Deputy Minister Briefing Material

August 2024

Overview of department
Governance and operations
Health system players
Annexes
1. Minister of health mandate letter
2. Minister of mental health and addictions mandate letter

I. Overview of department

A. Executive summary

The purpose of this binder is to provide background and contextual information on Health Canada. The binder presents: an overview of Health Canada’s branches and operations, an outline of the department’s legislative and regulatory responsibilities and governance structure, an overview of federal-provincial and territorial relations, and a summary of the health portfolio’s key stakeholders.

Health Canada & the health portfolio: A summary

Health Canada is the federal department responsible for helping Canadians maintain and improve their health. Health Canada promotes and helps protect the health and safety of Canadians by regulating products such as drugs, medical devices, consumer products and food. Health Canada also supports universally accessible, publicly funded health care for Canadians through stewardship of the Canada Health Act, leadership on emerging issues and collaboration with provinces and territories on health system improvements. This work is conducted under the purview of the Minister of Health and the Minister of Mental Health and Addictions and the Associate Minister of Health, alongside partners in the health portfolio. 

The health portfolio comprises Health Canada, the Public Health Agency of Canada, the Canadian Institutes of Health Research, the Canadian Food Inspection Agency, and the Patented Medicine Prices Review Board. These organizations strengthen Canada’s universal health care system, manage risks to health, respond to public health emergencies, and support health research and data collection. Additionally, the health portfolio plays a significant role in priority areas such as food safety, consumer products and cosmetics, legal and illegal substances, Canada’s legal cannabis framework, and environmental health. Although the response to the COVID-19 pandemic dominated the health portfolio’s work over the past few years, the portfolio’s efforts have shifted towards key priorities that impact health of Canadians, including addressing the longstanding and systemic issues within Canada’s healthcare system, dental care, pharmacare, mental health and substance use, and ensuring an agile and modern regulatory system to protect Canadians. 

To strengthen Canada’s health care system, through the ‘Working Together to Improve Health Care in Canada’ plan, Health Canada is working with provinces and territories to advance four shared priorities: reducing backlogs and supporting health workers; expanding access to family health services; improving access to quality mental health and substance use services; and modernizing the health care system. Helping people in Canada age with dignity and closer to home is also a priority. Health Canada has been working collaboratively with provinces and territories, including concluding bilateral funding agreements, negotiating action plans and discussing priorities with Indigenous partners to advance these shared health priorities to improve integrated health care for Canadians.

An integrated, inclusive approach to investments in health service teams, the health workforce, and data and digital tools will help to meet the health and mental health needs of Canadians. Health Canada has also worked with Canadian Institute for Health Information, Indigenous partners and the provinces and territories on health data indicators to monitor progress, addressing the challenges Indigenous Peoples face in receiving fair access to healthcare services, and advancing policy work on long-term care and aging.

Additionally, dental care and pharmacare are key federal priorities. The Government launched the Canadian Dental Care Plan to help make oral health care more affordable for millions of Canadian residents who do not currently have access to dental insurance. The Program covers seniors aged 65 and over, Children under the age of 18 and adults with a valid disability tax credit certificate.

On February 29, the Minister of Health introduced Bill C-64, An Act respecting pharmacare (Pharmacare Act), which proposes the foundational principles for first phase of national universal pharmacare in Canada and describes the Government of Canada’s intent to work with provinces and territories to provide universal, single-payer coverage for a number of contraception and diabetes medications. This legislation is an important step forward to improve health equity, affordability, and outcomes and has the potential of long-term savings to the health care system. Additionally, work is also underway to improve access to affordable and effective drugs for rare diseases aligned with the National Strategy for Drugs for Rare Diseases.

Over the past year, significant progress has also been made to improve access by Canadians to publicly funded mental health services, mental health equity, and a holistic approach to substance use services. This work has focused on [REDACTED] and mental health standards, timely access to mental health services and support [REDACTED]; suicide prevention (e.g., implementing 9-8-8 suicide prevention number) and advancing a comprehensive strategy to address substance use in Canada, including the overdose crisis. The department is also advancing Budget 2024 commitments related to a new Youth Mental Health Fund to improve access to mental health care and Emergency Treatment Fund to help municipalities and Indigenous communities provide rapid responses to the opioid crisis.

Additionally, the department has been focused on ensuring the health of Canadians is protected by advancing a modern and agile regulatory system while also protecting the environment. This work has focused on strengthening the Canadian Environmental Protection Act, including introducing mandatory labelling of chemicals, increasing testing of products, and protecting Canadians from exposure to toxic flames; ending cosmetic testing on animals; advancing comprehensive strategy to address problematic substance use, including requiring tobacco companies to pay for the cost of federal public investments in tobacco control; modernizing and strengthening the Pest Control Products Act; and promoting healthy eating through the ‘Healthy Eating Strategy’, particularly focusing on restrictions on the commercial marketing of food and beverages to children.

The pandemic affected the capacity of Canada’s healthcare systems and exacerbated several health system challenges. As such, Health Canada has focused on addressing and expanding its work on numerous priorities, including in biomanufacturing, pandemic preparedness and research modernization. Additionally, the department continues to bolster mental health resources and address the impacts of climate change to improve human health and environmental sustainability. The federal government works with the provincial and territorial governments to advance these priorities.

Federal-provincial-territorial relations

Health is an area of shared responsibility among federal, provincial, and territorial governments. While the provinces and territories are responsible for delivering health care to Canadians, the federal government plays a key role in coordinating this relationship. The federal government supports universally accessible, publicly funded health care for Canadians through transfer payments to provinces and territories via the Canada Health Transfer and the administration of the Canada Health Act. Both orders of government collaborate on health priorities, including new healthcare funding agreements, overdose response efforts, medical assistance in dying, drug supply disruptions and shortages, and anti-antimicrobial resistance. Additionally, they share responsibility for the collection and analysis of health information, and for funding research and innovation initiatives. In Canada’s decentralized system, the pan-Canadian health organizations support shared federal and provincial/territorial interests on a pan-Canadian scale.

Pan-Canadian health organizations and other key stakeholders

The Government of Canada created pan-Canadian health organizations (PCHOs) to address specific healthcare system needs and issues. There are currently eight PCHOs, each of which has its own mandate and activities: Canadian Centre on Substance Use and Addiction, Canadian Agency for Drugs and Technologies in Health, Canadian Institute for Health Information, Healthcare Excellence Canada, Canada Health Infoway, Canadian Partnership Against Cancer, Mental Health Commission of Canada, and Health Workforce Canada. The latter was created in December 2023 as a new, independent organization established by an Interim Steering Committee with support from the Canadian Institute for Health Information (CIHI). The organization has been created as a stand-alone entity that will work closely with CIHI and all health care system stakeholders to improve the collection and sharing of health workforce data and share practical solutions and innovative practices.

Although PCHOs are operationally independent, they are accountable to the Government of Canada and are responsible for developing targeted products and services that respond to changing health needs. These organizations play a strong leadership role in collaboration with partners across the country. For example, Canada Health Infoway has been instrumental in supporting the federal priority to ensure every Canadian should be in control of their own health information through online access and benefit from it being shared securely between health professionals in the country. Health Canada in partnership with Canada Health Infoway published the shared Pan-Canadian interoperability roadmap, which represents a key milestone to advance the Government’s commitment to secure access to electronic health information. The Roadmap, endorsed by the federal, provincial and territorial governments (with the exception of Quebec), outlines a long-term vision towards improving health information exchange in Canada to improve health outcomes for everyone. The department also continues to work with CIHI on process with provinces, territories and experts to review and refine these existing common indicators and develop a broader list, including new indicators. This will enable jurisdictions and CIHI to report to Canadians based on comparable indicators and data on how health care is delivered across Canada and how it is performing and how it compares internationally. Bilateral agreements prioritize the inclusion of indicators tailored to provincial and territorial needs.

Health Canada works with other federal departments and agencies, non-governmental organizations, Indigenous partners, and the private sector to ensure a healthy Canadian population. This work includes partnering on research, surveillance, public consultation, policy and program development, knowledge and information sharing, and engagement with people with lived and living experiences. The health systems, research, industry, and public health stakeholders provide valuable support in addressing Canada’s health priorities.

Health Canada consistently provides leadership on strengthening our universal public health system. The department moves forward in applying the lessons learned from COVID-19 to address public health issues, including workforce capacity, data analytics, and health equity to ensure it is prepared for any future emergencies. In collaboration with provincial and territorial governments and a broad range of partners, Health Canada continues to deliver on commitments to improve health services for all Canadians within a world-class health system.

B. Organizational charts

1. Health Canada

Deputy Minister of Health
Greg Orencsak

Associate Deputy Minister of Health
Eric Costen

Health Policy Branch (HPB)
Jocelyne Voisin, Assistant Deputy Minister
Michelle Boudreau, Associate Assistant Deputy Minister

Controlled Substances and Cannabis Branch (CSCB)
Kendal Weber, Assistant Deputy Minister
Jennifer Saxe, Associate Assistant Deputy Minister

Regulatory Operations and Enforcement Branch (ROEB)
Linsey Hollett, Assistant Deputy Minister

Chief Financial Officer Branch (CFOB)
Serena Francis, Assistant Deputy Minister and Chief Financial Officer

Oral Health Branch
Lynne René de Côtret, Assistant Deputy Minister

Pest Management Regulatory Agency (PMRA)
Manon Bombardier, Assistant Deputy Minister

Health Products and Food Branch (HPFB)
Pamela Aung-Thin, Assistant Deputy Minister
Celia Lourenco, Associate Assistant Deputy Minister

Healthy Environments and Consumer Safety Branch (HECSB)
Matt Jones, Assistant Deputy Minister

Health portfolio shared services with PHAC

Legal Services
François Nadeau, Executive Director and Senior General Counsel

Digital Transformation Branch (DTB)
Joanne Shields, Assistant Deputy Minister and Chief Digital Transformation Officer

Centre for Ombuds, Resolution, and Ethics
Sylvie Richard, Acting Ombuds and Executive Director

Communications and Public Affairs Branch (CPAB)
Sarah Lawley, Assistant Deputy Minister
Cathy Allison, Associate Assistant Deputy Minister

Corporate Services Branch (CSB)
Nadine Huggins, Assistant Deputy Minister

Office of International Affairs for the Health Portfolio (OIA)
Christine Harmston, Branch Head

Office of Evaluation and Audit (OAE)
Shelley Borys, Chief Audit and Evaluation Executive

Chief Medical Advisor
Supriya Sharma

Departmental Science Advisor
Cara Tannenbaum

2. Public Health Agency of Canada

President
Heather Jeffrey

Executive Vice-President
Nancy Hamzawi

Chief Public Health Officer
Dr.Theresa Tam

Regulatory Operations and Emergency Management Branch (ROEMB)
Cindy Evans, Vice President

Infectious Diseases and Vaccination Programs Branch (IDVPB)
Dr.Donald Sheppard, Vice President

Health Promotion and Chronic Disease Prevention Branch (HPCDPB)
Michael Collins, Acting Vice President

Strategic Policy Branch (SPB)
Stephen Bent, Vice President

Chief Financial Officer and Corporate Management Branch (CFOCMB)
Martin Krumins, Vice President and Chief Financial Officer

Data, Surveillance, and Foresight Branch (DSFB) and Office of the Chief Science Advisor (OSCO)
Dr.Sarah Viehbeck, Vice President and Chief Science Officer

National Microbiology Laboratory Branch (NML)
Dr.Howard Njoo, Acting Vice President and Deputy Chief Public Health Officer

3. Canadian Institutes of Health Research

Acting President
Tammy J. Clifford

Executive Vice President
Catherine MacLeod

Enterprise Corporate Priorities
Dwayne Martins, Vice President

Research Programs
Christian Baron, Vice President

Research Programs Operations
Adrian Mota, Associate Vice President

Research Learning Health Systems
Rhonda Kropp, Acting Vice President

Research Strategy
Vacant, Vice President

4. Canadian Food Inspection Agency

President
Paul MacKinnon

Executive Vice President
Jean-Guy Forgeron

Policy and Programs Branch
Robert Ianiro, Vice President
Diane Allan, Associate Vice President

Operations Branch
Debbie Beresford-Green, Vice President
Scott Rattray, Associate Vice President

Science Branch
David Nanang, Vice President

Digital Services Branch
Todd Cain, Vice President and Chief Information Officer

Communications and Public Affairs Branch
Jane Hazel, Vice President

International Affairs Branch
Kathleen Donohue, Assistant Deputy Minister

Human Resources Branch
Dr.Raman Srivastava, Vice President

Corporate Management Branch
Stanley Xu, Vice President and Chief Financial Officer

Audit and Evaluation Branch
Martin Rubenstein, Vice President and Chief Audit Executive

Legal Services
Kristine Allen, Executive Director and Senior General Counsel

C. Health Canada Branches

1. Health Policy Branch (HPB)

HPB organizational structure

Assistant Deputy Minister
Jocelyne Voisin

Associate Assistant Deputy Minister
Michelle Boudreau

Care Continuum, Aging, and Equity
Sharon Harper, Director General

Health Care Strategies Directorate
Elizabeth Toller, Director General

Programs, Planning, and Horizontal Functions
Cindy Moriarty, Director General

Canada Health Act Division
Jennifer Goodyer, Executive Director

Policy Coordination and Planning Directorate
Matthew Lynch, Director General

Indigenous, Federal, Provincial, and Territorial Relations Directorate
Luke Carter, Executive Director

Mental Health and Substance Use Directorate
Suki Wong, Director General

Office of Pharmaceutical Management Strategies
Daniel MacDonald, Director General

Pandemic Preparedness Coordination Directorate
Melissa Sutherland, Director General

Bilateral Agreements Taskforce *
Brent Lawlor, Executive Director

Health Human Resources Taskforce *
Michelle Owen, Executive Director

* Non-permanent taskforce

HPB key functions

Federal focal point for health care policy, with leadership and oversight responsibility for health care on pan-Canadian scale.
Support federal and pan-Canadian health care policy objectives through the delivery of a broad array of grants and contributions programs, including transfers to provinces and territories.
Horizontal strategic and corporate functions (e.g., cabinet and parliamentary affairs; federal-provincial/territorial relations) for Health Canada / health portfolio), and leadership on key horizontal policy files.

Federal focal point for health care policy

Provides policy leadership, analysis and advice on federal strategy for health care system issues and the federal stewardship and oversight role in health care.
Interprets and administers the Canada Health Act and supports the minister as steward of Canada’s universal, publicly funded health care system.
Negotiates and oversees federal-provincial/territorial accords/agreements (e.g. 2023 “Working together to improve health care for Canadians” federal health funding).
Responsible for the full scope of activities (including research and analysis, and data analysis and modelling) associated with development and implementation of health care policy initiatives in priority areas:
- Health system financing
- Pharmaceutical and health technology policy (i.e. Canada’s Drug Agency, pharmacare, patented drug price regulation, intellectual property, trade), and national strategy for drugs for rare diseases
- Mental health and substance use
- Health information, digital health, primary and virtual care
- Health care innovation
- Dental care
- Long-term care, home and palliative care, and end-of-life care (including medical assistance in dying)
- Aging with dignity
- Health workforce issues
- Sexual and reproductive health
- Organ and donation transplantation
- Addressing racism and discrimination experienced by Indigenous people, Black, and other racialized and religious minority populations in Canada’s health systems
Responsible for the assessment of modern treaty implications for the department, as per the cabinet directive, including annual reporting.
Hosts SGBA+ centre of excellence to provide leadership, expertise, advice, guidance to the department on incorporating an intersectional approach to diversity considerations, including providing analyses on all MCs, TB subs, regulatory packages, budget proposals.
Provides secretariat support for federal panels and task forces, including advising prominent panel chairs and members, on significant health sector issues.

1. Health care systems

Working together plan and bilateral agreements

HPB is the portfolio lead in implementing the ‘Working Together to Improve Health Care’ for Canadians plan.
On February 7, 2023, the Prime Minister announced an investment of close to $200 billion over 10 years to strengthen Canada’s universal public health care system. In addition to increases through the Canada health transfer, delivered through Finance Canada, this funding includes $25 billion over 10 years in bilateral agreement funding from Health Canada for PTs to advance four shared priorities:
- Expanding access to family health services, including in rural and remote areas
- Supporting our health workforce and reducing backlogs
- Improving access to quality mental health, substance use, and addictions services
- Modernizing health systems with health data and digital tools

Health data and digital health

A joint FPT action plan on health data and digital health endorsed by Health Ministers in October 2023, is being advanced to drive progress on the health data commitments of the Working Together to Improve Health Care for Canadians plan. Recent priorities within the plan include data stewardship, artificial intelligence in health, building public trust and literacy in health data and digital health, and better connecting Canada's healthcare system through implementation of the shared pan-Canadian interoperability roadmap.
To support advancement of the Roadmap, on June 6, 2024, the federal government introduced Bill C-72, the Connected Care for Canadians Act. The legislation aims to improve patient safety by removing technical barriers that prevent timely and secure access to health information, by requiring the adoption of common technical and data standards and prohibiting data blocking by health IT vendors.
Additionally, with an investment of $505 million over five years, the branch is working with the Canadian Institute of Health Information, Canada Health Infoway, and federal data partners to collaborate with provinces and territories in developing new health data indicators and improving use of digital tools, and to support the creation of Health Workforce Canada as a centre of excellence on health workforce data and underpin efforts to use data to improve health care.

Health workforce

HPB is working to implement budget 2024 decision to provide $77.1 million over four years, starting in 2025-2026, to effectively integrate internationally educated health care professionals into Canada’s health workforce by creating 120 specific training positions, increasing assessment capacity and providing support to navigate credential recognition systems.
Health Canada works closely with PT governments, as well as health system partners, to advance joint priorities related to HHR. This includes launch of the Nursing Retention Toolkit, which draws on the expertise and experience of the Canadian nursing community to support nursing retention. Further, responding to FPT Minister’s request, Health Canada has been leading an FPT study of the education and training supply and demand for healthcare professions.

2. Aging and equity

Safe Long Term Care Act

HPB is also working towards introducing a Safe Long Term Care Act, a component of the supply and confidence agreement with the NDP. Consultations to inform the development of the legislation took place during summer-fall 2023. This included consulting with experts, stakeholders, persons with lived experience, and provinces and territories, as well as building on existing collaborations with First Nations and Inuit partners. HPB is moving forward with developing legislation that respects provincial and territorial jurisdiction.
Policy work will also focus on implementing ‘aging with dignity agreements’ with PTs, which will help Canadians age with dignity closer to home and deliver the remaining funding for home and community care ($2.4 billion remains over 4 years) and long-term care (budget 2021, $3 billion over 5 years), as well as funding for personal support workers (budget 2023, $1.7 billion over 5 years).

Long-term and palliative care and medical assistance in dying

Since the launch of the 2019 action plan on palliative care, HPB has been working with stakeholders to implement projects to deliver on priorities raising awareness; providing public education on grief; improving palliative care skills and supports for health care providers, families, caregivers, and communities; enhancing data collection and research; and improving access to care for underserved populations and to culturally safe care for Indigenous communities.
In line with the person-centred approach to health care, HPB is supporting provincial and territorial work to implement safe practices for medical assistance in dying for eligible Canadians who are experiencing intolerable and enduring suffering from a serious and incurable illness. This work includes leading FPT governance to help accelerate information sharing and knowledge translation of best practices; issues management around MAID implementation, including supporting the development of health system resources related to complex cases, such as those where mental illness is the sole underlying condition; and data collection, analysis and reporting. HPB is responsible for publishing an annual report on MAID assessment and provision in Canada.

Part VII of the Official Languages Act

Under the modernized Official Languages Act, federal institutions are required to implement “positive measures” in all activities that may have an impact on official language minority communities, including grants and contributions programs, policies and bilateral agreements with provinces and territories. HPB is responsible for raising departmental awareness on these obligations in order to foster the vitality of official language minority communities, promote linguistic duality and protect the French language as well as report on results to the Treasury Board Secretariat. HPB is also responsible for delivering the official languages health program ($206,7 million over five years) to improve access to health services for official language minority communities.

Thalidomide

The Canadian thalidomide survivors support program is an ex-gratia transfer payment program, established by order in council, to support Canadian thalidomide survivors (n=127 as of July 2024) for the remainder of their lives. The department has faced 17 judicial reviews in relation to the eligibility criteria (4 in process, 13 closed) and one charter claim (in process) alleging breaches of sections 7 and 15 of the Canadian Charter of Rights and Freedoms.

Organ donation and transplant

HPB is supporting pan-Canadian efforts to improve the administration and delivery of organ donation and transplantation across Canada. This includes acting as secretariat to the pan-Canadian governance framework for organ donation and transplantation, endorsed by the FPT-CDM in April 2024. In addition, through budget 2019, Health Canada is providing $ 36.5 million in funding towards the development of a pan-Canadian data and performance reporting system for organ donation and transplantation to develop integrated data solutions to facilitate the collection, utilization and sharing of standardized data and information.

Addressing racism and discrimination in health system, including anti-Indigenous racism

Addressing racism in health care and the health care needs of specific populations such as Indigenous peoples, people living in Canada's territories, and official language minority communities continues to be a priority. Priorities include improving access to culturally safe care, establishing accountability mechanisms, building partnerships, and effecting transformative change in health systems. For example, department is providing funding to 27 organizations to improve capacity to create culturally safe and inclusive health services for Indigenous peoples.

3. Pharmaceutical policy

Pharmacare

In the 2022 supply and confidence agreement, the government committed to work towards a universal national pharmacare program by passing a Canada Pharmacare Act and then tasking the Canadian Drug Agency (CDA) to develop a national formulary of essential medicines and bulk purchasing plan by the end of the agreement. On February 29, 2024, the government introduced bill C-64 An Act Respecting Pharmacare (Pharmacare Act) forming the foundation for the first phase of national universal pharmacare and the government’s intent to work with PTs to provide universal single- payer first-dollar coverage for a number of contraception and diabetes medications. budget 2024 reiterated the intention to engage with PTs to deliver this priority and is expected to receive royal assent in Fall 2024. In addition, an expert committee will be appointed, within 30 days of royal assent, to advise on the financing and operation of universal, single-payer pharmacare.
In December 2023, Canada’s Drug Agency, built from the existing Canadian Agency for Drugs and Technologies in Health (CADTH), was established with an investment of over $89.5 million over 5 years, starting in 2024-25. As of May 1, 2024, the new operating name of Canada’s Drug Agency was adopted, with an official launch occurring later this year.
Preliminary work toward a national formulary has also been undertaken. At the request of Health Canada, Canada’s Drug Agency established a time-limited multidisciplinary advisory panel which recommended a framework and process for developing a future national formulary in June 2022.
The ‘improving affordable access to prescriptions drugs agreement’ with Prince Edward Island signed in March 2022 provides $35M over four years to support the province’s efforts to provide its residents with more affordable access to prescription drugs, including expanding access to 60+ new medications to treat a variety of conditions and reducing copays to $5 for some commonly prescribed medications. Bilateral funding agreements for contraception and diabetes will be negotiated with PTs in Fall 2024.

Patented Medicine Prices Review Board

To protect Canadians from excessive prices for patented medicines, amendments to the patented medicines regulations came into force on July 1 , 2022. This includes new basket of comparator countries and reduced reporting requirements for those medicines at lowest risk of excessive pricing.
PMPRB is now developing guidelines to operationalize the regulations.

Drugs for rare diseases

In March 2023, measures were announced in support of the ‘national strategy for drugs for rare diseases’, with an investment of up to $1.5 billion over three years. This funding will help provinces and territories improve access to new and emerging drugs, as well as support enhanced access to existing drugs, early diagnosis, and screening for rare diseases. In conjunction with national partners, it will also support national governance, improve collection and use of evidence to support decision-making, and advance a rare disease research agenda. Bilateral agreements on drugs for rare diseases will be negotiated in summer/fall 2024.

Health care policy priorities

1. Mental health and substance use

In November 2021, with the appointment of an inaugural Minister of Mental Health and Addictions, the portfolio quickly mobilized its policy resources to support the new mandate.
HPB, CSCB, PHAC and CIHR are assisting the minister to advance mental health and substance use priorities including:
- Providing the minister with integrated advice from across the health portfolio on cross-cutting mental health and substance use issues
- Developing mental health standards with a focus on health equity
- Working with provinces and territories to address complex needs through integrated mental health and substance use supports
Budget 2021 provided $45 million over two years to help develop national standards for mental health and substance use services, in collaboration with provinces and territories, health organizations, and key stakeholders.
Budget 2024 proposed $500 million over five years to support the establishment of a new youth mental health fund to:
- Help community health organizations provide more care for younger Canadians, and better equip these organizations to refer youth to other mental health services, and
- Ensure that future generations have the access they need for mental health supports so that they can have a healthy start to adulthood and can reach their full potential.
Health Canada’s controlled substance and cannabis branch is the key federal lead in addressing substance use.

2. Support federal and pan-Canadian health care policy objectives

Grants and contributions programs

HPB manages a wide array of grants and contributions programs in support of health care objectives and acts as HC’s centre of expertise.
The largest part of HPB’s budget is targeted transfers to PTs; federal funding is complemented by HPB work in related policy areas.
- Bilateral agreements with PTs under the working together plan and through the aging with dignity agreements.
- Territorial health investment fund (territorial innovation and medical travel).
Chairs the governance committee, manages relationships with, and funding for, the suite of federally created pan-Canadian health organizations known as PCHOs:
- Canadian Institute for Health Information
- Canada Health Infoway
- Canadian Centre on Substance Use and Addiction
- Canadian Partnership Against Cancer
- Canadian Drug Agency
- Mental Health Commission of Canada
- Healthcare Excellence Canada (formerly CFHI and CPSI)
- Health Workforce Canada (creation underway)
Responsible for programs designed to support specific federal interests:
- Health care policy and strategies program – covers broad range of health care policy priorities
- Sexual and reproductive health fund
- Official languages health program
- Addressing racism and discrimination
- Funding for blood research to Canadian blood services
- Development of an organ and tissue donation and transplantation system for Canada
- Canadian thalidomide survivors support program

3. Horizontal strategic and corporate functions

Coordination of cross-cutting corporate functions

Provides advice to minister and deputy minister on cabinet and parliamentary business.
Prepares HC annual submission to federal budget process and coordinates off-cycle funding requests, supports minister for main and supplementary estimates processes (with CFOB), reports on results to PCO.
Coordinates HC governance structures (e.g., executive committees, min-dm, director general policy committee, medium-term planning and transition exercises).
Manages departmental briefing functions (e.g., ministerial briefing unit).
Planning of ministerial travel and events.
Coordinates governor-in-council appointments.

Leadership on horizontal policy files

Focal point for Health Canada Indigenous-federal-provincial-territorial relations (with health portfolio-wide coordination), including leadership in engaging PT ministers and deputy ministers of health.
Focal point and portfolio coordination for Indigenous health, engagement, treaty impacts, anti-racism efforts, and interdepartmental work, including the implementation of UN declaration on the rights of indigenous peoples, the truth and reconciliation commission’s ‘calls to action’ and the national inquiry’s ‘calls for justice’.
Responding to the recommendations of the report of the advisory panel on the federal research support system to advance research ecosystem modernization.
Provides integrated advice to the minister on the implementation of his/her overall policy agenda, including mandate commitments.
Coordinates for the health portfolio when an integrated approach is needed for the minister (e.g., COVID governance support and facilitation of decision-making, cabinet and parliamentary business, federal budget submissions, preparation for FPT meetings, etc.).

Leadership on pandemic preparedness coordination and related priority science policy files

Focal point for health portfolio coordination in support of the joint Minister of Health and Minister of Innovation, Science and Industry’s mandate commitment for the ‘biomanufacturing and life sciences strategy’ (BLSS) and medical countermeasures pandemic preparedness.
- Budget 2021 committed $2.2B to the establishment of the BLSS with the objective of growing a vibrant domestic life sciences sector and improving pandemic preparedness.
- In Budget 2023, the Government committed to exploring new ways to be more efficient and effective in the development and production of the vaccines, therapies, and diagnostic tools for health emergencies. Work is currently being undertaken to consider a broad range of options for tackling these issues.
In April 2023, Health Canada initiated the review of the federal approach to pandemic science advice and research coordination, led by an external, expert panel chaired by Sir Mark Walport, former Chief Science Advisor in the UK and supported by a Health Canada secretariat.
- The review examined the science advice and research coordination functions of the health portfolio’s response to COVID-19. The panel met with over 300 stakeholders, producing a report with four key findings and twelve recommendations.
- The report was submitted to HC in May 2024 and is being prepared for public release in late summer/early fall 2024. The recommendations serve to improve the production of science advice and research coordination to better care for Canadians now, and during the next health emergency.
Ongoing management and maintenance of the COVID-19 lessons learned digital repository and associated records management of COVID-19 work within Health Canada, working with all implicated branches.

HPB financial overview 2024-25

Grants and contributions - $5,325.9M
Operating and maintenance - $8.4M
Salary - $33.8M
Total - $5,368.0M
Total FTEs - 366

Grants and contributions	Amount ($ in 000’s)*
The shared health priorities initiative	2,500,000
Strengthening Canada’s home and community care and mental health and addiction services initiative (HCMH)	1,800,310
Contribution to the Canadian Institute for Health Information (CIHI)	122,459
Canada Health Infoway (Infoway)	83,134
Territorial health investment fund	35,000
Contribution to the Canadian partnership against cancer (SPA)	47,500
Contribution to the Canadian Agency for Drugs and Technologies in Health (CADTH)	40,903
Mental Health Commission of Canada (MHCC) contribution program	14,250
Contribution to improve health care quality and patient safety (HEC – previously CFHI and CPSI)	24,600
Health care policy and strategies program (HCPSP)	78,990
Official languages health program (OLHP)	40,625
National strategy for drugs for rare diseases (DRD)	468,774
Canadian brain research fund program (Brain Canada)	15,174
Sexual and reproductive health (SRH) under HCPSP	10,650
Canadian thalidomide survivors support program (CTSSP)	13,219
Improving affordable access to prescription drugs program (IAAPD)	10,700
Organ, tissues and blood program (combined Canada Blood Services programs)	8,580
Substance use and addictions program (SUAP) – Canadian Centre for Substance Use and Addiction (CCSA)**	11,000
Total	5,325,867
Based on 2024-25 Main Estimates *Substance use and addictions program is primarily in CSCB and HPB manages CCSA portion

2. Controlled Substances and Cannabis Branch (CSCB)

Purpose

Provide a high-level overview of:

Branch structure
Programs and enabling functions
CSCB financial overview FY 2024-25

CSCB organizational structure

Assistant Deputy Minister
Kendal Weber

Associate Assistant Deputy Minister
Jennifer Saxe

Strategic Policy Directorate
John Clare, Director General

Licensing and Medical Access Directorate
David Pellmann, Director General

Compliance Directorate
Benoit P Séguin, Director General

Controlled Substances and Overdose Response Directorate
Aysha Mawani, Director General

Tobacco Control Directorate
Sonia Johnson, Director General

Horizontal Policy, Planning and
Program Directorate
Sheri Todd, Director General

Branch Operational Support Services
Eric Doré, Director

Controlled substances program: roles

Regulatory mandate

Support the design and implementation of the Controlled Drugs and Substances Act (CDSA) and its regulations.
Administer and monitor compliance with the CDSA and its regulations to allow legitimate activities with controlled substances and precursors, while also reducing the risk that substances will be used for illegal purposes.
- Grant or recommend authorizations, including licences, permits and exemptions.
- Under the CDSA (e.g., supervised consumption sites, drug checking, use of controlled substances in research, unique exemption request such as BC exemption for personal possession of drugs).

Policy advice

Provide advice on policy and regulatory direction related to the overdose crisis and substance use supported through a coordinated approach to research, data collection and evidence, in collaboration with stakeholders.
- Subject matter includes a continuum of substance use services and supports, including prevention, treatment and harm reduction services, alcohol use, alternatives to criminal penalties for the personal possession of controlled substances, reduction of stigma towards people who use drugs, and addressing chronic pain.

Health information

Inform Canadians about the safe use of controlled substances while de-stigmatizing addiction to reduce overdoses and other substance use related harms.

Controlled substances program: hot issues

Overdose crisis

Addressing the acute issues and urgent needs as well as the escalation of the crisis, with specific issues including:
- Synthetic drugs such as fentanyl and the precursor chemicals used to produce them illegally
- Perceived diversion of prescribed alternatives (PA)
- Substance use services (e.g. harm reduction, treatment) availability and accessibility
- The evolving exemptions landscape

Controlled substances program: ministerial priorities

New regulations for supervised consumption and drug checking services
[REDACTED]
Launch the call for proposals for the $150M emergency treatment fund announced in budget 2024 (fall 2024)
Public education and communication on overdose crisis and substance use (ease the burden, overdose response toolkits)
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Continue to implement the Canadian drugs and substances strategy, including an equity action plan

Cannabis program: roles

Regulatory mandate

Support the design and ongoing implementation of the Cannabis Act and its regulations.
- Promote, monitor, verify, and enforce compliance.
- Grant licences and other authorizations (cultivation, processing, sale for medical purposes, research, analytical testing, and cannabis drug licences import/export permits and personal and designated production registration certificates and exemptions).

Policy advice

Provide evidence-based advice on cannabis policy and regulatory direction, supported by a coordinated approach to research and data collection, in collaboration with partners and diverse stakeholders.

Health information

Develop and promote evidence-based information, public education resources and programming on the health and safety facts about cannabis use.

Cannabis program: ministerial priorities

[REDACTED]
Develop final regulatory amendments to the cannabis regulations to reduce administrative and regulatory burden for legal cannabis producers.
Develop and design updated cannabis health warning messages, including messages on psychosis and schizophrenia.
Policy work, consultation with partners and work to respond to the recommendations by the legislative review expert panel.

Tobacco program: roles

Regulatory mandate

Support the design and implementation of the TVPA and its regulations.
Conduct a legislative review biennially on the TVPA; the most recent report was tabled in Parliament on June 17, 2024.
Coordinate, design, and implement Canada’s tobacco strategy, which aims to reduce tobacco use to less than 5% by 2035, in collaboration with departmental partners, experts and stakeholders.
Advance a comprehensive strategy to require tobacco companies to pay for the cost of federal public investments in tobacco control.

Policy advice

Provide advice on policy and regulatory direction related to tobacco and vaping products, supported by evidence-based science, research, and data collection in collaboration with stakeholders.

Health information

Develop and implement public education resources and campaigns, information and programming on smoking prevention, harm reduction and cessation.
Inform on the health effects of tobacco and vaping as well as the relative risks of quit aids.

Tobacco program: hot issues

Vaping product flavours

In response to concerns about the high rates of vaping among youth, Health Canada consulted on a regulatory proposal that would, among other things, prohibit all sugars and sweeteners as well as most flavouring ingredients, with limited exceptions for those that impart tobacco and mint/menthol flavours.

Tobacco program: ministerial priorities

Cost recovery

The Minister’s 2021 mandate letter committed to “require tobacco manufacturers to pay for the cost of federal public health investments in tobacco control.” Budget 2023, the 2023 fall economic statement, and budget 2024 reiterated this commitment.

Legislative review

The TVPA includes a requirement for a legislative review of its provisions and operation to take place every two years. The third legislative review of the TVPA must be launched by May 23, 2025, and its report must be tabled in parliament by May 23, 2026.
[REDACTED]

Enabling functions

Horizontal responsibilities

The Horizontal Policy, Planning, and Program Directorate:

Provides horizontal coordination, integration and analysis on branch strategic planning, policy and regulatory issues, SGBA Plus, and ministerial requests.
Ensures coherence of strategic priorities.
Supports and solidifies governance and decision-making structures.
Leads, advise and coordinate the corporate planning and reporting functions of the branch, as well as the performance measurement and related accountabilities.
Manages the substance use and addictions program and the program integrity and reporting unit.

Grants and contributions

Mandate

The substance use and addictions program (SUAP) provides time-limited contribution funding (up to 5 years) to innovative projects at the local, regional, and national levels. Projects operate across the continuum of care (prevention, harm reduction, treatment & recovery); some address key issues related to the overdose crisis (e.g., chronic pain management).
The program integrity and reporting unit includes a Gs&Cs integrity centre of expertise for CSCB, a human resources and monthly variance reporting hub, and it leads on a Gs&Cs funding application system (a new IM/IT solution for Health Canada).

Investments

Budget 2024: emergency treatment fund - $150M over three years, starting in 2024-25.
Budget 2023: funds of $144M over 5 years. Call for proposals complete; negotiations currently underway; activities expected to begin in Q2 and Q3 of this year.
2017-July 2024: $602M in federal investments committed to 391 evidence-based projects.

SUAP: hot issues and ministerial priorities

Emergency treatment fund

Implement the fund, beginning with launching the call for proposals for the $150 M fund announced in budget 2024 (Fall 2024) (SUAP lead, input from CSORD)
Fund is aimed at municipalities and Indigenous communities to address urgent needs arising from the overdose crisis.

Prescribed alternatives projects (“safer supply”)

Prescribed alternatives is a harm reduction practice providing prescription-grade drugs to individuals at risk of overdose under healthcare practitioner supervision.
Health Canada has supported 31 prescribed alternatives pilot projects across Canada; total funding approaches $130M. 22 are active and will close in March 2025.
[REDACTED]
[REDACTED]
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- [REDACTED]

[REDACTED]

[REDACTED]

Corporate services

Provides corporate support and planning for the branch, in key areas such as IM/IT, accommodations, operational planning, security, access to information & privacy, litigation, finance & human resources and workforce initiatives. This includes:
- Advice and analysis to the ADMs and directorates on planning;
- Accountability and business service issues impacting the branch;
- Integrated corporate support to the ADMs and directorates by providing the tools and processes required for the effective daily operation of the branch, and;
- Single window coordination to the ADMs and directorates across a range of horizontal business functions with other branches.

CSCB financial overview (FY 2024/25) [REDACTION]

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3. Health Products and Food Branch (HPFB)

HPFB mission

Minimizing health risk factors to Canadians while maximizing the safety of health products and food. This is achieved through the administration of the Food and Drugs Act and its related regulations, policies, and guidance.
Providing information to Canadians and health practitioners to make informed decisions about their health.

HPFB organizational structure

Assistant Deputy Minister
Pam Aung-Thin

Associate Assistant Deputy Minister
Dr. Celia Lourenco

Chief Regulatory Officer
David K. Lee

Biologics and Radiopharmaceutical Drugs Directorate
Sophie Sommerer, Director General

Natural and Non-Prescription Health Products Directorate
Stephen Norman, Director General

Marketed Health Products Directorate
Kelly Robinson, Director General

Veterinary Drugs Directorate
Marilena Bassi, Director General

Chief Medical Advisor
Dr. Supriya Sharma

Prescription Drugs Directorate
Karen Reynolds, Director General

Food and Nutrition Directorate
Joyce Boye, Director General

Medical Devices Directorate
Bruce Randall, Director General

Policy Planning and International Affairs Resource Management and Operations
Ed Morgan, Director General

Domestic and international roles

Areas of regulatory responsibilities

Food (including Canada’s food guide)
Prescription drugs
Non-prescription drugs
Biologic and radiopharmaceutical drugs, including medical isotopes
Natural health products
Medical devices
Veterinary drugs
Blood
Assisted human reproduction

Legislative framework

Food and Drugs Act and its Regulations
Assisted Human Reproduction Act and its Regulations
Patent Act

International collaboration

Build and maintain working relationships with key partners: US, EU, UK, Japan, Australia
Increase multilateral engagement in targeted areas on advanced technologies, medical devices, and food

Key Stakeholders

Food industry
Health products industry
Canadian Blood Services (CBS)/Héma-Québec
Canadian health NGOs and scientific associations
Provincial/territorial health partners
Canada’s Drug Agency (CAD)/Institut national d’excellence en santé et en services sociaux (INESSS)
Health practitioner and patient organizations
Academia

Core business lines

Health products

Under the Food and Drugs Act, Health Canada evaluates and monitors the safety, efficacy, and quality of health products such as prescription and non-prescription drugs, vaccines and medical devices
This includes oversight across a product’s life cycle:
- Clinical trial review: regulate and review clinical trial applications
- Product evaluation: review evidence to determine whether the benefits of the product outweigh the risks, and whether the risks or uncertainties can be managed
- Monitoring and intervention: conduct analysis of safety issues, issue risk communications, and address advertising complaints. Monitor compliance and undertake enforcement activities (ROEB)

Life cycle approach to regulation

Clinical trial review

Product discovery
Pre-submission meeting
Pre-clinical studies
Clinical trials

Submission review

Pre-submission meeting
Product submission

Monitoring and intervention

Authorization
Early post-market period
Integration of new information
Re-evaluation of authorization and commitments
Potential removal of product
Knowledge of product and knowledge

Core business lines

Food

Develop evidence-based dietary guidance (e.g., Canada’s Food Guide)
Establish regulations, policies, and guidelines for the safety and nutritional quality of all foods sold in Canada; and provide pre-market assessment and authorization of food additives, novel foods, and infant formula
Provide health risk assessments to support CFIA’s food safety investigations
Provide advice and information to Canadians about potential risks to their health (e.g., safe food handling, food allergies and intolerances)

Blood

Regulate the safety of blood and blood components collected for transfusion and for manufacture into therapeutic products
Review and authorize submissions filed under the Blood Regulations to ensure the safety of the blood establishments’ operational procedures

Assisted human reproduction

Establish regulations and policies to protect Canadians making use of third party assisted human reproduction technology

Our workforce

HPFB’s regulatory work requires a high degree of scientific expertise.
Our highly specialized workforce is comprised of experts in health sciences and regulatory affairs, including pharmacists, medical doctors, veterinarians, biologists, chemists, nutritionists and other experts.
In addition to our scientific evaluation and monitoring functions, our work includes scientific research to help ensure that our regulations and regulatory activities are based on the latest scientific evidence and best practices.

HPFB scientific personnel

Biologists – 746
Regulatory scientist – 458
Chemist – 143
Laboratory technologist – 110
Physician – 75
Research scientist – 53
Veterinarian – 17
Nutritionist – 13

Regulatory decision making

The Minister of Health is responsible for all decisions outlined in the Food and Drugs Act and its associatedregulations.
Through policy, the minister's authorities are delegated down to departmental officials working in a capacity appropriate to the respective powers.
There is no involvement from the minister’s office, central agencies, or other organizations.
All of Health Canada’s regulatory decisions are independent and based on scientific evidence.

Regulatory decisions are made when:

Granting market authorization

Issuing market approval
Granting priority or conditional approvals in exceptional circumstances
Applying terms and conditions to certain products
Providing data protection for innovative drugs
Making clinical information public following regulatory decisions

Responding to emergencies

Approving extraordinary use new drugs (EUNDs)

Addressing unsafe products

Compel information or recall of unsafe products
Require label or package modifications
Disclose confidential business information in certain situations
Compel disclosure of foreign risk information
Require tests and studies to be conducted
Require a reassessment of benefits and risks
Have hospitals report serious reactions to drugs

HPFB priorities

1. Facilitating timely access and protecting patient and consumer safety

Modernize legislative and regulatory frameworks for health products and food

Continue work to modernize our legislative and regulatory frameworks to update outdated provisions, improve safety regulation and reduce regulatory burden.
Work toward legislation and regulations that are technology-neutral so that they do not become barriers to innovative products.
Develop flexible regulatory tools to help address unmet need for certain types of health products and food and to better respond to emerging situations.

Advance healthy eating initiatives to reduce the burden of chronic disease

Poor diets are a primary cause of the growing burden of chronic disease in Canada.
Implement healthy eating initiatives such as front-of-package nutrition labels and restrictions on the marketing of foods to children to facilitate healthier food options and environments, protect vulnerable populations, and enhance nutrition information to help Canadians make better choices.

2. Minimizing safety risks while promoting choice and access for Canadians

Enhance oversight of natural health products (NHPs)

Unauthorized products and false advertising issues in the NHP sector were highlighted in a 2021 audit conducted by the Office of the Auditor General (OAG).
Enhanced our ability to take action when NHP safety issues are identified (for example, by enabling us to require a recall) through legislative amendments in June 2023 that extended the Protecting Canadians from Unsafe Drugs Act (Vanessa’s Law) to NHPs.
Ongoing work continues to introduce a cost recovery program to recover a portion of the costs of our regulatory activities for NHPs, which would support improvements to the NHP program.
Going forward, we will continue to address the OAG’s recommendations to improve oversight of the quality, labelling, and advertising of NHPs.

3. Promoting better health outcomes for all Canadians

Address the needs of diverse and underrepresented populations

Biological – and sometimes social – differences between people can impact the way that health products function in different populations.
Collecting data from diverse clinical trial participants that are reflective of Canada’s diversity are key to understanding differences in health product safety or efficacy between populations.

Maintain strong international partnerships and increase alignment

Participate in key multilateral fora and maintain strong relationships with key reference regulators to bring needed products to Canadians sooner.
Collaborate on standard setting and regulatory harmonization to bring greater predictability and reduced burden for product sponsors.
Share scientific information, experience and best practices, including to address challenges posed by new trends and technologies, with the goal of increasing timely access for Canadians and reducing risks.

Foundation for key government initiatives

HPFB also contributes to key Government of Canada priorities, such as:

Canadian drugs and substances strategy: our involvement is crucial for evaluating and approving safe and effective treatments for substance use disorders.
Canadian Drug Agency: collaboration to ensure aligned drug review and health technology review assessment processes, minimizing time between submission and listing.
National strategy for drugs for rare diseases: continued input into efforts to increase access in Canada to drugs to treat rare diseases.
Canada’s biomanufacturing and life sciences strategy: “enabling innovation by ensuring world class regulation” one of five pillars of the strategy, recognizing key role of the regulator in the innovation ecosystem.
Pan-Canadian action plan on antimicrobial resistance: HPFB evaluates antimicrobials and establishes policies, standards and guidance on human and animal health.

4. Healthy environments and consumer safety branch (HECSB)

HECSB overview

HECSB supports the Minister of Health’s mandate to help Canadians maintain and improve their health through:
- Our mission - to protect the health of people living in Canada through active prevention, targeted oversight, and timely response by leading research, and regulating and managing chemicals, products of biotechnology, radiation, environmental contaminants, workplace hazardous products, consumer products, and cosmetics.
- Our vision - safe environments, healthy people living in Canada.

HECSB organizational structure

Assistant Deputy Minister
Champion for Science, including Anti-Racism in Science
Champion for Sustainable Development and Climate Change
Matt Jones

Consumer and Hazardous Products Safety Directorate (CHPSD)
Dennis Price, Director General

Environmental and Radiation Health Sciences Directorate (ERHSD)
Tim Singer, Director General

Safe Environments Directorate (SED)
Greg Carreau, Director General

Policy, Planning and Integration Directorate (PPID)
Brigitte Lucke, Director General

Climate Change and Health Office (CCHO)
Carolyn Tateishi, Director

Protecting the health of people living in Canada

HECSB helps people living in Canada maintain and improve their health by focusing on diverse risks from a variety of sources. Key issues that the branch works to address include the following:

Air pollution could lead to disease, increased hospitalizations, and even premature death.
Climate change is negatively impacting the health of people in Canada and is placing additional stress and costs on the health system.
Unsafe drinking water can expose people to waterborne diseases and unsafe levels of harmful substances.
Exposure to hazardous products in the workplace can be harmful to the health of employees.
Unintentional events (e.g., wildfires) and intentional events (e.g., malicious use of chemicals) pose risks to people living in Canada.
Canada has 19 operating nuclear reactors, ten of which are in the most populous areas of the country. Nuclear emergencies pose significant risks to human health and the environment.
Exposure to chemicals found in consumer products, cosmetics, pharmaceuticals, food products and industrial releases can cause immediate and long-term harmful effects (e.g., cancer) to human health.
Radiation exposure may cause health impacts including vision loss, tissue heating/burns, and in some cases DNA mutations that can lead to cancer.
Consumer products and cosmetics may pose dangers to human health or safety (e.g., exposure to hazards including mechanical, physical, toxicological, flammability, and electrical dangers of non-compliant products).

HECSB's core business lines are designed to manage and mitigate these risks to the health of people living in Canada.

Core business lines

1. Consumer and hazardous products safety

Helps to maintain and improve the health of people living in Canada by identifying, assessing, managing, and communicating health risks posed by consumer products and cosmetics, as well as hazardous workplace chemicals.

Consumer product safety

Protects people living in Canada from hazards associated with consumer products and cosmetics, using a post-market, risk-based approach.
Monitors and assesses risks to human health or safety from consumer products and cosmetics.
Develops national risk management strategies, such as policies, outreach, guidelines and regulations.
Works with national and international standards-development bodies in the development of standards.

Workplace hazardous products

Makes information available to workers on the hazards, appropriate precautions, and first aid treatment associated with hazardous chemicals in the workplace.
Assesses chemical substances and products against hazard classification criteria to foster accurate labelling and safety information.
Coordinates a national enforcement program with federal, provincial and territorial partners, and administers claims for exemption of confidential business information.

2. Environmental and radiation health sciences

Helps to protect and improve the health of people living in Canada through education, policy, regulation, and by performing high-quality research, monitoring and surveillance, analysis, and emergency preparedness and response.

Radiation protection

Leads the federal nuclear emergency plan (FNEP), the coordinated government response to a radiological or nuclear emergency.
Regulates radiation emitting devices (e.g., x-ray equipment, tanning beds, lasers).
Administers the national radon program to help manage the risk from radon exposure (i.e., lung cancer).
Operates the Canadian radiation monitoring network, a network of almost 100 monitoring stations and analytical laboratories.
Supports occupational radiation protections for workers in Canada through the national dosimetry service and national dose registry.

Environmental risks to health

Leads scientific research, monitoring, and surveillance related to reduction of risks to human health from environmental factors, chemicals, and exposure to radiation sources.

3. Safe environments

Helps to maintain and improve the health of people living in Canada by identifying, assessing, managing, and communicating health risks posed by their environment.

Chemicals and living organisms

Assesses and manages potential risks to human health posed by new and existing substances under the chemicals management plan, a joint program with Environment and Climate Change Canada.

Air and water

Works with provinces and territories to develop guidelines for drinking and recreational water quality, assesses the health impacts of air pollution, and develops national standards and guidelines for indoor and outdoor air quality.

Impact assessment contaminated sites

Contributes expertise on human health aspects for impact assessments of major resource projects (e.g., pipelines, mines) and efforts to address federal contaminated sites.

International engagement

Working with international partners and organizations (e.g. OECD, WHO) to strengthen global chemical management, including through multilateral environmental agreements (e.g., global chemicals framework)

4. Climate change

Works to protect the health of people in Canada from the impacts of climate change and supports adaptation and action to build climate-resilient health systems.

National adaptation strategy

Leads federal climate change and health policy, including the Health and Well-being system of the national adaptation strategy (NAS), a whole-of-society roadmap for a climate-resilient Canada.
Coordinates across the federal health portfolio and other federal health partners.

Health sector adaptation

Leads health sector adaptation, including expanding the capacity, resources, guidance, data, and information needed to support health systems to assess and adapt to climate change, such as through the HealthADAPT initiative.

Extreme heat

Works to better understand and address health risks from extreme heat, including through research, capacity building, guidance, tools, messaging, and supporting implementation of measures such as heat alert and response systems.

International

Works with international partners to advance understanding and action on climate change and health, including by co-chairing the World Health Organization (WHO)’s climate resilient health systems working group.

National assessment

Leads the national climate change and health assessment to provide the latest research on the impacts of climate change on health and adaptation options.

5. Departmental office in HECSB

Office of sustainable development

Leads the coordination of Health Canada’s input into the federal sustainable development strategy (FSDS) and the development of the departmental sustainable development strategy (DSDS).
Coordinates the domestic deliverables under the United Nations sustainable development goals (SDGs).
Leads the implementation and ensures compliance with the cabinet directive on the strategic environmental and economic assessment, which came into force April 1, 2024.
Supports departmental implementation of the Government of Canada greening government strategy (e.g., HC’s climate change risk assessment and adaptation plan).
Coordinates health portfolio contributions in support of domestic implementation of the global biodiversity framework.

Health emergency coordination office

Supports the department’s preparedness activities and facilitates a coordinated response for health emergencies.
Serves as a single window for coordination with PHAC on health portfolio emergency management.
As per the Emergency Management Act, conducts continuous improvement activities, leads departmental projects (e.g., capabilities assessments), represents HC at federal and FPT emergency management committees, and provides strategic advice on emergency management.

Departmental science and ethics policy bureau

Organizes the annual Health Canada science forum.
Administers the HC-PHAC research ethics board review process.
Supports the implementation of the departmental anti-racism in science action plan.
Implements the HC-PHAC scientific integrity policy.
Supports the departmental science advisor and ADM champion for science, including anti-racism in science.

Safe environments (FY 2023-24)

Over 10,000 chemicals management plan substances assessed since 2006 and 99% of priority existing substances addressed.
About 290 industry requests assessed to import or manufacture new substances in Canada.
210 risk management instruments in place.
117 Strategic environmental assessments reviewed.
7 water quality guidelines published.
87 site classifications and site-specific reviews completed.
119 impact assessment expertise and advice requests answered.

Consumer and hazardous products safety (FY 2023-24)

94,189 cosmetic notification forms reviewed.
2,664 reports triaged for consumer product and cosmetic incidents.
271 recalls of consumer products and cosmetics communicated to people in Canada.
965 claims of confidential business information processed for workplace hazardous products.

Environmental and radiation health sciences (FY 2023-24)

13 community-based radon outreach projects funded.
318 responses provided to enquiries on radiation-emitting devices from the public or stakeholders.
144 chemical incidents responded to within 20 minutes of notification.
670,870 radiation dosimeters analyzed and results reported.
10 nuclear emergency drills and exercises conducted.
25 safety concerns reported by poison centres and managed by Canadian Surveillance System for poison information.
107 articles published in peer-reviewed journals.
84 conference poster presentations.
96 research projects underway.

Key legislation and regulation

HECSB’s programs and policies are governed primarily by the following legislative and regulatory instruments:

Canada Consumer Product Safety Act and its regulations
Canadian Environmental Protection Act, 1999, and its new substances notification regulations
Emergency Management Act
Federal Sustainable Development Act
Food and Drugs Act and its cosmetic regulations
Hazardous Materials Information Review Act and its hazardous materials information review regulations
Hazardous Products Act and its hazardous products regulations
Impact Assessment Act
Radiation Emitting Devices Act and its radiation emitting device regulations
National Framework on Cancers Linked to Firefighting Act

HECSB contributions to mandate/priority commitments

Climate change impacts on human health and the health system

Implementing health adaptation measures in the national adaptation strategy to protect people in Canada from extreme heat and to build climate-resilient health systems, supporting a mandate commitment of the Minister of Environment and Climate Change. Completed June 2023.

Implement ban on cosmetic testing on animals

Made amendments to the Food and Drugs Act through the Budget Implementation Act, 2023 to ban cosmetic testing on animals, which came into force on December 22, 2023. Completed June 2023.

Increase testing of products for compliance

Increased product inspection testing to detect and prevent the sale and import of unsafe consumer products and cosmetics under Canadian standards. Launched the Canadian product safety pledge. Completed March 2024.

Protect Canadians from harmful substances

With ECCC, develop an implementation framework for a right to a healthy environment under the Canadian Environmental Protection Act, 1999 and modernize the framework for Canada’s chemicals management regime to reduce exposure to harmful substances (e.g., plan of priorities). Implement the budget 2024 commitment to enhance the chemical management plan’s existing cost recovery framework. Completion in 2025.

Mandatory labelling of chemicals in consumer products

Introduce new requirements to enhance the availability of information, including labelling, related to chemicals in consumer products, hazardous products, and cosmetics to support informed consumer decision-making and help protect people in Canada, including workers, from harmful chemicals. Completion in 2029.

Action plan to protect Canadians, including firefighters, from toxic flame retardants

Continue risk assessment and risk management actions regarding harmful chemicals and flame retardants. Implement the firefighter action plan and develop the national framework on cancers linked to firefighting. Publish final objective for PFAS in drinking water and the final state of PFAS report for PFAS in drinking water. Completion in 2029.

HECSB workforce distribution

HECSB directorates

There are 1,025 employees in HECSB

Occupational category

613 employees in scientific roles
251 employees in management
205 employees in policy roles
180 employees in program and services

Years of service

0 to 5 years – 31%
5 to 9 years – 18%
10 to 14 years – 11%
15 to 19 years – 23%
20 to 24 years – 13%
25 to 29 years – 2%
30 to 34 years – 1%
35 plus years – 0%

Employment equity groups

25 Indigenous persons
86 persons with disabilities
311 racialized persons
656 women

Age of HECSB workforce

Less than 25 – 8%
25 to 29 – 10%
30 to 34 – 9%
35 to 39 – 12%
40 to 44 – 16%
45 to 49 – 15%
50 to 54 – 12%
55 to 59 – 8%
60 to 64 – 6%
65 plus – 3%

Property

HECSB has five buildings across Ottawa of which three are laboratories, in addition to regional employees.

HECSB financial overview

2024 initial budget by category ($M) (excluding revenue and EBP)

A-base - $97.5M (63.7%)
Chemicals management plan - $39.3M (25.7%) – sunsets in 2025-26
National adaptation strategy - $6.9M (4.5%) – sunsets in 2027-28
Impact assessment - $3.7M (2.4%) – sunsets in 2027-28
Plastics - $1.8M (1.2%) – sunsets in 2026-27
Addressing the impacts of climate change - $1.6M (1.0%) – sunsets in 2027-28
Health emergency coordination office - $0.9M (0.6%) – sunsets in 2024-25
Genomics research and development initiative (RDI) - $0.8M (0.5%) – sunsets in 2024-25
Federal contaminated sites action plan (FSCAP) - $0.7M (0.4%) – sunsets in 2024-25 (B2024 announced new funding for 2025-26 to 2028-29; HC portion TBC)
Total budget (less corporate costs) - $153.3M
Total full-time equivalents (including students) – 1026.5

5. Pest management regulatory agency (PMRA)

What are pesticides?

Pesticides are generally toxic chemicals intentionally released into the environment to kill target pests, including in agriculture, forestry, homes and workplaces, and industrial processes. There are 680 active ingredients in approximately 7,900 registered pesticide products in Canada.

Pesticides play an important tole but also present risks

Canada's agriculture and agri-food system employs 2.3M people & generates $150B (~6.8%) of Canada’s GDP. Canada exported ~$99.1B in agriculture products in 2023.

Without pesticides, corn crop yields would drop by 50% ($56B impact) in Canada and the USA.

What are pesticides?

Products used to control pests are commonly referred to as pesticides.
They are either natural or chemically synthesized.
Approximately 7,900 pesticide products registered for use in a broad range of settings including agriculture, forestry and aquaculture, industrial settings (e.g., pulp and paper) and in Canadian homes to control pests including insects, rodents and bed bugs.

Why do we need pesticides?

Pesticides help manage pests, pathogens, and invasive species to:

Maintain safe food productivity and support food security for the ever-growing world population.
Support climate change efforts with zero-till agriculture, soil carbon sequestration and controlling invasive species.
Contribute to public health by controlling disease-carrying vectors.
Enable stability and growth in the agriculture/agri-food economic sector.

Why is oversight important?

Pesticides can present unacceptable risks to the environment, wildlife and human health if used inappropriately or improperly.
Vulnerable populations may be disproportionately exposed to and/or negatively impacted by pesticides.
The federal government regulates pesticides under the Pest Control Products Act (PCPA), which requires all pest control products to be registered or otherwise authorized before they can be sold or used in Canada or imported.

Our mandate

The Pest Management Regulatory Agency (PMRA) is the federal authority responsible for regulating pest control products in Canada, under the Pest Control Products Act.

Primary Objective - To prevent unacceptable risks to individuals and the environment from the use of pesticides.

Ancillary Objectives - support sustainable development; facilitate access to products that area lower risk; encourage public awareness; ensure only products of value are approved.

General distribution of responsibility

Federal

New pesticide registration and post-market monitoring and review
Science-based health, environment, and value assessments
Compliance and enforcement

Provincial/territorial

Transportation, sales, use, storage and disposal
Training, certification, licensing
Further conditions on use in accordance with federal standards

Municipal

Bylaws for further conditions on use where authority exists and in accordance with federal standards

Organizational structure

Assistant Deputy Minister
Manon Bombardier

Regulatory Science and Operations
Frédéric Bissonnette, Senior Director General

Horizontal Policy and Integration
Lindsay Noad, Senior Director General
Special Deployment (April-Dec 2024) *

Chief Registrar's Office and Registration Directorate
Jason Flint, Director General (Assignment)

Value Assessment and Re-Evaluation Management Directorate
Margherita Conti, Director General

Environmental Assessment Directorate
Heather Simmons, A/Director General

Health Evaluation Directorate
Minoli Silva, A/Director General

Office of Continuous Improvement
Hubert Saindon, A/Director General

Ruth Rancy
Director General, Policy and Operations Directorate

Our core activities

Pre-market Product Reviews

Scientific assessments are conducted to help ensure risks to the health of Canadians and the environment are acceptable and that the product has value (e.g., will meet a need to control a pest problem)
Pesticides must be registered or otherwise authorized before they can be sold or used in Canada

Post-market Monitoring and Reviews

Re-evaluation - to help ensure that pesticides meet modern standards for protection of health and the environment, all pesticides must have re-evaluations initiated on a 15-year cycle.
Special reviews - special reviews must be initiated if there are reasonable grounds to believe that the health and environmental risks posed by the product may no longer be acceptable.
Incident reporting and sales data reporting - pesticide manufacturers are required to report an incident involving the possible use of their products, new scientific studies identifying new risks, and volumes of products sold in Canada.

Transparency

Requirement to consult with the public on all proposed major registration decisions, including new registrations, major new uses of a pesticide, re-evaluations and special reviews.
A wide variety of pesticide regulatory documents are made available through the public registry.
The public can request to inspect the confidential test data (CTD) supporting pesticide registration decisions or proposed decisions in the case of post-market reviews (i.e., re-evaluations and special reviews).

Statistics

Approximate number of conventional PCPs, biopesticides, and non-conventional PCPs on the Canadian market – 8,000 registered PCPs.
Each PCP is re-evaluated every 15 years, as required by the PCPA.
Confidential test data requests jumped from 3 in 2021 to 25 in 2023 (increase of 833%).

Our robust evidence-based decision making

Because of the potential toxic nature of pest control products, the Pest Control Products Act requires a comprehensive (pre- and post-market) regulatory framework specific to pesticides and their uses.

Scientific assessments are conducted to help ensure risks to the health of Canadians and the environment are acceptable and that the product has value. These assessments consider the following:

	Health	Environment	Value
Toxicity	Poisoning Cancer Neurological, reproductive or endocrine effects Birth defects Genetic mutations	Acute (poisoning, death) and chronic (survivability, reproduction, development) of animals, plants, fish, pollinators, insects, etc.	Need for the pesticide in Canada Effectiveness at controlling pest Benefits to health or environment (e.g., control of disease or invasive species) Social and economic impact in Canada
Exposure	Food and drinking water Pesticide users Bystanders Special consideration for women, children, seniors	Presence in water, air, soil Bioaccumulation in environment Modelling and monitoring environmental levels

Regulatory decision - reasonable certainty that no harm to human health, future generations or the environment will occur.

Our federal partners

Safe and effective pesticide use is a shared commitment between growers, industry, provinces, and the federal departments and agencies that help to protect the health of people living in Canada, the environment and our food supply.
Health Canada (HC) is the authority responsible for the federal regulation of pest control products and acts on behalf of the Minister of Health under the authority of the PCPA to regulate the import, manufacture, sale and use of pesticides in the Canadian marketplace. Regulatory operations and enforcement branch (ROEB) is responsible for compliance and enforcement activities related to pest control products.
Other federal departments are important players in pesticide management and stewardship, including:
- Agriculture and Agri-Food Canada (AAFC): supports Canada’s market competitiveness and supports the implementation of innovative practices by working with industry and partners;
- Environment and Climate Change Canada (ECCC): protects the environment and wildlife while supporting sustainable development;
- the Canadian Food Inspection Agency (CFIA): monitors and enforces compliance of pesticide maximum residue limits (MRLs) in food and prevents the movement of plant pests.
- Fisheries and Oceans (DFO) also has regulatory authority over pesticides applied to and in water ways for the control of invasive alien species and aquaculture.
Some key collaborations with federal partners include:
- Kunming-Montreal global biodiversity framework (KMGBF): ECCC is leading work on a whole-of-government approach to implement the KMGBF, working with Health Canada, AAFC, and other departments on the development of Canada’s 2030 national biodiversity which aims to halt and reverse biodiversity loss.
- AAFC's (Pest Management Center) minor use program: this program brings pest control products to minor (smaller) crop and specialty crop growers in Canada.

International activities and drivers

Multilateral environmental agreements

The Government of Canada (GoC) is signatory to a number of multilateral environmental agreements (MEAs) and a member of, or participant in, several international governmental organizations (IGOs).

Rotterdam and Stockholm conventions

Canada is a party to the Rotterdam convention (on the prior informed consent procedure for certain hazardous chemicals and pesticides in international trade) and the Stockholm convention (on the persistent organic pollutants (POPs)).
PMRA is the policy co-lead with ECCC; PMRA is the technical/scientific lead for pesticides (ECCC for industrial chemicals).

Global framework on chemicals (GFC) – for a planet free of harm from chemicals and waste

The GFC provides a vision for a planet free of harm from chemicals and waste, for a safe, healthy and sustainable future – where industry and private sectors are strategic actors to foster innovation, move towards sustainable business models and drive change.
Health Canada’s healthy environments and consumer safety branch, horizontal and international policy division are the federal lead, PMRA contributes on pesticide-specific issues and cross-cutting policy/strategy issues.

Canada’s 2030 nature strategy and Kunming-Montreal global biodiversity framework (KMGBF)

On June 13, 2024, the Government of Canada released Canada’s 2030 nature strategy, which charts a path for how Canada will implement the KMGBF. This work is led by ECCC. For PMRA, relevant targets are:
- Target 7: reducing the negative impacts of pollution on biodiversity, specifically reducing the overall risk from pesticides to biodiversity by at least 50% by 2030. PMRA is advancing real world data on pesticides, enhancing protections for human health and the environment through a continuous oversight approach to regulating pesticides, amending the PCPR to strengthen considerations on species at risk and cumulative environmental effects, and creating fee incentives to support low-risk alternatives.
- Target 6: reduce the impact of invasive alien species on biodiversity. PMRA is exploring reduced financial barriers for FPT and other registrants, incentivizing registration of (alternative) biopesticides and maintaining market availability of low profit highly effective IAS products.

PMRA financial overview (FY 2024-25)

Funding summary	Pre-market	Post-market	Branch support	Pesticides TB sub B2024	Total
A-base	14,308,844	7,704,762	10,180,485	N/A	32,194,091
B-base chemicals management plan (expires 03-26)	N/A	5,261,448	N/A	N/A	5,261,448
B-base Canadian agricultural partnership/minor use (expires 03/28)	4,251,344	N/A	N/A	N/A	4,251,344
B-base pesticides B2024 (expires 03/26)	N/A	N/A	N/A	13,009,403	13,009,403
Revenues from user fees*	5,238,486	7,857,730			13,096,216
Total PMRA budget (includes EBP)	23,798,674	20,823,939	10,180,485	13,009,403	67,812,501
Full-time equivalents – 510 *Post-market cost-recovery fees are currently under review

Annex A: partnerships and key stakeholders

Federal and provincial partners*

Health Canada

Label compliance and enforcement activities
Strategic and horizontal policy
Chemicals management

Agriculture and Agri-Food Canada

Minor use registrations
Barriers to trade from pesticide residues in food

Global Affairs Canada

International trade agreements

Environment and Climate Change Canada

Multilateral environmental agreements
Environmental research and monitoring

Canadian Food Inspection Agency

Pesticide residues in food

Fisheries and Oceans Canada

Environmental research and monitoring

Natural Resources Canada

Canadian forest service

Engage with multiple FPT partners

P/T health and agriculture departments
F/P/T committee on pest management and pesticides
AAFC - F/P/T committee on pesticides management
AAFC - industry-government honeybee sustainability working group

Key stakeholders

National industry/retailers associations

CropLife Canada, Canadian Consumer Specialty Products Association – representing companies such as Bayer, Syngenta, 3M Canada, Home Hardware, Canada Pest Management Association

User/grower groups

Canada Grains Council, Fruit and Vegetable Growers of Canada, Canola Council of Canada, Soya Canada, Pulse Canada, the Canadian Federation of Agriculture
Non-agricultural user groups
Canadian Paint and Coatings Association, Wood Preservation Canada

Non-governmental organizations

David Suzuki Foundation, Safe Food Matters, Ecojustice, Equiterre, etc.

International regulatory bodies

United States Environmental Protection Agency (USEPA),
Australian Pesticides and Veterinary Medicines Authority (APVMA),
European Food Safety Authority (EFSA)

International organizations involved in regulatory harmonization

Canada-United States-Mexico Agreement (CUSMA)
The Organisation for Economic Co-operation and Development (OECD)
World Health Organization (WHO)
Food and Agriculture Organization (FAO) Codex Committee on Pesticide Residues

Advisory bodies

Science Advisory Committee on Pest Control Products (SAC-PCP) (reports to the Minister of Health) and supported by Community of Specialized Experts (CSE).
Pest Management Advisory Council (PMAC) (reports to the Minister of Health).

Indigenous partners

Indigenous communities, including individuals and organizations at the local, national, and regional levels.

Annex B: PMRA external advisory bodies

The Pest Management Regulatory Agency (PMRA) engages the expertise of two external advisory bodies: the Pest Management Advisory Council (PMAC) and the Science Advisory Committee on Pest Control Products (SAC-PCP).
Both the PMAC and the SAC-PCP adhere to the Health Canada policy on external advisory bodies.
The PMRA maintains the responsibility and the sole authority to make regulatory decisions on pesticides taking into consideration the advice provided by the committee.
Meetings are open to the public; however, certain portions of meetings, including deliberations or the formulation of recommendations, may be done in camera.

Pest management advisory council

Governance

Reports and provides advice to the Minister of Health through the deputy minister.

Inception

Established under s.5 of the PCPA in November 1998.

Provides independent advice on

Broad strategic directions, overall priorities of PMRA, policies and issues relating to the federal pest management regulatory system.

Membership

Individuals providing a balanced representation of interest in pest management issues, environmental and health groups, and individuals with appropriate expertise.
PMAC has a total of 18 regular members, including the Chair and the three ex officio members from the SAC-PCP and the FPT/CPMP (Federal / Provincial / Territorial Committee on Pest Management and Pesticides).

Science advisory committee on pest control products

Governance

Reports and provides advice to the Minister of Health through the Deputy Minister.

Inception

Established in June 2022 as part of the Government's August 4, 2021 announcement to strengthen the capacity and transparency of review processes for pesticides.

Provides independent advice on

Scientific issues to support PMRA in evidence-based decision-making on pesticides. Does not provide advice on policy.

Membership

9 scientific experts with broad knowledge relevant to the health, environment, exposure, and value assessment for pesticides, as well as Indigenous knowledge. Supported by 12 additional experts, known as the Community of Specialized Experts (CSE), who provide expert advice on specific issues or assessments as needed.

6. Regulatory operations and enforcement branch (ROEB)

ROEB mandate

ROEB is Health Canada’s dedicated compliance and enforcement (C&E) branch.

Our vision – to be a world class compliance and enforcement organization.

Our mission - to be a compliance and enforcement leader that informs and protects people in Canada from health risks associated with products, substances, and their environment.

ROEB organizational structure

Assistant Deputy Minister
Linsey Hollett

Health Product Compliance
Kim Godard, A/Director General

Medical Devices & Clinical Compliance
Christine Leckie, Director General

Consumer Products & Controlled Substances
Sally Gibbs, A/Director General

Cannabis
Melanie Morris-Jenkins, A/Director General

Health Product Shortages
Greg Loyst, Director General

Environmental Health & Pesticides
Denise MacGillivray, Director General

Laboratories
Marie-José Loffredo-Forest, Director General

Policy & Regulatory Strategies
Robert Coleman, A/Director General

Planning & Operations
Sara O’Connor, Director General

ROEB core business lines

ROEB delivers its core business through a national program delivery model.

Compliance and enforcement

Cannabis
Controlled substances
Consumer products and cosmetics
Pest control products
Tobacco and vaping products
Health products (drugs, natural health products)
Medical devices and biological products (blood, donor semen and ova, cells/tissues/organs)
Clinical trials
Border operations

Laboratories and scientific analysis

Illegal drugs and substances
Cannabis, health products, food, pesticides, tobacco and vaping products, and microbiology analysis
Air quality and human health risk assessments

Health promotion, protection, and outreach

Detecting, monitoring and mitigating drug and medical device shortages
Environmental health promotion
Internationally protected persons program
Domestic and international collaboration

Regulatory coordination, operations, and licensing

Health portfolio regulatory coordination
C&E and operational policy development
Drug and medical device establishment licensing
Invoicing and collection of fees for regulatory activities

ROEB national workforce

ROEB employees across Canada

ROEB is one of the largest federal C&E organizations, with over 1,600 employees in 30 locations across Canada. This includes:
- 488 inspectors
- 145 lab analysts and 56 lab specialists
- 50 environmental health specialists
Provincial workforce
- National capital region - 454
- British Columbia – 196
- Prairie – 142
- Ontario – 428
- Québec – 335
- Atlantic – 59

Compliance and enforcement activities

Includes various types of inspections, compliance verification, compliance promotion, border integrity support, laboratory analyses, licensing, and investigations.

Consumer products

61 inspectors
Retail locations (including online), company headquarters, and mail centres.

Controlled substances

31 inspectors
Licensed dealers, destruction facilities, and pharmacies.

Pesticides

47 inspectors
Users, retail (including online), distributers, manufacturers, border points and mail centres.

Cannabis

78 inspectors
Personal and designated production sites, licence holders, including cultivators, processors, and medical sales.

Biologics/clinical trials and border operations

56 inspectors
Hospitals, clinics, and border points.

Tobacco & vaping

30 inspectors
Retail locations (including online) and manufacturing facilities.

Laboratory services

145 lab analysts
56 lab specialists

Environmental health

50 environmental health risk specialists

Health products

121 inspectors
Domestic and foreign DEL holders (manufacturers, packagers, labellers, testers, importers, distributors, wholesalers); domestic NHP site licence holders, domestic and foreign Market Authorization Holders; compliance verification and risk management.

Medical devices

64 inspectors
Medical device establishment licence holders including class I device manufacturers, and importers and distributors for all devices; medical device compliance verification.

Operating context

ROEB operates in a complex and rapidly evolving environment.

The following drivers inform the way ROEB conducts its business:

Globalization

The evolving global supply chain requires increased harmonization and collaboration with other regulators, such as the U.S. Food and Drug Administration and European Medicines Agency, on good manufacturing practices inspections.

Innovation

The rapid pace of innovation requires the development of new regulatory frameworks that include C&E authorities (e.g., authority for inspectors to enter sites virtually and state-of-the-art laboratory equipment).

Technological advancement

Innovative products require establishing new and more agile C&E measures (e.g., setting terms and conditions on advanced therapies that are personalized) and state-of-the-art laboratory equipment and methods.

Credibility as a regulator

Protection of the Canadian population requires risk-based oversight, evidence-based regulatory decision-making, transparency of inspection results, high quality scientific results, and information on health and safety risks.

Operating context: post-pandemic

Pre-pandemic

Stabilized national program delivery
Modernized C&E
Paper-based licensing

Pandemic

Challenged existing C&E approaches, catalyzing shift from largely on-site to hybrid model -- virtual/remote inspections with some on-site elements based on risk; and
New regulatory pathways were put in place to support access to needed health products.

Post-pandemic

Using lessons learned to build back better.
Key priorities include: modernizing regulatory frameworks, transforming C&E program delivery, sharpening risk-based regulatory decision-making, and increasing international engagement.

The pandemic reinforced the need for agile and flexible approaches to C&E and the need to better prevent and mitigate health product shortages.

Key priorities

Core business activities

Inspections:

Conduct inspections across all product lines regulated by HC.

Management of non-compliance:

Compliance promotion, verification and enforcement (product seizures, stop sales, and destruction).

Information/risk communication:

Recalls, drug and medical device shortages, illicit drugs notification and trends, and posting of C&E results online.

Scientific and technical services:

Lab analysis of illicit drugs, cannabis, food products, pesticides, tobacco and vaping products, and health products.

Environmental health:

Identify, assess, and communicate health risks posed by environmental factors.

Compliance and enforcement transformation

Transformation of C&E Activities:

Implement a more proactive and risk-based C&E model.
Implement modernized and assertive inspection powers and enforcement approaches.
Utilize real-time data tools to support modernized, risk-based approach.
Increase engagement with regulated parties to align market-driven realities with regulatory requirements.
Strengthen international mutual reliance on C&E information-sharing.
Encourage innovation and optimization of processes and technologies to improve laboratory operations.

Regulatory frameworks and modernization

Regulatory modernization and innovation:

Coordinate the health portfolio regulatory prioritization and planning.
Develop new tools and approaches to better prevent shortages, when possible, and support a more resilient supply chain.
Leverage and align HC’s regulatory priorities with government-wide regulatory priorities.
Continue to work with international partners to share best practices and align regulatory frameworks.

ROEB financial overview

2023-24 budget (in millions)

Salaries and wages ($148.7M) represent 83.2% of ROEB’s overall budget of $178.7M.
Operating ($23.5M) represents 13.2% of ROEB’s budget and includes travel, training, professional services, equipment, and supplies.
Capital ($6.54M) represents 3.7% of ROEB’s budget.
$51.9 M (29%) of ROEB’s budget comes directly from the collection of fees.
Drug right to sell
- Medical devices right to sell
- Drug establishment licenses
- Medical device establishment licenses
- Dealer’s licenses
- Certificate of pharmaceuticals products

Appendix A: ROEB’s Covid-19 response

Interim orders (IOs)

ROEB used IOs to establish new regulatory requirements to prevent and mitigate therapeutic product shortages without compromising safety. These requirements have since been codified as regulations.
Exceptional importation: between March 2020 and March 1, 2022, 61 drug products were approved for exceptional importation. During the same period, 39 Tier 3 shortages involving exceptionally imported drugs were de-escalated. 313 medical devices were also approved for exceptional importation.
Medical device shortage notification: between March 2020 and March 2024, 526 confirmed shortage reports and 8 discontinuation reports for medical devices were posted to Health Canada’s website.

Regulatory flexibilities and risk-based decision making

Expedited the review of medical device establishment licenses to facilitate immediate access to critical medical devices, such as PPE.
Expedited the review of drug establishment licenses for drugs considered important in mitigating the risks of COVID-19.
Enhanced flexibilities on conducting inspections and enabling some flexibility related to documentation accepted and issuing electronic licenses.

Domestic and international alignment

Worked with P/T health partners to share information and guidance for reprocessing N95 respirators and engaged stakeholders to mitigate and prevent drug shortages and respond to medical device shortages.
Maintained a centralized COVID-19 website with relevant information for industry and health professionals.
Worked to align policy approaches and regulatory agility across international fora, including through information-sharing and joint reviews, raising public confidence in consistent regulatory standards across the globe.

Critical drug reserve

Working with the P/Ts and other partners, HC established a time-limited COVID-19 critical drug reserve (CDR) in 2020 that complements other federal, provincial and territorial drug shortage management efforts, and functions as a safety net by augmenting the supply of key drugs used in treating patients with COVID-19 in Canada.
With the closure of the CDR in September 2022, ROEB worked with P/Ts, as well as industry and other stakeholders, to gather lessons learned on this innovative model, including a playbook to serve as a blueprint should similar responses be needed in the future.

Appendix B: ROEB transformation roadmap

Vision

To be a world class compliance and enforcement organization.

Mission

To be a compliance and enforcement leader that protects and informs Canadians of health risks associated with products, substances, and their environment.

Strategic objectives

Maximize operational efficiency to help drive agile, efficient, and risk-based C&E and scientific activities through process optimization activities and implementation of new tools.
Strengthen data and analytics to inform operational and strategic decisions through the use of data and analytics.
Position ROEB for emerging priorities to respond to current and emerging issues through agility in our regulatory programs and frameworks.
Keep foundations strong to maintain a strong base through necessary policies, tools, processes, and training geared towards efficient program delivery.

Our driving force

To ensure we have the workforce we need to deliver our mandate, that our employees have the tools, resources and support they need, and that our workplace is healthy, respectful, diverse, inclusive and one of choice

Enablers

Strengthen data and analytics capabilities to inform decision-making.
Deliver digital tools and solutions to improve program efficiency by leveraging best practices.
Adapt and leverage automation tools to effectively manage high volume, repetitive and simple tasks to enable ROEB employees to focus on high value task and activities.
Use a hybrid approach to inspections (virtual/remote and on-site) across compliance and enforcement programs.
Adopt experimentation as a core practice to drive timely innovation.
Ensure regulatory oversight and coherent C&E approach to manage e-commerce and online market risks to health and safety.
Design and further improve efficient business processes.

7. Oral health branch (OHB)

OHB organizational structure

Assistant Deputy Minister
Lynne René de Côtret

Operations
Brad Martens, Director General

Policy and Programs
Lindy VanAmburg, Director General

Engagement, Outreach and Communications and FPT Relations
Marika Nadeau, Director General

Chief Dental Officer of Canada
Dr. James Taylor

Evolution of the oral health branch

Following budget 2022, the dental care task force was created under Health Canada’s strategic policy branch, tasked with developing and implementing a national program that provides dental care coverage for low-income Canadians.
- In December 2022, an interim Canada dental benefit (CDB) was launched, as a first step that would allow children under 12 to access dental care in the short term.
Budget 2023 confirmed intent to launch the Canadian dental dare plan (CDCP) and a set of complementary programming to improve the oral health of uninsured Canadians with family net incomes below $90,000.
- An oral health access fund (OHAF) and some time-limited investments in oral health data were announced at the same time.
- The CDCP opened for applications in December 2023; claims processing began in May 2023.
- The CDCP is currently being rolled out in phases, with full implementation by 2025.
In Fall 2023, the oral health branch was created, bringing together the dental care task force and the office of the chief dental officer of Canada (OCDOC) from the Public Health Agency of Canada.
Upon its creation, the OHB was tasked with:
- Continuing to support the CDB, until its sunset June 30, 2024;
- Undertaking the development and implementation of the CDCP; and
- Designing, developing, and implementing the OHAF to help address other barriers to accessing care that would otherwise hinder the ability of certain populations to fully benefit from the CDCP or to get access to oral health care.

Key OHB functions

OHB serves as the primary entity responsible for delivering departmental oral health commitments, aimed at enhancing access to oral health services and improving the overall well-being of Canadians.
OHB is responsible for developing, coordinating and administering the wide range of key functions and processes, including all related policies, guidelines, and standards (including some legislative elements); overseeing and designing operations of the CDCP and OHAF; public communications; stakeholder engagement; and program performance measurement, reporting and evaluation that aim to ensure the effective delivery of the program to Canadians.
Current OHB directorates include:
- Operations
- Policy and programs
- Engagement, outreach and communications, and federal-provincial and territorial (FPT) relations
- Office of the Chief Dental Officer for Canada

Operations directorate

Mandate

Implementation and delivery of the CDCP by providing a single window point of contact between the third-party benefits administrator (Sun Life), Employment and Social Development Canada/Service Canada (ESDC/Service Canada), Public Services and Procurement Canada (PSPC) and the Canada Revenue Agency (CRA) for all operational matters.
- This includes provider and member issues such as billing, claims processing and adjudication, eligibility and reassessment issues, and general client service through contact centres.
Oversight of benefits administrator’s CDCP delivery – contract compliance and renewals, task authorizations, governance, quality assurance, integrity measures, funding for provider payment processes, validating costs and billing accuracy, evaluating the adequacy of internal controls, assessing contractor’s performance.
Operational alignment – develop and maintain standard operation procedures (SOP) for benefits approvals, produce operational reports and operational plans, provide regular quality assurance and partnership management, undertake compliance planning and reviews and control testing, including fraud mitigation and investigation.

Key Files

Procurement
Member enrolment and eligibility (contact center)
ESDC on-line application and eligibility assessment
Provider participation, including training institutions
Claims operations
Claims processing and payment
Coordination of benefits
Provider and member portals
Operational oversight, planning, monitoring, reporting and procedures
Accessibility
Security
Privacy
Fraud, verification and audit

Policy and programs directorate

Mandate

Provide HC policy leadership in the area of oral health, including traditional strategic policy functions (e.g. cabinet, Treasury Board, budget/funding requests and legislative initiatives, briefings with DM/minister, liaison with central agencies).
Provide advice on CDCP design and program parameters – who is eligible, what is covered, what fees are paid.
Oversee technical oral health expertise related to the CDCP and soon will oversee decisions on requests for “exceptions” to coverage rules.
Design, administer and deliver new Gs&Cs program: OHAF.
Oversee interim CDB for children under 12 (ending June 30, 2024).
Conduct data analysis and modelling in-house to support evidence-based policy, program decision-making, planning, costing and performance reporting.
Lead on performance measurement, including work with Statistics Canada on the oral health statistics program (OHSP).

Key files

Policy and funding authorities
Policy parameters for the CDCP
Fees
Oral health centre of expertise
Review of exceptional cases
OHAF
Program oversight of the CDB
Data analytics and modelling/forecasting
Performance measurement and evaluation
IT infrastructure project management and oversight

Engagement, outreach, communications, and federal-provincial-territorial (FPT) relations directorate

Mandate

Central hub for engagements and relationship building with dental professionals, PTs, Indigenous partners, advocacy groups and other key stakeholders.
Support oral health communications strategies, oral health promotion and key messaging for the public, service providers, special interest groups; work in concert with the communications and public affairs branch on various communications initiatives and provide content input for communications products including social media, advertising, media relations.
Oversee the development and implementation of health literacy and outreach initiatives to inform Canadians of the CDCP.
Develop and manage the advisory framework and provide secretariat support to various committees at the ministerial and senior management level(s), including ADM FPT committees.
Prepare responses to correspondence, including inquiries from stakeholders, members of parliament and the public.
Develop and negotiate agreements with PTs.

Key files

FPT engagement and relationship management
Stakeholder engagement, targeting oral health care associations, advocacy organizations and key stakeholders
Work with CPAB on all public facing documents and communications activities

Office of the chief dental officer of Canada

Mandate

Provide leadership to Canadian dental practitioners and dental care professionals through the provision of expert technical and evidence-based oral health advice, consultation and information to support oral health initiatives.
Provide in-house clinical advice and expertise.
Work with partners and stakeholders nationally and internationally in identifying emerging issues, advising, facilitating, convening and building consensus
Act as the federal spokesperson and ambassador for oral health and lead various collaborative forums to mitigate national oral health challenges and respond to national/international cross-cutting oral health issues.

Key files

Represent Canada on international committees on oral health.
Contribute expertise on issues, such as the development of international standards and the sharing of best practices.
Engage with national and international professional organizations, Canadian federal, provincial and territorial governments, national and international regulatory organizations, global chief dental officer community, national and international educational organizations and global health organizations.

Dental care funding

Budget 2022

Provided “$5.3 billion over five years, starting in 2022-23, and $1.7 billion ongoing, to Health Canada to provide dental care for Canadians, starting with under 12-year-olds in 2022; followed by seniors, children under 18-year-olds, and persons with a disability in 2023; with full implementation by 2025.”

Budget 2023

Budget 2023 provided adjusted funding:

$13.0 billion over five years, starting in 2023-24, and $4.4 billion ongoing to implement the CDCP;
$250 million over three years, starting in 2025-26, and $75 million ongoing to establish the OHAF; and
$23.1 million over two years, starting in 2023-24, to Statistics Canada to collect data on oral health and access to dental care in Canada.

OHB profile

OHB structure

Creation of permanent branch head position is in the works, and subsequent EX structure to follow.
Currently higher EX to non-EX ratio in an effort to get the CDCP launched. OHB will right-size over the next two to three years in line with normal/steady operations of a program of this size and scope.

OHB total FTEs

Currently, there are 190 full-time employees in OHB.
OHB continues to ramp up to meet maximum possible FTE capacity (up to 277 FTEs) to deliver the CDCP and is actively reviewing talent available within the organization and working towards meeting overall employment equity objectives.

8. Digital transformation branch (DTB)

About us

In December 2020, in response to the COVID-19 pandemic, the Public Health Agency of Canada (PHAC), created the national digital transformation office (NDTO) to support the vaccine rollout.
Recognizing the heightened importance of digital capabilities and the opportunity to harness the agility of the NDTO team, the existing information management services directorate (IMSD) team within the corporate services branch (CSB) at Health Canada and the NDTO team at PHAC were consolidated to form a single unified technology, data and digital branch under Health Canada.
This integration aimed to streamline our operations and enhance our ability to deliver comprehensive and agile digital solutions. Building on these foundational elements, the digital transformation branch (DTB) was formally established in April 2022 to solidify and expand upon these core functions.

How we operate

The digital transformation branch provides enterprise IT services as a common service provider to both PHAC and Health Canada through a shared services partnership (SSP). This agreement has enabled the consolidation of several common functions, such as HR, communications, audit & evaluation and IM/IT, fostering collaboration and ensuring consistent service delivery across both organizations.
The digital transformation branch is led by an assistant deputy minister (ADM) and chief service and digital officer, who acts as the designated departmental chief information officer (CIO), the designated official for cyber security (DOCS) and the designated official for service, all of which are formal accountabilities with associated responsibilities delegated under the Treasury Board Secretariat policy suite for service and digital.
The digital transformation branch partners with service providers such as Shared Services Canada (SSC), Treasury Board Secretariat (TBS) and Public Services and Procurement Canada (PSPC) to deliver a wide range of services.

DTB organizational structure

A/Assistant Deputy Minister, Joann Shields

Chief Digital Transformation Officer
Designated Official for Service
Designated Official for Cyber Security

Branch Operations, François Desabrais-Boyer, A/Director

Enterprise reporting to TBS
Resource Management
TB Subs / MCs
IT Procurement
Branch Planning

Digital Transformation, Planning and Oversight, Monika Kumari, A/Director General

Client Relations & Service Excellence
Digital Strategy & Architecture
Digital Health
Branch Strategy, Planning & Oversight

Digital Product Development, Delivery & Management, Brent Johnston, Director General

PHAC Digital Health Solutions
HC Digital Health Solutions
Digital Product Management

IT Service Delivery, Daniel McLaughlin, Director General

IT Operations: Cyber Security
Enterprise Services: Cloud Services

Chief Data Officer, James Van Loon, Director General

Policy, Partnerships & Science
Data Services
Information Management

Our vision and digital strategy

Vision

We deliver trusted innovative services in the digital age.

Digital strategy

Our digital strategy, built on five (5) core pillars, embraces innovation by continually exploring and integrating cutting-edge technologies into our rapidly evolving digital landscape.

Service excellence ensures that we deliver top-tier services tailored to our clients’ needs, enhancing user experience and satisfaction.
We prioritize people, culture and skills to foster a supportive inclusive environment that nurtures talent and promotes continuous learning.
Robust governance frameworks are crucial for ensuring accountability, transparency, and strategic alignment.
Leveraging data and analytics enables us to make informed decisions and drive innovation through insights.
Enabling infrastructure underpins our efforts, providing the necessary tools and technologies to support seamless, efficient operations and future growth.

Strengths and challenges

We are continuously enhancing and maturing how we run our business.

Stakeholder management
Prioritization and capacity management
Cost recovery and financial management
Governance

We view the challenges we face as opportunities for growth and improvement.

Funding constraints
Interoperability and data standards
Siloed IT teams
Competing priorities
Procurement and digital talent
Cyber security

Key priorities: roadmap to service excellence

Strategic planning and governance

Cyber security roadmap
Tech debt investment strategy
Service management
Strategy, leadership and expertise in artificial intelligence

Operational excellence and service delivery

Multi-tiered IT support service
Mature cloud operations
Automation for efficiency in IT services
Support to dental program

Data management and digital strategy

Data standards and interoperability
Organizational change management
Enterprise architecture
Enterprise platforms

Talent and culture

Talent management
Development programs
Wellness
Employee experience and engagement

9. Chief financial officer branch (CFOB)

Mandate

The Chief Financial Officer (CFO) extends strategic advice to the minister(s), deputy minister, associate deputy minister, and departmental executives, to ensure fulfilment of their respective management responsibilities and accountabilities. The CFO is the lead executive with central agencies for departmental financial and asset management, with a functional reporting relationship to the comptroller general of Canada. CFOB ensures sound stewardship of resources, supports the achievement of results, and provides integrated financial services through a team of innovative, competent and client-focused employees.

Branch priorities

Our people
Corporate support excellence
Modern processes, systems, and tools

Organizational structure

Assistant Deputy Minister
Chief Financial Officer
Comptroller General
Serena Francis

Resource Management and Advisory Services Directorate
Karen Stewart, Director General

Financial Operations Directorate
Hicham Agoumi, A/Director General

Departmental Submissions and Performance Management Directorate
Naira Minto-Saeed, Director General

Procurement and Investment Management Directorate
Ryan Higgs, Director General

Real Property Directorate
Mark Featherstone, Director General

Overview of CFOB organizational areas

Financial operations

Prepares corporate accounting and reporting documents (e.g. public accounts and financial statements, quarterly financial reports).
Provides financial policy direction and training including the delegation of spending and financial authorities.
Undertakes the ongoing, risk-based monitoring strategy of internal controls over financial management.
Assesses quality assurance, controls and adherence to policies while processing payments and receivables.
Provides client based financial services (e.g. travel management, acquisition cards).
Maintains and enhances HC's comptrollership systems and tools (note HC currently hosts 6 departments on SAP).
Provides financial operations services to PHAC via the shared services partnership.
Provides department-wide awareness, tools, and oversight for fraud risk management.

Resource management & advisory services

Leads departmental forecasting, budget allocation, and pressures identification processes.
Provides strategic advice, monitors and oversees the departmental resource management.
Prepares reports to parliament through the estimates, departmental fees report, and financial input to the departmental plan and the departmental results reports.
Provides departmental guidance and oversight on costing, cost-recovery and revenue management.

Departmental submissions & performance measurement

Leads the development of the DP, DRR, corporate risk profile, and the head of performance measurement report.
Provides department-wide direction for performance measurement, risk management and the management accountability framework and Treasury Board (TB) submissions.
Liaises with TB Secretariat, coordinates TB submissions, and CFO attestation for other cabinet items (MCs and regulatory submissions).
Coordinates branch strategic planning, collective staffing processes, PSES results analysis and language training.
Leads branch level initiatives for workplace wellness, awards and recognition, equity, diversity and inclusion, SGBA plus, official languages, communications, security, business continuity planning, accommodations and special events.

Procurement and investment management

Through the SSP, provides centralized procurement and materiel management services to both HC and PHAC.
Ensures adherence to legislative policies, legal obligations, and directives while administering procurement activities.
Prepares and responds to procurement and materiel management reporting obligations.
Provides procurement policy direction, advice, oversight, and guidance to various stakeholders
Leads departmental project management governance by providing direction and support to ensure policy compliance and effective management of projects.
Provides investment planning services and advice and leads the development of the departmental investment plan

CFOB key files/priorities/issues

Issues requiring attention in the next few months:

Upcoming approvals and tabling

Summer 2024

Q1 quarterly financial report
HC 2023-24 departmental financial statements

Fall 2024

Departmental results report
Departmental fees report
Supplementary estimates ‘B’

Treasury board submissions

[REDACTED]

[REDACTED]
[REDACTED]

[REDACTED]

[REDACTED]

Upcoming internal reporting

Summer 2024

P3 departmental forecast

Procurement and project management

Updated governance, processes, and internal policies to address recent scrutiny, gaps, policy changes, and audit recommendations

Health Canada financial overview

As a result of Health Canada responding to the COVID-19 pandemic, its budget increased significantly in fiscal years 2021-22 and 2022-23. Starting in 2023-24 and continuing in 2024-25, focus has shifted and significant funding has been provided for health transfers to provinces and territories and to support the Canadian dental care plan.

Vote 1 operating

FY 2020-21 year end authorities - $1,316.7M
FY 2021-22 year end authorities - $4,943.0M
FY 2022-23 year end authorities - $1,603.2M
FY 2023-24 year end authorities - $1,432.1M
FY 2024-25 year-to-date authorities - $2,948.3M

Vote 5 capital

FY 2020-21 year end authorities - $21.3M
FY 2021-22 year end authorities - $21.1M
FY 2022-23 year end authorities - $24.0M
FY 2023-24 year end authorities - $33.8M
FY 2024-25 year-to-date authorities - $26.5M

Vote 10 G&Cs

FY 2020-21 year end authorities - $2,101.4M
FY 2021-22 year end authorities - $3,455.3M
FY 2022-23 year end authorities - $2,516.0M
FY 2023-24 year end authorities - $5,505.2M
FY 2024-25 year-to-date authorities - $5,765.7M

Total voted

FY 2020-21 year end authorities - $3,439.4M
FY 2021-22 year end authorities - $8,419.4M
FY 2022-23 year end authorities - $4,143.3M
FY 2023-24 year end authorities - $6,971.0M
FY 2024-25 year-to-date authorities - $8,740.5M

Statutory

FY 2020-21 year end authorities - $295.9M
FY 2021-22 year end authorities - $1,029.4M
FY 2022-23 year end authorities - $2,277.8M
FY 2023-24 year end authorities - $566.5M
FY 2024-25 year-to-date authorities - $281.0M

Grand total

FY 2020-21 year end authorities - $3,735.3M
FY 2021-22 year end authorities - $9,448.8M
FY 2022-23 year end authorities - $6,421.1M
FY 2023-24 year end authorities - $7,537.5M
FY 2024-25 year-to-date authorities - $9,021.5M

CFOB financial overview

CFOB's 2024-25 budget by program inventory

Financial management services - $31.2M or 78%
Acquisition management services - $5.7M or 15%
Management and oversight services - $2.5M or 6%
Material management services - $0.5M or 1%

2024-25 resources

Total base budget - $40.0M
Total full-time equivalents – 402
In addition to CFOB base budget, the branch provides several financial services to other government departments on a cost recovery basis:
- PHAC: $6.9M
- ISC/CIRNAC: $4.5M
- CANNOR: $74K
- PMPRB: $45K

Notes

Budgets based on 2024-25 main estimates and supplementary estimates ‘A’.
Budgets include statutory authorities of $9.1M for employee benefits plan and re-spendable revenue.
Budgets do not include SSC and accommodation costs.
Totals may not add due to rounding.

10. Corporate services branch (CSB)

Mandate

CSB plays an essential role as the internal services provider for both Health Canada (HC) and the Public Health Agency of Canada (PHAC). CSB work focuses on excellence on the delivery of services, advice, and solutions to advance the mandates of HC and PHAC. In an ever-changing context, CSB seeks to optimize workforce operations and organizational effectiveness, and foster an inclusive, psychologically healthy, accessible, bilingual, modern and safe workplace.

CSB transformation

To adapt to the changing needs of HC & PHAC in a post pandemic context, CSB has been actively transforming since January 2024. A realignment of functions was implemented on April 1, 2024, and transformation continues through the assessment of efficiencies, effectiveness and rationalization under the new structure in order to support the HC and PHAC of the future.

CSB organizational structure

Assistant Deputy Minister
Nadine Huggins

Assistant Deputy Minister Office
Sonja Webb, Chief of Staff

Human Resources Directorate
Joanna O’Reilly, Director General

Specialized Health Services Directorate
Nancy Porteous, Director General

Real Property and Security Directorate
Mark Featherstone, Director General

Corporate Policy, Planning, and Services Directorate
Dr.Gladis Lemus, Director General

Talent and Workplace Culture Directorate
Fabio Onesi, Director General

Human resources services directorate

Key role

Integrated HR operations of client services, labour relations, executive group services, HR policy and occupational and psychological safety as well as respect in the workplace.

Priorities

Promoting and supporting occupational health and safety for HC and PHAC
Stabilizing HR-to-pay processes
Modernizing staffing and classification
Improving and optimizing client service support to HC and PHAC

Talent and workplace culture directorate

Key role

Provides service delivery of talent and workplace culture functions with a commitment to values and ethics, mental health, talent management, retention, learning and outreach.
Home to the centre of expertise for official languages, and the centre of expertise for accessibility.
Provides support to ensure representation and inclusion of racialized communities and equity-seeking groups across all organizational levels.

Priorities

Developing, implementing and socializing a comprehensive values and ethics program for both HC and the PHAC.
Advancing the equity, diversity, inclusion and mental health agenda for HC and PHAC and implement new multi-year diversity and employment equity plans for both HC and PHAC.
Ensuring talent management related programs (e.g. learning, performance management, recognition) are implemented and well placed to effectively support both HC and PHAC in developing and retaining key talent
Advancing and promoting official languages and equitable access to language training programs
Supporting HC and PHAC as they meet the requirements under the accessible Canada legislation and the federal government accessibility strategy
Developing and disseminating effective, timely and relevant data and reports on all areas as required.

Real property and security directorate

Key role

Provides security services to safeguard people, assets and information.
Manages custodial assets and office space nationally and partners with PSPC to deliver real property and accommodations services, through policies, systems and procedures.

Priorities

Leading GC coworking office modernization projects.
Strengthening the national security program.
Enhancing capital investment in real property assets and advancing real property projects.
Advancing functions for emergency response for business continuity.

Corporate policy, planning, and services directorate

Key role

Serves as the Branch focal point for matters pertaining to strategic leadership for branch planning, oversight, reporting, and digital transformation with the goal of client service excellence.
Provides HC and PHAC library services and plays a key role in ensuring compliance with the Access to Information Act, the Privacy Act, and a number of Treasury Board Secretariat (TBS) policies.

Priorities

Leading CSB's business renewal and digital transformation efforts to innovate and modernize corporate service delivery.
Enhancing corporate service governance, stewardship and oversight, including enhanced performance measurement.
Advancing compliance on access to information and privacy requirements, including addressing the backlog created during the pandemic years.
Lead the revisions to the shared services partnership (SSP).
Advancing initiatives to improve workplace on-site presence.

Specialized health services directorate

Key role

Provides government-wide services to maintain and improve the health of Canadian public servants.
Acts as principal occupational health advisor to TBS while providing a wide range of occupational health and communicable disease services to federal employees.
Offers confidential employee counselling and specialized organizational services.

Priorities

Delivering the public service occupational health program which helps deputy heads meet the Canada labour code requirement to protect employee health and safety at work.
Delivering mental health supports, including the employee assistance program (EAP), on a cost-recovery basis to over 90 federal organizations.

Annex A: HC-PHAC shared services partnership (SSP)

In June 2012, deputy heads of HC and PHAC signed a shared services partnership agreement which underwent its last amendment in August 2016. Under this agreement, each organization is responsible for specific internal services and corporate functions, with accountability to both deputy heads.

HC responsibility

Communications and public affairs
Corporate services (human resources; mental health and wellness; employment equity, diversity, and inclusion; ombudsman, values and ethics, informal conflict management; real property and security, ATIP operations, privacy management)
Digital transformation (including IM/IT)
Financial operations/procurement

PHAC responsibility

Audit and evaluation
Emergency preparedness and response
International affairs

Annex B: CSB financial overview

2024-25 initial budget ($M)

Salary and operating (vote 1) - $109.0M
Revenue* - $38.0M
Capital (vote 5) - $4.6M
- Sub-total - $151.6M
SSP funding - $31.8M
Total - $183.4M
FTEs - 1265.4

*Data as of April 3, 2024.

CSB initial budget by function ($183.4M)

Management and oversight - $22.2M
Human resources - $42.6M
Library services - $5.1M
Real property and security - $72.0M
Specialized health services - $41.5M

*Revenue sources:

EAS (recovered)
MOUs an ILAs with other Government departments under Sec 29.2 of the Financial Administration Act
Internal Services revenue received from HC branches.

Annex C: CSB current structure (as of April 1, 2024)

Human resource services, Daryl Gauthier (Joanna O’Reilly as of May 1, 2024)

Human resource policy - David Kindschi
- HR planning
- Policy centre
Client services - Cathy Peters
- Staffing
- Specialized recruitment and pool
- Management
- Non-ex classification
- Program operations
- HR-to-pay and student office
- Compensation / internal pay
Labour relations - Daniel Aubrey
- HC/PHAC operations
- Corporate labour relations, policies and programs
- Conflict of interest
Occupational and psychological health and safety, Anne Lapierre

Talent and workplace culture, Fabio Onesi

Equity, diversity, and inclusion - vacant
- Reporting and organizational learning
- Network secretariat
- Policy/programs
Corporate mental health - Jennifer Peters
- Implementation of national standard for psychological health/safety in the workplace
- Develop and promote tools, training, events, and resources
Accessibility code - Safya Ratnani
- Meets requirements under accessible legislation and federal strategy
- Accessibility service center (WWSC)
Talent learning and outreach – Christine Benoit
- Corporate learning strategy
- Framework and oversight for mandatory training
- Planning events and outreach on CSB initiatives
- Awards and recognition
- Performance and talent management
- Support to science
Values and ethics – vacant
- Corporate policy / promotion of resources
Official languages code – Oscar Chen-See
- Official languages policy
- Single window access to language training (SWALT)
Data analytics – Shane Heath
- Human resources reporting
- Center of excellence
- Data peoplesoft

Corporate policy, planning, and services – Dr.Gladis Lemus

ATIP – Celline Henrie
- Meets legislative requirements under ATIP and Privacy Act
Privacy management – Prosper Béral
- Assistance and advice on the Privacy Act
Corporate Planning – Tim Appleby
- Strategic planning and reporting
- Risk and accountability
- Coordination and corporate policy analysis
Digital transformation and library services – Benjamin Woodman
- Business renewal
- Data transformation
- IM/IT project and planning
- Library services

Specialized health services – Nancy Porteous

Employee assistance services – Alain Contant
- 24-hour crisis and referral
- Short-term psychological support
- Trauma services
- Health and wellness
- Psychosocial, occupational, and critical incident services
- Conflict management services
- Specialized services
Public service occupational health program – Heather Watson
- Occupational health evaluations
- Communicable disease prevention and advice
- Occupational hygiene advice and consultations
Policy and strategic direction – Jesse Arnup-Blondin
- Recruitment of contracted service providers
- Support to cost-recovery operations
- Policy performance and data analytics
Research and innovation – Lindsay Olmstead
- Research and project management
- Program modernization
- Support innovation

Real property and security – Mark Featherstone

National program management – Seema Verma-Pharasi
- Internal HR and finance
- Special projects
- Policy and corporate planning and reporting
- Corporate owner investor and governance
- Building emergency and evacuation program
National accommodation facilities management – Samantha Todd
- Accommodation planning and reporting
- Regional facilities management services
- Project management
- Facilities management services
National asset management and lab operations – Pietro Rinaldi
- Asset planning and reporting
- Custodial project management
- NCA property management
- Regional property
- Lab safety
National security management – Sean Cooper, Philippe Guy
- Security screening
- Business continuity and event management
- Investigations and regional security management
- Security planning and performance management
- Physical security
National project delivery – Yixiong Rang
- Project leadership
- Project management

11. Center for Ombuds and Resolution (COR)

COR organizational structure

Ombuds and Executive Director
Sylvie Richard, Ph.D.

Informal Conflict Management Director and Associate Ombuds
Sarah Curry
Associate Ombuds
Thierry Casademont

COR key functions

Ombuds

Provides a safe and confidential space where employees at all levels can raise and discuss any workplace issue without fear of reprisal or judgment.
Identifies systemic issues and trends and prepare reports.

Informal conflict management services

Provides support to prevent, manage, and resolve workplace conflicts and develop a conflict competent workforce and organization.
COR provides services to Health Canada (HC) and the Public Health Agency of Canada (PHAC) .

Ombuds

The ombuds reports directly to the:

Deputy and associate deputy ministers for HC;
President and executive vice-president for the PHAC.

The ombuds:

Creates a safe space where employees can raise and discuss workplace issues without fear of reprisal or judgment and find options, resources, and recourse to address their situation;
Raises awareness about systemic issues and trends to those with the power to effect change;
Shares trends and promote promising practices when engaging employees, networks, champions, and unions.

COR supports the DMs with the clerks’ priorities:

Provides an ombuds-like function to provide all employees with a trusted, safe space to discuss harassment without fear of reprisal and to help navigate existing systems;
Calls to action on anti-racism, equity, and inclusion call to action on anti-racism, equity, and inclusion.
- By ensuring COR is trained and equipped to create safe spaces for employees facing racism or experiencing discrimination.
- By providing concrete tools for employees to respond to micro-aggressions in the workplace.
The ombuds is an active member of the council of organizational ombuds of the federal public service.
The ombuds is not responsible to receive complaints on behalf of HC or PHAC.

Informal conflict management services (ICMS)

COR provides ICMS to help HC and PHAC meet their legislative requirements, under two codes:

Public Service Labour Relations Act (s. 207)

Requiring to have an informal conflict management system in place designed to support the Government of Canada's commitment to "fair, credible and efficient resolution of matters arising in the workplace.

Workplace harassment and violence prevention regulations of the Canada labour code

COR provides conciliation services when requested by the principal party who made a notice of occurrence.

Our services:

Consultation, coaching, facilitated discussion, mediation, conciliation, group intervention and preventive training sessions;
Are complementary to formal processes such as grievances and workplace violence and harassment complaints;
Empower and equip individuals from HC and PHAC to address workplace issues and conflict constructively.

COR financial overview (2024-25)

Total COR Budget in 2024-25 is $1.9 M

O&M: $76.7K
Salary: $1.8 M (~18 FTEs)
Pressure funding requests ($316K) is pending for PHAC for full salary of 2.5 FTEs and 25% O&M adjustment.
Pressure funding from IT Services ($110K) has been granted to finalize a necessary case management system update, to be cloud-compliant.

12. Communications and public affairs branch (CPAB)

CPAB overview – what we do

CPAB is a full-service communications branch that directly supports HC and PHAC to deliver on their mandates through a Shared Services Partnership. This work helps to ensure that Canadians have access to the information they need to act on their health.
CPAB provides a broad range of strategic communications services, including issues management, crisis and risk communications planning and delivery, media services, ministerial media events, speechwriting, digital communications including web publishing and social media channel management, video and creative services, marketing and advertising, as well as services for public opinion research, consultations and stakeholder engagement.
It leads internal communications functions for both HC and PHAC.
It leads the correspondence function for HC and supports PHAC’s correspondence work.
It leads the reconsideration function for regulatory decisions through the Food and Drugs Act Liaison Office (FDALO).
CPAB is the primary liaison with Privy Council Office (PCO) Communications and with Communications staff in the Ministers’ Offices for all communications issues.

CPAB overview – about us

CPAB has 381 full-time equivalents in the National Capital Region and across six regions and a Vote 1 budget total of $49.7M in 2024/25. Resources are derived from A-base, the Shared Services Partnership, Treasury Board Submissions, and PCO’s Central Advertising Fund.
CPAB leads communications efforts for 9 HC branches, 7 PHAC branches, the Office of the CPHO, 4 SSP branches (21 direct partners) plus engages actively with Legal Services, CIHR and CFIA communications groups.

CPAB organizational structure

Assistant Deputy Minister
Sarah Lawley

Associate Assistant Deputy Minister (overseeing the Strategic Communications Directorate)
Cathy Allison

Public Affairs Directorate
Renée Couturier, Director General

Digital Communications
Patrycja Arkuszewski, Executive Director

Ministerial Communications Directorate
Jaqueline Théorêt, Director General

Public Health and National Microbiology Laboratory (NML)
Laura Russo, Executive Director

Mental Health, Substance Use, Strategic Policy, and Dental
Katie Kenney, Executive Director

Regulatory, CPHO, Science, Public Health, and Strategic Policy
Heather Magee, Executive Director

Service streams – strategic communications directorate

Strategic communications

Provides HC and PHAC with strategic communications advice and planning aligned with ministerial, agency, departmental and client branch priorities.
Prepares external communications strategies and products (e.g., news releases, media lines and social media) in support of ministerial announcements. In 2023-24 we developed and released 251 new releases / statements.
Conducts communications assessments of emerging issues and upcoming releases (e.g., responses to ATIs or OPQs, proactive disclosures, corporate plans and reports).

CPHO communications

Provides the CPHO with strategic communications advice, and supports her annual report to Parliament, public engagement and outreach to Canadians and stakeholders on her priorities, responses to media requests, speech writing, and management of the CPHO social media accounts.

Risk communications

Prepares for and manages risk communications for public health emergencies in close partnership with the health portfolio operations centre, federal partners, and the provinces and territories.
Communicates health and safety risks from HC and PHAC, including public health notices (e.g., infectious disease outbreaks), travel health notices to Canadians travelling in other countries, and advisories about health and consumer products.
Leads the recall and safety alerts database, which is populated by HC, the CFIA and Transport Canada, and contains advisories on food, pesticides, drugs and consumer products, as well as safety information on vehicles and child restraints.

Science communications

Supports science activities across the health portfolio and serve as a hub of science communication excellence. This includes a communications handbook for HC-PHAC scientists and researchers, and annual deputy minister science townhalls.
Coordinates media training for scientists, offers plain language training as well as internal and external communication opportunities for HC-PHAC scientists and researchers.
Supports lab crawls to showcase and celebrate the work of scientists in Health Canada labs.
Effectively communicating about our science is valuable for both producers and users of science, especially when communicating with the public.

Service streams – ministerial communications directorate

Media relations and media monitoring

Makes strategic use of the media to communicate health information to Canadians.
Develops and coordinates responses to media enquiries and provide issues management advice.
Manages all media calls (2,580 for HC in 2023-24 and 947 for PHAC) and facilitates all media interviews (approximately 133 for HC and 97 for PHAC). Pursues “detect and correct” on inaccuracies or errors in media articles (more than 70 corrected in 2023-24).
Provides media training to subject matter experts and support to spokespersons during interviews with media.
Provides monitoring, analysis and reporting on more than 100 traditional media, social media and online sources.

Ministerial services

Provide full-service event and announcement support for the ministers, including coordinating on-the-ground support in Ottawa and in the regions, managing event logistics, and writing speeches. In 2023-24, we handled:
- 156 speeches
- 76 events (ministers or delegates)
Maintain the ministerial calendar of events and announcements and coordinate approval, translation and distribution of communications products.

Internal communications

Facilitates the delivery and awareness of corporate priorities with internal audiences, including full logistical and messaging support for events and messaging led by the deputy heads, targeting all employees.
Supports deputy minister and president/ vice president with speeches for town halls and other internal events, all-staff messages, and departmental newsletters (entitled faces of Health Canada/the Public Health Agency) (6 HC DH events, 6 PHAC DH events, 5 joint internal events and 98 all-staff messages in 2023-24).
Centre of expertise to enable branches and partners to undertake effective employee engagement.
Develops speeches, messages and internal videos from the ministers.
Coordinates input for internal communications channels including daily broadcast news and health television.

Executive correspondence

Provides a single window for health portfolio correspondence to and from both ministers, the deputy minister and the associate deputy minister.
The executive correspondence division received more than 64,000 pieces of correspondence, including 52,853 campaign letters, in 2023-24.

Regional communications

Provides regional issues management support, including crisis, risk and emergency communications.
Engages with P/T and interdepartmental communications counterparts.
Provides logistical support for ministerial media events across the country.
Conducts regional media relations outreach and provides advice.
CPAB is transitioning to a national model, where all CPAB employees working outside of the NCR, support CPAB activities across the country (i.e. supporting a ministerial event in their location). This will complement the work of a small, dedicated regional team, with a western and eastern hub.

Service stream – public affairs directorate

Digital communications

Leads the Canada.ca/health presence and manage the integration of all HC and PHAC webpages to the Canada.ca environment.
Manages 50K+ live HC and PHAC webpages, including content coordination, and publishing. Received 6,000 digital publishing requests last year.
Leads the management and publishing of information to the HC and PHAC intranet (mySOURCE).
Leads the administration of the recalls and safety alerts system on behalf of eight regulatory programs at four departments/agencies.

Marketing, advertising, and partnerships

Develops social marketing strategies including advertising, outreach and partnerships to promote healthy lifestyle behaviours and help reduce the risk of disease.
Developed and delivered 17 marketing and advertising campaigns in 2023-24.
This year, the team will develop 6 HC and 6 PHAC campaigns (anticipated total budgets of $14.625M) including the Canadian dental care plan, opioids stigma and harm reduction, palliative care, routine childhood vaccinations, tobacco cessation, vaping prevention and food safety.

New media and digital insights

Provides design, publishing, video, copyright, printing and distribution services to all branches, and manages the Service Canada contract for the HC and PHAC 1-800 toll-free general inquiries lines.
Manages all HC and PHAC social media channels comprised of 1.93M followers (as of July 2024) by developing strategies and content and engaging across our platforms including X (Twitter), Facebook, LinkedIn, YouTube and Instagram.
Produces the healthy Canadians podcast, which is available on YouTube and all major podcast platforms.
Provides web writing, digital performance measurement, optimization, user experience services.
Produce analytical reporting that offers insights and key metrics to allow users to use data and evidence to support their decision-making.

Public engagement and public opinion research

Provides full-service public opinion research (POR) contracted through external firms or using our own survey software. In 2023-24, the team worked on 69 contracted POR projects and 35 internally-managed surveys.
Offers consultation expertise and services, from planning to implementation. In 2023-24, the team provided significant support to 22 consultations.
Manages the consultation and stakeholder information management system (CSIMS), a stakeholder registry that was used by HC and PHAC clients to identify and contact stakeholders for 200 engagement activities in 2023-24.
Maintains the Health Canada policy on external advisory bodies (EABs) and provide support and advice on its application to HC EAB Secretariats.

Food and drugs act liaison office (FDALO)

Housed in CPAB, the Food and Drug Act liaison office (FDALO) is an impartial, arm’s-length body that provides information and dispute-resolution services to improve relations between external stakeholders and representatives of Health Canada, as well as to increase openness and transparency in the regulatory process.
The office administers the reconsideration process for the pharmaceutical drugs directorate, biologic and radiopharmaceutical drugs directorate and the natural and non-prescription health products directorate.
Actively managed 328 cases in 2023-24.
FDALO also helps build staff competency in managing difficult communications with stakeholders.
- In 2023-24, the office offered training to 109 participants coming from Health Canada and from the community of federal regulators.

13. Office of audit and evaluation (OAE)

OAE organizational structure

The Office of Audit and Evaluation (OAE) provides independent and objective advice and assurance to Public Health Agency of Canada (PHAC) and Health Canada (HC) senior management on the adequacy and effectiveness of risk management, controls, and governance, as well as the relevance and performance of programs.

Chief Audit and Evaluation Executive
Shelley Borys

Program Evaluation and Internal Disclosure
Amanda Hayne-Farrell, Executive Director

Internal Audit and Special Examinations
Pascal Robert, A/Executive Director

Practice Management
Blenda Jong, A/Director

Our divisions

Internal audit and special examinations

Internal auditing provides independent, risk-based assurance that an organization’s governance processes, risk management, and internal controls are operating as intended by senior management and will help the organization achieve its objectives. We also provide special examination services for allegations of fraud or loss of money.

Program evaluation and internal disclosure

Evaluations involve the collection and analysis of evidence to assess the performance of programs, initiatives and policies in a systematic and neutral way, as well as provide considerations for how programs can be improved. We also ensure a secure and confidential process for disclosing serious wrongdoing in the workplace.

Practice management

The practice management team is responsible for quality assurance, annual audit and evaluation planning, governance of audit and evaluation committees, liaising and coordinating with external assurance providers, and following up on action plans to respond to recommendations.

How we do our work (audit)

Conduct risk-based audit planning

Identify key risks and timing for departmental audit and advisory projects over a two-year cycle.
Development of plan (aligned with TB’s policy on internal audit and institute of internal auditor’s global internal audit standards).
Consultation with senior management within each branch.
Departmental audit committee (DAC) recommendation for DM approval of final plan.

Conduct audit and advisory engagements

Terms of reference are shared with the office of primary interest (OPI).
Preliminary findings are presented to OPI for fact validation.
All draft reports go through a rigorous internal quality assurance process.

Report results off engagements

Final audit reports and the management response and action plan (MRAP) are presented to executive committee and DAC for review and feedback.
Report is submitted to DM for approval.

Publish audit reports

Audit reports are published on a dedicated Health Canada website within 90 business days of DM approval.
Audit reports are sent to TBS after DM approval.

Follow-up on management response and action plans

Follow up process to ensure deliverables are proceeding as planned.
Every six months, the DM receives a docket updating on MRAP progress.

How we do our work (evaluation)

Conduct evaluation planning

Determination of requirements (FAA and TB Submissions).
Consultation with programs and central agencies.
Confirmation with the performance measurement evaluation and results committee (PMERC) and DM approval of plan.

Conduct evaluations

Develop scope of evaluation (activities covered and questions asked) with programs and present to PMERC for endorsement.
Present preliminary findings to PMERC for endorsement or gap identification.

Report evaluation results

Final reports are presented to PMERC for endorsement.
The program is responsible to present the management response and action plan (MRAP).
Report is submitted to DM for approval.

Publish evaluation reports

Reports are sent to TBS within 14 days of DM approval.
Reports are published on a dedicated Health Canada website within 120 days.

Follow up on management response and action plans

Follow up process to ensure deliverables are proceeding as planned.
Every six months, the DM receives a docket updating on MRAP progress.

Revise as needed based on PMERC feedback.

Fundamental principles

Regardless of the oversight function, there are several principles that guide our work.

Collaboration - we work closely with program areas during all stages of engagement – from the development of questions and criteria in scoping to the formulation of recommendations in the final report. This ensures no surprises at all points in the process.
Verification - over the years, we have built in several steps in our process of verifying the accuracy of findings, as well as the feasibility of recommendations. This includes work with the programs as well as governance check-ins.
Evidence-based approach - through the use of sound and rigorous methods during engagements, we provide findings that are accurate and appropriate for the current context of a program.

Recently completed audit engagements

The following internal audits include an approved management response and action plan (MRAP) to respond to the areas identified for improvement. These MRAPs are followed up semi-annually by OAE who assesses, tracks, and reports on the completion of the MRAPs. We also provided consultancy services. Key findings can be found in the annex.

Internal audits

Audit of drug shortage reporting, monitoring, and compliance activities – May 2024
Audit of cyber security at HC and PHAC – November 2023
Audit of integrated risk management at Health Canada – May 2023

Consultancies and other activities

Consulting engagement for the PMRA transformation (risk management) – July 2023.
Audit readiness assessment for COVID-19 rapid testing – May 2023.
Audit readiness assessment on the federal response to the opioid overdose crisis – May 2023.
We also finalized five internal audits as well as multiple consultancies for the Public Health Agency of Canada.

Ongoing/planned audit engagements

1. Audit of occupational health and safety at HC & PHAC

Timing - January 2023 – June 2024
OPI/OSI - corporate services branch
Engagement type - assess whether HC and PHAC have implemented key controls to ensure that the OHS program operating in compliance with legal and policy requirements that support healthy and safe work environments

2. Audit of internal control over financial management (ICFM)

Timing - June 2023 – June 2024
OPI/OSI - chief financial officer branch
Engagement type - determine whether there is effective monitoring of HC’s system of ICFM and the extent to which OAE can rely on the assurance over financial controls provided by the internal control team.

3. Audit of information management (IM) at HC & PHAC

Timing - October 2023 – August 2024
OPI/OSI - digital transformation branch
Engagement type – determine whether the HC and PHAC have implemented an effective IM control framework which includes, but is not limited to, accountability, roles, responsibilities, policy framework, monitoring, and reporting to mitigate IM risks.

4. Readiness assessment for the interim Canada dental benefit

Timing - March 2024- September 2024
OPI/OSI - oral health branch
Engagement type - provide advice on the adequacy of the Canadian dental benefits closeout phase, with a focus on completeness. The assessment will also provide input to the oral health branch for future improvements.

5. Readiness assessment for the Canadian dental care program

Timing - May 2024- December 2024
OPI/OSI - oral health branch
Engagement type - provide advice on the adequacy of the Canadian dental care plan controls, with a focus on completeness and the integration of lessons learned as the program continues its implementation.

6. Audit of project management

Timing - August 2023 – September 2024
OPI/OSI - chief financial officer branch
Engagement type - assess whether HC has developed and implemented an effective project management framework that is working as intended to promote effective and efficient project management and to enable the realization of the expected benefits of projects.

7. OCG horizontal audit of procurement governance

Timing - June 2024 – Sept 2024
OPI/OSI - chief financial officer branch
Engagement type - horizontal audit led by the office of the comptroller general of Canada at the Treasury Board Secretariat for which HC is among 12 federal departments scoped in. The objective of this audit is to determine whether procurement management frameworks within selected departments:
- Are established, aligned with applicable TB policies, directives, and guides, and are implemented;
- Support the understanding and fulfillment of departmental and shared procurement related roles, responsibilities, and accountabilities between departments; and,
- Are established to enable information and data collection, with tools to inform decision making.

8. Audit of the shared services partnership

Timing - June 2024 – March 2025
OPI/OSI - all branches on the shared services partnership
Engagement type - assess the effectiveness of the SSP agreement. This will include the governance framework, the service standards from SSP branches, the funding allocation as well as the reporting and monitoring on performance.

9. Audit of Cybersecurity – remote work

Timing - July 2024 – June 2025
OPI/OSI - digital transformation branch
Engagement type - determine whether HC and PHAC have established processes and practices to effectively manage cybersecurity risks associated with remote work.

Recently completed evaluations

The following evaluations include an approved management response and action plan (MRAP) to respond to the areas identified for improvement. These MRAPs are followed up semi-annually by OAE who assesses, tracks, and reports on the completion of the MRAPs. We also provided consultancy services. Key findings can be found in the Annex.

Departmental evaluation plan projects

Evaluation of the pan-Canadian health organizations– March 2024
Evaluation of the health care policy and strategies program – February 2024
Evaluation of the pharmaceutical drugs program – February 2024
Evaluation of the chemicals management plan – February 2024
Evaluation of the territorial health investment fund – October 2023
Evaluation of the Canadian drugs and substances strategy– August 2023

Consultancies and other activities

Review of the PMRA transformation initiative – March 2024
We finalized four evaluations as well as some consultancies for the Public Health Agency of Canada.

Ongoing/planned evaluation engagements

1. Review of funding to employee diversity networks

Timing - January to September 2024
OPI/OSI - corporate services branch (OPI)
Engagement type – consultancy on the funding provided by HC and PHAC to staff positions within the employee diversity networks.

2. Evaluation of Health Canada’s safe restart agreement contribution program

Timing - January 2024 – January 2025
OPI/OSI - health policy branch (OPI)
Engagement type - funding to PTs and non-profit organizations to strengthen COVID-19 testing, contact tracing and data management.

3. Evaluation of the food and nutrition program

Timing - January 2024 – January 2025
OPI/OSI - health products and food branch (OPI), regulatory operations and enforcement branch (OSI) and the communications and public affairs branch (OSI)
Engagement type - regulations, guidelines, standards, and policies pertaining to food safety and nutrition.

4. Evaluation of radiation protection activities

Timing - April 2024 – March 2025
OPI/OSI - Healthy environments and consumer safety branch (OPI) and the regulatory operations and enforcement branch (OSI)
Engagement type - activities to protect people in Canada from health risks associated with radiation exposure from natural and human-made sources.

5. Evaluation of the biologic and radio-pharmaceutical drugs program

Timing - April 2024 – March 2025
OPI/OSI - health products and food branch (OPI), regulatory operations and enforcement branch (OSI)
Engagement type - regulations for biologicals; radiopharmaceuticals; human blood and blood components for transfusion; human cells, tissues and organs for transplantation; and assisted human reproduction.

6. Evaluation of the Canadian thalidomide survivors support program

Timing - July 2024 – January 2025
OPI/OSI - health policy branch (OPI)
Engagement type - financial support to eligible Canadian thalidomide survivors.

7. Horizontal evaluation of the federal contaminated sites action plan: phase IV

Timing - June 2023 – September 2024
OPI/OSI - Horizontal evaluation led by Environment and Climate Change Canada
Engagement type - activities to reduce environmental and human health risks from known federal contaminated sites and associated federal financial liabilities.

8. Evaluation of health portfolio’s tobacco and vaping activities

Timing - July 2024 – September 2025
OPI/OSI - controlled substances and cannabis branch (OPI), regulatory operations and enforcement branch (OSI) and the Public Health Agency of Canada (OSI)
Engagement type - activities aimed at helping people living in Canada quit tobacco, and protecting youth and non-tobacco users from nicotine addiction.

Key external audit engagements

External audits currently underway

Public Service Commission (PSC) - audit on the application of the order of preference for veterans. Expected publishing date: August 2024.
Office of the Auditor General (OAG) - audit of the 2023-24 consolidated financial statements. Expected completion date: Fall 2024.
Commissioner of the Environment and Sustainable Development (CESD) - audit on climate change adaption. Expected tabling date: April 2025.

Awaiting publication: external engagements and audits

OAG - update on past audits relating to “toxic substances” - publishing: July 2024 (TBC).
OAG - update on past audits relating to “pandemic preparedness” - publishing: July 2024 (TBC).
PSC - audit of employment equity representation in acting appointments - publishing: December 2024 (TBC).
Canadian Human Rights Commission – audit on the employment of racialized people in management and executive positions in the federal public service - publishing: December 2024 (TBC).

Previously tabled OAG audit

Antimicrobial resistance - tabled October 19, 2023.

Environmental petitions

Environmental petitions are under the CESD. OAE is currently coordinating the response to two petitions directed at Health Canada (and other federal government departments).

Departmental audit committee

About the departmental audit committee (DAC)

The DAC, under the Policy on Internal Audit, is an advisory body which provides advice and recommendations to the deputy head on sufficiency, quality and results of internal audit engagements, and on matters as requested by the deputy head.

Reviews management, control, and accountability processes using a risk-based approach.

DAC’s areas of responsibility

Values and ethics, risk management, management control framework, internal audit function, external assurance providers, follow-up on management action plans, financial and accountability reporting.

DAC membership

External members – Leah Collins, Lorraine Maheu, Linda Lizotte-MacPerson, and Aslam Bhatti. Internal members – deputy minister, associate deputy minister, chief financial officer, and chief audit and evaluation executive.

2024-25 meetings

Remaining 2024-25 DAC meetings are scheduled as follows:

October 9-10, 2024
December 17-18, 2024
February 25, 2025

Performance measurement, evaluation and results committee

About the performance measurement, evaluation and results committee (PMERC)

The performance measurement, evaluation and results committee (PMERC) is comprised of executive committee (EC) members and meets four times a year on evaluation topics (the head of performance measurement schedules other PMERC meetings that focus on performance measurement).
Each evaluation is discussed at three stages: scoping; preliminary findings; and final report and management response and action plan (MRAP).

2024-25 meetings

Remaining 2024-25 PMERC Meetings are scheduled as follows:

October 3, 2024
January 23, 2025
March 20, 2025

Next 100 days

The audit of occupational health and safety (HC & PHAC) and the audit of internal control over financial management will be presented at executive committee in September 2024 and at departmental audit committee (DAC) on October 9, 2024.
For the Office of the Comptroller General (OCG) horizontal audit of procurement governance, the HC’s audit finding summary, approved by the CFO and the CAEE, will be shared with the OCG on August 7, 2024. We will also report these findings to Executive Committee and DAC in Fall 2024.
Three external DAC members’ terms will expire in the coming year (one in December 2024 and two in May 2025). Joint declarations recommending the selected candidates’ appointments will need to be signed by the deputy minister and submitted to the OCG by February 2025 for inclusion in a cabinet submission.
September 2024: presentation of findings from the review on the funding to the employee diversity networks. Possible engagement of the networks on the findings through the leadership council on diversity and inclusion (committee co-chaired by the deputy minister).
October 2024: meeting of the performance measurement and results committee to discuss:
- Preliminary findings from the evaluations of the safe restart agreement contribution program and the food and nutrition programs.
- Scope of the health portfolio tobacco and vaping activities evaluation.

OAE financial overview

Branch allocation by function

Program evaluation and internal disclosure - $4,134,794
Internal audit and special examinations - $3,522,001
Practice management - $2,211,851
Director general's office - $1,029,295

OAE headcount

OAE’s salary budget supports an average head count of approximately 80 employees.
OAE is a shared service partnership with 48% of OAE’s budget coming from PHAC.

Key findings from recently completed audits

1. Audit of drug shortage reporting, monitoring, and compliance activities

Timing – May 2024
Program profile - HC’s drug shortages response management
Key findings - overall, it was found that the governance framework supports the oversight and management of drug shortages in Canada. There is an awareness of strategic and operational risks that are being identified and managed. At the same time, there are opportunities to formalize and strengthen strategic and operational risk management and the internal processes and controls in place to prevent and manage shortages, as well as to strengthen and formalize compliance monitoring to support mandatory drug shortage reporting by manufacturers.

2. Audit of cyber security at HC and PHAC

Timing - November 2023
Program profile - IT security governance and risk management processes designed to counter and mitigate cyber security risks
Key findings - overall, HC and PHAC implemented elements of the governance and risk management processes needed to identify and mitigate cyber security risks. However, the audit identified opportunities to further improve the key governance and risk management processes at HC and PHAC.

3. Audit of integrated risk management at Health Canada

Timing - May 2023
Program profile - risk management processes and activities at the corporate and branch levels
Key findings - HC's corporate and branch level risk management practices generally support the identification and integration of risk in planning and decision-making processes. However, we found that there are opportunities for the Department to improve risk management at the branch level by formalizing and standardizing related practices.

4. Consulting engagement for the PMRA transformation (risk management)

Timing - July 2023
Program profile - risk management practices for the PMRA transformation initiative
Key findings - overall, management established objectives for the PMRA Transformation and implemented formal practices to identify, assess, and manage risks to the achievement of those objectives. However, management could strengthen risk management practices by improving risk-related collaboration and communication between all stakeholders within PMRA and clarifying the approach for assessing risks.

5. Audit Readiness Assessment for COVID-19 Rapid Testing

Timing - May 2023
Program profile - HC and PHAC’s rapid testing initiative
Key findings - overall, HC and PHAC established adequate governance, risk management, and controls to support the implementation of the rapid testing initiative. However, the two organizations experienced some communication challenges with respect to procurement and contract amendments. In addition, improvements could be made in the collection and analysis of sufficient data to allow them to measure the success of the initiative against its overall objective of helping to curb COVID-19 transmission.

6. Audit readiness assessment on the federal response to the opioid overdose crisis

Timing - May 2023
Program profile - HC’s response management to the opioid overdose crisis
Key findings - overall, the opioid response team demonstrate sound governance and information management controls to respond to an external audit or review. The report made advice to management for their consideration on the topic of information management and the documentation of key decisions and lessons learned in a matter that is readily accessible in response to similar crisis event or requests for information.

Key findings from recently completed evaluations

1. Pan-Canadian health organizations (PCHOs)

Program profile – funding to 7 PCHOs to support and encourage sustainable and adaptable health systems by working with PTs and other partners on specific needs including data and health records.
Key findings
- Progress was made to address issues identified in external reviewed commissioned by the Health Minister in 2018.
- PCHOs made progress towards enhancing health system capacity, changing the behaviour of healthcare decision makers, and supporting improvements in health systems.
- Opportunities for improvement include increasing communication from the health portfolio, re-examining existing governance mechanisms and prioritizing requests to PCHOs.

2. Health care policy and strategies program

Program profile - contribution funding for projects on mental health care; home and community care; palliative and end-of-life care; and other federal, provincial, territorial, and emerging priorities.
Key findings
- Funded projects were effective at generating, accessing, and sharing knowledge products. There is some evidence that the use of these products have led to changes to guidelines and policies, and improvements in treatment and care for patients.
- There are opportunities to improve the sharing of information on projects or lessons learned with funding recipients and within HC.

3. Pharmaceutical drugs

Program profile - Regulation of human and veterinary pharmaceutical drugs sold in Canada.
Key findings
- Due to the number and complexity of submissions, pre-market reviews required more time than before. Decisions for generic drugs have been made increasingly closer to the deadlines.
- Several changes were put in place since 2017 to modernize regulatory processes. However, the end of the pandemic provides an opportunity to review priorities.

4. Chemicals management plan

Program profile - joint initiative with Environment and Climate Change Canada aimed at reducing the risks posed by chemical substances to Canadians and the environment.
Key findings
- CMP’s risk management activities, compliance promotion and enforcement actions have served to reduce human and environmental exposures.
- The evolving Canadian chemicals management landscape and expectations of increased transparency make CMP’s work increasingly complex. CMP will need to review its priorities to better meet future needs and expectations.

5. Territorial health investment fund

Program profile - grants to the 3 territories to support access to health service and territorial initiatives to build sustainable health care systems.
Key findings
- THIF allowed territories to offer direct health care services, recruit and train staff and adopt new technologies to improve service delivery. It has also enabled each territory to plan and execute initiatives to improve Indigenous health on multiple fronts.

6. Canadian drugs and substances strategy

Program profile - Joint pan-governmental initiative providing a comprehensive, collaborative, compassionate and evidence-based approach to drug policy. It covers a range of legal and illegal substances, including cannabis, alcohol, and opioids.
Key findings
- It helped to frame substance use as a public health issue and contributed to expanding access to harm reduction and treatment services.
- More work is needed in prevention and in better addressing the root causes of substance use, including the relationship with social determinants of health. Addressing alcohol use is a gap in the current approach.
- There remain gaps in disaggregated surveillance data, as well as limited information to effectively measure the strategy’s impact to address drug and substance use as a health and social issue.

7. Pest management regulatory agency (PMRA) transformation

Program profile - $42M investment over three years (2021-2022 to 2023-2024) to strengthen the pesticide review process.
Key findings
- As of fall 2023, PMRA had made significant progress to carry-out its Transformation, but most initiatives had yet to be transitioned into regular operations.
- Lessons learned from include the need to prioritize efforts and communicate a concrete transition plan to staff.

8. Health counsellors

Program profile - joint PHAC/HC funding of a position in Canada’s missions in Washington and to the UN (Geneva).
Key findings
- The function has been relevant to the health portfolio. It provides an increased ability understand nuances that cannot be grasped from abroad and to establish key contacts with partners at the right level.
- There is a need to provide more strategic directions to the counsellors on priority area of work, strengthen connections with headquarters and re-assess the competency requirements for the position.

14. Office of international affairs (OIA) for the health portfolio

Mandate

OIA strategically advances the health portfolio’s international priorities in support of Canada's domestic health policy and foreign policy objectives and ensures that Canada's interests and values are reflected in the global health agenda.

OIA key functions

International relations and engagement

Lead global health governance for the health portfolio; engage multilaterally and bilaterally. Build and sustain relationships and networks, establish and advance collaborative strategies.
Provide protocol and logistics advice and support for international events and official visits to support international exchanges, whether incoming visits or outbound missions.

Global health policy coherence

Provide horizontal global health policy coherence and international cooperation to advance the ministerial mandate and health portfolio global health priorities.
Share information, collaborate, and provide strategic advice on global health issues. Liaise with other health portfolio partners (CFIA, CIHR, PMPRB) and other government departments (e.g. GAC)] to foster a concerted approach to global health issues.

OIA is situated in PHAC and reports to both Health Canada and PHAC Deputy Heads. It is the single window into the international affairs of the health portfolio for the minister, the Deputies, other departments and international partners.

Organizational structure

Branch Head
Christine Harmston, Director General

Lynn Menard, Chief of Staff

Multilateral relations division
Josée Roy, Director

Bilateral Engagement Summits & Trade
Ranu Sharma, A/Director

Official Delegation & Strategic Integration Division
Sameera Hussain, A/Director

Plus two health counsellors in Geneva and Washington, reporting to the director general.
Chief negotiator for pandemic instrument, Zoe Kahn, reports to PHAC & HC deputies.

OIA financial profile 2024-25

Permanent funding

Salary - $5,277,058
O&M - $1,058,211
G&C - $1,030,000

Temporary funding

Salary – $1,459,025
O&M – $887,470
G&C – $150,000

Total budget 2024-25

As a shared service, OIA’s total A-base branch budget (excluding international health grants program) comes from both Health Canada ($4.07M) and PHAC ($2.26M).
OIA receiving additional B-based salary and O&M from PHAC phase 1 renewal through to March 2025.

Notes:

Managing structural deficit; stabilizing efforts are ongoing.
A-based funding supports 45 FTEs; OIA currently supporting 63 FTEs (excluding casuals and students).
Health counsellor roles currently being funded 50/50 by PHAC and Health Canada (total is 1.3M/year for both roles, includes significant transfer to GAC to support the roles in the embassies).
OIA is a shared service (part of shared service partnership) but does not receive internal services funding. Ongoing review of the SSP is important factor to support future of the branch.

Mega trends impacting public health globally, including Canada

Climate crisis - heat related illness and death, migrant health, food and water-borne contamination, vector-borne diseases, droughts and wildfire, precipitation changes.
Non-communicable diseases and mental health - chronic disease prevention and management, mental health, substance use.
Health care equity - access to health products and services, increasing cost of living, malnutrition, water and sanitation, child and maternal care, mental health, gender equality, social/economic/environmental determinants of health.
Healthcare workforce - healthcare worker shortage, health system sustainability.
Demographic shifts - aging population, urbanisation, migration.
Digitalized futures - telemedicine, personalized care, artificial intelligence and machine learning, data privacy.
Health emergency prevention/preparedness/response - infectious disease prevention, routine immunization, drug resistance, data quality and availability.
Infodemic management - misinformation and disinformation, science literacy, knowledge translation, public trust.

OIA stewards the governance of key international health obligations and goals

Objective - be stewards of the governance of binding international agreements as well as non-binding international policy frameworks that govern global discussions on health and rights.
Strategic outcome - meeting/preserving Canada’s obligations while also advancing Canada’s domestic health interests, values and priorities.

Examples of OIA roles

Represent Canada on multilateral health governance boards (WHO, PAHO, IANPHI).
Represent Canada in G7/G20 health meetings.
Serve as international secretariat of the global health security initiative.
International health regulations (IHR) and pandemic agreement to lead Canada’s negotiations on IHR amendments and establish a new pandemic agreement.
Framework convention on tobacco control to provide oversight on WHO FCTC’s budget and administration, with an aim to ensure transparency, accountability and overall good governance.

OIA advances strategic health policy coherence and agendas through ecosystem of multilateral/plurilateral engagement

Objective - leverage all opportunities to advance portfolio priorities; promote good governance, accountability and transparency; and advance broader foreign policy priorities beyond global health.
Strategic outcome - global health challenges are effectively addressed via appropriate institutions, rules and processes.

Examples of OIA roles

Regular and active participation in multilateral discussions, in close collaboration with GAC & Canada’s missions abroad, to advance global health decision-making and inform Canada’s domestic health policy agenda.
Regular collaboration with all health portfolio partners to inform positions.
Briefing package preparation; logistics and protocol preparation.

Key outputs/deliverables in near-term

Modernized international health regulations
Ministerial declarations, resolutions and global action plans
Pandemic agreements
Partners – WHO, PAHO, IARC, GHSA, GHSI, WHOFCTC

OIA advances strategic health policy agendas through ecosystem of regional & bilateral engagement

Objective - advance 'common ground' in health objectives through ministerial/senior official bilateral programs and through exchanges of technical 'know-how'; building relationships to inform bigger global health advocacy platforms in multilateral fora.
Strategic outcome - common global health goals are advanced through effective dialogue and cooperation (increasing interest by foreign interlocutors to establish formal agreements with defined workplans).

Examples of OIA roles

Lead and coordinate engagement across portfolio, senior management and OGD partners.
Preparation of briefing packages, logistics and protocol.

Key outputs/deliverables

Ministerial declarations.
Resolutions, outcome documents, global action plans.
Salient intelligence sharing to inform policy development and direction.
MOUs/bilateral agreements with South Africa, Taiwan, Denmark.
Other formal agreements exist from past years but are largely dormant.

OIA coordinates portfolio strategies on health trade files

Objective - support trade negotiations and maintain trade agreements, in particular, by advocating for the protection of Canada’s right to regulate in support of legitimate health objectives.
Strategic outcome - Canada’s domestic health interests are advanced and preserved.
Examples of OIA role - provide policy support and guidance on health impacts of trade agreements, disputes & challenges for key free-trade agreements.

Current stakeholders

India
UK
ASEAN
Indonesia
Mercosur
Ukraine

Enabling functions: international health grants program & protocol, travel and logistics service

The international health grants program (IHGP)

The IHGP is the main mechanism used by Health Canada and PHAC to advance domestic health priorities on the international stage. Its program objectives aim to increase knowledge of current and emerging global health issues, increase collaboration and strengthen relationships with key partners, strengthen Canada’s leadership on global health issues, and enhance global health capacity/participation in priority areas.
The program has $1M in available A-base funds. However, program areas use the terms and conditions (Ts&Cs) to advance priority areas. Historically, the IHGP funds approximately 10-15 projects per year (of which 4-6 are A-base).
The Ts&Cs are ‘owned’ by PHAC. HC does not currently have a grant mechanism to fund international organizations.
[REDACTED]

Protocol, Travel and Logistics

Provide travel and logistics support to Minister of Health; Minister of Mental Health and Addictions; DM of Health Canada; PHAC President and CPHO & supports incoming official visits at ministerial level.
Plans and coordinates operational and logistical components of international official events and visits including (but not limited to):
- Acting as pen on the official program (client-template, working closely and collaboratively with all policy teams whom have a stake in said visit);
- Working closely with client office to ensure the client’s personal and wellbeing preferences are reflected throughout programming (ie. jetlag, exercise, work blocks, early vs late briefings, ensuring reflection of past experiences into new projects, etc.); and
- Working closely with missions abroad to gather logistical, operational and budgeting feasibilities, cost and identify efficiencies.

Overview of key international events (April-Dec 2024)

77th World Health Assembly - May 27 to June 1 – Switzerland
PAHO 174th session of the executive committee (EC) - June 24 to 28 - Washington, DC
Asia Pacific Economic Cooperation (APEC) 2024 senior officials meeting - August 17 to 19 - Lima, Peru
United Nations General Assembly (UNGA) HLM on AMR - September 2024 - NY, USA
PAHO directing council - September 2024 - Washington, DC
G7 Health Ministers' Meeting - October 9 to 11 - Ancona, Italy
World Health Summit - October 13 to 15 - Berlin, Germany
G20 Health Ministers' Meeting - October 29 to 30 - Rio de Janeiro, Brazil

D. Departmental budget and financial overview

Health Canada 2024-25 financial overview

Budget by core responsibility (Voted)

Health care systems - $7,790M or 89%; 570 FTEs
Health protection and promotion - $709M or 8%; 6,109 FTEs
Internal services - $242M or 3%; 2,039 FTEs
Total budget - $9,022M
Total resources – 8,718 FTEs

Total budget (voted and statutory)

Vote 1 operating - $2,948M
Vote 5 capital - $26.5M
Vote 10 transfer payments (G&Cs) - $5,766M

Notes

Budgets based on 2024-25 main estimates and supplementary estimates A (excludes shared services and accommodation costs).
Internal services includes corporate services, communications, finance and legal services.
Totals may not add due to rounding.

External charging of fees

High impact litigation matters
Existing fee regime	Branch	Authority	Last year fees updated* and current status	2023-24	2024-25 Re-spendable Forecast **
Re-spendable Revenues
Drugs and medical devices	HPFB/ ROEB	Food and Drugs Act (FDA)/ Financial Administration Act (FAA)	2020 Under consideration for review	Re-spendable: $188.9M Total: $220.3M	$198M
Pesticides	PMRA/ ROEB	Pest Control Products Act (PCPA)	2018 Post market annual charge fees update targeting fall consultation in Canada Gazette I. Pre market review to commence shortly	Re-spendable: $15.1M Total: $17.1M	$15.9M
National dosimetry services	HECSB	Minister’s authority to enter into contract	2024 review completed in 2023	Re-spendable: $7M Total: $7.7M	$6.6M
Non re-spendable revenues
Cannabis	CSCB/ ROEB	Cannabis Act	2018 (Introduced) Review completed in 2022. No anticipated updates at this time.	$61.5M	n/a
Hazardous materials	HECSB	Hazardous Materials Information Review Act	Review anticipated to commence in 2025	$0.4M	n/a

*Other than the annual adjustment
**Included in Vote 1 operating budget
Potential fee regimes include natural health products, tobacco and chemical management Plan

II. Governance and operations

A. Key legislation

1. Organization

Health Canada

Enabling statutes

Department of Health Act

Assigned statutes

Assisted Human Reproduction Act
Canada Health Act
Canada Consumer Product Safety Act
Canadian Environmental Protection Act, 1999 (with Minister of Environment) Cannabis Act
Comprehensive Nuclear Test-Ban Treaty Implementation Act (Section 12(1))
Controlled Drugs and Substances Act
Criminal Code (section 241.31, regulations re medical assistance in dying)
Department of Health Act
Emergency Management Act (supports Minister of Public Safety & Emergency Preparedness)
Financial Administration Act [Regulations for application or renewal of a dealer's licence]
Food and Drugs Act
Framework on Palliative Care in Canada Act
Hazardous Materials Information Review Act
Hazardous Products Act
Agriculture and Agri-Food Administrative Monetary Penalties Act
Patent Act [Patented Medicines (Notice of Compliance) Regulations]
Pest Control Products Act
Pesticide Residue Compensation Act
Radiation Emitting Devices Act
Tobacco and Vaping Products Act

2. Organization

Public Health Agency of Canada

Enabling statutes

Public Health Agency of Canada Act

Assigned statutes

Department of Health Act
Emergencies Act
Emergency Management Act (supports Minister of Public Safety and Emergency Preparedness)
Federal Framework on Lyme Disease Act
Federal Framework on Post-Traumatic Stress Disorder Act
Federal Framework for Suicide Prevention Act
Health of Animals Act
Human Pathogens and Toxins Act
National Strategy for Alzheimer's Disease and Other Dementias Ac
Quarantine Act
International Health Regulations
National Framework for Diabetes Act

3. Organization

Canadian Food Inspection Agency

Enabling statutes

Canadian Food Inspection Agency Act

Assigned statutes

Agriculture and Agri-Food Administrative Monetary Penalties Act
Feeds Act
Fertilizers Act
Food and Drugs Act (as it relates to food)
Health of Animals Act
Plant Breeders’ Rights Act
Plant Protection Act
Safe Food for Canadians Act
Seeds Act

4. Organization

Canadian Institutes of Health Research

Enabling statutes

Canadian Institutes of Health Research Act

Assigned statutes

Canadian Institutes of Health Research Act

5. Organization

Patented Medicine Prices Review Board

Enabling statutes

Patent Act

Assigned statutes

Patent Act (Innovation, Science, and Economic Development)

B. Legislative and regulatory responsibilities

Introduction

In Canada, health is an area of shared jurisdiction. Under the Constitution Act, 1867, provincial responsibilities include the establishment, maintenance and management of hospitals, local matters, and property and civil rights. Over time, courts have interpreted these constitutional provisions to mean that provinces and territories (PTs) are primarily responsible for health care delivery, the administration of provincial health insurance plans, and the regulation of health professions.

Federal authorities in health are grounded in the federal government’s constitutional responsibilities for criminal law and taxation, and the federal spending power. These responsibilities provide the basis for helping to protect the health and safety of Canadians through the regulation of drugs, food, medical devices, controlled substances, cannabis, tobacco and vaping products, consumer products and cosmetics, pest control products, and medical assistance in dying.

Parliament also has the authority to spend money raised through taxation, and to attach terms and conditions to the authorized spending. Accordingly, the Canada Health Act establishes the criteria and conditions PT health insurance plans must meet to receive their full cash entitlement under the Canada health transfer.

Rooted in the “peace, order and good government” provisions of the constitution, the federal government also has key functions in relation to national health emergencies, and where public health matters are issues of national concern. Since the 1970s, federal power in public health has been interpreted to also include efforts in health research and promotion, disease prevention and health information.

Several other federal responsibilities include health elements, not all of which fall within the purview of the health portfolio. This includes economic powers related to trade; commerce and patents, which apply to drugs; medical devices and technologies; responsibilities in foreign affairs and immigration that relate to migration health (e.g., admission of foreign nationals with international credentials, and relations with international bodies and foreign governments); and supplementary benefits and health services for certain populations (First Nations and Inuit, refugees, the military).

Health portfolio legislation and regulation

There is a range of legislative mechanisms that the government can use to meet its desired objectives. Legislative tools include acts (statutes), regulations, and orders in council, all of which are relevant in the health portfolio context. While acts are laws enacted by parliament, regulations also have legally binding effects. Normally, the power to make regulations is conferred by parliament to the governor in council (cabinet), a minister, or, occasionally, an agency.

The Minister of Health is responsible for the administration and enforcement of aspects of approximately 40 acts (and their associated regulations) that have a direct impact on the health and safety of Canadians.

Three of the acts are enabling statutes, for which the minister is responsible for; that is, they create and provide the basis of the activities of the three largest portfolio organizations – Health Canada, the Public Health Agency of Canada, and the Canadian Food Inspection Agency.

These acts set out specific responsibilities carried out by these organizations in relation to the minister’s statutory responsibilities. These include: the promotion of the physical, social, and mental well-being of Canadians (Department of Health Act); taking public health measures, identifying and reducing public health risk factors, and supporting national readiness for public health threats (Public Health Agency of Canada Act); and setting safety standards for food sold in Canada, as well as enforcing the food provisions of the Food and Drugs Act (Canadian Food Inspection Agency Act and the Public Service Rearrangement and Transfer of Duties Act). In addition, the Patent Act provides the legislative basis for the establishment and functioning of the Patented Medicine Prices Review Board. As well, the Canadian Institutes of Health Research Act created in 2000 the Canadian Institutes of Health Research (CIHR), an arm’s-length agency that is under the management responsibility of its governing council and that reports to parliament via the Minister of Health. The objective of the CIHR is to excel in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system.

The Minister also has important responsibilities in relation to the administration of the Canada Health Act (CHA), Canada’s federal legislation on insured health services. The CHA defines the national principles that govern the Canadian health care system and aims to “… protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.” It establishes the criteria and conditions provincial and territorial health insurance plans must meet to receive their full cash entitlements under the Canada health transfer.

The Public Health Agency of Canada Act mandates the Public Health Agency of Canada and the Chief Public Health Officer to assist the Minister of Health "in exercising or performing the minister's powers, duties and functions of public health", which includes public health emergency preparedness and response. Under the Emergency Management Act, the Minister of Health has specific responsibilities to identify risks pertinent to his or her mandate and develop plans to address these risks. The Chief Public Health Officer also has explicit responsibilities in the emergency legislation. Emergency plans have been developed by the health portfolio that address a variety of public health risks (for example, pandemic influenza and foodborne illness).

To prevent the introduction and spread of communicable diseases in Canada, the Quarantine Act gives the Minister (and other designated officials) the power to take comprehensive public health measures. Since the very beginning of the COVID-19 pandemic in early 2020, those powers were relied upon to support the COVID-19 response, for instance by designating quarantine facilities. The Quarantine Act also provides the governor in council the authority to issue emergency orders prohibiting or imposing conditions on travelers entering Canada.

Under the Food and Drugs Act and the Pest Control Products Act, the minister also has the authority to issue interim orders (IO) if immediate action is required to deal with a significant risk, direct or indirect, to health, safety, or the environment. During the COVID-19 pandemic, IOs were used to expedite access to important COVID-19 drugs, vaccines, disinfectants, and medical devices.

To help respond to COVID-19 related restrictions, which impacted access to prescription medications containing controlled substances, an exemption to certain restrictions under the Controlled Drugs and Substances Act was issued (e.g. permitting pharmacists to extend, renew and transfer prescriptions and allowing practitioners to verbally prescribe such medications).

The cannabis regulations were also amended to extend the validity of medical documents whereby health care practitioners authorize their patients to access cannabis for medical purposes.

In addition to enabling statutes, there are several statutes that assign the Minister of Health as the minister responsible for that statute. There are assigned statutes that establish federal frameworks (e.g., palliative care, lyme disease, post-traumatic stress disorder) or national strategies (e.g., dementia), which confer specific responsibilities on the Minister of Health.

The balance of the assigned statutes relevant to the health portfolio set out responsibilities to be carried out by the Minister of Health in the context of regulating food, pharmaceutical drugs, controlled substances, tobacco and vaping products, pest control products, medical devices, biologics, human toxins and pathogens, radiation-emitting devices, and consumer products and cosmetics.

There are significant differences in the nature of these various regulatory regimes. However, some principles of decision-making are common to many of the acts for which the Minister of Health is identified as exercising a role. The following section sets out some key principles.

Powers, duties and functions in legislation

Most acts of parliament and associated regulations are administered by individual ministers, and this responsibility can include a variety of powers, duties, and functions. Depending on the legislation (or regulations), the responsible minister can be named in the act itself or designated by the governor in council (i.e. cabinet).

Typically, the various powers, duties and functions set out in an act or regulations are assigned to the responsible minister. However, in some circumstances, specific authorities are assigned to other identified individuals or groups of individuals. For example, powers to make regulations and amend schedules to an act are often assigned to the governor in council. In all cases, the Minister of Health would still be involved in setting overall policy direction for regulatory programs, developing regulations, and approving regulations recommended to the governor in council.

The Department of Health Act provides that the minister “has the management and direction of the department” and must “coordinate the activities of, and establish strategic priorities for, any board or agency for which the minister is responsible and may, subject to any terms and conditions that the minister considers appropriate, delegate those powers, duties and functions to the Deputy Minister of Health”.

A. Powers, duties and functions of the Deputy Minister of Health

The Deputy Minister of Health is appointed by the governor in council on the Prime Minister’s recommendation and holds office during pleasure, pursuant to s. 3 of the Department of Health Act. The deputy minister acts generally under the direction of the minister, who maintains responsibility for the overall management and control of the department of health. The powers, duties and functions of the deputy minister are derived from four main sources of law:

1. The general and implicit power to act on behalf of the minister

The deputy minister is empowered to act on behalf of the minister as section 24 of the Interpretation Act provides that words in legislation directing or empowering a minister of the crown to do an act or thing applying to that minister as the holder of the office, include the deputy minister and persons appointed to serve in the department with appropriate capacity. This authority recognizes that a minister is not required to exercise all of statutory powers personally but is assisted by departmental officials for that purpose.

2. Powers delegated by the minister to the deputy head through legislation

Many powers and responsibilities are delegated to the deputy minister by the minister through specific provisions in various pieces of legislation. For instance, section 34 of the Financial Administration Act requires that the minister authorize the person or positions who are responsible for the payment, certification and verification of financial expenditures in the department. Other legislation such as the Privacy Act (section 71) or the Access to Information Act (section 73) provides that the minister may delegate its powers to the deputy head.

3. Powers directly vested in deputy heads by legislation

As a deputy head, the deputy minister of health has some specific powers and responsibilities stemming directly from legislation. For instance, the Financial Administration Act imposes on the deputy head the specific obligations for commitment control (section 32), maintaining adequate records in relation to public property (section 62) or ensuring appropriate internal audit capacity (section 16.1). A deputy head also has numerous direct powers and responsibilities in human resources management stemming from the Financial Administration Act, the Federal Public Sector Labour Relations Act and the Public Service Employment Act. For instance, the deputy minister has the authority under subsection 12(1) of the Financial Administration Act to financially penalize, suspend, demote or terminate any employee for disciplinary reasons and to terminate or demote employees for non-disciplinary reasons, including unsatisfactory performance. The deputy minister has direct authority under the Public Service Employment Act to determine qualifications for positions to be staffed (section 31), to deploy employees (section 51), to lay off (subsection 64(1)), or to terminate the employment of employees on probation (section 62). The deputy minister has direct authority under the Federal Public Sector Labour Relations Act to establish a consultation committee (article 8), in consultation with the bargaining agents, under the Public Servants Disclosure Protection Act, the deputy minister is responsible for establishing a code of conduct applicable to the department of health, establishing internal procedures to manage disclosures made under this act, and designating a senior officer to be responsible for receiving and dealing with complaints of wrongdoing.

Finally, the deputy head has the authority in legislation to receive notices and reports from tribunals and other investigative bodies, including the Canadian International Trade Tribunal, the Commissioner of Official Languages, or the Canadian Security Intelligence Service.

4. Powers delegated to the deputy minister by others

The authority to appoint under the Public Service Employment Act belongs to the Public Service Commission, but has been delegated to the deputy minister for positions within the department of health (section 15 of the Public Service Employment Act). Order in council (P.C. 1991/1695) provides that Treasury Board may authorize deputy heads to make ex gratia payments. As such, the deputy minister may do so for the department of health.

Who makes regulatory decisions?

Depending on the legislation, the authority to make decisions may be specifically assigned to the minister, to other individuals (such as designated inspectors), or, occasionally, to the governor in council. The following section explains how these different types of decision-making authorities work.

A. The Minister of Health

1. Decisions made by the minister or on the minister’s behalf

Decision-making authority in legislation often resides with the minister. In the health portfolio context, this authority encompasses many possible kinds of regulatory decisions, and on any given day, many of these decisions are made. Accordingly, the majority of decisions are made by governmental officials. This has four important advantages:

Given the volume of regulatory decisions required, it is not practical for a minister to personally exercise all of his or her authorities;
The risk of perceived political interference in evidence-based decision-making is minimized;
Many regulatory decisions are highly technical in nature and require a specialized (often scientific) expertise; and
In the event a decision is challenged in a court of law (subject to judicial review), the person who makes the decision may need to give evidence.

At all times, where the decision-making authority in legislation resides with the minister, the responsible minister retains the authority to personally make those decisions. However, the practice of allowing officials to exercise regulatory decision-making powers that are appropriate to their functions is common to all regulatory departments and agencies.

Regulatory decisions can be scrutinized by industry, the media, the public, and the judiciary. Therefore, it is essential that the minister – or appropriately-placed officials in the health portfolio who make those decisions on behalf of the minister – are able to demonstrate integrity in their decision-making processes. It is important to demonstrate that each decision is the result of an objective – and, as applicable, science-based – assessment of all the information available to the regulator.

While routine and uncontroversial regulatory decisions are made every day by officials, if a decision is particularly sensitive in nature, additional background information may be provided so that the minister is aware of the context and basis for a decision.

2. Ministerial decision-making authority where a delegation order is required

In some specific instances, legislation may include specific provisions that allow the minister, as head of the institution, to make an order delegating particular powers, duties and functions to officers or employees of the institution (or to another institution within the portfolio). Relevant examples in the context of the health portfolio include the Access to Information Act and the Privacy Act.

Some examples of the decision-making authorities assigned to the Minister of Health include the power to:

Issue a “notice of compliance” permitting the sale of a new drug in Canada (food and drug regulations);
Order the recall of a drug or medical device if the minister believes it presents a serious or imminent risk of injury to health (Food and Drugs Act);
Issue a registration permitting the sale and use of a pest control product in Canada (Pest Control Products Act);
Issue authorizations for access to controlled substances (Controlled Drugs and Substances Act);
Order a stop sale or stop the import of a non-compliant hazardous product (Hazardous Products Act);
Order a recall of a consumer product that is a danger to human health or safety (Canada Consumer Product Safety Act);
Order the recall of a food, animal or plant product that poses a health risk (Canadian Food Inspection Agency Act); and
Establish a quarantine station and designate a quarantine facility at any place in Canada (Quarantine Act).
Issue an interim order under the Food and Drugs Act or the Pest Control Products Act if it is believed that immediate action is required to deal with a significant risk, direct or indirect, to health, safety, or the environment.

B. Other officials

Many acts confer decision-making powers explicitly on individuals other than the minister. For example, inspection powers (such as entry, examination of records, detention of substances, etc.) can only be exercised by a designated “inspector” in the Food and Drugs Act, the Controlled Drugs and Substances Act, and the Human Pathogens and Toxins Act, to name but a few. Under the Quarantine Act, a “quarantine officer” decides whether to require health assessments of individuals suspected of carrying a communicable disease. The Chief Public Health Officer is responsible for making certain decisions under the emergency orders issued under the Quarantine Act, including granting exemptions for essential workers and taking immediate public health measures to minimize the risk of introduction or spread of COVID-19 by imposing conditions on exempt persons.

In these instances, the minister may request a briefing in relation to the decision-making process and discuss the decision with officials, but may not make, nor is directly involved in, the decision itself.

C. Independent Tribunals

Some statutes create tribunals that operate independently of a minister. One such example in the health portfolio is the Patented Medicine Prices Review Board (PMPRB). The PMPRB is an independent, quasi-judicial body established under the Patent Act. The board determines whether the patented drug price set by the manufacturer is excessive and, if so, the board can order price reductions and/or the offset of excess revenues. Further, the board has the authority to issue non-binding guidelines regarding the administration of the board. However, before issuing any such guidelines, the board is required to consult with the Minister of Health, as well as other stakeholders.

Although the PMPRB carries out its mandate at arms-length from the Minister of Health and is independent of Health Canada, the Patent Act sets out several roles for the Minister of Health in relation to the PMPRB. This includes recommending new/amending regulations to the governor in council in relation to the PMPRB regime, and entering into agreements with any province to disburse funds collected by the PMPRB.

D. Governor in council (cabinet)

Legislation can expressly provide that the governor in council will exercise the decision-making power. An example of this is in the health portfolio is the emergency orders that can be made by the governor in council under the Quarantine Act, which prohibit or impose conditions on persons entering Canada. This can be done, for example, if they are coming from a country that has an outbreak of a communicable disease that could pose a threat to Canadians and no reasonable alternatives to prevent the introduction or spread of the disease are available. Since February 2020, the governor in council has exercised this authority to create prohibitions on entry into Canada and to impose mandatory isolation and quarantine on travelers to prevent the introduction and spread of COVID-19.

Another example is under the Pest Control Products Act, where the governor in council may make an order cancelling or amending the registration of a pest control product if considered necessary to implement an international agreement. Neither the minister nor departmental officials may make these types of decisions on cabinet’s behalf.

B. Legal services unit presentation deck

Mandate

Health Legal Services, which is part of the Department of Justice, provides support to Health Canada, PHAC and CIHR.

Employs approximately 55 counsel, 14 paralegals and 22 staff, including finance, HR, and administrative support.
Delivers services through a mix of co-located counsel and specialized experts located within the Department of Justice.
Contributes to the important work of the health portfolio by:
- Playing a key role in the development, interpretation and application of the legislative framework for which the Minister of Health and Minister of Mental Health and Addictions are responsible;
- Playing a key role in identifying and managing the legal risks inherent in HC, PHAC and CIHR activities;
- Defending in court the actions and decisions of HC, PHAC, CIHR officials.

Organizational structure

François Nadeau
Executive Director and General Counsel

Denise Oliver
Director and General Counsel
Healthy Environments and Consumer Safety Branch
Controlled Substances and Cannabis Branch

Vanessa Brochet
Director and General Counsel
Health Policy and Corporate Affairs
Public Health Agency of Canada

Robert Dufresne
Director and General Counsel
Health Products and Food Branch
Pest Management Regulatory Agency
Regulatory Operations and Enforcement Branch

Matthew Zadro
Director and General Counsel
Claims and Class Actions
Oral Health Branch

Full range of client services

Human rights law
Centre for information and privacy law
Centre for labour and employment law
Centre of expertise in procurement law
Commercial law section
Trade law bureau
Criminal law policy
Aboriginal law centre
Legislative drafting services
Health Canada regulations section
Privy council office legal services
Tax law services
Canada border services legal services
Canadian food inspection agency legal services
Other legal services unit
National litigation services
Official languages
Constitutional administrative and international law

Advisory matters involving legal risks

[REDACTED]
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High impact litigation matters

Financial overview 2024-25

Health legal services and other justice sectors

Health Canada counsel - $9,834,798.13 or 48%
Legislative / regulatory services counsel - $4,205,625.97 or 21%
Disbursements - $574,000.00 or 2%
Litigation and specialized services counsel - $5,797,886.33 or 29%

Health Canada MOU with Justice Canada

Total budget 2024-25 - $20.4M
Total budget 2023-24 - $23.6M
Reduction - $3.2M

Department of Justice counsel FTEs

Health legal services 2024-25 – 45
Health legal services 2023-24 – 50
Reduction of 10% - 5

D. Departmental governance

Executive committee membership

Members

Greg Orencsak, Deputy Minister of Health
Eric Costen, Associate DM
Catherine Allison, Associate ADM, CPAB
Francois Nadeau, DG and senior general counsel of LSU
Nadine Huggins ADM, CSB
Michelle Boudreau, Associate ADM, SPB
Frédéric Bissonnette, Senior Director General, PMRA
Jo Voisin, ADM, SPB
Kendal Weber, ADM, CSCB
Linsey Hollett, ADM, ROEB
Lynne René de Cotret, Associate ADM, OHB
Manon Bombardier, ADM, PMRA
Matt Jones, ADM, HECSB
Pamela Aung-Thin, ADM, HPFB
Celia Lourenco, Associate ADM, HPFB
Sarah Lawley, ADM, CPAB
Serena Francis, ADM, CFOB
Jennifer Saxe, Associate ADM, CSCB
Supriya Sharma, Chief Medical Advisor, HC / Senior Medical Advisor for HPFB
Sylvie Richard, Ombuds and Executive Director

Observers

Christine Harmston, Branch Head of the Office of International Affairs
Shelley Borys, DG, Evaluation and Chief Audit Executive
Matthew Lynch, Director General, Policy Coordination and Planning Directorate (PCPD)
Chief of Staff to the Deputy Minister
Advisors to the Associate Deputy Minister
Director, Strategic Policy, Priorities and Portfolio Affairs

Executive committee terms of reference

Authority

The executive committee (EC) functions under the authorities of the deputy minister (DM) and the associate deputy minister (AsDM) to set the strategic direction of the department, make key policy and management decisions, and coordinate cross-departmental activities.

Role and mandate

EC is Health Canada’s senior decision-making, direction setting and oversight body and convenes at two weekly meetings: executive committee and executive committee look ahead.

At EC meetings, members generally focus on policies, legislation and regulations, as well as emerging issues and trends that have departmental, portfolio or government implications. Members also ensure appropriate management oversight and accountability on progress, activities and performance of the department in financial management, program and service delivery, and human resources management.

At EC look ahead meetings, members generally focus on short-term departmental business planning such as upcoming cabinet business, parliamentary activities, treasury board submissions, communications, as well as ongoing business and issues requiring senior management attention.

The executive committee also acts as the departmental evaluation and performance measurement committee. In this role, it serves as an advisory body to the deputy head related to the departmental evaluation plan, resourcing, and final evaluation reports and may also serve as the decision-making body on other evaluation and evaluation-related activities of the department. (See Appendix D – roles and responsibilities of departmental evaluation committee).

Guiding principles

Health Canada’s governance structure is based on the following principles:

Leadership – achieving a department-wide commitment to good governance through leadership;
Accountability – being answerable for decisions and having meaningful mechanisms in place to ensure the department adheres to all applicable standards;
Integrity – acting impartially, ethically and in the interests of the department;
Stewardship – using every opportunity to enhance the value of the public assets and institutions that have been entrusted to care;
Efficiency – ensuring the best use of resources to further the aims of the department, with a commitment to evidence-based strategies for improvement;
Transparency/openness/predictability – having clear roles and responsibilities and clear procedures for making decisions;
Engagement – using all opportunities to create a learning organization and to foster staff engagement; and
Agility – ensuring a flexible, responsive, adaptive organization.

EC and its sub-committees commit to operate with due regard to:

Public service values, as described in the values and ethics code for the public service (i.e. democratic, professional, ethical and people values) and the Health Canada Code of Conduct;
The Treasury Board Secretariat integrated risk-management framework and the Health Canada decision-making framework;
Senior management responsibility to foster a work environment that is conducive to the effective use of both official languages, as stated in the Treasury Board Secretariat policy on official languages and Health Canada’s policy on language of work;
Horizontal collaboration within the department and portfolio;
Compliance with laws and regulations; and
Departmental and government priorities.

Position with governance structure

EC is supported by the following sub-committees:

EC – finance, investment planning and transformation (EC-FIPT)
EC – people management (EC-PM)
Deputy ministers’ policy committee (DMPC)
EC – regulatory operations (EC-RO)
EC – performance measurement and results (EC-PMR)
HACE – health accord executive committee

These sub-committees may serve as pre-vehicles for items scheduled for EC meetings. They may also have specific matters delegated to them for review or decision by EC. These sub committees are supported by:

DG planning
DG investment planning
DG policy committee
DG science
DG Compliance and Enforcement
Information management advisory committee

An additional sub-committee made up of assistant deputy ministers, called ADM-DAC, meets quarterly to review audits, progress reports against MRAPs and audit plans being tabled at departmental audit committee (DAC) meetings.

It should be noted that the structure of EC and its sub-committees should not preclude departmental management from creating and dissolving committees based on operational need. However, EC shall remain the most senior horizontal decision-making body in Health Canada.

Agenda setting

The business of EC is captured in the forward agenda of EC meetings as well as the fixed agenda of EC look ahead meetings. The forward agenda of EC meetings are populated by items:

Proposed by the chairs of the sub-committees and approved by the DM and AsDM
Proposed by branches and approved by the DM and AsDM
Requested by the DM and AsDM

Guidance for scheduling items at EC meetings

The scope of the issue suggests that it would benefit or requires input from multiple branches; or would require implementation by multiple branches (corporate policies, changes in internal/external service delivery, etc.).
The issue directly implicates the authority or accountability of multiple ADMs, the DM, the minister, cabinet or Treasury Board (e.g. memoranda to cabinet, regulatory amendments, compliance with central agency policies, etc.).
The issue involves or could involve significant financial materiality (e.g. financial transactions, resource allocations, capital planning, etc.).
The issue has policy implications with potentially significant impact to the department or the health of Canadians.

Branches are encouraged to use the same criteria in proposing items for EC consideration and are encouraged to interact with the EC Services for clarification as needed.

Membership

Chair:

Deputy minister/ associate deputy minister

Alternate chair:

ADM if designated by DM or AsDM

Members:

All assistant deputy ministers (ADMs) and associate ADMs
Executive director, pest management and regulatory agency
Senior general counsel (Legal services)

Observers:

Director general of evaluation and chief audit executive
Branch head of the office of international affairs
Health Canada ombuds
Executive director – equity, diversity and inclusion
Chief of staff to the deputy minister
Advisors to the associate deputy minister
Director general, policy coordination and planning directorate (PCPD)
Director, strategic policy, priorities and portfolio affairs

Members are expected to attend all meetings. Where this is not possible, EC members may designate a DG-level substitute for EC meetings, subject to the chair’s approval.

Guest presenters or observers may accompany a member for the presentation of an item, subject to the Chair’s approval. EC members are responsible for the preparation and timely submission of materials to executive committee services (ECS).

Frequency of meetings

EC meetings will be held weekly, or at the call of the chair
EC – look ahead meetings will be held weekly, or at the call of the chair
Additional special EC meetings may be organized at the call of the chair

Secretariat and administration

The Director general of policy coordination and planning directorate, with support from the strategic policy priorities and portfolio affairs division, and executive committee services are responsible for overall secretariat support for EC meetings, which includes:

Maintaining a forward agenda;
Providing guidance on the development of EC documents to be presented by EC members as needed;
Providing advice to the deputy and associate deputy minister on EC meeting agenda items;
Following up with branches post-meeting, as requested by the chair, to support the further development of the work presented;
Taking notes and preparing the records of decisions for EC meetings;
Coordinating overall logistics and distribution of documents;
Records management.

Procedures for executive committee meetings

1. Scheduling an item for a future EC meeting

The procedures described below apply primarily to EC meetings. EC look ahead meetings use a fixed agenda to plan short-term departmental business.

Proposing an agenda item to DMO for a future EC meeting

An item for a meeting may be either requested by the chair, proposed by a sub-committee chair or by a branch.
When a branch wishes to propose an agenda item for a future EC meeting, or is preparing an item at the request of DMO, it should submit sufficient information to ECS for appropriate planning in the forward agenda.
ECS will confirm when the item can be included in the forward agenda (subject to the chair’s approval).

Item summary (required for all items)

When an item is scheduled, an item summary (see appendix C) is required for each proposed EC agenda item, whether the item has been requested by DMO or suggested by a branch or a sub-committee chair.
The template distributed to ADMOs must be used to prepare item summaries (a copy of the template is attached as appendix C). The summary is to be provided in both official languages.
The item summary is used to determine appropriate timing and purpose of the item -decision or discussion. It also provides information on outcomes and recommendations from EC-subcommittees, as well as any previous discussions at EC, if any.

Cancellation or postponement of an item

To permit appropriate agenda planning, branches should advise EC as soon as possible of any cancellation or postponement of an item. For any cancellation or postponement within 2 weeks of a scheduled date, a rationale will need to be provided to EC.

2. Preparing documents for discussion and decision at EC Meetings

Unless otherwise specified in the action request, branches are to use their judgement to determine the documents most appropriate to support their items at an EC meeting.

Branches are expected to provide coherent, well-developed materials for EC consideration five business days in advance of the EC meeting to which they are assigned.

All documents submitted to EC must:

Be provided in both official languages
Have been approved by the sponsoring assistant deputy minister(s)
Be submitted by the requested deadline
Be submitted by e-mail if the matter is not SECRET or in hard copy or on a memory stick (password protected) if the matter is considered SECRET

If the document is being presented for decision, it must include:

Clearly identified options and recommendations
A clear statement of the decision being sought

3. Timelines

Deadlines	Deliverables
When a branch proposes an agenda item to DMO	Item summary for planning purposes is due in both official languages and must be ADM-approved
5 business days prior to the meeting, by 12:00 p.m	All documents are due in both official languages
2 business days prior to the meeting, by end of day*	Documents are circulated electronically to EC members through the secure database
2 business days prior to the meeting	Requests for the attendance of substitutes or guests (where applicable), for the chair’s approval
2 business days prior to the meeting	Requests for audio-visual equipment (where applicable)

* If documents are not provided as per the above deadlines, unless there are extenuating circumstances, the item will scheduled at a future EC meeting agenda, at the chair’s discretion.

4. Annex items

Annex items are for items that are intended for information purposes only and are not generally discussed.
At the discretion of the chair, contentious issues may result in the item being moved to a discussion item on that day’s agenda or at a subsequent meeting.

5. Presentation of items at EC meetings

It is expected that EC members will have reviewed the materials prior to EC meetings, and therefore, presenters will not go through a full presentation of material. Presentations will take no longer than five to ten minutes to specify the purpose of the presentation, articulate the decision sought from the committee, and highlight the salient points.

6. Participation in EC meetings

Procedures to be followed for participation at EC meetings are summarized below. Should you have any questions, please do not hesitate to contact EC Services (ECS).

Invitation

ECS sends an invitation to EC members in advance of each EC meeting.
EC members are expected to attend all EC meetings. Invitations indicate a deadline by which the participation of members must be confirmed. Should a member not be available to attend a meeting, his or her office must indicate the reason of their unavailability in their written response to ECS.

Substitutes

Should a member be unable to participate in a meeting, they may designate a DG-level substitute for EC meetings.
Requests for the attendance of a substitute must be sent to ECS no later than two business days in advance of the meeting.

Documents

The invitations are typically followed by electronic copies of the following documents for members (as soon as the documents are available): the agenda of the meeting; draft records of decisions from past meetings for members’ approval; the latest EC forward agenda; and the documents prepared for each item.

Guests

EC members may suggest the attendance of guests for certain agenda items. Requests for the attendance of guests are subject to the chair’s approval and must be submitted to ECS no later than two business days in advance of the meeting.

Equipment

Should a member or a guest presenter require the use of audio-visual equipment for their presentation, they must send a request to ECS no later than two business days in advance of the meeting to ensure that proper arrangements can be made.

7. Records of decision

A record of decision is prepared for each EC meeting.
A draft record of decisions will be circulated to members for their review and approval at a subsequent EC meeting.
An action list is prepared and distributed to EC members for EC look ahead meetings. At the discretion of the chair, a record of decision may be prepared for policy or management items that are discussed at EC look ahead meetings.
Members are responsible for communicating the outcome of EC discussions to their management team, as appropriate, as well as sharing the related content of records of decisions. Should an employee wish to obtain feedback about the presentation of an item at EC meeting, they may contact their assistant deputy minister’s office to obtain this information.

Appendix – EC item summary

Item (title)	Ensure the title of the item reflects the issue being presented at EC and corresponds with the presentation material.
Proposed date	Insert date proposed/requested for presentation.
Presenters, clickers and observers	Please name presenter(s), clicker, and observer(s).
Decision	What is the decision(s) being sought by the deputy minister/EC? Define the main issue requiring a decision. What is the desired outcome?
Discussion	What is the direction being sought by the deputy minister/EC? Define the main issue needing direction. What are the key issues that require consideration for moving forward? Clearly define what issues are relevant across the department and the key issues that require consideration for moving forward.
Annex items (for information)	In what context is the information being shared?
Rationale for presentation	To allow the departmental secretariat to assign priority to items on the forward agenda, please state the following: Clearly state why this item requires the attention of EC members; Clearly indicate any timing imperatives for the presentation and repercussions if the presentation is rescheduled; Links between this item and departmental and government priorities (e.g. speech from the throne, the MAF and/or PAA strategic outcomes), where applicable.
Status with DMO/MO	Status of this item with the deputy minister’s office/ minister’s office. Please indicate if this item has been considered at an EC meeting. Include reference to previous or future briefings; memoranda or any other work submitted/in progress to both offices; and due dates.
Status with sub-committee	If this item has been considered by an EC sub-committee please indicate the sub-committee, the date it was presented, and the outcome. All items proposed to EC must first be considered at the appropriate sub-committee. Please indicate if an item was not considered at a sub-committee meeting due to timing reasons.
Lead branch

Roles and responsibilities of the departmental evaluation committee

This committee serves as an advisory body to the deputy head related to the departmental evaluation plan, resourcing, and final evaluation reports and may also serve as the decision-making body on other evaluation and evaluation-related activities of the department. The departmental evaluation committee:

Reviews the adequacy of evaluation coverage, as expressed in a departmental evaluation plan developed by the head of evaluation, as well as the risk-based approach used for determining the evaluation approach and level of effort to be applied to the individual evaluations comprised in the plan, and recommends the plan for approval by the deputy head.
If requested by the head of evaluation: reviews and recommends approval of key elements of an evaluation, such as the terms of reference; and considers and responds to key evaluation-related issues.
Reviews final evaluation reports, including management responses and action plans, and recommends approval to the deputy head.
Ensures follow-up to action plans approved by the deputy head.
Reviews the adequacy of resources allocated to the evaluation function and recommends to the deputy head an adequate level of resources consistent with the departmental evaluation plan.
Reviews the adequacy of resources allocated to performance measurement activities as they relate to evaluation, and recommends to the deputy head an adequate level of resources for these activities.
Reviews the performance of the evaluation function, and recommends action to address any weaknesses.

Expert and advisory committees

Canadian Animal Health Products Regulatory Advisory Committee (CAHPRAC)

Pest Management Advisory Council

Scientific Advisory Board on Vaping Products (2021-2024)

Scientific Advisory Committee - Health Products for Women (SAC-HPW)

Scientific Advisory Committee - Medical Devices Used in the Cardiovascular System (SAC-MDCS)

Scientific Advisory Committee - Oncology Therapies (SAC-OT)

Scientific Advisory Committee - Respiratory and Allergy Therapies (SAC-RAT)

Scientific Advisory Committee on Digital Health Technology (SAC-DHT)

Science Advisory Committee on Pest Control Products

Youth Leadership Team on Tobacco and Vaping

Boards with deputy minister of health representation

As deputy minister, you will have a seat on several boards. For your reference, below are the boards where either the Deputy Minister is a member or the authority has been delegated.

Canadian Health Institute of Health Research (CIHR) – governing council

CIHR is governed by a governing council of up to 18 members. It’s role is to develop strategic directions and goals, evaluate overall performance, approve budget, establish, maintain and terminate Institutes and reviews the mandate and performance, provide advice to the Minister of Health. Deputy Minister of Health is an ex-officio member of the council.

The Canadian Institute for Health Information (CIHI)

CIHI’s 17-member Board of directors is proportionately constituted to create a balance among health sectors and regions of Canada. It links federal, provincial and territorial governments with non-governmental health-related groups. CIHI’s board serves as a national coordinating council for health information in Canada and fulfills 4 key roles: stewardship, advisory, fiduciary and monitoring. Deputy Minister of Health is expected to be a member of the board.

Canada’s Drug Agency (CDA)

The Board of Directors has overall responsibility for administering the affairs of the corporation and providing the strategic direction to guide our success as the Canadian "go-to" provider of evidence and advice on the use of drugs and other health technologies. Currently Michelle Boudreau, Associate Assistant Deputy Minister, sits on the board of directors.

Canada Health Infoway (Infoway)

The board of directors meets at least four times a year and has overall responsibility for the approval of investment program strategies, the annual summary corporate plan and key strategic directions. Currently Jocelyne (Jo) Voisin, Assistant Deputy Minister of Health Canada, sits on the board of directors.

Health Workforce Canada

Mandate: is the recently established centre of excellence to improve health workforce data, planning and knowledge translation to action. Its establishment responds to the Government of Canada’s budget 2023 commitments to support improvements to health workforce data as well as federal/provincial/territorial health ministers’ commitment to take concrete actions to address health workforce challenges. Currently Jocelyne (Jo) Voisin, Assistant Deputy Minister of Health Canada, sits on the board of directors for the deputy minister.

Healthcare Excellence Canada

This is the amalgamated organization of the Canadian Patient Safety Institute and the Canadian Foundation for Healthcare Improvement. It works with patients and other partners to share proven innovations and best practices that lead to lasting improvements in patient safety and healthcare quality. The board of directors is a voluntary group that includes a diverse group of leaders who are passionate about improving healthcare, with—and for—everyone in Canada. Currently Jocelyne (Jo) Voisin, Assistant Deputy Minister of Health Canada, sits on the board of directors.

The Canadian Centre on Substance Use and Addiction (CCSA)

The board of directors is a voluntary group composed of thirteen members that meets three to four times per year. The board represents the business and labour community and professional and voluntary organizations. These organizations also have a particular interest in alcohol and drug use that the board considers appropriate. Currently Eric Costen, Acting Deputy Minister of Health Canada, sits on the board and has also membership to Associate Assistant Deputy Minister of the controlled substances and cannabis branch.

The Canadian Partnership Against Cancer (CPAC)

The board of directors bring regional, professional and personal perspectives to our work and help drive measurable change that will benefit all Canadians with cancer.

The board is made up of representatives from cancer and health organizations; federal, provincial and territorial government agencies and departments; Indigenous representatives; patient organizations; individuals and families affected by cancer; clinicians and health-care providers; and researchers. Currently Jocelyne (Jo) Voisin, Assistant Deputy Minister of Health Canada, sits on the board of firectors.

The Mental Health Commission of Canada (MHCC)

The board of directors includes eleven members that share a common goal—to create a better mental health system for all Canadians. Currently Michelle Boudreau , Associate Assistant Deputy Minister, sits on the board of directors.

III. Health system players

A. Overview of the health portfolio

Health portfolio at a glance

Responsible for helping Canadians maintain and improve their health

Under your direct purview

Health Canada (HC)

Promotes and helps protect the health and safety of Canadians by regulating products such as drugs, medical devices, consumer products, cosmetics, food and managing the health risks of substances. HC supports universally accessible, publicly funded health care for Canadians through stewardship of the Canada Health Act, leadership on issues such as mental health, substance use and digital health and collaboration with provinces and territories on health system improvements.

Public Health Agency of Canada (PHAC)

Promotes and protects public health and health equity in Canada by preparing for and responding to public health issues and emergencies through national leadership, science, policy, programs and partnerships. Its activities focus on the prevention of disease and injury and the promotion of physical and mental health and wellbeing for all. PHAC facilitates a national approach to public health policy and planning and serves as a central point for sharing Canada’s health expertise both within Canada and with international partners.

Canadian Food Inspection Agency (CFIA)

Protects Canada and Canadians from food, plant, and animal health risks inherent in the modern environment, while supporting Canadian agriculture and agri-food businesses as they compete, innovate and grow in domestic and global markets (Minister of Agriculture and Agri-food), while the overall administration of CFIA including food safety, remains under the Minister of Health.

Arm’s-length organizations

Canadian Institutes of Health Research (CIHR)

Canada's federal funding agency for health research. Composed of 13 institutes, CIHR collaborates with national and international partners to support discoveries and innovations that improve Canadians’ health and strengthen Canada’s health care system. CIHR is a source of scientific evidence to inform the government’s decisions.

Patented Medicine Prices Review Board (PMPRB)

Quasi-judicial body that protects consumers and contributes to health care by ensuring that the prices of patented medicines sold in Canada are not excessive. The PMPRB also informs Canadians by reporting on pharmaceutical trends.

Role of the health portfolio

Managing risks to health

Maintaining readiness and responding to public health threats and emergencies (e.g. COVID-19 pandemic), such as providing domestic and international health security leadership, pandemic preparedness, border and travel health, supporting rapid research mobilization and nuclear emergencies (PHAC, HC, CIHR, CFIA).
Assessing, managing, and supporting research on health risks of controlled substances, alcohol, antimicrobial resistance, consumer products, cosmetics, chemicals, radiation, pesticides, climate change and addressing population harms of tobacco, in collaboration with partners and Indigenous peoples (HC, PHAC, CIHR, CFIA).
Managing food-related health risks through strong food safety regulations, surveillance, research and enforcement (PHAC, CFIA, CIHR).
Promoting mental health and well-being for Canadians (HC, PHAC, CIHR) and providing mental and occupational health advice and services to the federal public service (HC).
Overseeing the legal cannabis regime, including administering the Cannabis Act, granting licenses for production, and monitoring compliance with regulations (HC, CFIA).
Taking compliance and enforcement actions in relation to relevant acts and regulations (HC).

Supporting health research and science, data collection and surveillance capacity

Funding research to generate knowledge, improve health and health services, inform government priorities and decision-making, and support health innovation (CIHR).
Investing in knowledge mobilization and the dissemination of research evidence and data to improve the health care system and the health of Canadians (CIHR).
Building research capacity in under-developed areas, and training the next generation of health researchers (CIHR).
Promoting equity, diversity and inclusion (EDI) in the research system and the incorporation of EDI in research design and activities.
Supporting Indigenous health research, knowledge mobilization and capacity-building (CIHR).
Strengthening surveillance, risk analysis and risk intelligence research and public education on chronic and emerging infectious diseases.
Improving diagnostic, risk identification and analysis, and scientific capacity through national labs, to detect serious and emerging diseases.
Reporting on pharmaceutical trends of all medicines, and research and development spending by patentees (PMPRB).
Conducting research, monitoring and surveillance on health impacts of environmental contaminants, climate change and substances (HC).

Enabling access to safe and effective health products

Assessing, and regulating health products, including vaccines, to ensure their safety, effectiveness and quality, through a world class, modern regulatory regime (HC).
Monitoring health product safety and communicating risks to Canadians (HC).
Funding and overseeing clinical trials to ensure the integrity of the data and participants (HC, CIHR).
Working with stakeholders to mitigate shortages of therapeutic products (HC).

Strengthening Canada’s universal health care system

Stewardship of universally accessible, publicly-funded health care for Canadians through administration of the Canada Health Act (HC).
Providing leadership on emerging issues such as mental health, substance use, and digital health, and working multilaterally and bilaterally with provinces and territories on system improvements (HC).
Leading pan-Canadian initiatives on system innovation and quality improvements in new and emerging areas of health care (HC).
Investing in pan-Canadian health Organizations to drive progress on health system priorities (HC).
Administering and managing federal grants and contributions programs to support health system innovation and priorities (HC, CIHR).
Enhancing the affordability, accessibility and appropriate use of prescription drugs (HC, PMPRB).
Improving cultural safety, humility and responsiveness in the health system to improve Indigenous health and address racism (HC).

Supporting Canadians in making safe and healthy choices

Informing and engaging Canadians by being a trusted source of information on health and safety (HC, PHAC, CFIA), including:

The COVID-19 global pandemic (PHAC, HC);
The opioid overdose crisis (HC, PHAC); and
A range of health and safety issues, such as food and alcohol choices, health products, smoking prevention and cessation, youth vaping, cannabis use, concussion treatment, consumer product safety, safe food practices, and the safe use of hazardous products (HC,PHAC).
Addressing root causes of health inequalities and common risks that are important in preventing and avoiding disease, including disease surveillance, creating environments that support healthy choices, reduce chronic diseases, and support healthy aging (PHAC, HC, CIHR).

Provincial/territorial partners

PTs administer public health insurance plans for medically necessary services; plan and finance hospital care, physician and allied health services; deliver other services (drug plans, home care, etc.) on a discretionary basis; administer aspects of public health; collect and manage data critical for PH reporting and decision-making; and negotiate fee schedules for health professionals.
FPT governments must often collaborate to advance key health priorities for Canadians.

Indigenous partners

Engage with First Nations, Inuit and Métis to improve health outcomes and work to address inequities experienced by Indigenous peoples.

Federal government departments

Work collaboratively with other government departments on areas of shared priority/responsibility.

Health partners/industry/community stakeholders

Work with health stakeholders, including professional associations, regulatory bodies, standards development organizations, the research community, patient groups, communities with a stake in public health, social media influencers/risk communicators and industry to ensure responsive approaches to Canadians’ health needs.

International partners

Engage internationally to protect and advance Canadian health interests.
Participate in multilateral fora, particularly the World Health Organization, World Organization for Animal Health, and Food and Agriculture Organization of the United Nations.
Foster bilateral relationships with key partners and regions.
Partner on health research that affects Canadians and the global community, and position Canadian researchers as leaders.

Overview of Indigenous/federal/territorial roles and relations in health

Indigenous health

The provision of health services to Indigenous peoples is an area of shared responsibility between FPT governments and Indigenous partners. Provincial/territorial (PT) governments provide universally accessible and publicly insured health services to all residents, including Indigenous Peoples. Whereas Indigenous Services Canada (ISC) funds or directly provides supplemental health programs and services for registered/Status First Nations (primarily on-reserve) and recognized Inuit in addition to what is provided by PTs. ISC also administers the non-insured health benefits program, which provides eligible First Nations and Inuit clients, regardless of where they reside, a range of health benefits such as prescription drugs, vision and dental care and medical supplies and equipment and medical transportation to access health services. PHAC also delivers off-reserve programs, such as the aboriginal head start in urban and northern communities program.

Further, Indigenous governments and communities may be involved in directing, managing, and delivering a range of health programs and services, which vary by PT. Examples include the BC First Nations Health Authority and the Cree Board of Health and Social Services of James Bay in Quebec.

Recognizing the significant disparities in Indigenous health outcomes compared to the non-Indigenous population, federal departments are committed to working with PTs to ensure First Nations, Inuit and Métis partners are included in discussions to improve access to health services and health outcomes of Indigenous Peoples and discuss progress in these areas.

Health Canada ensures compliance with federal obligations through routine engagement with Indigenous partners where legislation, regulations, policy or programs might impact on their rights under Section 35 of the Constitution Act, within the cabinet directive on the federal approach to modern treaty implementation (2015) and the collaborative modern treaty implementation policy (2023), and under the UN Declaration Act (2021) to participate in decision-making on matters that affect them, including health (Article 18) and commits to consult and cooperate in good faith (Article 19). Additionally, the health portfolio is jointly responsible for four truth and reconciliation commission’s calls to action (19, 20, 22, and 23) and for murdered Indigenous women and girls (MMIWG) calls for justice related to health (3.1-3.7). Both of which commit to improving health equity, addressing discrimination and racism, and supporting self-determination and active involvement in developing policy, legislation, and programs.

As part of the governance structure, regular forums provide a platform for ongoing dialogue, feedback, and collaboration between Indigenous partners and ministerial and senior officials. These include the annual permanent bilateral mechanisms with three national Indigenous organizations (NIOs): Assembly of First Nations; Inuit Tapiriit Kanatami (and the four Inuit Nunangat regions); and Métis National Council and its governing members; and the intergovernmental leaders forum between the Prime Minister, appropriate federal ministers, and leaders of modern treaty and self-governing Indigenous governments.

The federal government has also affirmed Joyce’s Principle aimed at guaranteeing that all Indigenous people have a right of equitable access to all social and health services, without any discrimination as well as a right to enjoy the best possible physical, mental, emotional, and spiritual health. Under Jordan’s Principle, the federal government ensures that all First Nations children living in Canada can access products, services and supports regardless of jurisdictional responsibility. Additionally, the Inuit Nunangat policy applies to all federal departments and agencies, guiding them in the design, development, and delivery of all new or renewed federal policies, programs, services, and initiatives that apply in Inuit Nunangat.

The health portfolio is also involved in a range of activities, in collaboration with Indigenous, federal, and PT partners, to improve Indigenous health outcomes. For example, Health Canada is working closely with ISC on advancing the $2B over ten years Indigenous health equity fund that was part of the February 7, 2023 health funding announcement by the Prime Minister. The fund will support First Nation, Inuit, and Métis partners in helping to address health care gaps faced by Indigenous peoples. Health Canada also continues to support ISC on the co-development of Indigenous health legislation and addressing anti-Indigenous racism in Canada’s health systems.

FPT roles and responsibilities in health

Health is an area of shared responsibility among the federal government and PT governments. Health services delivery, the administration of provincial/territorial health insurance plans, and the regulation of health professions fall within PT jurisdiction.

The federal government supports universally accessible, publicly funded health care for Canadians through transfer payments to PTs via the Canada health transfer (CHT) and the administration of the Canada Health Act (CHA). The CHA establishes the requirements that PT health insurance plans must meet to receive their full cash contributions under the CHT. As the largest major transfer to PTs, the CHT is intended to provide long-term, predictable funding for health care.

Federal responsibilities include protecting health and safety through regulation, health security and emergency preparedness and response, health promotion and chronic disease prevention, infectious disease prevention and control, as well as support for health research and innovation.

While PTs must provide all residents with universally insured health services, the federal government is also responsible for the financing and administration of a range of health benefits and services for federal populations (i.e., primary health care services for members of the Canadian Armed Forces, inmates in federal penitentiaries, and refugee claimants; and supplementary benefits for registered/status First Nations and recognized Inuit, the Royal Canadian Mounted Police, and veterans). 

Additional areas of responsibility where both federal and PT levers can support common objectives include, amongst others, all aspects of public health such as surveillance, infectious disease prevention and control, health promotion and chronic disease prevention, as well as health security and emergency preparedness (including coordinating pandemic response efforts). Federal environmental health guidelines and regulations also provide guidance for provincial/territorial implementation and stewardship efforts. Both orders of government and their respective health organizations share responsibility for the collection and analysis of health information, and for funding research and innovation initiatives.

The diagram below summarizes the roles and responsibilities of FPT governments, including areas of overlap:

Federal government

Stewardship of canadian medicare;
Administration of the Canada Health Act (CHA);
Uses “spending power” to provide financial support to PTs tied to CHA principles;
Supports health care improvement and innovation;
Regulates market access for health products including drugs, medical devices, controlled substances, consumer and pest control products;
Regulates patented drug prices;
Provides funding and/or delivers some health care programs/services to federal populations such as First Nations and Inuit, federal inmates, military, and refugee claimants;
Coordinates national responses to public health emergencies and national public health surveillance;
Administers Canada dental benefit and upcoming Canadian dental care plan.

Provinces/territories (PTs)

Administer PT health insurance plans and other health care programs (e.g., drugs);
Deliver health services;
Determine organization and governance of the system;
Regulate health care facilities and professionals (e.g., physicians, nurses);
Regulate private health insurance;
Manage capital investments;
Negotiate drug purchasing and pricing for their drug plans.

Federal/provincial/territorial

Fund health care and public health;
Support health research and innovation;
Prevent, control and reduce infectious and chronic diseases;
Promote the health and well-being of Canadians;
Prepare for and respond to public health events and emergencies;
Collect and analyze health data and information;
Develop science-based public health advice;
Communicate risk and public health advice;
Fund health care for eligible First Nations and Inuit;
Dental care / oral care.

FPT collaboration

Canada’s health system has been shaped by key FPT legislative activities and policies spanning decades, and it has evolved to respond to changing population needs and fiscal capacity. Ongoing FPT collaboration is crucial, as both orders of government must work together to address a full range of health priorities. This is especially true in areas where responsibilities intersect, such as funding healthcare services, responding to public health emergencies, preventing chronic disease and the spread of infectious and communicable diseases, and health promotion, amongst others.

FPT governments continue to collaborate on a number of high-profile priorities, including expanding access to family health services, reducing backlogs and supporting health care workers, improving access to quality mental health and substance use services, modernizing health systems through the use of health data and digital tools, overseeing medical assistance in dying, managing drug supply disruptions and shortages, the affordability and accessibility of prescription drugs, anti-microbial resistance (AMR), and dental care, to name a few. Many of these areas require ongoing and robust FPT engagement with other sectors (e.g., agriculture, justice, and public safety). The health portfolio also frequently acts as a focal point for other sector engagement with PTs on health-related issues (e.g., Indigenous Services Canada, and Immigration, Refugees and Citizenship Canada).

FPT relations landscape

The level of FPT collaboration during the COVID-19 pandemic was unprecedented and helped ensure a pan-Canadian response to the pandemic. Areas of collaboration focused on procurement and distribution of personal protective equipment; vaccines; public health and clinical guidance; communications and education; testing and screening, surveillance, and national reporting; border measures; and health system capacity. Considerable federal funding, programs and procurement backed these efforts, including health-related investments through the safe restart agreement, and federal surge support made available through PHAC’s single-window to assist jurisdictions with health human resources, physical assets and supplies, and vaccination and epidemiological support, among others.

However, by the latter half of 2022, the FPT landscape and relationship became more heavily influenced by PT demands for broader health system funding and was hampered by direction from the council of the federation (CoF) to limit engagement on any new priorities until their calls for an increase to the CHT were met. The February 7, 2023 working meeting between the Prime Minister and PT Premiers marked a significant shift as the federal government announced its plan, providing a $2B top up in 2022 as well as a guaranteed 5% growth to the CHT for 5 years, and $25B over 10 years (beginning in 2023-24) in bilateral funding to support the priorities of:

Expanding access to family health services
Reducing backlogs and supporting health care workers
Improving access to mental health and substance use services
Modernizing health systems with health data and digital tools

These investments are available to PTs through two bilateral agreements:

The first set of funding agreements provide access to the first three years of funding to support the four new shared health priorities, as well as three years of funding for mental health and addictions services from Budget 2017 to advance the common statement of principles on shared health priorities (CSOP), beginning with a three-year agreement, supported by action plans for the same length of time.
The second set of agreements support the shared priority of helping people in Canada age with dignity and include the remaining $2.4B funding over four years for home and community care from the 2017 Budget to advance the CSOP commitments; and the $3B funding over five years for long-term care from budget 2021.
- Both sets of bilateral agreements were signed with all jurisdictions by the end of FY 2023-24.
- Negotiations are now underway with PTs to access the $1.709B available over 5 years to support wage increases for personal support workers and related professions and support other recruitment/retention measures starting in 2024-25. Access to this funding will be provided vis a vis an addendum to the aging with dignity agreement.

The use of bilateral health agreements has been an effective tool in advancing other common health objectives including:

$150M emergency treatment fund (2018) to support PTs in responding to the opioid crisis
$150M virtual care bilateral agreements to support PTs acceleration of virtual care during the pandemic (2021)
$1B for the safe long-term care Fund (2021) (via amendments to the home care/mental health bilateral agreements)

A similar approach is being pursued to flow funding to willing PTs in support of the national strategy for rare diseases and will also be used in support of the Pharmacare Act, following royal assent.

At the same time, however, PTs are becoming concerned with the degree of perceived federal overreach. In advance of the recent CoF meeting, held July 15 – 17, 2024, in NS, Premiers wrote to the PM reiterating calls for the federal government to “refrain from unilateral actions” and respect PT jurisdiction in matters including health care. These sentiments were echoed in their subsequent communiqué issued at the end of the meeting, where they further specified that “federal initiatives such as dental care, pharmacare, and long-term care must be developed in a way that is truly collaborative, aligns with provincial and territorial priorities, and respects jurisdiction.”

IFPT engagement

Building on the previous commitments made in the 2017 CSOP on shared health priorities, the February 7, 2023 working together plan set out that PTs would “agree to continue engaging with Indigenous peoples, organizations, and governments to ensure their right to fair and equitable access to quality and culturally safe health services free from racism and discrimination anywhere in Canada.”

The letter from then-Ministers Duclos and Bennett to PTs on February 15, 2023 also stated that “PT governments will also be encouraged to work in partnership with Indigenous organizations within their jurisdiction to support culturally safe and appropriate care for Indigenous peoples and leverage opportunities to align projects with the $2B Indigenous health equity fund.”

To support these efforts, Minister Duclos and Minister Hajdu (ISC) sent a joint letter to all jurisdictions (except QC) inviting them to participate in trilateral discussions with Indigenous leaders to help facilitate discussion on ways the funding can improve Indigenous access to quality and culturally safe health services.

Health Canada and ISC successfully convened trilateral meetings with all PTs (except QC) and their regional Indigenous partners in 2023-24 to support the development of PTs’ initial 3-year action plans. Efforts are also underway in those jurisdictions where a commitment was made to have follow-up meetings as well as scheduling meetings with the Métis National Council (MNC) governing member in Ontario, Alberta and Saskatchewan who were absent from the original trilateral meetings.

Health Canada is also working closely with ISC to help ensure that PTs are working closely with regional Indigenous partners to advance their action plans to support new healthcare funding under the working together plan.

Health and inclusion were among the key issues raised by NIOs during their meeting with Premiers on June 15. The meeting involved leaders of the AFN, MNC and ITK, and participation was also extended to the Native Women’s Association of Canada (NWAC), Congress of Aboriginal Peoples (CAP) and Nova Scotia Mi’kmaw Chiefs.

Core FPT health machinery

Ongoing collaboration is maintained through well-developed formal structures including: FPT health ministers’ meetings (HMM), meetings of deputy ministers (known as the conference of FPT deputy ministers of health, or CDM), and the pan-Canadian public health network (PHN).

The HMM forum is the key intergovernmental table through which FPT Ministers of Health discuss and provide collective direction on priority health issues and advance collaborative FPT work. The federal Health Minister is the co-chair of the HMM, and the Deputy Minister of Health Canada acts as co-chair of the CDM. Provincial/territorial co-chairs are nominated at the provincial/territorial level, and usually rotate annually following the annual in-person HMM. A network of committees (standing and ad hoc) supports the CDM and HMM on various files (Appendix A). In 2024, NS formally assumed the co-chair role from PEI. During their co-chair tenure, PEI hosted an in-person HMM in Charlottetown on October 11-12, 2023. The next face-to-face HMM is anticipated to be held in Halifax, in early November (week of November 11, date TBC). Timing may be also influenced by anticipated PT elections in the latter part of October (BC, NB, and SK).

FPT Ministers responsible for Mental Health and Substance Use have also been collaborating through dedicated MHSU ministerial meetings, supported by deputies and a recently established FPT ADM committee on mental health and substance sse. Along with the federal Minister of Mental Health and Addictions, 8 PTs now have separate, dedicated ministers (BC, AB, SK, MB, ON, QC, NB, and NS).

Throughout the pandemic, engagement at the CDM and HMM level was at an all-time high with weekly HMM teleconferences, and daily CDM calls during the early months, to ensure coordination and sharing of information at the most senior levels. Meeting frequency has been reduced post-pandemic, and PTs continue to express a desire to continue at a moderate meeting pace (e.g., quarterly FPT CDMs) with additional time built in for forward planning on agendas and meeting schedules. In addition to the annual fall in-person HMM, CDM meet 1-2 times per year in person. Any additional meetings for these tables as well as MHSU ministers are generally held virtually. The most recent in-person FPT CDM took place June 26-27, 2024, in Halifax.

Regular collaboration on public health occurs through the PHN structure and its network of supporting committees. Through the PHN, jurisdictions work collaboratively on a broad range of issues to strengthen public health in Canada, including health promotion, chronic disease prevention, public health infrastructure, emergency preparedness and response, and infectious diseases. The PHN recently finalized its 5-year strategic plan, as they look to reset their strategic priorities and structure following the pandemic. The strategic plan sets out key priorities in public health data, emergency management, communicable and infectious diseases, and health promotion and chronic disease prevention. The PHN is also focused on foundational elements of its work, including a commitment to upholding Indigenous rights and advancing reconciliation.

The 17-member PHN council (comprised of ADM-level FPT government officials responsible for public health) is accountable to the CDM, which provides direction and approves public health policy priorities for Canada. The Council of Chief Medical Officers of Health (CCMOH), which includes Chief Medical Officers of Health from all jurisdictions, is also responsible for technical collaboration and public health expert and scientific advice on technical issues and falls under the PHN. The CMOH from the First Nations Health Authority in BC is a member of CCMOH, and the council is seeking to expand membership to additional Indigenous CMOHs. Health Canada’s representative on the PHN council and CCMOH is Dr. Supriya Sharma, Chief Medical Advisor.

The PHNC has the authority to create FPT special advisory committee (SAC) which areas time-limited emergency mechanisms to advise the CDM and provide public health leadership to support a pan-Canadian, coordinated public health approach as required. SAC members include the Chief Medical Officers of Health from all PTs, the Chief Public Health Officer of Canada, and Chief Medical Officers from key federal departments, along with ADMs of public health from jurisdictions. The Committee is chaired by the co-chairs of the PHN council, Dr. Theresa Tam, Canada’s Chief Public Health Officer, and the current PT co-chair, New Brunswick’s Chief Medical Health Officer, Dr. Yves Léger. The SAC on COVID-19 was activated in January 2020 and deactivated in July 2023. A SAC on MPOX was activated in July 2022 and deactivated in December 2022. A SAC continues to address the toxic drug poisoning crisis. In addition, an ad hoc committee of senior leaders, consisting of CMOHs and Chief Veterinary Officers has been convening to support readiness and response on highly pathogenic avian influenza.

Additional FPT machinery

The federal Minister Sport and Physical Activity, supported by the Public Health Agency of Canada (PHAC) and Sport Canada, co-chairs the FPT Ministers of Sport, Physical Activity and Recreation (SPAR) table, alongside the Minister of Heritage and a PT co-chair (currently NL). The SPAR table is comprised of three distinct, but interrelated sectors: sport, physical activity, and recreation. PHAC’s President is one of three co-chairs of the FPT conference of deputy ministers of SPAR, with responsibility for physical activity items.

The President of the Canadian Food Inspection Agency (CFIA) participates at the FPT Ministers and Deputy Ministers of Agriculture meetings on matters pertaining to food safety, plant, and animal health as well as trade and market access for the agriculture sector.

The FPT food safety committee, on which Health Canada and CFIA participate, provides federal and provincial/territorial government leadership and partnership in food safety.

Additional FPT Committees have been established on mental health and substance use, cannabis legalization and regulation, antimicrobial resistance, health data, dementia, health workforce issues, medical assistance in dying, drug shortages, and interprovincial health insurance agreements, among others.

Health research and innovation

The Canadian Institutes of Health Research (CIHR) works closely with members of the National Alliance of Provincial Health Research Organizations as key partners in the Canadian health research ecosystem.

Canada’s strategy for patient-oriented research (SPOR) is a national coalition of stakeholders, dedicated to the integration of research into patient care, led by CIHR at the federal level, in close collaboration with PT partners. SPOR-funded health research and platforms provide a collaborative, co-led and co-funded FPT mechanism to address jurisdictional and national priorities, improving the health of Canadians and the FPT health care systems, including their cost-effectiveness.

To keep pace with current health care and health research realities, CIHR is leading a refresh of SPOR. From fall 2023 to spring 2024, CIHR undertook a formal engagement process with partners and the public. A “What We Heard” report will be published on the CIHR website in late Summer or early Fall 2024. Following its release, CIHR will plan to engage with FPT partners through formal FPT tables in Fall 2024.

CIHR is committed to working with the PTs to improve access to mental health and substance use services, for example, through integrated youth services (IYS). IYS is an approach that provides a one-stop-shop for youth ages 12-25, that brings together service providers, youth and their families, and communities to address and deliver responsive and culturally relevant services. As part of building a Canada-wide network of provincial and territorial learning health systems for IYS that allows for data-driven research and sharing of best practices across jurisdictions, CIHR is currently investing $9M over 5 years in six IYS provincial networks and the national Indigenous IYS networks to help these networks do more research; collect, process and share data; and coordinate their work. Along with partner funding, CIHR has also committed $21M in upcoming funding to expand this network to all PTs; over $10M to enable the Indigenous IYS network develop into a true pan-Canadian, distinctions-based, integrated network; and $18M for an IYS data platform to enable more comprehensive data sets on youth mental health and substance use.

Lastly, CIHR works to accelerate the self-determination of Indigenous eoples in health research by supporting research that is driven by, and grounded in, Indigenous communities and that addresses the health challenges and inequities experienced by Indigenous peoples, including racism within Canada's health care systems.

List of provincial/territorial ministers responsible for health

British Columbia, Adrian Dix
Minister of Health / Minister Responsible for Francophone Affairs (appointed July 18, 2017)

Alberta, Adriana LaGrange
Minister of Health (appointed June 9, 2023)

Saskatchewan, Everett Hindley
Minister of Health (appointed August 29, 2023)

Manitoba, Uzoma Asagwara
Minister of Health, Seniors and Long-Term Care (appointed October 18, 2023)

Ontario, Sylvia Jones
Minister of Health / Deputy Premier (appointed June 24, 2022)

Québec, Christian Dubé
Minister of Health and Social Services (appointed October 20, 2022)

New Brunswick, Bruce Fitch
Minister of Health (appointed July 15, 2022)

Nova Scotia, Michelle Thompson
Minister of Health and Wellness / Minister Responsible for the Office of Healthcare Professionals Recruitment (appointed August 31, 2021)

Prince Edward Island, Mark McLane
Minister of Health and Wellness (appointed April 14, 2023)

Newfoundland and Labrador, John Logan, K.C.
Interim Minister of Health and Community Services (appointed July 8, 2024)

Yukon, Tracy-Anne McPhee
Minister of Health and Social Services (appointed May 3, 2021)

Northwest Territories, Lesa Semmler
Minister of Health and Social Services (appointed December 12, 2023)

Nunavut, John Main
Minister of Health / Minister Responsible for Suicide Prevention / Minster Responsible for Seniors (appointed November 19, 2021)

List of provincial/territorial ministers responsible for mental health

British Columbia, Jennifer Whiteside
Minister of Mental Health and Addictions (appointed December 7, 2022)

Alberta, Dan Williams
Minister of Mental Health and Addiction (appointed June 9, 2023)

Saskatchewan, Tim McLeod
Minister of Mental Health and Addictions / Seniors and Rural and Remote Health (appointed August 29, 2023)

Manitoba, Bernadette Smith
Minister of Housing, Addictions and Homelessness (appointed October 18, 2023)

Ontario, Michael Tibollo
Associate Minister of Mental Health and Addictions (appointed June 20, 2019)

Québec, Lionel Carmant
Ministre responsable des Services Sociaux (appointed October 18, 2018)

New Brunswick, Sherry Wilson
Minister responsible for Addictions and Mental Health Services / Minister responsible for Women’s Equality (appointed June 27, 2023)

Nova Scotia, Brian Comer
Minister responsible for the Office of Mental Health, Youth and Communications (appointed August 31, 2021)

Prince Edward Island
No separate Minister for Mental Health and Addictions

Newfoundland and Labrador
No separate Minister for Mental Health and Addictions

Yukon
No separate Minister for Mental Health and Addictions

Northwest Territories
No separate Minister for Mental Health and Addictions

Nunavut
No separate Minister for Mental Health and Addictions

Supplementary contacts

British Columbia, Sheila Malcolmson
Minister of Social Development and Poverty Reduction (appointed December 7, 2022)

Alberta, Jason Nixon
Minister of Seniors, Community and Social Services (appointed June 9, 2023)

Ontario, Raymond Cho
Minister for Seniors and Accessibility (appointed June 29, 2018)

Ontario, Stan Cho
Minister of Long-Term Care (appointed May 7, 2024)

Québec, Sonia Bélanger
Ministre déléguée à la Santé et aux Aînés (nommé au portefeuille 20 octobre 2022)

Nova Scotia, Barbara Adams
Minister of Seniors and Long-Term Care (appointed August 31, 2021)

New Brunswick, Kathy Bockus
Minister for Seniors (appointed June 27, 2023)

Newfoundland and Labrador, Paul Pike
Minister of Children, Seniors and Social Development / Minister Responsible for the Status of Persons with Disabilities / Minister Responsible for the Community Sector / Minister Responsible for the Newfoundland and Labrador Housing Corporation (appointed June 14, 2023)

Prince Edward Island, Barb Ramsay
Minister of Social Development and Seniors (appointed April 14, 2023)

Northwest Territories, Lesa Semmler
Minister Responsible for Seniors / Minister of Health and Social Services / Minister Responsible for Persons with Disabilities (appointed December 12, 2023)

Nunavut, Pamela Gross
Deputy Premier / Minister of Education / Minister of Culture and Heritage / Minister Responsible for Languages / Minister Responsible for Seniors (appointed March 15, 2023)

List of provincial/territorial deputy ministers responsible for health

British Columbia, Stephen Brown
Deputy Minister of Health (appointed June 10, 2013)

Alberta, Andre Tremblay
Deputy Minister of Health (appointed to health portfolio June 9, 2023)

Saskatchewan, Tracey Smith
Deputy Minister of Health (appointed July 1, 2022)

Manitoba, Scott Sinclair
Deputy Minister of Health and Seniors (appointed March 20, 2023)

Ontario, Deborah Richardson
Deputy Minister of Health (appointed March 11, 2024)

Québec, Daniel Paré
Sous-ministre de la Santé et des Services sociaux (appointed July 10, 2023)

New Brunswick, Eric Beaulieu
Deputy Minister of Health (appointed July 1, 2022)

Nova Scotia, Dana MacKenzie
Deputy Minister of Health and Wellness / Deputy Minister Responsible for the Office of Healthcare Professional Recruitment (appointed January 18, 2024)

Prince Edward Island, Lisa Thibeau
Deputy Minister of Health and Wellness (appointed February 11, 2022)

Newfoundland and Labrador, John McGrath
Deputy Minister of Health and Community Services (appointed May 26, 2023)

Yukon, Tiffany Boyd
Acting Deputy Minister of Health and Social Services (appointed January 14, 2023)

Northwest Territories, Jo-Anne Cecchetto
Deputy Minister of Health and Social Services (appointed July 27, 2022)

Nunavut, Megan Hunt
Deputy Minister of Health (appointed January 13, 2023)

List of provincial/territorial deputy ministers responsible for mental health

British Columbia, Jonathan Dube
Acting Deputy Minister of Mental Health and Addictions (appointed April 15, 2024)

Alberta, Evan Romanow
Deputy Minister of Mental Health & Addiction (appointed to June 9, 2023)

Saskatchewan
No separate DM of Mental Health and Addictions

Manitoba, Catherine Gates
Deputy Minister of Housing, Addictions and Homelessness (appointed October 19, 2023)

Ontario
No separate DM of Mental Health and Addictions

Québec
No separate DM of Mental Health and Addictions

New Brunswick
No separate DM of Mental Health and Addictions

Nova Scotia, Kathleen Trott
Deputy Minister of the Office of Addictions and Mental Health (appointed September 14, 2023)

Prince Edward Island
No separate DM of Mental Health and Addictions

Newfoundland and Labrador
No separate DM of Mental Health and Addictions

Yukon
No separate DM of Mental Health and Addictions

Northwest Territories
No separate DM of Mental Health and Addictions

Nunavut
No separate DM of Mental Health and Addictions

Supplementary contacts

Alberta, Cynthia Farmer
Deputy Minister Alberta Seniors, Community and Social Services (appointed November 8, 2022)

Ontario, Melissa Thomson
Deputy Minister, Long Term Care and Seniors and Accessibility (appointed June 19, 2023)

New Brunswick, Jim Mehan
Deputy Minister of Social Development (appointed July 5, 2022)

Nova Scotia, Tracy Barbrick
Deputy Minister of Seniors and Long-Term Care (appointed September 14, 2023)

Prince Edward Island, Teresa Hennebery
Deputy Minister of Social Development and Housing (appointed: February 5, 2024)

Newfoundland and Labrador, Alan Doody
Deputy Minister Department of Children, Seniors and Social Development (appointed June 16, 2022)

Nunavut, Teresa Hughes
Deputy Minister of Culture and Heritage (appointed October 25, 2021)

Pan-Canadian health organizations

Overview

At different points over more than thirty years, the Government of Canada created pan-Canadian health organizations (PCHOs) to address specific health care system needs and issues. There are now eight such organizations.

PCHOs were created to address priorities in the Canadian health care system, recognizing their potential to tackle issues in a more targeted, pan-Canadian and flexible way than the federal government - or any one PT - can do on its own or at intergovernmental tables, with diverse mandates and activities. For example, Canada’s Drug Agency (CDA)’s reimbursement review program assesses the cost-effectiveness of drugs; Canada Health Infoway has directly supported provinces and territories (PTs) in the implementation of their virtual care and digital health needs; the Canadian Institute for Health Information (CIHI) reports on health system performance; and the Canadian Partnership Against Cancer and the Mental Health Commission of Canada have developed national strategies on pressing health issues (cancer control and mental health respectively). While most PCHOs were established exclusively through federal investment, two (CDA and CIHI) were created in partnership with provincial/territorial governments. The recently created Health Workforce Canada was created to improve the collection and sharing of health workforce data and share practical solutions and innovative practices.

The federal government remains the majority funder of all PCHOs accounting for about 60-100% of total individual PCHO budgets. Based on longstanding agreements, PTs provide financial support to CIHI (approximately 20% of its budget) and CDA (approximately 15% of its budget), while Infoway cost-shares with PTs on some of the projects it funds.

As not-for-profit corporations, each PCHO is governed by a board of directors on which the federal government generally holds one seat, some voting and some as observers (and in a few cases also designates the board chair). A senior public servant from Health Canada typically serves as the federal representative and PTs generally have public servant representation on PCHO boards. Although PCHOs are operationally independent, they are accountable to their majority funder - the Government of Canada – for federal investments and related objectives, and so they have a vested interest in developing products and services that respond to the priorities of the federal government and their primary partners, the PTs.

Mandate and core activities

The Canadian Institute for Health Information (CIHI) is the main national body charged with collecting, analyzing and reporting health data (e.g., wait times, quality of care and outcomes, health expenditures, allocation of health professionals), including collaborating with PTs, StatsCan, and data partners to develop and use comparable indicators on priority topics. CIHI data and information supports health system improvements and is used by Canadian governments, policy-makers and health system managers in making health policy decisions and in supporting effective health system management. CIHI relies heavily on PTs for collection of health data.

Canada’s Drug Agency (CDA) provides decision-makers with evidence and advice to help provincial/territorial health ministries and federal- provincial/territorial (FPT) drug plans make informed decisions about the effectiveness and efficiency of drugs, medical devices and other health technologies. The expert committees from the reimbursement review program make non-binding recommendations to public drug plans that support formulary listing and reimbursement conditions decisions for new drugs.

Canada Health Infoway (Infoway) works with PTs, health care providers and other partners to accelerate the development and adoption of digital health technologies, drive health innovation, and improve health outcomes. Infoway is currently focused on leading the development of a pan-Canadian interoperability roadmap for supporting the secure access and exchange of health data between digital solutions, supporting the adoption of standardized digital health solutions, supporting the adoption of standardized digital health tools with PTs, and an electronic proscribing system.

Healthcare Excellence Canada is the amalgamated organization of the Canadian Patient Safety Institute and the Canadian Foundation for Healthcare Improvement. It works with patients and other partners to share proven innovations and best practices that lead to lasting improvements in patient safety and healthcare quality (over the pandemic, its ‘LTC+’ program provided seed funding and programming support to long-term care and retirement homes to strengthen their pandemic preparedness and response). Its current focus areas include: care closer to home and community with safe transitions; care of older adults with health and social needs; pandemic recovery and health system resilience.

Health Workforce Canada is the recently established centre of excellence to improve health workforce data, planning and knowledge translation to action. Its establishment responds to the Government of Canada’s budget 2023 commitments to support improvements to health workforce data as well as federal/provincial/territorial health ministers’ commitment to take concrete actions to address health workforce challenges. As an independent, not-for-profit organization, HWC is working to convene and collaborate with health sector partners, including the Canadian Institute for Health Information, to improve the timely development, collection and sharing of health workforce data and advance the use of this data to support evidence-based workforce planning.

The Canadian Partnership Against Cancer (CPAC) provides national leadership to mobilize partners, including governments and cancer experts, to reduce the burden of cancer through coordinated, system-level change through the implementation of the Canadian strategy for cancer control (the strategy). The strategy is a framework for Canadian cancer control that reflects the views of cancer stakeholders, including all levels of government. It touches upon the full cancer control continuum from prevention, screening and early detection to treatment, standards and cancer guidelines through recovery and palliative care.

The Mental Health Commission of Canada (MHCC) acts as a catalyst for improving the mental health system and changing the attitudes and behaviours of Canadians around mental health issues (for example, by reducing the stigma associated with mental health illness and treatment). Its work focuses on four priority areas: population-based initiatives, suicide prevention, the integration of mental health and substance use, and engagement with Canadians.

The Canadian Centre on Substance Use and Addiction (CCSA) facilitates knowledge exchange and mobilizes research and expertise in the substance use field, promotes increased awareness among Canadians and health system stakeholders about substance use and addiction, convenes stakeholders across sectors (including those with lived and living experience) to reduce the harms of substance use, and promotes the use of programs shown to be effective in combating problematic substance use. CCSA is the only PCHO created by federal legislation.

Ministerial role and engagement

As PCHOs are operationally independent, the Minister of Health, the Minister of Mental Health and Addictions, and the Associate Minister of Health have no direct involvement in their day-to-day activities. The administration of contribution funding to each organization is delegated to Health Canada officials. The Minister of Health has ultimate oversight of federal investments in these organizations, including the use of federal funding to advance priorities and requests through cabinet for new funding to support emerging federal or FPT priorities.

Most federal board appointments are the prerogative of the deputy minister. However, the minister is charged with nominating a federal representative to the CPAC board of directors; the chair and one additional federal representative to the MHCC board of directors; and recommends governor in council appointments for the chair and up to four other representatives to the CCSA board of directors. Given the close relationship between the department and the organizations, the minister can also expect PCHOs to seek direct engagement from time to time on matters of relevance to their respective organizations.

Role in the health system

PCHOs play an important role in the health system. In Canada’s decentralized system, they can be helpful in advancing federal interests in areas of provincial/territorial responsibility, on a pan-Canadian scale. PTs are often more receptive to PCHO engagement than to direct federal government intervention. This is attributable in part to the shared governance model adopted by most PCHOs.

In 2018, an external review of the role of the PCHOs was conducted and produced a series of recommendations, including structural changes. In it, Drs. PG Forest and Danielle Martin made clear that while these organizations have made significant contributions over the years, the suite of PCHOs needs to be reconfigured and/or re-mandated to meet the needs of Canada's health systems in the future. Since the issuance of the report, the COVID-19 pandemic has further reinforced the need for organizations to be focused and responsive to federal and PT needs and objectives.

The amalgamation of CFHI and CPSI was a key structural change in 2021. Health Canada continues to reinforce opportunities for CCSA and MHCC to collaborate on initiatives that support an integrated/systems approach to MHSU&A policy and practice. The mental health and substance use impacts of the COVID-19 pandemic have been profound, amplifying the significant and expanding needs of people with mental health or substance use concerns, and the close interrelationship between these two areas.

In addition, Health Canada has been undertaking several recommended process improvements aimed at ensuring the PCHOs, individually and collectively, contribute in a more impactful manner to federal and provincial/territorial priorities for health system improvement. For example, Health Canada worked to clarify and improve the efficiency of funding administration and PCHOs are working together to drive progress on cultural safety and Indigenous reconciliation.

To better support Canadian health systems in their response to the pandemic, a PCHO chief executive officer table has also met biweekly to provide a coordinated response to urgent priorities with guidance from Health Canada. In addition, Health Canada has been working closely with PTs to ensure that individual PCHOs have the guidance and direction needed to better support work on specific priorities, such as Canada Health Infoway’s work during COVID-19 to support PTs on virtual care.

Other key players and stakeholders

The health portfolio works with a variety of key players in health, including provinces and territories, Indigenous partners, federally funded arm’s-length health organizations, non-governmental organizations, professional associations, charities, international organizations, industry, the research community, other federal departments and agencies, foreign regulators and people living in Canada. This work includes partnering on research, surveillance, public consultation, collaborative policy and program development, sharing information to support health system improvement, best practice/knowledge sharing and engagement with people with lived and living experience.

Provincial / territorial health ministers & public health agencies

e.g., Pan-Canadian public health network, regional authorities, P/T occupational health and safety organizations, and in specific cases, local health services, e.g., BC First Nations Health Authority

Pan-Canadian health organizations (PCHOs)

e.g., Canadian Institute for Health Information, Mental Health Commission of Canada, Canada Health Infoway, Canadian Agency for Drugs and Technologies in Health, Canadian Centre on Substance Use and Addiction, Healthcare Excellence Canada, Health Workforce Canada, Canadian Partnership Against Cancer

Health equity & community-based stakeholders

e.g., community health organizations, communities with a stake in public health (e.g., black communities, religious and racialized community groups, communities of practice, immigrants, senior and youth-based organizations, LGBTQ2+, etc.), social media influencers / risk influencers / risk communicators

National and regional Indigenous organizations

Modern treaty holders, and self governments e.g., Assembly of First Nations, Native Women’s Association of Canada, Inuit Tapiriit Kanatami, Pauktuutit Women of Canada, Métis National Council, Manitoba Métis Federation, Les Femmes Michif Otipemisiwak, Congress of Aboriginal Peoples, The National Association of Friendship Centres

International partners

e.g., US Food and Drug Administration, European Medicines Agency, World Health Organization, Multilateral Regulatory For a (ICMRA, ACCESS), Pan-American Health Organization, International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use, Global Research Collaboration for Infectious Disease Preparedness (GloPID-R), Organisation for Economic Co-operation and Development (OECD), US Environmental Protection Agency, United Nations Office on Drugs and Crime

Health system stakeholders

Health professionals (e.g., Canadian Medical Association, Canadian Nurses Association, Nurse Practitioners Association of Canada, Canadian Doctors for Medicare, Canadian Pharmacists Association, Local Medical Officers of Health, Canadian Dental Association, Canadian Dental Hygienists Association, Denturist Association of Canada)
Health institutions (e.g., Hospitals, Children's Healthcare Canada, Canadian Pediatric Society)
Patient groups (e.g., Institute of Safe Medicine Practices Canada, Patients Canada)
Health sector labour ynions (e.g., Canadian Labour Congress, Professional Institute of the Public Service of Canada)

Research & academic stakeholders

Universities and academic organizations (e.g., Association of Faculties of Medicines of Canada, Association of Faculties of Pharmacy of Canada, U15 Group, Universities Canada, Canadian Academy of Health Sciences, Canadian Black Scientists Network)
Hospital-based research institutions (e.g., SickKids)
Think tanks (e.g, Conference Board of Canada, Public Policy Forum)
Health charities and research foundations (e.g., JDRF, MS Society, Gairdner Foundation)
International research agencies (e.g., NIH, European Commission)
Provincial health research organizations: (e.g., The National Alliance of Provincial Health Research Organizations
International research agencies (e.g., NIH, European Commission)
Provincial health research organizations (e.g., The National Alliance of Provincial Health Research Organizations)
International research agencies (e.g., NIH, European Commission)

Industry stakeholders

Pharmaceutical and biologics (e.g., Innovative Medicines Canada, Canadian Generic Pharmaceutical Association, Group Purchasing Organizations, and distributors)
Medical devices (e.g., Medtech Canada)
Natural health products and non-prescription drugs (e.g., Canadian Health Food Association, Consumer Health Products Canada)
Food products (e.g., Canadian Supply Chain Food Safety Coalition, Dairy of Farmers of Canada, Canadian Beverage Association)
Pesticides (e.g., CropLife Canada)
Cannabis (e.g. Cannabis Council of Canada, Canada Hemp Trade Alliance)
Consumer products and cosmetics (e.g., Retail Council of Canada, Cosmetics Alliance Canada)
Workplace hazardous products (e.g., Canadian Consumer Specialty Products) Association, Canadian Paint and Coatings Association Responsible Distribution Canada)
OGD tables with industry (e.g., National Cross Sector Forum)
Health insurance companies (e.g., Canadian Life and Health Insurance Association)
E-health vendors (e.g., Maple, Telus)

Public health stakeholders

Health charities (e.g., Canadian Red Cross, Health Charities Coalition of Canada, disease specific - ALS, Alzheimers, Heart & Stroke, etc.)
National public health associations (e.g., Canadian Public Health Association, National Collaborating Centres on Public Health funded by PHAC)
Disease-based advocacy groups (e.g., Canadian Organization for Rare Disorders, Pain Canada)
Disease prevention/health promotion NGOs (e.g., Canadian AIDS Society, YMCA Canada)
People with lived and living experience (e.g., Canadian Association of People who Use Drugs, Community Addictions Peer Support Association, Black Health Education Collaborative)

IV. Annexes

Minister of Health mandate letter

December 16, 2021

Dear Minister Duclos:

Thank you for agreeing to serve Canadians as Minister of Health.

From the beginning of this pandemic, Canadians have faced a once-in-a-century challenge. And through it all, from coast to coast to coast, people have met the moment. When it mattered most, Canadians adapted, helped one another, and stayed true to our values of compassion, courage and determination. That is what has defined our path through this pandemic so far. And that is what will pave our way forward.

During a difficult time, Canadians made a democratic choice. They entrusted us to finish the fight against COVID-19 and support the recovery of a strong middle class. At the same time, they also gave us clear direction: to take bold, concrete action to build a healthier, more resilient future. That is what Canadians have asked us to do and it is exactly what our Government is ready to deliver. We will work to build that brighter future through continued collaboration, engagement, and the use of science and evidence-based decision-making. With an unwavering focus on delivering results, we will work constructively with Parliamentarians and maintain our strong partnerships with provincial, territorial and municipal governments and Indigenous partners. This decade has had an incredibly difficult start, but this is the moment to rebuild a more resilient, inclusive and stronger country for everyone.

The science is clear. Canadians have been clear. We must not only continue taking real climate action, we must also move faster and go further. As Canadians are increasingly experiencing across the country, climate change is an existential threat. Building a cleaner, greener future will require a sustained and collaborative effort from all of us. As Minister, I expect you to seek opportunities within your portfolio to support our whole-of-government effort to reduce emissions, create clean jobs and address the climate-related challenges communities are already facing.

This year, Canadians were horrified by the discovery of unmarked graves and burial sites near former residential schools. These discoveries underscore that we must move faster on the path of reconciliation with First Nations, Inuit and Métis Peoples. We know that reconciliation cannot come without truth and our Government will continue to invest in that truth. As Ministers, each of us has a duty to further this work, both collectively and as individuals. Consequently, I am directing every Minister to implement the United Nations Declaration on the Rights of Indigenous Peoples and to work in partnership with Indigenous Peoples to advance their rights.

We must continue to address the profound systemic inequities and disparities that remain present in the core fabric of our society, including our core institutions. To this effect, it is essential that Canadians in every region of the country see themselves reflected in our Government’s priorities and our work. As Minister, I expect you to include and collaborate with various communities, and actively seek out and incorporate in your work, the diverse views of Canadians. This includes women, Indigenous Peoples, Black and racialized Canadians, newcomers, faith-based communities, persons with disabilities, LGBTQ2 Canadians, and, in both official languages.

Across our work, we remain committed to ensuring that public policies are informed and developed through an intersectional lens, including applying frameworks such as Gender-based Analysis Plus (GBA Plus) and the quality of life indicators in decision-making.

Canadians continue to rely on journalists and journalism for accurate and timely news. I expect you to maintain professional and respectful relationships with journalists to ensure that Canadians are well informed and have the information they need to keep themselves and their families safe.

Throughout the course of the pandemic, Canadians and their governments have adapted to new realities. Governments must draw on lessons learned from the pandemic to further adapt and develop more agile and effective ways to serve Canadians. To this end, I expect all Ministers to evaluate ways we can update our practices to ensure our Government continues to meet the challenges of today and tomorrow.

The success of this Parliament will require Parliamentarians, both in the House of Commons and the Senate, to work together across all parties to get big things done for Canadians. I expect you to maintain constructive relationships with your Opposition Critics and coordinate any legislation with the Leader of the Government in the House of Commons. As Minister, you are accountable to Parliament both individually, for your style of leadership and the performance of your responsibilities, and collectively, in support of our Ministry and decisions taken by cabinet. Open and Accountable Government sets out these core principles and the standards of conduct expected of you and your office. I expect you to familiarize yourself with this document, which outlines my expectations for each member of the Ministry.

Our platform lays out an ambitious agenda. While finishing the fight against the pandemic must remain our central focus, we must continue building a strong middle class and work toward a better future where everyone has a real and fair chance at success and no one is left behind.

As Minister of Health, your immediate priority is to help finish the fight against COVID-19, working in close cooperation with provinces and territories. As we emerge from this pandemic, I expect you to work in partnership with provinces and territories to strengthen our universal public health care system and public health supports, backed by an early increase of investments in primary and virtual care and mental health services so all Canadians can get the care they need no matter where they live. Collaboration with provinces and territories will be key to ensuring the primary care system is positioned for the future, including accessible health system data, as well as working to improve the quality and availability of long-term care.

To realize these objectives, I ask that you achieve results for Canadians by delivering the following commitments.

Continue to provide leadership to finish the fight against COVID-19, including by:
- Working with colleagues, provinces and territories, municipalities, Indigenous communities and other partners to continue the roll-out of COVID-19 vaccines;
- Working with colleagues to continue to ensure sufficient domestic supply of COVID-19 vaccines and therapeutics, evaluate our border posture and ensure surge capacity supports are available to assist provinces and territories;
- Working with provinces and territories, municipalities, Indigenous organizations, the private sector and other partners to continue to ensure implementation of and adherence to public health measures, and support the availability of rapid tests and self-tests; 
- Launching a COVID-19 Proof of Vaccination Fund to support provinces and territories who implement a requirement for proof of vaccine credentials in their jurisdiction for non-essential businesses and public spaces;
- Overseeing the Public Health Agency of Canada, ensuring they have the resources and support necessary to continue protecting the health and safety of Canadians; and
- Continue working with the Minister of Public Safety and the Minister of Transport to protect the health and safety of Canadians through safe, responsible and compassionate management of the border with the United States and other ports of entry into Canada.
Work with the Minister of Innovation, Science and Industry to continue demonstrating leadership in public health by strengthening surveillance and capacity to detect and act on public health threats, strengthening the security of medical supply chains, working with colleagues to advance the Biomanufacturing and Life Sciences Strategy, and investing in the study of the long-term health impacts of COVID-19, including the effects of long COVID on different groups, notably vulnerable populations and children.
With the support of the Deputy Prime Minister and Minister of Finance, lead our renewed commitment to work in partnership with and increase funding to provinces and territories to strengthen our universal public health system, ensure health care workers are supported and recruited across the country and advance an integrated, comprehensive and patient-centric strategy, harnessing the full potential of data and digital systems, including by:
- Investing in supporting initiatives that will help to speed access to care for critical services;
- Supporting provinces and territories to hire new family doctors, nurses and nurse practitioners;
- Expanding virtual care, helping to cover digital infrastructure and other system improvements so that Canadians can access virtual medical consultations or remote monitoring;
- Expanding the number of family doctors and primary health teams in rural communities and working to give rural communities greater access to a full suite of health and social services professionals;
- Strengthening compliance with and modernizing the interpretation of the Canada Health Act on matters of extra billing for publicly insured services; and
- In consultation with provinces and territories and a broad range of partners, expediting work to create a world-class health data system that is timely, usable, open-by-default, connected and comprehensive.
Work with the Minister of Mental Health and Addictions and Associate Minister of Health and with the support of the Deputy Prime Minister and Minister of Finance to establish a permanent, ongoing Canada Mental Health Transfer, to help expand the delivery of high-quality, accessible and free mental health services, including for prevention and treatment.
With the support of the Minister of Seniors, negotiate agreements with provinces and territories to support efforts to improve the quality and availability of long-term care homes and beds. This includes working with provinces and territories to improve infection prevention and control measures, identify shared principles, and develop national standards and a Safe Long-Term Care Act to ensure seniors get the care they deserve. In support of this work, you will work with the Minister of Employment, Workforce Development and Disability Inclusion and provinces and territories to train up to 50,000 new personal support workers and raise wages.
With the support of the Minister for Women and Gender Equality and Youth, work to ensure that all Canadians have access to the sexual and reproductive health services they need, no matter where they live, by reinforcing compliance under the Canada Health Act, developing a sexual and reproductive health rights information portal, supporting the establishment of mechanisms to help families cover the costs of in vitro fertilization, and supporting youth-led grassroots organizations that respond to the unique sexual and reproductive health needs of young people.
Work with the Minister of Public Safety, President of the Queen’s Privy Council for Canada and Minister of Emergency Preparedness, Minister of Fisheries, Oceans and the Canadian Coast Guard and Minister of Transport, among other colleagues, to ensure the Government of Canada continues to be prepared to proactively mitigate, and respond to, emerging incidents and hazards.
In moving forward with a uniquely Canadian approach modeled on the Defense Advanced Research Projects Agency (DARPA), work with the Minister of Innovation, Science and Industry to develop a plan to modernize the federal research funding ecosystem to maximize the impact of investments in both research excellence and downstream innovation, with a particular focus on the relationships among the federal research granting agencies and the Canada Foundation for Innovation.
With the support of the Chief Science Advisor, continue to ensure science and evidence are integrated into our pandemic response.
With the support of the Minister of Foreign Affairs, work with the Minister of International Development to continue to reinforce international efforts to ensure that people around the world have access to health interventions to fight COVID-19, including vaccines, therapeutics and strengthened health systems.
Work with partners to take increased and expedited action to monitor, prevent and mitigate the serious and growing threat of antimicrobial resistance and preserve the effectiveness of the antimicrobials Canadians rely upon every day.
Continue engaging with willing provinces and territories towards national universal pharmacare, while proceeding with a national strategy on high-cost drugs for rare diseases and advancing the establishment of the Canada Drug Agency.
To protect Canadians from harmful chemicals, strengthen the Canadian Environmental Protection Act, introduce mandatory labelling of chemicals in consumer products, introduce legislation to end testing on animals, increase testing of products for compliance with Canadian standards, and implement an action plan to protect Canadians, including firefighters, from exposure to toxic flame retardants found in household products.
Work with the Leader of the Government in the House of Commons in their work to develop a plan to both make Parliament a more inclusive place for families and to respond with greater agility in the event of a future national health crisis.
To ensure Canadians are protected from risks associated with the use of pesticides and to better protect human health, wildlife and the environment, modernize and strengthen the Pest Control Products Act to ensure it supports transparency, use of independent scientific evidence and input to the decision-making process.
Recognizing that a healthy population is key to reducing vulnerability to health events, promote healthy eating by advancing the Healthy Eating Strategy. This includes finalizing the front-of-package labelling to promote healthy food choices and supporting restrictions on the commercial marketing of food and beverages to children.
In support of the Indigenous Early Learning and Child Care system, continue to invest in Aboriginal Head Start in Urban and Northern Communities Program.
In this, the UN Decade of Healthy Ageing (2021-2030), promote seniors’ physical and mental health to enable them to live longer at home, including by supporting the Minister of Seniors in their work to establish an expert panel to provide recommendations for establishing an Aging at Home Benefit.
In collaboration with provinces, territories, families and stakeholders, accelerate the development of the National Autism Strategy.

As Minister, you are also responsible for actively engaging with your cabinet and caucus colleagues. As we deliver on our platform commitments, it will be important that members of the ministry continue to collaborate and work constructively to support rigorous and productive cabinet decision-making. I expect you to support your colleagues in delivering their commitments, leveraging the expertise of your department and your own lived experiences.

To best achieve results for Canadians, Ministers must be rigorous and coordinated in our approach to implementation. I would therefore ask that you return to me with a proposed approach for the delivery of your mandate commitments, including priorities for early implementation. Furthermore, to ensure we are accountable for our work, I will be asking you to publicly report to me, and all Canadians, on your progress toward these commitments on a regular basis.

As we have been reminded throughout the pandemic, adapting to change is not only something government should do, it is something government must do. As you work to fulfil our commitments, I expect you to actively consider new ideas and issues as they emerge, whether through public engagement, your work with Parliamentarians or advice from the public service. I also expect you to work with your Deputy Minister to assess priorities on a continual basis as we build a better future for all Canadians. In addition to achieving results, you are responsible for overseeing the work of your department and ensuring the effective operation of your portfolio.

As you staff your office and implement outreach and recruitment strategies for federally appointed leadership positions and boards, I ask that you uphold the principles of equity, diversity and inclusion. This helps ensure that federal workplaces are dynamic and reflective of the Canadians we serve. You will also ensure your Minister’s office and portfolio are reflective of our commitment to healthy and safe workplaces.

Canadians expect us to work hard, speak truthfully and be committed to advancing their interests and aspirations. When we make mistakes – as we all will – Canadians expect us to acknowledge them, and most importantly, to learn from them.

I know I can count on you to fulfill the important responsibilities entrusted in you, and to turn to me, and the Deputy Prime Minister, early and often to support you in your role as Minister.

Sincerely,
Rt. Hon. Justin Trudeau, P.C., M.P.
Prime Minister of Canada

Minister of Mental Health and Addictions mandate letter

December 16, 2021

Dear Minister Bennett:

Thank you for agreeing to serve Canadians as Minister of Mental Health and Addictions and Associate Minister of Health.

As Minister of Mental Health and Addictions and Associate Minister of Health, you will work with the Minister of Health to build a healthier future, with a particular focus on ensuring that health inequities are understood and addressed, including for Indigenous Peoples, Black Canadians and vulnerable Canadians. You will work to ensure that mental health care is treated as a full and equal part of our universal health care system, working in close collaboration with provinces and territories, and lead a whole-of-society approach to address problematic substance use in Canada.  

To realize these objectives, I ask that you achieve results for Canadians by delivering the following commitments.

Work with the Minister of Health, and with the support of the Deputy Prime Minister and Minister of Finance, to establish a permanent, ongoing Canada Mental Health Transfer to help expand the delivery of high-quality, accessible and free mental health services, including for prevention and treatment.
In order to support the mental health of Canadians, develop and implement a comprehensive, evidence-based plan, leveraging existing and new investments, including to:
- Develop mental health standards, with a particular focus on health equity;
- Sustain improved access to virtual mental health services with Wellness Together Canada;
- Ensure timely access to perinatal mental health services;
- Implement a three-digit suicide prevention hotline; and
- Introduce a new fund for student mental health that will support the hiring of new mental health care counsellors, improve wait times for services, increase access overall and enable targeted supports to Black and racialized students at post-secondary institutions across Canada.
Support the Minister of Indigenous Services to co-develop and invest in a distinctions-based Mental Health and Wellness Strategy to meet the needs of First Nations, Inuit and the Métis Nation, including culturally appropriate wraparound services for addiction and trauma, suicide and life promotion and the building of treatment centres.
Oversee the implementation of our investments in mental health interventions and supports for people disproportionately impacted by COVID-19, including health care workers, front-line workers, seniors, Indigenous people, and Black and racialized Canadians.
Work with the Minister of Families, Children and Social Development and Minister for Women and Gender Equality and Youth to ensure mental health supports are accessible to children and youth as they recover from the impact of the pandemic.
Advance a comprehensive strategy to address problematic substance use in Canada, supporting efforts to improve public education to reduce stigma, and supporting provinces and territories and working with Indigenous communities to provide access to a full range of evidence-based treatment and harm reduction, as well as to create standards for substance use treatment programs.
Require tobacco manufacturers to pay for the cost of federal public health investments in tobacco control.
Support the Minister of Public Safety to continue advancing Canada’s first-ever National Action Plan on Post-Traumatic Stress Injuries, including additional investment to support the health and well-being of first responders.
Support the Minister of Veterans Affairs to ensure Canadian Armed Forces members and Veterans have access to adequate mental health resources, services and training programs tailored to their specific needs.
With the support of the Minister of Rural Economic Development, explore pathways to increase the accessibility of mental health services in rural areas.

As Minister, you are also responsible for actively engaging with your cabinet and caucus colleagues. As we deliver on our platform commitments, it will be important that members of the Ministry continue to collaborate and work constructively to support rigorous and productive cabinet decision-making. I expect you to support your colleagues in delivering their commitments, leveraging the expertise of your department and your own lived experiences.

I know I can count on you to fulfill the important responsibilities entrusted in you, and to turn to me, and the Deputy Prime Minister, early and often to support you in your role as Minister.

Sincerely,
Rt. Hon. Justin Trudeau, P.C., M.P.
Prime Minister of Canada

Page details

Date modified:: 2024-12-17

Deputy Minister Briefing Material

Table of contents

I. Overview of department

A. Executive summary

Federal-provincial-territorial relations

Pan-Canadian health organizations and other key stakeholders

B. Organizational charts

1. Health Canada

2. Public Health Agency of Canada

3. Canadian Institutes of Health Research

4. Canadian Food Inspection Agency

C. Health Canada Branches

1. Health Policy Branch (HPB)

1. Health care systems

2. Aging and equity

3. Pharmaceutical policy

Health care policy priorities

1. Mental health and substance use

2. Support federal and pan-Canadian health care policy objectives

3. Horizontal strategic and corporate functions

HPB financial overview 2024-25

2. Controlled Substances and Cannabis Branch (CSCB)

Controlled substances program: roles

Regulatory mandate

Policy advice

Health information

Controlled substances program: hot issues

Overdose crisis

Controlled substances program: ministerial priorities

Cannabis program: roles

Regulatory mandate

Policy advice

Health information

Cannabis program: ministerial priorities

Tobacco program: roles

Regulatory mandate

Policy advice

Health information

Tobacco program: hot issues

Vaping product flavours

Tobacco program: ministerial priorities

Cost recovery

Legislative review

Enabling functions

Horizontal responsibilities

Grants and contributions

SUAP: hot issues and ministerial priorities

Emergency treatment fund

Prescribed alternatives projects (“safer supply”)

[REDACTED]

Corporate services

CSCB financial overview (FY 2024/25) [REDACTION]

3. Health Products and Food Branch (HPFB)

HPFB mission

HPFB organizational structure

Domestic and international roles

Areas of regulatory responsibilities

Legislative framework

International collaboration

Key Stakeholders

Core business lines

Health products

Life cycle approach to regulation

Core business lines

Our workforce

Regulatory decision making

Regulatory decisions are made when:

Granting market authorization

Responding to emergencies

Addressing unsafe products

HPFB priorities

1. Facilitating timely access and protecting patient and consumer safety

2. Minimizing safety risks while promoting choice and access for Canadians

3. Promoting better health outcomes for all Canadians

Foundation for key government initiatives

4. Healthy environments and consumer safety branch (HECSB)

HECSB overview

HECSB organizational structure

Protecting the health of people living in Canada

Core business lines