Section 4: Evaluation of the National Emergency Stockpile System (NESS) – Summary
In many ways, the NESS is an insurance policy. No one ever wants to draw from that insurance policy because that would mean that an undesirable event has happened and many people are affected. Events for which NESS supplies have been deployed have included tsunamis and floods, train accidents, ice storms, pandemic influenza and terrorist attacks within Canada and abroad.
However, these types of events will continue to happen, and Canada has to be prepared. There is a need for a stockpile of public health supplies managed by the federal government. The responsibility for managing this stockpile fits with Public Health Agency's specific mandate and priorities.
Mix of supplies for the NESS
As outlined in the 2010 Audit of Emergency Preparedness and Response, a strategic long term plan is needed to guide the procurement and management of supplies within the stockpile. In line with developments in capacity, and the reality of current public health threats, the NESS program should focus on its niche role in current emergency response requirements when determining what supplies should be in the stockpile.
The updating of the NESS program should focus on the acquisition and management of assets that are operationally relevant to current risk assessments and that are most closely in line with the Public Health Agency's mandate and priorities. The Centre for Emergency Preparedness and Response should consider the Agency's role in the following when reviewing and assessing the need for current supplies and future procurements:
- pandemic preparedness and a review of the stockpile of antivirals in the NESS in light of any decisions regarding the size and composition of the National Antiviral Stockpile
- surge capacity to provinces and territories for planned mass gatherings of national significance, such as during the Vancouver Winter Olympic Games in 2010, and its role in medical and/or pharmaceutical responses to unplanned events, such as natural or man-made disasters
- preparing for national security threats, such as a chemical, biological or radio-nuclear event (in collaboration with Health Canada).
While there continues to be a need during public health events for a social service response, the capacity of the provinces and territories, and non-governmental organizations (such as the Canadian Red Cross and a variety of other response agencies), to assist with the provision of these supplies at the local level has increased. Other countries, as well as some provinces and territories in Canada, are already primarily working with non-governmental organizations for social services support during an emergency.
Retain some but not all of the current NESS asset mix. Focus on an appropriate public health role when planning for and determining the future strategic mix of assets rather than on a more general social services role in responding to events.
- a. Continue to ensure the following stock is available for provincial/territorial surge:
- pandemic preparedness supplies
- medical and pharmaceutical supplies for planned mass gatherings of national significance and unplanned natural or manmade disasters
- chemical, biological and radio-nuclear (CBRN) countermeasures.
- b. Consider eliminating social service supplies from the NESS asset mix while ensuring their continued availability.
For stock being acquired and retained, attention should also be paid to its life-cycle ssssmanagement – such as methods of procuring and storing supplies. (see Appendix A)
Should the Public Health Agency devolve itself of its role in the direct provision of emergency social service supplies, it should play a leadership role in the coordination of discussions with other government departments, provinces and territories, and non-governmental organizations to ensure transition plans are in place and needs continue to be met.
Disposal of supplies
The Centre for Emergency Preparedness and Response is currently developing a NESS strategic plan and operational business plan, based on a comprehensive risk assessment to guide future program activities. One of the key activities in the plan is the development of an inventory tracking system to support the lifecycle management of NESS operations.
Another sub-activity of the operational plan is the further development and continued implementation of an asset disposal policy and processes. Disposal of outdated supplies is a critical activity. Paying for the storage of outdated materials has been a source of frustration for some provinces and territories; disposing of outdated materials will therefore help to rebuild provincial and territorial confidence in the NESS program.
Disposal of supplies could also take into account any change in strategic planning that occurs as a result of the 2010 Audit of Emergency Preparedness and Response and this particular evaluation. Therefore, supplies that are no longer deemed strategic and/or appropriate for a Public Health Agency stockpile should also be disposed of.
Disposing of such a large number of assets will be costly and take time to complete. It may involve shipping materials back to Ottawa from warehouses and many pre-positioned sites around Canada, sorting through materials to assess the disposal strategy and moving these materials through the disposal system, and includes liaison and collaboration with Public Works and Government Services Canada. However, this activity will help to restore confidence in the NESS program and improve its ability to be relevant in emergency response.
Develop, resource and implement a disposal strategy to allow for the disposal of:
- a. equipment and supplies that are outdated, no longer meet current medical standards, or are of poor quality (i.e. emergency hospitals, casualty collecting units, etc.)
- b. individual social services items (i.e. cots and blankets) and social services units (i.e. mobile feeding units, reception centre kits, etc.) (contingent on the outcome of recommendation 1b).
Supporting an integrated response
Provinces, territories and other federal government departments have expressed confusion about components of the stockpile. In some jurisdictions there is very little information available to authorities on the NESS − they are not aware of which assets are available to them or the process for drawing from the NESS. The Public Health Agency therefore needs to develop a strategy to clarify processes, affirm responsibilities and raise awareness of the stockpile.
The Agency should support an integrated, coordinated pan-Canadian approach to the management of provisions for emergency public health response, ensuring that knowledge and expertise on public health stockpiling are shared within the federal government and across jurisdictions.
As is the case for disposing of outdated material, this effort will help build confidence in the stockpile and allow others who rely on this service to better understand what the stockpile can and cannot provide. The development of communications products and other tools should reflect the Public Health Agency's domestic, and potentially international, role in responding to emergencies.
The types of communications products will vary, depending upon the need and audience. Products such as planning guides, readily accessible to provinces and territories, fact sheets on processes related to deployment of the stockpile and training videos for particular products should be considered.
Develop, implement and monitor a strategy to help communicate the Public Health Agency's role in stockpiling supplies for public health responses, considering the following target groups:
- Other federal government departments and agencies
- Provinces/territories, including specialized areas:
- End users (health practitioners)
- Materiel management specialists
- Logistical teams.
The Public Health Agency has not yet articulated its international role or developed a Public Health Agency-wide strategy for approaching international issues or events. The Public Health Agency must specifically consider the NESS in developing its international strategy (currently under development).
While international deployment of supplies is not the primary objective of the NESS program, the stockpile has been used in the past to respond to international events. This approach is consistent with how other international jurisdictions view and use their domestic stockpiles. It is safe to assume that further requests for the deployment of supplies for international emergencies will continue to be received in the future. However, there are no ongoing authorities for deploying the stockpile internationally, and there are no established processes and protocols for the international deployment of the NESS for this purpose.
If the Agency decides to seek an ongoing mandate to deploy the NESS supplies internationally, consultations should be held with other government departments (such as the Canadian International Development Agency, the Department of Foreign Affairs and International Trade and the Department of National Defence) and non-governmental organizations (like the international arm of the Canadian Red Cross) to determine how the NESS program could best support a coordinated Canadian response to international public health events.
Include specific consideration of the NESS in the Agency's broader discussions of its international role.
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