors in 2004).
Section III – Supplementary Information
73
Table 6: Details on Transfer Payments Programs (TPPs) (continued)
1) Name of Transfer Payment Program: Contributions to non-profit community
organizations to support, on a long-term basis, the development and provision of
preventive and early intervention services aimed at addressing the health and
developmental problems experienced by young at-risk children in Canada
2) Start Date: 1998–99
3) End Date: Ongoing
4) Total Funding:
5) Description of Transfer Payment Program: Community Action Program for Children
(CAPC)
6) Objective(s), Expected Result(s) and Outcomes: To enhance community capacity to
respond to the health and development needs of young children and their families who
are facing conditions of risk, through a population health approach. To contribute to
improved health and social outcomes for young children and parents/caregivers facing
conditions of risk.
7) Achieved Results or Progress Made: There are approximately 450 CAPC projects
across Canada. Based on preliminary results from CAPC’s national process of
evaluation for the 2004–05 reporting period, it is estimated that CAPC projects serve
over 69,000 children and parents/caregivers in a typical month in more than 3,000
communities across the country. CAPC’s national process of evaluating the results
consistently showed that CAPC projects have developed successful partnerships with
many sectors and are supported by communities and other supporters. Early evaluation
of the program (1997) found that CAPC was successfully reaching its intended
population (i.e. children and families facing conditions of risk). Currently, work is
underway to develop a strategy to better understand CAPC’s current reach. CAPC
completed a Results-Based Management and Accountability Framework (RMAF) in
2004, and is now working with the Canada Prenatal Nutrition Program (CPNP) to
develop an integrated RMAF that will produce a coordinated approach to measuring
outcomes for the two programs. The integrated CAPC-CPNP RMAF will guide future
evaluation planning for CAPC.
74
Public Health Agency of Canada
9) Actual 10) Planned 11) Total 12) Actual 13) Variance(s)
8) Actual
between 10
Spending Authorities Spending
Spending Spending
and 12
2002–2003 2003–2004 2004–2005 2004–2005 2004–2005
14) Business
Lines (BL)
Health
Promotion
and
Protection
- Total Grants
- Total
Contributions
53.3
53.5
54.7
55.6
55.6
-0.9
15) Total for
BL (or PA)
53.3
53.5
54.7
55.6
55.6
-0.9
16) Total TPP
53.3
53.5
54.7
55.6
55.6
-0.9
- Total Other
Transfer
Payments
17) Comments on Variances: .
18) Significant Evaluation Findings and URL to Last Evaluation: Significant Evaluation
Findings: Preliminary results from the CAPC national evaluation process for the 2004–05
reporting period show that CAPC projects continue to have successful partnerships with
many sectors and are supported by communities and other supporters. (Please note that
approximately 50 Aboriginal projects in Ontario do not participate in the national
evaluation process, as they participate in a separate evaluation.) In 2004–05, over 6,000
partnerships were reported. Most CAPC projects reported partnering with a health
organization, such as a health department, a regional health authority, a community
health centre or a CLSC. Many CAPC projects reported in-kind contributions and
donations of time. These projects estimated receiving more than $6 million in in-kind
contributions of such things as facilities, program materials and project equipment, as
well as over 70,000 hours donated by participant volunteers, partner staff and others in
the community. A number of CAPC projects reported receiving funding from sources
other than CAPC, CPNP and AHS. Over $22 million in funding from other sources was
reported, including more than $11 million from provincial/territorial governments.
Section III – Supplementary Information
75
Table 6: Details on Transfer Payments Programs (TPPs) (continued)
1) Name of Transfer Payment Program: Contributions towards the Canadian Strategy
on HIV/AIDS
2) Start Date: 1998–99
3) End Date: Ongoing
4) Total Funding:
5) Description of Transfer Payment Program: HIV/AIDS
6) Objective(s), Expected Result(s) and Outcomes: To support prevention of HIV/AIDS, to
promote access to care, treatment and support for people affected by the disease.
Projects funded at the national and regional levels that will result in improved knowledge
and awareness of the epidemic and a strengthened community and public health
capacity to respond to the epidemic. Increased knowledge and awareness; enhanced
multi-sectoral engagement and alignment; increased individual and organizational
capacity; and increased coherence of the federal response.
7) Achieved Results or Progress Made: 46 new projects funded – 26 projects under the
Non-Reserve First Nations, Inuit and Métis Communities HIV/AIDS Project Fund; 10
projects under the National HIV/AIDS Capacity Building Fund; 2 projects under the
HIV/AIDS Information Service Initiative Fund; 2 projects under the National HIV/AIDS
Community-Based Social Marketing Fund; 6 projects under the National HIV/AIDS
Non-Governmental Organization Operational Fund.
Regional Program (AIDS Community Action Program [ACAP]): 83 community-based
organizations (CBOs) operationally funded; 68 CBOs funded to complete time-limited
projects; 12 CBOs received ACAP funding for the first time; thousands of volunteers
contributed time and effort to address HIV/AIDS through ACAP-funded organizations;
thousands of partnerships maintained through ACAP-funded projects.
76
Public Health Agency of Canada
9) Actual 10) Planned 11) Total 12) Actual 13) Variance(s)
8) Actual
between 10
Spending Authorities Spending
Spending Spending
and 12
2002–2003 2003–2004 2004–2005 2004–2005 2004–2005
14) Business
Lines (BL)
Health
Promotion
and
Protection
- Total Grants
- Total
Contributions
16.8
17.1
10.8
19.6
19.5
-8.7
15) Total for
BL (or PA)
16.8
17.1
10.8
19.6
19.5
-8.7
16) Total TPP
16.8
17.1
10.8
19.6
19.5
-8.7
- Total Other
Transfer
Payments
17) Comments on Variances: The variance of $8.7 million that was transferred from grants
to contributions, and an under-estimation of the new contribution resources that were
received in 2004–05 under the Treasury Board Submission for the Federal Initiative to
Address HIV/AIDS in Canada.
18) Significant Evaluation Findings and URL to Last Evaluation: Getting Ahead of the
Epidemic: The Federal Government Role in the Canadian Strategy on HIV/AIDS
1998–2008 – Key Findings: The federal response has expanded the federal reach to
address the epidemic; developed community capacity; placed HIV/AIDS in a human
rights context; supported national organizations in engaging in the full range of public
policy, research, prevention, treatment and care activities; developed flexibility in
supporting particularly vulnerable populations such as Aboriginal peoples, and in
targeting specific regions, in a manner consistent with the epidemic being a national
emergency; the epidemic continues to grow; Getting Ahead of the Epidemic identified a
need to develop a new approach to federal leadership and collaboration with provinces
and territories to support a sustainable coordinated approach to HIV/AIDS; to ensure
that those who are at risk of acquiring HIV/AIDS or are living with the disease have
equitable access to programs and services; and to strengthen HIV/AIDS-specific
services and supports, with a focus on those populations most affected.
http://www.phac-aspc.gc.ca/aids-sida/hiv_aids/federal_initiative/publications/ahead.html
Section III – Supplementary Information
77
Table 6: Details on Transfer Payments Programs (TPPs) (continued)
1) Name of Transfer Payment Program: Contributions to incorporated local or
regional non-profit Aboriginal organizations and institutions for the purpose of
developing early intervention programs for Aboriginal pre-school children and
their families
2) Start Date: 1995–96
3) End Date: Ongoing
4) Total Funding:
5) Description of Transfer Payment Program: Aboriginal Head Start; Early Childhood
Development
6) Objective(s), Expected Result(s) and Outcomes: To develop early intervention programs
for Aboriginal pre-school children and their families. Enhanced programming for parental
involvement and support for special needs children at 114 community sites. To expand
existing facilities in under-served communities and to create new centres in unserved
communities. To consult with the national advisory committee and regional offices to set
priorities for program expansion. To address the need to improve access to information
and training. To increase overall enrolment in the program by approximately 1000
children by 2004–05. To increase the number of parental involvement workers, the
number of special needs workers and training offered to project staff in areas such as
services to special-needs children and parental involvement.
7) Achieved Results or Progress Made: There are 131 community sites, with 1000 new
Aboriginal Head Start spaces. In the process of increasing the number of parental
involvement workers, the number of special needs workers, and training offered to
project staff in areas such as services to special-needs children and parental
involvement.
78
Public Health Agency of Canada
9) Actual 10) Planned 11) Total 12) Actual 13) Variance(s)
8) Actual
between 10
Spending Spending Spending Authorities Spending
and 12
2002–2003 2003–2004 2004–2005 2004–2005 2004–2005
14) Business
Lines (BL)
Health
Promotion
and
Protection
- Total Grants
- Total
Contributions
25.8
28.0
29.1
28.8
28.7
0.4
15) Total for
BL (or PA)
25.8
28.0
29.1
28.8
28.7
0.4
16) Total TPP
25.8
28.0
29.1
28.8
28.7
0.4
- Total Other
Transfer
Payments
17) Comments on Variances:
18) Significant Evaluation Findings and URL to Last Evaluation: Aboriginal Head Start (AHS)
conducts annual process evaluations and is in the final phase of a three-year impact
evaluation. Initial findings from the impact evaluation are as follows: children
demonstrate improved skills in school readiness and in other areas of early childhood
development; parents participate in AHS management and operations, in parenting
classes and in the classrooms; there is community mobilization around children; and
Aboriginal cultures and languages are strengthened in participants.
Section III – Supplementary Information
79
Table 6: Details on Transfer Payments Programs (TPPs) (continued)
Other Transfer Payments
1) Name of Transfer Payment Program: Payments to provinces and territories to
improve access to health care and treatment services for persons infected with
hepatitis C through the blood system
2) Start Date: 2000–01
3) End Date: 2014–15
4) Total Funding: 200.6
5) Description of Transfer Payment Program: Improved Resourcing for Hepatitis C Health
Care Services
6) Objective(s), Expected Result(s) and Outcomes: To improve access to health care and
treatment services for persons infected with hepatitis C through the blood system.
Federal transfers will be used for health care services indicated for the treatment of
hepatitis C infection, and medical conditions directly related to it, such as current and
emerging antiviral drug therapies, other relevant drug therapies, immunization and
nursing care. Regular reports to the public will be prepared on the nature of initiatives
benefiting from federal funding.
7) Achieved Results or Progress Made: Funds have been distributed among the provinces
and territories where access to health care and treatment service are being provided.
80
Public Health Agency of Canada
9) Actual 10) Planned 11) Total 12) Actual 13) Variance(s)
8) Actual
between 10
Spending Spending Spending Authorities Spending
and 12
2002–2003 2003–2004 2004–2005 2004–2005 2004–2005
14) Business
Lines (BL)
Health
Promotion
and
Protection
- Total Grants
- Total
Contributions
- Total Other
Transfer
Payments
21.2
44.0
50.1
50.1
50.1
0.0
15) Total for
BL (or PA)
21.2
44.0
50.1
50.1
50.1
0.0
16) Total TPP
21.2
44.0
50.1
50.1
50.1
0.0
17) Comments on Variances: No variances
18) Significant Evaluation Findings and URL to Last Evaluation: The first federal five-year
review of the Undertaking Agreement will occur in 2005–06.
Section III – Supplementary Information
81
Table 6: Details on Transfer Payments Programs (TPPs) (continued)
1) Name of Transfer Payment Program: Contributions to persons and agencies to
support health promotion projects in the areas of community health, resource
development, training and skill development, and research
2) Start Date: 1999–2000
3) End Date: 2005–06
4) Total Funding:
5) Description of Transfer Payment Program: Diabetes
6) Objective(s), Expected Result(s) and Outcomes: To expand the knowledge base for
program and policy development, to build more partnerships and to develop
inter-sectoral collaboration. Evidence-based policies and programs that promote healthy
activities and create a larger cadre of trained community members. Increased number of
community-based initiatives that foster evidence-based healthy living practices, healthy
environments, safe products and strong support systems. Greater number of
organizations and networks acting collaboratively to help Canadians make physical
activity a part of their daily lives. To provide Canadian consumers with expert-reviewed
information/resources focussing on how to stay healthy and to prevent disease and
injury so that Canadians can be better informed and empowered to have more control
over their health and improve their health literacy.
7) Achieved Results or Progress Made: With stronger linkages with our internal and
external partners, we have made significant progress on integrated approaches to public
health through the development and implementation of chronic disease policies and
programs, as well as providing leadership and expertise in pan-Canadian chronic
disease prevention and control.
82
Public Health Agency of Canada
9) Actual 10) Planned 11) Total 12) Actual 13) Variance(s)
8) Actual
between 10
Spending Spending Spending Authorities Spending
and 12
2002–2003 2003–2004 2004–2005 2004–2005 2004–2005
14) Business
Lines (BL)
Health
Promotion
and
Protection
- Total Grants
- Total
Contributions
6.7
7.1
6.0
6.0
5.9
0.1
15) Total for
BL (or PA)
6.7
7.1
6.0
6.0
5.9
0.1
16) Total TPP
6.7
7.1
6.0
6.0
5.9
0.1
- Total Other
Transfer
Payments
17) Comments on Variances: Deferral of staffing during the transition to the new Agency
contributed to the impact of turnover. Unanticipated operational constraints and staff
turnover prevented some planned activities/projects from being completed on time or as
planned.
18) Significant Evaluation Findings and URL to Last Evaluation:
Section III – Supplementary Information
83
Table 6: Details on Transfer Payments Programs (TPPs) (continued)
1. Name of Transfer Payment Program: Contributions to non-profit community
organizations to support, on a long-term basis, the development and provision of
preventive and early intervention services aimed at addressing the health and
developmental problems experienced by young at-risk children in Canada
2. Start Date: 1994–95
3. End Date: Ongoing
4. Total Funding:
5. Description of Transfer Payment Program: Canadian Prenatal Nutrition Program (CPNP)
6. Objective(s), Expected Result(s) and Outcomes: To improve community capacity to
respond to the needs of pregnant women who are living in circumstances that put their
health and the health of their infants at risk. To increase access to health and social
supports for pregnant women in approximately 330 projects in about 2000 communities
in Canada. To reach the intended audience, e.g., women living in challenging
circumstances such as poverty, poor nutrition, teenage pregnancy, social and
geographic isolation, recent arrival in Canada, alcohol or substance use and/or family
violence. The Fetal Alcohol Spectrum Disorder (FASD) portion aims to build community
capacity by developing tools and resources for the use of community-based front-line
workers.
7. Achieved Results or Progress Made: There are approximately 330 Canada Prenatal
Nutrition Program projects in about 2000 communities across Canada. The Program
serves about 50,000 prenatal and recently postnatal women annually. Each year, an
estimated 28,000 pregnant women and 1,800 postnatal women enter CPNP. The FASD
National Strategic Project Fund supported 8 projects that are now in the dissemination
and evaluation phase: – one developed a curriculum for a certificate program at the
college level which is being picked up by other colleges across Canada; – one
developed tools and resources for families and caregivers coping with FASD-affected
individuals; – one is raising awareness and knowledge among allied professionals to
help them cope with those affected by FASD in their sectors; – one maintains a
database of programs related to FASD; – and one was designed to adapt resources into
French for French-speaking communities across the country.
84
Public Health Agency of Canada
9) Actual 10) Planned 11) Total 12) Actual 13) Variance(s)
8) Actual
between 10
Spending Spending Spending Authorities Spending
and 12
2002–2003 2003–2004 2004–2005 2004–2005 2004–2005
14) Business
Lines (BL)
Health
Promotion
and
Protection
- Total Grants
- Total
Contributions
27.1
26.4
27.4
27.9
27.9
-0.5
15) Total for
BL (or PA)
27.1
26.4
27.4
27.9
27.9
-0.5
16) Total TPP
27.1
26.4
27.4
27.9
27.9
-0.5
- Total Other
Transfer
Payments
17) Comments on Variances:
18) Significant Evaluation Findings and URL to Last Evaluation: Significant Evaluation
Findings and URL to Last Evaluation: The CPNP is undergoing a comprehensive
evaluation, and information has been collected to measure reach and retention,
relevance, implementation and impact. According to evaluation findings from 1998 to
2003, the CPNP is reaching the intended audience and is estimated to have served 60%
of low income pregnant women in Canada, 40% of teenagers delivering live births in
Canada and 37% of Aboriginal pregnant women living off-reserve. The FASD projects
are in their last dissemination and evaluation year; as a result, there are no evaluation
findings yet.
Section III – Supplementary Information
85
Table 7: Conditional Grants (Foundations)
1) Name of Foundation: Canada Health Infoway Inc.
2) Start Date: start FY 04/05
3) End Date: end FY 08/09
4) Total Funding: $100 million
5) Purpose of Funding: One-time allocation to invest in the development and
implementation of pan-Canadian Health Surveillance System
6) Objective(s), expected result(s) and outcomes:
Objectives: To develop an implementation strategy for a pan-Canadian Public Health
Surveillance System based on a full assessment of the required tools for public health
surveillance (client and provider registries, domain repositories, peer to peer standards
repositories, surveillance applications, integration technologies) and to determine how
best to build upon what already exists.
There is a major gap in the capacity to manage surveillance data. Infoway can align the
required activities to address this gap with their work on the electronic health record. For
more information on the Canada Health Infoway Inc. (Infoway), please see the Health
Canada 2004-2005 Departmental Performance Report.
Link to TBS Estimates site:
2004–2005 Part III – Departmental Performance Reports (DPR)
http://www.tbs-sct.gc.ca/rma/dpr1/04-05/index_e.asp
Expected Results: The majority of jurisdictions have functional surveillance systems
that are interoperable with other health care systems and between jurisdictions leading
to:
mImproved reporting and analysis times from diagnosis to response for routine
public health activities, and outbreaks;
mSecure sharing of health data or information across multi-disciplinary teams;
mAn improved capacity to locate, notify and manage contacts and quarantined
persons in major outbreak situations;
mImproved public health efficiency in making routine and surveillance information
available to policy makers ad managers to support public heath program
management;
mPublic health business requirements incorporated into those initiatives around
data definitions, risk factors, process models, technology and enterprise
architecture;
mImproved knowledge of, and adoption of standards across jurisdictions to promote
standardization in reporting of public health data;
mImproved operability between disparate health systems and public health
applications;
mImproved security of personal health information; and
mIncreased transparency and accountability in the health system.
Outcome: Better health protection and improved health outcomes for Canadians.
86
Public Health Agency of Canada
7) Achieved results or progress made (within overall departmental results achieved):
1. Development of an investment strategy and its approval by the Infoway Board of
Directors in December, 2004.
This was done through consultations with stakeholders and in collaboration with a
Steering Committee comprised of F/P/T public health and information technology
experts. The strategy will focus on building the core common components of the
surveillance system solution, including infectious disease case management,
immunization management, outbreak management, health alerts, surveillance and
reporting, and integration to jurisdiction registries and laboratory repositories.
2. A high-level business requirements and software market study was completed. This
study provided an analysis of potential applications and tools that may be available in
the private and public sectors to build upon. It included both Public Health Agency of
Canada (PHAC) applications: i-PHIS and CNPHI-CIOSC.
3. A Requirements Definition document was completed, outlining the high level
requirements of the public health community for the solution to be built. It included an
analysis of the components of the Public Health Agency’s iPHIS product that could be
reused or adapted for pan-Canadian health surveillance needs.
4. A Solution Specification that compares candidate solutions and makes
recommendations for each required health surveillance component. The
recommended solutions are a combination of content leveraged from existing public
sector systems (reuse), off-the-shelf commercial products (buy), and custom-built
software (build).
11) Total 12) Actual 13) Variance(s)
9) Actual 10) Planne
8) Actual
between 10
Authorities Spending
Spending Spending d Spending
and 12
2004–2005 2004–2005
2002–2003 2003–2004 2004–2005
$ million
$ million
$ million
14)
Conditional
Grant(s)
N/A
N/A
0
100
100
100
15) Comments on Variances:
16) Significant Evaluation Findings and URL to last evaluation: An evaluation to measure
Infoway’s overall performance in achieving the outcomes identified in the Funding
Agreement is due March 31, 2006.
17) URL to Foundation site: http://www.infoway.ca
18) URL to Foundation’s Annual Report http://www.infoway.ca/pdf/CHI-fullAR-en.pdf
Section III – Supplementary Information
87
Table 8: Response to Parliamentary Committees, Audits and Evaluations for
FY2004–2005
Response to Parliamentary Committees
No committee responses were tabled during the time period indicated.
Response to the Auditor General
No Auditor General audits were tabled in 2004–05 with recommendations directed at the
former Population and Public Health Branch of Health Canada or the Public Health Agency
of Canada.
External Audits or Evaluations
Internal Audits or Evaluations
Internal Audits:
As a former branch of Health Canada, the Public Health Agency of Canada participated in
internal audits completed by Health Canada in fiscal year 2004–05. For information
regarding these audits, please refer to Table 17 of Health Canada’s Departmental
Performance Report. A risk assessment that is being conducted in fiscal year 2005–06 will
form the basis of the Agency’s first multi-year risk-based audit plan.
Evaluations:
There were no evaluations of programs of the Public Health Agency of Canada released in
2004–05.
A list of the evaluations conducted since 1982 by Health Canada, including its former
Population and Public Health Branch, can be found at http://www.hc-sc.gc.ca/iacb-dgiac/
arad-draa/english/programeval/report/reportindex.html. The Evaluation of the Canada
Prenatal Nutrition Program and the Synthesis of Canadian HIV/AIDS Related Evaluations,
1998–2003, released during 2004–05, pertained to the former Population and Public Health
Branch of Health Canada.
The Agency initiated the creation of a centre that will focus on program design and
excellence in evaluation during 2004–05. An assessment of evaluation resources and the
preparation of risk-based evaluation plans were undertaken to support the design of the
planned centre.
88
Public Health Agency of Canada
Table 9: Sustainable Development Strategies (SDS)
Sustainable Development Strategies
Department/Agency: Public Health Agency of Canada
Points to address
Departmental Input
1. What are the key
goals, objectives,
and/or long-term
targets of the SDS?
Prior to the creation of the Public Health Agency of Canada
(PHAC) in September 24, 2004, the former Population and
Public Health Branch (PPHB) was an integral part of the Health
Canada Sustainable Development Portfolio and contributed to
the development of Health Canada’s third Sustainable
Development Strategy (SDS) 2004–07, entitled Becoming the
Change We Wish to See.
The three-year strategy was developed with three thematic areas
for action which Health Canada (HC) is reporting on in the
2004–2005 DPR:
Theme 1: Helping to create healthy social and physical
environments
Theme 2: Integrating sustainable development into
departmental decision-making and management
processes
Theme 3: Minimizing the environmental health effects of the
Department’s physical operations and activities
Under Theme 1, PHAC or the former PPHB had one
commitment, the Active Transportation initiative, which was cited
in the HC 2004–05 RPP and in the PHAC 2005–2006 RPP.
The goals of the Active Transportation initiative are the following:
a) To build and to increase awareness among Canadians of the
implications of their current transportation practices and
costs of their personal, community and environmental health,
safety and transportation choices, and to increase the
number of Canadians choosing walking and cycling over
automobile use, especially for short trips; and
b) To increase awareness across sectors regarding the
significance of links between land use planning,
transportation, environment and health, to increase
awareness among decision makers at the municipal,
provincial and national level of the supportive social and
physical infrastructure required for active transportation, and
to improve public policies in this area.
Section III – Supplementary Information
89
Department/Agency: Public Health Agency of Canada
Points to address
Departmental Input
The objectives of this specific SDS are:
a) To increase knowledge on the barriers to active
transportation participation;
b) To enhance multi-sectoral collaboration; and
c) To create community active transportation plans.
2. How do your key
goals, objectives
and/or long-term
targets help achieve
your department’s/
agency’s strategic
outcomes?
By creating more liveable communities and improving the
physical environment to be more supportive of active
transportation, the objectives are improving Canadian’s health by
increasing physical activity levels, contributing to reversing the
growing trend towards obesity in Canada, reducing greenhouse
gas emissions and hospital admissions for respiratory illnesses
and creating stronger community interaction.
3. What were your
targets for the
reporting period?
Our targets for the reporting period were:
1) To support a National Active Transportation Survey and to
conduct focus groups across the country to assess changes
in active transportation knowledge, attitudes and behaviours;
and
2) To support active transportation workshops and community
charettes.
4. What is your
progress (this
includes outcomes
achieved in relation
to objectives and
progress on targets)
to date?
The National Active Transportation Survey was completed in
January 2005 by Go for Green (a national not-for profit
organization) and the Canadian Fitness and Lifestyle Research
Institute. This survey examined new and longitudinal data that
assessed changes in active transportation knowledge, attitudes
and behaviours (specifically participation levels, types of trips,
frequency and length of trips, barriers and opportunities of
increasing participation and magnitude of potential shifts. A final
report of results is available, and a comparative analysis will
begin within the next few months. Fact sheets and a PowerPoint
presentation as well as a media release will be developed by the
fall of 2005 to coincide with International Walk to School Week,
an event organized nationally by Go for Green.
Eight focus groups (including a total of 72 participants) with a mix
of adults and youth were conducted by Go for Green and Allium
Consulting, in Vancouver, Winnipeg, Ottawa and Halifax. These
focus groups provided useful insight into a variety of issues
related to Canadians’ use of active transportation and advice for
future strategic planning, communication, partnership
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Public Health Agency of Canada
Department/Agency: Public Health Agency of Canada
Points to address
Departmental Input
development and project planning for all levels of government
and non-governmental organizations (NGOs) working in the area
of active transportation.
Active Transportation workshops and community charettes were
held in several communities across Canada to assess the active
transportation quotient (an audit tool for communities to
determine the quality of the local active transportation
environment) and to create an active transportation vision within
their community. Health Canada/Public Health Agency of
Canada, Transport Canada and Environment Canada regional
offices were invited to participate in the workshops.
Go for Green has continued communications with these
communities and continues to forward additional resources.
There will also be follow-up assessments to document
implementation of active transportation community plans and
adoption policies supportive of active transportation.
Go for Green has received an overwhelming number of requests
from communities near the communities that implemented these
projects and from communities throughout Canada to conduct
these workshops and has not been able to keep up with demand.
Every attempt will be made to follow up with these communities
within this fiscal year or the next.
Go for Green also made a presentation to the Canadian Institute
of Transportation Engineers, at its Vancouver Conference, and to
three committees of the Transportation Association of Canada:
the Sustainable Transportation Standing Committee, the Traffic
Operations and Management Standing Committee and the
Geometric Design Standing Committee. The Canadian Institute
of Professional Engineers expressed some interest in working
with Go for Green to conduct a joint session on Active
Transportation at their spring meeting in April 2006.
Interdepartmental Collaboration:
The Agency’s Physical Activity Unit is now a member of the
Interdepartmental Working Group on Sustainable Urban
Transportation to help guide and influence various federal policy
frameworks to be more supportive of sustainable transportation
(including active transportation).
Section III – Supplementary Information
91
Department/Agency: Public Health Agency of Canada
Points to address
Departmental Input
The Physical Activity Unit has worked with various federal
departments including Transport Canada and Environment
Canada for a number of years in promoting active
transportation (e.g., by sponsoring Active and Safe Routes to
School, the Federation of Canadian Municipalities Moving
without Motors – A Guide to the Active Transportation
Community and various workshops and regional forums.
Transport Canada will be undertaking an analysis of active
transportation in Canada and the role of the federal
government, and will work closely with the Agency, along
with other federal departments, provinces and municipalities,
on this initiative.
As part of its Collaborative Plan of Action to increase physical
activity by 10 percentage points in every province and
territory by the year 2010, The Federal/Provincial/Territorial
(F/T/P) Physical Activity and Recreation Committee has
plans to build on Go for Green workshops and conduct
cross-Canada workshops on active transportation, with a
focus on family and school-aged children and an emphasis
on active and safe routes to school. Partnerships would
include F/P/T Sport Committee, the F/P/T School Health
Consortium, Go for Green, the Canadian Parks and
Recreation Council, the Federation of Canadian
Municipalities, Environment Canada, Transport Canada,
Infrastructure Canada and Industry Canada. Approval is
pending a decision at the August 2005 meeting of the
Federal/Provincial/Territorial Ministers responsible for Sport.
Active transportation is increasingly recognized as a practical
alternative to the single-occupant vehicle (SOV) for shorter
trips which offers many benefits for personal health and the
environment, and cost efficiencies for both government and
individuals. The following are some exciting examples of
advancements in the field: – The Canadian Institute of
Transportation Engineers is undertaking a project to develop
and disseminate a guide that will recommend site design
practices that can be applied through the land development
process to promote the use of more sustainable modes of
transportation such as walking, cycling and transit. This
guide will also identify a range of supporting policies and
actions that can be introduced to foster sustainable
transportation initiatives. – The Centre for Sustainable
Transportation is working on Child-Friendly Active
Transportation Guidelines for individual provinces.
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Public Health Agency of Canada
Department/Agency: Public Health Agency of Canada
Points to address
Departmental Input
5. What adjustments
have you made, if
any? (To better set
the context for this
information, discuss
how lessons learned
have influenced your
adjustments.)
Transport Canada and the Agency provided guidance on the
content of workshops, the National Active Transportation
Survey and focus testing. One adjustment made was the
decision to conduct the professional development workshops
within existing forums of the Canadian Institute of
Transportation Engineers and the Transportation Association
of Canada, for greater cost efficiency and efficacy in reaching
this group. Since the active transportation workshops were
conducted in the later part of the fiscal year, lessons learned
will be applied to future sessions. As mentioned earlier, the
Active Transportation Survey and focus groups provided
useful insight into a variety of issues related to Canadians’
use of active transportation and advice for future strategic
planning, communication, partnership development and
project planning for all levels of government and NGOs
working in the area of active transportation.
Table 10: Procurement and Contracting
The Public Health Agency of Canada obtains procurement and contracting services from
Health Canada. Please refer to Table 19 of the Health Canada 2004–2005 Departmental
Performance Report, as it also applies to the Agency.
Link to TBS Estimates site
2004–2005 Part III – Departmental Performance Reports (DPR)
http://www.tbs-sct.gc.ca/rma/dpr1/04-05/index_e.asp (English)
Section III – Supplementary Information
93
Table 11: Service Improvement Initiative (SII)
1. Programs and services covered by a service improvement plan
The Canadian Health Network (CHN) has participated in the SII and has reported many
of its findings through the Government On-Line initiative.
The CHN is a health promotion tool that provides consumers with expert-reviewed,
quality-assured health promotion and disease- and injury-prevention information, which
includes primary, secondary and tertiary prevention. It works to educate and influence
behavioural changes at the individual and community levels.
The CHN is an integrated public health information collection, management and
distribution program. Its content of almost 20,000 resources is entirely
consumer-focussed. The sources of the information are a vast Canadian network of
expert organizations, including federal, provincial and territorial governments, hospitals,
libraries, universities, non-government and community-based organizations. The
information is catalogued and quality-assured by 23 affiliate organizations whose
mandates include disseminating information to Canadians (and/or providing
community-level support for disseminating information) about a specific area of health.
Topic areas include diabetes, cancer, respiratory disease, cardiovascular disease
(including stroke) as well as those that touch on multiple risk factors, including
environmental health, active living, healthy eating, tobacco cessation, and stress.
2. Development of baseline client satisfaction levels and progress toward achieving
satisfaction targets
The CHN conducted client satisfaction surveys in 2002 and 2004. A third survey will be
conducted in the summer of 2005. The 2002 survey provided two key baseline statistics
on whether clients were able to find what they were looking for on the site, and overall
client satisfaction.
In 2002, 50 percent of users were satisfied or very satisfied with the CHN site. In 2004,
95 percent of users indicated they were satisfied or very satisfied with the site. This is
an increase of 45 percent, which is well over the SII goal of 10 percent.
The CHN has made significant progress in enhancing its service in response to the
comments received through the survey. Many of these enhancements deal with the
content of the CHN Web site; they are outlined in the Question 4 tables below.
3. Service standards for all key public services: setting of standards and
performance against those standards
On its Web site, the CHN provides a Health Information Requests (HIR) function that
allows clients to ask health-related questions by e-mail. The CHN Division receives the
questions and then, depending on the subject matter, directs them to the most
appropriate funded recipient for a response. In some cases, the CHN has coordinated
and sent to the client a response from several funded recipients.
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Public Health Agency of Canada
Due to privacy and confidentiality concerns, in 2004, the CHN and its funded recipients
worked together to improve this service. HIRs are now directed specifically to the
funded recipients instead of being sorted by the CHN Division. In addition, other
improvements were made by developing and implementing the following:
mMaking it easier to find the link to the HIR function on the Web site;
mMore direct links to specific funded organizations that have the expertise to
respond to a broader range of health-related questions (i.e. not only focussed on
prevention and health promotion) while ensuring the privacy of the client asking
the question;
mA standard five-day response commitment for all HIRs that is consistently applied
by all funded recipients; and
mA mechanism within the quarterly reports process whereby recipients provide
statistics on the number of HIRs received and responded to and on adherence to
the five-day response service delivery standard.
4. Main achievements in improving service from a citizen-centred perspective
A number of key achievements have been accomplished by the CHN in order to
improve its service. The following statistics, based on the 2002 on-line survey and public
opinion research conducted during 2004–05, indicate that the CHN has improved its
service from a citizen-centred perspective by more than 10 percent (the SII goal).
Area of improvement/
Specific Question
Findings
From 2002
Findings
From 2004
Overall level of satisfaction
with the CHN Web site
(satisfied or very satisfied)
50%
95%
Average monthly number of
unique visitors to the CHN
Web site
71,085
123,593
Notes/Comments
This represents an increase
of 45%, which is well over
the SII goal of 10%.
This represents a 74%
increase.
The number of unique
visitors has continued to
increase dramatically year
over year.
Number of Healthlink
subscribers (electronic
newsletter)
118
(June 2002)
12,781
(Dec. 2004)
Section III – Supplementary Information
The number of subscribers to
the CHN’s electronic
newsletter continues to rise
regularly each month.
Comments from users
indicate that the information
provided in the newsletter is
highly useful. No users have
unsubscribed. In fact, users
who have changed job or
location regularly inform the
CHN of their new e-mail
address.
95
Area of improvement/
Specific Question
Findings
From 2002
Findings
From 2004
Notes/Comments
The figures gathered from
June 2002 to December
2004 indicate an increase of
10,175% in subscriptions,
well over the SII target of
10%.
From June 2002 to June
2005, the increase is
18,976%.
Visiting the Web site for the
first time
72%
25%
Through better marketing
and leveraging of
partnerships, the CHN has
recorded a much lower
proportion of visits from
first-time users. This
indicates that there is a
higher percentage of repeat
users.
The statistics show a much
higher increase of repeat
users than the SII goal of
10%
Other service improvements were also made. Though there were no quantitative statistics
captured on this matter, many qualitative comments gathered suggest that the concerns
raised in 2002 were addressed.
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Public Health Agency of Canada
Area identified in 2002 for possible
improvement
Improvements made by the
CHN to date
Need to explain the purpose of the CHN
clearly on the Web site
In 2004, a new description was added on the
CHN home page (“What can you expect to find
at the Canadian Health Network?”).
Adding more content generally to the Web
site
In response to the changing needs of
Canadians, the CHN added new content areas
to its roster of topics and groups. It now
provides health information on the four chronic
diseases that cause two-thirds of deaths in
Canada. The number of resources available on
the site has increased to nearly 20,000 in
2005.
Improve the search engine capabilities
In 2003, the CHN launched a new Web
platform that included a content management
system and a new search engine that
significantly improved a client’s ability to
retrieve relevant results. Clients could then sort
information in various ways, pagination was
added and the indexing was expanded to
include additional metatags.
Improved access to feedback/answers to
questions
The CHN, as described in item 3, enhanced its
Health Information Requests function to
improve client privacy and confidentiality, while
at the same time ensuring that the link to the
HIR function became more visible and was
directed to the health organization that could
respond to the question.
Table 12: Horizontal Initiatives
Table 12 on The Canadian Strategy on HIV/AIDS (CSHA) and the Federal Initiative to
Address HIV/AIDS in Canada (FI) is available electronically at:
http://www.tbs-sct.gc.ca/rma/eppi-ibdrp/hrdb-rhbd/profil_e.asp
Section III – Supplementary Information
97
Table 13: Travel Policies
Comparison to the TBS Special Travel Authorities
Travel Policy of Public Health Agency of Canada:
The Public Health Agency of Canada follows the TBS Special Travel Authorities
Comparison to the TBS Travel Directive, Rates and Allowances
Travel Policy of Public Health Agency of Canada:
The Public Health Agency of Canada follows the TBS Travel Directive, Rates and
Allowances
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Public Health Agency of Canada

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