Results: what we achieved

Programs

Program 1.1: Public Health Infrastructure

Description

The Public Health Infrastructure Program strengthens Canada’s public health, workforce capability, information exchange, and federal, provincial and territorial networks, and scientific capacity. These infrastructure elements are necessary for effective public health practice and decision-making in Canada. The program works with federal, provincial and territorial stakeholders in planning for and building strategic and targeted investments in public health infrastructure, including public health research, training, tools, best practices, standards, and mechanisms to facilitate information exchange and coordinated action. Public health laboratories provide leadership in research, technical innovation, reference laboratory services, surveillance, outbreak response capacity and national laboratory coordination to inform public health policy and practice. Through these capacity-building mechanisms and scientific expertise, the Government of Canada facilitates effective coordination and timely public health interventions which are essential to having an integrated and evidence-based national public health system based on excellence in science. Key stakeholders include local, regional, provincial, national and international, public health organizations, practitioners and policy makers, researchers and academics, professional associations and non-governmental organizations.

Results

During 2016–17, PHAC made progress in supporting an effective Canadian public health system with results and highlights as noted below.

Scientific and Laboratory Capacity
  • PHAC scientists worked with public health partners to quickly provide sound testing guidance  to combat bacterial contamination in hospital heater-cooler units which had exposed cardiac surgery patients to serious health risks.
  • PHAC’s National Microbiology Laboratory rapidly responded to the Zika virus outbreak by establishing diagnostic methods and providing guidance for laboratory testing  which resulted in meeting Canada’s immediate testing needs.
  • As part of a laboratory technology modernization strategy, PulseNet Canada modernized its Listeria surveillance and outbreak response activities to whole genome sequencing technology to improve detection and response times to foodborne illnesses.
Domestic and International Public Health Capacity
  • To raise awareness of Canada’s role and responsibilities under the International Health Regulations (IHR) (2005),Footnote 3 PHAC provided training to federal partners focussed on strengthening protocols for the notification and reporting of public health events, such as infectious disease outbreaks.
  • In partnership with the Pan American Health Organization, PHAC completed missions to Suriname, Guyana, and Belize to strengthen each country’s capacity for reporting and managing potential public health events under the IHR.

PHAC FACT

PHAC provided staff epidemiologists to work with medical examiners and public health organizations across Canada to improve data analysis and reporting of opioid-related deaths.

Public Health Surveillance and Information Sharing
  • The Canada Communicable Disease Report provided public health professionals with practical and authoritative information on emerging and persistent infectious diseases in Canada to help inform policy, practice, and program development. In recent years, expanded readership across North America, the European Union, and Australia has resulted in a 50 percent increase in the subscription rate.
  • The Health Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice Journal provides science-based evidence to public health care professionals and researchers on a monthly basis, covering Canadian research and population relevant studies on disease prevention, health promotion, and health equity. Since April 2016, all published issues contained articles with research findings broken down by sex and/or gender, among other factors.
  • To help provide a much-needed national picture of the opioid crisis in Canada, PHAC collaborated with all P/T governments to share existing data, and developed a surveillance plan for the first-ever national surveillance of opioid deaths in Canada, which will be implemented in 2017–18.
  • PHAC supported the ongoing implementation of the Multi-Lateral Information Sharing Agreement which sets out why, how, what, and when federal, provincial, and territorial (F/P/T) governments share and use information on infectious diseases and public health events.
Results achieved
Expected results Performance indicators Targets (Dates) Actual results
2016–17 2015–16 2014–15
Canada has the public health system infrastructure to manage public health risks of domestic and international concern Level of Canada’s compliance with the public health capacity requirements outlined in the International Health Regulations 2Footnote 4
(by Mar. 31, 2017)
2 2 2
Public health professionals have timely access to peer reviewed laboratory and surveillance publications to inform public health action Number of citations referencing Agency laboratory research publicationsFootnote 5 1,800
(by Mar. 31, 2017)
2,974 2,850 2,138
Percent of accredited reference laboratory tests conducted within the specified turnaround timesFootnote 6 95
(by Mar. 31, 2017)
95.8 96.6 95.8
Budgetary financial resources (dollars)
2016–17
Main Estimates
2016–17
Planned spending
2016–17
Total authorities
available for use
2016–17
Actual spending (authorities used)
2016–17
Difference
(actual minus planned)
115,963,044 115,963,044 112,399,719 111,593,778 (4,369,266)
Human resources (full-time equivalents)
2016–17
Planned
2016–17
Actual
2016–17
Difference (actual minus planned)
723 743 20

Program 1.2: Health Promotion and Disease Prevention

Description

The Health Promotion and Disease Prevention Program aims to improve the overall health of the population—with additional focus on those that are most vulnerable—by promoting healthy development among children, adults and seniors, reducing health inequalities, and preventing and mitigating the impact of chronic disease and injury, as well as infectious diseases. Working in collaboration with provinces, territories, and stakeholders, the Program develops and implements federal aspects of frameworks and strategies (e.g., Curbing Childhood Obesity: A Federal, Provincial and Territorial Framework for Action to Promote Healthy Weights, national approaches to addressing vaccinations) geared toward promoting health and preventing disease. The Program carries out primary public health functions of health promotion, surveillance, science and research on diseases and associated risk and protective factors to inform evidenced‑based frameworks, strategies, and interventions.

Results

During 2016–17, PHAC made progress in addressing critical health promotion and disease prevention challenges as noted below.

Innovation and Experimentation
  • PHAC worked with partners to design and deliver innovative solutions to encourage Canadians to incorporate healthy living choices as part of their daily lives and reduce the risk of injury. For example, PHAC provided funding to support the following initiatives:
    • The Concussion Ed app gives free access to critical concussion resources;
    • The Carrot Rewards initiative builds on the concept of nudging to test whether an incentive-based mobile application can motivate healthier behaviours using loyalty points and rewards. The model brings together governments, non-governmental organizations and popular loyalty point providers to generate evidence on the results of these incentives. Building on its initial success in British Columbia, Carrot Rewards expanded to Newfoundland and Labrador (June 2016) and Ontario (February 2017); and
    • The Community Hypertension Prevention Initiative with the Heart and Stroke Foundation features an innovative Social Impact Bond funding model to increase awareness of high blood pressure and Cardiovascular Disease risk among participants aged 60+. This funding model is also intended to improve the ability of participants to manage modifiable risk factors through healthy behaviours (e.g., increase in physical activity and/or reduction in sedentary behaviour, healthy eating, and smoking cessation).
Infectious Diseases and Immunization
  • Budget 2016 committed $25 million over five years to improve the percentage of Canadians who receive all recommended vaccinations. Significant progress was made by:
    • Investing in the Immunization Partnership Fund to support projects aimed at increasing vaccination uptake, as well as providing leadership for national outreach and awareness activities promoting vaccinations;
    • Implementing a new research program, the Improved Immunization Coverage Initiative, in partnership with the Canadian Institutes of Health Research, to identify under and un-vaccinated populations in Canada with special emphasis on vulnerable populations such as Indigenous Peoples; and
    • Enhancing immunization surveys to better understand who is not getting vaccinated and why, and updating goals and targets for reducing vaccine preventable diseases, as recommended in an evaluation report.
  • PHAC contributed to the prevention of HIV, hepatitis C, and other STBBIs by:
    • Funding 158 community-based projects that reached over 250,000 individuals, practitioners, service providers, and policy makers resulting in improved knowledge and capacity to prevent infection and improved access to health and social services;
    • Engaging partners and stakeholders to share knowledge and identify concrete actions to make progress towards the elimination of STBBIs as public health threats in Canada; and
    • Demonstrating leadership and enhanced collaboration with P/T governments to strengthen approaches to measure progress on global HIV treatment targets known as 90-90-90.

PHAC FACT

PHAC hosted a major conference to develop the draft Federal Framework on Lyme Disease to help guide federal action on data collection and analysis, education, and best practices.

  • In collaboration with Immigration, Refugees, and Citizenship Canada, PHAC led the development of evidence-based approaches for optimizing Tuberculosis prevention and control for migrant populations. PHAC also collaborated with the Government of Quebec to implement an innovative pilot project to increase education, screening, and treatment for Latent Tuberculosis Infection in Nunavik.
  • PHAC led a national effort to develop a pan Canadian framework on antimicrobial resistance (AMR) and released the Canadian AMR Surveillance System 2016 Report which identified gaps in the surveillance of a number of priority pathogens that need to be addressed. This information is needed in order to develop a complete picture of AMRFootnote 7 across Canada and to guide the development of treatment guidelines and public health interventions to minimize the spread of AMR.
Healthy Living and Injury Prevention

PHAC worked with partners to design and deliver innovative solutions to encourage Canadians to make sustained healthy living choices and reduce the risk of injury. PHAC also expanded Canadians’ knowledge and understanding of the common reasons and ways they can protect themselves against chronic diseases and injuries by:

  • Implementing the Physical Activity, Sedentary behaviour, and Sleep (PASS) Indicator Framework to provide a clearer picture of how active Canadians really are, and provide health professionals with the information needed to develop policies and programs for a healthy and active population. To address challenges with traditional data collection, including falling response rates to surveys, PHAC initiated a "data challenge" with stakeholders to identify other data sources to improve PASS' capacity to provide health evidence in this area.
  • Using the data from the PASS Indicator Framework to support the development of the 24 Hour Movement Guidelines for Children and Youth (aged 5-17) led by the Canadian Society of Exercise Physiologists. The new Guidelines provide recommendations for the 4 Ss: "Sleep", "Sit", "Step", and "Sweat".
  • Partnering with Indigenous and Northern Affairs Canada and Health Canada (HC) on Nutrition North Canada to fund projects that increase knowledge of healthy eating, and support the development of skills related to the selection and preparation of healthy foods.
  • Partnering with ParticipACTION and the Royal Bank of Canada to fund RBC Learn to Play, awarding more than $6 million over three years (with $1.5 million awarded in 2016–17) to 591 local organizations across Canada to incorporate physical literacyFootnote 8 into their youth sport and recreation programs.
  • Providing new evidence on concussions related to sports and recreational activities among Canadian youth through an open-source tool that provides an interactive snapshot of brain injury statistics.Footnote 9
Mental Health Promotion, Suicide Prevention and Support for Survivors of Violence
  • PHAC launched the 2016 Federal Framework for Suicide Prevention (FFSP) to align federal activities in suicide prevention and complement the important work by stakeholders across Canada. The Mental Health and Mental Illness Evaluation noted PHAC’s strong collaborative efforts in this important area, and a Progress Report on the FFSP highlighted the Government of Canada’s actions on suicide prevention.
  • PHAC is investing $2 million over five years to support the development of a National Suicide Prevention Service, $475,000 of which was spent in 2016–17, to provide a free 24/7 service to support individuals in crisis, regardless of where they live in Canada.
  • PHAC invested $5.3 million in projects to improve the health of survivors of violence. In particular, the Violence Evidence, Guidance and Action project brought together 22 national health and social service associations to improve training resources to help health professionals better support victims of child maltreatment and intimate partner violence.
Seniors and Aging

As Canada’s senior population increases, it is more important than ever to support the health and well-being of older Canadians. PHAC supported healthy aging by:

Vulnerable Children and Families

Canada's children and youth face particular health challenges, with greater risks of poor health among vulnerable families and children. PHAC supported improved healthy child development and reduced differences in health among different populations by:

  • Renewing PHAC programming in over 3,000 communities across Canada to improve the health and well-being of children living in conditions of risk. An evaluation of these programs determined that they’ve successfully reached high-risk Indigenous Peoples, and are having a positive impact on early childhood development. These programs apply performance measurement tools designed to collect data on results broken down by sex, gender and other diversity factors.

PHAC FACT

By supporting early childhood education training at Nunavut Arctic College, a preschool was established in Pond Inlet to enhance Indigenous capacity in early child development.

  • Partnering with the University of Western Ontario on the Fourth RFootnote 10 (Uniting our Nations) mentoring program to provide opportunities for Indigenous students to connect cultural teachings with their current life experiences. Early evidence suggests that students built more self-confidence, developed more effective coping and conflict resolution skills, and were mentally healthier than their non-mentored peers.
Health Equity
  • PHAC released "Toward Health Equity: A Guide to Sex and Gender-based Analysis in Agency Programs and Policies", an internal document that includes key concepts and a practical, four-step process to apply sex and gender-based analysis (SGBA) in PHAC's work. The Guide has been used to support SGBA training and was shared by Status of Women Canada as a tool to support other departments and agencies in conducting SGBA.
Results achieved
Expected result Performance indicators Targets (Dates) Actual results
2016–17 2015–16 2014–15
Diseases in Canada are prevented and mitigated Rates per 100,000 of key infectious diseases HIV: 6.41Footnote 11
(by Mar. 31, 2017)
5.8 5.8 5.9
Hepatitis B: 15.1Footnote 11
(by Mar. 31, 2017)
13.2 15.2 15.2
Hepatitis C: 29.5Footnote 11
(by Mar. 31, 2017)
30.4 29.7 29.6
Tuberculosis: 3.6Footnote 11
(by Mar. 31, 2017)
4.6 4.4 4.7
E-Coli 0157: 1.39
(Ongoing)
1.14 1.05 1.28
Salmonella: 19.68 (Ongoing) 21.45 21.85 21.95
Invasive Pneumococcal Disease in adults, 60 years and older: 12.4 (Ongoing) 19.62Footnote a 20.38 20.43
80 percent decrease in varicella-related hospitalization rate, compared to pre-vaccine
(Ongoing)
N/AFootnote b N/AFootnote b N/AFootnote b
Five-year median incidence of non-imported cases of measles, aged 7 years or older: 0.7 (Ongoing) 0.15 N/AFootnote a N/AFootnote a
Number of pertussis (whooping cough) deaths in the target population of less than or equal to three months of age 0
(Ongoing)
0 0 1
Rate of key chronic disease risk factors (percent of adults aged 20 and over that report being physically active) 52Footnote 12
(by Mar. 31, 2017)
51.9 51.9 53.4
Rate of key chronic disease risk factors (percent of children and youth aged 5 to 17 who are overweight or obese) 32Footnote 13
(Ongoing)
31.2 31.2 31.2
Footnote a

Actual results are based upon preliminary data at this time.

Return to footnote a referrer

Footnote b

Actual results are not available given changes to the expected result and/or performance indicator methodology across the specified fiscal years.

Return to footnote b referrer

Budgetary financial resources (dollars)
2016–17
Main Estimates
2016–17
Planned spending
2016–17
Total authorities
available for use
2016–17
Actual spending (authorities used)
2016–17
Difference
(actual minus planned)
300,679,998 300,679,998 303,044,432 290,050,854 (10,629,144)
Human resources (full-time equivalents)
2016–17
Planned
2016–17
Actual
2016–17
Difference (actual minus planned)
849 795 (54)

Program 1.3: Health Security

Description

The Health Security Program takes an all hazards approach to the health security of Canada’s population, which provides the Government of Canada with the ability to prevent, prepare for, and respond to public health events/emergencies. This program seeks to bolster the resiliency of the populations and communities, thereby enhancing the ability to cope and respond. To accomplish this, its main methods of intervention include actions taken through collaborations with key jurisdictions and international collaborators. These actions are carried out by fulfilling Canada’s obligations under the International Health Regulations and through the administration and enforcement of pertinent legislation and regulations.

Results

During 2016–17, PHAC made progress in strengthening health security with results and highlights as noted below.

Emergency Preparedness and Response
  • In collaboration with HC, PHAC developed a strategy that enhanced recruitment and training of qualified personnel by building on lessons learned from recent public health events such as Ebola and Zika outbreaks. These personnel will provide short-term surge capacity to respond to significant public health events.
  • PHAC increased Canada's ability to protect Canadians from public health events by acquiring medical countermeasuresFootnote 14 against biological threats such as smallpox and anthrax.

PHAC FACT

PHAC supported the emergency response to the Fort McMurray, Alberta fires by deploying supplies from its National Emergency Strategic Stockpile.

Border and Travel Health
  • PHAC prevented the introduction and spread of communicable diseases by working with conveyance operators to help them comply with the Food and Drugs Act as well as the Potable Water on Board Trains, Vessels, Aircraft and Buses Regulations.
  • PHAC communicated travel health risks (e.g., Zika virus) on travel.gc.ca and on airport monitors to provide the necessary information so that Canadians can make choices on how to protect themselves while travelling to affected countries or major events like the 2016 Rio Olympics in Brazil. The Travel Health and Border Health Security Evaluation noted that Canadians turn to, and depend on, these advisories as trusted sources of information during outbreaks.
Health Security Partnerships
  • PHAC collaborated with F/P/T partners in exercises such as Pacific Quake and Ebola Virus Disease Collaborative Care as a means to test plans, procedures, and multi-jurisdictional responses to public health events/emergencies. These exercises provided insights into strengthening emergency plans and supporting F/P/T response efforts.
  • PHAC was re-designated as a World Health Organization Collaborating Centre for Biosafety and Biosecurity which strengthens the Agency’s ability to influence global health priorities, creates opportunities to promote safe and practical biosafety and biosecurity solutions abroad, and allows Canada to learn from the experiences of others.
  • PHAC collaborated with international partners to enhance global health security as a means to protect the health and safety of Canadians against threats such as pandemic influenza and events involving chemical, biological, radiological, or nuclear material. In particular, PHAC was an active partner in initiatives such as: Beyond the Border; the North American Plan for Animal and Pandemic Influenza; the Global Outbreak Alert and Response Network; and the Global Health Security Initiative.
  • PHAC worked with the World Health Organization on legal, regulatory, logistical, and communications considerations in the rapid international deployment of unlicensed or experimental medical countermeasures (e.g., Canada’s experimental Ebola vaccine) to respond to global disease outbreaks.
Supporting Regulatory Compliance
  • PHAC developed a Regulatory Openness and Transparency Framework that outlines how the Agency is improving access to timely and relevant health protection and promotion information. The Framework will help regulated parties fulfill their current and future requirements, and helps Canadians understand how regulations protect and promote their health.
  • PHAC developed a Regulatory Compliance and Enforcement Framework that outlines key activities carried out by the Agency’s regulatory programs to verify and enforce compliance. The Framework helps to set expectations and demonstrates that PHAC has a fair, consistent, transparent, and predictable approach to regulatory compliance and enforcement.
  • PHAC helped regulated parties transition to the new Human Pathogens and Toxins regulatory regime, providing them with knowledge and tools to navigate the application process and addressing any challenges they encountered. By January 2017, PHAC had processed all 893 licence applications received during the transition period.
Results achieved
Expected result Performance indicators Targets (Dates) Actual results
2016–17 2015–16 2014–15
Canadians are protected from threats to public health Percent of collaborative relationships with key jurisdictions and international organizations in place to prepare for and respond to public health risks and events 100
(by Mar. 31, 2017)
100 100 100
Percent of Government of Canada’s health emergency and regulatory programs implemented in accordance with the Emergency Management Act, the Quarantine Act, the Human Pathogens and Toxins Act and the Human Pathogens Importation RegulationsFootnote 15 100
(by Mar. 31, 2017)
100 100 100
Budgetary financial resources (dollars)
2016–17
Main Estimates
2016–17
Planned spending
2016–17
Total authorities
available for use
2016–17
Actual spending (authorities used)
2016–17
Difference
(actual minus planned)
77,462,190 77,462,190 77,368,767 66,895,158 (10,567,032)

Actual spending was less than planned mainly due to funding re-profile for Ebola Preparedness and Response Initiatives to Protect Canadians at Home and Abroad.

Human resources (full-time equivalents)
2016–17
Planned
2016–17
Actual
2016–17
Difference (actual minus planned)
315 314 (1)

Supporting information on results, financial and human resources relating to PHAC’s lower-level programs is available on PHAC’s website and on the TBS InfoBase.

Internal Services

Description

Internal Services are those groups of related activities and resources that the federal government considers to be services in support of programs and/or required to meet corporate obligations of an organization. Internal Services refers to the activities and resources of the 10 distinct service categories that support Program delivery in the organization, regardless of the Internal Services delivery model in a department. The 10 service categories are: Management and Oversight Services; Communications Services; Legal Services; Human Resources Management Services; Financial Management Services; Information Management Services; Information Technology Services; Real Property Services; Materiel Services; and Acquisition Services.

Results

PHAC collaborates with HC in a Shared Services Partnership for many internal services and corporate functions and takes part in government-wide efforts to modernize and transform common services and functions. Communications strategies are developed and implemented to raise awareness among Canadians and health system partners about key public health issues.

The following are key results and highlights for Internal Services:

Workplace Well-Being

  • Continued implementation of initiatives such as the Multi-Year Diversity and Employment Equity Plan which supported PHAC in meeting the statutory requirements of the Employment Equity Act. Actions were taken to recruit, develop, and retain a diverse workforce and build an inclusive, respectful and healthy workplace. As a result, representation of Women, Persons with Disabilities, Aboriginal Peoples, and Visible Minorities continue to exceed their respective labour market availability at PHAC.
  • Work in support of the Multi-Year Mental Health and Wellness in the Workplace Strategy included a number of initiatives such as:
    • The implementation of National Standard for Psychological Health and Safety in the Workplace action plans; and
    • The delivery of mandatory Mental Health First Aid sessions. In 2016–17, sessions were completed by 15% of employees bringing the cumulative total to 30% of all employees.Footnote 16

High-Performance Culture

  • PHAC continued to support a culture of high performance through initiatives such as the Performance Management Initiative (PMI) and the post-secondary recruitment (PSR) program. The PMI completion rate for PHAC year-end assessments was 86%, well above the public service average. PHAC hired 32 new PSR employees in 2016–17, achieving 133% of the yearly target.
  • PHAC continued implementation of workplace modernization projects such as the Workplace 2.0 standards that modernized the workspace and the GCDOCS pilot project.

Communications

  • PHAC took an enhanced digital approach to strengthening the country's ability to respond to public health threats, outbreaks and emergencies. The CPHO digitally engaged Canadians and stakeholders on a variety of issues, including healthy living, seasonal flu, Zika, Lyme disease, food safety, and foodborne illness. PHAC also used multiple social media channels to share information on the emergency response to the Fort McMurray (Alberta) fires and launched A Vision for a Healthy Canada to provide a one-stop shop for healthy living information.
  • PHAC used intelligence gathered from media monitoring, social media performance and analysis of media habits of target audiences to better communicate with clients, stakeholders and Canadians on matters affecting them. PHAC also conducted public opinion research and consultations to consider the views of Canadians and stakeholders during the development of its policies, programs, and public education campaigns.

Innovation and Experimentation

  • Career ConneXions was launched as an employee-driven Blueprint 2020 initiative created in response to the 2014 Public Service Employee Survey results. The vision of Career ConneXions is to empower managers and employees to manage their own career development with a focus on growth, learning, and leadership.
Budgetary financial resources (dollars)
2016–17
Main Estimates
2016–17
Planned spending
2016–17
Total authorities
available for use
2016–17
Actual spending (authorities used)
2016–17
Difference
(actual minus planned)
95,632,570 95,632,570 100,227,919 90,677,238 (4,955,332)

Actual spending was less than planned primarily due to delays in contracting and staffing processes.

Human resources (full-time equivalents)
2016–17
Planned
2016–17
Actual
2016–17
Difference (actual minus planned)
611 276 (335)

The variance in FTE utilization is mainly due to the annual transfer of resources from PHAC to HC under the Health Portfolio Shared Services Partnership Agreement. The corresponding variance is being reported in the HC DRR.

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