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Table 7: Horizontal Initiatives

  1. Federal Initiative to Address HIV/AIDS in Canada (FI)
  2. Preparedness for Avian and Pandemic Influenza
  3. Canadian HIV Vaccine Initiative (CHVI)

1. Name of Horizontal Initiative:  Federal Initiative to Address HIV/AIDS in Canada (FI)

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

3. Lead Department Program Activity:  Infectious Disease Prevention and Control

4. Start Date of the Horizontal Initiative: January 13, 2005

5. End Date of the Horizontal Initiative: Ongoing

6. Total Federal Funding Allocation (annual): $84.4 million

7. Description of the Horizontal Initiative (including funding agreement): The FI is the Government of Canada’s response to HIV/AIDS in Canada. The initiative strengthens domestic action on HIV and AIDS, builds a coordinated Government of Canada approach, and supports global health responses to HIV/AIDS. It focuses on prevention and access to diagnosis, care, treatment and support for those populations most affected by HIV and AIDS in Canada - people living with HIV/AIDS, gay men, Aboriginal people, people who use injection drugs, federal inmates, youth, women, and people from countries where HIV is endemic. The FI also supports and strengthens multi-sector partnerships to address the determinants of health. It supports collaborative efforts to address factors which can increase the transmission and acquisition of HIV including sexually transmitted infections (STI) and also addresses co-infection issues with other infectious diseases (e.g., Hepatitis C and tuberculosis) from the perspective of disease progression and morbidity in people living with HIV/AIDS. Gender-based analysis and human rights analysis are fundamental to the approach. People living with and vulnerable to HIV/AIDS are active partners in shaping policies and practices affecting their lives.

8. Shared Outcome(s):

Immediate (Short-term 1-3 years) Outcomes:

  • Increased knowledge and awareness
  • Enhanced multi-sector engagement and alignment
  • Increased individual and organizational capacity
  • Increased coherence of federal response

Intermediate Outcomes:

  • Reduced HIV/AIDS stigma, discrimination and other barriers to better health outcomes
  • Improved access to effective HIV/AIDS prevention, diagnosis, care, treatment and support
  • Strengthened pan-Canadian response to HIV/AIDS

Long-Term Outcomes:

  • Prevention of new infections
  • Reduction of the progression  of the disease and improved quality of life for persons living with HIV or AIDS
  • Reduction of social and economic costs of HIV/AIDS to Canadians
  • Global effort to reduce the spread of HIV/AIDS and mitigate its impact

9. Governance Structure(s):

The Responsibility Centre Committee (RCC) is the governance body for the FI. It comprises representatives of the10 responsibility centres which receive funding through the FI. Led by the Agency, the RCC promotes policy and program coherence among the participating departments and agencies, and ensures that evaluation and reporting requirements are met.

The link Agency is the federal lead for issues related to HIV/AIDS in Canada. Within the Agency, six Responsibility Centres, the HIV/AIDS Policy and Programs Division, the Regions’ AIDS Community Action Program, Corporate Evaluation,  the Community Acquired Infections Division, the Surveillance and Risk Assessment Division, and the National HIV and Retrovirology Laboratories are responsible for overall coordination, national and regional programs, epidemiology, laboratory science, knowledge transfer, social marketing, policy development, communications, reporting and evaluation.

link Health Canada supports community-based HIV/AIDS education, capacity-building, and prevention for First Nations on-reserve and some Inuit communities; and provides leadership on international health policy and program issues.

As the Government of Canada’s agency for health research, the link Canadian Institutes of Health Research sets priorities for and administers the extramural HIV and AIDS health research program.

link Public Safety Canada, provides health services, including services related to the prevention, diagnosis, care and treatment of HIV/AIDS, to offenders sentenced to imprisonment for two years or more.

($ millions)
10. Federal Partners 11. Federal Partner Program Activity (PA) 12. Names of Programs for Federal Partners 13. Total
14. Planned

15. Actual Spending for
16. Expected Results for
17. Results Achieved in
Public Health Agency of Canada PA 1 Infectious Disease Prevention and Control a. HIV/AIDS $35.2 plus
$0.1 from
$27.6 plus
$0.1 from
$24.7 Increased awareness of HIV and AIDS epidemic in Canada and the factors that contribute to its spread:

- development of an Agency-led social marketing campaign and support for targeted campaigns in populations most at-risk

Increased availability and use of evidence through:
- augmented risk behaviour surveillance; and

- targeted epidemiologic studies (expansion of I-TRACK and M-TRACK) and development of programs in other at-risk populations (A-track for Aboriginal populations);

- improved knowledge and characterization of the transmission of drug-resistant HIV in Canada; and
- improved reporting on progress through the implementation of the FI’s performance management framework

Improved quality assurance in HIV testing through:

- maintenance and improved quality of HIV testing in Canada;

- enhanced ability to monitor the performance of testing kits and algorithms used in provincial public laboratories; and

- enhanced HIV reference services

Strengthened pan-Canadian response to HIV/AIDS through:

- the development of a population specific framework for the FI, and status reports for gay men, women, people from countries where HIV/AIDS is endemic, Aboriginal people, injection drug users, youth at risk, prison inmates and people living with HIV/AIDS; and

- the development of a national HIV/AIDS research planning and knowledge exchange framework to strengthen the availability and utilization of evidence to inform policies and programs

Increased and improved collaboration and networking through:

- the review and re-design of committees and advisory bodies

Improved access to quality prevention, diagnosis, care, treatment and support through:

- increased availability of evidence-based HIV interventions which address the determinants of health; and

- increased availability of evidence-based HIV interventions which address co-infections which increase the susceptibility to acquiring and transmitting HIV and other infectious diseases which increase disease progression and morbidity in people living with HIV/AIDS (e.g., Hepatitis C, Sexually Transmitted Infections (STIs), and tuberculosis (TB))

Increased capacity (knowledge and skills) of individuals and organizations through:

- support for health and education professionals by providing evidence based guidelines, training and technical assistance on issues related to HIV/AIDS and other infectious diseases

- the implementation of a national HIV/AIDS knowledge broker to gather, synthesize and disseminate HIV/AIDS knowledge to strengthen the capacity of front-line organizations to develop and implement evidence-based programs and interventions

- developing the capacity for monitoring and evaluation of the HIV/AIDS epidemic in Canada
Knowledge of the factors that contribute to the spread of HIV infection was advanced through augmented HIV and risk behaviour surveillance programs. HIV/AIDS sentinel surveillance programs continue to be established and implemented among at-risk populations to develop targeted studies addressing questions and gaps arising from case-reporting surveillance, and to provide statistical support for HIV/AIDS modeling efforts to assess the hidden epidemic and produce national HIV estimates. Publications included HIV and AIDS in Canada: Surveillance Report, and HIV/AIDS Epi Updates.

Targeted epidemiological studies were developed and enhanced. In 2008-09 the I-Track system, the Agency’s surveillance system that focus on injection drug users, saw the completion of the third round of data collection with a total of ten survey sites across Canada. The M-Track system, the surveillance system that focuses on gay, bisexual and other men who have sex with men (MSM), started a second round of data collection from over 3000 participants in Montreal and Vancouver. Milestones were attained in the development are three additional Track systems:  the A-Track (focused on Aboriginal peoples), the E-Track (focused on persons who originate from countries where HIV is endemic) and the P-Track (focused on persons with HIV infection).

Software to estimate HIV incidence from surveillance data was developed. Work with provinces and territories to enhance HIV surveillance and reporting continued.

Memoranda of Agreement were developed to support the province-based work and the tracking of HIV strain and drug resistance in Canada.  Agreements were signed with Nova Scotia and Saskatchewan, and are under development with Ontario and Alberta.

The HIV/AIDS Status Report for People from Countries where HIV is Endemic – Black People of African and Caribbean Descent Living in Canada was completed.

An expert working group was established to provide advice on the development of an HIV testing framework and associated guidelines and a consultation plan for the framework. Expertise was provided by health care professionals, community organizations, from specific at-risk population groups, and provincial partners selected in consultation with the federal, provincial and territorial Working Group on and AIDS.

The Committee on HIV/AIDS, the ADM Committee on HIV and AIDS, the National Aboriginal Council on HIV and AIDS and the Ministerial Advisory Council advanced policy and program work on multi-sector issues related to HIV and AIDS.

In collaboration with Human Resources and Skills Development of Canada, the evaluation of a project was funded to examine the impact of a case management approach to housing and HIV treatment adherence on the health status and quality of life of Aboriginal persons living with HIV and AIDS.  As a result of the success of this approach, more joint action is planned. Discussion was also initiated with Citizenship and Immigration Canada for collaborative work on the determinants of health.

Virtually all non-reserve Aboriginal community projects which were funded have adopted integrated approaches to programs and services addressing HIV/AIDS and Hepatitis C.

An intra-agency working group on HIV-Hep C-STI co-infection was established, and opportunities for future collaboration were identified.

In collaboration with Center for Disease Control, the Agency hosted a policy dialogue in conjunction with AIDS 2008 Mexico, to advance best practices on co-infection in high resource/low prevalence countries.

Twenty projects were funded under the Non-reserve First Nations, Inuit and Metis Communities HIV/AIDS Project Fund for total contributions of $1.8 million. Seven organizations focussing on specific populations received $0.6 million. Seven national organizations were funded $3.3 million under the national voluntary sector response fund and the Canadian AIDS Treatment Information Exchange. As a result, the voluntary sector response to HIV and AIDS was sustained, community capacity to address HIV and AIDS was increased, and community-based social marketing campaigns focussed on the needs of specific populations most affected by HIV and AIDS in Canada were produced.

Technical expertise was provided through the Pan American Health Association (PAHO) for the development of HIV strain and drug resistance surveillance in Latin America and the Caribbean region. Technical expertise was also provided through the United Nations Joint Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) for more effective utilization of surveillance data using modelling software to estimate HIV incidence.

Policy expertise was provided to: the 53rd Session of the Commission on the Status of Women for care giving in the context of HIV; the 4th International Policy Dialogue on HIV/AIDS and Disability to assist in setting agenda and providing Canadian perspectives on episodic disabilities; the Northern Dimension Partnership on Public Health and Social Well-Being highlighting Canada’s initiatives on Aboriginal Health and HIV; the Universal Periodic Review on HIV and Aboriginal People, sex work, criminalization, harm reduction, women and children; WHO 124th Executive Committee input on HIV and mental health; the United Nations Office on Drugs and Crime; WHO and UNAIDS Policy Statement on HIV Testing and Counselling in Prisons for Canadian approach.

An invitation to submit applications for the development of community based social marketing activities was launched under the specific-populations fund.

The Canadian AIDS Treatment Information Exchange link (CATIE) was funded $3 million under a contribution agreement to develop accessible processes and a pro-active system for knowledge exchange among front-line organizations and people affected by or at risk of HIV/AIDS. Consultations were held with national and regional non-governmental organizations, and over 300 front-line workers; an online ordering and distribution centre was established; resource cataloguing was improved; an environmental scan on trends and issues in epidemiology and prevention was completed; and 1-800 telephone and online inquiry services were established. Resources were developed for prevention, care, treatment and support for community based organizations and affected populations, and people living with HIV and AIDS.

An implementation evaluation was completed, finding that the FI was essentially implemented as intended and recommending action to strengthen performance reporting and horizontal management.

Technical expertise was provided on the use of dried blood spots (DBS) for serological and molecular testing of various blood borne and sexually transmitted infections.

HIV lab testing was accredited to international standards: ISO 15189 – Medical Laboratories Standard.  An audit was conducted in Feb 2008, and formal recognition by Standards Council of Canada was received in June, 2008. Currently, The Agency’s HIV lab is the first and only lab in Canada to have this accreditation level.

The capacity of Canadian labs to perform accurate HIV-1 testing was enhanced through a national external quality control program providing standard samples, monitoring results, and responding to erroneous results.  This quality program was expanded to include additional diagnostic tests.

HIV-1 challenge samples including seroconversion and non-B reference samples were diagnosed and characterized. DNA sequencing on challenge samples revealed increasing genetic diversity in HIV strains in Canada. PHAC responded to more requests for diagnosis of acute HIV infections from Provincial Health Ministries.

More project management plans were developed and integrated to improve the delivery of Canadian Quality Assessment Program for CD4 T-cell measurement.

Expertise to implement a national quality assessment program was developed, along with expertise with affordable CD4 monitoring solutions to assist Canadian clinical labs.
b. AIDS Community Action Program (ACAP) $16.7 $15.0 $14.6 Increased and improved collaboration and networking through:

- multi-sector partnership development

Increased awareness of HIV/AIDS through:

- funding projects to engage target populations in awareness raising (promotion and prevention) events, presentations and campaigns on HIV/AIDS

- supporting initiatives which explore and address issues of co-infection with Hepatitis C, TB and STIs

Increased capacity (knowledge and skills) of individuals and organizations through:

- funding projects to provide skills building sessions for staff and volunteers

- development of specific strategies to reach priority populations, i.e., injection drug users, gay men, Aboriginal people, youth at risk, prison inmates, women, people from countries where HIV/AIDS is endemic

Improved attitudes and behaviours towards people living with HIV/AIDS through:

- policy changes and other initiatives that create a more supportive environment for people living with HIV/AIDS

Improved access to quality HI/AIDS prevention, diagnosis, care, treatment and support through:

- funding projects to increase the awareness of the social and economic factors that create barriers for those at risk and those people living with HIV/AIDS (e.g., addictions, housing, income)
129 ACAP projects were funded across Canada; 83 were operational and 46 were time-limited projects.  Four of these projects received joint funding through ACAP and the Hepatitis C Prevention program.  Existing information systems were enhanced to better track and report on project outputs and outcomes.

The ACAP projects reached all eight of the vulnerable populations identified in the FI.  In particular, 91 of the projects had a focus on people living with HIV and AIDS, 54 had a focus on women, 53 on youth at risk, and 50 on gay men. The majority of funded projected reported the increased involvement of the target population in project activities. About one third of funded projects reported improvements in reaching out to target populations. Other results include increased opportunities for those who are affected by HIV and AIDS to make their needs known, an increased sense of belonging, and decreased isolation. Projects also reported that they reduced institutional resistance and stigma.

In 2008-09, ACAP projects contributed to knowledge development by providing hundreds of prevention workshops for vulnerable populations, awareness campaigns and events, and support to people affected and/or living with HIV and AIDS. Participants, including service providers, indicated significant and widespread increases in knowledge of care, treatment and support options, as well as improved knowledge about HIV transmission and risk factors in target populations. In Ontario and Quebec, among projects tracking intentions to adopt practices that may reduce risk behaviours and HIV transmission, all reported improvements.

Projects worked with a variety of partners to enhance access to services and address many of the social determinants of health to improve the quality of life for people living with HIV and AIDS and those vulnerable to the disease.  In 2008‑09, 49 ACAP projects reported that it was their intention to improve access to health and social services. Among the 26 projects monitoring this systematically, over half reported improvements in access.

Projects also worked to enhance their organizational capacity by providing skills building sessions for staff and volunteers.  Projects developed organizational or community capacity beyond existing partnerships, attracted significant volunteer contributions, 25,900 hours at an estimated value of $528,000, made an impact on institutional and organization policies, and improved their evaluation practices and their capacity for reflective learning.
Health Canada PA 1
First Nations Inuit Health Programming and Services (FNIHB)
a. Bloodborne Diseases and Sexually transmitted Infections—HIV/AIDS $4.0 $4.0* $3.6 Increased awareness of HIV/AIDS: improved attitudes and behaviours through:

- support to regions and communities in their efforts to launch HIV/AIDS community awareness campaigns that challenge negative attitudes and behaviours

- support to Aboriginal organizations on HIV/AIDS activities with particular focus on youth, leaders and women

Improved coherence of federal response through:

- ongoing development of relationships within FNIHB, the Public Health Agency of Canada, and with other FN and Inuit partners such as Indian and Northern Affairs Canada and Correctional Services Canada to increase interdepartmental collaboration

Increased availability and use of evidence through:

- development of recommendations on how to expand HIV/AIDS program to other blood-borne pathogens (Hepatitis C and STIs)

- promotion of efforts for the collection of epidemiological and surveillance data to enhance understanding progression of HIV/AIDS and Hepatitis C and increase the relevancy and effectiveness of the program
First Nations (FN) and Inuit community organizations across Canada were funded to develop and deliver targeted prevention, education and awareness programs for health professionals, community leaders and community members, and to increase the knowledge and skills of individuals and organizations.

Partnerships with National Aboriginal Organizations (NAOs) were supported through contribution agreements, as follows:

The Assembly of First Nations (AFN) received funding to raise awareness around HIV/AIDS and for prevention, education, training and policy activities.

The Canadian Aboriginal AIDS Network (CAAN) received joint funding from FNIHB and the Public Health Agency of Canada (PHAC) for the Second Indigenous/Afro-Descendants Peoples’ Pre-Conference on HIV/AIDS Sexuality and Human Rights, as part of the 17th International HIV/AIDS conference.

CAAN was also jointly funded by FNIHB and PHAC to develop and promote Aboriginal AIDS Awareness Week.

link Pauktuutit hosted a Sexual Health Conference with joint funding from FNIHB and PHAC.

The above-mentioned joint activities with PHAC addressed HIV/AIDS, sexually transmitted and blood borne infections and co-infection issues. As a result, epidemiological and surveillance data were collected, enhancing the understanding of the disease through various studies. Another joint effort with PHAC produced a reference manual on HIV and AIDS and Hepatitis C for nurses providing care to on-reserve First Nations people; this manual was disseminated to the regions across Canada.

In Alberta, the Bloodborne Pathogens (BBP) and STI prevention program targeted funding was provided to 35 communities for community specific programs resulting in Wellness and STI Day, a provincial partnership to provide education, awareness and testing for HIV, Hepatitis C and STIs; condom, lube,  and dental dam distribution; teaching at community gatherings and Pow Wows; school presentations; partnering with prenatal, parenting and youth groups; integration of information and awareness into health education, resulting in healthier choices; and access to testing, treatment, care and support. Undertook joint contribution funding for a project to address risk of transmission of BBP, STIs and violence, resulting in increased awareness of the need to present and share information in their communities; and deliver a peer education program for First Nations targeting First Nation youth which  addresses relationships, violence and bullying, BBP/STIs, sexual health, alcohol and drugs.

Partnerships were developed to increase community capacity, involving on and off reserve programs, AIDS Service Organizations (ASO’s), Hepatitis C projects and reserves. Results included ASO’s going on reserve to offer presentations and direct support to on reserve HIV positive clients. 

The Harm Reduction 101 project was piloted with 6 reserves, resulting in increased awareness of the services in the city and risks of getting involved in drug use and sex trade, and support for setting up needle exchange on reserves. National Native and Alcohol and Drug Abuse Program (NNADAP) training was developed in Treaty 8 communities, along with a BBP/STI check list for NNADP’s use. Training and presentations were delivered to nursing and health staff in communities. In partnership with PHAC and the Alberta Community HIV Fund, a survey addressing aboriginal preferences for accessing HIV and AIDS information and services was developed. A joint Community Health Representative (CHR) conference with the FNIH TB Program resulted in increased awareness of the importance of TB and HIV testing, treatment and care. Regional representatives collaborated on the planning of the Alberta Harm Reduction Conference to ensure First Nations and aboriginal content and focus; partnered with the Health Protection team to develop the First Nations Health Status Report Alberta Region 2008 - 2009 and specific community reports, focusing on BBP/STIs;  and participated in the planning and dissemination of the reports. In addition, the regional representatives advised on the direct case management of clients and Prenatal HIV Mothers in partnership with Alberta Health Services, HIV Clinics and nurses on reserve as appropriate: no HIV positive babies were born on reserve.  Community healthcare workers were supported and encouraged to attend the 8th Biennial Western Sexual Health Conference, CAANS conference and the Alberta Harm Reduction Conference.

In Ontario, First Nation communities and Political Territorial Organizations (PTO) received $0.47 million through contribution agreements for education and awareness activities. Through a contribution agreement with the Canadian Aboriginal AIDS Network, a “Wise Practices Research and Capacity Building” conference and a BOOM drumming session were held in Toronto during November 2008.

Funding through a contribution agreement was provided to Six Nations for an STI Project. A total of $0.16 million was provided to a PTO for an Education Circle and Youth Peer Training program.

In Manitoba, training to identify regional partnerships was undertaken by Nine Circles Community Health Centre. A CHR Conference with a focus on HIV/AIDS and communicable disease control education was held involving 80 CHR’s from across Manitoba to share information and successes. Educational and awareness resources were provided to take back and use for community education. Manitoba region participated in the planning of  Partners in Caring Conference to bring a diverse audience of individuals working in health and corrections together to consider the factors that increase risk for transmission of Hepatitis C, HIV and STI’s.

Program staff participated in the Prairie HIV Conference in Winnipeg, in November 2008, hosted by Nine Circles, Health Sciences Centre, and Klinic to share information with other prairie organizations providing HIV/AIDS prevention education and awareness.

In the Atlantic region, a community based research project was established between Healing Our Nations and Dalhousie University. A sexual health survey was created for piloting in the communities of Eskasoni, Big Cove, Bear River, and Millbrook. A Sexual health workshop for Innu was held in Goose Bay for approximately 60 participants, mostly youth and education workers. Regional representatives worked with consultants to develop evaluation skills and education programming for Eskasoni schools during May Hepatitis Awareness month.  Cervical cancer awareness kits were distributed to Nova Scotia First Nation Tui’kn communities.  A health promotion program was rolled out with Eskasoni schools to collect baseline data and information regarding the effect on pap test rates.  Community Health Nurses (CHN) were provided with sexual health education at the annual Atlantic CHN nursing conference.

In Saskatchewan, 71 first Nations communities accessed funding and delivered HIV and AIDS prevention education and awareness programs with community specific objectives and activities. Youth, prenatal women, and FN communities attended workshops and educational activities addressing HIV in the broader context of healthy sexuality. CHNs, health directors, NNADAP workers, mental health, youth workers, and health councillors participated in HIV and AIDS related educational sessions.  Enhanced HIV Surveillance, using the Social Network Analysis tool with newly HIV diagnosed clients, facilitated enhanced social data collection and information, resulting in increased knowledge of HIV. There is continued support of harm reduction and needle exchange programs which incorporate culture and aboriginal teachings to address the risk of HIV transmission and the escalation of HIV cases in Saskatchewan. Environmental safety guidelines for sharps disposal were communicated to health care providers to enhance support of needle exchange, enhance safety and increase awareness of FN residents in alignment with Provincial Needle Exchange Review.  In response to the escalation of HIV cases in Saskatchewan, FN stakeholders including front line health care workers worked, in alignment with the provincial HIV strategy, to intensify activities and effectively address the HIV impact in FN communities. Needle exchange programs that incorporated culture and aboriginal teachings and culturally competent objectives were developed to target FN at risk and marginalized people.

In Quebec, 30 communities were funded to develop awareness and prevention activities specific to each community. The advisory committee

“Cercle de l’espoir” continued to convene provincial and federal aboriginal partners. Research on sexual behaviours in FN communities in Quebec was undertaken: surveys were developed and participating communities were selected. A three-day training workshop for youth on sexual health, Defis des jeunes aigles, was delivered. A brochure on HIV was adapted for use with First Nations communities.  Sexual health training was delivered to CHNs. Sexual health training in the Innu language was delivered to women in Innu communities. In partnership with the province, regional officials participated in harm-reduction programming involving nurses, psychologists and street workers to increase access to counselling, screening and needle exchange.

In Pacific Region, Hepatitis C, HIV, and STI educational materials were disseminated to communities:

Step Up (encourages HIV testing) and Stand True (discourages rumours and stigma) DVDs were developed and distributed at a First Nations and Inuit Health nursing conference, health fairs, community sites, and workshops. A flip book that shows how to put on a condom was completed, using humour to normalize the use of condoms. Chee Mamuk, a community organization developed, a curriculum on drugs and alcohol and HIV prevention for youth; and provided community HIV workshop to Snuneymuxw First Nation, involving 40 youth and adult participants. Two 5-day training sessions were provided on, Mobilizing on HIV and STIs in Aboriginal Communities for frontline staff working on-reserve to implement community plans. Follow up support was provided to participants, using the community readiness model to decrease barriers to community uptake, and to increase condom distribution.  A Youth Positive Sexual Health messaging campaign and DVD were produced in partnership with the community host and a local AIDS Service Organization. Mobilizing on HIV/AIDS and STIs in Aboriginal communities was evaluated, and recommendations were developed. The Around the Kitchen Table HIV-Hep C co-infection Pilot Project was delivered in March 2009. Twenty women from 5 First Nation communities were trained to develop and deliver lesson plans to educate community members about HIV and Hepatitis C, resulting in the adaptations of tools appropriate to the communities, integration with other health information for participants, and preliminary discussion of future information sessions. The 12th Annual HIV/AIDS Conference was held, co-hosted by Healing Our Spirit and Northern BC Aboriginal HIV/AIDS Taskforce in Prince George. Over 300 delegates throughout BC FN communities attended. The Taskforce hosted three, 3-day, regional sessions resulting in youth learning how to plan, prepare and facilitate training sessions in their home community on education, awareness and prevention of HIV/AIDS. All First Nation communities received per capita funding to provide a wide variety of prevention and awareness activities in their communities.

Point of Care training was piloted. A second FN community received POC training and provided testing as indicated. Evaluation plans and the involvement of additional communities were initiated.

Note: approximately $0.4M was transferred from Health Canada to the Public Health Agency of Canada.
PA 2 International Health Affairs a. Global Engagement $1.7 $1.6 $0.7 Improved coherence of the global federal response  to HIV/AIDS through:

- coordinated Government of Canada engagement in the XVII International AIDS Conference

- expanded information sharing opportunities and collaborative activities with international organizations and within international for a

- increased policy coherence across the Federal Government’s global HIV/AIDS  activities

Strengthened pan-Canadian response to HIV/AIDS through:

- support for projects that engage Canadian HIV/AIDS organizations in the global response
Government of Canada engagement in the XVII International AIDS Conference was coordinated, by leading the interdepartmental Federal Secretariat.

The International Policy Dialogue on HIV and Disability was hosted in Ottawa, March 2009, and produced recommendations.

Policy and technical expertise on HIV/AIDS, TB and Indigenous Peoples was shared among Health Portfolio experts and members of the Northern Dimension Partnership in Public Health and Social Well-being at a March 2009 meeting.

Renewed terms of reference and a work plan were developed for the Consultative Group on Global HIV/AIDS Issues. Conclusions from the recent review of the Group’s work and Terms of Reference indicate that all government and civil society partners see great value in continuing and strengthening this collaborative initiative. A number of concrete recommendations were provided in order to strengthen the relevance, focus, and functioning of the group, as well as its impact on policy and programme development.

Health Portfolio interests were integrated at UNAIDS Programme Coordinating Board meetings.

Policy support was provided to HRSDC for International Labour Organization negotiations on HIV/AIDS and world of work.

Eleven Canadian organizations were selected to receive HIV/AIDS small grants funding to undertake initiatives in palliative care, HIV treatment literacy, midwifery education, pre-exposure prophylaxis, and HIV testing.
Canadian Institutes of Health Research (CIHR) PA 1
HIV and AIDS Research Projects and Personnel Support
a. HIV and AIDS Research Initiative $22.6 $20.6 $21.9 Increased and improved collaboration and networking through:

- funding and participating in HIV/AIDS conferences/workshops; and

- participating in FI Accountability Working Group and Responsibility Center Committee and engaging appropriate federal partners in CIHR activities

Increased availability and use of evidence through:

- funding HIV/AIDS research projects across a broad spectrum including socio-behavioural, biomedical, clinical, clinical trials infrastructure, and community-based research

- providing new research funding opportunities for scientists in strategic areas of HIV/AIDS research

Increased capacity (knowledge and skills) of individuals and organizations through:

- launching strategic capacity building initiatives and providing funding for training and salary awards

Strengthened pan-Canadian response to HIV/AIDS through:

- finalizing a strategic plan for the CIHR HIV/AIDS Research Initiative and communicating it broadly

- participating in the development of a national research and knowledge translation framework

- building effective partnerships with and engaging in meaningful dialogue with key stakeholders
In 2008-09, with combined CIHR and Federal Initiative funding, CIHR funded 230 grants, 159 awards and 15 Canada Research Chairs in the area of HIV/AIDS.  This investment totalled approximately $39.7 million in HIV/AIDS research. This funding flowed directly to HIV/AIDS researchers in universities and research institutions across Canada. Through the Community-based Research Program, 14 new grants (4 Aboriginal Stream; 10 General Stream) and 9 capacity-building grants and awards (3 Aboriginal Stream; 6 General Stream) were approved in 2008-09.  HIV/AIDS researchers supported by CIHR made significant achievements in addressing the HIV/AIDS epidemic both in Canada and globally. CIHR-supported outcomes in this area included: improved housing policy and services spearheaded by the first longitudinal community-based initiative in Canada to examine housing stability and housing outcomes among people living with HIV. This community-academic-policy partnership has also been the catalyst for capacity development in the area and for local, national and international partnerships that are leading to better housing and other supports for people with HIV; the identification of more than 15 proteins in Kenyan sex workers that appear to be markers for natural immunity to HIV infection which could ultimately lead to the development of a vaccine or microbicide to prevent HIV infection; and demonstration of how two specific genes are involved in an innate resistance to HIV infection.  This study opens the way for new ideas in the fight against HIV infection through boosting the innate immune system.

Eight new research funding opportunities were developed and funded grants and awards were released through Priority Announcement competitions.

Meritorious research grants and awards resulted from CIHR open competitions for research that would not otherwise be funded.

Twelve targeted research funding initiatives were launched, addressing such themes as:  development of the integrated network of Canadian HIV/AIDS centres specializing in health services and policy research; mental health and addiction co-morbidities of HIV/AIDS; and creation of national training initiatives in HIV/AIDS research. Over the next five years, these funded groups will support research activities that support Federal Initiative areas of interest such as determinants of health, prevention, improved health services, knowledge exchange and global collaboration.

Five Requests for Application were launched under the HIV/AIDS Community-Based Research (CBR) program in June 2008, including key research and capacity-building components across both Aboriginal and General funding streams.

Evaluation of the CBR program was undertaken in 2008 against objectives of: promotion of role of communities in the research process; building on the strengths of communities best equipped to provide care, treatment and support to those already affected; prevention of HIV. The evaluation of CIHR'S HIV/AIDS Community Based Research Program Final Report demonstrated that the program was helping communities and academia respond to the HIV/AIDS epidemic, building research capacity at the community level and in academic circles.  Specific recommendations to improve the program were made, and a three-year implementation plan is under development.

link CIHR’s 2008-13 Strategic Plan for HIV/AIDS research was finalized after extensive consultation with the HIV and AIDS research community. Canada’s strategic HIV and AIDS research priorities, positioned in the context of an overarching CIHR strategic plan, will guide CIHR HIV and AIDS Research Initiative investments over the next five years.

The translation of HIV/AIDS research results into action was promoted as part of an integrated knowledge translation (KT) strategy, integrated KT requirements in team grants; and direct funding support for knowledge synthesis grants; knowledge to action grants; meeting, planning and dissemination grants; end of grant KT funding; travel grants; and partnerships for health system improvement grants.
Correctional Services Canada (CSC) PA1

PA 2 Community  Supervision
a. Institutional Health Services Public Health Services

b. Community Health Services

Community Public Health Services
$4.2 $4.2 $3.7 Improved collaboration and networking through:

- expanded information sharing opportunities and collaborative activities within the Federal, Provincial and Territorial Heads of Corrections Working Group

Increased awareness of HIV/AIDS through:

- increased awareness of the need for innovative research initiatives on infections diseases within the federal offender population

Increased capacity (knowledge and skills) of individuals and organizations through:

- continued support of and participation in training and learning opportunities for correctional health care professionals

Improved access to quality prevention, diagnosis, care, treatment and support through:

- improved coordinated discharge planning programs for federal offenders with infectious diseases and other physical health problems being released into the community

- enhanced, gender specific infectious disease care, treatment and support, in accordance with professionally accepted health standards for women offenders through the development of a framework for a women offender infectious disease strategy

- culturally appropriate health programs and services for Aboriginal offenders in federal correctional institutions

- reduced transmission of infectious diseases among federal offender populations through sustained harm reduction programs and measures

- expanded health promotion initiatives to encourage healthy behaviours with the federal correctional environment

Increased availability and use of evidence through:

- augmented surveillance and data collection activities in order to better inform infectious diseases policy and program initiatives

- better informed internal policies and programs using results of an extensive inmate survey on risk behaviours
The Federal, Provincial and Territorial Heads of Corrections Working Group on Health met twice. Representatives from CSC and each province and territory in Canada, as well as representatives from the Working Group on HIV/ AIDS and the Agency.

A variety of health promotion and education strategies were used to encourage healthy behaviour among offenders.  These included inmate-lead projects and activities to encourage healthy behaviours such as use of harm reduction measures under the Special Initiatives Program, educational sessions delivered by health professionals, health fairs in various institutions, and health-related interactive learning tools.

The Peer Education Course (PEC) was updated and its 19 modules provide in-depth information pertaining to Blood-Borne and Sexually Transmitted Infections (BBSTIs), Tuberculosis (TB), and health promotion. Upon completion of the course, Peer Educators, provide support, information and organize activities related to health, and BBSTI and TB prevention for other inmates. There is also a separate PEC Women’s Component which deals with infectious disease and other issues specifically related to women offenders.

Discharge Planning Guidelines were issued in February 2008. Regional training sessions were held to ensure continuity of care for offenders with complex, ongoing infectious diseases when being transferred to another institution, and during pre-release planning for their return to the community. Approximately 400 participants attended the regional training sessions. Regional Discharge Planning Coordinators also worked to ensure the continuity of care with community partners upon transfers and releases.

The Women's Infectious Disease Strategy had a needs assessment conducted to determine the course of action for the development of wellness materials for the women offenders.  As a result of the needs assessment, it was determined that it would be best to use an integrated approach to enhance the wellness information offered in other programs. The project will include the development of new materials and resources to be used by facilitators of the program and the women offenders to enhance self-responsibility of health.

Regional Aboriginal Health Coordinators promoted health among Aboriginal populations. An Aboriginal Health Strategy was developed in consultation with stakeholders.

Surveillance and data collection have been enhanced, increasing the timeliness of evidence-based decisions.

Preliminary analysis of results from the National Inmate Infectious Diseases and Risk Behaviours Survey was completed.
Total $84.4 $73.1* $69.2    

* In the section on Health Canada in the above table, the correction of a $1.3M overstatement in the 2008-09 Report on Plans and Priorities changed planned spending identified for Health Canada’s First Nations Inuit Health Programming and Services from $5.3M to $4M and total planned spending from $74.4M to $73.1M.

18. Comments on Variances: The original allocation of $84.4 million was reduced to $73.1 million in 2008-09 through reallocations to CHVI and other government priorities. The variance in planned spending and actual spending of $3.9 million was caused by the deferral of some activities.

19. Results to be achieved by non-federal partners (if applicable): Major non-governmental stakeholders are considered full partners in the Federal Initiative to Address HIV/AIDS in Canada. Their role is to engage and collaborate with government, communities, other non governmental organizations, professional groups, institutions and the private sector to enhance the Federal Initiative to Address HIV/AIDS in Canada’s progress on all outcomes identified above.

20. Contact information:
Stephanie Mehta
Senior Policy Analyst
100 Eglantine Driveway
Ottawa, Ontario K1A 0K9
(613) 954-4502

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

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

3. Lead Department Program Activity: Infectious Disease Prevention and Control

4. Start Date of the Horizontal Initiative: 2006

5. End Date of the Horizontal Initiative: ongoing

6. Total Federal Funding Allocation (start to end date): $617M from 2006-07 to 2010-11

7. Description of the Horizontal Initiative (including funding agreement):  Canada recognized the potential for the spread of Avian Influenza (AI) virus 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 was put in place starting in 2006.

In 2006 the Health Portfolio received $422 million over 5 years to improve preparedness for avian and pandemic influenza.  The majority 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 to enhance federal capacity to deal with an on-reserve pandemic.

Under the umbrella of Preparing for Emergencies, in 2006 the Canadian Food Inspection Agency obtained $195 million to be spent over 5 years to enhance Canada’s state of AI Preparedness. Canada’s AI 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.

8. 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 AI while increasing preparedness for a potential pandemic.
Greater Protection for Canadians from 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. 

Enhanced on-reserve planning and preparedness and improved federal capacity to deal with an on-reserve pandemic.
Response speed and understanding enhanced through prevention and early warning measures, risk communication and inter-jurisdictional collaboration.

9. Governance Structure(s): Under the auspices of the Deputy Minister’s Committee on Avian and Pandemic Influenza Planning (CAPIP) a Director’s General committee, with representation from the Agency, Health Canada, the Canadian Institutes of Health Research and the Canadian Food Inspection Agency, has been established to oversee this horizontal initiative.

($ millions)
10. Federal Partners 11. Federal Partner Program Activity (PA) 12. Names of Programs for Federal Partners 13. Total Allocation (from Start to End Date) 14. Planned Spending for
15. Actual Spending for
16. Expected Results for
17. Results Achieved in
Public Health Agency of Canada Infectious Disease Prevention and Control a Vaccine readiness and clinical trials Ongoing $13.3 $13.7 Support for expanded production capacity and production of clinical trials of a mock H5N1 vaccine to help ensure timely availability of a safe and effective vaccine to all Canadians in the event of a pandemic, helping to reduce the extent of illness and death. Improved vaccine adverse event reporting for both annual flu vaccine campaigns and the use of a vaccine in a pandemic to allow a timely response to any adverse effects and increase public confidence in Canada’s public health system. Materials were acquired to manufacture doses of pre-pandemic H5N1 vaccine.

A $2 million contract amendment was made for an H5N1 clinical trial on rapid dosing schedules.
Infectious Disease Prevention and Control b. Rapid vaccine development and testing Ongoing $1.8 $2.0 Enhanced domestic ability for research and development of vaccines for novel influenza viruses and other emerging infectious diseases and an improved body of knowledge to contribute to the development of new strategies for influenza vaccines and to help allow a more timely and effective response to future influenza threats. Established a rapid vaccine development testing capacity for the testing of new influenza vaccines.  Capacity in research and reference services was increased.
Emergency Prepared-ness and Response c. Contribution to National Antiviral Stockpile Ongoing $12.7 $1.4 An increased national stockpile of antivirals for the use of health care professionals and institutions will allow treatment to all Canadians who need it, helping to bridge the gap until a pandemic vaccine can be produced, thereby reducing the number of deaths in the event of a pandemic. Target stockpile of 55.7 million doses was achieved.
Emergency Prepared-ness and Response d. Additional antivirals in National Emergency Stockpile System (NESS) $12.5

(in 2007-08 only)
- $4.8 An antiviral reserve beyond the national antiviral stockpile to give the Government of Canada the flexibility to support the initial containment of a potential pandemic influenza outbreak, either domestically or abroad, by providing surge capacity to support provincial and territorial efforts against an outbreak and by providing appropriate protection to designated essential federal employees.  Contribute to a more timely and effective response to a pandemic situation thus providing better protection of Canadians. An additional stockpile of 14.9 million doses of antivirals was put in place in the NESS to provide surge capacity to support provinces and territories.
Infectious Disease Prevention and Control e. Capacity for Pandemic Preparedness Ongoing $4.9 $6.0 Strengthened capacity for pandemic issues to allow the Agency to provide more strategic policy advice to the Minister and support improved collaboration and coordination on avian and human influenza issues across the Government, with provinces and territories, internationally, and with the private sector.

Further, strengthened capacity for policy advice in federal, provincial, territorial liaison, the private sector and executive briefing will allow for more timely identification of issues and responsive decision making in a changing environment.

Provide timely and consistent strategic regional intelligence on matters related to avian and pandemic influenza.  A system to collect, analyze and disseminate regional intelligence will be developed which, along with more coordinated intergovernmental and regional communication involving the federal health portfolio and other stakeholders, will strengthen collaboration and increase the capacity of the Agency and its partners to anticipate and respond to an outbreak.
Capacity was in place for the Agency to provide leadership, advice and coordination for the government, provinces and territories, across sectors and internationally on avian and human health matters relating to potential influenza pandemic.  Examples include a Private Sector Working Group (PSWG) meeting on avian and pandemic influenza, several meetings with provinces and territories including progress on a Memorandum of Understanding on Roles and Responsibilities in Pandemic Preparedness and Response.  A travel health booklet was distributed.  A federal, provincial and territorial Oversight Committee was established reporting to the Public Health Network.

Regional staff was augmented in some areas.  Participation at provincial and regional communications network meetings was increased.  Developed systems for monitoring and reporting on the Canadian public health, including protocols for intergovernmental action.  Urban First Nations and Métis Pandemic Preparedness Think Tanks were held in Saskatoon and Winnipeg.  A Nunavut community template for pandemic preparedness was developed.
Infectious Disease Prevention and Control


Strengthen Public Health Capacity
f. Surveillance Program Ongoing $8.9 $5.4 Improved and interoperable components of the Canadian public health surveillance system will reach into a broader range of settings and issues such as surveillance in health care settings, wild bird surveillance and ensuring the safety of the blood supply. This system, supported by a robust systems platform, new and/or improved policies and/or information sharing agreements, and the efficient analysis and interpretation of the data collected, will allow more timely identification of potential outbreaks, thereby moving towards a more effective response and thus reducing illness and death in the event of an AI outbreak or human influenza pandemic. A governance structure was put in place to implement a comprehensive surveillance strategic plan that will address areas of integration, partnerships and collaboration, knowledge management, and performance measurement.  A new National Non-Enteric Zoonotic Disease Working Group within the Public Health Network’s Communicable Disease Control Expert Group was formed to deal with issues related to animal-to-human infections that are not typically transmitted through food or water.

Early detection in wild birds was improved through a better integrated Canadian surveillance system. 

Collaboration with provinces and territories was improved through the revisions of Annex F of the Canadian Pandemic Influenza Plan. Potential for pandemic influenza in the blood system was monitored and work began on the related World Health Organization and Health Canada recommendations. Continued support was provided for national case management systems such as Public Health Information System (iPHIS) and Canada Health Infoway’s Panorama.
Emergency Prepared-ness and Response g. Emergency preparedness Ongoing $7.1 $7.2 A more robust, efficient, effective response to a human influenza pandemic through improved communications, integrated and tested plans, and improved local capacity to result in reduced mortality and morbidity among Canadians, and demonstrate Government of Canada leadership and foresight in the event of an avian or pandemic influenza outbreak.

The Agency’s Regional Offices actively engaged in promoting and enhancing national, regional, provincial and territorial pandemic planning through a variety of activities, including facilitating and promoting pandemic planning among federal departments and with provincial, Aboriginal and local governments and stakeholders.
Emergency Operations Centre (EOC) technology was upgraded to provide seamless communications with federal, provincial, territorial and international stakeholders.  Six regional emergency preparedness and response officers were engaged and established coordination centres in each region.  Tabletop pandemic preparedness exercises were conducted for the health portfolio in the regions.  Regional staff was trained in the Incident Command System.  Canadian laboratories that deal with dangerous pathogens were certified or re-certified.  Work was undertaken for Canada to meet its June 2012 International Health Regulations obligations.  Preparatory meetings were held with various interested parties throughout the country.
Emergency Prepared-ness and Response h. Emergency human resources Ongoing $0.4 $0.2 A viable response plan for the human resource capacity of the Agency and effective operational support to meet Agency requirements during a health crisis to allow the quick mobilization of Agency staff members in the event of a health crisis. Supporting preparedness measures to ensure that Agency’s services to Canadians can continue uninterrupted in the event of a public health emergency, reinforcing public confidence in the Canadian health system. Several staffing measures to address shortages were undertaken including providing focussed staffing expertise to address pandemic influenza related positions.
Infectious Disease Prevention and Control i. Winnipeg lab and space optimization Ongoing $4.5 $2.4 Additional biocontainment research space to allow additional efforts on diagnostic testing and research on avian and human influenza, resulting in more timely identification of a pandemic virus and a better understanding of its characteristics, thus helping to reduce illness and death in the event of an outbreak or pandemic.

Establishing an off-site storage and stores facility to allow the National Microbiology Laboratory (NML) to reallocate existing lab-related space and expand the capacity to receive and process specimens.
The laboratory building purchased and the renovations started. The naming process approval was obtained.  The concept design was produced and programs and services that will occupy the building have been confirmed.

Space in the NML for laboratory research and response capacity has been increased with the move of shipping and receiving and storage to the off-site location.
Infectious Disease Prevention and Control j. Strengthening the public health lab network Ongoing $1.2 $1.1 An increased and better linked and coordinated capacity across jurisdictions for laboratory diagnostic testing, with a focus on antiviral, immunization and surveillance issues, will help to ensure more timely identification of new or emerging viruses, allowing a pandemic virus to be more quickly isolated so that vaccines and more effective treatment options can be developed, thus reducing illness and death in the event of an AI outbreak or human pandemic. The Canadian Public Health Laboratories have been instrumental in revising the laboratory component of the pandemic plan.  A network of the Agency’s laboratory surveillance officers in provincial and territorial laboratories has been established to coordinate a national laboratory response in support of the surveillance strategy.  Federal and provincial public health laboratories acquired pandemic influenza diagnostic equipment.
Infectious Disease Prevention and Control k. Influenza research network Ongoing $6.8 $0.8 Improved decision-making respecting pandemic preparedness, control and treatment through systematic identification of research priorities along with mechanisms to rapidly generate research findings and promote access to and utilization of new knowledge through effective translation strategies. Some research activities have started, but other priorities have required resources being assigned to other areas.
Infectious Disease Prevention and Control l. Pandemic influenza risk assessment and modeling Ongoing $0.8 $0.6 An improved federal capacity for mathematical modeling, statistical analysis, and operations research on pandemic influenza issues will allow a better understanding of the spread of influenza and the effect of epidemics or pandemics on Canadians, allowing more timely and evidence-based decision making on public health responses, thus helping to reduce the extent of illness or death in the event of an AI outbreak or human pandemic. Fourteen studies, including peer-reviewed articles and workshop reports, were produced on the use of mathematical modelling to evaluate intervention effectiveness.  A working partnership was established with a network of mathematical modellers in Canadian universities and internationally, such as the World Health Organization H1N1 Modelling Network.  A working partnership was established with provincial modelling networks led by two key provincial public health agencies: British Columbia Centre for Disease Control and Ontario Agency of Health Protection and Promotion.
Infectious Disease Prevention and Control m. Performance and evaluation Ongoing $0.6 $0.4 Collection of relevant information to effectively measure the design, management, implementation, and impact of the Pandemic Influenza Strategy.  Future evaluation activities and measurement of intended outcomes will contribute to ongoing decision making that reflects best practices and value for money, thereby ensuring that avian and pandemic influenza preparedness measures are reaching their intended objectives. A performance measurement framework and evaluation plan was developed and approved.  A common web-based data collection system was prepared for finalizing and piloting. The evaluation data analysis framework was developed.
Infectious Disease Prevention and Control n. Pandemic influenza risk communications Strategy Ongoing $1.8 $1.2 Provide citizens, governments and key stakeholders with appropriate information to make effective decisions about health and safety before and during an influenza pandemic.

Ensure consistent and complementary communications among health partners through strong communications networks.

Support the federal government’s leadership role and credibility with citizens and partner organizations to reinforce confidence in Canada’s public health system, before, during, and after an influenza pandemic.
A 3-year pan-Canadian social marketing campaign on influenza and infection prevention strategy was developed and approved by PHN Council and Deputy Ministers.  A behavioural study on infection prevention and control of the general population, Aboriginals, and parents with children under 18 to inform social marketing, web, and communications planning, was carried out. Inventories of federal / provincial / territorial influenza and pandemic communications and social marketing products and interventions were compiled. A federal / provincial / territorial portal, link, was launched as a cornerstone for coordinated marketing and communications efforts. To address gaps in operational communications protocols, a federal / provincial / territorial Pandemic Communications Operational Plan was developed to address considerations identified in the pandemic horizontal risk assessment.
Infectious Disease Prevention and Control


Strengthen Public Health Capacity
o. Skilled national public health workforce Ongoing $5.6 $3.3 The new Canadian Public Health Service Program (CPHSP) to hire a variety of public health professionals to address key gaps in provinces, territories, local jurisdictions and other public health organizations, as part of an expanded and strengthened public health work force. Public Health Officers in this program are directly serving their host organizations, while having the benefit of individualized learning plans supported by the Agency. Through the combination of  career-positive professional development and field experience, the program will address current gaps in public health at all levels, including planning, surveillance and management of disease, risks to health, and emergency response with particular reference to avian or pandemic influenza.

Discussions concluded with all provincial departments of health to determine public health capacity gaps and how CPHS staff can be most effectively deployed to address them.  A system of regional coordination in place to contribute to efforts to achieve better integration across jurisdictions and address gaps and surge capacity.
Progress in staffing has been made in regions and headquarters to address critical shortages.   Regional CPHS coordinators were provided an orientation program.
 Health Canada Health Products a. Regulatory activities related to Pandemic Influenza Vaccine - Ongoing $1.4 $1.4 HPFB will implement the recommendations of the World Health Organization (WHO) assessment visit of National Regulatory Authority held in January 2007.

Health Canada is proceeding with amendments to the Food and Drug Regulations to introduce new regulations for   Extraordinary Use New Drugs (e.g., an authorization process specific to drugs for emergency preparedness) and Block Special Access Program (e.g., the release of a quantity of unauthorized drug for use in an emergency scenario).  Amendments finalized by early 2008-09. Should a pandemic be declared in advance of completion of these amendments, they would be implemented via the interim order provision.  Interim order prepared to authorize a vaccine against H5N1 strain, which would be donated to WHO for stockpiling and distribution to lesser developed countries in need of vaccine.   This order will be drafted by end of this fiscal year.
In response to the WHO recommendations, Health Canada’s Biologics and Genetic Therapies Directorate is working with the Public Health Agency of Canada to strengthen linkages between the programs, and are implementing Quality System processes within the program.

Health Canada participates in the development of WHO Guidelines on Regulatory Preparedness for Human Pandemic Influenza Vaccines.

Health Canada finalized the guidance document for manufacturer of pandemic vaccines.

Health Canada has also completed the evaluation of a candidate/prototype vaccine and authorized its use for Canadian clinical trials, we have trained additional laboratory staff to support the increased demand for lot release testing, and have established an immunochemical method for potency testing in lot release, as well as optimizing the universal antibody assay for seasonal and pandemic flu vaccines to increase sensitivity.

Although unfunded under AI/PI, work continues with regard to the SAP Block Release Regulatory Amendments. As a result of new regulatory requirements implemented by TBS, the publication in Canada Gazette had to be delayed. The new target date is Q3 2009-10.
Public Policy Services b. Resources for review and approval of antiviral drug submissions for treatment of pandemic influenza Ongoing $0.3 $0.3 Health Canada to develop an “accelerated review process” based on the current review process models and this new process for reviewing the influenza drug submissions applied.  This accelerated review process will be posted on our regular channels of communication, including on the Web, as Guidance Document to the Industry. The reviewers are being trained on the aspects of the “accelerated review” and will be ready to apply the new protocol. Health Canada has completed a draft external Issue Analysis Summary and Expedited Pandemic Influenza Drug Review Protocol.

Drug Submission Reviewers training in the “accelerated review” process is ongoing.

The accelerated review process for reviewers use is currently being revised and finalized for distribution through regular communication channels.
Human Resource Management c. Establishment of a crisis risk management unit for monitoring and post market assessment of therapeutic products Ongoing $0.4 $0.4 Emergency preparedness plans specific to pandemic influenza will be put into place for dealing with staff shortages and lack of trained personnel for pharmacovigilance and product vigilance.

Strategies developed for expedited surveillance, assessment and risk communication for anti-virals and other relevant health products.

Recruitment and cross training of existing staff provided for a limited incremental increase to risk surveillance, assessment and management capacity to deal with anti-viral adverse reaction information.

Communication links with federal, provincial, territorial and other stakeholders continued to be refined.

Outreach and education provided to all staff.

Surveillance on antivirals now ongoing.

FN/Inuit Community Programs d. First Nations and Inuit Surge Capacity $1.5

(2007-08 to 2009-10)
$0.4 $0.4 Ongoing development and delivery of culturally appropriate training packages for First Nations and Inuit communities to allow them to build an increased capacity to respond to AI or a human pandemic with the health care workers already in those communities, helping to ensure a more rapid identification of and immediate response to any outbreaks, and thus reducing illness and death in the event of a pandemic. First Nations and Inuit Health Regions have developed educational materials (e.g., posters, pandemic preparedness checklists, and manuals) on infection control, self-care measures and pandemic planning for FN. Furthermore, pandemic preparedness and response presentations have been delivered in FN communities across the country.
Governance and Infrastructure support to FN/I health system e. Strengthening Federal Public Health capacity Ongoing $0.7 $0.7 Enhanced capacity to deal with outbreaks or emergencies in First Nations and Inuit communities, along with strengthened links to other public health and emergency preparedness actors, allow a more timely response to avian pandemic influenza outbreaks in these communities, thus reducing illness and death in the event of a pandemic. Communicable Disease Emergency Nurse Coordinators are employed in all First Nations and Inuit Health Regional offices, and regional plans developed. Relationships have been established with other federal departments, national and regional Aboriginal organizations, provinces, to ensure a comprehensive and coordinated response to public health emergencies, including an influenza pandemic, in on-reserve First Nations communities.
Emergency Preparedness f. First Nations and Inuit emergency preparedness, planning, training and integration Ongoing $0.4 $0.4 Ongoing development and testing of community pandemic influenza preparedness plans in all FN/I communities, along with established emergency management communication pathways among local communities and health authorities, regional, provincial and national partners and stronger linkages with federal efforts will ensure a more effective response in the event of an outbreak in an FN/I community, and thus contribute to reduced illness and death in the event of a pandemic. To date, on-reserve First Nations communities have been engaged in influenza pandemic planning, but at differing levels. Close to 400 on-reserve First Nations communities have tabletop tested their community-level influenza plan. Provinces have attended or participated in many of these exercises.
Passenger Conveyances g. Public health on passenger conveyances Ongoing $0.3 $0.3 A trained and prepared cadre of Emergency Health Officers and other partners at points of entry to help to ensure more timely detection, identification and remediation of avian or pandemic influenza as public health threats onboard conveyances or at ancillary service sites, thereby helping to reduce illness or death in the event of a pandemic. These measures also help improve Canada’s compliance with the International Health Regulations, although some gaps may still be present. Ongoing program delivery.

Delivered enhanced quarantine and decontamination training to designated Environmental Health Officers; conducted Training needs assessment.

Led and participated in capacity testing exercises at major and secondary points of entry.

Maintained active partnership with Public Health Agency of Canada Quarantine Program in place to provide a cohesive Health Portfolio response capacity.

Active input to development of IHR Capacity Assessment process.
Canadian Institutes of Health Research Pandemic Preparedness Strategic Research Initiative a. Influenza research priorities $21.5

(2006-07 to 2010-11)
$5.5 $5.2 Peer review and fund research projects.

Develop and launch requests for research applications, if needed. 

Hold first annual meeting of funded researchers, stakeholders and decision makers to review progress on funded projects, research outcomes and consult on future research needs. 

Chair Research Sub-committee meetings of Avian and Pandemic Influenza Operations Director General Committee 
Mid term evaluation.
Applications were peer reviewed and funded:

• 9 Team Grants
• 2 Team Leader Grants
• 1 Operating Grant
• 3 Catalyst Grants
• 1 Meeting, Planning and Dissemination Grant

Through partnership, an additional $2.7 million was invested in the 16 funded projects.

New targeted funding opportunities focused on public health, outbreak research and translation of research findings were developed and launched.

The Canadian Pandemic Preparedness Meeting: From Discovery to Frontlines, held in Winnipeg in November 2008, helped to enhance collaboration by providing researchers with networking opportunities and by building ties between researchers and research users, and between animal and human researchers.

Continued to develop a strong network of researchers, ensuring Canada has the necessary expertise to respond effectively in the event of a pandemic.  This expertise can also be used to assist other countries in crisis.

The first meeting of the Research Working Group (RWG) was held in December 2008. Terms of Reference where developed for the RWG and approved by the Avian and Pandemic Influenza Operations DG Committee.

A midterm evaluation assessed the overall design and implementation phase of the Initiative. Results of the evaluation will be used to inform future activities and other emerging infectious disease initiatives.

The evaluation identified the following important areas requiring attention:

- stimulation of pandemic preparedness research with a public health focus and;

- facilitation of broader engagement of the influenza research community in knowledge exchange and uptake.

The evaluation found that the initiative has been especially successful in developing solid and productive partnerships, developing consensus on research priorities, implementing tools to address these priorities and providing a solid foundation for future success.

The overall conclusion of the evaluation is that the design, delivery and initial outputs are ensuring that its goals of improving Canada’s pandemic preparedness and increasing research capacity in the area can be met.
Canadian Food Inspection Agency Zoonotic Risk a. Animal vaccine bank $2.4 $0.4 - Maintain a high state of preparedness for the possible use of poultry vaccination as a disease control tool during an AI outbreak in order to control AI in animals and prevent its spread to humans. Discussions continued on the disposition of previously purchased poultry vaccine which will reach its sustainable shelf life in 2009.

A vaccine sharing agreement has been put in place between the United Sates Department of Agriculture and CFIA.
Zoonotic Risk b. Access to antivirals $0.6 $0.1 - Maintenance and exercise of protocols and strategies to provide access to antivirals to enhance the Government of Canada’s flexibility to support the initial containment of a potential AI outbreak and provide appropriate protection to federal employees, ensuring a more timely and effective response to an AI situation and better protection of Canadians. Continued to maintain the antiviral stockpile.

Response to outbreak situations (AI in British Columbia) provided an opportunity to test and refine protocols for the provision of antivirals to responders
Zoonotic Risk c. Specialized equipment $33.6

(2006-07 to 2008-09)
$20.0 $0.5 Continued investment in and maintenance of specialized supplies and equipment to enhance capacity and allow a more timely and effective response to possible AI outbreaks, containing the spread and contributing to better protection of Canadians. Successfully deployed the national stockpile inventory as part of an AI emergency response in 2009.  Further developed the inventory to ensure ready-access to necessary equipment and supplies within hours of a declared emergency. 

Specialized equipment maintained by the Agency in 2008-09 includes four Modified Atmospheric Chambers (MAC) used for the humane destruction of infected poultry.

Purchased equipment to enhance CFIA’s capacity to respond to an avian influenza outbreak including: equipment for maintenance of telecommunications satellite connectivity, data loggers, probes, temperature sensors, air monitoring equipment, calibration equipment, respirators, shelters, pressure washers and manifolds.

Rented storage space for large equipment, including CO2 manifolds.
Zoonotic Risk d. Laboratory surge capacity and capability $22.1 $2.6 $4.6 Increased coordination capacity with the creation of an integrated lab network across the country (federal, provincial and university labs).  This network to allow for rapid testing, detection and reporting of AI. Improved surge capacity and diagnostic capability across Canada by training and certifying lab analysts that are part of the Canadian Animal Health Surveillance Network (CAHSN) laboratories, and by continuing to offer training, re-training and/or certification sessions.

Established an information sharing link between the CAHSN and the U.S. Animal Health Laboratory Network with the goal of a future direct electronic link between the two networks.

Staffed positions and trained staff - there are now 17 staff at NCFAD involved in building and maintaining laboratory surge capacity and capability for the diagnosis of AI across Canada, and approximately 80 analysts in CAHSN labs who are trained and certified by NCFAD to perform AI testing on behalf of CFIA.

The CAHSN Quality Assurance (QA) Support Team continued to consult with Network laboratories to help them implement QA management systems, receive ISO accreditation training, prepare standard operating procedures, and fulfill quality management operational requirements.

Progress has been made to enable lab data transmission from the Network and CFIA’s labs to the CAHSN data system.

To ensure biosecurity, all Network Laboratories were required to meet new disease containment standards which necessitated retrofits in many Laboratories.
Zoonotic Risk e. Field surge capacity $5.0 $0.9 $1.9 Ongoing development of a viable response plan for urgent needs to increase human resource capacity to respond to foreign animal disease emergency response situations. Conducted training, identified additional responders and back-ups, tracked and monitored human resources, and conducted simulation exercises (see reference in section k, field training to poultry depopulation exercise)

Continued to develop a human resources skills inventory database which will provide a centralized information source to identify appropriately trained individuals to respond in an emergency.

Identified retired CFIA staff who could return to active duty during an emergency disease outbreak as required.
Zoonotic Risk f. National veterinary reserve $8.8 $2.3 $1.8 In January 2007, the Canadian Veterinary Reserve (CVR) was established to identify available private sector veterinarians to help respond to animal health emergencies. This reserve of professional veterinarians to enhance domestic and international surge capacity, and provide expertise and rapid response capability for foreign animal disease control efforts.  The CFIA will continue to promote the growth of the CVR, and provide training to CVR members. Continued to work with the Canadian Veterinary Medical Association on the development of the Canadian Veterinary Reserve to increase specialized capacity in the event of a large scale emergency. Thirty (30) additional reservists were trained in 2008-09, bringing the total to 160.
Zoonotic Risk g. Enhanced enforcement measures $6.7 $1.4 $2.2 Provide CBSA with increased veterinary expertise, in order to increase capacity to support enhanced screening procedures for live birds or poultry products at Canada’s ports of entry.  These actions can mitigate the risk of future AI outbreaks in Canada. Enhanced enforcement capacity related to monitoring AI disease symptoms in abattoirs, investigating animal health non-compliance incidents that may increase the risk of AI, and reviewing import documents.

Offered CFIA veterinarian expertise to the Canada Border Services Agency for screening procedures at ports of entry.
Zoonotic Risk h. Avian and biosecurity farms $23.9 $4.2 $1.1 Implementation of the National Avian Biosecurity Strategy (NABS), the objective of which is horizontal integration and coordination of biosecurity-related activities, including on-farm biosecurity standards, flock management, governance, and stakeholder engagement to mitigate the introduction or spread of AI and build a foundation for a sustainable industry that minimizes economic and production losses. Completed the National Avian On-Farm Biosecurity Standard which was ratified by Avian Biosecurity Advisory Council (ABAC) and national poultry producer organizations.

Ongoing development of producer guidance for the avian biosecurity standard in collaboration with ABAC.

Produced a 2009 calendar with monthly tips on biosecurity and disease prevention for small flock owners.

In cooperation with the provinces, held information sessions in Ontario, British Columbia, Newfoundland and Prince Edward Island for small flock owners on how to protect the health of their birds.

Final project of Avian Biosecurity Technology Development Fund nearing completion.  Refer to section “r” for calendar and information sessions.
Zoonotic Risk i. Real property requirements $4.0

 (2006-07 to 2007-08)
- $2.3 Investment in real property and accommodation to support efficient work environments and locations to support the CFIA’s action plan for AI. Acquired and outfitted new space, and re-configured existing space to provide accommodation to new employees hired for the implementation of the AI Plan.
Zoonotic Risk j. Domestic and wildlife surveillance program $14.4 $2.7 $3.0 Development of better integrated Canadian surveillance systems, supported by a robust systems platform and the analysis and interpretation of the data collected to allow more timely identification of potential outbreaks, and more timely response to AI situations. Developed and implemented the Canadian Notifiable Avian Influenza Surveillance System (CanNAISS) in partnership with industry to provide an AI surveillance system for domestic birds that is efficient for all partners and satisfies international trade requirements (European Union); 601 commercial poultry flocks were sampled across the country, all with NAI negative findings.

Carried out national wild bird surveillance of both dead and live birds in cooperation with provincial and territorial governments, the Canadian Cooperative Wildlife Health Centre, Environment Canada and the Government of Iceland. 

The monitoring of these wild birds allows for the characterization of AI strains in circulation and provides and early warning of potential incursions of Asian H5N1 into Canada.

The early warning of the arrival of H5N1 strains from Asia will allow precautions to be taken to protect domestic poultry populations and to warn those individuals who have contact with wild birds of potential danger of infection with the strain.
Zoonotic Risk k. Field training $6.9 $1.8 $0.7 Investment in development and delivery of an effective and appropriate training package to contribute to a skilled and experienced workforce ready to respond to an AI outbreak. Completed a poultry depopulation exercise in the Atlantic Area to practice field staff’s emergency roles and responsibilities

Continued to train staff on emergency response plans, documents, procedures and equipment, along with emergency management training.

Developed field-level partnerships and shared best practices with U.S. veterinarians and industry through participation at foreign animal disease  conferences

Enhanced knowledge and skills of responders through the completion of  the following National Training Initiatives: Orientation to Outbreak Response e-Learning Module, Accredited Veterinarian Program – Pre-Accreditation Orientation Sessions, one FAD Recognition Lab Course, Module B9 – FAD Emergency Plan for Poultry Abattoirs, three additional self-study modules for poultry slaughter inspection staff, four modules for industry staff involved in examination of poultry carcasses and two poultry trainer’s instruction manuals.
Zoonotic Risk l. AI enhanced management capacity $4.0 $0.8 $2.4 Ongoing investment in infrastructure, tools, enhanced emergency management informatics systems and staff training to increase the Agency’s capacity to track, monitor and respond to outbreaks; and help provide emergency response teams with the ability to quickly deploy the necessary equipment and resources; maintenance of mobile command centres. Continued the development of CFIA’s emergency management response system database: expanded capability and capacity to deal with high volume of samples collected during outbreaks.
Zoonotic Risk m. Updated emergency response plans $11.3 $2.2 $0.7 Continued review and updating of the comprehensive emergency response plans to reflect lessons learned and the most current available scientific information. Strengthen capacity and achieve the desired state of readiness as rapidly as possible. Provide more effective leadership and support the provinces and territories and promote an integrated, collaborative response to possible AI issues or outbreaks. Strengthened capacity for the Agency in federal, provincial and territorial liaison, policy analysis and executive briefing to allow for more timely identification of issues and responsive decision making in a changing environment. Continued the development of detailed emergency response procedures for CFIA field staff to respond to AI emergencies.

Contributed to the design of, and participated in, the tabletop exercise by the North American Plan for Avian and Pandemic Influenza (NPAPI) that aimed at validating the coordination and communications aspects of a response to an avian and/or pandemic influenza incident in North America.
Zoonotic Risk n. Risk assessment and modeling $11.5 $2.2 $0.2 Investment in an improved federal capacity for mathematical modelling, statistical analysis, and operations research on AI issues to allow a better understanding of the spread of influenza and the effectiveness of disease control measures. Specifically, risk rankings for possible pathways of entry of AI to Canada to be established. These investments will allow more timely and evidence-based decision making on AI responses, thus helping to reducing the risk of transmission to humans and mitigating economic and production losses. Risk assessments were initiated and/or completed on avian influenza risk issues including those related to importation of live birds from various AI infected countries, and those related to the importation of animal product that might contain AI virus.

Avian disease spread modeling within the North American Animal Disease Spread model (NAADSM) was used to assist Agriculture and Agri-Food Canada (AAFC) to develop self-insurance for poultry producers in Ontario.
Zoonotic Risk o. AI research $6.3 $1.3 $1.6 Investment in an improved federal capacity for mathematical modeling, statistical analysis, and operations research on AI issues will allow a better understanding of the spread of influenza and the effectiveness of disease control measures.  These investments allow more timely and evidence-based decision making on AI responses, thus helping to reduce the risk of transmission to humans and mitigating economic and production losses.

Identification of the research gaps related to AI and development, with partners, of effective tools and knowledge to facilitate decision making and policy development.

To support the need for mass depopulation and disposal, research projects are ongoing in the areas of humane euthanasia and effective disposal methodologies.
Continued three research projects on rapid detection, control and risk assessment strategies for AI. 

Developed reagents for rapid tests and for the evaluation of potential new vaccine strains.

Participated in and completed a collaborative project with AAFC, Alberta Agriculture and Rural Development (AARD), and Iowa State University to study the disposal of large ruminant carcasses via composting in a disease outbreak.
Zoonotic Risk p. Strengthened economic and regulatory framework $5.4 $1.0 $0.2 Strengthened capacity for increased regulatory review including analysis of current legislative and regulatory framework, capacity to address regulatory developments and economic options associated with AI outbreaks, and consult with stakeholders, provinces and territories. Increased regulatory review capacity also supports stronger leadership and coordination on AI issues across government, provinces and territories, industry and internationally. In conjunction with the provincial and territorial governments, animal and public-health experts and industry representatives, explored regulatory options that could result in more effective control of disease spread, assessed compensation options within the parameters of the existing legislative framework

Initiated the development of appropriate cost valuation models, which will continue in 2009-2010.
Zoonotic Risk q. Performance and evaluation $4.9 $1.0 $1.6 Evaluation of activities and outcomes to allow future decision making that reflects best practices and ensures value for money, thereby ensuring that avian and pandemic influenza preparedness measures are providing Canadians with the protection they need and reinforcing public confidence in Canada’s food inspection system. Continued to support the internal coordination of AI projects, and the research and writing of various reports.

The 2007-2008 Avian Influenza Lessons Learned Review: The CFIA’s Response to the 2007 Avian Influenza Outbreak in Saskatchewan report was completed. This internal AI lessons-learned review noted consensus that the CFIA response to this AI crisis was successful.
Zoonotic Risk r. Risk communications $9.9 $1.6 $0.9 A risk communication and public education strategy focussed on AI prevention and preparedness, which engages stakeholders and provincial and territorial governments and informs and reassures Canadians, supports the federal government’s leadership role, credibility, and authority. It will help to reinforce public confidence in Canada's inspection systems, before, during, and after an AI situation. Produced a 2009 calendar with monthly tips on biosecurity and disease prevention for small flock owners.

In cooperation with the provinces, held information sessions in Ontario, British Columbia, Newfoundland and Prince Edward Island for small flock owners on how to protect the health of their birds.

Conducted public opinion research on AI biosecurity awareness among targeted groups.

Continued the travelers’ biosecurity outreach campaign using airport posters, web site and brochures in more than 20 languages.

Participated in the North American Plan for Avian and Pandemic Influenza communications working group as well as the inter-disciplinary table-top exercise.
Zoonotic Risk s. International collaboration $7.1 $1.4 $0.5 Contribution to the global effort to slow the progression of AI in support of Canada’s leadership role and international commitments designed to slow the progression of AI.

Continue to deploy people internationally to assist with AI preparedness and response activities (e.g., International Partnership On Avian and Pandemic Influenza (IPAPI)).
Deployed CFIA staff to the World Organization of Animal Health (OIE) Central Bureau and Buenos Aires Regional Office to support, develop, promote the use of science-based standards, risk assessment, capacity building, and training.

Supported capacity development and infrastructure in developing countries through the Canadian Chapter of Veterinarians without Borders and the Canadian Veterinary Reserve

Leveraged resources to international standard setting bodies through support of international vaccine banks and laboratory twinning for capacity building and training.
Total N/A $127.7 $85.8    

18. Comments on Variances: The Agency’s Actual spending is $19.8 million less than planned spending because $13.4 million was re-profiled to future years for vaccine readiness and clinical trials and antivirals and $1.4 million was transferred to CIHR for influenza research projects and $5.0 million was surplused.  Although significant progress was made during the year on staffing, PHAC was not able to staff all key public health officer positions for surveillance and the skilled national public health workforce.  In addition, there were delays in establishing agreements to fund influenza research and some costs to renovate the Ward Lab were deferred to future years due to the delayed acquisition of the Ward laboratory from the Province of Manitoba.

In 2008-09, CFIA received approval from the government of a $16.9M budget reduction as part of Strategic Review.  In addition, internal reallocations totalling $4.8M were made by CFIA to other priority programs. The Planned Spending and Total Allocation figures in the preceding table have not been adjusted for this reduction in funds.  Along with a $4.8M reallocation of funds to other program areas, this accounts for the variance between Total Planned Spending of $47.9M and Total Actual Spending of $26.2M in 2008-09.

19. Results to be achieved by non-federal partners (if applicable): N/A

20. Contact information:
Dr. John Spika
Director General,
130 Colonnade Road
Ottawa, Ontario K1A 0K9
(613) 954-1612

1. Name of Horizontal Initiative: Canadian HIV Vaccine Initiative (CHVI)

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

3. Lead Department Program Activity: Infectious Disease Prevention and Control

4. Start Date of the Horizontal Initiative: February 20, 2007

5. End Date of the Horizontal Initiative: March 2013

6. Total Federal Funding Allocation (start to end date): $111 million

7. Description of the Horizontal Initiative (including funding agreement): The CHVI, Canada’s contribution to the Global HIV Vaccine Enterprise, is a collaborative undertaking between the Government of Canada and the Bill & Melinda Gates Foundation to contribute to the global effort to develop a safe, effective, affordable and globally accessible HIV vaccine. This collaboration builds on the Government of Canada’s commitment to a comprehensive, long-term approach to address prevention technologies. Participating federal departments and agencies are the Canadian International Development Agency (CIDA), the Public Health Agency of Canada (Agency), Industry Canada (IC), the Canadian Institutes of Health Research (CIHR), and Health Canada (HC). The CHVI’s overall objectives are to: strengthen HIV vaccine discovery and social research capacity; strengthen clinical trial capacity and networks, particularly in low and middle income countries (LMICs); increase pilot scale manufacturing capacity for HIV vaccine clinical trial lots; strengthen policy and regulatory approaches for HIV vaccines and promote the community and social aspects of HIV vaccine research and delivery; and ensure horizontal collaboration within the CHVI and with domestic and international stakeholders.

8. Shared Outcome(s):

Immediate (Short-Term 1 - 3 years) Outcomes:

  • Increased and improved collaboration and networking
  • Enhanced knowledge base
  • Increased readiness and capacity in Canada and LMICs

Intermediate Outcomes:

  • Pilot scale HIV vaccine manufacturing facility for clinical trial lots is fully operational and globally accessible
  • Strengthened contribution to global efforts to accelerate the development of safe effective, affordable, and globally accessible HIV vaccines

Long -Term Outcomes:

  • The Canadian HIV Vaccine Initiative contributes to the global efforts to reduce the spread of HIV/AIDS particularly in LMICs

9. Governance Structure(s):

The Minister of Health, in consultation with the Minister of Industry and the Minister of International Cooperation, will be the lead for the CHVI for the purposes of overall coordination. Communications for the CHVI will be handled jointly.

In support of the Ministers, coordination for the Government of Canada is provided by an Interdepartmental Steering Committee consisting of representatives from the participating federal departments and agencies. The Interdepartmental Steering Committee is responsible for providing strategic directions and priorities, and reviewing progress.

Multi-stakeholder advisory committees and working groups, involving governments, the private sector, international stakeholders, people living with HIV/AIDS, researchers and Non-Governmental Organizations (NGOs) and other relevant stakeholders, have been, and will continue to be established to inform the CHVI. The role of participating departments and agencies involved in the CHVI are:

  • The Agency contributes its public health scientific, policy and program expertise and provides secretariat support for the CHVI.
  • Health Canada applies its wider range of expertise, including vaccine related policy, regulations and protocols; facilitates collaborative networks of specialists with a particular focus on the community and social dimensions of vaccine research, development and delivery; and enhances international collaborations.
  • CIHR provides scientific leadership and strategic guidance through its linkages to the Canadian research community, as well as brings critical expertise in peer review mechanisms and related professional support services to identify and fund eligible HIV vaccines projects.
  • Industry Canada applies its industry specific knowledge and experience to provide linkages to the Canadian and International vaccine industry, as well as assist with industry-related issues, including the appropriate engagement of potential private sector collaborators.
  • CIDA provides effective linkages to international development efforts and ensures consistency with Canada’s international commitments. Moreover, CIDA will provide strategic guidance to ensure that the goals of the CHVI promote the development and delivery of HIV vaccines that benefit the needs of the highly endemic HIV/AIDS countries in the developing world.

($ millions)
10. Federal Partners 11. Federal Partner Program Activity (PA) 12. Names of Programs for Federal Partners 13. Total Allocation (annual) 14. Planned Spending for
15. Actual Spending for
16. Expected Results for
17. Results Achieved in
1. Public Health Agency of Canada PA: Infectious Disease Prevention and Control Public Health Contributions Program $27.0 $2.2 $1.3 Completed open and transparent selection process for a Not for Profit Corporation (NPF) to build and operate a pilot scale clinical trial lot manufacturing facility.

1st joint (Canada-international partner-led) policy dialogue completed.

New HIV Vaccine Community Engagement Funding Program implemented (in partnership with Health Canada).

Evaluation framework design completed.
Four NPFs were successful in completing the Letter of intent process and were invited to submit full applications.  Once in place, the facility will increase global capacity to manufacture lots of HIV vaccines.

An international scan of current global policy issues was completed.  This scan will inform the development of a policy agenda for the CHVI.

Applications from community-based organizations were received and are being considered for funding. Once in place, these projects will promote community engagement in HIV vaccines development.

An evaluation firm was hired to conduct a mid-term evaluation of the CHVI.  The evaluation will assess progress on CHVI objectives and make recommendations to improve the design and delivery of the CHVI.
Health Canada PA 1.3: International Health Affairs Grants to eligible non-profit Canadian and international organizations in support of their projects or programs on health $1.0 $0.2 - New HIV Vaccine Community Engagement Funding Program implemented (in partnership with the Agency). Applications from community-based organizations were received and are being considered for funding.  Once in place, these projects will promote community engagement in HIV vaccines development.
2008/09 funding was re-profiled to 2012-2013
Industry Canada PA: Industry Sector – Science and Technology and Innovation N/A $13.0 $3.3 - Support provided to (Agency-led) open and transparent selection process for a NFP to build and operate a pilot scale clinical trial lot manufacturing facility. Four NPFs were successful in completing the Letter of intent process and were invited to submit full applications.  Once in place, the facility will increase global capacity to manufacture lots of HIV vaccines.
Canadian International Development Agency PA 1.4: Enhanced capacity and effectiveness of Multilateral institutions and Canadian/ International organizations in achieving development goals International Development Assistance Program $60.0 $8.9 $0.4 Support provided to (Agency-led) open and transparent selection process for a NFP to build and operate a pilot scale clinical trial lot manufacturing facility.

In collaboration with CIHR, establishment of a large team discovery and social research program to foster and support larger, collaborative teams of Canadian and LMICs researchers.

Establishment of a program to support teams of Canadian and LMICs researchers and research institutions to strengthen their capacity to conduct high-quality clinical trials of HIV vaccine and other related prevention technologies.

Activities supported to improve regulatory capacity in LMICs, especially those where clinical trials are planned or ongoing
Four NPFs were successful in completing the Letter of intent process and were invited to submit full applications.  Once in place, the facility will increase global capacity to manufacture lots of HIV vaccines.

Stakeholder consultations completed.  Development of call-for-proposal materials.

Grant signed with the International Development Research Centre to build sustainable African capacity and leadership to conduct future prevention trials, and advance the collaboration and networking of African, Canadian and international researchers in global HIV/AIDS prevention efforts.

Application received for a multi-year project designed to strengthen the regulatory capacity of LMICs.
Canadian Institutes of Health Research HIV/AIDS Research Initiative HIV/AIDS Research Initiative $10.0 $2.0 $0.7 Canadian researchers, working either independently or in small teams, supported through operating grant programs

In collaboration with CIDA, establishment of a large team discovery and social research program to foster and support larger, collaborative teams of Canadian and LMICs researchers.
Five catalyst grants and two operating grants were awarded. The Operating Grants are intended to support Canadian researchers to conduct research in HIV prevention, and build capacity in the field of HIV vaccine research. The Catalyst Grants are intended to support innovative HIV vaccine-related research activities.

For the large team grants, stakeholder consultations completed.  Call-for-proposal materials are in development.
Total $111.0 $16.5 $2.4    

18. Comments on Variances: The CHVI is a new initiative, and extensive consultations were conducted to ensure that the CHVI’s program areas are responsive to the initiative’s stakeholders and potential program recipients. As a result, this has delayed the implementation of some of the CHVI’s program areas.

19. Results to be achieved by non-federal partners (if applicable): Non-governmental stakeholders (including research institutions and NFP community organizations) are integral to the success of the CHVI. Their role is to engage and collaborate with participating departments and agencies, the Bill & Melinda Gates Foundation and other funders to contribute to CHVI objectives and to a significant Canadian contribution towards the Global HIV Vaccine Enterprise.

20. Contact information:
Steven Sternthal
200 Eglantine Driveway
Ottawa, Ontario K1A 0K9
(613) 952-5120