ARCHIVED - Public Health Agency of Canada

Horizontal Initiative

1. Name of Horizontal Initiative:
The Federal Initiative to Address HIV/AIDS in Canada (FI)
http://www.phac-aspc.gc.ca/aids-sida/fi-if/index.html

 2. Name of Lead Department(s):
Public Health Agency of Canada

3. Start Date of the Horizontal Initiative:
FI: 2004-05

4. End Date of the Horizontal Initiative:
FI: ongoing

5. Total Federal Funding Allocation:
The Federal Initiative to Address HIV/AIDS in Canada was launched on January 13, 2005 and replaced the Canadian Strategy on HIV/AIDS.
(in millions):
2004/05 - $47.2
2005/06 - $55.2
2006/07 - $63.2
2007/08 - $71.2
2008/09 - $84.4 (ongoing)

6. Description of the Horizontal Initiative: The Federal Initiative to Address HIV/AIDS in Canada is an evolution from the Canadian Strategy on HIV/AIDS (1998-2004). The Federal Initiative to Address HIV/AIDS in Canada introduces a refocused approach for the federal role in HIV/AIDS, building on the lessons learned over the previous five years, accomplishments, and the evidence for change. It focuses on those populations most vulnerable to HIV/AIDS epidemic - people living with HIV/AIDS, gay men, Aboriginal people, injection drug users, inmates, youth and women at-risk, and people from countries where HIV is endemic. Gender-based analysis and human rights are fundamental to the approach. An integrated approach to program development encompasses issues related to the determinants of health, sexual health and issues related to sexually transmitted infections, co-infections with hepatitis C and tuberculosis. People living with and vulnerable to HIV/AIDS are active partners in shaping policies and practices affecting their lives.

7. Shared Outcome(s):

Immediate Outcomes:

• Increased and improved collaboration and networking;
• Increased availability and use of evidence;
• Improved quality assurance in HIV testing;
• Increased awareness of HIV/AIDS;
• Improved attitudes and behaviours towards people living with HIV/AIDS;
• Increased coherence of federal response; and
• Increased capacity (knowledge and skills) of individuals and organizations.

Intermediate Outcomes:

• Increased practice of healthy behaviours;
• Improved access to quality prevention, diagnosis, care, treatment and support; and
• Strengthened Canadian response to HIV/AIDS.

Long Term Outcomes:

• Improved health status of people living with or vulnerable to HIV/AIDS;
• Reduced social and economic impact of HIV to Canadians; and
• Contribution to the global effort to reduce the spread of HIV and mitigate its impact.

8. Governance Structure(s):

The Agency (http://www.phac-aspc.gc.ca/new_e.html) is the federal lead for issues related to HIV/AIDS in Canada. The Public Health Agency is responsible for overall coordination, communications, national/regional programs, policy development, evaluation, surveillance and laboratory science.

Health Canada (http://www.hc-sc.gc.ca/english/index.html) provides community-based HIV/AIDS education, capacity-building, prevention and related health services to First Nations on-reserve and Inuit communities; leadership on international health policy and program issues; and assistance and guidance on evaluation.

As the Government of Canada’s agency for health research, the Canadian Institutes of Health Research (http://www.cihr-irsc.gc.ca/e/193.html) sets priorities for and administers the extramural research program.

Correctional Service Canada, (http://www.csc-scc.gc.ca/text/home_e.shtml) which is an agency of the Ministry of Public Safety Canada (http://www.ps-sp.gc.ca/index-en.asp), provides health services, including services related to the prevention, care and treatment of HIV/AIDS, to offenders sentenced to imprisonment for two years or more.

A new interdepartmental coordinating committee has been established by the Public Health Agency to promote policy and program coherence among the participating departments and agencies, and to maximize the use of available resources.
Health Canada’s International Affairs Directorate provides the secretariat for the Consultative Group on Global HIV/AIDS and the Interdepartmental Forum on Global HIV/AIDS Issues. The Consultative Group on Global HIV/AIDS Issues acts as a forum for dialogue between government and civil society on Canada’s response to the global epidemic, and includes the provision of advice on the global HIV/AIDS epidemic; and of guidance and suggestions regarding collaboration and policy coherence to ensure a more effective response. The Interdepartmental Forum on Global HIV/AIDS Issues meets quarterly to discuss on-going issues and to provide overall coordination and coherence in the federal government’s approach. Participating departments and agencies include the Agency, Health Canada, Canadian International Development Agency (CIDA), Department of Foreign Affairs and International Trade, and the Canadian Institutes of Health Research. Other government departments are invited to attend on an as-needed basis.

The Ministerial Council on HIV/AIDS (http://www.phac-aspc.gc.ca/aids-sida/fi-if/minister_e.html) provides independent advice to the Minister of Health on pan-Canadian aspects of HIV/AIDS.

The Federal/ Provincial/ Territorial Advisory Committee on AIDS (http://www.phac-aspc.gc.ca/aids-sida/fi-if/ftp_e.html), a liaison committee of the Public Health Network, serves as a forum to promote a coordinated governmental response to the HIV/AIDS epidemic.

The National Aboriginal Council on HIV/AIDS (http://www.phac-aspc.gc.ca/aids-sida/fi-if/national_e.html) provides advice to the Public Health Agency of Canada and Health Canada on issues relating to HIV/AIDS and Aboriginal populations.

The Federal/Provincial/Territorial (FPT) Heads of Corrections Working Group on Health is a sub-committee of the FPT Heads of Corrections. The Working Group on Health promotes policy and program development that is informed and sensitive to the complex issues surrounding the health of inmates, and provides advice to the FPT Heads of Corrections on trends and best practices as they relate to health in a correctional setting.

Other federal departments have mandates to address broader social determinants that affect people living with HIV/AIDS or their vulnerability to acquiring the infection, as well as to address the global epidemic. A Government of Canada Assistant Deputy Ministers’ Committee on HIV/AIDS has been struck to establish appropriate links and assist with the development of a broader Government of Canada approach to HIV/AIDS.

9. Federal Partners Involved in each Program

10. Names of Programs

11. Total Allocation

12. Forecasted Spending for 2006‑07 (in millions)

13. Actual Spending in 2006‑07 (in millions)

I Public Health Agency of Canada

Infectious Disease Prevention and Control

Ongoing
(incremental increases from 2004 to 2008) $27.1

$27.1

$25.6

14. Planned Results for 2006‑07

15. Achieved Results in 2006‑07

• Enhanced knowledge of the HIV/AIDS epidemic in Canada and the factors that contribute to its spread through:

• Increased general awareness of HIV/AIDS through the development of an Agency-led social marketing campaign

• Strengthened Canadian response to HIV/AIDS through:

• Improved access to more effective prevention, care, treatment and support through:

The Agency is engaged in: (i) augmented HIV surveillance and risk behaviour surveillance; (ii) targeted epidemiologic studies (i.e., expansion of I-TRACK and M-TRACK for injection drug users and gay men) and the development of programs for at-risk populations; and (iii) improved knowledge and characterization of HIV strains and the transmission of drug-resistant HIV in Canada. During 2005-2006, the Agency worked with national and international partners to update the estimates of national HIV incidence and prevalence in Canada for 2005. The new estimates were released prior to the International AIDS Conference in Toronto in August 2006 and are now being used to guide program and policy actions to address HIV/AIDS in Canada.

The Agency also continued to develop Canada’s second-generation HIV surveillance program for monitoring HIV and related risk behaviours among groups at high risk for HIV infection. The monitoring program for people who inject drugs (I-Track) now extends from Quebec to British Columbia, and the program for men who have sex with men (M-Track) completed its first round of surveys in Montreal and was piloted in Ontario. A pilot study for E-Track (persons from HIV-endemic countries) was started in the Montreal Haitian community and discussions are underway with the Africa-Caribbean Council for HIV in Ontario regarding similar studies. As well, a working committee has been struck involving the National Aboriginal Council on HIV/AIDS to provide guidance on developing second-generation HIV surveillance studies in the Aboriginal community.
In addition, the Agency continued to improve the quality of routine case reporting surveillance at the national level in Canada. The Agency supports the Laboratory Enhancement Study in Ontario which enhances the data on exposure categories for newly diagnosed cases of HIV. A national HIV/AIDS surveillance meeting was held in early March 2007 to address a number of issues with respect to data quality, comparability, and completeness.

The Agency’s domestic Quality Assurance Program delivered by the HIV/AIDS laboratories has been expanded to include HIV resistance (in addition to CD4 T cell counting, serology and viral load testing). Among other research initiatives, the program is exploring how to quality assure HIV rapid testing, which generally does not occur in a controlled laboratory setting.

The HIV Genetics Research Program has expanded into the field of molecular epidemiology, which allows researchers to use the genetic code of HIV sub-types to understand how the virus is transmitted among certain groups. For example, based on HIV sub-types in newly diagnosed infections from 2004 (collected by the Canadian HIV Strain and Drug Resistance Surveillance Program), it was determined that 45 per cent of newly diagnosed infections were related to at least one other new infection. Results such as these can better inform prevention efforts for specific target groups. Molecular epidemiology can also assist public health efforts by identifying clusters of infections and supporting outbreak investigations.

The Agency’s HIV/AIDS laboratories are also:
- investigating alternative specimens for diagnostic and prognostic testing of individuals in remote communities where there is no laboratory infrastructure. One option being explored is the use of dry blood spots, which are easy to transport to domestic or international laboratories (since the virus is dead, the sample does not need refrigeration). Dry blood spots can be tested for HIV, viral load and drug resistance.
- investigating low-cost systems for CD4 T cell monitoring in resource-limited countries (when an individual’s CD4 T count drops below a certain level, they are diagnosed to have AIDS). Laser systems are being investigated that may reduce the cost of CD4 T cell monitoring machines from about $200 000 for the sophisticated equipment used in developed countries to about $5 000 per machine. Systems that are robust enough for use in Asia could also have applications in Canada’s Far North.

In 2006-07, the Public Health Agency continued to work with EKOS Research Associates on the HIV/AIDS Attitudinal Tracking Survey 2006, and in partnership with Health Canada, First Nations and Inuit Health Branch (FNIHB), on the HIV/AIDS Aboriginal Attitudinal Survey 2006. The Agency also worked with D-Code and Environics to conduct focus groups to explore tactical approaches for the national HIV/AIDS social marketing campaign on stigma and discrimination. These research components, in addition to a literature review on the demographic and psychographic characteristics of our initial target audience, provided the foundation for the development of preliminary creative concepts and a media strategy for the campaign. In these ways, the Agency made significant headway towards the development of an Agency-led social marketing campaign.

In 2006-07, experts and stakeholders were engaged by the Agency to assist the development of Population-Specific HIV/AIDS Status Reports for people from countries where HIV/AIDS is endemic, for gay men, for women and Aboriginal people. The first Status Report for people from countries where HIV/AIDS is endemic is expected to be completed by Fall 2007 with subsequent reports for gay men, women, Aboriginal people, people living with HIV/AIDS, prisoners, people who use injection drugs and youth at risk to be completed in 2008 and 2009. The status reports will significantly advance the evidence base for HIV program planning, policy-making and interventions.

In July 2006, the stakeholder-led Canadian HIV Vaccines Plan entitled the Canadian HIV Vaccines Plan: Towards a World Without AIDS was published. The Plan was acknowledged internationally as one of the first country-wide HIV vaccines plans that promotes a comprehensive strategy for vaccine research, advocacy and funding.

The committee review has been deferred to 2007-08, so that it can be incorporated into Federal Initiative evaluation commitments.

A Responsibility Centre Committee was established in 2006 to serve as an oversight body to ensure that the Federal Initiative is implemented as planned, that programs are aligned and that accountability commitments (as described in the Results-Based Management and Accountability Framework and the Risk-Based Audit Framework) are met. The Committee subsequently set up an Accountability Working Group, comprising representatives of each of the 11 responsibility centres engaged in delivering the Federal Initiative, to carry out the ongoing performance measurement, evaluation and reporting work and to bring results forward for approval. As initial steps to strengthen the performance measurement system, the Accountability Working Group reviewed and simplified the logic model for the Federal Initiative and began to revise the performance indicators.

In addition, the Agency is providing HIV surveillance and laboratory services in support of CIDA-funded projects abroad. For example, the Agency is supporting the establishment of an effective second-generation HIV/AIDS surveillance system in Pakistan, which is being financed by CIDA. The information acquired through this system will be used by the Government of Pakistan to monitor the epidemic and to plan, implement and evaluate an expanded response. Similarly, the Public Health Agency and CIDA have supported the Government of Bulgaria in strengthening its HIV/AIDS surveillance system. Following the establishment of both routine and second-generation surveillance among vulnerable populations, the Government of Bulgaria requested and is receiving continued technical support from the Agency for HIV/AIDS surveillance.

Similarly, the Agency has provided technical support to the WHO and UNAIDS for a number of expert committees and working groups, such as the UNAIDS/WHO Reference Group on HIV Estimates, Modeling and Projections and the WHO’s Global HIV Resistance Surveillance Network (WHO HIV ResNet).

The Public Health Agency also expanded its International Quality Assurance Program in 2005-2006. Ensuring accurate CD4 T cell counting and other testing is critical for antiretroviral drugs to be successfully introduced into resource-limited countries. The International Quality Assurance Program aims to ensure a reasonable level of testing in participating countries, and is the only such network that offers services and training in both English and French (French is a common language in sub-Saharan Africa, the region hardest hit by HIV/AIDS). PHAC also manages training for some U.S. Centers for Disease Control and Prevention programs that target French-speaking countries.

In 2006-07, the Public Health Agency undertook preliminary discussions to identify potential Interdepartmental Pilot Projects to address, through horizontal partnerships between the Agency and other federal departments, determinants of health affecting people vulnerable to HIV and people living with HIV/AIDS. Time-limited pilot projects will carry out activities that:
- Address the determinants of health to prevent HIV/AIDS or increase access to diagnosis, care, treatment and/or support; and/or,
- Policy and program analysis on the determinants of health related to HIV/AIDS and federal government action.
Several reports based on data from Enhanced Surveillance of Canadian Street Youth were released on rates of sexually transmitted infections and blood-borne infections, risk behaviours and health determinants in the Canadian street youth population. This 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. Work was conducted towards the development of data standards for sexually transmitted and bloodborne infections in order to improve national data quality and timeliness.

The 2006 Canadian Guidelines on Sexually Transmitted Infections, which represents the most current available knowledge on the management of sexually transmitted infections, was distributed to health care professionals and made available on the Agency website. The Agency's national guidelines on sexual health education have been reviewed to identify "best practice" models of school-based sexual health promotion. The above activities were partially supported by the Federal Initiative on HIV/AIDS.

Small amounts of Federal Initiative funding were found beneficial in the leveraging of cooperative cost-shared projects such as the 4 Health 4 Wellness National Youth Retreat in Banff, Alberta, in February 2006. The retreat attracted youth aged 13 to 29 from across Canada who are active in their communities around infectious diseases, social determinants of health and related health and wellness issues. The retreat focussed on peer education and awareness, harm reduction and prevention, care and quality of life, and health and social determinants. Similarly Federal Initiative funding allowed support to be provided to M-Track in order to achieve a better understanding of the risk behaviours involved in acquiring HIV co-infection with viral hepatitis and/or sexually transmitted infections. As a second generation surveillance system, M-Track goes beyond disease reporting to try to understand changes in the epidemic and the behaviours that precede infection. This information can be translated into public health and community interventions to prevent infection or plan for care and support initiatives.

9. Federal Partners Involved in each Program

10. Names of Programs

11. Total Allocation

12. Forecasted Spending for 2006‑07 (in millions)

13. Actual Spending in 2006‑07 (in millions)

Regional HIV/AIDS Program

$12.3

$12.3

$10.9

14. Planned Results for 2006‑07

15. Achieved Results in 2006‑07

• Improved access to more effective prevention, care, treatment and support through strengthened population-specific funding programs delivered through regional community-based organizations.

The Public Health Agency’s regional offices are responsible for administering the AIDS Community Action Program (ACAP), which supports community-based organizations in delivering HIV/AIDS prevention education, creating supportive environments for those infected with and affected by HIV/AIDS, and increasing the capacity of people living with HIV/AIDS to manage their condition (health promotion). ACAP supported a total of 148 projects in 2005-2006, with total grants and contributions funding of $10.3 million. Examples include:

• In Atlantic Region, the AIDS Committee of Newfoundland and Labrador received funding for a two-year project entitled the Gay Urban Youth Zone (GUYZ). The objective of GUYZ is to increase understanding and awareness of HIV, hepatitis C (HCV) and sexually transmitted infections (STIs) among young gay men (aged 19 to 29) and service providers in the St. John’s area. Based on a needs assessment of the target population and a literature review of best practices, prevention materials such as pamphlets, posters and videos are being developed. Key stakeholders will be invited to attend a one-day workshop on HIV/HCV issues at the end of the GUYZ project.
• The Agency’s regional office in Quebec provided funding to CACTUS Montréal, a community-based organization that is working to prevent HIV transmission among injection drug users and sex-trade workers, for a “peer helper” project that achieved positive results. The project involved hiring a street youth to coordinate production of a food guide and recipe book for Montreal street youth living with HCV, which shares common modes of exposure with HIV. In addition to providing exemplary leadership, this individual encouraged a number of other street youth to participate in the project, some of whom were later able to find jobs. The project was co-funded by Health Canada’s Hepatitis C Prevention, Support and Research Program.
• In Ontario Region, Voices of Positive Women received funding for a project aimed at reducing the isolation, increasing the self-esteem and enhancing the quality of life of women living with HIV through a provincial peer network. The Peer Network Community Collaboration Program also increased access to community supports, services and healthcare by developing and distributing women-specific HIV resources; increased the capacity of organizations to respond to the needs of HIV-positive women through consultation, training and joint programming; and enhanced the leadership skills of HIV-positive women.
• In Manitoba and Saskatchewan Region, the All Nations Hope AIDS Network of Saskatchewan produced a model to assist other Aboriginal organizations in developing HIV/AIDS partnerships between youth and Elders, both of whom are greatly impacted by HIV/AIDS. In Manitoba, the federal and provincial governments, along with the regional health authority and community-based organizations, partnered to develop an integrated model of HIV/AIDS prevention, care and support. The result is the Nine Circles Community Health Centre, a community-based, multi-faceted primary health care centre that provides support for people living with, affected by or at risk for HIV/AIDS.
• In Alberta Region, funding from ACAP and Alberta Health and Wellness (managed by the Alberta Community Council on HIV) helped the Opokaa’sin Early Intervention Society create a culturally appropriate, supportive environment for providing HIV prevention education to two-spirited youth in the Lethbridge area. The Society partnered with local education, police, professional and health care stakeholders to develop and deliver a presentation on two-spirited people to students and service providers in the area, followed by a two-day conference targeting both Aboriginal and non-Aboriginal communities. Two-spirited youth and adults alike reported experiencing a welcome sense of inclusion at the conference, some for the first time.
• The Northern Region supported a number of projects in Nunavut, including a series of six HIV/AIDS and hepatitis C community science fairs that featured Aboriginal people living with HIV/AIDS as guest speakers. As well, sexual health newsletters were produced to interpret northern-specific HIV/AIDS epidemiological data in ways that were culturally, linguistically and socially relevant for Inuit. The newsletters also contained regional reports and profiles, best practice models, information on local HIV/AIDS and HCV projects, Inuit HIV-related community announcements and contact information. Funding was also provided to support a toll-free sexual health information line.
• The Agency’s regional office in British Columbia, in partnership with the Provincial Health Services Authority, provided funding to the Pacific AIDS Network (PAN), which comprises more than 50 community-based AIDS organizations from across B.C. working together to deliver a coordinated community response to the epidemic. PAN provides opportunities for front-line volunteers, staff and people living with HIV/AIDS to build essential skills in HIV prevention and support. It also plays a vital role in consulting with public health officials and government on sensitive issues such as mandatory HIV reporting, new HIV testing technologies and improving access to antiretroviral therapy.

The ACAP Evaluation Working Group is contributing to greater coherence in the federal response by developing a common data collection, evaluation and analysis system that will strengthen the Agency’s ability to systematically collect and assess evidence on the results of ACAP projects. In 2005, the Working Group developed common indicators for outputs and immediate outcomes that will allow for systematic collection across Canada of project-level evidence about ACAP’s effectiveness. Evaluation questions to address these common indicators – which have been aligned with the Federal Initiative – are currently being piloted in a new program evaluation and analysis tool.

9. Federal Partners Involved in each Program

10. Names of Programs

11. Total Allocation

12. Forecasted Spending for 2006‑07 (in millions)

13. Actual Spending in 2006‑07 (in millions)

II. Health Canada

First Nations on-reserve and Inuit Community Health

$2.7

$2.7

$2.5

14. Planned Results for 2006‑07

15. Achieved Results in 2006‑07

• Improved access to more effective prevention, and awareness through:

First Nations and Inuit Health Branch (FNIHB)’s HIV/AIDS program supported an International Indigenous Peoples’ Committee, charged to develop a one day conference held the day before the official opening of the XVI International AIDS Conference in Toronto August 12-18, 2006. The Branch provided funding to support the participation of 50 on-reserve First Nations and Northern Labrador Inuit people living with HIV.

In 2006-07, new resources allocated under the Federal Initiative were provided to the regions to support their efforts in developing and delivering targeted prevention, education and awareness programs.

Manitoba Region provided a"101 HIV Training" course to community-based workers in 06/07. In Atlantic region, a contest was held for junior high/high school students to develop posters with safe sex and protection from STIs and pregnancy (Sheshatshiu). There was also a school based education program (education and awareness) in 2 Innu communities (Natuashish and Sheshatshiu). Awareness of condom use and distribution of same (youth and at community health centers). A Crystal Meth and Youth program focused on Youth has been developed by Healing Our Nations. 13 First Nations community based workshops were held in the first half of the fiscal year. There were 4 STI community based workshops held for youth. Promotion of AIDS Walk at all Healing Our Nations events. New guidelines or policy changes by provincial public health are disseminated to community health nurses as required. An HIV Skills Building workshop, March 2007 was held in Goose Bay, Labrador. There were 32 participants (including youth, community health staff). "Advanced Training" for Healing Our Nations staff took place. This training covered family-training support model, step by step model, community response, rumour protocol, harm reduction, cross cultural training. In Alberta, in November/06 and January/07 Community Health Nurses and treatment nurses from all treaty areas and most communities were provided HIV/AIDS and Hepatitis C in-servicing during two FNIHB Nursing Conferences. Other nurses and Community Health Representatives (CHR) were given similar training in their communities and at the CHR Refresher Program site. Study notes were provided to all groups, and PowerPoint presentation CDs were provided to all nurses and CHRs who requested them. The funding was both at the Regional and National level. Saskatchewan Region had enhanced targeted special projects in 3 First Nations communities this last year. On October 24, 2006 FNIHB Nurses and South-Central transferred nurses - about 70 - 75 people attended training in Saskatoon where issues on HIV surveillance, hepatitis C and needle exchange as well as STIs were discussed. The feedback was very positive

The HIV/AIDS and hepatitis C nursing guidelines for nurses working on reserve were completed. However, the translation along with the development and implementation of a train the trainer workshop and a dissemination plan will be completed in 2007-08.

FNIHB participates actively in the Federal, Provincial and Territorial HIV/AIDS Advisory Committee. Through a 3 year letter of agreement with the Public Health Agency, FHIHB continues to provide support for Aboriginal AIDS Awareness Week and Pauktuutit. FNIHB also continues to provide support to the Assembly of First Nation (AFN)’s HIV/AIDS activities and to support the National Aboriginal Council on HIV/AIDS (NACHA) for improved programming.

Work on the Federal Initiative’s Performance Measurement Strategy started in 2005-06, under the Public Health Agency’s lead, and FNIHB continues to implement evaluation tools and mechanisms at regional levels.

9. Federal Partners Involved in each Program

10. Names of Programs

11. Total Allocation

12. Forecasted Spending for 2006‑07 (in millions)

13. Actual Spending in 2006‑07 (in millions)

International Health

$1.6

$1.6

$1.5

14. Planned Results for 2006-07

15. Achieved Results in 2006‑07

• Increased coherence of federal response through:

• Strengthened Canadian response to HIV/AIDS through support for projects that engage Canadian organizations in the global response to HIV/AIDS.

The International Affairs Directorate, Health Canada, increased policy coherence through the effective coordination of the Federal presence at the XVI International AIDS Conference in Toronto, August 13-18, 2006. IAD co-ordinated the Federal AIDS 2006 Secretariat, an interdepartmental committee involving 14 departments and agencies. Government of Canada officials were involved in over 15 Satellite sessions, 30 oral/poster presentations and some 20 other events.

Canadian engagement in the global response was enhanced through the provision of 7 Global Engagement Grants to Non-government organizations (NGOs) and academic institutions. Activities supported include an international workshop on best practices related to the Prevention of Mother-to-Child-Transmission of HIV; an exchange between Canadian and Malawian clinicians on responding to the rehabilitation needs of people living with HIV/AIDS; and a consultation contributing to the development of model legislation designed to protect the rights of women living with, vulnerable to and affected by HIV/AIDS.

9. Federal Partners Involved in each Program

10. Names of Programs

11. Total Allocation

12. Forecasted Spending for 2006‑07 (in millions)

13. Actual Spending in 2006‑07 (in millions)

Program Evaluation

$0.1

$0.1

$0.1

14. Planned Results for 2006‑07

15. Achieved Results in 2006‑07

• Enhanced capacity to monitor the HIV/AIDS epidemic in Canada through the provision of strategic performance measurement and evaluation support

The Departmental Performance Measurement and Evaluation Directorate at Health Canada, supported the development of the Federal Initiative’s performance management system and evaluation planning.

9. Federal Partners Involved in each Program

10. Names of Programs

11. Total Allocation

12. Forecasted Spending for 2006‑07 (in millions)

13. Actual Spending in 2006‑07 (in millions)

III. Canadian Institutes of Health Research

HIV/AIDS Research Projects and Personnel Support

$17.0

$ 17.0

$ 16.6

14. Planned Results for 2006‑07

15. Achieved Results in 2006‑07

• Increased understanding of the epidemic, factors contributing to the spread of HIV and effective responses (including treatment and prevention interventions) through:

• Increased capacity for HIV/AIDS research through funding for research trainees and strategic capacity-building initiatives
• Increased number of trials relevant to vulnerable populations and improved treatments for HIV/AIDS through enhancements to the Canadian HIV Trials Network

CIHR, with the assistance of the CIHR HIV/AIDS Research Advisory Committee (CHARAC), and following consultation with a wide range of stakeholders, finalized the priorities for CIHR-funded HIV/AIDS research. The priorities are guiding the development of strategic funding opportunities and investment of Federal Initiative funding in extramural HIV/AIDS Research. The priorities encourage research focusing on high-risk populations within Canada and include a broad range of topics in HIV/AIDS research; the priorities are as follows: Health Systems, Services and Policy; Resilience, Vulnerability and Determinants of Health; Prevention technologies and interventions; Drug development, toxicities and resistance; Pathogenesis; and Issues of co-infection.

In response to the priorities, the HIV Prevention Operating Grant Request for Applications (RFA) was launched in December 2006. The RFA was developed to enhance research on the prevention of HIV and to build future Canadian research capacity in this area. The RFA promotes biomedical as well as social/behavioural approaches to prevention and was developed with the assistance of an expert working group which included stakeholders from multiple sectors. A second expert working group was also established in 2006-07 to provide recommendations to CHARAC on RFAs and other activities to address the priorities of Health Systems, Services and Policy; and Resilience, Vulnerability and Determinants of Health. The work of this group will continue in 2007-08.

CIHR continued to sustain and enhance Canada’s HIV research activities by funding grants and awards in priority areas through Priority Announcement competitions. Priority Announcements provide funding for meritorious research grants and awards submitted to CIHR open competitions that would not otherwise be funded. In the Priority Announcement competitions, 10 Operating Grants (1 Health Services/Population Health Stream; 9 Biomedical/Clinical Stream), 12 Doctoral Research Awards (3 Health Services/Population Health Stream; 9 Biomedical/Clinical Stream), 12 Fellowship Awards (2 Health Services/Population Health Stream; 10 Biomedical/Clinical Stream), and 2 New Investigator Awards (1 Health Services/Population Health Stream; 1 Biomedical/Clinical Stream) were approved through the HIV/AIDS Initiative and Federal Initiative Funding.

Six RFAs were launched under the HIV/AIDS Community-Based Research (CBR) program in June 2006. The RFAs included key research and capacity-building components. Through these RFAs, 7 new CBR grants (2 Aboriginal Stream; 5 General Stream) and 11 capacity-building grants and awards (3 Aboriginal Stream; 8 General Stream) were approved in 2006-07.

In addition to the funding provided by the Federal Initiative, CIHR contributes further funding to HIV/AIDS research from its base budget. In total in 2006-07, with combined CIHR and Federal Initiative funding, CIHR funded 299 research grants and awards directly related to HIV/AIDS: 149 Research Grants; 7 Group/Team Grants; 122 Salary and Training Awards; 8 Workshop Grants; 8 CBR Capacity-building Grants; and 5 Other Grants. CIHR also administered 17 Canada Research Chairs in the area of HIV/AIDS. CIHR invested a total of $37.5 million in HIV/AIDS research in 2006-07 ($25.8 million in the 299 grants and awards directly related to HIV/AIDS; $2.6 million in Canada Research Chairs in HIV/AIDS; and an additional $9.2 million in research that is related and important for HIV/AIDS but where HIV/AIDS is not the primary focus of the research).

In 2006-07, CIHR established the HIV/AIDS Community-Based Research Steering Committee and the first meeting of the Committee was held on June 13, 2006. The mandate of the Committee is to help guide the future development of the HIV/AIDS CBR Program and make recommendations to CHARAC and CIHR regarding future CBR Requests for Applications. This Committee will help to guide the program and ensure the goals of the HIV/AIDS CBR program are supported by appropriate policies and programs.

The Canadian HIV Trials Network (CTN) continued to receive funding from CIHR in 2006-07 in support of research infrastructure. Examples of CTN activities in 2006-07: CTN became involved with a national cohort investigating HIV/HCV co-infection and examining the effect of HAART on liver disease; continued efforts to improve access to clinical trials with the initiation of a new project focused on Aboriginal peoples.

9. Federal Partners Involved in each Program

10. Names of Programs

11. Total Allocation

12. Forecasted Spending for 2006‑07 (in millions)

13. Actual Spending in 2006‑07 (in millions)

IV. Correctional Service Canada

Health Services

$2.4

$2.4

$ 2.0

14. Planned Results for 2006‑07

15. Achieved Results in 2006‑07

• Improved access to more effective prevention, care, treatment and support through, for example, safer tattooing and pre-release planning programs

In the summer-fall of 2005, CSC initiated a pilot program on safer tattooing practices in an effort to enhance infectious disease management and control activities in prisons. The pilot concluded in the fall of 2006 and was cancelled by the Minister of Public Safety in December 2006.

CSC requested advice from the Agency with respect to the usefulness of needle exchange as a means of preventing infectious disease transmissions/acquisition in correctional facilities. The Agency report is under review by CSC.

Draft Discharge Planning Guidelines have been developed that will enhance current efforts to provide support for inmates with ongoing care and treatment needs for infectious diseases while under the community supervision portion of their sentence. Inmates with chronic health conditions who require support in transition to the community will be identified during the reception process and will be monitored through their sentence. Health care in the community will be facilitated for low functioning offenders with ongoing health needs and counselling and support in the community will promote compliance with ongoing treatment requirements. The Guidelines will be finalized by March 2008.

CSC continued to offer the Special Initiatives Program, which provides inmates with the opportunity to develop educational materials and/or organize activities dealing with HIV (and other infectious diseases) prevention, for other inmates.

Total $84.4 in 2008-09

Total $63.2

Total $59.2

18. Contact Information:

Marsha Hay Snyder
Tel. 613-946-3565

Horizontal Initiative

1. Name of Horizontal Initiative:
Preparedness for Avian and Pandemic Influenza

2. Name of Lead Department(s):
Public Health Agency Of Canada/Canadian Food inspection Agency

3. Start Date of the Horizontal Initiative: late 2006

4. End Date of the Horizontal Initiative: Ongoing

5. Total Federal Funding Allocation (first 5 years): $617M Cash basis

6. Description of the Horizontal Initiative (including funding agreement): Canada is facing 2 major, inter-related animal and public health threats: the potential spread of avian influenza virus (H5N1) to wild birds and domestic fowl in Canada and the potential for a human adapted strain to arise, resulting in human-to-human transmission, potentially triggering a human influenza pandemic. A coordinated and comprehensive plan to address both avian and pandemic influenza is required.

In 2006 the Health Portfolio received $422M over 5 years to improve preparedness for avian and pandemic influenza. The bulk of the initiatives are ongoing. Initiatives are being launched in the areas of vaccines and antivirals, surge capacity, prevention and early warning, emergency preparedness, critical science and regulation, risk communication, and inter-jurisdictional collaboration. Efforts also will be undertaken to fill gaps in on-reserve planning and preparedness and enhance federal capacity to deal with an on-reserve pandemic.

Under the umbrella of “Preparing for Emergencies”, in 2006 the CFIA obtained $195M to be spent over 5 years to enhance Canada’s state of AI preparedness. Canada’s Avian Influenza Working Group was established in 2006 to update policies, protocols, operating procedures, and systems to enhance Canada’s state of preparedness—through collaborations and partnership— in 5 pillars of strategies and processes for prevention and early warning, emergency preparedness, emergency response, recovery, and communications.

7. Shared Outcome(s): These initiatives will allow the federal government to strengthen Canada’s capacity to prevent and respond to immediate animal health and economic impacts of avian influenza while increasing preparedness for a potential pandemic.

Greater Protection for Canadians will come about with improved vaccines and antivirals, improved emergency preparedness, and increased surge capacity to better address peak periods, as well as through critical science and regulation processes in the area. There will be enhanced on-reserve planning and preparedness and improved federal capacity to deal with an on-reserve pandemic.

Response Speed and Understanding will be enhanced through prevention and early warning measures, risk communication and inter-jurisdictional collaboration.

8. Governance Structure(s): At time of writing the governance structure is under development. Current thinking is that under the auspices of the Deputy Minister’s Committee on Avian and Pandemic Influenza Planning (CAPIP) a series of committees and working groups would be established focussing on each of the key horizontal areas coordinated by a DG committee with leadership provided by an ADM committee with a representative from each of the funded departments or agencies.

9. Federal Partner(s)

10. Names of Programs for the Federal Partner(s)

11. Total Allocation From Start to End Date

12. Planned Spending for 2006–07
(includes PWGSC Accommodation Costs)

13. Actual Spending in 2006–07

14. Planned Results for 2006–07

15. Results Achieved in 2006–07

1. Public Health Agency of Canada (PHAC)

(a) Vaccine
readiness & clinical trials

ongoing

$10.7M

$0.3M

Revised GSK contract reflecting readiness fee, facility upgrade as well mock vaccine(s) production costs and clinical trials.

Staff hired & trained and have begun designing clinical trials and regional projects for adverse event reporting and strengthened adverse event surveillance and reporting.

Increase knowledge of influenza vaccine safety monitoring

A change in ownership of the Contractor (now wholly owned by GSK) led to a number of incidental benefits to Canada. GSK upgraded their commercial manufacturing facility to required bio-security levels .This reduced the need for a separate pilot plant, however, its continued value to Canada for future work is still being investigated. GSK has produced a mock vaccine and done preliminary clinical trials. The results of these trials are still being assessed and will be used to design new trials to answer additional questions of specific interest to Canada. As a result, the funding allocated for Cdn. trials was re-profiled to a future fiscal year

(b) Rapid Vaccine development and testing

ongoing

$.1M

$0.0M

Lead scientist recruited.

Work Description for Lead Scientist is being prepared; however, recruiting for this specialized expertise is expected to be difficult.

(c) Contribution
to National
Antiviral Stockpile

ongoing

$29.9M

$15.1M

A mix of antivirals is procured to bring the national stockpile to its 55.7 million doses target.
Access to the national stockpile is coordinated with by federal, provincial and territorial governments, including access for FN/I.

The national antiviral stockpile was increased to approximately 50 M doses through new purchases and an agreement in principle that P/Ts with existing stocks would absorb them into the national stockpile – subject to the funding arrangement previously agreed to by FPT Ministers. Funding allocated in 2006/07 went to new procurement (approx. 6.3 M doses).

(d) Additional antivirals in NESS

$12.5M
(2007-08)

$0

$0

Nothing in 2006-07.

Nothing in 2006-07.

(e) Capacity for Pandemic Preparedness

ongoing

$5.1M

$2.4M

Pandemic Preparedness Secretariat in place; establishment of a grants and contributions fund/program; and investments in strategic policy, executive briefing and support, risk assessment, correspondence and support to the Communicable Disease Control Expert Group and regional policy/communications liaison.

Pandemic Preparedness Secretariat has been established.
Terms and conditions for the grants and contributions program were finalized and a grant to the WHO to assist in the development of international vaccine capacity was made.
Strategic policy positions were in the process of being staffed. Strategic policy support and advice was provided through Memorandum to Cabinet (contingency reserve), and by supporting the private sector working group.
The competitions to fill the regional policy and communications positions started but were not completed in 06-07
Issues Coordination
Unit created at the Corporate level to support the timely provision of information (briefing materials, correspondence).
Manager of the Unit hired. Positions were filled by temporary help while indeterminate staffing was underway.
Structure of the Unit was defined (employee skill sets, classification).
 

(f) Surveillance Program

ongoing

$5.6M

$1.9M

New staff engaged and expanded access to alert system

Infection control guidelines revised

Improved early detection in wildfowl

Training designed for early detection and response for health professionals

Options assessed for monitoring disease severity and for placing surveillance officers

Developed options to address gaps in readiness for electronic health record and continued development/support for existing systems

Hiring process ongoing. All 5 CNPHI FTE’s have been staffed and additional funds from the Salary envelope were used to staff a sixth and seventh position (on term/casual basis).

An Expert Working Group was established, which met on April 26-27 2007, to initiate a comprehensive review and revision of Annex F of the Canadian Pandemic Influenza Plan (CPIP), Infection Control and Occupation Health Guidelines during Pandemic Influenza in Traditional and Non-Traditional Health Care Settings. This process will include an independent review of the modes of transmission of influenza as well as an examination of the risk-benefit considerations in the use of N-95 respirators. The revision will be ongoing over the next 6-8 months.

Implementation of Migratory Waterfowl and Wild Bird Surveillance in Canada – Canada’s Interagency Wild Bird Survey to sample species of wild birds to better understand the wildlife reservoirs of influenza A viruses in Canada.

Initiated the development of an accredited course for front-line and public health physicians across Canada for early detection and reporting of emerging or re-emerging infectious diseases of public health significance (contract signed with the Canadian Public Health Association).

Implementation of the Public Health Network Issue Group: National Non-Enteric Zoonotic Diseases Committee (monthly teleconference from April/May 2006 to November 2006 and inaugural face-to-face meeting on March 23, 2007).
Initiation of an Integrated International Multi-Species Influenza Surveillance project in January 2006.

Support the integrated public health information system (iPHIS) and undertook necessary enhancements such as the improved capability to extract pertinent data thereby enhancing its robustness ensuring that jurisdictions using it are ready for its optimal usage while responding to any outbreaks and health emergencies.

(g) Emergency Preparedness

ongoing

$5.9M

$5.5M

Regional networks for the collaboration and coordination of plans across jurisdictions, including an interface with FN/I community plans.

Plans for expanding Vancouver, Montreal and Halifax maritime ports.

National coordinator hired to focus on emergency social services that includes the development of a framework for enhancing community preparedness.

Office established to support the development of a national incident command system.

NESS will have acquired critical supplies and hired staff to manage the additional materials.

Hired an engineer to provide improved capacity to review and assess laboratory certification plans.

Development of exercises to test pandemic plans.

Upgraded video capacity of the Emergency Operations Centre.

Networks developed with FNIHP, provinces/territories, INAC to support First Nation communities in the development of Pandemic Plans.
Continued federal, provincial and territorial government support to the Expert Group on Emergency Preparedness and Response, Council of Health Emergency Management Directors and the Council of Emergency Social Services Directors. Formation and support to the federal, provincial and territorial Pandemic Preparedness Health Operations Coordination working group. Support to the Directors of the Voluntary Organizations Council. Formation of inter-agency emergency management working groups for gender, seniors, and people with disabilities. 2006 National Form on Emergency Preparedness and Response. In collaboration with First Nations and Inuit Health Branch, we established a federal, provincial and territorial government working group to integrate and support their health emergency management policy and planning activities.

Discussions with provinces and territories to develop procedures operationalzing the Quarantine Act.
Three Quarantine Officer (QO) positions were approved for marine ports. Personnel protective equipment was approved for purchase for the Quarantine Officers in Halifax, Montreal and Vancouver. Consultation was held with Marine partners for the development of National Marine Quarantine Protocol. A Table top exercise was held to evaluate this protocol in February/March 2007.

A plan was developed to hire a Coordinator to oversee federal, provincial and territorial emergency social services. A federal, provincial and territorial government secretariat and coordination mechanism were established with our Office of Program and Business Coordination. Collaboration was established with the Council of Emergency Social Services Directors, the Directors of Voluntary Organizations Council. Worked with Canadian Red Cross and Public Safety Canada to develop a vulnerability/resiliency framework. Formed and supported the Inter-agency Psychosocial Working Group.

The Agency coordinated and supported a federal, provincial and territorial government working group to establish a national framework for the development and implementation of the National Health Incident Management System. Mechanisms were established for communication and coordination with other jurisdictions.

NESS continues to build a robust stockpile to respond to modern day risks. In 2006/07, NESS hired one store person and invested $2.6 million in the procurement of critical supplies to enhance its capacity to respond to an avian flu type incident.

An engineering position was created, support staff was brought in on secondment in the interim.

A federal, provincial and territorial government table top exercise was held in December 2006 in conjunction with the National Forum to test communications among partners and stakeholders. Planning was started to develop and present detailed exercises for federal, provincial and territorial government partners.
Different exercises took place all year in various locations across the country, including with Federal Councils and provincial partners.

The Emergency Operations Centre purchased video equipment required for the upgrade of the video capacity of the centre.

(h) Emergency human resources

ongoing

$0.2M

$0.1M

Health Crisis Response Plan completed and provided logistical support for a comprehensive consultation process.

HRD Health Crisis Response Plan and BCP completed following extensive consultative processes.

(i) Winnipeg lab & space optimization

ongoing

$1.5M

$0.2M

Effective Project Approval (EPF) for the purchase of the Logan Lab obtained.
Equipment purchased for the shared services location and started the migration of services to the offsite location.

A property for the Offsite Storage facility was identified and a lease entered into via PWGSC.

(j)Strengthening the public health lab network

ongoing

$3.0M

$1.3M

Team leader and technicians in place and procurement of sensors and analyzers started.

One Surveillance Officer position was staffed.
Of $2.7M in O&M/LTCP, $1.5M was reprofiled to 2007-08 to allow time to confirm requirements with provincial and territorial partners. Remainder of funds were expended for enhancement of Influenza Lab, Core Services, and CPHLN, etc.

(k) Influenza research network

ongoing

$1.1M

$0

Membership established and planning for the first meeting completed.
The Agency secretariat function developed and parameters for intra-mural research put in place.

As funding was reprofiled to 2007-08, these activities were not initiated.

(l) Pandemic influenza risk assessment & modelling

ongoing

$0.6M

$0.2M

New positions staffed and three workshops held.
Contact let for the development of operations research analysis tools and the Synchrony, waves and spatial spread of influenza in Canada project initiated.

One new position (ES-5) has been staffed, as per the HR commitments for FY2006/7; and the staffing of three other positions (REM-2, MA-5 and ES-3) is currently underway, for FY2007/8.

National/international workshops were held, on transmission dynamics of infectious diseases with a special focus on pandemic influenza, the interface between modeling and public health practice, and operations research and public health.

The Synchrony, waves and spatial spread of influenza in Canada project was initiated, and work will continue throughout Y2007/8.

(m) Performance & evaluation

ongoing

$0.4M

$0.3M

Evaluation positions filled and an integrated RMAF-RBAF for the new Terms and Conditions relating to the new grants and contributions programs completed.

An Integrated Result-based Management and Accountability Framework and Risk-based Audit Framework for the Public Health Grants and Contributions Programs was approved by TBS.

An Interdepartmental Evaluation Plan is near completion and is scheduled to be submitted to TBS in September 2007. This document includes a performance measurement framework, an evaluation framework (including a plan for the summative evaluation in 2011/12), and a logic model.

Work is underway to fill evaluation positions at the Centre for Excellence in Evaluation and Program Design (CEEPD). A Senior Evaluation Analyst has been hired, and a staffing consortium is underway and will be used to recruit Evaluation Analysts to work on the pandemic file.

(n) Pandemic influenza risk communications strategy

ongoing

$1.2M

$1.8M

Research updated and initial plans around citizen readiness/public information and media relations outreach are developed.
The development of campaign material started.
Communications infrastructure was to be strengthened.

Advanced the public involvement strategy.
Piloted an ethical framework for pandemic influenza preparedness.

Technical briefings with media on antivirals strategy done across the country.
Citizens were consulted on the Antivirals Strategy.

(o) Skilled national public health workforce

ongoing

$0.3M

$0.2M

Core staff to be engaged for planning and design of the Canadian Public Health Service.

Agreements on selection and deployment to be established with the provinces and territories.
Provinces and terririories and local public health organizations to identify key occupational and location gaps.

Instruments for administering grants developed.

Core staff engaged; Regional Lens process to outline activities and create budget for Agency Regional involvement completed; initial consultations for internal collaboration among Agency field staff programs held.

Plans for internal/external advisory group for staff selection and deployment completed.

First round of consultations with Provinces completed; initial identification of key occupational and location gaps received.

Public Health Terms and Conditions for use of grant money completed.

2. Health Canada (HC)

(a) Regulatory activities related to Pandemic Influenza Vaccine

ongoing

$0.6M

$0.3M

Prepared for the WHO assessment of Canada’s national vaccine regulatory system as part of its program to pre-qualify vaccines that will be purchased by UN agencies.

Completed the WHO pre-inspection visit of the National Regulatory Authority for vaccines (Pre-inspection completed Oct 06).

Prepared for the WHO Assessment of the National Regulatory Authority for Vaccines (BGTD/HC). The assessment was completed in Jan/07. Pending recommendations resulting from the assessment, compliance activities may require further action in 07-08.

Over the course of the fiscal year, several activities were completed that supported the review capacity in the lot release area:

•reviewed guidance document for submission content requirements

•developed reagents for the evaluation of pandemic vaccines

•developed alternative assays for conserved regions of flu virus (to facilitate a more rapid development of vaccine against a new strain)

•transfer of knowledge, methods and techniques for quantification of contaminants in vaccines

•coordinated validation of assays with other Centres within BGTD (this included collaboration with the Centre for Biologics Research in developing tests for a pandemic influenza vaccine)

•trained technical and review staff in high performance liquid chromatography (HPLC) and capillary electrophoresis (CE) methods for testing.

(b) Resources for approval of antiviral drug submissions for treatment of pandemic influenza

ongoing

$0.1M

$0.0M

Identify scenarios under which Interim Orders for the approval of a pandemic influenza vaccine can be applied. Drafting of instructions for the various interim orders.

A new Assessment Officer was hired in March, 2007. Assigned the task of developing a guidance document for the submission and Expedited Review of pandemic drugs. Since joining TPD he initiated the project of drafting of the review guidance document entitled Expedited Pandemic Influenza Drug Review (EPIDR). Consultations within Health Canada are currently ongoing to ensure the EPIDR process would be the best path to rapidly and efficiently review drug submissions in the event of an influenza pandemic. It is expected that the draft will be available in the coming year for internal management comments / input.

Some acquisitions for office set-up were made.

(c) Establishment of a crisis risk management unit for monitoring and post market assessment of therapeutic products

ongoing

$0.1M

$0.0M

Training of technical and review staff in methods for testing and development of reagents and assays for the evaluation of pandemic vaccines.

MHPD completed acquisitions required for the establishment of the Crisis Management Unit.

(d) FN/I Surge Capacity

$1.48M
(2007-08 to 2009-10)

$0

$0

No deliverables expected in this period.

In advance of 07/08 funding, FNIHB began preparatory work using existing resources to initiate discussions with national and provincial Aboriginal organizations, the Agency and the provinces.

(e) Strengthening Federal Public health capacity

ongoing

$0.1M

$0.1M

The devlopment of recommendations on how health emergency preparedness and response teams will best support the needs of the pandemic program.

With respect to addressing gaps in pandemic-related medical supplies in FNIHB on-reserve health facilities, consultations took place with key stakeholders and experts in FN/I and/or infection control, resulting in a survey that will be conducted in May 2007.

A paper recommending how to establish the health emergency preparedness and response teams can be specifially attributed to this initiative. These recommendations will be presented to senior management in 07/08 and will form the basis upon which the teams will be established.

(f) First Nations & Inuit emergency preparedness, planning, training and integration

ongoing

$0.4M

$0.4M

To enhance FNIHB’s ongoing work with Aboriginal organizations and First Nations and Inuit communities to support development of community level pandemic influenza preparedness plans and to integrate with provincial planning. facilities.

As an enhancement to existing resources, it is difficult to attribute specific outcomes to this initiative. In terms of the emergency preparedness/ planning component, this initiative has resulted in the development by the Assembly of First Nations (AFN) of a common, culturally appropriate approach to pandemic planning on reserve. This approach was pilot tested in three on-reserve communities in 2006/07.

(g) Public health on passenger conveyances

ongoing

$0.1M

$0.1M

1. Training materials: a better understanding of the Quarantine Act, roles and responsibilities.

2. Purchase of and training on Personal Protective Equipment (PPE): preparedness and competance in use.

3. Development of Standard Operating Procedures (SOPs): clear direction to staff and transparency in process.

4. Establish network contacts/agreements/MOUs: efficient and effective emergency response due to pre-existing protocls and agreements.

5. Participate in Interdepartmental Preparedness planning: a better capacity to respond to emergencies.

6. Provide advice, consultation and routine inspections at designated sites: meeting national and international obligations.

7. Training of staff: increased competance.

8. Development of contigency planning: program resiliance and capacity.

9. Designation of EHOs: empowered to enforce the Quarantine Act.

10. Develop Surge Capacity: increased capacity to respond

1. Training materials created and presented.

2. Purchase of and training on Personal Protective Equipment (PPE).

3. Development of Standard Operating Procedures (SOPs).

4. Establish network contacts/agreements/MOUs.

5. Participate in Interdepartmental Preparedness planning.

6. Provide advice, consultation and routine inspections at designated sites.

7. Trained staff and increased competence.

8. Development of contigency planning.

9. Designation of EHOs.

10. Develop and tested use of surge capacity.

3. Canadian Institutes of Health Research (CIHR)

(a) Influenza research priorities

$21.5M
(2006-07 to 2010-11)

$2.5M

$1.8M

Create Pandemic Preparedness Strategic Research Initiative Task Group and identify research prioritites

Task Group was created and meetings were held to develop draft priorities. Key stakeholders were consulted and priorities were finalized.

Establish partnerships with stakeholder organizations

Partnerships were established with the Agency, CFIA, Health Canada, the International Development Research Centre, Canada's Research-Based Pharmaceutical Companies (Rx&D)/Health Research Foundation, Canadian Foundation for Infectious Diseases and Association of Medical Microbiology and Infectious Disease Canada.

Develop and launch new targeted funding programs

Developed and launched the first request for applications (RFA).

Peer reviewed and funded applications (34 grants funded).

Developed and launched second round of three RFAs

Hire staff

Position role profile developed, posted and interviews completed.

Develop reporting strategy

Working with other departments and agencies on reporting strategy.

4. Canadian Food Inspection Agency (CFIA)

(a) Animal vaccine bank

ongoing

$0.5M

$.08M

(b) Access to antivirals

ongoing

$0.1M

$0.2M

(c) Specialized equipment

$33.73M
(2006-07 to 2008-09)

$5.5M

$1.1M

(d) Laboratory surge capacity & capability

ongoing

$2.7M

$0.8M

(e) Field surge capacity

ongoing

$1.0M

$0.8M

(f) National veterinary reserve

ongoing

$0.8M

$0.0

(g) Enhanced enforcement measures

ongoing

$0.8M

$0.7M

(h) Avian biosecurity on farms

ongoing

$3.8M

$2.7M

(i) Real property requirements

$4.04M
(2006-07 to 2007-08)

$2.7M

$1.8M

(j) Domestic and wildlife surveillance program

ongoing

$2.5M

$4.7M

(k) Field training

ongoing

$1.0M

$0.9M

(l) AI enhanced management capacity

ongoing

$0.2M

$0.9M

(m) Updated emergency response plans

ongoing

$1.6M

$0.6M

(n) Risk assessment and modelling

ongoing

$2.5M

$0.9M

(o) AI research

ongoing

$0.5M

$0.9M

(p) Strengthened economic & regulatory framework

ongoing

$0.9M

$0.0

(q) Performance & evaluation

ongoing

$0.6M

$0.5M

(r) Risk communications

ongoing

$2.5M

$0.0

(s) International collaboration

ongoing

$0.9M

$0.02

Total $

Total $100.6M

Total $49.6M

16. Comments on Variance(s):

17. Results Achieved by Non-federal Partners: NA

18. Contact Information:

Dr. Arlene King
Director General
Pandemic Preparedness
Infectious Disease & Emergency Preparedness Branch
Public Health Agency of Canada
130 Colonnade Road
Ottawa ON K1A 0K9
(613) 948-7929