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PHAC facts...

By most standards, link This is particularly true when comparing Canada’s infant mortality rate (which is among the lowest in the world at 5 deaths per 1000 live births) to the rate among First Nations people living on reserve (7 deaths per 1000 live births). And while link life expectancy at birth in Canada averaged 80.4 years, life expectancy was 75.5 years for Aboriginal women and 70.4 years for Aboriginal men, almost 7 years less, on average, than for non-Aboriginal people.

In 2007-08, the Agency had four program activities — health promotion, disease prevention and control, emergency preparedness and response, and strengthen public health capacity. Some of the work done in these program activities included using information generated from surveys and other research studies to monitor, plan, implement and evaluate programs. The Agency also used a mix of policy development and program delivery activities to carry out its responsibilities. In addition, the Agency’s grants and contributions programs funded partners in the health sector and at the community level to pursue shared goals.

Collectively, the Agency’s four program activities contributed towards the strategic outcome of healthier Canadians and a stronger public health capacity.

Program Activity – Health Promotion

Financial Resources ($ millions)
Planned Spending Total Authorities Actual Spending
186.5 200.2* 192.1**
* The $13.7 million net increase between planned spending and authorities is due to: (a) increase of $7.9 million for operating budget carry-forward from 2006-07 ($6.9 million) and to cover other operational requirements such as collective agreements ($0.3 million) and uncontrollable salary costs ($0.7 million); (b) increase of $4.1 million resulting from realignment of resources between program activities to cover additional requirements in transfer payments; (c) increase of $3.6 million for items in Supplementary Estimates (A) not included in Planned Spending, such as one-time named grant for MedicAlert ($2 million) and 2008 Advertising campaign ($2 million); and (d) decrease of $1.9 million due to reduction in Employee Benefit Plan costs.

** Actual Spending was $8.1 million lower than Authorities due to:  (a) capacity and technical restraints which impeded the full use of approved resources ($5.6 million in operating expenditures); and (b) delays in the approval and solicitation process and transition to the new Innovation Learning Strategy ($2.5 million in transfer payments).
Human Resources (Full-Time Equivalents)
Planned Actual Difference
416 381 35*

*The difference of 35 Full-Time Equivalents is due to:  (a) delays in the staffing process; (b) difficulty in finding qualified personnel because of low labour market availability for positions requiring unique public health specialization; and (c) constraints due to shortage of accommodation space.

Health promotion is the process of enabling people to increase control over and improve their health. This process is based on the understanding of the important influences that determinants of health (such as gender, income, and literacy) have on an individual’s health. Health promotion activities move beyond health education and changes in personal behaviours to address social change, institutional change and community change.

Performance Analysis

In 2007-08, the Agency re-issued link Sensible Guide to a Healthy Pregnancy to provide the reliable information about how prospective mothers can safeguard their health and the health of the expected baby.

PHAC facts...

Children in Quebec are coping with their schoolwork crunch by enjoying a healthy daily crunch of fruits and vegetables. “My Daily Crunch” is an annual project supported by the Agency and administered by the Association régionale du sport étudiant de Québec et de Chaudière-Appalaches, a non-profit organization. Its collaborators include Capitale nationale and Chaudière-Appalaches regional public health directorates, IGA and the Quebec Produce Marketing Association. The project has developed support materials in English and French such as activity binders, information and promotional items. “My Daily Crunch” reaches over 800 elementary schools and some 220,000 children and their parents.

In 2007-08, link funding was provided to support the creation of knowledge, skills, tools and resources to help communities, organizations and individuals act to improve their health. For example, Active Healthy Kids Canada developed a project called Canada's Physical Activity Report Card for Children and Youth. It provides a comprehensive measurement of how Canada is delivering on its responsibility to provide physical activity opportunities for children and youth, and also increases awareness and common understanding of the issue of physical inactivity. In addition, the annual SummerActive and WinterActive programs were implemented but were not sufficiently effective in reaching their target audiences. These initiatives were led by the Agency in collaboration with other government departments, and provincial and territorial governments. They were designed to help Canadians improve their health by encouraging them to adopt healthier lifestyles, including participating in physical and sport activities, making healthier food choices and living tobacco-free.

The Agency continued to support the four Centres for Excellence for Children's Well-Being (Early Child Development, Special Needs, Youth Engagement and Child Welfare) in translating knowledge into practical tools for parents using, an online Early Childhood Development Encyclopaedia. The Agency also provided a Special Needs Information Directory of services and resources available to parents of children with special needs. The usefulness of this work has been validated directly through a link visitor survey.

PHAC facts...

A 2002 CAPC National Impact Evaluation demonstrated positive results of the child-caregiver funding. A link 2007 formative evaluation demonstrated that CAPC mobilized communities in support of at-risk children and families.

A 2007 link CPNP formative evaluation demonstrated that it has been successful in reaching its target population and achieving positive health results.

The Agency funded community-based programs to increase access to health and social supports for prenatal and post-partum women and children facing challenges such as poverty, teen pregnancy, isolation, recent arrival in Canada and substance abuse. The programs were developed and delivered in partnership with the provinces and territories through joint management agreements. For example, the link Canada Prenatal Nutrition Program (CPNP) funded community-based projects and coalitions in approximately 2000 communities, providing over 50 000 pre- and postnatal women with food supplements, as well as support, education and counselling on health and lifestyle issues.

PHAC facts...

A 2006 National Impact Evaluation of the AHSUNC Program found significant gains for the target children in physical, personal, social and health development domains, as well as increased school readiness.

The Agency continued to fund the Aboriginal Head Start in Urban and Northern Communities (AHSUNC) program in collaboration with the provinces, territories and community organizations to provide culturally appropriate programs and activities for pre-school First Nations, Métis and Inuit children and their caregivers or parents. The program provided opportunities for preschoolers to learn readiness skills and acquire healthy living habits. At the same time, their parents and caregivers learned about healthy child development, practical child safety tips and what resources and services were available to them. During 2007-08, over 4,500 children were enrolled in 129 sites.  

As a member of the link Joint Consortium for School Health (a federal/provincial/territorial health and education consortium), the Agency contributed to the promotion of a comprehensive and coordinated approach to school health across Canada through knowledge development, leadership and capacity building.

The Agency also supported the operations of the Canadian Health Network in its final year of operation. During 2007-08, the Network delivered quality, non-commercial health promotion information to over 4 million visitors to its website. Work was undertaken to enhance the Agency's own website to provide key health promotion information so that the continuing needs of the users would be met.

Other steps taken by the Agency focussed on enabling better collaboration, increased understanding and improved policies. For example, the Agency negotiated agreements on Physical Activity and Healthy Eating with eight jurisdictions (Alberta, British Columbia, New Brunswick, Northwest Territories, Nova Scotia, Nunavut, Ontario and the Yukon) to identify areas of common understanding for priority action and resources.

PHAC facts...

A 2008 FASD summative evaluation found that 38% of respondents viewed the initiative as a key contributor to the change in the level of maturity within the communities over the past five years.

In 2007-08, the Agency supported the release of a report titled link Canadian Journal of Public Health and the Journal of Applied Physiology, Nutrition and Metabolism in November 2007.

The Agency continued its surveillance of injuries in Canada, helping to identify trends, issues and priorities. For example, it supported and led the modernization of the Canadian Hospitals Injury Reporting and Prevention Program, and maintained up-to-date information for an link on-line injury surveillance website, contributing to the evidence base for injury prevention.

PHAC facts...

The CIS underwent a 2003 process evaluation which identified areas for improvement in efficiency and effectiveness in training material and data collection which have since been implemented. The CIS will be evaluated in 2008-10 after its third cycle.

The Agency led the link Fetal Alcohol Spectrum Disorder (FASD) Initiative, which fosters a better understanding in Canada of the impact of alcohol use during pregnancy. The initiative aims to prevent alcohol-affected births and mitigate the impact of those already living with the condition. Funded projects resulted in advances in counselling women of child-bearing age and screening pregnant women for alcohol use. The Agency sponsored a National Roundtable on the Development of a Canadian Model for Calculating the Economic Impact of FASD which contributed to improving the tracking of both the economic and social costs of FASD, and to strengthening intervention planning, implementation and evaluation.

PHAC facts...

Recognizing that the achievement of results is cumulative and long-term, a recent release of the link earlier evaluation that found in general that initiatives and the responsible organizations provided relevant and value-added information.

In 2007-08, the Agency worked with all provinces and territories on the surveillance of both intentional and unintentional injury through tools such as the Canadian Hospitals Injury Reporting and Prevention Program and the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS). The CIS has been expanded to strengthen the data collection for child maltreatment for First Nations, Inuit and Métis children.

Along with Health Canada, the Agency co-led an Interdepartmental Task Force to coordinate a potential federal strategy to address mental health and mental illness in Canada. The Agency also participated in the creation of a Mental Health Issue Group, a sub-group of the federal, provincial and territorial Public Health Network Population Health Promotion Expert Group.

The Agency continued to lead on healthy aging issues for seniors through its work on emergency preparedness and seniors; age-friendly communities; seniors’ falls prevention and seniors’ mental health. The Agency also contributed to knowledge development and transfer by providing link useful resources on seniors' falls prevention, age-related chronic diseases, health promotion/public health issues in printed format (over 150 000 printed resources) and electronic dissemination (over 270,000 unique visitors).

PHAC facts...

Federal Health Minister Tony Clement link received an international award from Help the Aged UK, distinguishing him as a leader on seniors' health issues. Dr. Jane Barratt, Secretary General of the International Federation on Ageing, acknowledged the leadership that the Agency has shown in a World Health Organization project developing an Age-Friendly Cities Guide. With 33 participating cities across the globe (including four Canadian cities), the project analyzed the needs of an aging population and created the guide to help communities make their urban centers more age-friendly. This ground-breaking initiative provides the tools necessary for cities to make their communities better, healthier and safer places for seniors – and persons of all ages - to live and thrive

During 2007-08, the Agency engaged domestic and international partners to develop and document the most effective means of addressing the factors that determine health and health inequalities, based on documented research findings. The Agency was successful in influencing the international agenda of the WHO to include issues particularly relevant to Canada (e.g., addressing the determinants of Indigenous Peoples’ health). Additionally, the Agency facilitated communication, knowledge translation and multi-jurisdictional collaboration through the establishment of the Canadian Reference Group for the WHO Commission on Social Determinants of Health, a civil society network and links to the business sector to help advance work on health disparities.


All Health Promotion Program Activity work planned in the Report on Plans and Priorities (RPP) for the fiscal year 2007-08 was successfully achieved with the exception of: 

  • The Canadian Hospitals Injury Reporting and Prevention Program completed its modernization but did not release an annual report until 2008-09. This program is carried out in partnership with fourteen hospitals across the country, and operates with information systems, training, and services provided by the Agency. 

Benefits to Canadians

The Agency made progress toward its expected results of improved health behaviours; improved health and well-being; and reduced health disparities through knowledge development and translation; collaborative policy development; public awareness efforts; and the development, assessment and monitoring of information and related systems. For more information on this program activity, please visit: link (

Program Activity – Disease Prevention and Control

Financial Resources ($ millions)
Planned Spending Total Authorities Actual Spending
311.8 290.3* 240.5**
* The $21.5 million net decrease between planned spending and authorities is due to:  (a) decrease of $16.9 million resulting from realignment of resources to cover increased requirements in other program activities; (b) decrease of $3.5 million due to reduction in Employee Benefit Plan costs; (c) decrease of $2.5 million for items in Supplementary Estimates (A) not included in Planned Spending; (d) decrease of $1.5 million for transfers to other departments in Supplementary Estimates (B), including to Health Canada for the Science Library Network A Base ($0.3 million), to Canadian Institute for Health Research for avian and pandemic research ($0.6 million), to Canadian Institute for Health Research for hepatitis C research training programs ($0.3 million) and to Department of National Defence for Chemical, Biological, Radiological-Nuclear and Explosives (CBRNE) Research and Technology Initiative (CRTI) acquisition plan ($0.3 million); and (e) increase of $2.9 million for transfers from Treasury Board votes to cover collective agreements ($0.8 million) and uncontrollable salary costs ($2.1 million).

** Actual Spending was $49.8 million lower than Authorities due to the deferment of $27.7 million in funding to subsequent fiscal years for Clean Air Agenda ($1.0 million), Canadian HIV Vaccine Initiative ($4.6 million), clinical trials related to Avian and Pandemic influenza ($15.6 million), and the Avian and Pandemic Winnipeg Laboratory and Space Optimization project ($6.5 million ). (Note that this laboratory is also known as the Logan, Ward or J.C. Wilt Laboratory.) $16.5 million was lapsed in operating expenditures due to delays in staffing and other capacity and technical restraints which impeded the full utilization of approved resources and $5.6 million was lapsed in transfer payments due to delays in the approval and solicitation process and transition to the Canadian Strategy for Cancer Control.
Human Resources (Full-Time Equivalents)
Planned Actual Difference
1282 1168 114*
*The difference of 114 Full-Time Equivalents is due to:  (a) delays in the staffing process; (b) difficulty in finding qualified personnel because of low labour market availability for positions requiring unique public health specialization; and (c) constraints due to shortage of accommodation space.

The Agency develops and implements policies and programs to prevent, control and reduce the impact of disease and injury. Disease prevention covers measures not only to prevent the occurrence of disease (e.g., risk factor reduction), but also to stop its progress and reduce its consequences once established. Disease prevention actions usually emanate from the health sector, dealing with individuals and populations identified as exhibiting identifiable risk factors, often associated with different risk behaviours. Disease control means ongoing operations or programs aimed at reducing incidence and/or prevalence, or elimination of such conditions.  

Performance Analysis

1. Decreasing the Proportion of Canadians who Develop or Acquire Disease

PHAC facts...

In the link May 2008 Report of the Auditor General of Canada, the Agency's surveillance of infectious diseases was examined and assessed. The Report concluded that “the Agency has the capacity and systems to detect an emerging infectious disease, a new strain of an existing disease, or a re-emerging infectious disease. We also conclude that the informal mechanisms for detecting and monitoring these diseases need to be strengthened. Coupled with gaps and delays in the supply of the data by the provinces and territories, this means that the Agency cannot always systematically analyze and report information on public health threats. The Agency is working to improve how it communicates relevant information to its partners.” The Agency has also made several commitments to address other recommendations.

Work to decrease the number of Canadians developing or acquiring diseases included public health surveillance; immunization and pandemic preparedness; prevention and control measures; and provision of unique research and testing capabilities:

Public Health Surveillance

Public health surveillance is the ongoing, systematic use of routinely collected health data to guide timely public health action. Surveillance without effective follow-up does not limit disease, but it is critical to Canada's ability to anticipate, prevent, identify, respond to, monitor, and control diseases and injuries – and to the federal government's ability to design, deliver and evaluate public health activities. For this reason, surveillance is a core function of the Agency.

To obtain the needed information on what is impacting the health of the Canadian population, the Agency worked with federal departments and agencies and other levels of government, as well as health professionals, hospitals and laboratories across the country to deliver and improve approximately 20 public health surveillance programs.

Understanding and tracking chronic diseases, their risk factors and determinants with effective surveillance is a key element of chronic disease prevention and control. To address significant risk factors (e.g., obesity) or to understand the impact of changing demographics, chronic disease surveillance systems provide baseline information and track trends. To support planning, decision-making and measurement of progress, as well as to inform policies, programs, and services on chronic diseases, the Agency continued to provide timely, ongoing and comprehensive health information through its website, reports, conferences, and consultations with governments and stakeholders. The expansion of existing data sources (i.e., national data sources, Statistics Canada surveys, the Canadian Cancer Registry, hospitalization and mortality databases) was achieved with the addition of data from provincial and territorial health care system databases. link Existing public analytic tools were also expanded to generate maps, graphs and tables of chronic diseases and their risk factors by region across Canada. Collaboration in 2007-08 with provinces and territories to develop a National Chronic Disease Surveillance System led to the approval of a Chronic Disease Surveillance Action Plan in April 2008.

The Agency continued to operate laboratories with strong analytical and research capabilities to help determine whether infectious disease cases are linked, whether there were new disease agents and how to combat transmission. Agency disease prevention and control resources also worked with partners across Canada to identify diseases and conditions to be monitored and reported, to establish what information is important to track and to help create agreements for information to be shared. The Agency received, stored, quality tested and analyzed the data; and published information products including the link Respiratory Virus Detections/Isolations in Canada and the link Transfusion Transmitted Injuries Surveillance System Report.

PHAC facts...

In the May 2008 Report of the Auditor General of Canada, the development of the Global Public Health Intelligence Network (GPHIN) was cited as a major accomplishment for Canada. According to the report, Canada, other countries, and WHO depend on this system as an essential source of information about the spread of new infectious diseases. link An analysis by WHO found that during 2001 and 2002, the Network supplied about 40 percent of WHO's early warning outbreak information.” GPHIN information accounts for over 50 percent of first-time reports of international public health events provided to the WHO.

The Agency continued to operate and enhance the Canadian Network for Public Health Intelligence, used by all provinces and territories, providing a method for distribution of information about relevant public health events. An Agency-developed system called the link Global Public Health Intelligence Network (that continuously scans media reports from around the world in eight languages, with human analysts to filter and interpret the output) – continued to be relied upon by governments and international bodies as an essential information source about the spread of new infectious diseases.

The Agency undertook the implementation of the cell/tissue/organ transplantation and assisted human reproductive surveillance system, intensified/ enhanced surveillance of hepatitis B and C and needle stick injuries, and led a federal government initiative to monitor bird flu (avian influenza) in wild birds and potential human cases.


Carried out by Canada's provinces and territories, immunization has proven to be one of the most cost-effective public health interventions. To help fulfill the federal role, the Agency collaborated internationally on issues related to immunization and vaccine-preventable infectious diseases, and also provided scientific, program, policy, information dissemination, coordination and administrative support to the National Advisory Committee on Immunization, and the federal, provincial and territorial Canadian Immunization Committee (CIC). With Agency support, the CIC developed scientific and programmatic recommendations on Human Papillomavirus (which is associated with cervical cancer) to inform provinces and territories of options for immunization program planning.

As part of its leadership role in preparing for a potential avian or pandemic influenza, the Agency continued to administer contracts to develop and maintain domestic pandemic vaccine production and testing capacity.

To support the Canadian HIV Vaccines Plan and to contribute to the global response, the Agency participated in the link Canadian HIV Vaccine Initiative. Partners in this Initiative include Health Canada, the Canadian Institutes of Health Research, the Canadian International Development Agency, Industry Canada, and the Bill and Melinda Gates Foundation. In addition, the Agency supported activities to increase manufacturing capacity for HIV vaccine clinical trial lots; strengthen policy approaches for HIV vaccines, promote the community and social aspects of HIV vaccine research and delivery; and enhance horizontal collaboration with domestic and international stakeholders.

Prevention and Control of Infectious Diseases

PHAC facts...

The seven-year evaluation (1999-2000 to 2005-06) of the hepatitis C component of the Communicable Disease and Infection Control program recognized the significant strides made to address the hepatitis C epidemic. The program had an impressive record of achievement including: extensive capacity building; increased research capacity; significant efforts toward prevention; and establishment of key partnerships / collaborations. As a result, the Government approved funds to the Agency for “A Renewed Public Health Response to Address hepatitis C” to sustain and build on the accomplishments achieved to date.

The Agency provided a national focus on communicable diseases and for foodborne, waterborne, and animal-carried infections. The Agency continued to maintain and publish guidelines for the prevention, diagnosis, treatment and management of disease such as hepatitis C, HIV/AIDS, Sexually Transmitted Infections and Tuberculosis. Its Infection Control Guideline series is widely used by health care providers, governments and other institutions as a source of best practice information used for the prevention and control of infections in health care facilities. These link guidelines have now been adapted for the entire spectrum of Canadian health care providers, such as acute and long-term care, office and outpatient care, and home care.

PHAC facts...

A process evaluation to assess HIV/AIDS program relevance is underway and will be finalized in the fall 2008. A comprehensive evaluation is planned for 2009-10.

The Agency continued to lead the link Federal Initiative to Address HIV/AIDS in Canada, a partnership that includes Health Canada, the Canadian Institutes of Health Research and Correctional Service Canada. The Agency provided $20 million to community-based organizations to carry out 163 national and front-line activities across Canada. These activities – aligned with the Agency’s work in surveillance, behavioural studies, laboratory quality assurance and strain surveillance and key population-specific status reports – are designed to work together to achieve Federal Initiative results in the area of improved access to more effective HIV/AIDS prevention, diagnosis, care, treatment and support for populations most affected by HIV/AIDS in Canada.


The Agency's laboratories, which are important for surveillance and for responding to health emergencies such as SARS or pandemic influenza, conduct scientific research and development in a wide range of areas related to viral, bacterial and prion infectious agents. They identify novel agents (e.g., new strains of influenza virus) as they arise, using a variety of approaches including genomics, proteomics (the study of the structure and function of proteins) and bioinformatics. They develop and apply these modern public health technologies to diagnostics, vaccines, and molecular epidemiology. 

During 2007-2008, the Agency continued to develop unique capabilities as a national resource, with a focus on infectious disease prevention and control, the application of biotechnologies and genomics to population health, and mitigation of human illnesses arising from the interface between humans, animals, and the environment. Agency research supported public health officials and decision-makers in preventing and controlling disease in Canada.

2. Maintain and Enhance Quality of Life; and Minimize Complications and Premature Deaths in Persons with Disease

Steps taken during 2007-08 to maintain and enhance quality of life and to minimize complications and premature deaths in those with disease included the previously discussed initiatives in HIV/AIDS, plus the following disease-specific initiatives:


In collaboration with the National Cancer Institute of Canada, the Canadian Cancer Society, and Statistics Canada, and under the guidance of the Canadian Cancer Statistics Steering Committee, the Agency provided the analysis and statistical support for the production of the link 2008 Canadian Cancer Statistics contributing in particular to the special chapter on childhood cancer, which was the theme for that year. This annual publication was widely distributed, read and referred to by health care professionals, researchers and policy makers working in the cancer field across Canada.


The Agency’s collaboration with provinces and territories to update and enhance the link Highlights from the National Diabetes Surveillance System was released detailing ongoing, systematic and validated Canadian analysis for basic prevalence and other diabetes information. This report included two special Aboriginal projects conducted with the Québec James Bay Cree and the British Columbia First Nations populations. Discussions with National Aboriginal Organizations, researchers, and provinces and territories took place to determine how the NDSS is being used and how it could be used to support Aboriginal public health surveillance. Contribution agreements were put in place with three provincial Métis organizations to link their registries to the NDSS.

Building on the success of the NDSS in tracking diabetes prevalence in Canada in a cost-effective manner, the foundation was laid in 2007-08 for the scope to be expanded to become the National Chronic Disease Surveillance System.

Cardiovascular Disease (CVD)

PHAC facts...

Agency’s support and collaboration with the Canadian Hypertension Education Program enabled real improve­ments in the management of high blood pressure in Canada. Two CVD implementation reviews carried out in 2005-06 and 2006-07 found efficient coordination and governance structures. As well, based on data from a link 2007 independent survey, Canada is a world leader in high blood pressure treatment and control.

Agency analysis of the data from the 2005 Canadian Community Health Survey conducted by Statistics Canada has revealed some startling facts. Nine in ten adult Canadians have at least one risk factor for cardiovascular disease and one in three have three or more risk factors (i.e., smoking, inadequate consumption of fruits and vegetables, high blood pressure, diabetes, overweight or obesity, high stress, and physical inactivity). To help address these issues, the Agency funded the development of a Canadian Heart Health Strategy and Action Plan, anticipated to be submitted to the federal Minister of Health in the fall of 2008. In the interim, the Agency continued its collaboration with the Canadian Hypertension Education Program, Blood Pressure Canada and the Canadian Hypertension Society to reduce high blood pressure prevalence and incidence in Canada.

3. Decreased Personal, Social and Economic Burden of Disease for Individuals and Society

PHAC facts...

The burden of preventable death and disease has been growing in Canada and internationally, reducing quality of life, increasing wait times for care, and challenging the sustainability of the health system. Agency analysis of link Statistics Canada’s Mortality Database and the 2005 Canadian Community Health Survey has discovered that chronic diseases cause four out of five deaths in Canada Two Canadians out of five aged 12 and over have at least one chronic disease. As these diseases are more prevalent in older people, the burden is growing as Canada’s population is aging. Many of these chronic diseases have one or more common risk factors (e.g., smoking, inadequate consumption of fruits and vegetables, high blood pressure, diabetes, obesity, high stress, and physical inactivity).

The steps taken above to minimize disease prevalence and the steps taken to reduce the impact of the disease the persons and families affected will assist in decreasing the personal, social and economic burden of disease for individuals and society. The Agency also continued to develop risk analysis and modeling methods that support policy and regulatory decision making processes, to support reducing the burden of disease in Canada and internationally. 

4. Strengthened Response to Managing Diseases in Canada

The Agency fostered new partnerships and networks; coordinated networks of scientific experts, public health officials, advisory committees and working groups; proposed prevention and control strategies through sound policy analysis and public health advice; and targeted risk analysis and research to investigate diseases of provincial and/or national importance. These steps as well as others taken in the program activity strengthened the response to managing diseases in Canada.

Support from the other Program Activities

Initiatives undertaken in the Health Promotion program activity also support the achievement of minimized disease prevalence and decreased burden of disease. The same two expected results are supported by work done under the Emergency Preparedness and Response program activity, which funds the provision of quarantine services to safeguard the health of Canadians against communicable diseases that could be carried into Canada from abroad.

The work done in the Strengthening Public Health Capacity Program Activity supports the achievement of all the Disease Prevention and Control expected results. Relevant initiatives included the negotiation of information sharing agreements with the provinces and territories which are vital for secure surveillance; development and publication of a Surveillance Strategic Plan, and providing surveillance tools; training public health professionals in identifying and properly responding to infectious disease outbreaks, and providing tools such as the geographic information systems program; developing methods to better estimate the economic burden of illness in Canada, and publishing reports with such estimates; and supporting the National Collaborating Centres whose knowledge development and exchange work provides important information that the Agency makes available to stakeholders.


All Disease Prevention and Control Program Activity work planned in the RPP for the fiscal year 2007-08 was successfully achieved with the exception of:

  • The publication of the sixth report on heart disease and stroke in Canada was delayed until 2008-09.
  • Work began to revise the on-line data management and entry system for the winter 2007 national childhood surveillance study of cancer. However, due to short delays, the revised system did not come into operation in 2007-08.
  • While the Agency continued funding the Canadian Breast Cancer Initiative, planned funding was excluded for care and treatment which are now under the mandate of the Canadian Partnership Against Cancer Corporation.
  • The Canadian Immunization Committee, co-chaired and supported by the Agency, developed scientific and programmatic recommendations on Human Papillomavirus (HPV) to inform provinces/territories of options for immunization program planning. This work involved collaboration between the Canadian Immunization Committee and National Advisory Committee on Immunization Working Group. With Agency leadership and support, the Canadian Immunization Committee also developed draft scientific and programmatic recommendations on meningococcal vaccine programs. At the end of 2007-08, these recommendations were pending final review and approval.
  • The Agency completed the planning and field work phase of the formative evaluation of the link Federal Initiative to Address HIV/AIDS in Canada. The Agency reviewed internal documents and conducted key interviews to assess relevance, progress, and issues related to the delivery and design of the Federal Initiative during the period 2003-04 to 2006-07. It is expected that the evaluation report will be finalized in 2008.
  • Although a national registry for bone marrow transplant recipients was not established in 2007-08 (awaiting access to the National Microbiology Laboratory infrastructure), the Agency made notable progress on several contributing activities. For example, the Agency worked on creating the Canadian Bone Marrow Transplantation Surveillance System to assess the incidence and risk of transmission of bloodborne pathogens like HBV, HCV and HIV in bone marrow recipients.
  • The Agency undertook the implementation of a national cell, tissue, organ and assisted human reproduction surveillance system. At the end of 2007-08, the system remained in its pilot phase because some data were not yet available from the provinces/territories.
  • The Agency did not start clinical trials on a H5N1 mock pandemic vaccine produced in Canada. A contract was in place with GlaxoSmithKline Inc. (GSK) to undertake the clinical trials, but due to changes in company ownership, GSK did not solicit federal funding for the clinical trials in 2007-08. However, GSK proposals for clinical trials were received in 2008-09.  

Benefits to Canadians

The Agency made progress toward its expected results of decreased proportion of Canadians who develop or acquire disease; maintained and enhanced quality of life; fewer complications and premature deaths in those with disease; decreased personal, social and economic burden of disease for individuals and society; and strengthened response to managing diseases in Canada through public health surveillance; immunization and pandemic preparedness; activities to prevent and control of infectious diseases; and provision of unique research and testing capabilities. For more information on this program activity, please visit: link (

Program Activity – Emergency Preparedness and Response

Financial Resources ($ millions)
Planned Spending Total Authorities Actual Spending
115.9 137.8* 121.3**
* The $21.9 million net increase between planned spending and authorities is due to:  (a) increase of $13.1 million resulting from realignment of resources between program activities to cover increased operating requirements; b) increase of $8.5 million for transfers from Treasury Board votes for the operating budget carry-forward from 2006-07 ($7.7 million), and to cover other operating requirements such as collective agreements ($0.2 million) and uncontrollable salary costs ($0.6 million); (c) increase of $0.2 million for Employee Benefit Plan costs; and (d) increase of $0.1 million for items in Supplementary Estimates (A) not included in Planned Spending.

** Actual Spending in operating expenditures was $16.5 million lower than Authorities due to:  (a) the deferment of funding for National Antiviral Stockpile to subsequent fiscal years ($12.5 million); and (b) capacity and technical constraints which impeded the full utilization of approved resources ($4.0 million).
Human Resources (Full-Time Equivalents)
Planned Actual Difference
367 353 14*
*The difference of 14 Full-Time Equivalents is due to: (a) delays in the staffing process; (b) difficulty in finding qualified personnel because of low labour market availability for positions requiring unique public health specialization; and (c) constraints due to shortage of accommodation space.

The Agency provides a national focal point for anticipating, preparing for, responding to and facilitating recovery from threats to public health, and/or the public health complications of natural disasters or human caused emergencies.

Performance Analysis

PHAC facts...

In 2007-08, the Agency successfully conducted such emergency exercises as:

  • link CADEOUS MAJOR 07, the largest, most complex exercise of its kind in Canadian history (which built on lessons learned from smaller exercises held in June and in October 2006);
  • BI-EX WEST, a series of two tabletop exercises and one field trial designed to enhance the capability of organizations to respond to biological terrorist events; and
  • JUDICIOUS ALERT to test the notification process and issues management to be used during the first few hours following the identification of an influenza pandemic index case in Canada.

The Agency's link International Health Regulations (IHR) and the link Canada–US–Mexico Safety and Prosperity Partnership Agreement.

In 2007-08, the Agency put in place Canada's first link Health Emergency Response Team (HERT) in Eastern Ontario/Western Quebec. With more than 200 people in rapid response, mission support and medical response teams, this HERT was recruited, trained and exercised to readiness standards where they would make a measurable contribution to public health and safety in a disaster. All aspects of a HERT Unit deployment involving logistics, equipment and supplies, were validated as a planning function and in a field environment. While the unit is ready for deployment, there has been no request from provinces and territories for federal assistance.

Memoranda of Understanding (MOUs) were developed and implemented between the Agency and its international partners (e.g., WHO, the US Centers for Disease Control, and European partners) who were connected to the Agency's Health Portfolio Emergency Operations Centre. The MOUs allowed units within the Agency to build relations with respective international partners. Operational procedures and processes were put in place during February 2008, including regular tests conducted with the international partners. Communication testing between Canada and the US were expanded to include Mexico.

The Agency provided funding and secretariat support for expert groups on emergency preparedness and response including the Pandemic Preparedness Health Operations Coordination Expert Working Group, the Public Health Network Council, the Council of Chief Medical Officers of Health, the Council of Health Emergency Management Directors (provincial and territorial disaster, health, and emergency health personnel) and the Council of Emergency Social Services Directors. 

The Agency began significant work towards the implementation of the WHO’s IHR. In 2007-08 the basic structure was put in place for the Agency's Emergency Operations Centre system to have capacity to operate around the clock – required for achieving IHR compliance by 2012.

Agency expertise in laboratory biosafety is recognized worldwide and as one of five designated WHO Biosafety Collaborating Centres, the Agency provided training to over 18 African countries in a week-long biosafety outreach workshop. The Agency was mandated to implement the Human Pathogens Importation Regulations and issued approximately 2000 import permits to allow human pathogens to enter Canada into approved laboratories. In 2007-08 the Agency published and continued to maintain the link Laboratory Biosafety Guidelines to ensure that best practices are used in Canadian labs, thus protecting the health of workers, the community and the environment. In addition, the Agency monitored for any accidental release of biological materials from certified facilities.

The Agency provided link $25 million funding to InterVac – the International Vaccine Centre to be located in Saskatchewan which will focus on vaccine development for both animal and human pathogens. The Agency also provided a detailed, technical microbiological and engineering biocontainment review as the preliminary step to the facilities inspection and certification to ensure compliance to the national biosafety guidelines.

The Agency operated a nationwide quarantine service staffed by nurses and physicians based at the six airports that have 94% of international travellers: Vancouver, Calgary, Toronto, Ottawa, Montreal and Halifax. Three additional quarantine officers were hired during 2007-08 to augment coverage for the Vancouver, Montreal and Halifax marine ports.

The Agency strengthened its regional presence across the country by expanding the role of its link Regional Offices and adding core public health functions such as emergency preparedness and response, public health knowledge development and exchange, public health policy, planning and intergovernmental relations, surveillance and coordination of the Canadian Public Health Service Program.

Support from the Agency's other Program Activities

The achievement of the Emergency Preparedness and Response expected result was assisted by the work done for the strengthening public health capacity program activity (e.g., expanding and training the public health workforce, negotiating agreements to share information and to provide mutual aid in the event of a public health emergency, and providing information systems to monitor public health incidents and quickly identify outbreaks).

Work done in the Agency's Disease Prevention and Control Program Activity also helps to ensure that Canada is one of the countries best prepared to respond to the public health risks posed by natural and human-caused disasters. For example, laboratories are staffed with scientific and technical personnel capable of identifying outbreak strains and test pathogen infectiousness – and how a spread can be stopped – is an important element of preparedness for a future outbreak.

All Emergency Preparedness and Response Program Activity work planned in the RPP for the fiscal year 2007-08 was achieved. 

Benefits to Canadians

The Agency made progress toward its expected result of “Canada is one of the countries best prepared to respond to the public health risk posed by natural and human-caused disasters, such as infectious disease outbreaks, hurricanes, floods, earthquakes and criminal or terrorist acts such as explosions and the release of toxins” by conducting its planning and testing of exercises, and negotiating and implementing international commitments. For more information on this program activity, please visit: link (

Program Activity – Strengthen Public Health Capacity

Financial Resources ($ millions)
Planned Spending Total Authorities Actual Spending
55.6 55.8* 53.0**
*The $0.2 million net increase between planned spending and authorities is due to:  (a) increase of $1.0 million for transfers from Treasury Board votes for the operating budget carry-forward from 2006-07 ($0.2 million), and to cover collective agreements ($0.2 million) and uncontrollable salary costs ($0.6 million); (b) increase of $0.1 million for items in Supplementary Estimates (A) not included in Planned Spending; (c) decrease of $0.3 million resulting from realignment of resources between program activities; and (d) decrease of $0.6 million due to reduction in Employee Benefit Plan costs.

** Actual Spending was $2.8 million lower than Authorities due to capacity and technical restraints which impeded the full utilization of approved resources ($2.3 million in operating expenditures) and due to delays in the approval and solicitation process ($0.5 million in transfer payments).
Human Resources (Full-Time Equivalents)
Planned Actual Difference
311 263 48*
*The difference of 48 Full-Time Equivalents is due to:  (a) delays in the staffing process; (b) difficulty in finding qualified personnel because of low labour market availability for positions requiring unique public health specialization; and (c) constraints due to shortage of accommodation space.

Working with national and international partners, the Agency developed tools, applications, practices, programs, training and understandings that supported, improved and expanded the capabilities of public health practitioners across Canada.

Performance Analysis

PHAC facts...

The Agency has Canada’s foremost field epidemiology training program which has produced some of the country’s leading medical and public health professionals. This program has contributed to the investigation of outbreaks and environmental health risks across Canada and around the world.

The public health human resources were strengthened by providing training opportunities in public health; developing and delivering on-line modules for distance learning in public health; identifying the core competencies for public health practice; providing scholarships and bursaries for research work and career advancement in public health; deploying human resources in support of surveillance and disease control as part of surge capacity in jurisdictions; negotiating with Agency partners for these deployments across Canada; and providing essential support to the Public Health Human Resource Task Group and its working groups.

Knowledge and information systems were strengthened by promoting link Public Health Information System – a tool provided to provinces and territories to support public health case management and better surveillance of outbreaks. The Agency provided support to the National Collaborating Centres for knowledge translation activities; enhanced the Agency data infrastructure including acquisition, cleaning, value-added restructuring and analysis, and provided data access to professionals across the Agency. The Agency also provided essential support to the Surveillance and Information Expert Group of the Public Health Network; worked with national partners to prepare a Memorandum of Agreement on information sharing during public health emergencies; and established a surveillance strategic plan. As well, the link Chief Public Health Officer’s Annual Report on the State of Public Health in Canada was prepared in 2007-08 and published in 2008-09.

The public health law and ethics component was strengthened by concentrating on conducting research and analysis on law-based interventions, practices and tools; providing these analyses to practitioners to increase their knowledge base and strengthen their competencies in applying law and ethics to public health practice; and providing consultation and discussion opportunities to share best practices.   


All Strengthen Public Health Capacity Program Activity work planned in the RPP for the fiscal year 2007-08 was successfully achieved with the exception of: 

  • Finalizing a comprehensive professional development plan for all Agency staff. Although the Agency worked to finalize a comprehensive professional development plan for its staff in 2007-08, it was determined that more time will be required to gather staff learning needs in some key competency areas such as surveillance and chronic diseases, which are  two of the key functions that the Agency performs. The plan will be tabled with Senior Management of the Agency in 2008-09. 
  • Launching three new modules in its Skills Enhancement for the Public Health Program. The Agency piloted three modules and launched two others -"Basic Biostatistics" and "Communicating Data Effectively”. 
  • Due to shifting priorities, the Agency did not collaborate with the WHO in developing public health legislative strategies and tools intended for tabling at the World Health Assembly in 2008. Priorities were shifted to reflect the immediate need to address implementation of the link International Health Regulations, a legally-binding agreement administered by the WHO to help countries to identify, contain and control health risks. 

Benefits to Canadians

Overall, the Agency’s initiatives increased public health capacity in Canada and helped the Agency achieve progress in preparing the country for health emergencies, and in providing national leadership for disease prevention and control. For more information on this program activity, please visit: link (

Overall Lessons Learned

Having been created in September 2004, the Agency is at an early stage of development and performance. However, there have already been some overarching lessons learned.

Partnerships and Stakeholders

Given that the Agency’s expected results and strategic outcome are realized over the long term, it is important to make progress on those areas where the Agency’s federal role is clearly defined. Since the public health system involves many partners and stakeholders, effective consultation with government and non-government stakeholders is a pre-requisite for successful policy implementation which requires openness, thoughtful negotiations, and program delivery. This lesson was also learned as part of the Agency’s first phase of an link initiative on intersectoral action (IA) for health which examined approaches at the global, sub-regional, national, sub-national, and community levels in more than 15 countries and found that:

  • The broader context for decision-making (political, economic and socio-cultural) affects how issues are framed and the choice of approaches (including IA), mechanisms and tools to address the problem. 
  • IA is a strategy that can address a wide range of health problems. 
  • IA is both dynamic and resource-intensive in terms of people, money and time. 
  • As the number of partners and interests increases, logistical challenges make it more difficult to initiate and sustain IA. More documented success stories of IA appear at the community level than at the national and global levels, and many sources acknowledge the problem of increasing complexity at higher levels of governance 

Other initiatives have shown that partnership-enabled community-based organizations to extend their reach and undertake programs much more effectively than on their own. Collective action undertaken through partnership development and collaboration with others is more likely to achieve success. This is particularly valuable in the areas of promotion and advertising since using partners enhances program participation rates. Similarly, finding and supporting "champions" – people/organizations who are committed to the work – is essential to the development and implementation of initiatives. The importance of building a shared vision is another critical success factor in ensuring the initial and ongoing commitment of partners. The need for continuous communication and associated mechanisms is fundamentally important for policy changes affecting many stakeholders.


Over the years, the Office of the Auditor General of Canada (OAG) has assessed the surveillance of infectious diseases (including when such responsibilities belonged to Health Canada prior to the Agency’s creation). In the May 2008 report, the OAG acknowledged that the Agency has a strong laboratory capacity that provides a base for detecting and describing new diseases. However, more work needs to be done with partners to establish an action plan for implementing the MOU on the sharing of information during a public health emergency. The Agency has committed to take action to address these and other concerns. For example, while the MOU has not been officially approved, the Agency is already working to implement the MOU, as it is on the meeting agenda of the F/P/T Ministers of Health in September 2008. In addition, the Agency made progress by developing a surveillance strategy and establishing the Surveillance Integration Team to improve and better integrate surveillance activities across the Agency. link (

Public Service Renewal

PHAC facts...

Public Service Renewal “is about making sure that the federal public service preserves and strengthens its capacity to contribute to Canada’s successes through the delivery of excellent public services and policy advice”.

As a new organization, there has been a high risk in the Agency's ability to attract and retain competent and skilled people, and in developing internal capacity to address skill requirements needed to deliver on its commitments. In an effort to address these issues, the Agency took a step forward towards developing an Integrated Business and Human Resource Plan to strengthen succession planning, to identify gaps in the workforce, and to put in place the human resource strategies to close those gaps and meet business needs. The Agency will improve integration based on lessons learned from the previous planning exercise in support of link Public Service Renewal.

Revising and improving plans is an indication of sound management practices. Plans are expected to change in response to lessons learned from past performance as well as new circumstances. Thus the Agency intends to continue to validate its link 2007-12 Strategic Plan on an annual basis.

Management, Results and Resources Structure

Developing a sustainable and useful link Management, Results and Resources Structure (MRRS) is a major undertaking that requires dedicated time, effort and leadership from all management levels, planning and performance advisors, functional specialists (e.g., finance, human resources, science), and others. As the Agency looks to redevelop its MRRS, it will apply lessons from previous exercises to identify what works well, what does not, and what is essential to fulfill the MRRS policy objective.

Audit and Evaluation

The Agency has made significant progress in developing its internal audit capacity with the establishment of an link Internal Audit Committee including a panel of 3 distinguished external, independent members. Invaluable audit lessons learned, oversight and guidance are the cornerstone elements for the way ahead.

The Agency requires additional evaluation information to assess the effectiveness of its program activities. A link five-year Evaluation Plan will be developed to inform senior management of the scope of the Agency’s evaluation commitments to the Treasury Board Secretariat (TBS). This Plan will help to ensure compliance with the requirements of the Federal Accountability Act and to evaluate 100% of grant and contribution programs. A copy of the approved Plan will be forwarded to TBS and will be available on the Agency website.

In preparing for the implementation of the upcoming TBS Evaluation Policy, the Agency will be reviewing its evaluation processes and products. Examples of activities include reviewing the Terms of Reference for the Evaluation Advisory Committee; revising the format and content of the Agency Evaluation Plan; and developing an Agency-specific Evaluation Policy.