Independent review of the Global Public Health Intelligence Network (GPHIN)

On this page

• Status of the review
• Reports from the External Review Panel
• Panel members
• Background
• Terms of reference

Status of the review

The final report from the External Review Panel is now available, and offers recommendations to prepare for future health events and improve public health surveillance tools at PHAC.

The 36 recommendations in the final report relate to:

• the role and purpose of GPHIN, including articulating its role and functions as part of PHAC's public health surveillance activities, extending its partnerships and subscriber outreach, and regularly evaluating its processes and products;
• organizational considerations and flow of information, including establishing a new Risk Assessment Office at PHAC, linking GPHIN to PHAC's broader surveillance activities, and training and recruiting GPHIN staff; and
• technology, such as incorporation of additional social media and other new sources of data, platform improvements, and advice on the next generation of public health intelligence systems.

These recommendations will inform the work underway at PHAC to review its processes and identify improvements, and to clarify and streamline the decision-making process for the issuance of GPHIN products, including alerts. The report will also inform work to respond to the GPHIN recommendation from the Auditor General from "Report 8 - Pandemic Preparedness, Surveillance, and Border Control Measures".

Establishment of the review

The Public Health Agency of Canada is committed to scientific excellence and continuously adapting its processes to enable effective responses to emerging public health issues.

In the fall of 2020, the Minister of Health requested an independent review of Canada's global public health surveillance system, the Global Public Health Intelligence Network (GPHIN), to assess how it continues to meet today's public health needs.

Ms. Margaret Bloodworth was selected as the chair of the External Review Panel that conducted this independent review. The other panelists included Dr. Paul Gully and Dr. Mylaine Breton. The External Review Panel was selected based on diverse experience and expertise in relevant fields, including public health, health security and intelligence, and governance.

This review considered:

• the capabilities of the existing system
• its role in detecting and informing the Public Health Agency of Canada's response to COVID-19, and in global and domestic public health surveillance
• opportunities to improve the system
• the future of Canada's global health surveillance system, including advice on the next generation of intelligence systems and lessons learned from COVID-19, so that Government of Canada is well positioned to respond to future public health events

The terms of reference for the review were determined in consultation with the External Review Panel.

Reports from the External Review Panel

• Interim report
• Final report

Panel members

• Ms. Margaret Bloodworth (chair)

  Margaret Bloodworth is a former senior federal public servant, most recently Associate Secretary to the Cabinet and National Security Advisor to the Prime Minister (2006-2008). Prior to that, she was the first Deputy Minister of Public Safety (2003-2006), Deputy Minister of Defence (2002-2003), and Deputy Minister of Transport (1997-2002).

  Currently she is Vice Chair of the Board of Directors and Chair of the Nominating and Governance Committee of the Canada Foundation for Innovation, a member of the Judicial Compensation and Benefits Commission and Chair of the Advisory Committee to the School of the Public Service.

  Formerly she was Chair of the Boards of the Council of Canadian Academies and Cornerstone Housing for Women and a member of the Board of the Ottawa Community Foundation where she chaired the Grants Committee.

  She is an honorary Senior Fellow of the Graduate School of Public and International Affairs at the University of Ottawa. She is a member of the Order of Canada. She has received:

  • the Upper Canada Law Society Medal
  • the Public Service of Canada Outstanding Achievement Award
  • the Vanier Medal of the Institute of Public Administration of Canada
  • honorary degrees from the University of Winnipeg and Carleton University
  • an honorary diploma from the Canadian Coast Guard College
  • charter membership in the Common Law Honour Society of the University of Ottawa

  She is a graduate of the University of Winnipeg and the University of Ottawa and was called to the Ontario bar in 1979.

• Dr. Paul Gully

  Dr. Paul Gully is a senior public health physician with specialist qualifications in the UK and Canada, and over 30 years of experience. He worked as a general practitioner in Africa and the Canadian Arctic then in public health in the UK primarily in the area of infectious diseases.

  In Canada, Dr. Gully worked in Saskatchewan, and Health Canada, from 1990-2004 and was directly involved in the federal response to SARS in 2003. Dr. Gully was with the Public Health Agency of Canada (PHAC) from 2004-2006 working in the areas of infectious diseases and emergency preparedness and response. At PHAC, he was a Deputy Chief Public Health Officer for Canada.

  Dr. Gully was seconded to the World Health Organization (WHO) from PHAC in 2006 to work on pandemic preparedness, and returned to work for Health Canada in 2009, where he was involved in responding to the 2009 pandemic of influenza.

  Dr. Gully retired from the federal public service in 2013. Since that time, he has worked for the First Nations Health Authority of British Columbia, for the WHO, in Geneva, and in Sierra Leone on Ebola, and has consulted for the British Columbia Provincial Health Services Authority.

  He is an Adjunct Professor at the School of Population and Public Health, Faculty of Medicine, University of British Columbia. His main area of interest is communicable disease, and his recent activities relate to teaching global health and supporting community medicine residents.

• Dr. Mylaine Breton

  Mylaine Breton, MBA, Ph.D. is a 2019-2020 Canadian Harkness Fellow in Health Care Policy and Practice funded by Commonwealth Fund. She did a sabbatical year at the Center for Primary Care at Harvard Medical School.

  Since 2012, she has been a professor in the Department of Social Science and Medicine at the University of Sherbrooke's Longueil campus, and holds a Canada Research Chair in Clinical Governance on Primary Health Care.

  Professor Breton's research program is comprised of applied research projects undertaken in partnership with clinicians and managers to improve the organization of health care. Her current research focuses on primary health care with a focus on better understanding promising organizational innovations to improve accessibility and continuity, such as implementing a centralized waiting list for patients without primary health care providers and advanced access models.

  Professor Breton's scientific output consists of more than 60 peer-reviewed articles published in the last five years.

  Professor Breton completed basic training as an occupational therapist, and holds an M.B.A. from Université Laval. She earned her Doctorate in Health Service Management from University of Montréal in 2009 and completed a post-doctoral appointment at Université de Sherbrooke/McGill University.

Background

GPHIN is an early-warning and situational awareness system for potential chemical, biological, radiological and nuclear public health threats worldwide. This includes monitoring of infectious disease outbreaks.

GPHIN was established in 1997. Since that time, a significant number of non-governmental entities now conduct open source surveillance and alerting along with governmental systems. This global shift to both private and public sector public health surveillance has impacted the role that GPHIN plays in Canada and on the world stage.

GPHIN shares a variety of information products with users about public health issues.

• Canadian users receive timely information about public health issues through the GPHIN Daily Report, which includes curated collections of links and articles of interest.
• GHPIN Alerts are links to articles of interest that may merit further attention, and are shared with domestic and international users.
• A range of domestic and international public health partners have access to the GPHIN database.

Terms of reference

The following terms of reference for this independent review were finalized with the External Review Panel in November 2020.

Context

Headquartered at the Public Health Agency of Canada (PHAC), the Global Public Health Intelligence Network (GPHIN) is an event-based, multilingual, early-warning and situational awareness network for potential chemical, biological, radiological and nuclear public health threats worldwide - including outbreaks of infectious disease. GPHIN has played a key role in the early detection of past international outbreaks, including H1N1, MERS and Ebola.

Since the formation of GPHIN in 1997, global shifts in communications technologies, data gathering and analytics have affected the role that GPHIN plays in Canada and on the world stage. A significant number of non-governmental entities now conduct open-source surveillance and alerting alongside governmental systems, and the speed at which information can be shared around the world is now incredibly fast. Information about the ongoing COVID-19 outbreak was disseminated early and swiftly to public health authorities around the world through multiple mechanisms, including GPHIN.

On August 17, 2020, the Minister of Health requested an independent review of GPHIN, to be conducted by an External Review Panel. This was reported publicly on September 7, 2020. The results of this review will inform future policy decisions around Canada's global public health intelligence system and support GPHIN's ongoing contribution to public health in Canada and around the world.

Mandate

The Minister of Health has mandated the establishment of an External Review Panel (the "Review Panel") to undertake a time-limited and independent review of GPHIN. The Review Panel is to deliver a final report to the Minister that will be made available to the public.

The activities of the Review Panel will be carried out in accordance with departmental and federal policies and practices for external advisory bodies.

While the objective of the review is to provide advice and recommendations to the Minister of Health, the Minister retains the ultimate responsibility, accountability, and sole authority for any decisions resulting from the advice received from the Review Panel.

Scope and objectives

The review of GPHIN will focus on the following:

• A review of GPHIN's current effectiveness, its contribution to public health intelligence domestically and internationally, including its role in the Agency's early response to COVID; and
• A comprehensive look at the future role of GPHIN in the context of event-based surveillance.

In addition, this panel will be made aware of any relevant findings from the surveillance audit being conducted concurrently by the Office of the Auditor General.

External Review Panel

The members of the Review Panel will be appointed by the Minister.

The Minister will establish a diverse panel of professionals and experts from outside of PHAC. Members will be selected based on their experience and their knowledge, with specific expertise sought in the relevant fields of public health, security and intelligence. Biographies of the members will be made publically available online.

The Review Panel will consist of a Chair and a number of panelists.

Secretariat roles and responsibilities

The Review Panel will be supported by a dedicated Secretariat responsible for operational advice, coordination and administration in key areas:

• Administration, operations, and logistics for meetings and engagements;
• Development of appropriate meeting and engagement records; preliminary and final reports; and budgets; and
• Providing strong context, content, and process knowledge in panel management.

Panel roles and responsibilities

By accepting to serve on the Review Panel, members agree to be bound by the conditions of the Terms of Reference.

Deliverables

The Review Panel will be asked to undertake this review on a part-time basis beginning in November, 2020. The Panel will provide an interim report by February, 2021 and a final report at the Panel's conclusion in the spring of 2021. This work will be supported by the Secretariat.

Panel activities

In order to advance its work, the Panel could undertake a range of activities including:

• In camera discussions to exchange perspectives, establish a shared understanding of issues, identify key themes, and develop advice;
• Request analysis of selected themes and issues from the Secretariat;
• Invite guests with experience and expertise in key areas and issues to make presentations to, and engage in dialogue with, them; and
• Prepare interim reports to the Minister on emerging findings and/or specific themes, as well as a final report with conclusions and advice in accordance with its mandate.

The members of the Review Panel have a responsibility to give their best advice and fulfill their roles through their integrity, expertise, experience, and openness to the dialogue and deliberation.

The Review Panel will have full independence in formulating practical and implementable advice and recommendations.

With regard to conflicts of interest:

• The Review Panel acknowledges the importance of offering advice and recommendations that are independent, expert, and made in good faith.
• Members shall immediately report to the secretariat any real, potential or apparent conflict or bias resulting from their roles on the Review Panel and any outside interests or activities, including organizational affiliations, other advisory committees or boards of directors.
• Members shall disclose to the Secretariat any advice which, if adopted and implemented by the Government of Canada, could result in direct or immediate financial gain to the Member, either professionally or personally, or to any of the members' family members or to any organization with which the member is affiliated.

Members will direct any media inquiries to the Secretariat and notify the Secretariat about the inquiry.

The Chair of the Review Panel will have the following additional responsibilities:

• oversee preparations for Review Panel meetings, including agenda preparation;
• lead discussions among the members as to whether sufficient information or material has been provided to inform deliberations or decisions;
• attempt to achieve consensus where members express conflicting positions, views or advice; and
• oversee the final report and recommendations to the Minister.

Timeline

The review will commence in November, 2020, and the first meeting of the Review Panel should take place no later than two weeks after the panel has been established.

The review is expected to be conducted over a period of five to six months, subject to input and advice from the Chair of the Review Panel.

Expenses

Members will be reimbursed for expenses incurred to participate in Panel meetings in accordance with Government of Canada policies, including the Treasury Board's Travel Directive and the Directive on the Management of Expenditures on Travel, Hospitality and Conferences.

Confidentiality and public communications

Review Panel members may discuss or review confidential or sensitive issues and documents, and should note that the confidentiality and privacy policies of the Government of Canada apply. Therefore, the members will require an appropriate security check.

To support their ability to provide well-informed advice, the Review Panel may request and receive confidential information from PHAC and Health Canada. Every member of the panel will commit to keeping this information secure and confidential, and sign a Confidentiality Agreement before participating on the Review Panel.

PHAC will mark information according to the level to which it is protected under the Policy on Government Security.

All information gathered by the Review Panel in the course of its work is subject to the provisions of the Access to Information Act and the Privacy Act.

Over the course of the review and after its completion, members of the Review Panel are not permitted to divulge confidential information or any materials to a third party without the prior consent of the Government of Canada. Any inquiries from third parties regarding the Review Panel's activities should be referred to the Secretariat. Safeguards related to confidentiality and public communications are not intended to limit the ability of the Review Panel to conduct analysis and make recommendations essential to fulfilling its mandate.

Changes to the terms of reference

The Minister or her delegate may amend these Terms of Reference at any time after consultation with the Panel. Members will be notified of any changes.

Related links

• About GPHIN
• Emergency preparedness and response
• Public health surveillance