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Table 7: Horizontal Initiatives

Over the next three years, the Public Health Agency of Canada will participate in the following horizontal initiatives:


Name of Horizontal Initiative: Canadian HIV Vaccine Initiative
Name of Lead Department(s):
Public Health Agency of Canada
Lead Department Program Activity:
Infectious Disease Prevention and Control
Start Date of the Horizontal Initiative:
February 20, 2007
End Date of the Horizontal Initiative:
March 2013
Total Federal Funding Allocated (start to end date): $111M
Description of the Horizontal Initiative (including funding agreement):
The Canadian HIV Vaccine Initiative (CHVI), Canada’s contribution to the Global HIV Vaccine Enterprise, is a collaborative undertaking between the Government of Canada and the Bill and Melinda Gates Foundation to contribute to the global effort to develop a safe, effective, affordable and globally accessible HIV vaccine. This collaboration builds on the Government of Canada’s commitment to a comprehensive, long-term approach to address prevention technologies. Participating federal departments and agencies are the Public Health Agency of Canada, Industry Canada, Health Canada, the Canadian Institutes of Health Research, and the Canadian International Development Agency. The CHVI’s overall objectives are to: strengthen HIV vaccine discovery and social research capacity; strengthen clinical trial capacity and networks, particularly in low and middle income countries (LMICs); increase pilot scale manufacturing capacity for HIV vaccine clinical trial lots; strengthen policy and regulatory approaches for HIV vaccines and promote the community and social aspects of HIV vaccine research and delivery; and ensure horizontal collaboration within the CHVI and with domestic and international stakeholders.
Shared Outcome(s):

Immediate (Short-Term 1 - 3 years) Outcomes:
• Increased and improved collaboration and networking
• Enhanced knowledge base
• Increased readiness and capacity in Canada and LMICs

Intermediate Outcomes:
• Pilot Scale vaccines clinical trial lot manufacturing is fully operational and globally accessible
• Strengthened contribution to global efforts to accelerate the development of safe effective, affordable, and globally accessible HIV vaccines

Long -Term Outcomes:
• The Canadian HIV Vaccine Initiative contributes to the global efforts to reduce the spread of HIV/AIDS particularly in LMICs.
Governance Structure(s):
The Minister of Health, in consultation with the Minister of Industry and of International Cooperation, will be the lead Minister for the CHVI for the purposes of overall coordination.  Communications for the CHVI will be handled jointly.

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

Multi-stakeholder advisory committees and working groups, involving governments, the private sector, international stakeholders, people living with HIV/AIDS, researchers and NGOs and other relevant stakeholders, will be established to inform the CHVI.

The role of participating departments and agencies involved in the CHVI are:

The Public Health Agency of Canada (http://www.phac-aspc.gc.ca/new_e.html) contributes its public health scientific, policy and program expertise and provides secretariat support for the CHVI.

Health Canada (http://www.hc-sc.gc.ca/english/index.html) applies its wider range of expertise, including vaccine related policy, regulations and protocols; facilitate collaborative networks of specialists with a particular focus on the community and social dimensions of vaccine research, development and delivery; and enhance international collaborations.

Canadian Institutes of Health Research (http://www.cihr-irsc.gc.ca/e/193.html) provides scientific leadership and strategic guidance through its linkages to the Canadian research community, as well as brings critical expertise in peer review mechanisms and related professional support services to identify and fund eligible HIV vaccines projects.

Industry Canada (http://www.ic.gc.ca/ic_wp-pa.html) applies its industry specific knowledge and experience to provide linkages to the Canadian and International vaccine industry, as well as assist with industry-related issues, including the appropriate engagement of potential private sector collaborators.

Canadian International Development Agency (http://www.acdi-cida.gc.ca/cidaweb/acdicida.nsf/En/Home ) provides effective linkages to international development efforts and ensures consistency with Canada’s international commitments. Moreover, CIDA will provide strategic guidance to ensure that the goals of the CHVI promote the development and delivery of HIV vaccines that benefit the needs of the highly endemic HIV/AIDS countries in the developing world.
Federal Partners Federal Partner Program Activity (PA) Names of Programs for Federal Partners Total Allocation from (start to end date) Planned Spending for 2008-2009 Expected Results for 2008-2009
1. PHAC PA: Infectious Disease Prevention and Control Public Health Contributions Program $27M $2.16M Completed open and transparent selection process for a Not for Profit Corporation to build and operate a pilot scale clinical trial lot manufacturing facility

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

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

Secretariat support services provided to CHVI committees

Evaluation framework design completed

CHVI website and day-to-day communications managed
2. HC Program Activity 1.3 International Health Affairs Grants to eligible non-profit international organizations in support of their projects or programs on health $1M $0.2M New HIV Vaccine Community Engagement Funding Program implemented (in partnership with the Agency)
3. IC Strategic outcome: innovative economy
Program Activity: Industry Sector- Science and Technology and Innovation
N/A $13M $3.25M Support provided to (Agency-led) open and transparent selection for pilot scale manufacturing facility for HIV vaccines clinical trial lots
4. CIDA Program Activity 1.4, Institutions  --  Enhanced capacity and effectiveness of Multilateral institutions and Canadian/ International organizations in achieving development goals International Development Assistance Program $60M $8.85M In collaboration with CIHR, establishment of a large team discovery and social research program to foster and support larger, collaborative teams of Canadian and LMICs researchers

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

Activities supported to improve regulatory capacity in LM ICs, especially those where clinical trials are planned or ongoing

Support provided to (Agency-led) open and transparent selection for pilot scale manufacturing facility for HIV vaccines clinical trial lots
5. CIHR HIV/AIDS Research Initiative -- Program Activity Architecture Code: 12300 HIV/AIDS Research Initiative $10M $2M Canadian researchers, working either independently or in small teams, supported through operating grant programs
In collaboration with CIDA, establishment of a large team discovery and social research program to foster and support larger, collaborative teams of Canadian and LMICs researchers
Total     $111.0M $16.46M  
Results to be achieved by Non-Federal Partners):
Non-governmental stakeholders (including research institutions and not-for-profit community organizations) are integral to the success of the CHVI.  Their role is to engage and collaborate with participating departments and agencies, the Bill and Melinda Gates Foundation and other funders to contribute to CHVI objectives and to a significant Canadian contribution towards the Global HIV Vaccine Enterprise.
Contact Information:
Steven Sternthal
Tel: 613-952-5120

 


Name of Horizontal Initiative: The Federal Initiative to Address HIV/AIDS in Canada http://www.phac-aspc.gc.ca/aids-sida/hiv_aids/index.html
Name of Lead Department(s):
Public Health Agency of Canada
Lead Department Program Activity:
Infectious Disease Prevention and Control
Start Date: January 13, 2005 End Date: Ongoing
Total Federal Funding Allocated:
• 2005/06 - $55.2M
• 2006/07 - $63.2M
• 2007/08 - $71.2M
• 2008/09 - $84.4M (ongoing)
Description:
The Federal Initiative to Address HIV/AIDS in Canada is the Government of Canada's response to HIV/AIDS in Canada. The initiative will strengthen domestic action on HIV/AIDS, build a coordinated Government of Canada approach, and support global health responses to HIV/AIDS. It will focus on prevention and access to diagnosis, care, treatment and support for those populations most affected by the HIV/AIDS epidemic in Canada - people living with HIV/AIDS, gay men, Aboriginal people, people who use injection drugs, inmates, youth, women, and people from countries where HIV is endemic. The Federal Initiative will also support and strengthen existing multi-sectoral partnerships to address the determinants of health. It will support collaborative efforts to address factors which can increase the transmission and acquisition of HIV including sexually transmitted infections (STI) and also address co-infection issues with other infectious diseases (for example, hepatitis C and tuberculosis) from the perspective of disease progression and morbidity in people living with HIV/AIDS. Gender-based analysis and human rights analysis are fundamental to the approach. People living with and vulnerable to HIV/AIDS will be active partners in shaping policies and practices affecting their lives.
Shared Outcomes:

Immediate (Short-Term 1 - 3 years) Outcomes:
• Increased and improved collaboration and networking;
• Increased availability and use of evidence;
• Improved quality assurance in HIV testing;
• Increased coherence of federal response;
• Increased awareness of HIV/AIDS;
• Improved attitudes and behaviours towards people living with HIV/AIDS; and
• Increased capacity (knowledge and skills) of individuals and organizations;

Intermediate Outcomes:
• Increased practice of healthy behaviours
• Improved access to quality HIV/AIDS prevention, diagnosis, care treatment and support; and
• Strengthened pan-Canadian response to HIV/AIDS.

Long-Term Outcomes:
Federal Initiative to Address HIV/AIDS in Canada contributes to the:
• Improved health status of persons living with or vulnerable to HIV;
• Reduction of social and economic costs of HIV/AIDS to Canadians; and
• Global effort to reduce the spread of HIV/AIDS and mitigate its impact.
Governance Structures:
The Public Health Agency of Canada (http://www.phac-aspc.gc.ca/new_e.html) is the federal lead for issues related to HIV/AIDS in Canada. The Public Health Agency is responsible for overall coordination, communications, national/regional programs, policy development, surveillance and laboratory science.

Health Canada (http://www.hc-sc.gc.ca/english/index.html) supports community-based HIV/AIDS education, capacity-building, and prevention for First Nations on-reserve and Inuit communities; provides leadership on international health policy and program issues; and assistance and guidance on evaluation.
As the Government of Canada's agency for health research, the Canadian Institutes of Health Research (http://www.cihr-irsc.gc.ca/e/193.html) sets priorities for and administers the extramural research program.

Correctional Service Canada, (http://www.csc-scc.gc.ca/text/home_e.shtml) which is an agency of the Ministry of Public Safety and Emergency Preparedness Canada (http://www.psepc.gc.ca/abt/index-en.asp), provides health services, including services related to the prevention, diagnosis, care and treatment of HIV/AIDS, to offenders sentenced to imprisonment for two years or more.

An interdepartmental coordinating committee has been established by the Public Health Agency to promote policy and program coherence among the participating departments and agencies, and to maximize the use of available resources.

Health Canada's International Affairs Directorate coordinates global engagement activities and provides the secretariat for the Consultative Group on Global HIV/AIDS Issues. The Consultative Group on Global HIV/AIDS Issues acts as a forum for dialogue between government and civil society on Canada's response to the global pandemic, and includes the provision of advice; guidance and suggestions regarding collaboration and policy coherence to ensure a more effective response. The Interdepartmental Forum on Global HIV/AIDS Issues meets quarterly to discuss on-going issues and to provide overall coordination and coherence in the federal government's approach to the global pandemic. Participating departments and agencies include the Agency, Health Canada, CIDA, DFAIT, and the Canadian Institutes of Health Research. Other government departments are invited to attend on an as-needed basis.

The Ministerial Council on HIV/AIDS (http://www.phac-aspc.gc.ca/aids-sida/fi-if/minister_e.html) provides independent advice to the Minister of Health on pan-Canadian aspects of HIV/AIDS.

The Federal/ Provincial/ Territorial Advisory Committee on AIDS (http://www.phac-aspc.gc.ca/aids-sida/fi-if/ftp_e.html) serves as a forum to promote a coordinated governmental response to the HIV/AIDS epidemic.

The National Aboriginal Council on HIV/AIDS (http://www.phac-aspc.gc.ca/aids-sida/fi-if/national_e.html) provides advice to the Public Health Agency of Canada and Health Canada on issues relating to HIV/AIDS and Aboriginal populations.

The Federal/Provincial/Territorial (FPT) Heads of Corrections Working Group on Health is a sub-committee of the FPT Heads of Corrections. The Working Group on Health promotes policy and program development that is informed and sensitive to the complex issues surrounding the health of inmates, and provides advice to the FPT Heads of Corrections on trends and best practices as they relate to health in a correctional setting.

Other federal departments have mandates to address broader social determinants that affect people living with HIV/AIDS or their vulnerability to acquiring the infection, as well as to address the global epidemic. A Government of Canada Assistant Deputy Ministers' Committee on HIV/AIDS has been struck to establish appropriate links and assist with the development of a broader Government of Canada approach to HIV/AIDS.
Federal Partners Involved in each program Names of Programs /
Program Activity
Total Allocation Planned Spending for
2008-09 (Millions)
Expected Results for 2008-09 
Public Health Agency of Canada Infectious Disease Prevention and Control / Infectious Disease Prevention and Control $35.2 M
(plus $0.1 from HC-DPMED)
$27.6 M
(plus $0.1 from HC-DPMED)
Increased awareness of HIV/AIDS epidemic in Canada and the factors that contribute to its spread through:

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

Increased availability and use of evidence through:

- augmented risk behaviour surveillance; and

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

- improved knowledge and characterization of the transmission of drug-resistant HIV in Canada; and

- improved reporting on progress through the implementation of the Federal Initiative's performance management framework

Improved quality assurance in HIV testing through:

- maintenance and improved quality of HIV testing in Canada;

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

- enhanced HIV reference services

Strengthened pan-Canadian response to HIV/AIDS through:

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

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

Increased and improved collaboration and networking through:

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

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

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

- increased availability of evidence-based HIV interventions which address co-infections which increase the susceptibility to acquiring and transmitting HIV (eg. other sexually transmitted infections [STIs]) and other infectious diseases which increase disease progression and morbidity in people living with HIV/AIDS (eg. hepatitis C, STIs, tuberculosis)

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

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

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

- developing the capacity for monitoring and evaluation of the HIV/AIDS epidemic in Canada
  AIDS Community Action Program (ACAP)/Infectious Disease Prevention and Control $16.7 M $15.0 M Increased and improved collaboration and networking through:

- multi-sectoral partnership development

Increased awareness of HIV/AIDS through:

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

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

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

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

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

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

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

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

- funding projects to increase the awareness of the social and economic factors that create barriers for those at risk and those people living with HIV/AIDS (e.g. addictions, housing, income)
Health Canada (HC) First Nations On-Reserve
First Nations Inuit Health Programming and Services
$4.0 M $5.3 M Increased awareness of HIV/AIDS: improved attitudes and behaviours through:

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

-Support to Aboriginal organizations (AFN, CAAN, Pauktuutit) on HIV/AIDS activities with particular focus on youth, leaders and women

Improved coherence of federal response through:

-ongoing development of relationships within FNIHB, the Agency, and with other FN/I partners such as INAC and Correctional Services to increase interdepartmental collaboration

Increased availability and use of evidence through:

-Development of recommendations on how to expand HIV/AIDS program to other blood-borne pathogens (Hepatitis C and Sexually transmitted infections)

-Promotion of efforts for the collection of epidemiological and surveillance data to enhance understanding progression of HIV/AIDs and HCV and increase the relevancy and effectiveness of the program
  Global Engagement
Program Activity 1.3 International Health Affairs
$1.7 M $1.6 M Improved coherence of the federal response through:

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

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

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

Strengthened pan-Canadian response to HIV/AIDS through:

- support for projects that engage Canadian organizations in the global response to HIV/AIDS
  Program Evaluation
(Transferred to the Agency – Infectious Disease Prevention and Control/ Infectious Disease Prevention and Control
    Improved coherence of Federal response through :

- the provision of strategic performance management framework: ongoing performance measurement, monitoring, evaluation and reporting of performance results

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

- developing the capacity for monitoring and evaluation of the HIV/AIDS epidemic in Canada
Canadian Institutes of Health Research (CIHR) HIV/AIDS Research Projects and Personnel Support/ HIV/AIDS Research Initiative $22.6 M $20.6 M Increased and improved collaboration and networking through:

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

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

Increased availability and use of evidence through:

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

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

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

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

Strengthened pan-Canadian response to HIV/AIDS through:

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

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

- building effective partnerships with and engaging in meaningful dialogue with key stakeholders
Correctional Service Canada (CSC) Health Services

Program activity: 1.0 Custody (Garde) under public health services in institutions;

Program Sub-activity 1.3 Institutional Health Services; Program sub-sub activity 1.3.1 Public Health Services

And

Program activity 3.0 Community Supervision for public health services for offenders under supervision in the community.

Program sub-activity: 3.3 Community Health Services

Program sub-sub activity: 3.3.1 Community Public Health Services
$4.2 M $4.2 M Improved collaboration and networking through:

- expanded information sharing opportunities and collaborative activities within the F/P/T/ Heads of Corrections Working Group

Increased awareness of HIV/AIDS through:

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

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

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

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

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

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

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

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

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

Increased availability and use of evidence through:

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

- better informed internal policies and programs using results of an extensive inmate survey on risk behaviours
Total   $84.4 M in 2008-09 $74.3 M - 2008-09 total planned spending includes $1.3M additional investment by HC-FNIHB
Results to be achieved by Non-Federal Partners:
Major non-governmental stakeholders are considered full partners in the Federal Initiative to Address HIV/AIDS in Canada. Their role is to engage and collaborate with all levels of government, communities, other non-governmental organizations, professional groups, institutions and the private sector to enhance the Federal Initiative to Address HIV/AIDS in Canada's progress on all outcomes identified above.
Contact:
Marsha Hay Snyder
Tel. 613-946-3565
Marsha_Hay-Snyder@phac-aspc.gc.ca
Approved by:
Felix Li
Tel. 613-948-3557
Felix_li@phac-aspc.gc.ca
November 2007

 


Name of Horizontal Initiative: Preparedness for Avian and Pandemic Influenza
Name of Lead Department(s): Public Health Agency of Canada Lead Department Program Activity: Infectious Disease Prevention and Control
Start Date of the Horizontal Initiative: late 2006 End Date of the Horizontal Initiative: ongoing
Total Federal Funding Allocation (start to end date):   $617M from 2006-2007 to 2010-2011
Description of Horizontal Initiative (including funding agreement): Canada is facing 2 major, inter-related animal and public health threats: the potential spread of avian influenza virus (H5N1) to wild birds and domestic fowl in Canada and the potential for a human-adapted strain to arise, resulting in human-to-human transmission, potentially triggering a human influenza pandemic. A coordinated and comprehensive plan to address both avian and pandemic influenza is required.

In 2006 the Health Portfolio received $422M over 5 years to improve preparedness for avian and pandemic influenza.  The bulk of the initiatives are ongoing.   Initiatives are being launched in the areas of vaccines and antivirals, surge capacity, prevention and early warning, emergency preparedness, critical science and regulation, risk communication, and inter-jurisdictional collaboration.  Efforts also will be undertaken to fill gaps in on-reserve planning and preparedness and enhance federal capacity to deal with an on-reserve pandemic.

Under the umbrella of “Preparing for Emergencies”, in 2006 the CFIA obtained $195M to be spent over 5 years to enhance Canada’s state of AI preparedness. Canada’s Avian Influenza Working Group was established in 2006 to update policies, protocols, operating procedures, and systems to enhance Canada’s state of preparedness—through collaborations and partnership— in 5 pillars of strategies and processes for prevention and early warning, emergency preparedness, emergency response, recovery, and communications.
Shared Outcome(s):  These initiatives will allow the federal government to strengthen Canada’s capacity to prevent and respond to immediate animal health and economic impacts of avian influenza while increasing preparedness for a potential pandemic.

Greater Protection for Canadians will come about with improved vaccines and antivirals, improved emergency preparedness, and increased surge capacity to better address peak periods, as well as through critical science and regulation processes in the area.  There will be enhanced on-reserve planning and preparedness and improved federal capacity to deal with an on-reserve pandemic.

Response Speed and Understanding will be enhanced through prevention and early warning measures, risk communication and inter-jurisdictional collaboration.
Governance Structure(s): The governance structure is in its final stages of development.  Under the auspices of the Deputy Minister’s Committee on Avian and Pandemic Influenza Planning (CAPIP) a series of committees and working groups will be established focussing on each of the key horizontal areas coordinated by a DG committee with leadership provided by an ADM committee with a representative from each of the funded departments or agencies.  This structure will be in place before the end of the fiscal year 2007-08. 
Federal Partners Names of Programs for Federal Partners Total Allocation (from start to end date) Planned Spending for
2008-2009
Expected Results for 2008-2009
1.PHAC a. Vaccine readiness & clinical trials ongoing $ 13.3M Support for expanded production capacity and production of clinical trials of a mock H5N1 vaccine will help ensure timely availability of a safe and effective vaccine to all Canadians in the event of a pandemic, helping to reduce the extent of illness and death. Improved vaccine adverse event reporting for both annual flu vaccine campaigns and the use of a vaccine in a pandemic will allow a timely response to any adverse effects and increase public confidence in Canada’s public health system.
  b. Rapid vaccine development and testing ongoing $1.8M Enhanced domestic ability for research and development of vaccines for novel influenza viruses and other emerging infectious diseases and an improved body of knowledge will contribute to the development of new strategies for influenza vaccines, which will help allow a more timely and effective response to future influenza threats.
  c. Contribution to National Antiviral Stockpile ongoing $12.7M
 
An increased national stockpile of antivirals for the use of health care professionals/institutions will allow treatment to all Canadians who need it, helping to bridge the gap until a pandemic vaccine can be produced and thereby reducing the number of deaths in the event of a pandemic.
  d. Additional antivirals in NESS $12.5M in 2007-08 only $0M An antiviral reserve beyond the national antiviral stockpile will give the Government of Canada the flexibility to support the initial containment of a potential pandemic influenza outbreak, either domestically or abroad, by providing surge capacity to support P/T efforts against an outbreak and by providing appropriate protection to designated essential federal employees.  This will contribute to a more timely and effective response to a pandemic situation thus providing better protection of Canadians.
  e. Capacity for Pandemic Preparedness ongoing $4.9M Strengthened capacity for pandemic issues will allow the Agency to provide more strategic policy advice to the Minister and support improved collaboration and coordination on avian and human influenza issues across the Government, with provinces and territories, internationally, and with the private sector. Further, strengthened capacity for policy advice in F/P/T liaison, the private sector and executive briefing will allow for more timely identification of issues and responsive decision making in a changing environment.

In 2008-09, Agency Regional Offices will provide timely and consistent strategic regional intelligence on matters related to avian and pandemic influenza.  A system to collect, analyze and disseminate regional intelligence will be developed which, along with more coordinated intergovernmental and regional communication involving the federal health portfolio and other stakeholders, will strengthen collaboration and increase the capacity of the Agency and its partners to anticipate and respond to an outbreak.
  f. Surveillance Program ongoing $8.9M
 
Improved and interoperable components of the Canadian public health surveillance system will reach into a broader range of settings/issues such as surveillance in health care settings, wildbird surveillance and ensuring the safety of the blood supply. This system, supported by a robust systems platform, new and/or improved policies and/or information sharing agreements, and the efficient analysis and interpretation of the data collected, will allow more timely identification of potential outbreaks, thereby moving towards a more effective response and thus reducing illness and death in the event of an avian influenza outbreak or human influenza pandemic.
  g. Emergency preparedness ongoing $7.1M A more robust, efficient, effective response to a human influenza pandemic through improved communications, integrated and tested plans, and improved local capacity will result in reduced mortality and morbidity among Canadians, and demonstrate Government of Canada leadership and foresight in the event of an avian or pandemic influenza outbreak.
The Agency’s Regional Offices are actively engaged in promoting and enhancing national, regional and provincial/territorial pandemic planning through a variety of activities, including facilitating and promoting pandemic planning among federal departments and with provincial, Aboriginal and local governments and stakeholders.
  h. Emergency human resources ongoing $0.4M A viable response plan for the HR capacity of the Agency and effective operational support to meet Agency requirements during a health crisis will allow the quick mobilization of Agency staff members in the event of a health crisis. Supporting preparedness measures will ensure that Agency’s services to Canadians can continue uninterrupted in the event of a public health emergency, reinforcing public confidence in the Canadian health system.
  i. Winnipeg lab & space optimization ongoing $4.5M Additional biocontainment research space will allow additional efforts on diagnostic testing and research on avian and human influenza, resulting in more timely identification of a pandemic virus and a better understanding of its characteristics, thus helping to reduce illness and death in the event of an outbreak or pandemic.

Establishing an off-site storage and stores facility will allow the NML to reallocate existing lab-related space and expand the capacity to receive and process specimens.
  j. Strengthening the public health lab network ongoing $1.2M An increased and better linked and coordinated capacity across jurisdictions for laboratory diagnostic testing, with a focus on antiviral, immunization and surveillance issues, will help to ensure the more timely identification of new or emerging viruses, allowing a pandemic virus to be more quickly isolated so that vaccines and more effective treatment options can be developed, thus reducing illness and death in the event of an avian influenza outbreak or human pandemic.
  k. Influenza research network ongoing $6.8M Improved decision-making respecting pandemic preparedness, control and treatment through systematic identification of research priorities along with mechanisms to rapidly generate research findings and promote access to and utilization of new knowledge through effective translation strategies.
  l. Pandemic influenza risk assessment & modelling ongoing $0.8M An improved federal capacity for mathematical modelling, statistical analysis, and operations research on pandemic influenza issues will allow a better understanding of the spread of influenza and the effect of epidemics or pandemics on Canadians, allowing more timely and evidence-based decision making on public health responses, thus helping to reduce the extent of illness or death in the event of an avian influenza outbreak or human pandemic.
  m. Performance & evaluation ongoing $0.6M Collection of relevant information to effectively measure the design, management, implementation, and impact of the Pandemic Influenza Strategy.  Future evaluation activities and measurement of intended outcomes will contribute to ongoing decision making that reflects best practices and ensures value for money, thereby ensuring that avian and pandemic influenza preparedness measures are reaching their intended objectives.
  n. Pandemic influenza risk communications Strategy ongoing $1.8M Provide citizens, governments and key stakeholders with appropriate information to make effective decisions about health and safety before and during an influenza pandemic.

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

Support the federal government’s leadership role and credibility with citizens and partner organizations to reinforce confidence in Canada’s public health system, before, during, and after an influenza pandemic.
  o. Skilled national public health workforce ongoing $5.6M The new Canadian Public Health Service Program (CPHSP) will hire a variety of public health professionals to address key gaps in P/T, local jurisdictions and other public health organizations, as part of an expanded and strengthened public health work force. Public Health Officers in this program are directly serving their host organizations, while having the benefit of individualized learning plans supported by the Agency. Through the combination of  career-positive professional development and field experience, the program will address current gaps in public health at all levels, including planning, surveillance and management of disease, risks to health, and emergency response with particular reference to avian or pandemic influenza.

In 2008-2009 discussions will be concluded with all provincial departments of health to determine public health capacity gaps and how CPHS staff can be most effectively deployed to address them.  A system of regional coordination will contribute to efforts to achieve better integration across jurisdictions and address gaps and surge capacity.
2.HC a. Regulatory activities related to Pandemic Influenza Vaccine ongoing $1.4M HPFB will implement the recommendations of the World Health Organization (WHO) assessment visit of National Regulatory Authority held in January 2007. The official report will be received in late 2007-08.[The unofficial report gave Canada a passing grade, and suggested minor revisions].

Health Canada is proceeding with amendments to the Food and Drug Regulations to introduce new regulations for   Extraordinary Use New Drugs (e.g. an authorization process specific to drugs for emergency preparedness) and Block Special Access Programme (e.g. the release of a quantity of unauthorized drug for use in an emergency scenario).  It is anticipated that these amendments will be finalized by early 2008-2009. Should a pandemic be declared in advance of completion of these amendments, they would be implemented via the interim order provision.  Health Canada will be preparing an interim order to authorize a vaccine against H5N1 strain, which would then be donated to WHO for stockpiling and distribution to lesser developed countries in need of vaccine.  This order will be drafted by end of this fiscal year.
  b. Resources for review and approval of antiviral drug submissions for treatment of pandemic influenza ongoing $0.3M Health Canada is developing an "accelerated review process" based on the current review process models and will apply this new process for reviewing the influenza drug submissions.  This accelerated review process will be posted on our regular channels of communication, including on the Web, as Guidance Document to the Industry.  The reviewers are being trained on the aspects of the "accelerated review" and will be ready to apply the new protocol.
  c. Establishment of a crisis risk management unit for monitoring and post market assessment of therapeutic products ongoing $0.4M Emergency preparedness plans specific to pandemic influenza will be put into place for dealing with staff shortages and lack of trained personnel for pharmacovigilance and product vigilance.
Strategies are being developed for expedited surveillance, assessment and risk communication for anti-virals and other relevant health products.

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

Communication links with F/P/T and other stakeholders will continue to be refined.
  d. FN/I Surge Capacity $1.48M (2007-08 to 2009-10) $0.4M Ongoing development and delivery of culturally appropriate training packages for FN/I communities that will allow them to build an increased capacity to respond to avian influenza or a human pandemic with the health care workers already in those communities, helping to ensure a more rapid identification of and immediate response to any outbreaks, and thus reducing illness and death in the event of a pandemic.
  e. Strengthening Federal Public Health capacity ongoing $0.7M Enhanced capacity to deal with outbreaks/emergencies in FN/I communities, along with strengthened links to other public health and emergency preparedness actors, will allow a more timely response to avian/pandemic influenza outbreaks in these communities, thus reducing illness and death in the event of a pandemic.
  f. First Nations & Inuit emergency preparedness, planning, training and integration ongoing $0.4M Ongoing development and testing of community pandemic influenza preparedness plans in all FN/I communities, along with established emergency management communication pathways among local communities and health authorities, regional, provincial and national partners and stronger linkages with federal efforts will ensure a more effective response in the event of an outbreak in an FN/I community, and thus contribute to reduced illness and death in the event of a pandemic.
  g. Public health on passenger conveyances ongoing $0.3M A trained and prepared cadre of Emergency Health Officers and other partners at points of entry will help to ensure more timely detection, identification and remediation of avian or pandemic influenza as public health threats onboard conveyances or at ancillary service sites, thereby helping to reduce illness or death in the event of a pandemic. These measures also help improve Canada’s compliance with the International Health Regulations, although some gaps will still be present.
3.CIHR a. Influenza research priorities $21.5M (2006-07 to 2010-11) $5.5M Peer review and fund research projects.

Develop and launch requests for research applications, if needed. 

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

Chair Research Sub-committee meetings of Avian and Pandemic Influenza Operations DG (APIO DG) Committee. 
Mid term evaluation.
4. CFIA a. Animal vaccine bank $2.4M $0.43M Maintain a high state of preparedness for the possible use of poultry vaccination as a disease control tool during an avian influenza outbreak in order to control avian influenza in animals and prevent its spread to humans.
  b. Access to antivirals $0.6M $0.11M Maintenance and exercise of protocols and strategies to provide access to antivirals to enhance the Government of Canada’s flexibility to support the initial containment of a potential avian influenza outbreak and provide appropriate protection to federal employees, ensuring a more timely and effective response to an avian influenza situation and better protection of Canadians.
  c. Specialized equipment $33.6M $20.0M Continued investment in and maintenance of specialized supplies and equipment to enhance capacity and allow a more timely and effective response to possible avian influenza outbreaks, containing the spread and contributing to better protection of Canadians.
  d. Laboratory surge capacity and capability $22.1M $2.57M Increased coordination capacity with the creation of an integrated lab network across the country (federal, provincial and university labs).  This network will allow for rapid testing, detection and reporting of AI.
  e. Field surge capacity $5.0M $0.87M Ongoing development of a viable response plan for urgent needs to increase HR capacity to respond to foreign animal disease emergency response situations.
  f. National veterinary reserve $8.8M $2.27M In January 2007, the Canadian Veterinary Reserve (CVR) was established to identify available private sector veterinarians to help respond to animal health emergencies.  This reserve of professional veterinarians will enhance domestic and international surge capacity, and provide expertise and rapid response capability for foreign animal disease control efforts.  The CFIA will continue to promote the growth of the CVR, and provide training to CVR members.
  g. Enhanced enforcement measures $6.7M $1.37M Provide CBSA with increased veterinary expertise, in order to increase capacity to support enhanced screening procedures for live birds or poultry products at Canada’s ports of entry.  These actions can mitigate the risk of future avian influenza outbreaks in Canada.
  h. Avian and biosecurity farms $23.9M $4.16M Implementation of  the National Avian Biosecurity Strategy (NABS), the objective of which is horizontal integration and coordination of biosecurity-related activities, including on-farm biosecurity standards, flock management, governance, and stakeholder engagement to mitigate the introduction or spread of avian influenza and build a foundation for a sustainable industry that  minimizes economic and production losses.
  i. Real property requirements $4.0M $0M Investment in real property and accommodation to support efficient work environments and locations to support the CFIA’s action plan for AI.
  j. Domestic and wildlife surveillance program $14.4M $2.71M Development of a better integrated Canadian surveillance systems, supported by a robust systems platform and the analysis and interpretation of the data collected to allow more timely identification of potential outbreaks, and more timely response to avian influenza situations.
  k. Field training $6.9M $1.78M Investment in development and delivery of an effective and appropriate training package that will contribute to a skilled and experienced workforce ready to respond to an AI outbreak.
  l. AI enhanced management capacity $4.0M $0.85M Ongoing investment in infrastructure, tools, enhanced emergency management informatics systems and staff training to increase the Agency’s capacity to track, monitor and respond to outbreaks; and help provide emergency response teams with the ability to quickly deploy the necessary equipment and resources; maintenance of mobile command centres.
  m. Updated emergency response plans $11.3M $2.24M Continued review and updating of the comprehensive emergency response plans to reflect lessons learned and the most current available scientific information. For example lessons learned from the recent 2007 HPAI outbreak in Saskatchewan and in BC’s Fraser Valley in 2004. This will strengthen capacity and achieve the desired state of readiness as rapidly as possible.  This will allow CFIA to provide more effective leadership and support the provinces and territories and promote an integrated, collaborative response to possible avian influenza issues or outbreaks. Strengthened capacity for the Agency in F/P/T liaison, policy analysis and executive briefing will allow for more timely identification of issues and responsive decision making in a changing environment.
  n. Risk assessment and modeling $11.5M $2.24M Investment in an improved federal capacity for mathematical modelling, statistical analysis, and operations research on avian influenza issues will allow a better understanding of the spread of influenza and the effectiveness of disease control measures.  Specifically, risk rankings for possible pathways of entry of AI to Canada will be established. These investments will allow more timely and evidence-based decision making on avian influenza responses, thus helping to reducing the risk of transmission to humans and mitigating economic and production losses.
  o. AI research $6.3M $1.29M Investment in an improved federal capacity for mathematical modelling, statistical analysis, and operations research on avian influenza issues will allow a better understanding of the spread of influenza and the effectiveness of disease control measures.  These investments will allow more timely and evidence-based decision making on avian influenza responses, thus helping to reducing the risk of transmission to humans and mitigating economic and production losses.
Identification of the research gaps related to AI and development, with partners, of effective tools and knowledge to facilitate decision making and policy development.
To support the need for mass depopulation and disposal, research projects are ongoing in the areas of humane euthanasia and effective disposal methodologies.
  p. Strengthened economic and regulatory framework $5.4M $1.05M Strengthened capacity for increased regulatory review including analysis of current legislative/regulatory framework, capacity to address regulatory developments and economic options associated with Avian influenza outbreaks, and consult with stakeholders, provinces and territories. Increased regulatory review capacity will also support stronger leadership and coordination on Avian Influenza issues across government, provinces and territories, industry and internationally.
  q. Performance and evaluation $4.9M $1.04M Evaluation of activities and outcomes will allow future decision making that reflects best practices and ensures value for money, thereby ensuring that avian and pandemic influenza preparedness measures are providing Canadians with the protection they need and reinforcing public confidence in Canada’s food inspection system.
  r. Risk communications $9.9M $1.58M A risk communication and public education strategy focussed on AI prevention and preparedness, which engages stakeholders and PT governments and informs and reassures Canadians will support the federal government's leadership role, credibility, and authority. It will help to reinforce public confidence in Canada's inspection systems, before, during, and after an avian influenza situation.
  s. International collaboration $7.1M $1.36M Contribution to the global effort to slow the progression of avian influenza in support of Canada’s leadership role and international commitments designed to slow the progression of avian influenza.
Continue to deploy people internationally to assist with AI preparedness and response activities e.g. International Partnership On Avian and Pandemic Influenza (IPAPI). 
      Total $127.72M  
Results to be Achieved by Non-federal Partners
(if applicable)
Contact Information:
Dr. Arlene King
Director GeneralPandemic Preparedness
Infectious Disease & Emergency Preparedness Branch
Public Health Agency of Canada
130 Colonnade Road
Ottawa ON K1A 0K9
(613) 948-7929

Further information on the above-mentioned horizontal initiatives see http://www.tbs-sct.gc.ca/est-pre/estime.asp