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Section I – Overview

Message from Canada’s Minister of Health

Minister of Health, Tony ClementI am pleased to present the Public Health Agency of Canada’s Performance Report for 2006-07. Health and access to a strong and effective health care system continue to be among the highest priorities for Canadians. These priorities are shared by Canada’s New Government, and they continue to be my paramount concerns as Minister of Health.

I recognize the key contributions of the Agency and its deputy, the Chief Public Health Officer, in improving public health in Canada. This is why my first piece of federal legislation was the introduction of The Public Health Agency of Canada Act. I was proud to see the Act approved by Parliament and entered into force in December 2006, as it reaffirmed the Government of Canada’s commitment to public health. The Agency enhances the federal government’s ability to plan for and respond to public health emergencies, such as SARS or pandemic influenza; works to reduce disease and injury; and provides ongoing leadership in strengthening the public health infrastructure in Canada. This Performance Report shows the significant achievements made by the Agency during 2006-07, its second full year of operation.

Guaranteeing patient wait times remains one of our government’s highest priorities. Reducing the burden on the health care system by improving overall public health continues to be one of the most effective ways of achieving this goal. Because major chronic diseases share common risk factors, Canada’s New Government, with the support of the Public Health Agency and in collaboration with the provinces, territories and key stakeholders, continued its work to address health promotion and the prevention and control of chronic diseases such as cancer, diabetes and cardiovascular disease, through a combination of integrated and disease specific strategies and programs. Budget 2007 provided $300 million over three years to support provinces and territories to launch human papillomavirus (HPV) vaccination programs targeting cervical cancer. For this the Agency took the leadership role in coordinating Canada’s first collaborative planning exercise for immunization programs.

In February 2007 the Prime Minister’s announcement of the Canadian HIV Vaccine Initiative reflected the Agency’s contribution to worldwide efforts to develop safe and effective HIV vaccines. The Agency’s partners in the Initiative include Health Canada, the Canadian Institutes of Health Research, the Canadian International Development Agency, Industry Canada, and the Bill & Melinda Gates Foundation. Work towards HIV vaccines complements the Agency’s other HIV initiatives such as the AIDS Community Action Program which supported 148 beneficial projects across Canada.
The Agency helped our government provide Canadians with safe and secure communities by effectively reducing the threat of infectious diseases. In particular, the Public Health Agency took a leadership role in updating and publishing the updated Canadian Pandemic Influenza Plan for the Health Sector in December 2006, in collaboration with federal partners and the provinces and territories. This plan provides guidance on the measures and systems that will be needed to respond to a pandemic. Drawing on an investment of $1 billion from the 2006 Budget, the Agency and its partner federal departments continued to strengthen the plan and to enhance important initiatives including prevention, early warning, vaccines, antivirals, and critical science.

In collaboration with a number of countries and international organizations, the Agency assisted the Kenyan Ministry of Health in containing an outbreak of Rift Valley Fever that was responsible for a large number of human and animal deaths. In January 2007 five scientists and a mobile lab from the Agency were deployed on a mission which helped Kenya manage this deadly disease. Experiences like this one will be beneficial in preparing for possible public health emergencies in Canada.

While the Agency led federal efforts to prevent disease and injury and to promote and protect national and international public health, it also continued to support this government’s vision and direction on accountability and efficiency in all government operations and initiatives.

In support of a stronger public health system in Canada and around the world, and in moving forward on fulfilling our government’s priority of improving health and access to health care for Canadians, I am proud to report on the performance of the Public Health Agency of Canada during 2006-07.

The Honourable Tony Clement
Minister of Health

Message from Canada’s Chief Public Health Officer

Dr. David Butler-JonesThe Public Health Agency of Canada exists to strengthen the Government of Canada’s ability to protect the health and safety of Canadians, and to provide a national focal point to lead efforts in the advancement of public health both nationally and internationally. I am pleased to take part in this accounting to Parliament and the Canadian public of the Agency’s work over 2006-07.

It is the role of the Chief Public Health Officer of Canada to report on matters relating to public health and to share information and best practices with governments, public health authorities and others in the health field, both within Canada and internationally. It is also the Chief Public Health Officer’s responsibility to speak to Canadians as a credible and trusted voice on public health issues, and to advise the Minister of Health on matters of public health and on the operations of the Public Health Agency.

Because public health is complex, success requires a comprehensive team approach that brings in partners from across all sectors of society. The Agency actively engages many partners, including Health Canada and the rest of the health portfolio, other federal departments, the provinces and territories, stakeholders, and non-governmental organizations to promote and protect the health of Canadians.

Public health often receives its greatest attention during times of crisis, and one of the Agency’s highest priorities is to prepare and plan for such events, including a potential influenza pandemic. The money provided to the Public Health Agency from the $1 billion investment in pandemic preparedness initiated in Budget 2006 enabled the Agency to increase collaboration with its partners and to take additional steps to protect Canadians from public health emergencies. In co-operation with Public Safety Canada, the Department of Foreign Affairs and International Trade and the Canadian Food Inspection Agency, the Public Health Agency co-developed the North American Avian and Pandemic Influenza Plan with the United States and Mexico which outlines how the three countries will work together if needed. The Agency also played a key role in the development of a proposed Federal, Provincial, and Territorial Memorandum of Understanding on the Provision of Mutual Aid in Relation to Health Resources during an Emergency. In addition, the Agency continued collaboratively building an effective national emergency stockpile system of critical supplies including anti-viral drugs in the event of an influenza pandemic.

Public health is about keeping people healthy, which helps to ensure a solid foundation for a prosperous society. The Agency helps strengthen this foundation by ensuring that we, as a society, take steps to address health disparities. During 2006-07 the Agency provided financial support for initiatives across the country that increased community capacity to address factors affecting the health of vulnerable groups. Also, during 2006-07 the Agency contributed to and disseminated learnings from the World Health Organization’s Commission on Social Determinants of Health. In particular the Agency led the Commission’s Canadian Reference Group, a partnership involving federal government departments such as the Canadian International Development Agency, Health Canada and the International Development Research Centre, as well as provinces, territories, and non-governmental organizations.

The Agency also took concrete steps to improve the overall health and quality of life of Canadians through programs focused on healthy eating and physical activity, thereby addressing the health, social and economic burden of chronic disease in Canada.

To anticipate and respond to the immediate and future health needs of Canadians, the Agency developed Strategic Plan 2007-2012. This comprehensive plan promises to enhance the management and effective delivery of the Agency’s programs.

Through these and other measures, the Agency lived up to its mandate. It anticipated and prepared for threats to public health, carried out health surveillance, reported on diseases and preventable health risks, and used the best available tools to inform and advise Canadians on improving and protecting their health.

This Performance Report shows that the Agency, through its dedicated staff across the country, continued to move forward on fulfilling the vision of healthy Canadians and communities in a healthier world.

Dr. David Butler-Jones, M.D.
Chief Public Health Officer

Management Representation Statement

I submit for tabling in Parliament the 2006-07 Departmental Performance Report (DPR) for the Public Health Agency of Canada.

This document has been prepared based on the reporting principles contained in the Guide for the Preparation of Part III of the 2006-07 Estimates: Reports on Plans and Priorities and Departmental Performance Reports:

  • It adheres to the specific reporting requirements outlined in the Treasury Board Secretariat guidance;
  • It is based on the department’s approved Strategic Outcome(s) and Program Activity Architecture that were approved by the Treasury Board;
  • It presents consistent, comprehensive, balanced and reliable information;
  • It provides a basis of accountability for the results 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, M.D.
Chief Public Health Officer

Summary Information

How This Report is Structured

The 2006-07 Departmental Performance Report of the Public Health Agency of Canada (the Agency) is structured as follows:

After the messages from the Minister and the Chief Public Health Officer, and a statement confirming the validity of the information in this document, Section I discusses performance information, and presents a brief overview of the Agency’s reason for existence, including its mission, vision, mandate, role, structure, geographic locations and key collaborations and partnerships.

Section I then reports the overall financial and human resources utilized during the fiscal year, and presents a table summarizing resources used and progress on the six priorities set out in the Agency’s 2006-07 Report on Plans and Priorities.

An assessment is then provided of the Agency’s performance in the context of the operating environment - the key factors that have an impact on the way programs are delivered. How the Agency’s work links to Government of Canada outcome areas is then reviewed. Section I concludes by explaining the Agency’s progress against each of the six priorities for the year.

Section II, Analysis by Strategic Outcome and Key Program, provides more detailed information on resources used, activities undertaken and progress made.

Section III, Supplementary Information, provides detailed financial and operational information in the sequence and format specified by the Treasury Board Secretariat.

Section IV provides more organizational information, including information on strategic, business, and sustainable development planning, a detailed organization chart, a risk communications framework, and the new Program Activity Architecture adopted for 2007-08.

Included throughout the report are links to the Agency's website and to websites of external partners and other organizations. Readers are encouraged to visit these sites for additional information about the work of the Agency and our partners.

How Performance Information is Gathered and Used at the Agency

The Agency gathers and uses both financial and non-financial information for operational and reporting purposes. Financial performance information is carefully monitored to ensure financial commitments are met and expenditures accounted for. Performance information is used for making operational decisions and for communicating with stakeholders. When appropriate, evaluations are used to generate and/or confirm performance information; they are also used to create or amend policies and/or procedures and to renew or change program design.

The financial information at the heart of this report has been generated by the Finance and Administration Directorate, using the Agency’s financial management systems. These numbers are verified internally, and may be validated from time to time through external reviews and audits.

The non-financial performance information used in this report was gathered from multiple internal sources including the senior managers responsible for carrying out the commitments set out in the 2006-07 Report on Plans and Priorities. These managers report back on the actions taken and the results they have achieved. Through the departmental performance reporting process senior managers are held accountable to report back on the commitments made by the Agency for the previous year.

The Agency’s Reason for Existence

Canadians are among the healthiest people in the world. Two factors which contribute to Canadians’ high quality of life are their access to a modern and sustainable publicly-funded health care system and the existence of a strong public health system. The actions of the public health community are often not as apparent as those in the conventional health care system, because public health targets the entire population, working upstream to avoid potential problems and to deal with them as they occur. Public Health works to identify threats and risks to the health of Canadians at large, as opposed to health care, which focuses on individuals. While they are both part of the continuum of health, the emphasis in public health is prevention. By helping keep Canadians healthy, the Agency, in partnership with the public health community, not only improves health and quality of life, but can also relieve some of the pressure on the health care system, helping to constrain costs and lessen patient wait times.

Public health involves a range of players and partners engaging in initiatives that promote health, prevent and control both infectious and chronic diseases, support public health research and surveillance activities, and protect people from the consequences of health emergencies. 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. The Agency works closely with other federal departments and agencies, provinces and territories, and other stakeholders to keep Canadians healthy.

Events like the emergence of severe acute respiratory syndrome (SARS) in 2003 demonstrated the need for Canada to have a national point of focus for public health issues. In response, the Public Health Agency of Canada was established on September 24, 2004, and Dr. David Butler-Jones was appointed as the country’s first Chief Public Health Officer. The creation of the Agency marked the beginning of a new approach to federal leadership, and to collaboration with the provinces and territories in the Government’s efforts to renew the public health system in Canada. On December 15, 2006, the Public Health Agency of Canada Act came into force, providing a statutory basis for the Agency. The Act formally establishes the position of the Chief Public Health Officer (CPHO) and recognizes his unique dual role as deputy head of the Agency and as Canada’s lead public health professional:

As the deputy head of the Agency, the CPHO is accountable to the Minister of Health for the daily operations of the Agency, and advises the Minister on public health matters. The CPHO can engage other federal departments and mobilize the resources of the Agency to meet threats to the health of Canadians.

The CPHO is also Canada’s lead public health professional, with demonstrated expertise and leadership in this field. For this reason, the CPHO has the legislated authority to communicate directly with Canadians and to prepare and publish reports on any public health issue. He is also required to submit to the Minister of Health, for tabling in Parliament, an annual report on the state of public health in Canada. By providing the CPHO with authority to speak out on public health matters and ensuring that he or she has strong qualifications in the field of public health, the Public Health Agency of Canada Act protects the CPHO’s credibility.

The role of the Agency can be summed up as follows:

  • To take a lead role in the prevention of disease and injury and the promotion of health;
  • To provide a clear focal point for federal leadership and accountability in managing public health emergencies;
  • To serve as a central 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
  • To strengthen intergovernmental collaboration on public health and facilitate national approaches to public health policy and planning.

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 by:

  • 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.

The Agency at a Glance

Type of Organization

Federal Agency, funded by Parliament


To promote and protect the health of Canadians through leadership, partnership, innovation and action in public health


Healthy Canadians and communities in a healthier world

Strategic Outcome for reporting period

Healthier Population by Promoting Health and Preventing Disease and Injury

Strategic Outcome for 2007-08

Healthier Canadians and a stronger public health capacity

Government of Canada Outcome Directly Supported

Healthy Canadians

Enabling legislation

Public Health Agency of Canada Act

Acts and Regulations Administered

The Quarantine Act
The Importation of Human Pathogen Regulations

Key Activities

  • Health Promotion
  • Chronic Disease Prevention and Control
  • Infectious Disease Prevention and Control
  • Emergency Preparedness and Response
  • Strengthening Public Health Capacity

Reporting to Parliament

The Agency reports to Parliament through the Minister of Health

The Agency’s Structure

The following organization chart depicts how the Agency is structured within the Federal Health Portfolio.
The Agency's Structure

The Agency’s Operations Across Canada

To maintain the knowledge and skills needed to develop and deliver the public health advice and tools required by Canadians, the Agency calls upon the efforts of public health professionals, scientists, technicians, communicators, administrators, and policy analysts and planners. These employees work across Canada in a wide range of operational, scientific, technical and administrative positions.

The largest concentration of employees is in the National Capital Region. The head office in Winnipeg forms a second pillar of expertise. In times of a national health emergency, the Emergency Operations Centre based in both in Ottawa and Winnipeg can be utilized to manage the crisis.

The Public Health Agency of Canada recognizes the need to have a strong presence throughout the country to connect with provincial and territorial governments, federal departments, academia, voluntary organizations and citizens. Outside of Winnipeg and the National Capital Region, the Agency’s Canada-wide infrastructure consists of 16 locations in six Regions: British Columbia & Yukon, Alberta & Northwest Territories, Manitoba & Saskatchewan, Ontario & Nunavut, Quebec, and AtlanticSome Agency programs are delivered to the Yukon, Nunavut and the Northwest Territories through Health Canada’s Northern Region office under an interdepartmental agreement. The Agency’s Regional Offices promote integrated action on public health throughout the country. Working in partnerships that cross sectors and jurisdictions, staff in these offices facilitate collaboration on national priorities, building on resources at the regional, provincial and district levels.

The Agency operates specialized research laboratories in several locations across Canada. The Canadian Science Centre for Human and Animal Health in Winnipeg houses the Agency's state-of-the-art National Microbiology Laboratory which is one of the world’s high containment research laboratories. The Agency's Laboratory for Foodborne Zoonoses, which studies the risks to human health from diseases arising from the interface between animals, humans and the environment, is headquartered in Guelph, Ontario and maintains units in St. Hyacinthe, Quebec and Lethbridge, Alberta.

The following map shows where the Agency’s staff, offices and laboratories are located (employee numbers are as of March 31, 2007):
Map of Locations

Collaboration and Partnership

Most public health activities, including those performed by the Agency, 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 usually reflect the success of joint efforts by multiple partners.

The Government of Canada’s Health Portfolio consists of approximately 11,700 employees and an annual budget of $4.6 billion. The Agency works closely with the other members of the Health Portfolio, as well as other federal departments and agencies whose work has an impact on public health. Key federal departments and agencies that the Agency works with include:

The Government of Canada’s Health Portfolio
  • Assisted Human Reproduction Agency of Canada
  • Canadian Institutes of Health Research
  • Hazardous Materials Information Review Commission
  • Health Canada
  • Patented Medicine Prices Review Board
  • Public Health Agency of Canada

For more information see:


Other Government of Canada Partners

  • Agriculture Canada;
  • Canada Border Services Agency
  • Canadian Food Inspection Agency
  • Canadian Heritage - Sport Canada
  • Environment Canada
  • Infrastructure Canada
  • Public Safety Canada
  • Statistics Canada
  • Transport Canada

Financial Resources 2006-07

Planned Spending Total Authorities Actual Spending
$629.7 million $536.2 million* $510.8 million**

    * The $93.5 million difference between planned spending and authorities is mainly due to the deferment of $44 million in funding for Avian and Pandemic Influenza Preparedness to subsequent fiscal years, and expected funding of $51 million for Canadian Strategy for Cancer Control not flowing through the Agency.

  ** Actual spending was $25.4 million lower than total authorities primarily due to capacity and technical constraints which impeded the full utilization of approved resources. Of the 25.4 million, operating expenditure accounted for $20.5 million and transfer payments $4.9 million.

Human Resources (Full-Time Equivalents*) 2006-07

Planned Actual Difference
2,119 2,050 69

*To properly include persons employed for part of the year and/or employed part time in a measure showing average employment over the year, 'full-time equivalent' is calculated based on days worked . The Agency began the fiscal year with approximately 1,968 employees and ended it with approximately 2,157.

Status on Performance

The following table provides a “report card” of progress on each priority for 2006-07, and shows the financial resources planned and spent.

Performance and spending by priority 2006-07

Strategic Outcome: Healthier Population by Promoting Health and Preventing Disease and Injury

Program Activity: Population and Public Health

Priority Expected Results Performance Status Planned Spending
($ millions)
Actual Spending
($ millions)

Develop, enhance and implement integrated and disease-specific strategies and programs for the prevention and control of infectious disease (ongoing)

Enhanced strategies and programs for the prevention and control of infectious disease

Successfully met



* Actual spending was $45.4 million less than plan primarily due to deferment of $44.1 million Avian and Pandemic Influenza Preparedness funding to subsequent fiscal years.

Develop, enhance and implement integrated and disease – or condition-specific strategies and programs within the health portfolio to promote health and prevent and control chronic disease and injury (ongoing)

Enhanced strategies and programs for to promote health and prevent and control chronic disease and injury

Successfully met


127.4 *

* Actual spending was $52.5 million less than planned mainly due to expected funding of $51 million for Canadian Strategy for Cancer Control not flowing through the Agency.

#3 :
Increase Canada's preparedness for and ability to respond to public health emergencies, including pandemic influenza (ongoing)

Increased preparedness for and ability to respond to public health emergencies, including pandemic influenza

Successfully met




Strengthen public health within Canada and internationally by facilitating public health collaboration and enhancing public health capacity (ongoing)

Stronger public health capacity

Successfully met




Lead several government-wide efforts to advance action on the determinants of health (new)

Advanced action on the determinants of health

Successfully met


51.2 **


Develop and enhance the Agency’s internal capacity to meet its mandate (previously committed)

Increased Agency internal capacity and ability to meet mandate.

Successfully met



* Actual spending exceeded plan by $12.9 million due primarily to use of $11.0 million to address IM\IT infrastructure requirements, comply with mandatory government-wide IT security policy, and respond to a computer malware infection.

** Actual spending was less than plan by $19.4 million. Some of this was due to delays and timing changes such as the review of program strategy for the Integrated Healthy Living and Chronic Disease Strategy as well as the requirement to allocate funding for new priorities. In addition, $2.2 million could not be used as expected for vaccine readiness and surveillance tools, and $1.2 million stemmed from an uncontrollable delay in contracting for work on a Winnipeg laboratory expansion project.

Note: The Agency’s total planned spending of $629.7 million included $13.9 million not allocated to the six priorities. The main unallocated item was $10.4 million for Hepatitis C, as the program was sunsetting. The program was subsequently extended, and has been allocated to the ‘actual spending’ for the priorities, as has all other Agency spending for 2007-08.

Overall Departmental Performance

Strategic Context/Operating Environment

The expanding global economy, the convergence of people in large urban areas and the ease with which people and goods travel around the world are but some of the factors challenging Canada’s public health system.

External factors which influenced the Agency’s activities during 2006-07 included the emergence of infectious diseases, such as avian influenza and other potential pandemics, both nationally and internationally; natural disasters; Canada’s gradually aging population; social trends affecting the risk of chronic diseases; the changing nature of our environment; and the continued rapid evolution of science and technology.

Infectious Disease Levels and Trends

The number of Canadians dying from or living with infectious diseases has been climbing since the 1980s. Worldwide, infectious diseases are the second leading cause of death and the leading killer of infants and children. The World Health Organization (WHO) estimates that in 2002, the most recent year for which statistics are available, approximately 11 million of the 57 million deaths that occurred worldwide were caused by infectious and parasitic diseases. While the impact of this phenomenon is being felt most profoundly in developing countries, Canada has not been immune. The increase in the speed and volume of global travel places Canadians within 24 hours of almost any other place in the world – which is less than the incubation period for most communicable diseases transported by individuals or products. The threat of emerging and re-emerging infectious diseases and the potential for bioterrorism has made the ability to rapidly identify infectious agents and clusters of disease vitally important.

Risks of Avian and Pandemic Influenza

There were two major infectious disease threats that Canada faced in 2006-07. Each could have had a significant impact on Canada’s economic and social stability as well as on collective and individual health and safety. The first was the potential for the highly contagious and deadly H5N1 (Asian) sub-type of avian influenza to spread to domestic birds in Canada. The second was the growing potential for the appearance of a new strain of this (or another) virus that has adapted to humans, resulting in human-to-human transmission and the possible setting off of a human influenza pandemic. According to WHO, the occurrence of the next pandemic influenza is “a question of when, not if.”

The H5N1 (Asian) avian influenza virus has demonstrated the ability to infect and cause fatal illness in humans. During the period from December 2003 to April 2007, 291 human cases, resulting in 172 deaths, were laboratory-confirmed in 12 countries.

Natural Disasters

Natural disasters such as the Asian Tsunami and Hurricane Katrina vividly underscore the importance of emergency preparedness and capacity building in order to enable the quick and effective responses necessary to minimize suffering and loss. Recent natural disasters have provided many lessons and highlighted the need for integrated and coordinated emergency management and effective emergency communications at all levels of government, among federal departments and agencies, and with other stakeholders including individual citizens.


Changing demographics are an important factor in Canada. While Canada has the highest rate of population growth among the ‘G8’ (group of eight economically leading countries), the majority of this comes from immigration. Due to a combination of low birth rates and longer life spans, there is an upward trend in the proportion of seniors in the Canadian population. It is projected that by 2016, those 65 years of age and older will represent approximately 16% of the country’s population. This change will have an impact on the incidence and distribution of many diseases, and is likely to place increasing pressures on health services in Canada.

Risk Factors for Chronic Disease

Changes in Canadian society have resulted in shifts in nutrition patterns and in living and working conditions. These changes are key factors in the development of the leading chronic diseases in Canada. They have the potential to trigger significant increases in these diseases at substantial cost to the country’s economy and society. Unhealthy eating, lack of physical activity and obesity continue to be critical public health issues that have a significant bearing on health outcomes for Canadians and the health care system.


Canadians are increasingly recognizing the linkages between health and the environment, not only in areas like the effects of toxins and pollutants, but also in the impacts of climate change and the trade-offs involved in sustainable development. Growing populations are placing an increased pressure on the environment globally while, in Canada, greater urbanization brings with it increased demands for energy, land and other resources, as well as increased concentrations of toxins and pollutants. A strong and comprehensive public health policy is needed to identify and address linkages between health and the environment and to assist affected communities.

Rapid Evolution of Science and Technology

The rate of scientific discovery and technological innovation has increased dramatically in the past decade, but the impact on the health sector has been mixed. On the one hand, advances in treatment and care offer new opportunities to address illness and improve health. On the other hand, these advances have placed increased cost pressures on Canada’s already stressed health system. By providing new approaches for improving health and preventing disease, advances in public health can help mitigate these costs. For example, there have been rapid advances in public health genomics - an emerging field that assesses the impact of the interaction between genes and the environment (i.e., physical environment, diet, behaviour, drugs, and agents of infectious diseases) on population health. There is a potential that the knowledge from advances in biotechnology and genome-based research can be applied to prevent disease and improve the health of populations.

Link to the Government of Canada Outcome Areas

The Agency’s focus on public health allows it to contribute directly to a key Government of Canada Outcome: Healthy Canadians

The Agency’s work also supports achievement of other Government of Canada outcomes, including:

Safe and secure communities - The Agency plays an important role in reducing the threat of infectious diseases and chemical and biological agents, and accordingly contributes to the safety of Canadian communities;

A safe and secure world through international cooperation - The Agency is committed to strengthening global health security in collaboration with its international partners. To support Canada’s participation in the Global Health Security Initiative, the Agency advances pandemic influenza preparedness, moves forward to prepare against chemical and biological threats, and leads the Global Health Security Action Group Laboratory Network. The Agency’s efforts contribute to Canada’s effective participation in the Security and Prosperity Partnership of North America;

An innovative and knowledge-based economy - The Agency, in its own laboratories and working with partners, conducts and provides financial support for applied research on health technologies. For example, it facilitates the translation of research to develop and test newer, faster, and more productive technologies that can deliver safe and effective vaccine products to Canadians and thus advance broader socio-economic interests. This leading-edge work has the potential to generate ‘spin off’ economic development while it significantly boosts public confidence in Canada's ability to deal with emerging health threats.

(For more information about Government of Canada Outcomes see ).

Details of Performance

The following section provides an explanation of the progress summarized in the ‘report card’ above. It identifies each commitment, indicates whether the Agency successfully met, partially met, or exceeded expectations, and then elaborates on what was accomplished.

1. Develop, enhance and implement integrated and disease-specific strategies and programs for the prevention and control of infectious disease - Successfully met

In 2006-07 the Agency delivered a number of key initiatives in collaboration with its partners and stakeholders. It reviewed, revised, and expanded the scope of its widely used Infection Control Guideline Series; published the Canadian National Report on Immunization; provided surveillance for diseases including Lyme disease, West Nile virus and health-care acquired infections;collaborated with provinces and territories as well as internationally on issues related to immunization and vaccine-preventable infectious diseases; took the leadership role in coordinating Canada’s first collaborative immunization program planning exercise, focussing on a vaccine for the human papillomavirus; and helped to organizethe Canadian Immunization Conference. The Agency’s street-youth surveillance pilot project, undertaken in collaboration with external stakeholders, has led to the development of more effective mechanisms to reach street youth and provide testing and care for HIV, sexually transmitted infections and related infections.

Through this and other work the Agency developed proposals to achieve a more integrated and coordinated approach to managing infectious disease and improving the health status of those who become infected. This included developing, enhancing and implementing integrated and disease-specific strategies and programs. Overall, the Agency was successful in strengthening multisectoral, multijurisdictional, and multidisciplinary approaches to infectious disease prevention.

2. Develop, enhance and implement integrated and disease- or condition-specific strategies and programs within the health portfolio to promote health and prevent and control chronic disease and injury - Successfully met

In 2006-07, the Agency worked closely with its partners and stakeholders to implement components of the Healthy Living and Chronic Disease initiative. This included:

  • launching the Canadian Best Practices Portal for Health Promotion and Chronic Disease Prevention, an on-line tool which disseminates information and monitors adoption of best practices in chronic disease prevention;
  • supporting the launch of development of the Canadian Heart Health Strategy and Action Plan, and establishment of an Expert Advisory Committee on Hypertension;
  • establishing a steering committee to help develop a national lung health framework with stakeholders;
  • identifying shared priorities in chronic disease surveillance, with a focus on an enhanced mental illness surveillance system, and expansion of the National Diabetes Surveillance System to other chronic diseases; and
  • Establishing new directions for the renewed Canadian Diabetes Strategy, with a focus on high-risk populations and earlier detection.

Additionally, the Agency was a key stakeholder in the development of the Canadian Strategy on Cancer Control (CSCC) by supporting and facilitating the transition of responsibility for the implementation of the CSCC to the new Canadian Partnership Against Cancer, an arms length, not-for-profit entity.

3. Increase Canada's preparedness for and ability to respond to public health emergencies, including pandemic influenza - Successfully met

The Agency continued to take an all-hazards approach encompassing emergency medical response to infectious disease outbreaks, natural disasters, explosions or chemical, biological or radiological/nuclear incidents in 2006-07. As a member of the Global Health Security Initiative, the Agency supported an effective national emergency management system and advanced work, globally and within Canada, on infectious disease outbreaks and pandemic influenza preparedness.

To increase Canada's preparedness for and ability to respond to public health emergencies, including pandemic influenza, the Agency engaged in extensive emergency preparedness and response planning with provincial and territorial governments, other federal departments and agencies, and non governmental organizations to identify emerging priorities, establish work plans and coordinate activities. Work was done to put in place arrangements with provincial and territorial governments to facilitate mutual assistance and information exchanges during public health emergencies. The Agency played a key role in the development of the Federal, Provincial, and Territorial Memorandum of Understanding on the Provision of Mutual Aid in Relation to Health Resources during an Emergency, which was received by the Conference of Deputy Ministers of Health.

The Agency, in co-operation with Public Safety Canada, the Department of Foreign Affairs and International Trade and the Canadian Food inspection Agency, the Public Health Agency of Canada co-developed the North American Avian and Pandemic Influenza Plan with the United States and Mexico to 1) detect, contain and control an avian influenza outbreak and prevent transmission to humans; 2) prevent or slow the entry of a novel strain of human influenza to North America; 3) coordinate emergency management and communications; 4) minimize unwarranted disruptions to the flow of people, goods and services at the borders and 5) sustain critical infrastructure.

Guided by the Council of the Pan-Canadian Public Health Network (PHN), the Agency led robust citizen and stakeholder dialogues as one part of a multi-faceted decision making process in the development of a national policy recommendation on the use of antivirals for prevention during an influenza pandemic.

Also, the Agency continued to build an effective stockpile of critical supplies including anti-viral drugs in order to respond to a pandemic and other public health emergencies.

4. Strengthen public health within Canada and internationally by facilitating public health collaboration and enhancing public health capacity - Successfully met

In 2006-07 the Agency built on initial successes such as the establishment of the Pan-Canadian Public Health Network. For example, the Agency provided secretariat, policy, technical, and financial support to the Network’s following groups:

  • Public Health Network Council
  • Council of Chief Medical Officers of Health
  • Population Health Promotion Expert Group
  • Surveillance and Information Expert Group
  • Emergency Preparedness and Response Expert Group
  • Communicable Disease Control Expert Group
  • Chronic Disease and Injury Prevention and Control Expert Group
  • Canadian Public Health Laboratories Expert Group

The Agency also continued to work closely and cooperatively with all of its partners toward a seamless and comprehensive pan-Canadian public health system by addressing cross-jurisdictional human resources capacity, collaborative information systems and tools, knowledge dissemination, and the public health law and policy system.

Further, through partnerships and initiatives at the local, regional, national and international levels, and with the help of the National Collaborating Centres for Public Health, the Agency supported public health professionals and stakeholders in their efforts to keep pace with rapidly evolving conditions, knowledge and practices.

5. Lead several government-wide efforts to advance action on the determinants of health - Successfully met

During the fiscal year, the Agency, while recognizing the many influences that lie within the purview of other departments, jurisdictions and sectors, continued to strengthen its partnerships to help address the factors that lead to disparities in health status. In the process the Agency advocated for healthy public policy and led efforts to advance action on the determinants-of-health approach to health policy. In particular, the Agency contributed to and helped disseminate learnings from the WHO Commission on Social Determinants of Health through its partnerships with other countries and through its leadership of the Canadian Reference Group (CRG), a partnership involving federal departments, provinces, non-government organizations and academia. The CRG held dialogue sessions with non governmental organizations to determine common agendas. It also organized numerous presentations and dialogues on the social determinants of health. Further, the Agency held an exploratory meeting with leading health economists from across Canada to consider the feasibility of developing an economic case for investment in the determinants of health.

The Agency’s funding programs used grants and contributions to support initiatives across the country to increase community capacity and promote intersectoral action on the determinants of health. In the Atlantic Region, the Population Health Fund supported projects which built community capacity to promote healthy public policies, particularly as they affect inequity and chronic disease. In Quebec, this Fund supported projects to promote healthy, sustainable communities and to address the links between environment and health. The Manitoba/Saskatchewan Region used the Population Health Fund to support projects that address issues such as food security and healthy aging, with a focus on aboriginal populations. Further, programs like the Diabetes Prevention and Promotion Contribution Program, the AIDS Community Action Program and the Hepatitis C Prevention, Support and Research Program also fund projects which consider linkages between health determinants, risk behaviour and disease incidence and support approaches which address the root causes of these conditions.

6. Develop and enhance the Agency's internal capacity to meet its mandate - Successfully met

The Agency developed and enhanced its internal capacity. This included reviewing its Program Activity Architecture, developing risk mitigation and management strategies, and initiating strategic and business planning processes that addressed capacity issues including expansion of laboratories as well as further development of the Winnipeg headquarters and the Agency’s regional offices.

During 2006-07 the Agency had a single strategic outcome and a single program activity. Work done during the year including updating the strategic outcome and creating an enhanced Program Activity Architecture for fiscal year 2007-08, to better reflect the Agency’s responsibilities and to enable a more detailed reporting on accomplishments and resource use.

The Strategic Risk Communications Framework and Handbook was launched, a new and unique tool designed to enable the Agency to integrate strategic risk communications into effective risk management, using a science-based process to support effective decision-making. The tools and techniques better enable the Agency to plan and conduct effective risk communications as an integral component of good decision-making with stakeholders and ultimately the Canadian public.

An Agency Corporate Risk Assessment and Profile was developed during 2006-07 with extensive participation from management at all levels, and elements of an integrated risk management strategy were put in place. For example, Senior Management met on a regular basis to review risk areas and take action, when needed, to mitigate risk. The Agency's planning was informed by risk, and risk mitigation processes were implemented in a number of Agency programs. The Agency has committed to further develop and operationalize the corporate risk profile as the first step in incorporating an integrated risk-management framework into the Agency's daily operational practices.

During 2006-07 the Agency embarked on its first ever strategic planning process, to set the broad directions and establish the priorities to guide Agency efforts over the next five years. The Agency’s Strategic Plan will become the core of an integrated approach to planning, providing a policy overlay to ensure that annual business plans are well-integrated, resources are aligned accordingly, and the entire effort is supported by clear accountabilities. The strategic plan is available at

In 2006-07, the Agency made progress with its initial Corporate Business Plan. The Agency’s program and support areas identified their objectives, challenges, and strategies in developing the Agency's initial business plan, and laid the foundation for an effective annual business planning process.

Other notable internal capacity development achievements by the Agency during 2006-07:

  • The Agency created and staffed the position of Chief Audit Officer, to ensure that the public’s money was well-utilized and that good systems of checks and balances were in place.
  • An Evaluation Advisory Committee was established, and development work commenced for a five year risk-based evaluation plan.
  • The Agency’s Sustainable Development Strategy was tabled and approved during the year. It contributes to a framework for results by setting out initial goals, objectives, targets and performance indicators. The Strategy also includes an internal accountability framework showing how the Agency will plan, monitor, evaluate and report on the results.
  • As programs and administrative processes and organizations matured, the number of employees expanded from 1,968 on March 31, 2006 to 2,157 one year later – growth of 9.6%.
  • The Agency made further progress in establishing its own infrastructure to deliver human resources services from within the Agency with less recourse to external service providers. As a result, corporate human resources policies, labour relations, and human resources planning became the sole responsibility of the Agency and were managed independently of Health Canada. This allowed better alignment of these services with the Agency’s mandate and corporate goals.

Further information on the Agency’s Strategic Plan, Program Activity Architecture, and other internal capacity building initiatives is available in Section IV of this document.