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ARCHIVED - RPP 2006-2007
Health Canada
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Section 2: Analysis of Program Activities by Strategic Outcome
Strengthened Knowledge Base to Address Health and Health Care Priorities
| This program activity contributes to the Government of Canada Strategic Outcome: Healthy Canadians with Access to Quality Health Care. | ||||
| Planned Spending and Full-Time Equivalents (FTEs) | ||||
|---|---|---|---|---|
| ($ millions) | Forecast Spending 2005-2006 | Planned Spending 2006-2007 | Planned Spending 2007-2008 | Planned Spending 2008-2009 |
| Net expenditures | 375.1 | 288.4 | 218.2 | 215.0 |
| FTEs | 717 | 627 | 604 | 588 |
|
Notes: The decrease in expenditures from 2005-2006 to 2006-2007 is mainly due to a decrease in the level of funding of the Primary Health Care Transition Fund, the sunset of the Northern Health Supplement to the 2003 Health Accord, and the Expenditure Review Committee (ERC) reduction. The decrease in expenditures from 2006-2007 to 2007-2008 is mainly due to the sunset of the Primary Health Care Transition Fund. The decrease in expenditures from 2007-2008 to 2008-2009 is mainly due to a decrease in funding for the Implementation of Health Canada's Therapeutic Access Strategy. Figures include an amount for other departmental and regional infrastructure costs supporting program delivery. |
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Program Activity Description
The objective of this program activity is to provide policy advice and support to the Minister in making decisions to protect and improve the health of Canadians. Health Canada supports the delivery of programs and services to Canadians by developing policies and building and maintaining linkages with other partners to support health care system reform. We also work with international organizations to advance a global health agenda and contribute Canadian expertise. This helps to ensure the health, safety and security of Canadians in a healthier world. We provide a leadership role in strategic planning for the Department. We administer the Canada Health Act, and work with provinces and territories on health care renewal and support. We work with others to provide access to health care services for official language minority communities, and the interface between different sectors of the health care system.
To ensure that all Canadians have access to health services when and where they need them, that the quality of those services is continually improved, and that the system can provide the necessary care today and has the capacity to identify and adapt to the emerging needs and challenges of tomorrow, we are focussing renewal efforts, amongst other things, on the health human resources.
Another type of renewal effort is in the legislative and regulatory arenas. Legislation and Regulatory Renewal is an opportunity to deliver a much anticipated, significant and modernized legislative framework for the Health Portfolio. Much of the health protection legislation that forms Health Canada's regulatory base is out of date and not in line with modern technological advancements or public expectations, leading to gaps in what is covered, inconsistencies in addressing health risks and inadequate enforcement/compliance powers.
We provide policy advice and lead initiatives to advance women's health and to increase understanding of how gender interacts with the other determinants of health to affect health outcomes of women, men, boys and girls over their lifespan.
We undertake research and analysis to improve the availability, quality and use of evidence in health policy decision-making. We reach our goal by identifying future policy research needs, conducting extramural peer-reviewed policy research to meet these needs, communicating the results within Health Canada and externally, and by providing the expertise and tools needed for a sound and rigorous analysis of health policy options.
Our priorities
In addition to tracking emerging issues on an ongoing basis, we continue to actively participate in and collect invaluable information from various scanning activities to help identify future risks to Canadians and challenges to Health Canada. It is important to note that numerous external factors can influence our ability to focus exclusively on our priorities (e.g., the increased attention to global preparedness and response to a possible pandemic influenza outbreak or coordinating relief efforts for natural disasters). We intend to focus on the following priorities in 2006-2007:
Partner in health reform
In the 2004 Health Accord, federal, provincial and territorial governments committed to health system reforms that will improve
timely access to quality care. To support the Accord, the federal government is flowing $41 billion to provinces and territories
over ten years, including $5.5 billion to augment provincial/territorial existing investments and efforts in wait times reduction.
In December 2005, provincial and territorial governments announced a first set of ten common evidence-based benchmarks in the
areas such as cancer screening and care, cardiac surgery, hip and knee replacements and cataracts. Health Canada will work with
the provinces and territories on the development of a Patient Wait Times Guarantee. Care guarantees have been suggested by many
experts as one of the measures to reduce wait times.
We have made progress on all initiatives in the Accord and all governments are moving forward with their health system reforms.Work is also continuing to implement 2004 Health Accord initiatives in the following areas:
- implementing the Internationally Educated Health Care Professionals (IEHP) Initiative, which will provide additional funds to accelerate and expand the assessment and integration of IEHPs for participating governments;
- monitoring the commitment to provide first-dollar coverage by 2006 for certain home care services, based on assessed need, including: two week provision of case management and intravenous medications related to discharge diagnosis, nursing and personal care for short-term acute home care; two-week provision of case management and crisis response services for short-term acute community mental health home care; and case management, nursing, palliative-specific pharmaceuticals and personal services for end-of-life care;
- working to ensure that the populations served by federal departments (specifically First Nations, Inuit and veterans) will have access to the home care services specified in the Accord;
- continuing to support the Best Practices Network for primary health care, which is facilitating information sharing and addressing common barriers to progress; and
- working with the Health Council whose mandate is to monitor and make annual public reports on the implementation of the 2003 First Ministers' Accord on Health Care Renewal and to report on progress of the elements set out in the 2004 Health Accord.
In 2006-2007, we will continue to collaborate with our provincial and territorial counterparts as we implement commitments to health care system reform. 1
The Primary Health Care Transition Fund (PHCTF) ($800 million over six years) is providing funding to the provinces and territories to support their efforts in reforming their primary health care systems. One of the objectives of the primary health care reform is to strengthen health promotion and prevention activities (both primary and secondary) within the sector so it can help Canadians make healthy lifestyles choices and thereby reduce the incidence of conditions such as diabetes and cancer. With PHCTF-funded initiatives concluding in 2006-2007, dissemination activities are planned to promote the uptake of knowledge and results. In turn, these knowledge transfer activities will support ongoing reform activities.
In concert with other departments involved in the Action Plan on Official Languages, we will work towards implementing administrative practices and policies to ensure that the enhanced accountability provisions of the Official Languages Act, which were introduced in November 2005, will be reflected in the provision of health services to official language minority communities across Canada.
Hepatitis C
The Government of Canada is committed to helping all those infected with hepatitis C. On July 25, 2006, the Prime Minister
announced that the government reached an agreement on the elements of a settlement for those Canadians who contracted hepatitis C
from the blood system before January 1, 1986 and after July 1, 1990.
Under the terms of the agreement, the Government of Canada will set aside nearly $1 billion in a special settlement fund. The level of compensation will be based on the principle of parity with compensation already provided by the federal government for those who were infected between 1986 and 1990.
Benefits will be paid on a present-value basis, meaning that class members will receive the entire sum of their compensation up front, based on such factors as current disease level and probability of disease progression. This will also serve to minimize administrative costs.
The Government of Canada will be working as quickly as possible to complete the steps needed before compensation is provided to the class. A final detailed agreement needs to be completed, and must be approved by Courts in four jurisdictions. Furthermore, an administrative structure must be set up to evaluate applications and forward payments. The federal government cannot control the timing of every remaining step, however, all efforts will be made to ensure that this proceeds as quickly and as effectively as possible.
Pandemic Influenza
Health security is a critical component of Canada's objectives for health policy, foreign policy and national security. The most
pressing challenge for health security at the current time is the threat of an influenza pandemic. As such, it is critical that
the Government of Canada is prepared for an influenza pandemic, and that work is undertaken with partners in the public and
private sectors domestically and internationally to strengthen preparedness throughout Canada.
The potential severity and impacts have resulted in unprecedented co-operation and collaboration on a global health issue. We will continue to play an active role in preventing and preparing for avian and human pandemic influenza. This involves close collaboration with the Public Health Agency of Canada, which is the public health lead for pandemic influenza preparedness in the Government of Canada. We will strengthen preparedness in the Department's key areas of responsibility, such as First Nations and Inuit health, the regulation of vaccines, and occupational health services for federal employees. We will also complete a business continuity plan in the event of an influenza pandemic to ensure that support is provided for employees and that critical services can continue to be delivered in the event of large-scale worker absenteeism.
We will also focus on international collaboration for avian and human pandemic influenza preparedness and response, which is a critical element of Canada's domestic preparedness. Governments across the world have declared avian influenza to be a "global threat", and have recognized that international collaboration is necessary in order to control the H5N1 avian influenza outbreak, and to prepare for an influenza pandemic. Intensive efforts are underway through multilateral organizations (e.g., World Health Organization, Food and Agricultural Organization, World Organization for Animal Health) and through regional organizations (e.g., Asia Pacific Economic Cooperation, the Security and Prosperity Partnership in North America) and other fora such as G8 to collaborate in preparedness efforts.
Mental Health
Mental health and well-being are fundamental to Canadian's quality of life, as well as our social and economic development. At the
same time, mental illnesses such as depression, anxiety disorders, schizophrenia and bi-polar disorders represent a significant
public health challenge, impacting as many as 1 in 5 Canadians and resulting in significant costs to the health care system,
society and the economy.
In May 2006, the Standing Senate Committee on Social Affairs, Science and Technology released a report on mental health, mental illness and addiction in Canada. Entitled Out of the Shadows at Last, the report underscored the breadth of the challenge associated with mental health, mental illness and addiction, as well as the need for governments to work together in addressing this important issue. Canada is currently the only G7 country without a national strategy or action plan on mental health. The federal government will work with its partners to build the foundation for a national approach to mental health and mental illness in Canada.
Health Canada will also continue to support the development of sound mental health policies and programs within the federal government, and among the provinces and territories. This includes ongoing improvements to the mental health programs, services and support to First Nations and Inuit, as well as broader efforts to improve the mental health and well-being of all Canadians, in areas such as research, information and knowledge exchange, and best practices.
Pharmaceuticals Management Strategy
Drug therapy is an increasingly important component of modern health care. Appropriately prescribed and used, pharmaceuticals can
improve health outcomes for individuals and reduce costs in other health care sectors, e.g., hospitals. The development of new
drugs has the potential for even greater benefits in the future. Despite their benefits, prescription drugs pose a number of
challenges related to equitable and affordable drug access, drug safety and effectiveness, optimal drug therapy, and health care
system sustainability. 2
Health Canada has a number of roles with respect to pharmaceuticals at different points in the drug life cycle, including at the research and development, market approval, prescribing, access, utilization and reimbursement stages. In support of improved health outcomes for Canadians and system sustainability, we will work to optimize these roles using available policy, regulatory and program instruments to better integrate pharmaceuticals into a seamless, robust health care system. We will seek to capitalize on opportunities in areas such as post-market drug safety and effectiveness, appropriate drug prescribing and use, and the drug pricing and research role of the Patented Medicine Prices Review Board.
We will also continue to work with the provinces and territories on pharmaceutical activities initiated as part of the 2004 Health Accord under the National Pharmaceuticals Strategy -- an integrated, collaborative, multi-pronged approach to addressing pharmaceutical challenges that builds on governments' shared roles in the pharmaceuticals sector and previous collaborative pharmaceutical initiatives. These activities will be linked, where appropriate, to federal initiatives to modernize the regulatory system for therapeutic products and to integrated pharmaceuticals management among federal jurisdiction drug plans.
Legislative Renewal and Regulatory Reform
Under the Health Protection Legislative Renewal exercise, which responds to shortcomings in Health Canada's legislative basis for
health protection, Health Canada, with the Public Health Agency of Canada, continues to review its health protection legislation.
The review is intended to modernize and reinforce key existing legislation, namely the Food and Drugs Act (1953), the Hazardous
Products Act (1969) and the Radiation Emitting Devices Act (1969) through the development of enhanced health
protection legislation. The resulting legislative framework will serve to modernize and strengthen the existing federal laws
dealing with health protection and provide clear policy direction. As part of this exercise, the Department is also engaged in
reviewing the proposed legislation to determine whether to proceed with a single piece of legislation or to continue with a phased
approach as started by the expediting of the new Quarantine Act (2005).
Under the auspices of the Government of Canada's Smart Regulation initiative, Health Canada has been actively contributing to the development of a series of policies, frameworks and tools aimed at modernizing the Canadian regulatory system so that it can better respond to the challenges it currently faces (e.g., rapid scientific developments, globalization, or cross-boundary health risks, etc.) The goal of the initiative is to build a robust and flexible regulatory system that not only maximizes health, safety and environmental protection but also promotes an innovative economy.
This year, we will continue to coordinate the Department's input into a proposed Government Directive on Regulating (GDR), which is intended to build on the existing Federal Regulatory Policy by promoting increased regulatory transparency, the alignment of legislative and regulatory planning, and strategic coordination and collaboration with provincial, territorial and international partners. 3
Establishment of the new Assisted Human Reproduction Agency of Canada and new regulations
We will continue to work toward the implementation of the Assisted Human Reproduction Act, including support to the Assisted Human
Reproduction Agency's successful establishment in Vancouver, B.C. in 2006-2007. The Agency will license and inspect activities
controlled under the Act. The recruitment process leading to Governor in Council appointments to the Agency's new board of
directors will be completed.
We are proceeding concurrently with the development of the components of the regulatory framework, which are required before the Agency can implement the licensing and regulatory regime for activities controlled under the Act. The fact that very little currently exists in terms of established guidelines, standards or regulations necessitates careful and comprehensive consultations, to ensure that regulatory objectives are met while at the same time minimizing the regulatory burden on Canadians. Regulations are expected to be promulgated in 2006-2007 to bring the last outstanding prohibition into effect and work will continue to develop the remaining components of the regulatory framework to implement the Act.
Health Human Resources
The health care sector is labour intensive. Between 60 and 80 cents of every health care dollar in Canada is spent on health human
resources (HHR), and this does not include the costs of education. Currently, there are reported shortages for physicians, nurses
and other health care providers. HHR is one of the four cornerstones to support real health system change. Therefore, building
capacity in the system and providing adequate supply, distribution, and appropriate use of HHR is critical to reducing wait times
and improving timely access to health care.
Building on health human resource activities that support the 2003 Accord and the 2004 Ten-Year Plan, we will continue with the implementation of the Health Human Resource Strategy through three broad initiatives (Pan-Canadian Health Human Resource Planning; Interprofessional Education for Collaborative Patient-Centred Practice; and Recruitment and Retention) and the Internationally Educated Health Care Professionals (IEHP) Initiative, which will provide additional funds to increase health care professional supply through the acceleration and expansion of the assessment and integration of IEHPs for participating governments.
Role of science
It is through scientific discoveries and innovations that the greatest potential benefits for the health of Canadians lie. Science also provides a foundation of evidence for policies and programs to improve the health of Canadians. In addition to work in many health sciences policy areas, we will focus on the following areas in 2006-2007:
- The dramatic increase in the development and use of genetic technologies in the health system has clear implications for the sustainability of Canada's health care system in terms of potential new ways to prevent, diagnose, treat and cure thousands of conditions. The development of new genomic-based drugs (pharmacogenomics) and diagnostics will also affect health care delivery. We will undertake policy research and analysis to support federal discussions and action in both domestic and international fora on issues such as pharmacogenomics, patent pooling in medical genetics, intellectual property issues related to stem cell research, and the development and uptake of OECD guidelines on quality assurance in genetic testing. We will also explore approaches to stimulate innovation and undertake analysis of various incentive mechanisms to spur research and development to address health needs, including vaccine development.
We continue to be committed to working with our partners on early issue identification and the monitoring of emerging technologies that impact the health of individuals, vulnerable populations and the overall health system. We will support the development of evidence-based recommendations and strategies through continued collaborative work to support excellence in the ethical conduct of human research in areas such as: research ethics education, quality improvement, the examination of models of accreditation and the development of process standards for research ethics boards; policy development on good research practices related to biobanking of human biological material samples; and the identification of potential societal impacts of nanotechnology. 4
Human resources risks and challenges
The human resources challenges are very similar to those faced in other areas of the Department and even across the federal government including staff turnover, retention and the recruitment of skilled and knowledgeable policy analysts. Given the extent of our involvement in policy work and the importance of a viable policy capacity, these issues must be addressed to ensure we maintain an adequate capacity to address future policy issues. Though we are heavily involved in recruitment programs (e.g., Economist and Sociologist Development Program), we continue to face challenges in recruiting and retaining policy analysts, given the competitive labour market in this area.
Horizontal linkages
We continue to manage and collaborate on horizontal files for the Department and build linkages within and outside of Health Canada. For example, we manage and coordinate the Federal Inter-departmental Task Force on Mental Health.We also work across the Health Portfolio to ensure that public health is integrated within our advice and support to the Minister.
Continuing on the horizontal policy research themes (Health Innovation, Research on Regulation, Healthy Communities and First Nations and Inuit Health Sustainability) that resulted from the policy research priority setting exercise completed in 2004-2005, cross Portfolio steering committees pertaining to each of the four priority themes were established under Memoranda of Understanding (MOUs) among our branches and the Public Health Agency of Canada. These MOUs will guide our research efforts over the next two to four years.
Since February 2004, the federal Interdepartmental Working Group on Trafficking in Persons, including organs and tissues (IWG TIP), with 14 federal departments and co-chaired by the Departments of Foreign Affairs and Justice, was mandated to coordinate federal efforts to address TIP and develop a federal strategy.We are the lead for the Health Portfolio and we continue to coordinate the Portfolio's input while promoting a holistic approach to the inclusion of health, gender and diversity considerations.
Performance Measurement Strategy
We continue to enhance our performance measurement to provide information on our activities. To streamline the numerous reporting mechanisms, we adopted a new strategy, linking our activities directly to outcomes over the immediate (one to three years), intermediate (three to five years) and long term for outcomes five years and beyond. This approach will support all of our public reporting requirements including the Program Activity Architecture and the Departmental Performance Report. During this reporting cycle, we will work towards collecting performance information to report on the period over the next three years.
The intermediate outcomes planned for the policy planning and research program activity identified below will be addressed in various areas. As a result, a wide spectrum of activities across the Portfolio will be directed towards the same goal.
| Expected Results | Performance Indicators |
|---|---|
| Goals and objectives identified for specific strategies and initiatives |
|
| Knowledge development and transfer of specific health policy issues |
|
Key Programs and Services
Health Care System Policy
In September 2000, First Ministers agreed to continue to make primary health care reform a priority and indicated that improvements to primary health care are crucial to the renewal of health services. In response to this commitment, the Government of Canada announced the Primary Health Care Transition Fund (PHCTF), an $800 million investment from 2000-2001 to 2006-2007. The Fund is supporting provinces, territories and various health care system stakeholders, via contribution agreements, in their efforts to reform the primary health care system. More specifically, it will support the transitional costs of implementing sustainable, large-scale primary health care renewal initiatives which will improve access, quality of care, accountability, and integration of services. Although the PHCTF itself is time-limited, the main goal of the Fund is to bring about permanent and sustainable changes to the organization, funding and delivery of primary health care services. The fund is supported by a federal, provincial and territorial advisory group and Health Canada plays an active facilitation role to foster dialogue and knowledge sharing between and among recipients (government and non-government). With PHCTF-funded initiatives concluding in 2006-2007, all recipients will be submitting final reports including their evaluation reports, and dissemination activities are planned to promote the uptake of knowledge and results. In 2004-2005 a mid-term evaluation of the PHCTF was conducted to assess program structure and effectiveness. The final, or summative evaluation, will be conducted in 2006-2007 and will focus on the results and impact of the PHCTF; it will be available in early 2007-2008.
Health Canada is also supporting knowledge transfer and the uptake of successful strategies the Best Practices Network (FMM 2004). The Primary Health Care Transition Fund will ensure the results and lessons learned of the program are shared for continued progress in primary health care renewal. Planned activities include:
- a series of synthesis papers highlighting the evidence in areas such as chronic disease management, information management, collaborative care (i.e. teams) and evaluation methodology;
- a series of fact sheets on the results and evidence of each initiative;
- a national conference in February 2007; and
- a database, accessible via Health Canada website, to be an ongoing resource for provinces/territories, stakeholders and the public.
Several provincial and territorial governments have publicly committed to continuing the primary health care reforms begun under the PHCTF.
Recognizing the evidence gap for quantitative data on primary health care in Canada, the PHCTF funded the Canadian Institute of Health Information to develop a set of consensus-based national indicators. A legacy of the PHCTF will be the improved capacity for evaluating primary health care. As well, the Health Council of Canada's monitors and reports publicly on primary health care progress.
Note: With the exception of Quebec, all provinces and territories (and in fact all recipients) are required to submit regular reports to Health Canada including narrative progress reports, financial reports, final reports on results and final evaluation reports. These requirements are consistent with the Treasury Board Transfer Payment Policy and related accountability requirements associated with contribution agreements.
| Expected Results | Performance Indicators |
|---|---|
| Knowledge development and transfer of specific health policy issues |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 66.1 | 20 | 0.1 | 0 | 0.1 | 0 |
| *All financial figures in millions of dollars | |||||
Intergovernmental
Health Canada is responsible for the administration of the Canada Health Act (CHA), which involves monitoring a broad range of sources to assess provincial and territorial compliance with the criteria and conditions of the Act, working in partnership with provinces and territories to investigate and resolve CHA compliance issues, pursuing activities to encourage provincial and territorial compliance with the CHA, providing policy advice and informing the Minister of possible non-compliance with the Act, and recommending appropriate action.
The Department also provides strategic advice and coordination on a full range of Health Portfolio policy issues involving collaboration with provincial and territorial partners, while ensuring that federal priorities are advanced.
Under the Official Languages Act and the Action Plan for Official Languages, we manage health contribution programs to support the vitality of official language minority communities across Canada and ensure ongoing consultations with these communities.
| Expected Results | Performance Indicators |
|---|---|
| Knowledge development and transfer of specific health policy issues |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 44.0 | 64 | 29.8 | 64 | 29.8 | 64 |
| *All financial figures in millions of dollars | |||||
International
Public health risks and threats originating beyond Canada's borders increasingly influence the health of Canadians. International collaboration on global health policies and developments is of growing importance to the sustainability and responsiveness of Canada's health system. Health Canada positions itself internationally to: anticipate and respond to international health developments and their impact on Canadians and the health system; influence international health events and fora to improve health globally; provide leadership on selected health issues such as pandemic preparedness, HIV/AIDS and tobacco; and work with the multiplicity of players on the global health scene to advance health and health security.
In order to shape and strengthen the international agenda on health and health care issues, consistent with Canada's priorities and values, we will continue to work in close cooperation with multilateral agencies such as the World Health Organization (WHO) and the Pan American Health Organization (PAHO).
| Expected Results | Performance Indicators |
|---|---|
| Knowledge development and transfer of specific health policy issues |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 21.8 | 26 | 21.6 | 26 | 22.0 | 26 |
| *All financial figures in millions of dollars | |||||
Assisted Human Reproduction Implementation Office
Description: Set-up of Assisted Human Reproduction Agency of Canada
| Expected Results | Performance Indicators |
|---|---|
|
The Assisted Human Reproduction (AHR) Agency begins operations in 2006-2007. Regulatory development - Consultations to continue on all remaining sections of the AHR Act in 2006-2007 to be followed by drafting of regulations in preparation for prepublication in Canada Gazette Part I. Progress towards the development of the Personal Health Information Registry. |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 4.9 | 29.8 | 3.3 | 22 | 1.6 | 8 |
| *All financial figures in millions of dollars | |||||
Legislation Renewal
Health Canada will continue the development of a proposal to replace the Food and Drugs Act(1953), parts of the Hazardous Products Act (1969/safety of consumer and industrial products) and the Radiation Emitting Devices Act (1970), with a new Health Protection Legislative framework. The objective of the new framework is to update, strengthen, and integrate federal health protection legislation to be more responsive to present and future social and technological realities and provide the tools needed to better protect the health and safety of Canadians.
| Expected Results | Performance Indicators |
|---|---|
|
Goals and objectives identified for specific strategies and initiatives |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 1.3 | 0 | 1.3 | 0 | 1.3 | 0 |
| *All financial figures in millions of dollars | |||||
Women's Health and Gender Analysis
Health Canada works horizontally to promote equitable health outcomes across the lifespan for women, men, boys and girls. It provides leadership and oversight to: women's health; women's health research and information; gender based analysis; and, with a diversity overlay, in policy development within the Health Portfolio. It funds the Centres of Excellence for Women's Health, Canadian Women's Health Network as well as Research Working Groups, and collaborates with an expansive network of women's health organizations and other stakeholders at the international, provincial and regional levels to engage the public in the policy development process.
| Expected Results | Performance Indicators |
|---|---|
|
Knowledge development and transfer for specific health policy issues Enhanced health policy research capacity (ongoing) |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 4.9 | 19 | 4.9 | 19 | 4.9 | 19 |
| *All financial figures in millions of dollars | |||||
Applied Research, Dissemination and Accountability
In the area of applied research and analysis, we support policy decision-making by developing and implementing a strategic policy research agenda for medium and long-term issues, helping co-ordinate internal and external policy research activities, and funding extramural research under the Health Policy Research Program. This fosters a performance-based and outcomeoriented culture by developing the tools and information base for better accountability. It plays a key role in knowledge management by managing a policy research dissemination program, including publication of the Health Policy Research Bulletin, and by making core data sets and the informatics tools to access them available.
| Expected Results | Performance Indicators |
|---|---|
|
Target audiences accessing data, analysis and information that is useful for evidence-based policy and program development |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 4.9 | 60 | 36.6 | 60 | 36.6 | 60 |
| *All financial figures in millions of dollars | |||||
Endnotes
1 www.hc-sc.gc.ca/hcs-sss/delivery-prestation/fptcollab/2004-fmm-rpm/index_e.html
2 For more information on these challenges, see the National Pharmaceuticals Strategy Progress
Report, summer 2006.
3 www.regulation.gc.ca/default.asp?Language=E& Page=thegovernementdirectiveon
4 Nanotechnology is defined as the application of science to develop new materials and products,
where at least one dimension is smaller than 100 nm, and involves the manipulation of matter at the nanometre scale - a nanometre
(nm) is a billionth of a metre (10-9m), or a hundred times smaller than a virus.
Other programs and services that contribute to this program activity total $140.5 million for 2006-2007.
Strategic Outcome: Access to Safe and Effective Health Products and Food and Information for Healthy Choices
Program Activity - Health Products and Food
This program activity contributes to the Government of Canada Strategic Outcome: Healthy Canadians with Access to Quality Health Care.
| ($ millions) | Forecast Spending 2005-2006 | Planned Spending 2006-2007 | Planned Spending 2007-2008 | Planned Spending 2008-2009 |
|---|---|---|---|---|
| Gross expenditures | 294.6 | 303.3 | 300.4 | 289.3 |
| Less: Expected respendable revenues | 37.7 | 41.2 | 41.2 | 41.2 |
| Net expenditures | 256.9 | 262.1 | 259.2 | 248.1 |
| FTEs | 2,503 | 2,592 | 2,667 | 2,656 |
|
Notes: The increase in expenditures from 2005-2006 to 2006-2007 is mainly due to an increase in the level of funding for Strengthening the Safety of Drugs, and is partially offset by a decrease in funding for the Implementation of Health Canada's Therapeutic Access Strategy and the Expenditure Review Committee (ERC) reduction. The decrease in expenditures from 2006-2007 to 2007-2008 is mainly due to the sunset of funding for Health Canada's Response to Bovine Spongiform Encephalopathy in Areas of Risk Management and Targeted Research. The decrease in expenditures from 2007-2008 to 2008-2009 is mainly due to decrease in funding for the Implementation of Health Canada's Therapeutic Access Strategy, and the sunset of a transfer from Agri-Food and Agriculture Canada for the Agriculture Policy Framework. The change in the FTEs is due to the increase of the salary component of the operating budget. Figures include an amount for other departmental and regional infrastructure costs supporting program delivery. |
||||
Program Activity Description
As Canada's federal authority responsible for the regulation of health products and food, Health Canada evaluates and monitors the safety, quality and effectiveness of the thousands of drugs, vaccines, medical devices, natural health products and other therapeutic products available to Canadians, as well as the safety and nutritional quality of their food. Under this program activity we also review veterinary drugs sold in Canada for safety and effectiveness for animals, and for the safety of foods derived from animals treated with these drugs. Finally, we promote the health and well being of Canadians through a broad range of activities related to health products and food, including developing nutrition policies and standards such as Canada's Food Guide to Healthy Eating.
A core federal health protection responsibility is the regulation of therapeutic products under the legislative framework of the Food and Drugs Act. The federal government's role in protecting health and safety is well recognized and supported by Canadians. However, the regulatory system for drugs and other therapeutic products is facing a number of challenges, including: rapidly advancing science and technology; public expectations for access, safety and transparency; improving linkages to health system decision-making regarding coverage for, and cost of, pharmaceuticals and related products in current systems; and meeting industry demands for faster approvals and increased intellectual property protection.
There is strong evidence of rising rates of acute and chronic disease directly associated with diet (e.g., diabetes among Canadians). While Canadians are increasingly aware of the threats to their health from factors like poor diet, physical inactivity and excessive weights, work and leisure patterns in our society have changed, making us less active and more reliant on foods high in energy which is contributing to increasing rates of chronic disease. With respect to food safety, emergence of new foodborne pathogens and emerging infectious diseases (e.g., avian influenza), and the threat of bioterrorism (e.g., linked to botulism), have increased consumer expectations in Canada and abroad for the role of governments in ensuring the quality and safety of Canada's food supply.
In moving forward, there is a need to continue to modernize legislative and regulatory frameworks to keep pace with changing science, consumer expectations, international developments and other pressures for change. To ensure an integrated approach, it is suggested that a long-term plan to modernize the regulatory system for therapeutic products be developed, based on a vision to improve access to safe, effective and affordable drugs and other therapeutic products. To strengthen collaboration with provincial and territorial governments in their health system and drug plan management roles, this plan needs to be strongly linked to the National Pharmaceuticals Strategy. From the perspective of food and nutrition, Health Canada will continue to work with Health Portfolio partners, the Canadian Food Inspection Agency and other partners to provide leadership on food policy issues in order to improve health outcomes for Canadians and reduce the burden on the health care system.
Health Canada relies heavily on science and risk management in making our regulatory and policy decisions. As scientific knowledge and technical expertise are critical inputs into the development of our regulations, policies and advice, we will continue to conduct laboratory-based research. We will focus on the human health implications of potentially hazardous chemicals in the food supply, including effects on behaviour and the immune system; conditions leading to the survival, growth and toxin production of infectious and toxigenic bacteria; awareness of hazard-prone foods; establishment of safe levels to prevent human injury; and risks and benefits associated with nutrients in the diet. We will also continue to conduct research in areas related to the safety and effectiveness of biotherapeutics, blood and blood products, and vaccines.
Health Canada faces a pressing challenge in sustaining our human resources. It is estimated that within the next five years a significant number of our employees in the specialized and technical fields, which includes biologists, chemists and medical officers, will be eligible for retirement.We will continue to address this through our human resources planning.
We are working with federal science and technology partners to promote and protect the health and safety of Canadians. Some of our work includes collaborating directly with Agriculture and Agri-Food Canada, Environment Canada, the Canadian Food Inspection Agency (CFIA) and the Public Health Agency of Canada (PHAC) to develop responsive food policies and regulations, such as Canada's Strategy for Safe Food. We are also working with CFIA to promote food safety as a science priority for Canada. Our ongoing work with Statistics Canada and PHAC is enabling us to collaborate on public health data surveys as well as to share information that is important in our ongoing analysis of and preparation for potential health risks associated with emerging diseases.
Internationally, Health Canada is working with the World Health Organization (WHO) and other multilateral organizations on health product and food safety issues. We are also working with other governments to strengthen and promote broader regulatory cooperation and encourage technical information exchange. We will continue to implement the commitments in the Security and Prosperity Partnership of North America, including hosting discussions on pharmaceutical review processes, food safety regulatory coordination, assessment and enhanced surveillance research with related agencies in Canada, the U.S. and Mexico. Bilaterally, we will work with the U.S. Food and Drug Administration through our memorandum of understanding, and on initiatives such as the development of a single set of reference values for nutrition labelling and improving the compatibility between our approaches to food fortification.
Health Canada's regional offices contribute to the delivery of our mandate by developing and delivering key programs and services, including monitoring risks, and the investigation and inspection associated with the importation, sale and manufacture of health products. Working directly with regional stakeholders and provincial and municipal governments, regional offices promote and facilitate consultation and collaboration.1 These partnerships are allowing our regional offices to participate in the monitoring of adverse reactions and assist in developing policy responses on food safety, nutrition, natural health products, antimicrobial resistance, and the efficacy of health products. Further, regional laboratories are increasing our science capacity to develop and manage food safety research and surveillance projects on natural toxins, genetically modified food, food allergen detection, method development and nutrition as part of the national laboratory network. Two of these laboratories are also supporting our responsibilities to ensure manufacturer compliance with regulatory requirements for health products.
Performance Measurement Strategy
The Performance Measurement Strategy for this strategic outcome will help us measure our expected results over time, and determine if our current program activity is appropriate to ensure Canadians have access to safe and effective health products and food, as well as to provide useful information for healthy choices.
| Expected Results | Performance Indicators |
|---|---|
| Access to Safe and Effective Health Products and Food and Information for Healthy Choices |
|
Key Programs and Services
Pre-market evaluation and regulatory process improvement
Description: Making regulatory functions more efficient, effective, and responsive to Canadians by streamlining processes and collaborating more closely with other organizations to ensure Canada continues to have a world class regulatory environment.
| Expected Results | Performance Indicators |
|---|---|
|
Improved timeliness, transparency and predictability of the regulatory process |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 125.8 | 1,164.3 | 124.4 | 1,198.0 | 119.1 | 1,193.1 |
|
* Data is collected and reported quarterly. Our commitment is to meet 90% of performance targets for new pharmaceutical drug submission reviews by March 2006, and for new biologic drug submissions by March 2007. Baseline data for expected performance results is available within current tracking systems and internal records. ** All financial figures in millions of dollars |
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Health Canada will contribute to regulatory renewal through improving regulatory performance and modernizing the regulatory system. 2 For example, given the increasing number and complexity of drug submissions, the initiatives under the Therapeutics Access Strategy will continue to reduce and eliminate submission backlogs, enabling us to meet our performance targets for pharmaceuticals in March 2006 and biologics and genetic therapies by March 2007. 3 In addition, we are reducing submission times for veterinary drugs and have set service standards dependent on submission type. These milestones will be met by enhancing human resources capacity and increasing international collaboration and cooperation as well as adopting and applying project management techniques. The Community of Federal Regulators, a partnership of all federal departments and agencies that have a regulatory role, is working to meet the requirements of the proposed new Government Directive on Regulating and Smart Regulations. 4
We will continue to develop and apply innovative approaches to the regulation of health products and food to improve and sustain the timeliness and efficiency of the regulatory process to address the concerns of Canadians regarding safety, effectiveness and access. We will develop new regulatory approaches for radio-pharmaceuticals used for diagnosis and radiation therapy; for product-specific health claims for foods; for drug product licensing to support early access to promising drug therapies; and for a national approach to clinical trials. As well, a new external charging regime will be developed as part of a long term funding strategy to ensure adequate resources to sustain regulatory performance for human and veterinary drugs and other therapeutic products. We will begin to review regulations that require the pre-market safety assessment and authorization of foods and food products before they can be offered for sale.
As part of Health Canada's initiative to strengthen the safety system for therapeutic products, we will strengthen the oversight of clinical trials and investigational testing of medical devices conducted in Canada, access points for patients to new and innovative therapies. The trials and investigational testing provide the evidence of safety and efficacy required by the Regulations before a product may receive a general market authorization from Health Canada. The Department will increase capacity in 2006-2007 to allow the continued assessment of an increased number of applications within targeted time-frames; strengthen capacity to assess clinical trial and investigational testing of adverse reaction reports in order to detect, communicate and act on safety signals; and engage sponsors earlier in the clinical trials process. Moreover, through the safety initiative, Health Canada will update the national standards for blood and for cells, tissues and organs, while continuing to develop and implement an appropriate regulatory framework for these components. A program for compliance inspections of establishments will also be implemented.
Health Canada will work with the federal, provincial and territorial health and agriculture agencies involved in administering the national food safety system to better respond to current and emerging food safety issues. A major initiative will be Canada's Strategy for Safe Food. It engages federal, provincial and territorial governments, industry, academia and consumer groups to improve the overall management of the food safety system in Canada by developing a common vision and national priorities, and national public health outcomes, targets and indicators.
We will continue to lead development of a federal Biotechnology Stewardship Framework to encourage an integrated approach to managing the risks and benefits of biotechnology products and services in the public interest.
Information, education and outreach on health products, food and nutrition
Description: Responding to the growth of Canadian public interest in health issues by disseminating more information, written in language that is easy to understand, on how Canadians can maintain and improve their health.
| Expected Results | Performance Indicators |
|---|---|
|
Improved adoption in making safe and healthy choices for health products, food and nutrition |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 13.1 | 93.6 | 13.0 | 96.3 | 12.4 | 95.9 |
|
* Data is analysed and reported every two years. Health Canada will conduct a survey to assess the rate at which people use information to make health related choices. The target and actual rate will be determined in 2006-2007. The date to achieve the target is April 2008. *All financial figures in millions of dollars |
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Health Canada will continue to provide useful information about the risks and benefits related to health products and food in order to help Canadians make informed decisions about their health. For example, we will develop food labelling policies as part of an integrated health and food safety policy tool kit that will be capable of responding more quickly and effectively to current and emerging health and food safety challenges. MedEffect, part of the initiative to strengthen the therapeutic products safety system, will enable us to maintain a website for posting safety alerts, public health advisories, press releases and notices for health professionals, consumers and other interested parties. 5 A similar website has been developed for veterinary drugs. 6 Also, as part of the overall effort to better inform Canadians, Health Canada will continue to provide balanced information on newer technologies and their applications, including biotechnology and nano-technology.
Promoting and supporting healthy eating and informing Canadians about risks related to the food supply are key in helping them to maintain and improve their health. For instance, Canada's Food Guide to Healthy Eating plays an important role in communicating healthy eating to Canadians. In 2006, a revised Food Guide will be completed and disseminated along with supporting materials, including a resource for intermediaries and a web-based interactive component. The Food Guide is being revised to ensure the guidance it offers continues to promote a pattern of eating that meets nutrient needs, promotes health, and minimizes the risk of nutrition-related chronic diseases. At the same time, the revision will strive to improve Canadians' understanding and application of the Food Guide.
Health Canada is working with the Public Health Agency of Canada to advance the healthy eating component of the Integrated Strategy on Healthy Living and Chronic Disease with a focus on multisectoral leadership and collaboration nationally and internationally. In addition, through this initiative Health Canada will develop nationally agreed upon nutrition indicators and targets, enhance efforts in knowledge development, synthesis and exchange, as well as develop and enhance nutrition surveillance capacity.
In 2006, an interactive Nutrition Label tool on the Health Canada website will be launched to help Canadians make informed choices about the foods they eat. 7 The tool will explain how the information on the new food label, which became mandatory on most prepackaged foods in December 2005, can be used to make healthy food choices. Enhancing awareness of nutrition labelling will also be accomplished through related initiatives such as the launch of the revised Canada's Food Guide.
Monitoring safety and therapeutic effectiveness and risk management
Description: Increasing the responsiveness to specific public health issues through the development of monitoring and surveillance systems and stronger compliance and enforcement activities.
| Expected Results | Performance Indicators |
|---|---|
|
Strengthened vigilance over safety and therapeutic effectiveness for health products and food on the market |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 104.8 | 1,171.3 | 103.7 | 1,205 | 99.2 | 1,200.3 |
|
* Health Canada's performance will be assessed through surveys, compliance rates and statistical analysis of adverse reaction data. Results from surveys such as those conducted by the Canadian Hemophilia Society will be reviewed as they are available. 8 Target of 95% compliance from inspections based on internal records has been set for health products. Implementation of new technologies will be used to meet internally harmonized standards for adverse reaction reports by 2007. *All financial figures in millions of dollars |
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Recognizing the cross cutting nature of nutritionrelated surveillance activities, we will continue to transfer knowledge and build capacity needed for creating and improving evidence-based policies, programs and community interventions in collaboration with the following partners: Statistics Canada, the Public Health Agency of Canada, the Canadian Institutes of Health Research, and stakeholder organizations such as the Federal/Provincial/Territorial Group on Nutrition, the Network on Healthy Eating and the Canadian Community Health Survey (CCHS) User's Group. Specific activities in 2006-2007 will include the approval of national nutrition indicators, the dissemination of a user's guide to assist nutrition stakeholders with the interpretation of the CCHS nutrition data, and the dissemination of a themed report on Food Security using CCHS data. 9
The 2006-2007 Canadian Health Measures Survey conducted by Statistics Canada will help increase Health Canada's capacity to monitor determinants of healthy eating. For example, the results of the survey will help decision-making related to the fortification of foods and the assessment of the prevalence of nutrition-related risk factors for cardiovascular disease and diabetes.
Health Canada will implement new safety measures to strengthen post-market surveillance activities designed to improve real world safety and effectiveness that are linked to the National Pharmaceutical Strategy. We have developed and used the Canadian Adverse Drug Reaction Information System to monitor suspected adverse reactions to health products. With significant advancements in technology and the establishment of international standards for data transmission, we will obtain and begin the implementation of a new and advanced adverse reaction monitoring system. The system will enable the collection and assessment of adverse reaction reports which span the entire life-cycle of health products, from pre-market testing to postmarket use, and will improve the overall efficiency of processing, managing and assessing adverse reaction reports. The system will comply with international standards recommended by the International Conference on Harmonization. For veterinary drugs, we have developed an adverse drug reaction reporting system and plan to develop a closer link between pre-market and post-market activities. In addition, Health Canada will consult with stakeholders and Environment Canada to develop environmental assessment regulations to help minimize the effects of therapeutic products on the environment.
Clinical trials require compliance inspections to protect people enrolled in them as well as the integrity and accuracy of the data that supports the application for new drugs bound for market. Through the initiative to strengthen the safety system, the number of clinical trial inspections in 2006-2007 will be increased to 60, equivalent to 1.5% of all clinical trials, with a view to achieving the international level of 2% in future years. This objective was recommended by the Standing Committee on Health in 2004. 10
Health Canada will continue to work with PHAC to implement the Canadian Pandemic Influenza Plan and to support the WHO's Global Agenda for Influenza Surveillance and Control. The Department will spend $6.2 million over 5 years, as well as $1.2 million ongoing, for planning and preparedness activities, providing regulatory guidance during the development of a prototype vaccine, developing a regulator's emergency implementation plan and designing an accelerated approval process.
Transparency, public accountability and stakeholder relationships
Description: Bringing more transparency to our decision-making processes by providing more accessible information about the science underpinning our decisions. Health Canada is also strengthening its capacity to involve the public in decisionmaking that in the past have been limited to scientific experts.
| Expected Results | Performance Indicators |
|---|---|
|
Improved public confidence and trust in the safety of health products, food and the regulatory system Level of public confidence of safety of health products, food, and nutrition |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 18.3 | 163.0 | 18.1 | 167.7 | 17.4 | 167.0 |
|
The progress of public confidence will be monitored with the aim of maintaining or increasing this level. The goal is to attain 85% of stakeholders holding a positive view on transparency and openness initiatives related to health products and food. Feedback from stakeholders will be sought as part of consultation activities to learn and improve over time. *All financial figures in millions of dollars |
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Incorporating the views of citizens and stakeholders is critical for effective regulation in the public interest. Maintaining and strengthening public confidence is especially important in a world where the accelerating rate of scientific and technological advances carries both benefits and risks. Public confidence in the regulatory system, particularly as it applies to healthrelated products and services, is a prerequisite for ensuring that new and sustainable health innovations are available to and used by Canadians. As such, Health Canada is developing new tools to improve the transparency and openness of our regulatory system including convening national consultations and public forums on therapeutic health product and food safety issues important to Canadians, as well as developing and updating food safety guidelines, and assuring that new substances used in health products meet Canada's environmental assessment requirements.
Health Canada's Office of Paediatric Initiatives will serve as a focal point for an integrated approach to child health and safety issues across a number of regulatory areas, including food and nutrition and the safety and effectiveness of health products. The Office will bring together internal and external stakeholders to focus on these issues. The intended result for Canadians is improved, accessible information on the safety and effectiveness of health products used in children and on safe and nutritious food for them to consume.
In its April 2004 report, the Standing Committee on Health recommended that Canada introduce measures to ensure public confidence in the clinical trial process, starting with the disclosure of information about clinical trials through a public database. An External Working Group was formed to develop options for the registration and disclosure of clinical trial information. Further consultations will be held over the next year and will be informed by international efforts to create a harmonized approach to clinical trial registration and disclosure. 13 This process will allow for improved public access to meaningful clinical trial information while respecting the need for patient privacy and commercial confidentiality.
Endnotes
1 The Ayurvedic Medicine Information Session, Dietary Guidance Regional Consultations,
MedEffect Information Session, and Regional Stakeholder Food Forum.
2 www.pco-bcp.gc.ca/smartreg-regint/en/08/rpt_fnl.pdf
3 Numbers of Health Canada clinical trial applications and medical device investigational testing
applications
| 2001 | 2002 | 2003 | 2004 | 2005(Q1-2) | |
|---|---|---|---|---|---|
| Clinical Trial Applications (30-day) | 642 | 614 | 691 | 707 | 628 |
| Clinical Trial Applications (7-day) | 129 | 677 | 796 | 1,026 | 1,066 |
| Clinical Trial Application - Total | 771 | 1,291 | 1,487 | 1,733 | 1,694 |
| Investigational Testing | 89 | 94 | 100 | 123 | 131 |
4 www.cfr-crf.gc.ca
5 www.hc-sc.gc.ca/dhp-mps/medeff/index_e.html;
www.hc-sc.gc.ca/ahc-asc/branch-dirgen/hpfb-dgpsa/mhpd-dpsc/pediat_e.html
6 www.hc-sc.gc.ca/dhp-mps/vet/index_e.html
7 www.hc-sc.gc.ca/fn-an/surveill/index_e.html
www.hc-sc.gc.ca/fn-an/label-etiquet/nutrition/index_e.html
8 www.hemophilia.ca/en/10.1.4.php
9 www.hc-sc.gc.ca/fn-an/surveill/index_e.html
www.hc-sc.gc.ca/fn-an/surveill/nutrition/commun/index_e.html
10 www.hc-sc.gc.ca/dhp-mps/compli-conform/clini-pract-prat/report-rapport/2003-2004_tc-tm_e.html
11 www.oag-bvg.gc.ca/domino/reports.nsf/html/20040302ce.html
12 www.hc-sc.gc.ca/dhp-mps/compli-conform/info-prod/md-im/insp_strat_md-strat_insp_im_tc-tm_e.html
13 www.hc-sc.gc.ca/dhp-mps/prodpharma/activit/proj/enreg-clini-info/index_e.html
Strategic Outcome: Reduced Health and Environmental Risks from Products and Substances, and Safer Living and Working Environments
Program Activity - Healthy Environments & Consumer Safety
This program activity contributes to the Government of Canada Strategic Outcome: Healthy Canadians with Access to Quality Health Care.
| ($ millions) | Forecast Spending 2005-2006 | Planned Spending 2006-2007 | Planned Spending 2007-2008 | Planned Spending 2008-2009 |
|---|---|---|---|---|
| Gross expenditures | 289.9 | 305.4 | 301.9 | 302.3 |
| Less: Expected respendable revenues | 12.0 | 15.4 | 15.7 | 16.0 |
| Net expenditures | 277.9 | 289.9 | 286.2 | 286.3 |
| FTEs | 1,927 | 1,956 | 1,963 | 1,966 |
|
Notes: The increase in expenditures from 2005-2006 to 2006-2007 is mainly due to an increase in the level of funding for the Canadian Environmental Protection Act, which is partially offset by the Expenditure Review Committee (ERC) reduction. The decrease in expenditures from 2006-2007 to 2007-2008 is mainly due to a sunset of funding for Implementing the Border Air Quality Strategy and Related Air Quality Measures initiative. This decrease is partially offset by an increase in the level of funding for the Canadian Environmental Protection Act. Figures include an amount for other departmental and regional infrastructure costs supporting program delivery. |
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Program Activity Description
This program activity touches many elements of day-to-day living that have an impact on the health of Canadians. These include drinking water safety, air quality, radiation exposure, substance use and abuse (including alcohol), consumer product safety, tobacco and secondhand smoke, workplace health, and chemicals in the workplace and in the environment. We are also engaged in other health and safety related activities including the Government's public safety and anti-terrorism initiatives; chemical and nuclear emergency preparedness; inspection of food and potable water for the travelling public; and health contingency planning for visiting dignitaries. Much of this work is governed through legislation including the Food and Drugs Act, the Controlled Drugs and Substances Act, the Hazardous Products Act, the Radiation Emitting Devices Act, the Canadian Environmental Protection Act, the Tobacco Act, the Quarantine Act and others.
The Canadian public and governments are increasingly recognizing the critical link between human health, the physical environment and the economy. There is growing evidence that environmental factors, hazardous products, tobacco, alcohol and controlled substances contribute to a number of health problems including cancer, asthma and other illnesses and injuries which ultimately will have an impact on our health care system and society as a whole.
Building on our work to help protect the health of Canadians and in accordance with the principles of sustainable development, we will generate new research, partnerships and increased federal leadership to improve health outcomes, particularly for vulnerable populations such as children and young adults by:
- Reducing health and safety risks associated with tobacco consumption and the abuse of drugs, alcohol and other controlled substances; and
- Reducing risks to health and safety, and improving protection against harm associated with workplace and environmental hazards, consumer products (including cosmetics), radiation-emitting devices, new chemical substances and products of biotechnology.
From a health protection perspective, the Department will continue to focus on regulatory priorities such as Legislation Renewal and its impacts on the Hazardous Products Act, and we will also address regulations in the area of tobacco and other controlled substances. We will continue to improve national compliance and enforcement programs so they are effective, riskbased, and harmonized with provincial, territorial and international partners and stakeholders.
To protect the health of Canadians, we will continue to advance science and use evidence-based research to formulate our health promotion and harm prevention programs and policies. Health Canada will conduct research and use the science conducted by a network of external science organizations to respond to emerging health and safety challenges to Canadians. We will create a science plan which will outline the strategic scientific directions for our five key program areas for the coming years and we will continue to work closely with a number of other federal departments and agencies on common science-based issues, such as water.
We rely on professionals with expertise in applied sciences (e.g., toxicology, epidemiology, biology) and in both occupational and public health (e.g., nurses, medicine, psychologists, industrial hygienists) to achieve our key results for Canadians. The Healthy Environments and Consumer Safety Branch must compete with other organizations to attract highly qualified scientists and health professionals. To address this risk, we will develop and implement a Human Resources Strategy focussed on succession planning, learning, recruitment and retention in order to ensure we have the human resources to support our activities under this strategic outcome.
The broad mandate under this strategic outcome requires sustained partnerships that have a significant impact on the health of Canadians. For example, Health Canada is the lead on horizontal files that require significant interdepartmental collaboration, such as Canada's Drug Strategy. We contribute significantly to the Government of Canada's efforts on health and environment issues. For example, we share responsibility for the Canadian Environmental Protection Act with Environment Canada. We also work closely with Environment Canada on files such as climate change.
Internationally, we will continue to advance some of our key work with the U.S. on a range of issues such as children's health and the environment, sound risk-management of chemicals and the Canada-U.S. Memorandum of Understanding on Consumer Product Safety.
Within the Health Portfolio, the Healthy Environments and Consumer Safety Branch works in partnership with the Public Health Agency of Canada, First Nations and Inuit Health Branch, and Health Products and Food Branch to achieve integrated approaches to health. We also collaborate with the provinces and territories through various committees to develop guidelines on issues such as safe drinking water and to coordinate nuclear emergency preparedness actvities.
Performance Measurement Strategy
| Expected Results Branch PAA | Performance Indicators |
|---|---|
| Reduced risks to health and safety, and improved protection against harm associated with workplace and environmental hazards and consumer products (including cosmetics) |
|
| Reduced health and safety risks associated with tobacco consumption and the abuse of drugs, alcohol and other substances |
Prevalence of drug and substance abuse in Canada
|
Key Programs and Services
Tobacco Control
Description: As lead department for the Federal Tobacco Control Strategy, Health Canada supports the four pillars of prevention, cessation, protection and harm reduction. Health Canada works with partners to pilot and evaluate a range of stop smoking approaches. For instance, the Department develops and implements national and regional education campaigns that inform Canadians about the health impacts of smoking and that provide information and referrals to help more Canadians quit smoking, and reduce exposure to second hand smoke in public and private spaces. On the international front, Health Canada, through its International Affairs Directorate, supports tobacco control initiatives around the globe.
| Expected Results | Performance Indicators |
|---|---|
|
Reduce smoking prevalence among the Canadian population to 20%
Reduce number of cigarettes sold in Canada by 30% |
Smoking prevalence rate
Consumption rates - number of cigarettes sold in Canada
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 53.8 | 282 | 53.6 | 282 | 53.7 | 282 |
|
*All financial figures in millions of dollars |
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Key Initiatives
As part of our commitment to monitor and report on the progress and success of the tobacco control initiative, Health Canada will conduct an evaluation of the first five years of the Federal Tobacco Control Strategy. In order to determine the direction for tobacco control over the next five years, the Department will analyse the outcomes from strategic planning sessions and consultations held with partners during the previous fiscal year. The knowledge derived from this evaluation will help us to most effectively focus Tobacco Control resources and activities for the future.
While considerable inroads have been made in reaching our targets and reducing smoking prevalence to 20% of the population, certain segments of the Canadian population continue to experience persistently high tobacco use, and further improvements to the smoking prevalence rate will depend upon addressing tobacco use among this population. Historically, young adults aged 20 to 24 have had the highest rates of smoking as compared with rates for all other age groups in the Canadian population, and this trend continues. For the first half of 2005, the smoking prevalence for those aged 20 to 24 was 27% as compared to 20% for the entire population 15 years of age and older (CTUMS). Therefore, the Department will focus its attention on youth and young adults who are most at risk of smoking, and will work with the provinces and territories to identify appropriate interventions and future directions for this important demographic. We will also provide support for targeted prevention and cessation activities of the no-smoking message through youth engagement initiatives, such as Health Canada's "Youth Action Committee on Tobacco", which will engage youth from across the country to help young people in their schools and communities live smoke-free.
Drug Strategy and Controlled Substances
Description: Health Canada administers the Controlled Drugs and Substances Act (CDSA) and its regulations, develops harm reduction and promotion strategies to combat alcohol and drug abuse (including health promotion activities targeted at youth), and provides expert scientific advice and drug analysis services to law enforcement agencies. Health Canada leads Canada's Drug Strategy, which was renewed in 2003. The Strategy is designed to coordinate and enhance substance abuse programs across the country, and strengthen knowledge and partnerships in the areas of prevention, treatment, harm reduction and enforcement to create healthier Canadians and communities.
Health Canada uses a variety of partnerships and funding vehicles to fulfill its mandate in this area. The Drug Strategy Community Initiatives Fund (DSCIF) was recently established to fund initiatives at the national, regional, provincial/territorial and local levels in two broad areas: health promotion and prevention, and harm reduction. DSCIF is delivered through Health Canada's national and regional offices and Northern Secretariat, with an overall aim to address problematic substance use and to promote public awareness of alcohol and other drug issues. The Alcohol and Drug Treatment and Rehabilitation Program (ADTR) aims to improve treatment for women and youth who are dealing with substance abuse problems. Health Canada also provides funding for the treatment component of Drug Treatment Courts.
| Expected Results | Performance Indicators |
|---|---|
|
Reduced health and safety risks associated with the abuse of drugs, alcohol and other controlled substances by managing the Controlled Drugs and Substances Act and its Regulations, and providing national leadership for Canada's Drug Strategy. |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 65.1 | 347 | 64.8 | 347 | 65.0 | 347 |
|
*All financial figures in millions of dollars |
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Key Initiatives
Advancing the National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances in Canada continues. Key planned components include the initiation of the Canadian Alcohol and Drug Use Monitoring Survey; the development of a National Alcohol Strategy; the implementation of the National Strategy to Combat the Production and Distribution of Marihuana and Synthetic Drugs and the Diversion of Precursor Chemicals; the development of a national and integrated approach to psychotropic pharmaceuticals; and the establishment of single website access to information about Canada's Drug Strategy. There will be an increase in research done in Canada on drug and alcohol abuse, and a detailed analysis of the Canadian Addiction Survey (CAS) of unique components (e.g., alcohol, youth, etc.) in order to support sound, evidence-based decision-making.
We will develop a strategy to enhance our inspection capacity for compliance with the Controlled Drugs and Substances Act (CDSA) and its regulations, in particular the Precursor Control Regulations. From a regional perspective, we will work on the provincial Alberta Methamphetamine Partnership Strategy Committee on Illicit Drug Use.
Marihuana is categorized as a controlled substance. The Marihuana Medical Access Regulations allow people who are suffering from grave and debilitating illnesses access to marihuana. It is important to note that the Regulations deal exclusively with the medical use of marihuana. Through authority of the Marihuana Medical Access Regulations, we will proceed with the development of a pilot project to assess the feasibility of distributing marihuana for medical purposes through the conventional pharmacy-based drug distribution system.
Safe Environments
Description: The environment continues to be a key determinant of health for all Canadians. Recent studies demonstrate that environmental factors contribute to a number of health problems. Air pollution, for example, is a factor in 5,900 deaths per year in Ontario and is responsible for 30% of asthma and 5% of cancers in children. Improving the health of Canadians by addressing environmental factors will strengthen their quality of life. The Safe Environments Programme promotes and protects the health of Canadians by identifying, assessing and managing health risks posed by environmental factors in living, working and recreational environments. The scope of activities encompassed within this area includes research on drinking water, air quality, contaminated sites, climate change, and vulnerable populations assessment of risks from environmental impacts, as well as preparedness for environmental emergencies. Health Canada is also the lead for coordinating Canada's preparedness for nuclear emergencies under the Federal Nuclear Emergency Plan.
| Expected Results | Performance Indicators |
|---|---|
|
Availability and Canada-wide adoption of measures to control the risks to human health posed by environmental contaminants Increased knowledge, understanding and involvement by Canadians in environmental health issues Science-based decision-making within Canada regarding health risks of environmental contaminants** Improved scientific knowledge and capacity within the Canadian scientific community and international collaboration on environmental health issues to ensure that Canadians have increased confidence in environmental health information and protection mechanisms* |
** Please Note: Work is in progress to develop a better set of indicators for these expected results by Fall 2006 |
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 68.4 | 576 | 68.1 | 582 | 68.3 | 584 |
|
*All financial figures in millions of dollars |
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Key Initiatives
Health Canada's Sustainable Development Strategy (2004-2007) reflects our commitment to protect the health of Canadians from environmental threats. Under this strategy, the department will advance the development of the Guidelines for Canadian Drinking Water Quality, and an integrated source-to-tap approach to drinking water quality in Canada. In collaboration with other federal departments, Health Canada will develop a "Federal Waterborne Contamination and Illness Response Protocol" to ensure a coordinated and systematic federal approach to dealing with outbreaks of waterborne illness and contamination of drinking water. Health Canada is also partnering with all three levels of government on the Technical Advisory Committee on Safe Drinking Water (TACSDW) to effectively address public health issues pertaining to drinking water in Alberta.
To assist in monitoring health risks attributable to changes in air quality, the Department will continue to build on its recently completed collaborative international research to develop an Air Health Indicator and will release the Air Quality Benefits Assessment Tool to help quantify the health impacts of changes in air pollution. In particular, the Safe Environments Programme in Ontario and Region is working to support the Canada-United States Border Air Quality Strategy, and will examine the impacts of air pollution on the health of children and other vulnerable populations, such as pregnant women and diabetics, in the Great Lakes Basin region. Health Canada will also complete and disseminate the Canadian Climate Change and Health Vulnerability Assessment in 2007, which will assess climate change impacts on human health and well-being.
To protect the health of Canadians from environmental contaminants, Health Canada will make additional progress under the Canadian Environmental Protection Act, 1999 (CEPA) by completing the identification and prioritization ("categorization") of the 23,000 Existing Substances on the Domestic Substances List. The Domestic Substances List (DSL) is a compilation of about 23,000 substances used, imported or manufactured in Canada for commercial use.
In partnership with the Public Health Agency of Canada and working through the joint Emergency Preparedness Sub-Committee on Chemical Emergencies, we will develop a joint Health Portfolio response plan for chemical emergencies in 2006 - 2007. Health Canada is also working with its provincial counterparts to strengthen guidelines to protect the health of Canadians in the event of a nuclear emergency, and will be participating in international nuclear emergency exercises to assess the implications of implementing radiation contamination counter-measures.
Product Safety
Description: As part of our legislative mandate, Health Canada identifies, assesses, manages and communicates to Canadians the health and safety hazards and health risks associated with: consumer products; hazardous workplace materials; cosmetics; new chemical substances; products of biotechnology; radiation produced by radiation emitting devices; environmental noise; and solar UV radiation.
To carry out this mandate, we advance critical research, carry out needed risk assessments and develop risk management strategies to minimize the exposure of Canadians to toxic substances in consumer, commercial, personal care and pharmaceutical products. The Department annually carries out health risk assessments of approximately 800 new chemicals and products of biotechnology notified under the New Substances Notification Regulations of the Canadian Environmental Protection Act, 1999. When a significant risk is identified, control measures are imposed.We identify which of the Food and Drugs Act substances in Canadian commerce between 1987 and September 2001 require priority assessment, and work with stakeholders on the process for notification of these substances. The Department also carries out screening level health risk assessments on existing micro-organisms, and both environmental and health risk assessments on new Food and Drugs Act substances, including risk management when necessary.
Health Canada's National Office of Workplace Hazardous Materials Information System (WHMIS) provides leadership to its federal, provincial and territorial MOU partners regarding effective hazard communication of workplace chemicals, including the delivery of training for WHMIS inspectors across the country. In addition, the Department will continue its involvement and participation in standardization work to ensure continued improvement of radiation emitting equipment safety.
| Expected Results** | Performance Indicators |
|---|---|
|
Reduced risk of death and injury from exposure to hazardous products and substances associated with: Consumer products; cosmetics; workplace chemicals; new chemical substances; products of biotechnology; radiation-emitting devices; environmental noise; solar UV radiation. |
|
| 2006-2007 | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 25.6 | 334 | 25.5 | 334 | 25.5 | 334 |
|
*All financial figures in millions of dollars |
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Key Initiatives
In support of the government's commitment to the health of children, we will proceed with the implementation of the Lead Risk Reduction Strategy (LRRS) for Consumer Products. These measures will protect the health of Canadians by reducing health risks related to lead exposure. Lead is hazardous to health and is particularly dangerous for infants and young children because they are more susceptible to its harmful effects. The LRRS proposes maximum lead content limits for four categories of consumer products with which children are likely to interact. Regulations for each category will be developed separately, moving first on product groups where the risk to children is greatest. We will also check for compliance rates for products already regulated for lead content. Performance will be based on the removal of such hazardous products from the Canadian marketplace and the level of public awareness of risks.
Other regulatory and educational activities will also support the commitment to the protection of children's health. For example, to protect the health of children and reduce strangulation hazards that are associated with flexible loops employed in the manufacture and use of window covering products (mini-blinds and curtains), regulations will be developed to require mandatory adherence by importers, advertisers and retailers to safety standards for these corded window covering products.
To effectively manage the continuing incidence of skin cancer, we need to ensure that children develop healthy behaviours with regards to their outdoor activities. The best time to influence or change behaviours is at the time the behaviour is being established. This is the fundamental driver for the Sun Awareness Project, a school-based outreach program to teach primary school children and teenagers of both the benefits of sun exposure and the risks associated with excessive sun exposure. The Sun Awareness Project involves learning elements and exercises integrated into the regular teaching schedule at both primary and secondary schools.
At the World Summit on Sustainable Development in 2002, Canada made a commitment to fully implement the Globally Harmonized System (GHS) of Classification and Labelling of Chemicals by 2008. The GHS is viewed globally as the basis for the sound management of chemicals, and enhances the protection of human health and the environment by harmonizing chemical hazard classification and communication internationally. Building on stakeholder consultations on the GHS, Health Canada will make further progress toward carrying out the legislative and regulatory changes needed for full implementation by 2008.
In carrying out our responsibilities under the Canadian Environmental Protection Act, 1999, a priority will be placed on working with Environment Canada to develop regulatory amendments to the New Substances Notification Regulations (Organisms) that reflect changes in the regulatory, policy and science environment, such as the production of transgenic, chimeric and cloned animals (e.g., livestock). In addition, we will work to develop appropriate environmental regulations for substances in products that are regulated under the Food and Drugs Act.
Workplace Health & Public Safety
Description: The Workplace Health and Public Safety Programme (WHPSP) provides services to protect the health and safety of the federal public sector, the travelling public, dignitaries visiting Canada, and others. It also establishes and promotes national workplace health and safety policies.
Health Canada will continue to provide occupational health services to nearly 200,000 federal employees working in Canada and overseas for approximately 100 departments and agencies. Health Canada delivers Employee Assistance Program services on a cost recovery basis to approximately 143 Canadian public and para-public sector organizations. Through the International Health Bureau, Health Canada provides emergency health services to Internationally Protected Persons and their families while they are on official visits to Canada.
The health of those who travel within Canada is protected through voluntary inspection programs for passenger conveyances to address public health risks relating to food, water and sanitation. Potable water regulations provide some authorities for inspection and enforcement of water quality on conveyances. As well, under the Quarantine Act and in fulfilment of WHO International Health Regulations, WHPSP Environmental Health Officers are responsible for inspecting and assessing conveyances, goods and cargo, and ordering the detention, remediation, removal and destruction when necessary to protect against the transmission of communicable quarantinable diseases.
| Expected Results** | Performance Indicators |
|---|---|
|
Healthy Public Service Improved Public Health for the Travelling Public |
|
| 2006-2007* | 2007-2008 | 2008-2009 | |||
|---|---|---|---|---|---|
| $ | FTEs | $ | FTEs | $ | FTEs |
| 24.5 | 417 | 24.4 | 418 | 24.5 | 419 |
|
*All financial figures in millions of dollars |
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Key Initiatives
In light of newly emerging health threats, Health Canada works with the Public Health Agency of Canada (PHAC), Public Security and Emergency Preparedness Canada, and other organizations to plan, prepare and implement physical and psychosocial emergency responses to national health emergencies such as pandemic influenza and terrorist or suspected terrorist attacks. Health Canada supports departments and agencies in their emergency preparedness and response activities through the provision of advice, guidance, training, health evaluations, prophylaxis and immunizations and will continue to support PHAC with environmental quarantine services. We will also continue to offer psycho-social services in support of federalized emergency responders and federal public employees who provide essential services during and immediately following critical incidents.
We will develop approaches to better identify and manage mental health and addictions in the workplace. Areas of activity will focus on: preventing and mitigating mental disorders and addictions among federal employees through mental health promotion, early identification and referral; a disability case management program; and the development and implementation of a comprehensive federal workplace health strategy.
Web Links
Tobacco
Canada's Drug Strategy
Marihuana Medical Access Regulations
Scheduling of a number of controlled substances and development of other proposed amendments to the Precursor Control Regulations
Controlled Substances and Precursor Chemicals
Reducing the supply of and demand for drugs through prevention, harm reduction, treatment and enforcement programming.
National Framework for Action on Substance Use and Abuse.
National Research Agenda
Drug Strategy Community Initiatives Fund
The Drug Strategy Community Initiatives Fund -- At a Glance
Canada's Drug Strategy Campaign publications
Canada's Drug Strategy Publications
Climate Change
Air
Water
Canadian Environmental Protection Act
Human Health and the Canadian Environmental Protection Act (CEPA): An Overview
Healthy Living Initiative
Protect Yourself Don't Delay Learn the Facts about UV Rays
Globally Harmonized System
The Globally Harmonized System of Classification and Labelling of Chemicals (GHS)
Lead Risk Reduction Strategy
Workplace Health
Workplace Health and Public Safety Programme
* Other programs and services that contribute to this program activity total $52.5 million for 2006-2007
Program Activity - Pest Control Product Regulation
This program activity contributes to the Government of Canada Strategic Outcome: Healthy Canadians with Access to Quality Health Care.
| ($ millions) | Forecast Spending 2005-2006 | Planned Spending 2006-2007 | Planned Spending 2007-2008 | Planned Spending 2008-2009 |
|---|---|---|---|---|
| Gross expenditures | 60.5 | 58.6 | 58.2 | 54.1 |
| Less: Expected respendable revenues | 5.9 | 7.0 | 7.0 | 7.0 |
| Net expenditures | 54.6 | 51.6 | 51.2 | 47.1 |
| FTEs | 675 | 652 | 656 | 604 |
|
Notes: The decrease in expenditures from 2005-2006 to 2006-2007 is mainly due to the Expenditure Review Committee (ERC) reduction. The decrease in expenditures from 2006-2007 to 2008-2009 is mainly due to a decrease in the level of funding for Building Public and Stakeholder Confidence in Pesticide Regulation initiative. Figures include an amount for other departmental and regional infrastructure costs supporting program delivery. |
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Program Activity Description
Health Canada's program activity, Pest Control Product Regulation, protects human health and the environment by minimizing risks associated with pesticides imported, sold, or used in Canada. The activity is strengthened through the use of sound, progressive science, modern risk assessment, risk management approaches and innovative approaches to sustainable pest management.
Science is the foundation for Health Canada's activities related to Pest Control Product Regulations. We conduct assessments of risk to human health and the environment arising from exposure to chemical and biological pesticides as well as assessments of the value of these products. In support of this work, we develop assessment methodologies, pesticide testing protocols, risk reduction strategies and risk management tools. Scientific expertise is in place in the following areas: toxicology, environmental toxicology, analytical chemistry, environmental fate and chemistry, biochemistry, endocrinology, ecology, crop science, plant pathology, entomology, occupational and bystander assessment, and aggregate and cumulative assessment.
To meet the primary objective of this program activity "to protect the health of Canadians and the environment from unacceptable risks associated with pest control products", we collaborate with experts in a variety of disciplines throughout the Health Portfolio and with the five natural resource departments. We also work with: the Canadian Food Inspection Agency and provincial governments on compliance activities; with Agriculture and Agri-food Canada to develop risk reduction strategies and improve access to specialized pest control; and with a federal interdepartmental working group on pesticide research and monitoring. This working group provides the opportunity for us to discuss our research and monitoring needs, as well as obtain information on the levels of pesticides in the environment, effects on human health and the environment, testing protocols, risk reduction practices, pest control alternatives, and pesticides for minor use. It also gives our partners the opportunity to effectively link their research results to regulatory decisions, and, at the same time, it will improve our regulatory decision making process for pesticides.
Advisory groups play an important role in decisionmaking at Health Canada. The Minister's Pest Management Advisory Council allows for dialogue between stakeholders and Health Canada. The Economic Management Advisory Committee provides strategic advice on improving efficiency and cost effectiveness, and the Federal, Provincial, Territorial Committee on Pest Management and Pesticides helps strengthen federal, provincial and territorial relationships in the area of pest management and pesticides. The Committee also provides advice and direction to federal, provincial, and territorial governments on programs, policies and issues.
The major human resource challenge for this program activity is to keep up with the pace of growing scientific knowledge and industry innovation. We will need to continue to recruit additional resources that have the appropriate knowledge base, and develop and train staff in a number of scientific disciplines.
This program activity has three main objectives: protected health and environment; increased use of reduced risk pest management practices and products; and increased public and stakeholder confidence in pesticide regulation. To achieve these objectives we focus on five main activities that respond to a number of challenges facing Health Canada such as consumer demands, globalization, and rapid scientific and technological change. They are:
1. Regulatory Improvement
The new Pest Control Products Act, which came into force June 28, 2006, will strengthen health and environmental protection by enshrining in legislation modern risk assessment and risk management approaches that are currently applied as a policy matter. These include specific protection for infants and children, accounting for pesticide exposure from all sources (including food and water), and considering cumulative effects of pesticides that act in the same way. It will also continue to support pesticide risk reduction by ensuring that only pesticides that make a useful contribution to pest management are registered and by expediting the registration of lower-risk products. The registration system will be made more transparent by establishing a public registry to allow access to test data detailed evaluation reports on registered pesticides. Health Canada will continue to share scientific results on pesticides with provincial, territorial and international regulators to enhance the process for international joint reviews of pesticides.We will share sustainable pest management practices with provinces and territories to enhance agricultural stewardship. As a result, Canadian growers will have improved access to newer and safer pesticides so they can be more competitive in the marketplace.
In addition, the new PCPA will strengthen postregistration controls for all products. These requirements include: reporting by pesticide companies of adverse effects related to their pesticide products; re-evaluation of older chemicals on a cyclical basis; public transparency regarding the basis of regulatory decisions; and ensuring in legislation the special review program to address potential identified specific concerns for registered products.
To support the need to provide Canadians with a transparent and participatory regulatory process, we will transform our work from traditional business interfaces and information delivery practices to interactive, web-based practices. This transformation will allow information to be delivered, stored, accessed, retrieved, exchanged and used more effectively and efficiently, and will lead to more efficient and cost-effective management of the regulatory process.
2. New Pest Control Product Registration
New pesticides undergo an extensive pre-market assessment by Health Canada to ensure their use poses no unacceptable risks. This includes an assessment of human health risk (including worker and bystander exposure), food residues, environmental risk (including environmental fate and potential effects on wildlife), and an assessment of value. Assessments are carried out using the most modern scientific methods available and meet international best practices.
To provide for continual updating of our assessments, we are participating in a joint review program with the United States through NAFTA that is being expanded globally through the Organisation for Economic Co-operation and Development (OECD). This furthers the goals of timely registrations, harmonization and work sharing efforts to ensure pesticide risk assessments are efficient and benefit from the best science available internationally. Public consultation will continue to be used routinely for the development of major science policies and for registration decisions.
3. Registered Pest Control Product Evaluation
We re-evaluate older pesticides currently on the market to determine if their continued use is acceptable in consideration of modern data and current scientific approaches. Significant public consultation is undertaken on risk assessments and risk management proposals to engage stakeholders, including registrants, other government departments, growers and their associations, other non-governmental organizations, as well as the general public.
Risk mitigation measures will continue to be implemented where required to address concerns regarding risks that could emerge during the re-evaluation of a chemical. As required, under the PCPA, we will continue to work with the Environmental Protection Agency in the United States on a proposed approach to re-evaluation and develop a plan to work cooperatively on future re-evaluations.
4. National Pesticide Compliance Program
We have the ongoing responsibility to help protect the health of Canadians and their environment by facilitating, encouraging and maximizing compliance with the PCPA and its regulations. Where non-compliance is detected, we apply the appropriate enforcement (e.g., education, monetary penalties or prosecution). Health Canada promotes and monitors compliance with the Act and Regulations principally through its National Pesticide Compliance Program (NPCP).
The NPCP includes programs that address regional, multi-regional or national compliance and enforcement problems and issues. Much of this work is accomplished through a regional network of designated officials who inspect and investigate those who manufacture, distribute and use pesticides. An example of compliance activities is the monitoring of pesticide use in grape and blueberry production that will be done this coming year. Other pesticides will be monitored as issues arise.
In addition, we will continue to work in partnership with provincial and other federal regulators and will explore further opportunities for coordination and collaboration with international organizations. Specifically, in 2006-2007 Health Canada plans, through an OECD workshop, to continue to develop performance indicators for the compliance area.
5. Pesticide Risk Reduction in Agriculture
The Pesticide Risk Reduction Program supports the objectives of the new Pest Control Products Act to facilitate access to reduced risk products and enhance sustainability in agriculture. It is a growerled, commodity-based program that is jointly facilitated by the Sustainable Pest Management Section of the Pest Management Regulatory Agency and the Pest Management Centre of Agriculture and Agri-Food Canada (AAFC). The goal of the program is to improve the sustainability of Canadian agricultural commodities through the development and implementation of commodity-based risk reduction strategies. Benefits resulting from this program will include the development and adoption of alternative pest management practices through applied research into reduced risk alternative tools and biopesticides.
AAFC and Health Canada will continue working with stakeholders to develop commodity-specific pesticide strategies for twenty priority crops including apples, potatoes, dry beans and greenhouse vegetables. Active stakeholder participation in building and implementing strategies is critical to the success of the program.
Performance Measurement Strategy
| Expected Results | Performance Indicators |
|---|---|
|
Access to safer pesticides
Strengthened compliance with PCPA and Regulations Users informed of reduced risk practices Transparency of pesticide regulation Improved regulatory efficiencies and cost effectiveness
Informed public and stakeholders |
|
Web Links
Pest Management Regulatory Agency (PMRA)
home page: Health Canada's Pest Management Regulatory Agency (PMRA)
PMRA Strategic Plan 2003-2008
The Strategic Plan - Pest Management Regulatory Agency (PMRA)
Strategic Outcome: Better Health Outcomes and Reduction of Health Inequalities Between First Nations and Inuit and Other Canadians
| ($ millions) | Forecast Spending 2005-2006 | Planned Spending 2006-2007 | Planned Spending 2007-2008 | Planned Spending 2008-2009 |
|---|---|---|---|---|
| Gross expenditures | 1,930.8 | 2,124.6 | 2,139.7 | 2,159.2 |
| Less: Expected respendable revenues | 3.4 | 5.5 | 5.5 | 5.5 |
| Net expenditures | 1,927.5 | 2,119.1 | 2,134.2 | 2,153.7 |
| FTEs | 2,722 | 2,884 | 2,883 | 2,857 |
|
Notes: The increase in expenditures from 2005-2006 to 2006-2007 is mainly due to the yearly growth of the Indian Envelope and an increase in the funding level for the Follow-Up to the Special Meeting of First Ministers and Aboriginal Leaders (September 12, 2004). This increase is partially offset by the Expenditure Review Committee (ERC) reduction. The increase in the expenditures from 2006-2007 to 2007-2008 is mainly due to the yearly growth of the Indian Envelope and an increase in the funding level for the Follow-Up to the Special Meeting of First Ministers and Aboriginal Leaders (September 12, 2004). This increase is partially offset by the Expenditure Review Committee (ERC) reduction. The increase in expenditures from 2007-2008 to 2008-2009 is mainly due to the yearly growth of the Indian Envelope. This increase is partially offset by a decrease in funding for the sunset of the Implementation of the First Nation Water Management Systems initiative. The change in the FTEs is due to the increase of the salary component of the operating budget. Figures include an amount for other departmental and regional infrastructure costs supporting program delivery. |
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Program Activity Description
The objectives of Health Canada's First Nations and Inuit health program activity are improving health outcomes, ensuring the availability of and access to quality health services, and supporting greater control of the health system by First Nations and Inuit.
To achieve these goals, the Department must face many of the same challenges as other Canadian health care providers such as increasing costs, health human resource shortages and an aging population. The First Nations and Inuit health system has additional challenges due to rapidly growing populations with a higher than national average rate of injuries and disease burden, and a population living largely in remote and rural areas.
Within this context, Health Canada will focus on four key priority areas in 2006-2007: continuing to provide health-related programs and services; improving quality and access to health-related programs and services; promoting healthy living and disease prevention; and improving accountability and performance measurement. These priorities recognize the importance that determinants of health such as education and family income play in improving health outcomes, as well as the need for innovation in the field of health. They will also be informed by a government review of the health commitments of the 2005 Meeting of First Ministers and Aboriginal Leaders.
Continued health-related programs and services
Health Canada provides a range of First Nations and Inuit health programs and services that will continue into 2006-2007. In partnership with First Nations and Inuit, we will continue to provide primary health care services in approximately 200 remote communities by approximately 600 nurses through nursing stations and community health centres in remote and/or isolated communities. Through our regional offices, we also deliver programs focussed on children and youth, mental health and addictions, chronic diseases, environmental health, and communicable and noncommunicable disease prevention. These services supplement and support the services that provincial, territorial and regional health authorities provide.
The Non-Insured Health Benefits (NIHB) coverage of drugs, dental care, vision care, medical supplies and equipment, short-term crisis intervention mental health services, and medical transportation will continue to be available to all 765,000 registered Indians and recognized Inuit in Canada, regardless of residency.
Health Canada works closely with our health partners and other federal departments. We support the Public Health Agency of Canada in its delivery of Children and Youth programming through the Aboriginal Head Start in Urban and Northern Communities program as well as a number of pan-Aboriginal programs. We also work closely with Indian and Northern Affairs Canada through the First Nations Water Management Strategy to ensure that all First Nations communities across Canada have access to a safe and reliable water supply.
Improving quality of and access to health-related programs and services
The key elements of this priority include: working towards seamless integration of services; increasing the number of Aboriginal health professionals; support for accreditation; improved community dental capacity; and capital improvements and investments.
We will work to make progress towards better integration of federal, provincial and territorial health programming and services to First Nations and Inuit and to ensure that services meet the needs of Aboriginal peoples. This will include implementation of the Aboriginal Health Transition Fund, which was designed to enable federal, provincial and territorial governments, First Nations governments who deliver health care services, and Aboriginal communities to devise new ways to integrate and adapt existing health services. Attention will also be given to implementation of best practices and lessons learned from a series of Health Integration Initiative pilot projects.
Health Canada will continue to fund the Aboriginal Health Human Resources Initiative to increase the long-term supply of First Nations, Inuit and Métis health professionals. In order to focus on Aboriginal youth, scholarship and bursary funds will be made available to eligible youth who pursue post-secondary studies in health support. To meet the continuing challenge of recruitment and retention of nurses to support health services in communities, we will provide ongoing professional development and continuing education opportunities. In partnership with the Canadian Nurses Association, we will launch a National Nursing Portal to provide critical support to nurses in rural and remote areas.
Health Canada will also continue to support the development and implementation of First Nations and Inuit accreditation and quality improvement activities. This will increase the number of accredited health care services in First Nations communities and ensure that the health care provided is responsive to the needs of the communities. We will also continue to implement, in selected communities, the Children's Oral Health Initiative to improve the oral health of First Nations children. This will focus on increasing the awareness of preventive oral health care and positive self-care practices for parents and caregivers, and will serve to increase the capacity of communities to deliver and maintain dental public health initiatives.
Finally, Health Canada supports the construction, operation, maintenance and environmental management of on-reserve health facilities and staff residences. In 2006-2007, fifteen health facilities will be constructed or expanded, and recapitalization initiatives (repairs, replacements, upgrades) will improve the working environment of clients and staff, and enhance the quality of health care services offered at the community level. In 2006-2007, Health Canada will also invest $1.2 million in environmental remediation and assessment to ensure operations of health facilities in First Nations communities meet environmental codes and requirements and are consistent with the Department's commitments to sustainable development.
Promoting healthy living and disease prevention
This priority focuses on maternal and child health, mental wellness, suicide prevention, prevention of chronic disease, communicable disease readiness, and safe drinking water. Initiatives have been put in place, such as a Maternal and Child Health (MCH) program to further expand and enhance the continuum of services provided and to improve health and social outcomes for pregnant women and families with infants and young children within a targeted number of First Nations and Inuit communities. In 2006-2007, Health Canada will continue to expand the number of sites and spaces available for Aboriginal Head Start On Reserve (AHSOR) children and will provide training to AHSOR workers.
Health Canada will oversee the development of a strategic action plan in 2006-2007 to improve mental wellness outcomes for First Nations and Inuit. Among other issues, the strategic action plan will guide Health Canada's efforts to more effectively position its current programming so that they are better able to serve the diverse needs of Aboriginal communities.
We will also continue to implement the National Aboriginal Youth Suicide Prevention Strategy (NAYSPS). This new strategy will establish projects in a targeted number of Aboriginal communities, where it will focus on building a solid foundation for effective approaches for preventing youth suicide. The activities supported by NAYSPS will include: skills training; tool and resource development; and primary prevention and awareness initiatives that promote mental wellness and youth resiliency. The strategy will also develop protocols to respond to communities in crisis and support various research projects. In addition to these new activities, Health Canada will continue to offer a continuum of mental health and emotional support services to former students of residential schools and their families as Canada renews its efforts to resolve Indian Residential School legal claims more expeditiously in 2006-2007.
Health Canada will continue its efforts to address high rates of chronic disease within the Aboriginal community. In particular, the Department will enhance the Aboriginal Diabetes Initiative by increasing the level of community-based funding that communities can access to expand promotion, prevention and care activities. Beyond our efforts to address diabetes, we will develop a First Nations and Inuit Chronic Disease Prevention Strategic Plan that will be developed in partnership with key stakeholders and experts and will inform the development of future chronic disease prevention approaches.
In light of federal responsibilities to protect First Nations communities against health risks associated with communicable diseases, Health Canada will begin to implement Communicable Disease Emergencies Plans. Efforts will be focussed on increasing emergency planning and response capacity at the regional and community levels, strengthening collaborative relationships with provinces, territories and stakeholders and ensuring that emergency supplies are purchased and readily available to First Nations and Inuit communities. Health Canada will develop and pilot test Pandemic Influenza Plans in First Nations and Inuit communities by the end of 2006-2007.
Finally, through the Water Management Strategy, Health Canada will work in partnership with First Nations communities (except the Yukon and the Territories), to implement drinking water monitoring as per the Guidelines for Canadian Drinking Water Quality. This will involve the development of options and an action plan for the implementation of a regulatory regime for drinking water in First Nations communities. Health Canada will investigate potential drinking water problems and provide advice and recommendations to First Nations communities and federal partners such as Indian and Northern Affairs Canada. Health Canada is also actively involved in the development of community-based education and awareness activities on drinking water quality issues.
Improving accountability and performance measurement
Health Canada has developed a strategy to monitor, measure progress and report on program performance results. This includes establishing performance measurement strategies in consultation with the organizations delivering the services at the community level.
We will undertake efforts to improve health surveillance and information analysis, including data development, data analysis, research evidence to support priority-setting and decision-making on health-related investments. For example, as a further enhancement to the Aboriginal Diabetes Initiative, Health Canada will begin to support the development of an Aboriginal-specific diabetes research agenda and will increase the Department's surveillance activities in an effort to identify research priorities that will inform future diabetes programming.
Health Canada also draws information from evaluation and review studies on areas for improvement. In 2006-2007, we will conduct a joint evaluation with Indian and Northern Affairs Canada on the First Nations Water Management Strategy. The Department will also develop processes and tools and collect information for evaluating primary health care, immunization and mental health programs. It will finalize the evaluation of the Home and Community Care program.
Performance Measurement Strategy
The First Nations and Inuit Health program has established expected results and performance indicators to assess progress towards the achievement of the strategic outcome. Use of the information below will contribute to providing a snapshot of the health status of First Nations and Inuit.
| Expected Results | Performance Indicators |
|---|---|
| Strengthened community programs; better health protection; improved primary health care; and access to non-insured health benefits contribute to improved health status of First Nations and Inuit individuals, families and communities. |
|
Key Programs and Services
The following describes six key program areas that Health Canada will continue to be engaged in throughout 2006-2007: children and youth; mental health and addictions; chronic disease and injury prevention; environmental health and research; communicable disease control; and primary health care.
Children and Youth Programs
Description: These programs are designed to collectively improve the cultural, emotional, intellectual and physical growth and development of First Nations and Inuit infants, children and youth. Programs targeting maternal, infant and child health, increasing children's knowledge of language and culture, and increasing children's readiness for school are the main priorities of the Department's children and youth programming. These programs include: Aboriginal Head Start on Reserve; the Canada Prenatal Nutrition Program; the Fetal Alcohol Spectrum Disorder program; and the Maternal Child Health program.
| Expected Results | Performance Indicators |
|---|---|
|
Improved continuum of programs and supports in First Nations and Inuit communities Increased participation of First Nations and Inuit individuals, families, and communities in programs and supports |
|
| 2006-2007* | 2007-2008* | 2008-2009* | |||
|---|---|---|---|---|---|
| $ | Salary $ | $ | Salary $ | $ | Salary $ |
| 102.2 | 6.1 | 109.8 | 6.1 | 115.7 | 6.1 |
|
* Based on the PAA with adjustments for approved Treasury Board submissions. It was assumed that no growth would be applied to new funding and non-envelope funding. It was also assumed that 3% growth would be applicable to envelope funding. Only salary dollars was provided because the information on the number of FTEs is not available at this level. ** All financial figures in millions of dollars |
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Mental Health and Addictions Programs
Description: These programs provide culturally appropriate counseling services, addiction prevention and promotion services and mental wellness services that are largely delivered by Aboriginal people. These programs include: Building Healthy Communities; the Brighter Futures program; the National Native Alcohol and Drug Abuse Program (NNADAP) - Residential Treatment; the National Native Alcohol and Drug Abuse Program - Community based; the Youth Solvent Abuse Program; the First Nations and Inuit Tobacco Control Strategy; the National Aboriginal Youth Suicide Prevention Strategy; the Labrador Innu Comprehensive Healing Strategy; and the Indian Residential Schools-Mental Health Support Program.
| Expected Results | Performance Indicators |
|---|---|
|
Improved continuum of programs and services in First Nations and Inuit communities Increased participation of First Nations and Inuit individuals, families and communities in programs and services |
|
| 2006-2007* | 2007-2008* | 2008-2009* | |||
|---|---|---|---|---|---|
| $ | Salary $ | $ | Salary $ | $ | Salary $ |
| 139.1 | 5.8 | 130.7 | 4.3 | 133.3 | 4.4 |
|
* Based on the PAA with adjustments for approved Treasury Board submissions. It was assumed that no growth would be applied to new funding and non-envelope funding. It was also assumed that 3% growth would be applicable to envelope funding. Only salary dollars was provided because the information on the number of FTEs is not available at this level. ** All financial figures in millions of dollars |
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Chronic Disease and Injury Prevention Programs
Description: These programs support the development and implementation of community-based activities that promote healthy lifestyle choices and support healthy and active living. Over the long term, these programs will contribute to the prevention of chronic disease and injuries within First Nations and Inuit communities across Canada. These programs include: the Aboriginal Diabetes Initiative; Nutrition and Physical Activity Promotion; and Injury Prevention.
| Expected Results | Performance Indicators |
|---|---|
|
Improved continuum of programs and supports in First Nations and Inuit communities |
|
| 2006-2007* | 2007-2008* | 2008-2009* | |||
|---|---|---|---|---|---|
| $ | Salary $ | $ | Salary $ | $ | Salary $ |
| 34.9 | 2.8 | 45.1 | 2.8 | 50.1 | 2.8 |
|
* Based on the PAA with adjustments for approved Treasury Board submissions. It was assumed that no growth would be applied to new funding and non-envelope funding. It was also assumed that 3% growth would be applicable to envelope funding. Only salary dollars was provided because the information on the number of FTEs is not available at this level. ** All financial figures in millions of dollars |
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Environmental Health and Research Programs
Description: These programs are designed to reduce the risk of exposure to environmental health hazards by improving the capacity of communities to implement measures to manage, contain and control them. They also create and maintain healthy and safe community environments through: the investigation of potential environmental health-related outbreaks; raising awareness of environmental health hazards such as waterborne, foodborne and vector borne illnesses including health problems associated with poor indoor air quality, such as mould in housing. They provide for pest control and build community human resource capacity to adapt to environmental conditions, to maintain safe environments and to deal safely with environmental hazards. These programs include: First Nations Water Management Strategy; West Nile Virus; Contaminated Sites; Transportation of Dangerous Goods; Food Safety, Facilities Health Inspections; housing; and research.
| Expected Results | Performance Indicators |
|---|---|
|
Improved environmental health risk management |
|
| 2006-2007* | 2007-2008* | 2008-2009* | |||
|---|---|---|---|---|---|
| $ | Salary $ | $ | Salary $ | $ | Salary $ |
| 46.1 | 11.9 | 46.7 | 11.9 | 22.2 | 9.1 |
|
* Based on the PAA with adjustments for approved Treasury Board submissions. It was assumed that no growth would be applied to new funding and non-envelope funding. It was also assumed that 3% growth would be applicable to envelope funding. Only salary dollars was provided because the information on the number of FTEs is not available at this level. ** All financial figures in millions of dollars |
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Communicable Disease Control Programs
Description: These programs support public health needs and priorities in the design, implementation, management and delivery of programs to protect First Nations and Inuit communities from communicable diseases, and to implement measures to manage, contain and control risks of outbreak. These programs include: Tuberculosis; Immunization; HIV/AID; and Communicable Disease Emergencies.
| Expected Results | Performance Indicators |
|---|---|
|
Improved access to communicable disease prevention and control programs for First Nations and Inuit individuals, families, and communities |
|
| 2006-2007* | 2007-2008* | 2008-2009* | |||
|---|---|---|---|---|---|
| $ | Salary $ | $ | Salary $ | $ | Salary $ |
| 26.0 | 6.1 | 26.8 | 6.4 | 28.0 | 6.4 |
|
* Based on the PAA with adjustments for approved Treasury Board submissions. It was assumed that no growth would be applied to new funding and non-envelope funding. It was also assumed that 3% growth would be applicable to envelope funding. Only salary dollars was provided because the information on the number of FTEs is not available at this level. ** All financial figures in millions of dollars |
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Primary Health Care Programs
Description: Comprehensive health care services are provided to remote and/or isolated First Nations and Inuit settlements to supplement and support primary care services provided by provincial, territorial and/or regional health authorities. These include emergency and acute care health services. Health Canada ensures links to appropriate care by other health care providers and/or institutions as required by the client condition. The continuum of community health care and primary care services includes illness and injury prevention and health promotion activities. This includes the Home and Community Care Program and the Oral Health Strategy, for example.
| Expected Results | Performance Indicators |
|---|---|
|
Improved access to primary health care programs and services for First Nations and Inuit individuals, families and communities |
|
| 2006-2007* | 2007-2008* | 2008-2009* | |||
|---|---|---|---|---|---|
| $ | Salary $ | $ | Salary $ | $ | Salary $ |
| 232.9 | 66.7 | 233.7 | 66.4 | 237.8 | 65.7 |
|
* Based on the PAA with adjustments for approved Treasury Board submissions. It was assumed that no growth would be applied to new funding and non-envelope funding. It was also assumed that 3% growth would be applicable to envelope funding. Only salary dollars was provided because the information on the number of FTEs is not available at this level. ** All financial figures in millions of dollars |
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Web Links
Other programs and services that contribute to this program activity total $1,539.9 million; for further information on those programs and services please see the following web links.
Aboriginal Head Start On Reserve
Aboriginal Head Start On Reserve
Fetal Alcohol Syndrome and Fetal Alcohol Effects
Fetal Alcohol Syndrome/Fetal Alcohol Effects
Aboriginal Diabetes Initiative
Injury Prevention
www.hc-sc.gc.ca/fnih-spni/promotion/injury-bless/index_e.html
Indian Residential Schools
National Native Alcohol and Drug Addictions Program
National Native Alcohol and Drug Abuse Program
Tobacco Control Strategy
NIHB
Non-Insured Health Benefits Directorate
Communicable Disease Control
Communicable Disease Control Division
Children's Oral Health Initiative
Children's Oral Health Initiative
Environmental Health
Drinking Water Quality
Home and Community Care
E-Health
Aboriginal Health Human Resource Initiative
Aboriginal Health Human Resources Initiative
