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Minister's Message

The Honourable Leona AglukkaqI am pleased to present the 2009-10 Performance Report for the Public Health Agency of Canada.

Over the past year, the Agency worked with PHAC's National Microbiology Laboratory who quickly responded by sequencing the full genome of virus samples from Canada and Mexico, thereby making a significant contribution to the global understanding of H1N1. The Agency's Global Public Health Intelligence Network (GPHIN) played a critical role in providing early-warning and ongoing reports regarding various public health threats including H1N1 to Canadians, international partners and link World Health Organization (WHO) officials. The WHO has acknowledged GPHIN's contribution to the early detection of the pandemic. These successes demonstrate Canada's commitment to world-class research and our commitment to promote and protect the health of Canadians.

Other actions of the Agency that touched all Canadians include the publication of the link H1N1 Preparedness Guide in print and online, and nation-wide advertising and education efforts about public health measures to prevent the spread of infection. Over 45 percent of Canadians were immunized in an unprecedented national immunization campaign. And, the public exceeded expectations in their response to advertising and education programs to manage and reduce the transmission of the H1N1 flu virus by coughing in their sleeves and washing their hands more thoroughly and frequently.

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Internationally, the Agency offered professional support and assistance to the relief effort in Haiti. Working with the United States Health and Human Services and the Pan American Health Organization, Agency employees conducted public health needs assessments in the early stages of the response. The experiences gained and partnerships formed by Agency employees and Canadian medical professionals with international disaster response organizations are invaluable contributions to building the Agency's capacity and will strengthen Canada's emergency response capability.

The Agency continues to work diligently to promote healthy lifestyles and prevent and mitigate diseases in Canada. For example, the link Community Action Program for Children reach out to vulnerable populations living in conditions of risk by providing funding to community-based groups and coalitions. These programs promote the health and social development of pregnant women, infants, children (0-6 years) and their families. The Agency also supports link CLASP (Collaboration Linking Science and Action for Prevention) projects that will accelerate chronic disease prevention in Canada, including a focus on northern and Aboriginal communities.

I would like to conclude by saying how proud I am of the Agency's and its partners' efforts. Year after year we are working toward building a healthier Canada.

 

The Honourable Leona Aglukkaq, P.C., M.P.
Minister of Health
Government of Canada



Message from the Chief Public Health Officer

David Butler-Jones, M.D.The ability of the Public Health Agency of Canada to work with provinces, territories, national and international partners to mitigate threats to public health has helped us become a respected leader in creating and fulfilling our vision for healthy Canadians and communities in a healthier world.

While the majority of preventable premature mortality is usually a result of everyday events such as chronic disease and injury, 2009 presented a unique challenge particularly to the health of young adults. The H1N1 influenza pandemic challenged the Agency's leadership ability, its emergency preparedness plans and its capacity to respond effectively and efficiently to public health threats. The Agency rose to the challenge by using a number of mechanisms such as link FluWatch, the Agency's national surveillance system that monitors the spread of influenza and influenza-like illnesses in Canada. We made great strides as a country to control the spread of H1N1, but we must remain vigilant. The Agency supports the federal role in public health as a national coordinating body working with partner agencies at all levels. When dealing with disease outbreaks, physicians, nurses and pharmacists are the primary and most trusted sources of information on immunization for the general public. The Agency worked collaboratively with the provinces and territories to assist health workers and others by developing effective online learning programs regarding safe immunization and by distributing consistent and accurate public health information.
The Agency worked in partnership with the Canadian Food Inspection Agency and Health Canada  to address the recommendations of link Lessons Learned: Public Health Agency of Canada's Response to the 2008 Listeriosis Outbreak. For example, the Foodborne Illness Outbreak Response Protocol was revised and shared with the provinces and territories in February 2010. The revised protocol includes clarified roles and responsibilities of food safety partners.

The Agency is also helping to build the skills and knowledge base of Canadians because good decisions are based on good knowledge. To that end, as one example, the Agency published link Tracking Heart Disease and Stroke in Canada, the most current and comprehensive picture of cardiovascular diseases in Canada.

Children are the focus in the link Chief Public Health Officer's Report on the State of Public Health in Canada 2009 Growing Up Well - Priorities for a Healthy Future. The challenges faced by many Aboriginal, disabled and low-income children call for attention. The report noted that the problem of inadequate income persists in Canada. Approximately 12 percent of Canadians still live below the poverty line, and the links between poverty and children's health are significant. Infant mortality rates are 61 percent higher in low-income areas and children who experience poverty are more likely to suffer health problems, developmental delays and behaviour disorders that will persist over their life course. The Agency continues its work to increase awareness and education about determinants of health such as promoting healthy lifestyles and increased physical activity.

In all of these areas, while there are many accomplishments to celebrate, there is still much work to be done. I look forward to the continued leadership of the Public Health Agency of Canada as we strive to meet these challenges.

 

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



Section I Overview

1.1 Summary Information

Raison d'tre

Public health involves the organized efforts of society to keep people healthy and to contribute to the prevention of injury, illness and premature death. It is a combination of programs, services and policies that protect and promote the health of all Canadians. In Canada, public health is a responsibility that is shared by the three levels of government, the private sector, non-government organizations, health professionals and the public.

In September 2004, the link Public Health Agency of Canada (the Agency or PHAC) was created within the federal Health Portfolio to deliver on the Government of Canada's commitment to help protect the health and safety of all Canadians, to increase its focus on public health, and to contribute to improving health and strengthening the health care system. Its activities focus on promoting health, preventing and controlling chronic and infectious diseases, preventing injuries, preparing for and responding to public health emergencies, and enhancing Canada's public health capacity.

Responsibilities

The Agency has the responsibility to:

  • contribute to the prevention of disease and injury, and the promotion of health;
  • enhance the quality and quantity of surveillance data and expand the knowledge of disease and injury in Canada;
  • provide federal leadership and accountability in managing public health emergencies;
  • serve as a central point for sharing Canada's expertise with the rest of the world and applying international research and development to Canada's public health programs; and
  • strengthen intergovernmental collaboration on public health and facilitate national approaches to public health policy and planning.

In December 2006, the link Public Health Agency of Canada Act came into force, giving the Agency the statutory basis to continue fulfilling these roles.

Strategic Outcome and Program Activity Architecture (PAA)

In order to pursue its mandate effectively, the Agency aims to achieve a single strategic outcome of healthier Canadians, reduced health disparities, and a stronger public health capacity supported by its Program Activity Architecture (PAA), depicted in the following figure. In fiscal year 2008-09, the Agency initiated the renewal of its existing PAA to address Management Accountability Framework (MAF) Round V assessment results and address conditions as part of the 2008 Strategic Review approval letter. The 2010-11 PAA and supporting Performance Measurement Framework (PMF) were subsequently approved by Treasury Board in spring-summer 2009.

Strategic Outcome and Program Activity Architecture

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1.2 Planning Summary


2009-10 Financial Resources ($ millions)
Planned Spending Total Authorities Actual Spending
653.5 1,202.5* 944.2**


2009-10 Human Resources (Full-Time Equivalents - FTEs)
Planned Actual Difference
2,434.9 2,558.1 (123.2)***

*Total Authorities were significantly greater than Planned Spending mainly due to new Authorities received to fund the response to the H1N1 pandemic. Other new Authorities that were received included funds for Modernizing Federal Laboratories and funding for collective bargaining.

**PHAC received funding for the H1N1 vaccine and other costs based on the best available information in the summer. However, by fall, the containment of the outbreak was effective which resulted in lower than anticipated costs. Funding Authorities for a new influenza vaccine fill line and the Canadian HIV Vaccine Initiative were moved to future years, which resulted in lower Actual Spending in 2009-10.

***The variance between Planned and Actual FTE Utilization is mainly due to H1N1 influenza pandemic response requirements. This large variance does not depict lower than expected staff additions in some program activity areas due to the continued difficulty in identifying and recruiting appropriately qualified public health professionals.

Performance Summary

PHAC Facts
HALE at Birth Top OECD Nations (years)
1. Japan
2. Switzerland
3. Australia
3. Iceland
3. Italy
3. Spain
3. Sweden
8. Canada
8. France
8. Germany
8. Ireland
8. Luxembourg
8. Netherlands
8. New Zealand
8. Norway
76
75
74
74
74
74
74
73
73
73
73
73
73
73
73

Source: World Health Organization link World Health Statistics 2010 (2007 data)

Health Adjusted Life Expectancy (HALE) is a composite measure that attempts to capture a more complete estimate of population health than standard Life Expectancy (LE). It combines age- and sex-specific measures of both health status (morbidity) and mortality into a single statistic. HALE is an estimate of the average number of years that an individual is expected to live in full health by taking into account years lived in less than full health because of illness and/or injury.1 In general, years lived in ill health are weighted according to severity of illness and injury and overall life expectancy is adjusted to take this into account. By moving beyond mortality data, HALE is meant to measure not just how long people live, but also the quality of their health throughout their lives.

PHAC contributes to increasing HALE in Canada through the Agency's Health Promotion and Chronic Disease Prevention and Control programs. These programs provide federal leadership and support in promoting health, reducing health disparities and the prevention and mitigation of chronic diseases in Canada in collaboration with federal, provincial and territorial (F/P/T) health partners.

Strategic Outcome: Healthier Canadians, reduced health disparities and a stronger public health capacity
Performance Indicators Targets 2009-10 Performance
Health-adjusted life expectancy (HALE) at birth Canada is among the nations with the highest healthy life expectancy at birth As of 2001, Statistics Canada reports overall HALE at birth in Canada at 69.6 years. Women have a HALE of 70.8 years and men have a HALE of 68.3 years at birth.2

Based on World Health Organization (WHO) methodology and using internationally comparable data, the WHO estimates Canada's overall HALE at 73 years in 2007.3 This puts Canada in a tie with seven other nations for 8th among the 31 OECD nations. The United Kingdom (UK) places in a tie for 16th with a HALE of 72 years and the U.S. 24th with a HALE of 70 years. All three nations have increased their absolute HALE from 2002 numbers4; however, their performance relative to other OECD nations is mixed. From 2002 to 2007 the UK rose 3 places from 19th to 16th, Canada maintained its rank of 8th, and the U.S. slipped from 22nd to 24th.
The difference, in years, in HALE at birth between the top-third and the bottom-third income groups in Canada. Determine baseline by March 31, 2011 Canadian men and women in the highest income group have a HALE of 70.5 and 72.3 years as of 2001, respectively. Comparison of HALE across income groups shows that, at birth, women in the highest income group have a HALE that is 3.2 years higher than women in the lowest group. Similarly, men in the highest group have a HALE that is 4.7 years higher than men in the lowest income group.5

($ millions)
Program Activity 2008-09
Actual
Spending
2009-10 Alignment to Government of Canada Outcomes
Main
Estimates
Planned
Spending
Total
Authorities
Actual
Spending
Health Promotion 200.8 194.5 194.5 184.5 180.9 link Healthy Canadians
Chronic Disease Prevention and Control 52.9 60.3 60.3 50.2 47.8 link Healthy Canadians
Infectious Disease Prevention and Control 256.1 261.3 261.3 747.2 529.3 link Healthy Canadians
Emergency Preparedness and Response 30.9 26.8 32.3 67.8 39.2 link Safe and Secure Canada
Strengthen Public Health Capacity 42.1 31.1 31.1 37.8 35.5 link Healthy Canadians
Internal Services* 74.0 74.0 114.9 111.5  
Total 582.9 648.0 653.5 1,202.5 944.2  

*Commencing in the 2009-10 Estimates cycle, the resources for the Internal Services program activity are displayed separately from other program activities: they are no longer distributed among the remaining program activities, as was the case in previous Main Estimates. This has affected the comparability of spending and Full Time Equivalent information by Program Activity between fiscal years.

Notes: Total excludes cost of services received without charge. Due to rounding, there may be insignificant variances.

H1N1 influenza emerged in April 2009 and accounted for most of the $549M increase in the Agency's Total Authorities. Funding received for the Operating Budget Carry-Forward from 2008-09, collective bargaining agreements, non-controllable salary costs (i.e., severance pay, parental benefits and vacation credits payable after termination of employment with the public service), and Modernizing Federal Laboratories (part of Canada's Economic Action Plan) were other factors accounting for the difference between Planned Spending and Total Authorities.

PHAC received funding for the H1N1 vaccine and other costs based on the best available information in the summer. However, by fall, the containment of the outbreak was effective which resulted in lower than anticipated costs. Funding Authorities for a new influenza vaccine fill line and the Canadian HIV Vaccine Initiative were moved to future years, which resulted in lower Actual Spending in 2009-10.

Contribution of Priorities to Strategic Outcome

Operational Priorities Status Links to Strategic Outcome(s)
Enhance surveillance
(New)
Somewhat met PHAC has made continued and significant progress in implementing the recommendations of the link May 2008 OAG Report on the Surveillance of Infectious Diseases. To date, eight of the 12 recommendations are either fully or substantially implemented. Plans and timelines are in place for the remaining four.

The Agency has: developed new data sources and continued data analysis for a comprehensive national chronic disease surveillance system; improved the Agency's internal response capacity; and developed and implemented an Incident Management Structure. The Agency is actively integrating Panorama6 into existing surveillance systems and has fully adopted the governance structure of the PHAC Surveillance Strategic Plan 2007-2012. Mechanisms and processes for managing surveillance issues and product development have been developed, approved, and implemented based on objectives and priorities defined in the Agency's Surveillance Strategy Framework 2007-2012.

The demand placed on Agency resources by the H1N1 influenza pandemic delayed progress on enhancing national child health surveillance for congenital anomalies, developmental disabilities and disorders, and product-related injuries as well as vaccine preventable disease surveillance.
Disease prevention and control
(Ongoing)
Mostly met The Agency takes many different approaches to disease prevention and control, from research and genetic sequencing to public awareness campaigns. For infectious disease, the Agency continues to develop novel genetic biomarkers that will lead to earlier detection, enhanced monitoring and more targeted action to improve public health through the identification of vulnerable subpopulations.

It continues to research and disseminate knowledge regarding sexually transmitted and blood-borne infections through a collaborative working group. And, Agency scientists have developed new methodologies to perform HIV drug-resistant testing, making these important tests more accessible and less expensive.

With respect to chronic diseases, the Agency has taken a multi-pronged approach to the prevention of major chronic diseases such as diabetes, cancer, cardiovascular diseases, and respiratory illness. It has developed and disseminated new risk assessment tools and a breast cancer screening decision aid, and has launched multi-year initiatives to increase awareness of prevention, early detection, and self-management of lung diseases via public information products.

All the Agency's activities involve building partnerships and mobilizing stakeholders from municipal to international levels. The link Noncommunicable Disease and Mental Health Cluster and the link International Cancer Screening Network.
Review of the federal approach to immunization, with a view of strengthening the National Immunization Strategy (NIS)
(New)
Somewhat met One of the planned activities for the Agency in 2009-10 was to review how best to improve the effectiveness and efficiency of the NIS. The policy research and analysis phase of this review was undertaken throughout 2009-10 and was aimed at identifying viable approaches to address immunization-related challenges. Some of these challenges relate to vaccine uptake, safety and supply, while others are of a more cross-cutting nature, such as program research and evaluation, surveillance, and governance. The NIS review is projected to be completed in fiscal year 2010-11.
Emergency preparedness for disease outbreaks including pandemic influenza
(Ongoing)
Mostly met The successful passing of the PHAC's ability to reduce the risk, and be better empowered to deal with incidents of disease arising from the improper laboratory handling of human pathogens by regulating pathogens and toxins whether imported or domestically acquired. An accountability and reporting structure has been established and a detailed five-year project plan is in place to develop a program and regulatory framework to fully implement the Act in consultation with stakeholders, provinces and territories.

By preparing for full compliance with and supporting the World Health Organization's work towards establishing international public health emergency standards by June 2012, PHAC advanced progress toward preventing and mitigating disease and injury during domestic and international public health emergencies. Further, the Agency's emergency preparedness activities advanced its strategic outcome through: screening and control of public health risks via quarantine activities at ports of entry into and out of Canada; 24/7 health emergency response and surge capacity; improved availability and access to a modernized emergency medical supply stockpile; and International Health Regulation (IHR) 2005-compliant Operations Centres affecting timely and coordinated response to public health emergencies.

The Agency and its domestic health partners have been active in strengthening domestic and global partnerships so Canada can continue to meet its IHR 2005 obligations. It has created a national network of IHR Champions which functions as a coordinating and monitoring mechanism for national implementation activities and implementation strategy development.
Transformation of Grants and Contributions
(New)
Somewhat met The Agency has implemented a number of initiatives to improve the manner in which Grants and Contributions (Gs&Cs) cause transformational change in public health such as: Risk Management and Recipient Audit policies and tools to strengthen the delivery of Gs&Cs; updated Standard Operating Procedures to comply with Gs&Cs awarded.

This Agency-wide approach to modernizing the delivery of Gs&Cs is setting the stage for improved alignment with PHAC's mandate and public health priorities.

Risk Analysis

The Public Health Agency of Canada is committed to achieving its Strategic Outcome and delivering on priorities in the context of new and emerging trends and challenges that may negatively impact the Agency's ability to fulfill its mandate. These challenges emerge from an environment characterized by: an unprecedented pace of change in population demographics; uncertainties in the global economy; a changing climate; science and technology; intergovernmental and non-governmental partnerships; and growing expectations from Canadians to be responsive to public health events and emergencies. Within the context of such a dynamic operating environment, PHAC continues to invest and evolve in order to ensure that it is able to effectively respond to shifting, emerging and immediate priorities, and deliver results to Canadians.

Demographic Change

PHAC's approach to mitigating the risks of demographic change in Canada is to develop specialized programming for each target population. While there is necessary overlap in the target populations, the Agency's activities can be generally classified as programs for children and families, the elderly, and rural and remote communities including Aboriginal populations. Emphasis is placed on preventative health care and increasing healthy living knowledge to mitigate health risks for children and rural and remote communities. For example, the Canadian Prenatal Nutrition Program and the Community Action Program for Children funded intervention programs for children and the community to promote health and social development such as the PHAC funded link Aboriginal Head Start in Urban and Northern Communities (AHSUNC) developed culturally appropriate recipe guides, parenting programs and academic and social skills National School Readiness Assessment Tool. Successfully piloted for AHSUNC participants in the Northwest Territories, the tool will be rolled-out nationwide in September 2010. To address specific health risks for the growing elderly population in Canada, the Agency is focussing on preventing falls, building elder-friendly communities, increasing awareness of elder abuse, and developing a greater understanding of the risk profile of elderly drivers.

Agriculture and Environmental Risks

The Agency is also incorporating agriculture and environmental determinants in research activities as it employs a holistic approach to mitigating risks associated with changing demographics and vulnerable populations. Analyzing human genome-based risks, the Agency developed approaches to prevent adverse health outcomes of infectious and chronic diseases. It is developing genome-based biomarker tools that will lead to earlier detection, enhanced monitoring and action through targeted community risk prevention activities. The Agency's preventative risk approach includes providing the public health lens to a link United Nations Action Team 6 that focuses on the application of space technologies in the early warning of infectious diseases.

The effects of climate change and its impact on public health continue to be addressed through research on enhanced surveillance systems and decision tools specific to climate-related diseases, such as the National West Nile Virus Surveillance System.

Chronic Disease Prevalence

The Agency is actively building knowledge and sharing best practices in chronic disease prevention and control. PHAC scientists were at the forefront of an expert panel that definitively linked active and second-hand smoke to breast cancer in women. Of note, the Agency produced the first nation-wide link report on heart disease in Canada since 2004. Information gathered from surveillance activities demonstratesin every age groupthat more than one in two Canadians consume more than the recommended tolerable intake of sodium.7 The Agency is also developing risk assessment screening tools for cancer and diabetes, and enhancing knowledge on the emerging public health implications of widespread obesity.

Utilizing Science and Technology

Innovations in science and technology amplify the availability of public health information and health options from a multitude of sources. This helps mitigate the risk of under-informed policy response and preventative care approaches to infectious disease. The Agency's GPHIN) was one of the first surveillance networks to detect and disseminate details on the H1N1 outbreak. GPHIN provided PHAC and its international partners with accurate and timely information in order to help mitigate the impact of the pandemic. The Agency's link National Microbiology Laboratory (NML)the World Health Organization's (WHO) National Influenza Center for epidemiology and control of influenza in Canadahas been in the forefront of this research effort. It was one of the first laboratories to complete and share the genetic sequencing of both the Mexican and Canadian strains of the virus. The NML performed vaccine efficacy studies in collaboration with F/P/T laboratories and utilized genotyping, genomic fingerprinting and bioinformatics procedures for characterizing H1N1 and its evolution.

Pandemic Planning and Infectious Diseases

The Agency is also pursuing reduced risk of serious illness and death from pandemic influenza. As part of the F/P/T response to the H1N1 outbreak a platform for real-time surveillance and monitoring of pandemic influenza associated pneumonia was developed. To reduce the risk of serious illness and death from acquiring long-term infectious disease, the Agency is advancing HIV knowledge and prevention through augmented HIV and risk behaviour surveillance programs.

Privacy Concerns

To reduce the risk that individuals' right to privacy could be eliminated through advancements in science, technology and surveillance activities, the Agency has developed a Privacy Management Framework. Initial steps towards full implementation of the framework include a Web-based tool for assessing the privacy impact of surveillance activity and the integration of the Policy on the Collection, Use and Dissemination of Public Health Data.

Partnerships

The horizontal cross-cutting nature of public health creates the risk of gaps in public health policy and programming, and of overlaps stemming from poor communication or lack of communication among stakeholders. To mitigate this ever-present risk, the Agency participates in and leads multi-stakeholder fora domestically and internationally. Domestically, the Health Portfolio Operations Centre (HPOC) manages the joint response of Health Canada and the Agency to major public health events. With the capacity to operate 24/7, HPOC produces and distributes a number of communication and operational products, day to day and during periods of activation, that serve to provide situational awareness to stakeholders. At the operational level, the Agency has initiated discussions with regulatory bodies on inter-jurisdictional licensing of health professionals to mitigate the risk of insufficient public health capacity at a time of crisis.

Agreements at the operational level supplement the Agency's establishment of the Central Repository of Emergency Response Agreements as identified in link Government of Canada - Progress on Food Safety. This report provides details of the progress made by Health Canada, PHAC and the Canadian Food Inspection Agency (CFIA) on reducing food safety risks, enhancing surveillance and early detection, and improving emergency response. It includes the development of a risk communications strategy involving social networking media and audio-video webcasts, a collaborative link Foodborne Illness Outbreak Response Protocol, and an incident command structure for improved coordination and capacity.

Social Media

PHAC mitigated the risk of inadequate communication with the general public by actively participating in the newest media fora. PHAC utilized communications technology and multiple media fora to provide timely and accurate information to Canadians, and support and inform decision-making. For example, the PHAC's link Facebook page and link Twitter activity. As of April 1, 2009, PHAC had 125 fans on Facebook; on March 31, 2010, PHAC had 2,323 fans, predominantly females aged 25-44. And by March 31, 2010, the Agency's Twitter followers totaled 2,186. To highlight the vast reach of this community, PHAC's presence on Facebook produced 50,000 referrals to the Web site during H1N1.

Global Economics and Security

Recent economic instability in world financial markets created both opportunities and threats to Canadian public health. Low travel prices and economic disparity overseas created the conditions for increased immigration and travel to and from Canada. These conditions reinforced and confirmed PHAC's past decision to provide a link 24/7 quarantine service to contribute to protecting Canadians from ill international travelers.

To mitigate and ultimately eliminate the risks of security breaches such as that which occurred at the National Microbiology Laboratory in 2009, the Agency has updated its security screening process to meet the requirements of the Treasury Board Secretariat (TBS) Policy on Government Security (PGS) (July 1, 2009). Wait times for security clearances have been reduced considerably. However, several areas require attention, or would benefit from enhancements in order to ensure full compliance with the PGS and associated TBS Standards.

As a result of the federal government's decision to purchase vaccines and antivirals in bulk to enhance preparedness to respond to avian influenza and pandemic influenza, the Agency acquired additional physical space to house the National Emergency Stockpile System's (NESS) valuable and sensitive assets. To enhance availability of these assets to Canadians in times of need, the NESS warehouses and distribution depots are secured in accordance with the TBS Operational Security Standard on Physical Security, RCMP guidelines, and additional measures identified through site security design and Threat Risk Assessments.

Expenditure Profile

In 2007-08, the Agency's spending was slightly higher than in 2008-09 due to the purchase of antivirals and personal protective equipment to augment national stockpiles for the link Preparedness for Avian and Pandemic Influenza Initiative. In 2008-09, funding for Vaccine Readiness Fees and National Antiviral Strategy was re-profiled for future years to align with the anticipated expenditure.

In 2009-10, Canada experienced an H1N1 outbreak in the spring and fall which accounted for most of the additional $361.3M spending. This additional spending was for the purchase of vaccines and pandemic response activities. The Agency also spent $49.7M on the Hepatitis C Health Care Services Program which provides funding to the provinces and territories to compensate for the care of individuals infected with hepatitis C through the blood system. As well, the Agency received funding to: assist with the installation of a domestic vaccine fill line; establish a stronger safety and security regime to protect the health and safety of the public against the risks posed by human pathogens and toxins; and address the recommendations made in the link Report of the Independent Investigator into the 2008 Listeriosis Outbreak.

Departmental Spending Trend

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Canada's Economic Action Plan

In April 2009, an expansion of the Canadian Science Centre for Human and Animal Health (CSCHAH)which serves PHAC's National Microbiology Laboratory and the Canadian Food Inspection Agency's National Centre for Foreign Animal Diseasewas approved as part of Canada's Economic Action Plan (CEAP). This was in response to a lack of physical space at CSCHAH and is consistent with Budget 2009 priorities, specifically Modernizing Federal Laboratories. The CSCHAH renovations will provide additional space to support waste management, specimen receiving, culture media preparation, stores, shipping/receiving, and real property safety and security activities within the CSCHAH. Authorities for the project were $3.5M in 2009-10 with actual spending of $2.9M. For a more complete discussion of CEAP spending, see Section 2.2.

Canada's Economic Action Plan Spending

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Voted and Statutory Items
($ millions)
Vote # or Statutory Item (S) Truncated Vote or Statutory Wording 2007-08
Actual
Spending
2008-09
Actual
Spending
2009-10
Main
Estimates
2009-10
Actual
Spending
40* Operating expenditures 393.3 371.3 352.7 652.8
45* Capital expenditures 9.6 14.3
50* Grants and Contributions 188.7 184.2 255.4 242.9
(S) Contributions to employee benefit plans 24.9 27.3 30.3 34.2
Total 606.9 582.9 648.0 944.2

*Effective in 2009-10, the Agency had a new Vote for Capital expenditures. In 2007-08, Votes 40 and 50 were numbered Votes 35 and 40. In 2008-09, Votes 40 and 50 were numbered Votes 40 and 45.

Actual spending in operating expenditures was higher in 2009-10 than in 2008-09 mainly due to H1N1-related expenditures as well as funding to address Human Pathogens and Listeriosis.

Actual spending in Grants and Contributions was greater in 2009-10 by $58.7M mainly due to $49.7M that was paid to the provinces/territories under the Hepatitis C Health Care Services Program which occurs once every five years until 2014-15. Additionally, a greater level of funding to recipients was achieved in 2009-10 than in 2008-09 because of improved processes.