ARCHIVED - RPP 2007-2008
Public Health Agency of Canada

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Section IV - Other Items of Interest

Strategic and Developmental Initiatives

The Public Health Agency of Canada recognizes that strategic and developmental initiatives are required to support the achievement of its priorities and advance the work of improving public health. Since its inception, the Agency has undertaken a number of activities to fulfill its role as a voice for public health, to define its structural needs and to establish the necessary elements, to build new and expanded relationships, and to explore new avenues for improving the public health system in Canada.

As a new organization, the Agency finds itself in an opportune time to define its role within the public health system and to develop efficient and effective internal mechanisms and processes. Initiatives are underway to define the Agency's priorities, to strengthen its internal capacity and accountability and to align resources, research, programs and policies.

Public health is a responsibility shared across governments and other stakeholders. In order to achieve tangible results, the Agency works closely and cooperatively with all of its partners to provide a cohesive, national approach to public health. The Agency is working to strengthen relations with provincial, territorial and international authorities, to facilitate working relationships across sectors and to ensure a comprehensive engagement of all stakeholders. Recognizing the critical importance of evidence-based programs and policies, the Agency is working to develop its internal capacity for knowledge generation and translation, as well as mechanisms for information sharing and exchange with external partners.

Achieving Policy Coherence

Children

Children continue to be a priority population for the Public Health Agency of Canada. Through work with non-governmental organizations, other federal partners, provinces and territories and communities, the Agency makes significant contributions both domestically and internationally to improving the health and quality of life of children and youth. The Public Health Agency of Canada works with partners to promote the health of children and prevent injury and disease. The Agency carries out a range of activities concerning children's issues, from surveillance, research, knowledge development and knowledge exchange to disease prevention and health promotion. On behalf of the Minister of Health, the Agency co-leads, with the Department of Justice, the federal government's efforts on matters concerning the United Nations Convention on the Rights of the Child.

The Agency will work to support the efforts of the federal Ministerial Advisor on the Health Issues of Children and Youth in her efforts to examine how the Health Portfolio can best promote and protect the health of Canadian children and youth. This will include the identification of key social determinants of health and their impact on child health outcomes. As well, the Agency will work with the World Health Organization to develop a Policy Framework for the Prevention of Chronic Diseases in Schools that will promote healthy outcomes for children and youth.

Seniors

The Public Health Agency of Canada devotes significant resources to Canada's senior population, helping to ensure that their unique and evolving needs are addressed. Working collaboratively with provincial and territorial governments, other federal government departments (such as Human Resources and Social Development Canada [HRSDC]) and nongovernmental organizations, the Public Health Agency of Canada is addressing the concerns of Canada's seniors. The Division of Aging and Seniors, the Agency's focal point for seniors issues, is engaged in national and international collaborations on healthy aging, emergency preparedness and seniors, falls prevention and seniors' mental health. Agency responsibilities for the promotion of active living, healthy eating and injury prevention as well as disease prevention include seniors as a specific target population.

Ensuring the concerns of Canada's seniors are addressed is also a priority for the federal government, which has created the National Seniors Council Comprised of experts and representatives of seniors' organizations, the Council advises the ministers of Health and of Human Resources and Social Development, and the Secretary of State (Seniors), on issues of national importance. The Agency will be collaborating closely with HRSDC and the Secretary of State (Seniors) to support the ongoing work of the Council.

Environment

Canadians increasingly recognize the linkages between health and the environment. Novel measures to improve air quality in Canada and stricter environmental standards, with appropriate enforcement, have been identified as key government priorities. Changes in climate, air and water quality, wildlife habitats and other aspects of the environment all have an impact on the Canadian public's health. The Agency is committed to developing strong and comprehensive policy on possible public health effects stemming from the physical environment. The Agency is well-positioned to work horizontally, with other federal players and partner organizations, to incorporate a public health perspective in the broader health and environment agenda. As a member of the Health Portfolio, the Public Health Agency of Canada works closely with Health Canada's Healthy Environments and Consumer Safety Branch on addressing the links between health and the environment. The Agency can also provide public health expertise to other federal partners such as Environment Canada, Natural Resources Canada, and Indian and Northern Affairs Canada.

Aboriginal Public Health

In the course of the public hearings on Bill C-5 (the Agency's enabling legislation), observations were made concerning the need for the Agency to clarify its role in relation to promoting Aboriginal public health, engaging National Aboriginal Organizations and placing an increased emphasis on Aboriginal public health considerations.

Based on these observations, the Agency will build on existing initiatives aimed at improving Aboriginal health and pursue the following actions over the three-year planning period, in order to strengthen policy foundations, capacity and focus within the Agency for Aboriginal public health issues:

• Conduct further analysis of the health status of Aboriginal peoples in Canada and related public health issues, the results of which will be documented in the annual CPHO report on the state of public health in Canada;
• Create formal mechanisms to link the Public Health Agency of Canada with Health Canada's First Nations and Inuit Health Branch (FNIHB). This would serve to strengthen Agency involvement and positioning in FNIHB's Aboriginal public health strategy and the joint Health Canada / Assembly of First Nations Task Group on areas of mutual interest in First Nations health;
• Strengthening bilateral and multilateral relationships among the Agency, FNIHB, Indian and Northern Affairs Canada, the Assembly of First Nations, Inuit Tapiriit Kanatami and other National Aboriginal Organizations, as well as the provinces and territories, to ensure an effective collaboration and coordination of responses on public health issues;
• Further clarifying the Agency's role with other stakeholders in addressing Aboriginal public health issues and determining the most appropriate and effective mechanisms to accomplish this.

These actions will serve to build a network of relationships, clarify and solidify the Agency's role in and approach to Aboriginal public health, and better position the Agency and the Government of Canada to effectively address Aboriginal public health issues and, more broadly, the determinants of Aboriginal people's health. A Secreatariat will be established within the Agency to help coordinate these activities.

Vaccines

Vaccines are one of the most cost-effective public health interventions available. The Public Health Agency of Canada and the Government of Canada have made a series of recent investments to improve domestic capacity in vaccine research and development. Together, these investments will enhance domestic capacity at all stages of the vaccine development continuum from pre-clinical research and testing in animals to manufacturing of promising candidate vaccines for clinical trials in humans, eventually leading to the large scale manufacturing and marketing of fully licensed vaccines. Specific initiatives include the following:

• Investments in the Rapid Vaccine Development Team and the acquisition of additional laboratory space at the National Microbiology Laboratory (NML) will strengthen vaccine discovery research and pre-clinical development of candidate vaccines.
• Investments in InterVac, a high-containment vaccine research laboratory at the University of Saskatchewan, will fill a capacity gap in the pre-clinical testing of promising candidate vaccines in large animals as well as provide parallel capacity to the NML Rapid Vaccine Development Team. NML researchers will also benefit from the opportunity to access InterVac's capacity for large animal testing.
• Investments in pandemic vaccine development will support vaccine readiness by increasing large scale influenza vaccine manufacturing capacity in Canada, as well as supporting clinical trials, enhanced regulatory review capacity, and discovery research focused on both avian and human influenza vaccines.
• The Government of Canada is also investing in HIV vaccine development. An agreement has been reached between the Government of Canada and the Bill & Melinda Gates Foundation to collaborate and strengthen global HIV vaccine development efforts.

Together, these investments will enhance Canada's capacity to effectively respond to infectious disease threats and strengthen Canada's position as a leader in health research and innovation.

Immunization, which is the administration of vaccines to prevent disease, saves more lives than any other medical intervention. While provinces and territories are the providers of immunization programming in Canada, the Public Health Agency of Canada supports equitable and efficient access to recommended vaccines through the National Immunization Strategy, which was instituted in 2003 with an investment of $45 million over five years and ongoing funding of $10 million per year.

Healthy Living and Chronic Disease Initiative

Evidence demonstrates that individual health behaviour changes as well as reductions in disease prevalence are most effectively accomplished by working across sectors and jurisdictions. The Agency's ongoing work in promoting health and preventing and controlling chronic disease is supported in part through the implementation of a Healthy Living and Chronic Disease initiative, which works collaboratively across the Health Portfolio, with other federal departments and agencies, and with stakeholders to promote the health of Canadians, reduce the impact of chronic disease in Canada, and address the key determinants of health.

This initiative focuses on:

• Promoting health by addressing the conditions that lead to unhealthy eating, physical inactivity, and unhealthy weight;
• Preventing chronic disease through action on the major chronic diseases and their risk factors; and
• Supporting platforms for early detection and management of chronic diseases.

This approach to health promotion and chronic disease prevention and control supports the Agency's priorities by facilitating collaboration and capacity building. It supports Agency leadership in government-wide efforts to advance action on the determinants of health. It also facilitates and is directly linked to one of the government's top priorities – reductions in patient wait times. Ultimately, it is expected to contribute to building a healthier nation, decreasing health disparities, and ensuring the sustainability of the health care system in Canada.

Leadership on the Determinants of Health

The Agency intends to continue to lead national efforts to advance action on the determinants of health. Taking leadership means strengthening the Agency's work in the area of reducing health disparities, enhancing existing partnerships within and across government departments and jurisdictions, and developing new partnerships to address the underlying determinants of health in efforts to reduce disparities. Such action is critical to achieving health gains and reducing health disparities. Through the development of new knowledge, strategic partnerships (including with NGOs, the private sector and other sectors) and intersectoral policy initiatives, the Agency will contribute to a better understanding of the ways in which the determinants of health can be more effectively addressed.

In a comprehensive health system, action is needed to keep Canadians healthy as well as to prevent infectious diseases, chronic diseases such as cancer, diabetes and cardiovascular disease, and injuries. Action is also required to mitigate the burden of existing illness and disease. Evidence increasingly shows that efforts to influence behaviour are least effective with segments of the population that are dealing with situations such as poor living conditions that compromise their health. Consequently, considering and acting on the underlying living and working conditions, or determinants of health, that facilitate or hinder behaviour change are critical to the effectiveness of existing investments and programs.

A number of activities will allow the Agency to achieve government objectives, including: addressing the underlying factors and conditions that determine health by focusing on preventing disease to keep people well; improving the health of those at risk of premature disease and death; reducing pressures on the health care system and reducing wait times for care; and contributing to a more productive workforce. In particular, addressing the determinants of health will help to achieve better heath outcomes for those experiencing health disparities such as people of lower socio-economic status, Aboriginal Canadians, children and youth and seniors.

The Agency will develop a strategic, evidence-based action plan to guide the Health Portfolio in an intersectoral federal government approach to address the determinants of health. To support this work, partnerships and initiatives with the Canadian Institutes of Health Research and other governmental and non-governmental stakeholders will be strengthened, with the objective of advancing the Canadian research agenda and related knowledge on health disparities. The Agency will also further its engagement with The Conference Board of Canada's Roundtable on Socio-Economic Determinants of Health, which serves as a forum for collaborative efforts with the private sector, other federal departments, provincial health and non-health ministries and NGOs.

The Agency will continue its strategic partnership with the World Health Organization (WHO) in support of the latter's Commission on the Social Determinants of Health (SDOH). The new knowledge and evidence from this commission will be instrumental in advancing Canadian policy and action to address the SDOH. This work, which will be a critical contribution to global efforts to address SDOH, is being carried out through various knowledge networks on Early Childhood Development, Health Systems and Aboriginal Health and through civil society engagement. This global work will also address aging and health, strengthening Canadian work on this issue.

As a key component of this initiative, the Agency is providing leadership and support to the Canadian Reference Group on SDOH to facilitate multidisciplinary action on the underlying factors that cause health disparities. The Reference Group involves key stakeholders, including Health Canada and other federal departments, provincial government officials, NGOs, academics and others, all of whom will be critical to the success of this strategy in Canada.

Canada will also continue to work with other partners in WHO countries such as the public health institutions in the United Kingdom, Sweden and Chile, and international organizations such as the European Commission and the Organization for Economic Cooperation and Development (OECD), to develop a strong case for global action on the determinants of health, with a strategic focus on the economic benefits of this action.

The Agency is supporting the 2007 World Conference on Health Promotion and Education to be held in Vancouver. Aboriginal health is a central focus in the conference's scientific program, which includes a pre-event on indigenous health, and seniors' and children's health issues will be addressed in symposia and presentations. In addition, the Agency is supporting the WHO Commission on Social Determinants of Health meeting to be held in Vancouver in June 2007. Focused federal Health Portfolio participation in these events will be facilitated, as a further means of advancing action on the determinants of health, particularly through the engagement of non-government stakeholders.

Health Goals for Canada

As part of the Ten-Year Plan to Strengthen Health Care, Canada's First Ministers committed to the development of “goals and targets for improving the health status of Canadians through a collaborative process“. As a result, the Agency engaged in a broad consultation process that culminated in the drafting of health goal statements that were validated by governmental and non-governmental partners, public health experts and stakeholders. The Health Goals for Canada, approved by federal, provincial and territorial Ministers of Health, provide a tool to guide further action on the determinants of health and help to strengthen the management of horizontal issues. The Health Goals provide key stakeholders in government with a vehicle through which they can work together on public health issues.

Moving forward through the three-year planning period, the Agency will be advancing the Health Goals for Canada by embarking on three streams of federal engagement:

• Federal system - developing: benchmarks and targets within the federal system to support collaboration on common priorities that support the Health Goals; and, over the short term, benchmarks and targets for populations within federal jurisdiction;
• Intergovernmental - exploring the development of a set of measurable targets which will help Canadians to understand how the goals have been translated into commitments by governments to achieve better public health and measure progress; examining international efforts to incorporate a population health perspective in public policy development; identifying opportunities to work with provinces and territories; identifying existing work in cities and communities to promote population health; and helping to develop a toolkit of best practices related to advancing the Health Goals;
• Citizen engagement – developing communication products to engage Canadians in public health issues; and liaising with professional associations and non-governmental organizations (NGOs) to encourage and facilitate activities that apply the principles of the Health Goals.

International Initiatives

Public health is a critical international issue with economic, security and development dimensions. While infectious diseases continue to exact a high human toll in lives lost, particularly among children, chronic and non-communicable diseases now form the majority of the burden of disease and premature deaths in the world, including in a significant number of developing countries. The Public Health Agency of Canada will continue to use multilateral and regional organizations as well as bilateral relationships to confront these global public health challenges and build upon past successes. During the planning period, the Agency will take a leadership role in supporting international initiatives that build capacity in key areas and influence global policies that are in the interests of public health in Canada.

Globalization has a major impact on public health. There are emerging influences and global forces affecting health which are broader than national in scope. These include trade agreements, foreign policy, security issues, etc. New expertise and analytical tools are therefore required to support policy coherence. As part of its ongoing collaboration with the WHO, the Agency will be co-sponsoring a workshop on Trade and Healthy Diets in the fall of 2007. The impact of globalization has also been recognized by the WHO Commission on Social Determinants of Health, to which Canada is a major contributor, particularly through the work of the Globalization Knowledge Network led by the University of Ottawa. The Agency is committed to strengthening international links with key global public health players and increasing Canadian participation in international public health activities.

Through its WHO Collaborating Centre on Chronic, Non-communicable Disease (CNCD) Policy, the Agency contributes to the strengthening of the global response to chronic diseases and to the support of the development and implementation of chronic disease prevention policy in Canada, the Americas and Europe. The WHO Collaborating Centre coordinated the development and signing of a Framework for Cooperation on Chronic Disease between the WHO, the Public Health Agency of Canada and Health Canada. It also maintains an ongoing commitment of technical support for CNCD policy analysis to the WHO Country-wide Integrated Non-Communicable Disease Intervention (CINDI) program in Canada and Europe, and in the PAHO-CARMEN program, its equivalent in the Americas. Finally, it is cosponsoring, with the WHO and the Pan American Health Organization (PAHO), the development of a Chronic, Non-Communicable Disease Observatory of Policy Development and Implementation Processes in Latin America.

Increasingly, the Public Health Agency of Canada is being asked by other government departments to contribute to identification of priorities for work with multilateral organizations, given the importance of health as a foreign policy issue and as a key component of Canada's international development programs. International public health issues are also high on the agenda of top policy decision-making bodies such as the G8 and Asia-Pacific Economic Cooperation (APEC), where countries are collaborating to address health issues at the regional and international levels. A specific example of these collaborations is Canada's contributions to AIDS research and the global HIV vaccines effort through partnerships with organizations like the Bill & Melinda Gates Foundation

In 2007-2008, the Agency will further an international health strategy and an organizational approach for managing international activities. In addition to supporting Canada's domestic public health goals, this investment provides a more solid foundation for strategic international initiatives to strengthen global public health security; to strengthen international efforts to build capacity in public health systems; and to reduce the global burden of disease and global health disparities – three interconnected and mutually supportive objectives. Strengthening international public health infrastructure enhances public health globally and is integral to reducing the global disease burden and improving global public health security. This area is demanding new approaches to ensure that a critical line of defence is maintained to protect Canadians against many current and emerging public health and other health-related threats.

The Agency's investments in 2007-2008 will expand its capacity to implement the international health strategy and strengthen Canada's links in the international public health arena. They will enable Canada to meet its international obligations and share more public health expertise with global partners. During the planning period, the Agency will also continue to develop and strengthen relationships with bilateral and multilateral partners and institutions, such as the WHO (a Government of Canada strategy with regard to this relationship is currently being developed), the Pan American Health Organization, the OECD and the International Union for Health Promotion and Education. The resulting exchanges of information will improve the Agency's domestic work by allowing the best practices of other countries to be reflected in the development of Agency policies.

The Agency's work on its strategic and developmental initiatives specifically addresses Priority 5: Lead several government-wide efforts to advance action on the determinants of health, and in general supports all of its other priorities.

Pan-Canadian Public Health Network

The 2005 launch of the Pan-Canadian Public Health Network was an important, strategic step in strengthening public health capacity across Canada. In establishing the Network, federal, provincial and territorial (F/P/T) Ministers created a mechanism for multilateral sharing and exchange among federal, provincial and territorial public health institutions and professionals. This new, more collaborative approach to public health policy and initiatives is critical during public health emergencies, and will also assist Canada in establishing a more efficient approach to addressing serious public health issues.

The Network will continue to focus on joint strategies and action in the following six public health areas: communicable disease control; emergency preparedness and response; public health laboratories; public health surveillance and information; non-communicable disease and injury prevention; and population health promotion.

Over the planning period, the Agency will continue to capitalize on investments made in the Pan- Canadian Public Health Network. Key planned initiatives for the Network over this period include:

• Implementation of the Memorandums of Understanding (MOU) on Mutual Aid and Information Sharing in public health emergencies;
• A continued focus on pandemic influenza preparedness, including the delivery of a national policy recommendation on whether or not to provide antivirals for disease prevention during an influenza pandemic, and the development of the technical and operational components of the Memorandums of Understanding describing respective federal/provincial/territorial roles and responsibilities in pandemic preparedness and response;
• The design and application of tools to support timely and efficient public health communications and links within the Pan-Canadian Public Health Network;
• Further development of the National Health Emergency Management System; and
• Enhancing the capacity of the public health system through public health human resource planning and development as well as furthering the Agency's laboratory capabilities.

The Agency is also exploring opportunities to include expertise in Aboriginal public health in the work of the Network.

Pan-Canadian Public Health Strategy

In September 2004, under the Ten-Year Plan to Strengthen Health Care, the First Ministers committed to accelerate work on a Pan-Canadian Public Health Strategy. The vision for this strategy is to provide a framework for existing public health approaches and initiatives; identify gaps, vulnerabilities and risks in the public health system; and develop a strategic agenda to address the aforementioned. The Pan-Canadian Strategy would integrate the federal directions and vision for public health within Canada, and build on recent investments in public health. Preliminary discussions have taken place with the Pan-Canadian Public Health Network (PHN) Council to consider the scope, focus and timing of the Strategy. The consensus among all jurisdictions was to continue to lay a foundation for the Strategy and revisit its development once short term priorities are met. Work done on the early commitments of the Network represents important groundwork for the future development of the Strategy.

Over the three-year planning period, the Agency will work through the PHN to continue to identify emerging public health priorities and will gauge readiness to move forward on the Pan- Canadian Strategy in the PHN federal, provincial and territorial forum. In 2007-2008, the Agency will enhance its capacity in the area of strategic information (SI) – a systematic approach to needs assessment, information gathering, analysis, related policy advice and information sharing – in order to better understand the public health environment in Canada (e.g. evolving provincial/territorial, Aboriginal and non-government stakeholder policy positions). Steps to move in this direction include defining the SI initiative and its scope and objectives, and communicating them to Agency Branches and Centres; examining models that exist in other government departments; assessing approaches and capacity to coordinate SI within the Agency; and recommending and implementing an approach that would build on existing mechanisms. Closely aligned with this initiative are ongoing efforts within the Agency to strengthen regional policy development capacity and to prepare an internal communications plan. Agency actions in this area will help ensure strong federal leadership and content direction in the development of the Strategy. Ultimately, the Pan-Canadian Strategy will contribute to an organized, strategic and efficient approach to public health in Canada, as well as foster innovative domestic and international partnerships to respond to increasingly complex public health issues.

Management Initiatives and Capacity Development

The Public Health Agency of Canada Act

Bill C-5, the Public Health Agency of Canada Act, was tabled in the House of Commons on April 24, 2006. On December 15, 2006, the Act came into force. The Act has three main functions. First, it gives the Public Health Agency of Canada a firm statutory base as a separate department within the federal Health Portfolio. Second, it establishes the unique dual role of the Chief Public Health Officer of Canada as deputy head responsible for the Agency and as a credible spokesperson on public health at the federal level, able to communicate directly with Canadians and to publish reports on issues of public health, including a mandated annual report on the state of public health in Canada. Third, the regulations will provide the Agency with clear authority to receive, manage and protect health information, ensuring that it will be able to obtain the information it needs to fulfill its mandate and that it will be able to protect the privacy of Canadians' personal health information.

Moving forward through the three-year planning period, the Agency will develop regulations that will authorize and govern the collection, analysis, interpretation, publication, distribution and protection of public health information. These regulations, stemming from the authority contained in paragraph 4(2)(h) of the Department of Health Act, as enabled by section 15 of the Public Health Agency of Canada Act, will apply to the Health Portfolio in its use of public health information.

Health Portfolio Review

The Health Portfolio, like other federal organizations, is expected to practice prudent management of its resources and to avoid duplication and overlap of services at every level. In 2007-2008, the Agency will participate in a review to improve the efficiency and effectiveness of the Portfolio's strategic policy and corporate service functions. A steering committee has been formed to oversee the work; it includes representatives at the Assistant Deputy Minister level from each department and agency in the Portfolio. The steering committee is supported by two working groups – one addressing strategic policy and one representing corporate services functions. A final report and implementation plan is anticipated for fall 2007.

Policy Capacity

The Agency will enhance and augment its policy capacity in order to strengthen its public health leadership and its contribution to the priorities of the Health Portfolio and the health-related priorities of other government departments. In doing so, the Agency will be in a better position to identify, coordinate, and bring forward high-quality strategic proposals and options for the consideration of the Minister of Health and Cabinet; enhance policy synergies; and develop and make use of a variety of levers, partnerships, and innovative delivery mechanisms. The development of policies will better integrate results and value-for-money considerations.

The Agency's Five-Year Strategic Plan

As the organization responsible for federal efforts to promote and advance public health in Canada, the Agency has worked over the past two years in an environment of changing priorities and newly emerging concerns to provide leadership on key public health issues. The Agency is also working to continue the shift from operating as a branch of Health Canada to its new status as a separate Agency serving the Minister in a Health Portfolio context.

As the Agency entered its third year, it has embarked on a strategic planning process, reflecting on future challenges and priorities in order to align its resources accordingly and make the right strategic choices with regard to its research, program and policy capabilities, its support systems and networks, and its partners and stakeholders. The Public Health Agency of Canada's five-year strategic plan is being developed by and for all staff of the Agency.

Three broad themes are guiding this important work:

• Delivering on policy and programming priorities;
• Aligning programs and research with priorities; and
• Enhancing Agency capabilities and accountability.

To move the five-year strategic plan forward, a Corporate Business Plan is being developed to align the Agency's human capital with its strategic and business goals. The broad strategic directions and Agency priorities identified in the strategic plan under development, coupled with the implementation strategy and accountability mechanisms set out in the Corporate Business Plan, will improve performance and organizational success through integrated planning and efficient action.

Corporate Business Planning

In its first Business Plan in 2006-2007, the Agency's program and support areas identified their objectivities, challenges, strategies and plans. During 2007-2008, a more comprehensive and integrated Business Plan will further address human resource planning, based on analysis of the current workforce, forecasts of future needs and gap analysis/succession planning. The five-year strategic plan will be the reference point for discussing the Agency's capacity to deliver on its plans and priorities.

Risk Management

As part of the due diligence undertaken as its organizational structure is evolving, the Agency is developing a corporate risk profile. This involves taking stock of the operating environment and the organization's capacity to deal with key high-level risks linked to the achievement of corporate objectives. The profile will inform senior officials on the prevailing departmental perspective on risks inherent to the Agency's mandate and risks emerging from the changing operating environment, and how these risks are to be mitigated, managed and communicated. This is the first step in incorporating an integrated risk-management framework into the Agency's daily operational practices. The adoption of such a framework supports the federal agenda of modernizing management practices and supporting innovation through more responsible risk-taking.

During a series of workshops held early in 2006, risks that could prevent the Agency from meeting its objectives were identified and assessed. The Agency's key strategic risks are being defined with a risk-assessment tool that has both qualitative and quantitative application.

Strategic Risk Communications

A plan to launch the Strategic Risk Communications Framework and related handbook and to implement strategic risk communications at the Agency has been developed. Strategic risk communications is defined as “a purposeful process of skilful interaction with stakeholders supported by appropriate information to enable well-informed decision-making and action on risks.“ Integrating strategic risk communications principles into the work of the Public Health Agency of Canada will provide support for informed decision-making and communication; help stakeholders, and ultimately all Canadians, make well-informed decisions on key public health issues; and foster the confidence of Canadians in the Agency by serving as a foundation for integrated risk management in public health.

The Strategic Risk Communications Framework outlines guiding principles, implementation guidelines, and a seven step process for doing strategic risk communications. The process – an integral component of risk management – is fully aligned with the Health Canada Decision- Making Framework (DMF). Complementing the new Framework is a handbook which will help communicators, program managers and policy makers to operationalize risk communications. The launch plan includes training for the Agency's Communications Directorate and program employees as needed, as part of professional development activities.

Business Continuity Plan and Pandemic Influenza Preparedness Annex

Business continuity plans (BCP) allow critical services or products to be continually delivered to clients regardless of any major disruption of normal activities (e.g. due to a disaster or major outbreak of disease), instead of being focused on resuming business after critical operations have ceased or recovering after a disaster. Critical services or products are those that must be delivered to ensure survival, avoid causing injury, and meet legal or other obligations of an organization. The Agency's business continuity planning is a proactive planning process that ensures critical services and products are delivered during a disruption.

The Agency's Business Continuity Plan includes:

• Plans, measures and arrangements to ensure the continuous delivery of critical services and products, while the organization recovers its facilities, data and assets in the event of an interruption;
• Identification of necessary resources to support business continuity, including personnel, information, equipment, financial allocations, legal counsel, infrastructure protection and accommodations; and
• A Pandemic Influenza Preparedness Annex

The Agency's business continuity planning has proactively increased awareness of the organization's critical services with employees, shareholders and customers. All Branches within the Agency have been actively engaged in completing their service level BCPs, and the majority of these service level plans have been entered into a BCP database.

The Agency provided Treasury Board Secretariat and Public Safety and Emergency Preparedness Canada with an action plan on business continuity planning in August 2006. Key action items include the completion of an employee skill set survey and conducting a table top exercise (scheduled for March 2007). This exercise will test and validate the Agency's BCP in the event of a pandemic influenza outbreak.

Pandemic Influenza Preparedness Annex outlines the Agency's response in the event of a pandemic influenza outbreak. In this situation, the identification of employees with various skills sets that are not utilized in their current job, but that may be required in the event of a pandemic (e.g. nursing, doctor) would be essential. The BCP's Pandemic Influenza Preparedness Annex provides the Agency with a tool to track employee skill sets and will permit easy identification of employees who might be required for critical services or who might be crosstrained to move within the Agency so that critical services can be maintained.

The Agency plans to launch a skills set survey of Agency employees and then will analyze the data collected for the implementation of the Pandemic Influenza Preparedness Annex.

Regional Operations

The Agency includes a Canada-wide infrastructure consisting of six Regional Offices and a Northern Secretariat, with approximately 275 employees posted in 16 locations. A strong regional presence ensures that the Agency can provide leadership and promote coordinated action on population and public health across the country.

The Agency's Regional Offices work in collaboration with provincial and territorial governments, federal departments and agencies, academia, voluntary organizations and citizens. They connect and support stakeholders, including those outside the health sector, to take action on national priorities, gather public health information and build on resources at the regional, provincial and district levels. Key roles include the following:

• Engaging and mobilizing citizens, provincial and territorial governments, and local partners (community groups, academia, the non-governmental organization sector);
• Developing partnerships and collaborations that support long term action on national health priorities;
• Implementing, managing and monitoring the regional component of national programs;
• Ensuring that Agency programs complement and are aligned with provincial initiatives;
• Leading the federal Health Portfolio in preparing for and responding to emergencies that occur in the regions;
• Contributing regional knowledge and policy input to national program and policy development;
• Promoting an evidence base to inform program and policy development, which includes surveillance, evaluations and national and international research studies; and
• Enhancing the capacity of public health professionals by supporting continuous professional development.

During the three-year planning period, the Agency's Regional Offices will continue to align regional structures, procedures and resources to most effectively deliver on Agency priorities, innovate and respond to emerging health issues and opportunities in the regions and facilitate action across the country to strengthen the public health system.

Sustainable Development

During 2007-2008, the Public Health Agency of Canada will launch its first Sustainable Development Strategy (SDS). In this strategy, the Agency has committed to incorporate sustainable development considerations into the planning and implementation of its activities, ensure that the Agency conducts its operations in a sustainable manner, and build capacity to implement the Strategy. The commitments made in the SDS will advance the Agency's goal of healthier Canadians and communities in a healthier world and by doing so will support the Government's priority of reducing patient wait times. Because sustainable development is a comprehensive and balanced concept, it recognizes the links between the economy, the environment and social well-being, including health. Sustainable development aims to improve human health and well-being to enable Canadians to lead economically productive lives in a healthy environment while sustaining the environment for future generations.

In order to accomplish these balanced objectives, the Agency is committed to integrating best practices for sustainable development into its decision making, processes and operations. It will also be working closely with the provinces and territories and other partners to achieve sustainable development, keep Canadians healthy, and help reduce pressures on the health care system. At the same time, the Agency recognizes that sustainable development is a long-term journey. It is one that the Agency is committed to pursuing over the coming years.

The Agency's Sustainable Development Strategy deliverables for 2007-2008 include:

• Reviewing the outcomes of Population Health Fund sustainable development projects in the Quebec Region;
• Beginning work to identify (through their genetic imprint) and respond to antibioticresistant organisms in the North;
• Reinforcing the public health system by establishing public health chairs in at least 10 universities; and
• Establishing a committee to monitor the health effects of a changing climate.

In 2007-2008, the Agency will also initiate several projects for the greening of its operations, and will begin to integrate sustainable development into its strategic and business planning and reporting. The first progress report to the Management Committee on the Agency's Sustainable Development Strategy will be made in December 2007.

Program Management Committee

Grants and Contributions (Gs&Cs) programs assist the Agency in fulfilling its mandate and public policy objectives by entering into funding relationships with public, private, volunteer and not-for-profit organizations that are working to promote and protect the health of Canadians. These include initiatives that deliver health promotion and protection programs, undertake research, knowledge synthesis and exchange initiatives, strengthen public health capacity and develop strategies and networks to build healthy communities and respond to emerging public health issues.

The Program Management Committee (PMC), a permanent senior management committee, which was established in 2006, is mandated by the CPHO to provide direction and oversight of the Agency=s programs and related Gs&Cs activities. This Committee is responsible for ensuring that Agency programs are closely aligned with the Agency=s public health policy objectives, enhance Agency capabilities and accountability and are invested with care to achieve results for Canadians.

Over the next year, the PMC will recommend to the Agency's Executive Committee opportunities for adjusting existing programs to fulfil policy objectives including the reallocation of existing program resources to move from lower to higher priorities, and recommend ways to strengthen the management, oversight and effective delivery of programs.

Access to Information Program

The Agency continues to develop the corporate infrastructure to deliver and support its day to day business, and on January 1, 2007, the newly created Public Health Agency of Canada's Access to Information and Privacy (ATIP) Division assumed responsibility for the ATIP function at the Agency. During this period, to improve the Agency's ability to respond to ATIP requests, the Division is undertaking staffing, developing Access to Information and Privacy policy, and launching an Agency-wide ATIP training and awareness program.

Financial Management Control Framework

The Agency has developed a financial management control framework that will assist it in ensuring that there is prudent and effective management of Agency resources. During this period, the framework will be implemented to ensure that:

• Agency program delivery and major project decisions routinely take into account financial management considerations;
• Long-term and short-term plans and proposed initiatives include an appropriate analysis of their financial implications;
• Objective reviews are made of the funding and financial management implications of all plans and proposed initiatives;
• Timely, reliable and consistent advice and information is available to managers at all levels to support their financial management responsibilities;
• Relevant and reliable financial management reports support the decision-making and accountability of Agency managers;
• All legislation, regulations and executive orders applicable to financial management are complied with, and spending limits are observed;
• There is an adequate system of internal control over assets, liabilities, revenues and expenditures, taking materiality, sensitivity and risk into account; and
• Managers at all levels are aware of their financial management responsibilities and have the training to fulfill them.

Audit

In December 2006, as part of the strategy to implement the Treasury Board (TB) Policy on Internal Audit, the Public Health Agency of Canada appointed its first Chief Audit Executive. This executive is overseeing the conduct of internal audits and providing the Chief Public Health Officer (CPHO) assurance on the adequacy of internal controls in the Agency, in particular by assessing controls over financial management and financial reporting and the delivery of programs and activities with due regard to economy, efficiency and effectiveness.

In the fall of 2006, a Three-Year Risk-Based Audit Plan (2006-2007 to 2008-2009) was approved by the CPHO and the Agency's Executive Committee. The audit projects will be undertaken by the Office of the Chief Audit Executive. The audit reports will be made available to the public on the Agency's Web site. Observations and information regarding the audits will be included in the Agency's future Departmental Performance Reports and Reports on Plans and Priorities.

The Agency's Audit Committee will be created in early 2007-2008. It will be chaired by the CPHO. Membership on the committee will include members external to government, as required by the TB Policy on Internal Audit Directive on Departmental Audit Committees.

Evaluation

The Agency's Centre for Excellence in Evaluation and Program Design (CEEPD) is tasked with ensuring that the Agency has a well-articulated corporate evaluation function that promotes effective, well-communicated and consistent evaluation work practices for all Agency programs. The role of the CEEPD is to provide stewardship and governance, leadership, advisory services, capacity building and planning support to maintain and strengthen the evaluation function in PHAC. In 2006, the CEEPD established an Agency Evaluation Advisory Committee to assist the Chief Public Health Officer (CPHO) in fulfilling his responsibility for evaluation, including an associated responsibility for performance measurement. This committee, which is chaired at the Deputy Chief Public Health Officer level, has the responsibility of reviewing and recommending Agency evaluation reports for CPHO approval and their corresponding Management Responses and Action Plans for CPHO acceptance. In addition, the Committee plays a proactive role and is involved in such activities as overseeing the development and implementation of the Agency evaluation policy and providing advice on Agency evaluation plans.

Management Resources and Results Structure

During 2008-2009, the Agency intends to develop its Management Resources and Results Structure (MRRS) to enhance transparency and accountability. To do so, the Agency will review its Strategic Outcome and develop a clear and detailed inventory of its programs in an enhanced Program Activity Architecture (PAA). A Performance Measurement Framework will also be developed for the Strategic Outcome and for all programs identified within the Architecture. The Agency will also identify the governance structure that ties these elements together.

List of Partners

The Agency is continually involved in an evolving framework of partnerships and collaborations at many levels. The list below highlights but a few examples. Please note that this list is far from exhaustive, and space limitations prevent us from listing all of the partners.

Federal Departments and Agencies

• Health Canada
• Canadian Food Inspection Agency
• Canadian Institutes of Health Research
• Agriculture and Agri-Food Canada
• Canada Border Services Agency
• Canadian International Development Agency
• Citizenship and Immigration Canada
• Human Resources and Social Development Canada
• Public Safety and Emergency Preparedness Canada
• Statistics Canada
• Transport Canada

International Organizations

• World Health Organization (WHO)
• Pan American Health Organization (PAHO)
• European Commission
• Centers for Disease Control and Prevention (United States)

The Agency also works in collaboration with Canada's provinces and territories, voluntary organizations, professional associations, academic groups, non-governmental organizations and industry.

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¹ 2004 Canadian Community Health Survey: Nutrition, Statistics Canada.
http://www.statcan.ca/Daily/English/050706/d050706a.htm
² 2005 Canadian Community Health Survey.
³ Public Health Agency of Canada, using 2003 vital statistics data from Statistics Canada, 2006.
⁴ Health Canada (2002), Economic Burden of Illness, 1998.
⁵ Canadian Cancer Statistics, 2006.
⁶ 2004 Canadian Community Health Survey: Nutrition, Statistics Canada; <http://www.statcan.ca/Daily/English/050706/d050706a.htm>
⁷ Canadian Cancer Society and National Cancer Institute of Canada. Canadian Cancer Statistics 2006, p. 54.

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