Minister of Health Pocket Book
Table of Contents
- A: Health Portfolio Overview Highlights
- B: Minsterial Responsibilities
- C: The Portfolio
- D: Key Messages
- E: Priority Issues
- F: Key Contacts
A: Health Portfolio Overview Highlights
- Health Canada (HC)
- Public Health Agency of Canada (PHAC)
- Canadian Food Inspection Agency (CFIA)
- Canadian Institutes of Health Research (CIHR)
- Patented Medicine Prices Review Board (PMPRB)
Deputy Minister and Agency Heads
- Dr. Stephen Lucas, DM – HC
- Tina Namiesniowski, President – PHAC
- Dr. Siddika Mithani, President - CFIA
- Dr. Michael J. Strong, President – CIHR
- Dr. Mitchell Levine, Chair – PMPRB
2019-20 Budget and Full-Time Equivalents (FTEs)
- Health Canada: $2,521,568,000 / 7677 FTE
- PHAC: $625,648,000 / 2499 FTEs
- CFIA: $732,223,000 / 6021 FTEs
- CIHR: $1,178,622,000 / 478 FTEs
- PMPRB: $16,613,000 / 82 FTEs
Health of Canadians
- Overall life expectancy at birth for Canadian men and women is above international benchmarks at 79.9 years (men) and 84.0 years (women) in 2017, and Canadians are amongst the highest proportion of people among G7 countries who report feeling in good to excellent health.
- Certain regions and populations in Canada continue to experience poorer health than the average Canadian (Northern and rural and remote communities, low-income families, children living in conditions of risk, Indigenous Peoples, un- or under-employed adults, older adults, and LGBTQ2S+).
- Areas of concern such as mental health and suicide continue to significantly impact Canadians. 1 in 3 Canadians (over 9 million people) will experience a mental illness or substance use disorder in their lifetime.
- There are concerning trends in infectious diseases, including the re-emergence of vaccine-preventable diseases such as measles, an increase in some sexually transmitted infections, the threat of antimicrobial resistance and the expansion of certain vector borne illnesses, such as Lyme disease.
- As the population ages, the burden of chronic diseases increases. Obesity, physical inactivity, heavy alcohol consumption, and poor nutrition are risk factors for major chronic conditions.
- Since 2001, there has been a significant decrease in the rate of daily or occasional smokers. However, rates of vaping are on the rise, with dramatic increases amongst youth. Vaping-related lung illness is reported in Canada and responsible for deaths in the US.
- Canada is experiencing an ongoing crisis of overdose deaths from opioid misuse and toxic illegal supply (more than 12,800 Canadians have died since 2016).
Health System in Canada
- Health is an area of shared jurisdiction among the federal government and provincial and territorial (PT) governments.
- The Minister of Health is responsible for setting and administering national standards for the health care system through the Canada Health Act (CHA), in accordance with the key principles of public health insurance: public administration, comprehensiveness, universality, portability, accessibility, and no patient charges.
- Federal health activities include programs to protect and promote health, the regulation of health and consumer products, food and harmful substances, and the regulation of patented drug prices.
- Health services delivery, the administration of PT health insurance plans, and the regulation of health professions fall within PT jurisdiction.
- The federal government provides health care to certain populations (e.g., First Nations on reserve and Inuit communities). Health services for Indigenous peoples (off-reserve) are provided by PT governments.
- Federal, Provincial and Territorial (FPT) collaboration, as well as collaboration across federal departments, is crucial to address health issues and health system challenges, especially in areas where responsibilities intersect, such as mental health and addiction, public health promotion, prevention of the spread of communicable diseases, and responding to public health emergencies.
Federal Health Regulation
- A key function of the Health Portfolio is the administration and enforcement of over 160 regulations in more than 40 Acts that have a direct impact on the health and safety of Canadians.
- This includes providing regulatory oversight throughout the lifecycle of a wide range of health products including drugs, biologics (such as vaccines and tissues), medical devices, veterinary drugs consumer products, natural health products, food, chemicals and pesticides. Oversight includes clinical trials, product authorization, and surveillance of safety and effectiveness once products are on the market.
- The Portfolio also takes appropriate compliance and enforcement action in relation to acts and regulations (e.g., recalls).
Health Research and Innovation in Canada
- The primary health research organization in Canada is the Canadian Institutes of Health Research (CIHR).
- Research and innovation are supported at the federal level through other granting councils, the National Research Council, and programs delivered by Innovation, Science and Economic Development Canada, and regional agencies.
- Organizations of the Health Portfolio support many health care initiatives through targeted funding to a variety of partners, including: health research organizations; professional and regulatory bodies; and partners at various levels of government.
- These targeted federal initiatives address key system challenges, such as: health system innovation; home, community and end-of-life care; and mental health and addiction services.
B: Minsterial Responsibilities
- The Health Portfolio is mandated to help Canadians maintain and improve their health.
- Portfolio responsibilities include:
- Strengthening Canada's universal health care system;
- Enabling access to safe and effective health products;
- Supporting Canadians in making safe and healthy choices;
- Managing risks to health; and
- Supporting health research and science, data collection and surveillance capacity.
- The Minister of Health is supported by five science-based organizations:
- Health Canada (HC);
- Public Health Agency of Canada (PHAC);
- Canadian Food Inspection Agency (CFIA);
- Canadian Institutes of Health Research (CIHR); and
- The quasi-judicial Patented Medicine Prices Review Board (PMPRB).
C: The Portfolio
Health Canada (HC)
- Supports universally accessible publicly funded health care for Canadians through administration of the Canada Health Act, leadership on emerging issues, and cooperation with PTs on system improvements.
- Enables access to safe and effective health products by assessing and regulating health products, including prescription and non-prescription drugs, and natural health products.
- Supports Canadians in making safe and healthy choices through public education and awareness campaigns to communicate health and safety information.
- Manages the health risks of harmful substances, cannabis, consumer products, chemicals and pesticides by setting regulations and safety standards and through compliance and enforcement actions.
- Enables access to safe and healthy food choices by developing food safety and nutrition standards and policies, assessing food safety risks through research, surveillance and pre-market evaluation, and promoting healthy eating.
Public Health Agency of Canada (PHAC)
- Manages risks to public health by preparing for and responding to public health emergencies, and protecting Canadians from infectious disease threats and vaccine preventable diseases.
- Supports Canadians in making healthy choices by promoting healthy behaviour and practices, and addressing the root causes of health inequalities.
- Provides timely information to Canadians on important public health issues.
- Strengthens Canada's health systems by collaborating with provinces and territories and international partners on shared health priorities.
- Supports public health action through surveillance, evidence and public education, and promotes the use of evidence by public health practitioners and policy makers.
Canadian Food Inspection Agency (CFIA)
- Mandated to protect Canada and Canadians from food, plant, and animal health risks inherent in the modern environment.
- Contributes to safeguarding Canada's food supply, including health and safety, nutrition, and labelling.
- Supports Canadian food businesses as they compete, innovate and grow in domestic and global markets.
- Comprised of four operational areas (Western, Ontario, Quebec, Atlantic), 17 regional offices, 132 field offices, 702 federally registered meat establishments (e.g. processing plants), and 13 laboratories.
- CFIA reports through the Minister of Health except agriculturally focused areas, where the agency reports through the Minister of Agriculture.
- All of CFIA's funding is appropriated through Health Canada.
Canadian Institutes of Health Research (CIHR)
- Mandated to support research and innovation to improve the health of Canadians and to strengthen the health care system by integrating research evidence into Portfolio and other government policies.
- Invests over $1 billion annually to support over 13,000 world-class researchers and trainees.
- Supports Canada's research enterprise by working closely with other federal funders (the Natural Sciences and Engineering Research Council of Canada and the Social Sciences and Humanities Research Council), the Canada Foundation for Innovation, and other departments and agencies.
- Composed of 13 "virtual" institutes focusing on a specific area of research.
- The work of the institutes embraces the four pillars of health research:
- health services; and
- population health.
Patented Medicine Prices Review Board (PMPRB)
- Mandated to protect Canadian consumers from excessive drug pricing and report on drug trends and research and development (R&D) spending by patentees.
- PMPRB is an independent, quasi-judicial consumer protection agency at arm's length from the Minister of Health.
- PMPRB's Executive Director is responsible for the day-to-day administration and oversight of its public servants staff.
- As Minister of Health, you have policy responsibility for the PMPRB and the authority under the Patent Act (s. 90) to direct the PMPRB to inquire into any matter regarding patented medicine prices and report its findings back to you.
- As of July 1, 2020, new regulations will give the PMPRB new tools to regulate the prices of drugs.
D: Key Messages
- I am honoured to be appointed Minister of Health.
- I look forward to being briefed by officials from my Health Portfolio on the pressing issues affecting the health and safety of Canadians.
- I also look forward to working collaboratively with the provinces and territories and my federal counterparts.
If pressed on specific Health Portfolio issues:
- Thank you for your question. That is certainly something on my radar, and an issue I look forward to learning much more about.
- As mentioned, I will soon be meeting with officials from the Health Portfolio. I welcome the opportunity to speak to you in more depth on this issue in the weeks to come.
E: Priority Issues
In June 2019, the Advisory Council on the Implementation of National Pharmacare released its final report with the recommendation that the Government of Canada implement universal single-payer pharmacare.
Most Canadians have some form of prescription drug coverage, but the terms of coverage vary considerably, leaving many households facing cost barriers when they have prescriptions to fill.
- No Canadian should have to choose between paying for prescription drugs and putting food on the table. Unfortunately, many are still forced to make this impossible decision.
- We are committed to moving forward with national pharmacare, working with provinces and territories, so that Canadians have the prescription drug coverage they need at an affordable price.
Opioid Overdose Crisis
The latest data published in September 2019 by the Public Health Agency of Canada reported that 12,813 apparent opioid-related deaths occurred between January 2016 and March 2019. Highly potent opioids, such as fentanyl, have permeated the illegal drug supply, fueling an unprecedented rate of overdoses and deaths.
- I am deeply concerned about the opioid overdose crisis in Canada.
- I am troubled by the many stories of individuals, families and communities impacted across the country.
- We are committed to doing everything possible to help save lives.
Vaping - Severe Lung Illness
Beginning in mid-August 2019, news media began reporting on a series of severe lung illnesses in the United States linked to the use of vaping products. As of November 8, 2019, there are two confirmed cases (in Quebec) and five probable cases (two in New Brunswick and three in British Columbia) of severe lung illness associated with vaping in Canada.
- I am aware of the emergence of cases of severe lung illness related to vaping in Canada and the United States.
- I look forward to being briefed by my officials on work to date with provinces and territories to monitor cases in Canada and to understand the underlying cause of the illnesses.
Vaping – Youth
The Government of Canada is concerned about the marked increase in vaping rates among Canadian youth. Health Canada is working to develop options at the federal level to address youth vaping in Canada.
- I am concerned about the increase in vaping reported among Canadian youth.
- I will be meeting with my officials shortly to understand what work is underway to prevent youth vaping and what more we can do in collaboration with the provinces and territories to address this situation.
- I am committing to looking at this issue as a priority.
Medical Assistance in Dying
In response to a recent Quebec Superior Court decision striking down part of the regime governing medical assistance in dying in Canada, the Government will be required to make amendments to the Criminal Code of Canada. The Quebec Court ruled that requiring a reasonably foreseeable natural death is contrary to the Charter of Rights and Freedoms.
- Medical assistance in dying is a difficult, complex and deeply personal issue.
- Canadians have diverse and evolving views which need to be considered.
- The Government of Canada confirmed in October 2019 that it would not appeal the Truchon and Gladu decision and the way forward requires legislative reform.
- As the Prime Minister indicated, we are committed to making progress within the six- month timeframe set out by the court.
Drug shortages are a complex, global problem, which remains a persistent and pressing concern for many Canadians and a strain on the health system. Drug shortages might arise from production issues, sole source contracting, unexpected surges in demand, and difficulties accessing raw supplies. Health Canada collaborates with the provinces and territories, key players in the supply chain, and patient groups to help mitigate national shortages of necessary drugs.
- Drug shortages can have a significant impact on patients and the health system.
- Addressing the complex issue of drug shortages involves many players.
- I welcome the opportunity to learn about the measures already in place to mitigate national shortages of necessary drugs, and what more we might be able to do.
Bulk importation of prescription drugs by the U.S.
On July 31, 2019, the U.S. Department of Health and Human Services (HHS) announced that the HHS and the Food and Drug Administration would propose a rule to allow states and other groups to pursue pilot projects to import drugs from Canada. Stakeholders in Canada have expressed concerns that such proposals, if implemented, could impact access to prescription drugs in Canada. [REDACTED]. The HHS is expected to begin public consultations soon as part of its standard regulatory process.
- Ensuring that Canadians have access to the medicines they need is a top priority.
- I understand that my officials are engaging with a range of partners, including U.S. counterparts, to better understand the potential implications of the U.S. proposal.
- I'm committed to safeguarding access to prescription drugs for Canadians.
Canadians rely on antibiotics to treat common infections and for routine health care procedures. Infections are becoming increasingly resistant to treatment, with grave consequences for health and health care. Left unchecked, antibiotic resistance could lead to some infections becoming untreatable. The new Council of Canadian Academies report estimates that 5,400 Canadians died last year from an antibiotic-resistant infection and warns that deaths will increase over the coming years.
- Antibiotics, used to treat a variety of infections, are essential to the health of Canadians and have been part of the health care landscape for decades.
- Antimicrobial resistance (AMR) is a growing public health threat in Canada and around the world. Addressing AMR will require coordinated action across multiple disciplines within the human and animal health sectors.
- I am keen to meet with my officials to learn more about Canada's approach to limiting the development and spread of AMR, including the Pan-Canadian Action Plan on AMR.
Throughout 2019, there has been ongoing media coverage related to measles outbreaks in many Canadian cities and across numerous countries. Some provinces have also spoken about possible mandatory vaccination programs.
- Vaccination is essential to protecting the health of Canadians.
- I look forward to hearing about work underway to support vaccination programs.
- Regarding vaccine programs and policies, including mandatory vaccination, I'll refer you to provinces and territories as these programs are under their jurisdiction.
F: Key Contacts
Prime Minister's Office Switchboard
Minister's Office Reception
Dr. Stephen Lucas
Public Health Agency of Canada
Dr. Theresa Tam
Chief Public Health Officer
Canadian Food Inspection Agency
Dr. Siddika Mithani
Canadian Institutes of Health Research
Dr. Michael J. Strong
Patented Medicine Prices Review Board
Dr. Mitchell Levine
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