Evaluation of the COVID-19 Safe Restart Agreement Contribution Program – 2020-2021 to 2023-2024

Final Report – Executive Summary
March 2025
Prepared by the Office of Audit and Evaluation
Health Canada

Table of contents

• Executive summary
  • Background and evaluation scope
  • Findings
  • Lessons learned

Executive summary

Background and evaluation scope

Health Canada's COVID-19 Safe Restart Agreement (SRA) Contribution Program was launched in 2020-2021 as a short-term strategy to fund innovative projects and to increase capacity in testing, contact tracing, and data management. Funding recipients included provinces and territories (PTs), municipal governments, and academic institutions, as well as for profit, not-for-profit, and Indigenous organizations.

The evaluation focused on program activities conducted between 2020-2021 and 2023-2024. The purpose of the evaluation was to assess the Program's governance and delivery, and the achievement of outcomes, excluding projects undertaken by provinces and territories. This evaluation also documented lessons learned and best practices to inform planning and decision making for future public health emergencies. Data was collected from document and literature reviews, financial and project report analyses, and interviews.

Findings

Effectiveness of governance mechanisms

The SRA Contribution Program funded recipients through contribution agreements to quickly release funds and maintain federal oversight. It funded 28 projects through 34 contribution agreements with 25 non-provincial or territorial recipients. The Program also provided funding to all provinces and territories for 24 initiatives through letters of agreement.

Health Canada leveraged its relationships with federal, provincial, and territorial (FPT) governance bodies to ensure co-development and alignment on federal government priorities. Funding recipients were selected through targeted proposal solicitation from qualified organizations with which Health Canada had pre-existing relationships. This supported fast program implementation but limited the diversity of the recipient pool which may have resulted in missed opportunities to broaden program reach.

The Program was established at a time when there was limited knowledge about the duration of the pandemic and the nature of the associated federal response. This uncertainty and the needs of the response which evolved as the pandemic unfolded left limited capacity for robust oversight and reporting mechanisms. The lack of measurable assessment criteria challenged the proposal review process, while staff capacity challenges including frequent turnover, as well a lack of standardized reporting instruments and structured report review process limited performance monitoring.

Achievement of immediate and intermediate outcomes

The Program largely achieved its immediate and intermediate outcomes, namely it:

• supported critical scientific advancements in testing and screening activities including wastewater surveillance;
• expanded Canadian capacity in economic evaluation of screening programs;
• advanced approaches to surveillance of viral transmission of SARS-CoV-2 and other pathogens through scientific research studies;
• established screening programs in the 13 PTs; and
• facilitated the distribution of millions of tests and masks to support the safe reopening of the Canadian economy.

Through funding provided to Indigenous organizations, the Program supported initiatives that helped close health data gaps and led to the improvement and/or establishment of data management systems in First Nations and Métis communities, as well as the creation of data sharing agreements with provinces.

Lessons learned

The Program, while successful, experienced challenges and limitations that were a result of the speed at which it had been established and its expedited schedule. Some of these included the following:

• a lack of defined proposal assessment criteria;
• the absence of an overarching performance measurement and reporting framework; and
• the absence of staff with experience administering grants and contributions.

The evaluation identified the following lessons learned, in lieu of recommendations, to inform planning and decision making for future public health emergencies.

Lesson 1: The administrative and oversight issues faced during the implementation of the Program would have been lessened by using established tools, templates, and processes.

The expedited Program design and implementation schedule necessitated by pandemic needs led to the swift development of tools, templates, and processes that consequently had some limitations. A sleeper protocol for program delivery may help streamline the implementation of similar initiatives during public health emergencies in the future. The suggested protocol would be activated during public health emergencies and could include defined guidelines for governance and decision making, implementation procedures, and performance measurement tools.

Lesson 2: Staff capacity challenges could have been mitigated by a roster of personnel skilled and trained in grants and contributions.

Program staff and executives designed and implemented the Program to quickly respond to emerging pandemic needs. However, the lack of staff with experience administering grants and contributions meant that program tools and processes had some limitations. A roster of staff and executives with the requisite experience to staff and provide surge capacity for program delivery and staff already trained in grants and contributions may have mitigated these issues.

Lesson 3: Once recognized as a priority population, the funds allocated for Indigenous communities should have been transferred promptly to Indigenous Services Canada (ISC).

Indigenous communities were identified as priority populations for funding early in the Program. To ensure swift release of funds, Health Canada collaborated with partners in other government departments to solicit proposals from Indigenous organizations. This led to the funding of projects in First Nations and Métis communities, but not in Inuit Nunangat. The resource constraints faced by Indigenous communities during the pandemic prevented the finalization of some proposals, including those of Inuit Nunangat. There were also some challenges during the implementation of projects. The prompt transfer of funding to ISC, given it has the requisite knowledge and experience in Indigenous communities, as well as flexible transfer payment mechanisms, could have helped address those challenges.

Lesson 4: Health Canada and its partners in other government departments may have missed opportunities by focusing funding efforts on recipients with whom they had pre-existing relationships.

Recipients were largely successful in achieving the Program's objectives, but the pool of beneficiaries was limited to those with whom Health Canada and its partners in other government departments had pre-existing relationships. The development of a roster of potential funding recipients, identified through a mapping exercise, would help expand the pool and diversity of beneficiaries in future public health emergencies.