The Public Health Agency of Canada's 2023–24 Departmental Results Report

Également disponible en français sous le titre : 
Rapport sur les résultats ministériels 2023–2024 de l'Agence de la santé publique du Canada

To obtain additional information, please contact: 
Public Health Agency of Canada 
130 Colonnade Rd 
Address Locator 6501H 
Ottawa, ON K1A 0K9 
Toll free: 1-844-280-5020
Fax: 613-941-5366 
TTY: 1-800-465-7735 
E-mail: hc.publications-publications.sc@canada.ca

^©His Majesty the King in Right of Canada, as represented by the Minister of Health, 2024

Publication date: December 2024 
This publication may be reproduced for personal or internal use only without permission provided the source is fully acknowledged. 
Cat.: HP2-27E-PDF 
ISSN: 2561-1410 
Pub.: 240417

• Description
• Progress on results
• Resources required to achieve results
• Related government-wide priorities
• Program inventory

Results achieved

Supporting mental health initiatives

Equitable access to mental health support and to high-quality mental health crisis services for everyone remained a key priority for PHAC. In 2023–24, the Agency increased access to mental health resources and care, and reduced barriers, such as stigma, discrimination and racism.

As of November 30, 2023, all people living in Canada can call or text 9-8-8 to reach free, 24 hours a day, 7 days a week, bilingual suicide prevention crisis support from experienced and well-trained partners. The 9-8-8: Suicide Crisis Helpline is led and coordinated by the Centre for Addiction and Mental Health (CAMH), with service delivery provided by a network of approximately 40 local, provincial and national crisis and distress lines. Specialized lines, such as Kids Help Phone and Hope for Wellness, are part of the 9-8-8 network and offer tailored support to youth and Indigenous populations. People who reach out to 9-8-8 are offered trauma-informed and culturally appropriate support by responders that are trained to listen and provide help without judgement. The 9-8-8 Helpline builds upon the pan-Canadian suicide prevention service Talk Service Canada and is a crucial step to prevent suicide in Canada.

The Agency increased awareness of and engagement with the 9-8-8 Helpline and other mental health information, supports and services by collaborating with partners, including CAMH, as well as through an advertising campaign. This campaign, titled Out of Frame, was tailored for Indigenous Peoples, the 2SLGBTQIA+ community, parents and guardians, men aged 35 and older, young adults and racialized communities. The campaign's advertisements were seen more than 117 million times and generated more than 165,000 visits to the Agency's mental health webpage.

Through the Promoting Health Equity: Mental Health of Black Canadians (MHBC) Fund, PHAC promoted culturally-focused knowledge, capacity building and tailored programs that addressed mental health and its determinants for Black people in Canada, including youth. With the MHBC Fund, PHAC supported more than 20 projects in Canada from 2019 to 2024, including a Knowledge Mobilization Network and projects led by and tailored for Black 2SLGBTQIA+ communities. For example, the Black Wellness Network website, published by the TAIBU Community Health Centre, provided centralized access to a wealth of knowledge regarding Black mental health and other MHBC-funded projects' resources. The MHBC Fund also supported the 2024 ACT Now! Second National Conference on Black Mental Health and Wellbeing. In collaboration with the TAIBU Community Health Centre and MHBC-funded project leads, PHAC also published a series of Project Stories and MHBC infographics that summarized the impact of MHBC-funded projects on participants. Preliminary results indicated that the majority of individuals who participated in MHBC-funded projects were women and 61% reported improvements in mental health. Another 71% of participants reported an increase in knowledge of mental health.

Furthermore, PHAC promoted mental health and well-being of individuals, families and communities by supporting 15 innovative community-based projects through Mental Health Promotion Innovation Fund (MHPIF). These projects reached over 105,000 children, youth and caregivers in 200 communities across Canada in 2023–24. Early results demonstrated improved protective factors for mental health such as an increased sense of belonging and community, enhanced resilience and improved relationships. Results also suggested that participation in these projects decreased anxiety and depression, with 70% of participants reporting increased knowledge on mental health literacy, 43% reporting increased protective factors, such as coping strategies, improved school engagement and socio-emotional development, and 52% reporting improved well-being tosuport sustainable changes.

The Agency also supported projects that aimed to improve the mental health of new parents and guardians, newborns, children and youth. For example, in 2023–24, the Agency collaborated with Statistics Canada to develop the national Parental Experience Survey. This survey focused on Canadians' mental health, their access to mental health services and other key issues (e.g., breastfeeding, substance use, etc.) during the perinatal period. PHAC also provided mental health professionals with a new standardized tool, the Strengths and Difficulties Questionnaire, that is better adapted to assess the mental health of children and youth in Canada, in collaboration with the Children's Hospital of Eastern Ontario.

Supporting healthy aging and those affected by dementia

In 2023–24, PHAC coordinated the Government of Canada's efforts to support the United Nations (UN) Decade of Healthy Ageing (2021–30). In collaboration with provinces and territories, PHAC adapted the social and physical environment of nine communities to older adults' needs so that they were age-friendly. PHAC accomplished this by collaborating with WHO and following their model of Age-Friendly Communities, providing expertise, knowledge and tools.

As part of its collective effort to help those affected by dementia, PHAC also led the implementation of the national dementia strategy, A Dementia Strategy for Canada – Together We Aspire. In 2023–24, PHAC raised awareness of dementia by funding 28 projects with the Dementia Strategic Fund (DSF). These projects enhanced knowledge related to preventing dementia, reducing risk of developing dementia and addressing stigma, as well as improving access to and use of dementia guidance. PHAC also enhanced evidence-informed dementia-related information on provincial and territorial governmental websites by investing in two new projects. With the Dementia Community Investment (DCI), PHAC funded 13 projects of which six were new community-based projects that focused on optimizing the health and well-being of people living with dementia, their family, friends and caregivers. Data from these projects shows that 90% of the 1,725 participants reported increased knowledge or skills, and 83% of participants also reported positive behavioural changes as a result of the programming. These projects contributed to increased knowledge about dementia, risk and protective factors through community-based intervention research.

In 2023–24, PHAC raised awareness on methods to reduce the risk of developing dementia through a national public education campaign. Through digital advertising campaign, articles for use by media organizations and a risk reduction digital poster for Indigenous Peoples, the campaign reached stakeholders across Canada. Traffic to Canada.ca dementia web pages totaled 480,000 visits during the campaign period from September 2023 to March 2024, which is an increase of over seven-fold compared to the five-month period before the campaign. Two new video testimonials from people in Canada living with dementia were a key feature of the stigma campaign and viewed over one million times. During the risk reduction phase of the campaign, digital advertisements were shown over 62 million times and users clicked on the advertisements more than 400,000 times. A new television feature on Canadian Broadcasting Corporation's (CBC) Family Feud and Société Radio-Canada's (SRC) Au Suivant game shows integrated dementia content into quiz questions.

PHAC conducted two public health opinions research projects on dementia prevention in 2023–24. The research projects found that the number of people intentionally taking steps to reduce their risk of developing dementia increased from 22% in 2020 to 34% in 2023, suggesting people in Canada are more aware of the prevention methods against dementia (81% in 2023 compared to 74% in 2020).

In addition, in 2023–24, PHAC's Enhanced Dementia Surveillance Initiative addressed data gaps on people living with dementia and their caregivers by completing 15 projects which increased available data on the causes, progression stages, impacts, sociodemographic characteristics, risks and protective factors of dementia for people living with the syndrome and their caregivers. As a result, the monitoring of dementia in diverse populations was improved, new methods to assess the risk factors of dementia and their impacts on prevention were developed and the reporting on dementia was broadened. These findings were presented to the Ministerial Advisory Board on Dementia and can be found on the Enhanced Dementia Surveillance Initiative website.

Supporting Autistic people, their families and caregivers

PHAC enhanced the collection of autism-related data through pan-Canadian surveys and generated evidence and informed the planning, implementation and evaluation of public health practices to better support Autistic individuals, their families and caregivers. Between 2022–24, PHAC collected information on the pathway and perceived barriers to getting an autism diagnosis in collaboration with Statistics Canada, the Canadian Institutes of Health Research (CIHR) and the Offord Centre for Child Studies at McMaster University, by funding the second cycle of the Canadian Health Survey on Children and Youth. Data collected included sociodemographic characteristics (e.g., population group, household, education and income) as well as co-occurring conditions and functional difficulties associated with autism.

With the Federal Framework on Autism Spectrum Disorder Act having come into effect in spring 2023, PHAC finalized the Framework for Autism in Canada and the National Autism Strategy, which were respectively tabled and launched in September 2024. In summer 2023, in collaboration with Autism Speaks Canada and the Pacific Autism Family Network, the Agency announced up to $500,000 in funding for the Autism Alliance of Canada to determine the guiding principles that could support the implementation of the strategy through a National Autism Network during a consultation process leveraging the perspectives and needs of Autistic people and their families. To sustain the Agency's ongoing commitment to support autism in Canada, PHAC also funded the Pacific Autism Family Network to manage the Autism and Intellectual Disability Knowledge Exchange Network Project.

Engaging global partners to advance Canadian best practices

PHAC and the Health Portfolio partners supported the Minister of Mental Health and Addictions in the commitment to highlight Canada's best practices on the international stage. For instance, in October 2023, learnings from the Mental Health Promotion Innovation Fund (MHPIF) were showcased as an innovative funding program to improve mental health in the Organisation for Economic Cooperation and Development (OECD) report. Project summaries can be found on the MHPIF Knowledge Development and Exchange Hub. PHAC also actively participated in the Global Leadership Exchange and exchanged Canadian best practices and learning with the 13 participating Member States, which informed our domestic priorities.

Furthermore, in 2023–24, Canada actively advanced the mental health cause on the international stage. Specifically, PHAC endorsed the integration of both physical and mental health, as well as addictions, in the delivery of a primary health care framework at the September 2023 UN High Level Meeting on Universal Health Coverage and at the G7 and G20 Health Ministers Meetings in 2023. The Agency also adopted the Strategy for Improving Mental Health and Suicide Prevention in the Region of the Americas along with the Pan American Health Organization's other 34 Member States during the 60th Directing Council. PHAC also engaged stakeholders bilaterally and regionally to advance mutual interests related to mental health. This included PHAC leading the Asia Pacific Economic Cooperation (APEC) Sub-Working Group on Mental Wellness and leading APEC's session on Digital Health on Mental Health and Healthy Ageing.

Results achieved

Preventing substance-related harms

PHAC generated evidence about the sociodemographic characteristics of those who have died from substance-related acute toxicity and highlighted the root causes of substance-related inequities by releasing quarterly data on opioid and stimulant-related harms. This revealed that the number of deaths, hospitalizations and emergency responses in 2023 were the highest observed since the beginning of data collection in 2016. Harms were most common among males and individuals aged 20 to 39 years. In addition, PHAC published an updated simulation model of opioid-related deaths in December 2023 to better plan and tackle the opioid crisis.

PHAC also implemented a comprehensive public health approach to substance use with measures aiming to increase awareness around opioids and reduce stigma. The Agency improved provinces' and territories' surveillance capacity initiatives of modernizing data systems and enhancing public-facing dashboards by supporting eight funding agreements, totaling over $600,000. These initiatives spanned reporting on drug-checking, peer engagement, community drug strategy development, forensic data collaboration, monitoring of alcohol magnitude and urban public health surveillance. Strengthening surveillance capacity on substance-related harms improved the accuracy, timeliness and reliability of meaningful data to support a public health response to the drug toxicity crisis. This provided better data for federal, provincial and territorial partners to enable decision-making, policy-developing and programming that reflects the latest, most accurate evidence.

The toxic illegal drug supply and the rapid increase in opioid-related harms and deaths continued to impact families and communities across the country. PHAC addressed this by supporting the launch of the renewed Canadian Drugs and Substances Strategy (CDSS) in October 2023. The renewed CDSS is focused on four key integrated priority areas for action, called foundational elements: prevention and education, substance use services and supports (treatment, harm reduction and recovery), evidence, and substance controls. As part of this strategy, PHAC deployed public health officers in eight provinces and territories to help with the pan-Canadian monitoring and reporting of substance-related harms and provided specialized training to 11 epidemiologists across regional public health offices in Canada. The officers collected evidence on health events and social determinants and contributed to policy, programming and public health actions across Canadian jurisdictions. Also part of the renewed CDSS, funding to support 52 projects across Canada under the Substance Use and Addictions Program was announced in October 2023. The Agency also supported the federal harm reduction efforts through the Harm Reduction Fund (HRF) under CDSS. With the HRF, PHAC complemented provincial and territorial harm reduction strategies to help reduce HIV and hepatitis C among people who share injection and inhalation drug-use equipment, as well as other sexually transmitted and blood-borne infections by investing $7 million annually in 40 community-based and time-limited projects across Canada.

PHAC also highlighted best practices and increased awareness to reduce opioid stigma in pharmacy settings, partnering with the Centre for Addiction and Mental Health (CAMH) to develop and disseminate a toolkit for pharmacy professionals. This toolkit was distributed to 54,923 individual addresses and to 18 national health organizations with a presentation delivered at the Chief Public Health Officer (CPHO) Health Professional Forum.

In recent years, greater attention has been paid to the role of schools in addressing substance use and substance-related harms among youth. Following the publication of the Blueprint for Action in 2021, in 2023–24, PHAC engaged school stakeholders, such as the Canadian School Boards Association, educators and school health professionals at the Healthy Schools Forum and at the Physical and Health Education Canada national conference. PHAC collaborated with external researchers to guide and enhance prevention research and support schools and communities in implementing best practices to prevent substance-related harms among youth. This work focused on approaches that enhanced resiliency in youth, promoted health equity, identified some of the root causes of substance use and reduced stigma and harms in youth across the country as well as influenced school communities to think upstream about their approach to preventing youth substance use.

Expanding on youth substance use prevention, PHAC continued to implement a Budget 2023 investment of $20.2 million and funds reallocated internally to support new, community-based programs to prevent substance use and its related harms among youth. These funds supported projects that work to influence risk and protective factors associated with a community-driven approach to substance use under the Agency's new Youth Substance Use Prevention Program. As well, PHAC partnered with the Students Commission of Canada to develop a series of public education social media resources that emphasized harm reduction and encouraged youths to make evidence-informed decisions about youth cannabis vaping. Two infographics (i.e., a flow chart and shareable social media post) and two social media videos were developed in collaboration with youth to ensure the messaging and delivery resonated with the target audience. The infographics obtained 2,019 clicks, the social media posts obtained 1,314 clicks and the video reached 852 views. In addition, in collaboration with the Canadian Students for Sensible Drug Policy and the Postsecondary Education Partnerships – Alcohol Harms Network, PHAC used a student-centered approach to develop and disseminate public education resources (i.e., printable posters and shareable social media content) to enable students to make informed decisions concerning alcohol use and reduce potential harms. The posters were printed and disseminated 3,643 times and 40 prevention and substance-related harms (PSRH) websites were seen 62,740 times.

Fostering positive early development and stronger beginnings

In 2023–24, PHAC continued to invest in programs such as the Community Action Program for Children (CAPC) and the Healthy Early Years (HEY) Program. These programs are dedicated to promoting and improving the health and well-being of children, from birth to six years of age, who face challenges that may put their health at risk and who live in official language minority communities (OLMC). CAPC funds 400 projects annually and serves over 191,000 children and caregivers across the country, whereas HEY supports 66 projects annually and serves approximately 22,000 children, parents and guardians, pregnant women and people and caregivers in OLMC. The Agency also promoted the health and well-being of school-aged youth (aged 13 to 19) with the School Health Grant for Youth. This grant funded projects aimed to empower youth to develop their own initiatives that encourage and promote healthy living in their schools.

In May 2023, the Agency provided new parents and guardians with accurate information and enabled them to make healthy and informed decisions to take care of themselves, their family and their new baby by publishing a postpartum guide for Canadian families. Additionally, PHAC focused on the health and well-being of pregnant women and people and their babies who face challenges that put their health at risk by investing in programs such as the Canada Prenatal Nutrition Program (CPNP). In 2023–24, this program funded 240 community projects and supported approximately 41,000 pregnant women and people, parents and guardians across the country. The Agency also supported positive health behaviours from preconception through childhood with the Nobody's Perfect parenting program. This program offered education and support for child health, development and behaviour, as well as parenting and coping skills. Furthermore, with the Fetal Alcohol Syndrome Disorder (FASD) National Strategic Projects Fund, PHAC provided funding to the Canada FASD Research Network to design and pilot an online FASD training course for CAPC and CPNP program workers that is tailored to the needs of families dealing with challenges related to FASD. The FASD National Strategic Projects Fund also supported five contribution agreements in 2023–24, including two new agreements, which supported the prevention of FASD and reduction of stigma associated with the syndrome. These projects reached an audience of non-pregnant women and people of childbearing age, pregnant women and people, their partners, young adults, people with FASD, service providers and policy makers.

Investing in Indigenous early learning and childcare in urban and northern communities

PHAC continued to support the Aboriginal Head Start in Urban and Northern Communities (AHSUNC). This initiative is a national community-based early intervention program that focuses on culturally appropriate early childhood development for First Nations, Inuit and Métis children and their families living off-reserve. In 2023–24, AHSUNC served 3,001 Indigenous children and families at 133 AHSUNC sites across Canada. As a result, 100% of children enrolled in AHSUNC experienced developmental benefits in a context that celebrates Indigenous cultures and language.

Preventing and addressing family and gender-based violence

PHAC contributed to the prevention of family and gender-based violence and improved health outcomes for survivors by supporting community-based organizations to deliver health promotion programs and interventions. These programs reached children, youth, older adults and families affected by or at higher risk of violence in different provinces and territories. For example, the Beauséjour Family Crisis Resource Centre in New Brunswick received $582,216 between 2022 and 2025 for the Kids Club and Mom's Empowerment programs (see below). The Park-Extension Youth Organization in Québec, which received $406,013 between 2022 and 2025, delivered and evaluated community outreach arts intervention service. Using storytelling and creation with 84 immigrant and low-income families residing in Montréal, participating families learned new ways of communicating peacefully and resolving conflicts more constructively. Finally, the Centre of Excellence for Women's Health (CEWH) in British Columbia received $980,392 between 2022 and 2026 to adapt and test a virtual self-guided workbook and a social support group model for women who have lived experience of both intimate partner violence and problematic substance use. In 2023–24, a pilot was implemented with both participants and service providers, which indicated that the immediate threat of violence may overshadow concerns about substance use among participants.

In 2023–24, the Agency increased research capacity in child maltreatment and child welfare by investing in the development and launch of a national research training platform by the Childhood Adversity and Resilience (CARe) research team at the University of Manitoba. This initiative works towards preventing and reducing the impact of child maltreatment, improving child welfare practices and increasing the accessibility of effective interventions across Canada. Furthermore, to understand trends, risks and protective factors that concern child maltreatment, PHAC led the work on the Canadian Child Welfare Information System (CCWIS) in collaboration with provincial and territorial partners, national Indigenous organizations and academic researchers. The CCWIS is the only national administrative data hub collecting data on children and families involved with child and family services. The first CCWIS report on children in out-of-home care was published in February 2024 and was widely disseminated to governments, service agencies and Indigenous organizations to influence decision-making, policy-developing and programming.

PHAC also worked with Health Portfolio partners to support the health of 2SLGBTQIA+ populations by strengthening the 2SLGBTQIA+ Action Plan (2022–27) and expanding both targeted and inclusive data collection and disaggregated data analysis initiatives. The Agency funded eight projects working with 2SLGBTQIA+ youth and families. For example, the Centre for Sexuality in Calgary advanced its Raising Rainbows initiative, which supported parents of 2SLGBTQIA+ children and youth by developing a psychoeducational program and creating drop-in groups for parents and guardians.

To prevent and address the mistreatment of older persons, PHAC provided funding to the Université de Sherbrooke to develop and deliver virtual educational programs in both official languages, targeting employees and volunteers in community organizations in Québec which increased knowledge on mistreatment of older persons by caregivers and contributed to its prevention.

Preventing injury in sport

In March 2024, Parachute, a national injury prevention organization funded by PHAC, released the Second Edition of Canadian Guideline on Concussion in Sport. This helped athletes with a suspected concussion to receive timely and appropriate care to allow them to return to their sport. The Guideline, existing concussion strategies (e.g., return to school, sport and daily activities) and online concussion resources (e.g., Concussion Ed app) were updated as a result of new recommendations for concussion in sport published in the British Journal of Sports Medicine in June 2023.

Results achieved

Promoting healthy living and preventing chronic disease in priority populations

In 2023–24, PHAC supported projects aimed to prevent chronic diseases, such as diabetes, cardiovascular disease and cancer, and addressed health inequities among priority populations who were at greater risk for these conditions. With data contributions from provinces and territories, PHAC enhanced the scope of data on chronic diseases and supported the planning and development of health resources, health policies and programs with its work on the Canadian Chronic Disease Surveillance System (CCDSS).

To recognize and address the unique needs and context of priority populations with regards to diabetes, PHAC funded an Indigenous-led engagement process to help increase the understanding of issues related to diabetes faced by Indigenous Peoples and communities. This distinctions-based process was led and coordinated by the National Indigenous Diabetes Association and aimed to identify priorities and best approaches to address diabetes for Indigenous Peoples across Canada.

Addressing the social determinants of health, namely income, education and housing, is crucial for reducing the risk of chronic disease and promoting health equity in communities. PHAC addressed social determinants of health impacts on communities through intersectoral action with the funding of 15 new projects in 2023–24 through the Intersectoral Action Fund (ISAF) that prioritized communities that experience systemic racism and discrimination, such as Indigenous and Black communities, other racialized communities, 2SLGBTQIA+ communities and communities living on low-income.

Initiatives funded under PHAC's Healthy Canadians and Communities Fund (HCCF) promoted healthy behaviours for people living in Canada who face health inequities and who are at higher risk of developing chronic diseases. A total of 72 new and ongoing projects targeted behavioral risk factors, such as physical inactivity, unhealthy eating and tobacco use, and created environments that promote better health. Overall, 53% of the 550,000 participants to projects funded by the HCCF improved their health behaviours. For example, the Western University's Hockey Fans in Training program engaged 997 middle-aged men considered overweight or obese across 42 communities. After 12 months of participation, improvements in weight, blood pressure, physical fitness, health-related quality of life and well-being were observed.

Another example of HCCF projects is the LMC Healthcare's Diabetes Prevention program centered around intensive lifestyle changes promoting physical activity, dietary education and individual support. This program reached over 2,000 individuals at risk of developing type 2 diabetes and more than two-thirds of participants lowered their average blood glucose, lost weight, reduced their waist circumference and lowered their fasting blood sugar.

A final example is the University of Alberta's Housing for Health project, which aimed to improve the health of older adults in the metropolitan Edmonton region by increasing physical activity, healthy eating and improving social connections through urban design. This project achieved significant community engagement by building over 250 partnerships across diverse sectors and resulted in three pilot housing developments, where 55% of respondents reported improved interaction and engagement within their neighbourhood.

In 2023–24, SGBA Plus considerations were integrated into several Agency programs, projects and initiatives under Core Responsibility 1 and informed the development of information, tools and resources designed to meet the needs of diverse populations.

The Community Action Program for Children (CAPC), Canada Prenatal Nutrition Program (CPNP) and Healthy Early Years (HEY) programs continued to play a long-standing role in promoting the health of the entire family unit, including diverse and non-traditional families, young children and pregnant women and people. The programs consistently applied SGBA Plus to assess and better understand the diverse needs of the priority populations they served. For instance, funded recipients of the CPNP delivered comprehensive, culturally appropriate, locally controlled and designed programs for pregnant women and people, postpartum women and people, their infants and families across Canada facing challenges that put their health at risk.

Organizations that applied for funding through the Dementia Strategic Fund (DSF) and the Dementia Community Investment (DCI) were asked to incorporate and annually report on the consideration of sex and gender along with other identity factors into their proposals. Across all DSF and DCI projects, 27% of the projects focused on individuals living in official language minority communities, 26% on individuals from ethnic and cultural minority communities, 25% on Indigenous individuals and communities, 15% on members of the 2SLGBTQIA+ community and one project on individuals living with intellectual and developmental disabilities.

In addition, projects funded by the Promoting Health Equity: Mental Health of Black Canadians (MHBC) Fund reached and impacted diverse Black populations such as newcomers, immigrants, refugees, people living on low incomes, individuals experiencing homelessness, individuals with physical and mental health issues, members of the 2SLGBTQIA+ community, children, youth, adults and older adults facing social and economic barriers or pre-existing mental health conditions. Programs supported by the MHBC Fund considered the impacts of intersecting systems and structures of power, oppression and privilege (e.g., racism, sexism, heterosexism and cissexism) in the project design and delivery stages. Additionally, projects considered differential impacts on diverse and intersecting identities to create equity-informed programs and initiatives. The application of SGBA Plus or other critical approaches (e.g., Afro-centric perspective, Black feminism, etc.) in project development was encouraged to acknowledge how experiences of diverse Black people in Canada intersected with locations, social systems and structures. Results from MHBC-funded projects indicated that among the 7,743 Black people in Canada who participated in programs, 60% were females, 35% were male and 5% identified as gender diverse, and 41% percent were children and youth, 53% were adults and 6% were older adults.

Further to a Budget 2021 commitment of $100 million to promote mental health and prevent mental illness in populations most affected by the COVID-19 pandemic, in 2023–24, PHAC supported 54 related projects targeting disproportionately impacted populations, such as 2SLGBTQIA+ communities, children and youth, older adults, First Nations, Inuit and Métis Peoples, Black and other racialized populations. These projects helped build evidence enhancing the capacity of individuals, service providers and organizations to respond in safe, effective and trauma-informed ways to best support these populations. Budget 2021 also provided $50 million to support projects that address post-traumatic stress disorder (PTSD) and trauma in healthcare providers, frontline, other essential workers and others affected by the pandemic. In 2023–24, PHAC funded 14 projects targeting healthcare workers, long-term care workers, personal support workers, public safety personnel and their families, teachers and Veterans. These projects adapted, scaled-up and delivered peer-to-peer support and resiliency training for at-risk populations who are regularly exposed to potentially psychologically traumatic events. They also developed evidence-informed resources to help individuals and caregivers better recognize and support those affected by trauma and PTSD and have been shown to reduce stigma and improve help-seeking and system navigation among these populations.

To help those living with long-term impacts of the COVID-19 pandemic, PHAC also provided financial and scientific support to McMaster University to develop six Canadian evidence-informed guidelines addressing the full spectrum of Post COVID-19 conditions (i.e., long COVID). Throughout the development of the Canadian Guidelines for Post COVID-19 Condition to date, equity considerations have been emphasized through the application of SGBA Plus and with the help of an equity advisory committee. This advisory group identified and focused on nine priority groups, including 2SLGBTQIA+ communities and women. Efforts were made to specifically seek out evidence relevant to these priority groups and on how equity considerations, feasibility, acceptability, resource use and other factors should be applied to them.

Through its international multilateral efforts for the prevention of family and gender-based violence, PHAC considered health equity and highlighted the experiences of people who are impacted by intersecting systems of power and oppressions. Specifically, prior to implementing or incorporating any chronic disease or healthy living commitments included in documents from key international organizations such as the World Health Organization (WHO), PHAC reviewed all documentation to establish how intersectoral and equity considerations were included. PHAC also promoted on a global stage the incorporation of language and considerations related to health equity, social determinants of health and priority populations, including those who may be at higher risk of developing chronic diseases. During these discussions, PHAC encouraged the use of disaggregated data and indicators in international analyses and frameworks to measure progress on the prevention of noncommunicable diseases from an equity-informed perspective. Finally, to reduce barriers to health equity for Indigenous Peoples and people more affected by the impacts of climate change on public health, the International Health Grants Program funded 16 projects in 2023–24, totaling approximately $3.2 million. The projects addressed food safety hazards in northern and Indigenous foods systems in the Arctic to strengthen community resilience, preservation of cultural heritage through safe traditional practices and improved health outcomes among Arctic populations. The funded projects also aimed to support the creation of sustainable and resilient health systems that are better prepared to deliver healthcare during extreme weather events, reducing climate-related health risks and fostering long-term environmental and public health sustainability.

In 2023–24, PHAC supported the United Nations Sustainable Development Goal (SDG) 3: Ensure healthy lives and promote well-being. With the Healthy Canadians and Communities Fund, PHAC moved to achieve SDG 3 by supporting 72 projects that contributed to improving health behaviours (e.g., physical activity, healthy eating and reducing tobacco use) of people in Canada and promoting well-being. PHAC also funded over 600 projects which contributed to the health and well-being of children, pregnant women and people and families. PHAC's work on mental health promotion and addressing mental health inequalities also advanced the achievement of SDG 3. For example, the Mental Health Promotion Innovation Fund supported 15 community-based projects that promoted mental health, and the Pan-Canadian Health Inequalities Reporting Initiative and Data Tools were updated to expand its indicators to priority population groups (e.g., older adults and official language minority communities). Furthermore, PHAC improved suicide prevention with the launch of Canada's first National Suicide Prevention Action Plan. Through the Dementia Strategic Fund and the Dementia Community Investment, PHAC supported projects that raise awareness of dementia, seek to improve the well-being of people living with dementia, their family, friends and caregivers, increase knowledge about dementia and its risk and protective factors, and improve access to high-quality dementia guidance.

PHAC's work also supported SDG 10: Reduce inequalities within and among countries by implementing SGBA Plus considerations and tailoring programs for priority populations to promote their mental and physical health and to prevent chronic diseases. For instance, by supporting 32 projects through the Promoting Health Equity: Mental Health of Black Canadians Fund, the Agency improved the understanding of factors that impact the mental health of Black people in Canada and developed culture-sensitive knowledge, capacity and programs for this population. Moreover, the Agency's programming advanced reconciliation and implemented the United Nations Declaration on the Rights of Indigenous Peoples by providing culturally appropriate early childhood development programs to 3,001 First Nations, Inuit and Métis children and their families with the Aboriginal Head Start in Urban and Northern Communities. To help prevent chronic diseases among priority populations, the Enhanced Surveillance for Chronic Disease Program focused on Indigenous, people with lived experience of incarceration, 2SLGBTQIA+, people experiencing homelessness, ethnic minorities, older adults and those experiencing lower socio-economic conditions to understand the built environment's influence on chronic disease factors.

By implementing an Age-Friendly Communities model, PHAC contributed to the achievement of SDG 11: Make cities and human settlements inclusive, safe, resilient and sustainable. This model establishes policies, services and structures adapted to the physical and social needs of older adults which helps them live safely, enjoy good health and stay involved. PHAC also held nine meetings of the Pan-Canadian Age-Friendly Reference Group to facilitate the development and exchange of age-friendly information, resources and best practices throughout Canada.

More information on PHAC's contributions to Canada's Federal Implementation Plan of the 2030 Agenda and the Federal Sustainable Development Strategy can be found in PHAC's 2023 to 2027 Departmental Sustainable Development Strategy (DSDS).

PHAC funded innovation through funding models, specifically challenge prizes, to seek new and promising solutions for diabetes prevention and concussion detection. For example, the Type 2 Diabetes Prevention Challenge developed in partnership with Impact Canada aimed to identify and develop novel methods to reduce a person's risk of developing type 2 diabetes. Innovators who participated in this Challenge were encouraged to use approaches that were co-designed with communities to address the barriers and determinants of health that lead to an increased risk of developing type 2 diabetes. Additionally, the Detecting Concussion Using Objective Indicators Challenge was delivered as part of the Innovative Solutions Canada Program at Innovation, Science and Economic Development Canada. The Challenge aimed to find solutions to prevent severe health outcomes associated with concussions. PHAC announced HealthTech Connex as the winner of the second phase of the challenge in 2023–24. This organization received $1 million over two years for their project aiming to detect concussions using an artificial intelligence and machine learning data model to evaluate concussion severity.

In 2023–24, PHAC developed new approaches using alternative data sources, notably machine learning and other advanced dynamic modelling, to improve understanding of the factors that impact the health of people across Canada. In collaboration with the Centre for Aging and Brain Health Innovation, PHAC funded and launched 77 new innovative projects aiming to advance research and innovation efforts in dementia and brain health as part of a $30 million investment announced in Budget 2022. Approximately 100 innovators were involved in these projects aiming to improve the quality of life of older adults, people living with dementia and their caregivers.

• Description
• Progress on results
• Resources required to achieve results
• Related government-wide priorities
• Program inventory

Results achieved

Wastewater and monitoring systems

Wastewater monitoring is a crucial tool for informing public health measures that help mitigate the introduction and spread of infectious diseases and allows their tracking and comparison over time and between communities across Canada. In 2023–24, PHAC provided Canadians with timely, reliable and accessible data on COVID-19 trends in their communities and enabled health officials and partners to identify and respond to outbreaks rapidly through an updated COVID-19 wastewater monitoring dashboard. This was accomplished in collaboration with federal departments, provincial, territorial and municipal governments, Indigenous partners and academia, as the dashboard monitored 68 community sites across the country and published data for 52 of those sites. As of the publishing of this report, Ontario has decided to discontinue its wastewater surveillance program but has indicated that it will work with the federal government to assess sites for the federal wastewater monitoring.

Wastewater monitoring was expanded from solely detecting COVID-19 to identifying new and concurrent pathogens of national and international concern, including antimicrobial resistant organisms, mpox, polio, respiratory syncytial virus (RSV) and influenza viruses. PHAC published and emphasized updates to the wastewater monitoring dashboard on social and mainstream media, increasing public awareness and community engagement. As such, the expanded wastewater monitoring program helped protect the Canadian population against infectious diseases and make evidence-based decisions about the introduction and spread of infectious diseases over time and location.

Working closely with at-risk Northern, Remote and Isolated (NRI) communities, PHAC provided essential testing supplies, training and ongoing quality assurance to encourage the adoption of wastewater testing. This enabled communities to test samples locally, receive early outbreak warnings and thereby implement swift public health responses. For example, six NRI communities in the Northwest Territories used wastewater testing to successfully detect multiple outbreaks which resulted in prompt preventive actions that curbed further spread.

Reducing the emergence and spread of Antimicrobial Resistance (AMR)

Antimicrobial resistance (AMR) occurs when bacteria, viruses and other microorganisms that cause illness become resistant to the antimicrobial drugs used to treat them. PHAC is a key contributor to the Government of Canada's work with international, provincial and territorial counterparts, Indigenous Peoples, industry stakeholders and partners across One Health sectors to reduce the emergence and spread of AMR and help protect people who live in Canada.

The Agency coordinated and collaborated with domestic and international networks as well as multidisciplinary partners to strengthen collective efforts against AMR and protect Canadian populations, especially vulnerable ones. PHAC engaged with bilateral partners, such as the US, the United Kingdom, and Japan to advance mutual interests on AMR, and signed a memorandum of understanding with Denmark which furthered collaboration on AMR. PHAC also made commitments in the G7 Nagasaki Health Ministers Communiqué and G20 Gandhinagar Health Ministers' Meeting Outcome Document to develop AMR research and track AMR comprehensively following a One Health Approach.

In June 2023, PHAC released the 2023–27 Pan-Canadian Action Plan on Antimicrobial Resistance (PCAP), which establishes federal, provincial and territorial commitments on AMR over the next five years. The Compendium to the Action Plan highlighted PHAC's key efforts in 2023–24 to implement the Action Plan, such as expanding modelling approaches to assess the impact of vaccines, antimicrobial use (AMU), on-farm infection prevention and control measures, as well as related interventions for exposure to foodborne AMR. PHAC supported global and domestic antimicrobial innovations towards clinical development by investing $6.3 million in Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X).

In addition, PHAC provided recommendations to bring existing antimicrobials to the Canadian market and encouraged the development of new ones. The Agency also expanded and enhanced its AMR monitoring efforts. By performing consistent, standardized surveillance, the Canadian Nosocomial Infection Surveillance Program (CNISP) produced reliable estimates of the healthcare-associated incident burden in Canada, established benchmark rates for national and international comparison and informed timely public health interventions, programs and policies to improve patient health outcomes. CNISP also advanced the understanding of infections and AMR in acute care hospitals by launching a CNISP viral respiratory infections InfoBase, conducting a national survey to assess the feasibility of AMR surveillance in long-term care home settings and publishing nine peer reviewed journal articles in these fields of study.

PHAC also extended its surveillance capability for AMR with the addition of two provincial laboratories to the Antimicrobial Resistance Network (AMRNet), which now totals seven provinces and territories. This Network monitors data from bacterial and fungal samples tested for AMR in clinical and veterinary laboratories. Similarly, the Agency also improved the national representativeness of data regarding antimicrobial resistant gonorrhea with the addition of another province committed to its surveillance.

In November 2023, PHAC highlighted AMR and AMU surveillance findings from 2017–21 by publishing the 2023 Canadian Antimicrobial Resistance Surveillance System (CARSS) Executive Summary, which supported evidence-based prescribing and limited inappropriate use of antimicrobials. The Agency also provided key information to guide public health research, policies and action on AMR and the reduction of inappropriate AMU. Specifically, PHAC launched a new interactive dashboard on AMR pathogens and AMU with improved data timeliness and availability and supported the development and dissemination of national antimicrobial prescribing guidelines for healthcare prescribers. Furthermore, PHAC supports the AMR Aware Canada, a Canada-wide campaign to build awareness about AMR. In partnership with the Canadian Nurses Association, PHAC also promoted an antimicrobial stewardship competency framework for nurses in Canada.

Reducing the health impacts of Sexually Transmitted and Blood-borne Infections (STBBI)

In 2023–24, PHAC worked towards reducing the impact of Sexually Transmitted and Blood-borne Infections (STBBI) for people living in Canada by monitoring trends, funding projects, conducting research and producing public health guidance on STBBI for evidence-based approaches. For instance, PHAC informed the effectiveness of current STBBI public health strategies in Canada and guided prevention and care activities by publishing surveillance and monitoring results and resources on its website. This information included routine and enhanced data on chlamydia, gonorrhea, syphilis, hepatitis B, hepatitis C and HIV, as well as blood, tissue and organ-related adverse events. To accelerate progress on STBBI prevention and control, PHAC advanced efforts related to bio-behavioural surveillance as part of the Tracks Enhanced Surveillance System. In particular, PHAC partnered with the Community-Based Research Centre to conduct Tracks surveys that help identify underlying determinants contributing to rates of STBBI among gay and bisexual men, as well as men who have sex with men. PHAC also collected data from 12 new sites on people who inject drugs.

The Agency developed new and updated guidance for public health professionals. For example, in December 2023, PHAC produced an updated evidence review on the risk of sexual transmission of HIV at varying viral loads and the risk of HIV transmission via breastfeeding. The Agency also updated recommendations on screening for gonorrhea and chlamydia during pregnancy, as well as for syphilis in non-pregnant adults, adolescents and groups at higher risk of developing the infections. Furthermore, PHAC supported improved practices for public health professionals to prevent and control STBBI in Canada by partnering with the University of British Columbia (UBC) to develop and host the Barriers to STBBI Screening course. PHAC also provided funding to UBC to develop a continuing medical education course for nurses to increase their understanding of HIV treatments and transmissibility.

Continuing with its focus to further prevent and control STBBI in Canada, PHAC supported 170 community-based projects that addressed HIV, hepatitis C and other STBBI by providing $33.4 million in time-limited funding with the HIV and Hepatitis C Community Action Fund (CAF) and the Harm Reduction Fund (HRF). The preliminary data from 2023–24 suggests that projects in the CAF reached approximately 43,000 individuals from key populations and more than 16,000 individuals from target audiences, and projects from the HRF reached roughly 55,000 individuals from key populations, including 2,900 from target audiences. PHAC also supported the procurement and distribution of 140,000 HIV self-test kits to more than 54,000 individuals via 425 participant community-based organizations across Canada by providing an additional $8.6 million to the HIV Self-Test Initiative in 2023–24. With this funding, the percentage of first-time testers reached 46% to 57% among several national programs, demonstrating that low barrier access to HIV self-testing is an effective means of reaching the undiagnosed.

The Agency reduced stigma around the transmission of HIV by endorsing the Undetectable = Untransmittable (U=U) message, highlighting that HIV cannot be passed on by having sex with a person being treated for HIV and whose HIV levels remain very low. This new position on the state of transmission was shared by PHAC with the support of the Council of the Chief Medical Officer of Health. The U=U message, along with information regarding the testing and treatment of HIV, was promoted during an awareness campaign, which featured paid advertising on popular Canadian websites, YouTube videos, LinkedIn posts and posters in clinics and hospital break rooms. These advertisements were seen more than 41 million times and generated 85,000 visits to the campaign's website. The campaign was also promoted by a social media influencer raising awareness and by the inclusion of a public service announcement on the dating app Grindr, significantly extending its reach and garnering over 266,000 unique views. With an outstanding engagement rate of 7.23%, which is well above industry benchmarks, the Agency deemed this campaign successful. Moreover, further awareness of this message was facilitated with resources (e.g., posters, factsheets) produced in five Indigenous languages and shared with over 22,000 recipients.

Furthermore, in February 2024, PHAC developed and launched a public awareness campaign on rising syphilis cases, following community consultations with federal partners and stakeholders. The campaign provided resources and marketing materials in 17 languages to inform people living in Canada on the symptoms of syphilis and to raise awareness about early detection, timely treatment and cure of syphilis. Digital advertising was targeted towards regions with higher infection rates (i.e., AB, MB, NU, NT, ON, YT). The campaign advertisements were seen more than 10 million times resulting in 40,000 visits to the campaign's website. A social media influencer campaign and outreach efforts to post-secondary schools further increased the campaign's reach, which generated over 838,000 unique views and an engagement rate of 7.7%. Meaningful and engaging conversations with students also occurred in 30 campuses across the country. In February 2024, the Chief Public Health Officer issued a public health statement regarding syphilis data, testing and treatment which increased media attention on the issue and expanded the campaign's reach. PHAC also supported health professionals and community-based organizations to address syphilis by developing additional materials and providing critical information such as clinical manifestations at various stages of infection.

As part of PHAC's awareness campaigns on HIV and rising syphilis cases, the Agency produced 17 new infographics, factsheets and posters on U=U and syphilis, several of which were made available in 13 non-official languages, including seven Indigenous languages. PHAC also launched three new video testimonials and released a Healthy Canadians podcast episode focusing on U=U messaging.

Partnering for better results

In February 2024, PHAC published the renewed edition of the Government of Canada's Sexually Transmitted and Blood-borne Infections (STBBI) Action Plan 2024–30, which reflects lessons learned regarding the importance of effective public health messaging and tailored interventions for key populations as well as the need for collaborative and multidisciplinary action. To support the development of the Action Plan, the Agency received more than 800 contributions from over 450 stakeholders across Canada, including healthcare professionals, community-based organizations, researchers, advocates and people with lived and living experience of STBBI. PHAC also collaborated with nine federal departments to identify 16 priorities and 49 actions to guide the federal STBBI response. The Agency also worked with provincial, territorial and Indigenous partners to develop indicators and targets to measure progress in implementing the Pan-Canadian STBBI Framework for Action.

Strengthening immunization in Canada

PHAC continued efforts to reinforce Canada's preparedness for future pandemics and health emergencies. For instance, in 2023–24, the Agency provided guidance regarding regulatory requirements that may apply to Moderna's new domestic mRNA vaccine manufacturing facility, the construction of which was completed this year. When operational, this facility will produce up to 100 million doses of pandemic vaccines annually as part of the long-term agreement with Moderna for the domestic production of mRNA vaccines in Canada. This is a major milestone in Canada's efforts to strengthen its domestic vaccine and therapeutics production capacity and research and development as part of the Biomanufacturing and Life Sciences Strategy supporting Canada's preparedness for health emergencies.

PHAC also purchased high-dose seasonal influenza vaccine, which were distributed to provinces and territories for use in long-term care facilities. Furthermore, the Agency established a federal reserve of the mpox vaccine to support a rapid public health response to an mpox outbreak and built surge capacity to support provincial and territorial vaccination efforts.

To help people in Canada access vaccines and acquire accurate information on the uptake, safety and effectiveness of vaccines to make informed vaccination choices, the Government announced a renewed $10 million commitment to the Immunization Partnership Fund (IPF). In 2023– 24, this investment supported 55 organizations to address gaps in vaccine coverage in marginalized communities across Canada. As a result, healthcare workers were trained to support individuals with lived and living experiences of homelessness, organizations were informed how to combat mis- and disinformation, and the importance of immunization was elevated with the help of Elders in Indigenous communities. To increase vaccine confidence and uptake, the IPF funded community-based projects, such as an Indigenous-led project, which supported vaccine education and uptake among Métis people in Saskatchewan. Another example is a community-led initiative that eliminated barriers to vaccination and built vaccine confidence in Black communities. The IPF also supported local, regional and national organizations as well as provinces and territories to strengthen immunization in Canada.

In 2023–24, PHAC informed the development of public and professional education programs on immunization, the planning of immunization campaigns and the creation of target interventions for key populations, such as children, by publishing results from the 2021 Childhood National immunization Coverage Survey (cNICS), the 2023 Childhood COVID-19 Immunization Coverage Survey (CCICS) and the 2023 Adult National Immunization Coverage Survey (aNICS). These surveys contributed to monitoring vaccination and immunization coverage within specific populations, since immunization coverage tends to vary by ethnicity (e.g., South Asian individuals tend to have higher immunization coverage for polio vaccine than other ethnicities). The surveys provided key information about knowledge, attitudes and beliefs regarding vaccines, intentions to vaccinate, hesitancy and barriers to vaccination, as well as select sociodemographic information to inform analyses when possible.

To further promote the importance and benefits of vaccination, the Agency worked closely with provinces, territories and stakeholders to deliver immunization advertising campaigns. In 2023–24, PHAC launched outreach initiatives on the importance of vaccination, the use of personal protective measures and actions people can take to protect themselves against respiratory viruses. These advertising initiatives included the Childhood Vaccination Campaign, ongoing social media posts highlighting Ministerial and Chief Public Health Office (CPHO) statements, the Seasonal Flu Vaccination campaign, the Personal Protective Measures (PPMs) advertising campaign and the COVID-19 vaccination campaign. PHAC distributed advertisements via public infrastructures, published web banners, shared audio and video advertisements on popular digital media platforms, published social media posts, distributed pamphlets in healthcare settings and in the mail and produced posters for stakeholders to display. Altogether, these initiatives generated approximately 1.6 billion clicks on Canada.ca and advertisements were seen approximately 450 million times. In addition, outreach initiatives equipped almost 6,000 trusted partners and organizations with PPM resources. Campaigns were emphasized during the respiratory illness season and efforts were made to reach high-risk populations and the people in contact with these groups.

To build and maintain vaccine confidence in Canada, PHAC funded a series of community-based projects through the Vaccine Community Innovation Challenge that were tailored towards disproportionately impacted populations experiencing health and social inequities. The Agency also worked with other government departments to develop newsletter articles on the importance of vaccination to reach other disproportionately impacted populations such as older adults.

In 2023–24, the Agency launched the renewal of the National Immunization Strategy (NIS) and embarked on an extensive engagement process in fall 2023 with federal, provincial, territorial and Indigenous partners as well as other key immunization stakeholders. The NIS improved the relevance, effectiveness and efficiency of immunization programming in Canada by providing a cross-jurisdictional collaboration framework for a wide array of programs and partners. The renewed NIS includes reviewed priority areas and objectives as well as an overarching vision for 2025–30.

PHAC also monitored and provided policy guidance on the delivery of the Vaccine Injury Support Program, which is administered by OXARO, formally Raymond Chabot Grant Thornton Consulting Inc., a third-party administrator. First established in 2021, VISP provided individuals in Canada, excluding Québec, with access to financial support in the rare instance that they experienced a serious or permanent injury from a Health Canada authorized vaccine administered in Canada after December 8, 2020.

Advancing federal, provincial and territorial health data partnerships, public trust and health data literacy

PHAC relies on accurate and timely health data from provincial, territorial and other partners to make informed decisions that protect and improve the health outcomes of Canadians. In response to lessons learned and featuring a renewed focus on public health by all governments, the Working Together to Improve Health Care for Canadians Plan took action on modernizing the health care system with standardized information and digital tools. Building on work initiated in 2022 with the Federal, Provincial and Territorial Digital Health Action Plan, PHAC supported the publication of the Shared Pan-Canadian Interoperability Roadmap developed by Infoway in May 2023, which was endorsed by all provinces and territories (except Québec). The Roadmap set a long-term path for achieving a more connected health system with the adoption of common standards.

In October 2023, Canada's Health Ministers, with the exemption of Québec, endorsed a Joint Federal, Provincial, and Territorial Action Plan on Health Data and Digital Health (FPT Action Plan on Health Data) that drove system-wide changes in health data policy, sharing, interoperability, management and stewardship. The Agency launched a process to develop a public health data sharing instrument that responds to the needs of public health in the digital age. Underpinning this work was the Pan-Canadian Health Data Charter, which set out common principles and a unified vision for health data management in Canada. This Charter sought to facilitate access to and distribution of health information for practitioners and individuals, adopting a person-centered approach to health data management. It also established that health data should follow individuals across points of care to support clinical decision-making and respect privacy.

Modernizing PHAC data and surveillance systems with interoperability

In 2023–24, PHAC continued to modernize its approach to gather, process, manage, analyze and share data with stakeholders to enable them for effective public health decisions. As part of this work, PHAC launched the Data Modernization and Interoperability Initiative to work more effectively with partners in other government departments, provinces and territories with respect to health data infrastructure, interoperability and policy. The Agency evaluated its existing data systems, designed and implemented the tangible applications of interoperable data systems, and developed a protected cloud environment to provide a flexible and powerful infrastructure for data storage and analysis in which personal information can now be stored and shared safely.

PHAC also supported projects, activities and initiatives that advanced health systems interoperability and tools. For instance, the Integrated Threat Assessment Platform (ITAP), which was built on the principles of interoperability, provided Weekly Threat Reports that described public health threats, summarized the actions taken to address the threats and outlined planned next steps to mitigate the threats. Health system interoperability was also implemented in the Wastewater Surveillance Platform supported by PHAC, which tracked infection rates across Canada and enabled laboratories and municipalities to share, standardize, analyze and disseminate public health data to people living in Canada. Finally, a single and easily searchable repository aggregated data related to investigations of outbreaks of gastrointestinal illnesses caused by pathogens, as a result of implementing Phase 1 of the Canadian Enteric Detection Assessment and Response System. This allowed PHAC epidemiologists to focus on finding sources of the outbreaks rather than addressing data management issues.

In addition to improving health data infrastructure, policies and interoperability, PHAC strengthened its surveillance systems which are a critical component of Canada's emergency preparedness. With this work, PHAC established Minimum Performance Standards (MPS) to assess the Agency's surveillance systems performance against PHAC priorities.

Advancing work to mitigate impacts of climate change on health

Acknowledging the significant and growing impacts of climate change in Canada, PHAC provided advice, analysis and direction to support the advancement of Canada's first National Adaptation Strategy on Climate Change, as well as the implementation of the Government of Canada Adaptation Action Plan. To do so, the Agency worked closely with health partners and other governmental organizations on adaptation and health action in Canada. This included the implementation of the Infectious Disease and Climate Change (IDCC) Program to conduct surveillance and climate change risk assessments. It also gathered evidence on monitoring, prevention and control methods to enable early warning of emerging diseases as a result of climate change. For example, PHAC developed laboratory methods to monitor diseases that may emerge or re-emerge as a result of climate change, which are increasing health professional capacity.

The Agency also helped health professionals and people living in Canada to better understand health risks associated with climate-sensitive infectious diseases by enhancing systems and tools. Furthermore, PHAC reiterated the importance of taking preventative actions, including by exploring the application of behavioural science insights into program delivery and policy advice. As part of the IDCC Program, PHAC also invested in the Infectious Disease and Climate Change Fund, which supported new and innovative projects for health professionals, communities and priority populations to increase resilience to climate change.

Recognizing the growing public health risks associated with increasing climate-related events, in December 2023, the Agency established an internal information hub on climate change and public health to support the development of an action plan and advance horizontal coordination and collaboration on climate change and public health. This included efforts to help advance preparedness and response activities related to wildfires, in collaboration with federal partners including Health Canada. PHAC published the Public Health Risk Profile on Wildfires in Canada on June 2023, which characterized the public health risk considerations from short-term exposures of wildfire smoke and evacuations, and their acute impacts on exposed populations.

PHAC also supported public health authorities in the prevention, mitigation, preparedness, response and recovery of wildfire-related human health risks, and integrated both physical and mental health characteristics by developing a factsheet on the use of respirator masks for wildfire smoke and developed the Wildfire Toolkit for Public Health Authorities.

Applying behavioural science to advance public health objectives

In 2023–24, the Agency leveraged its partnerships with public health stakeholders to expand its behavioural science research activities. PHAC gathered evidence from behavioural science research and accelerated high impact innovations in several priority and urgent public health areas, such as mis- and disinformation and vaccine confidence. For example, PHAC produced evidence related to vaccine uptake, coverage, safety and effectiveness. The Agency posted bi-weekly reports on vaccination uptake and quarterly reports on adverse events following immunization to increase understanding, confidence and trust in the safety and effectiveness of Health Canada-authorized vaccines. In collaboration with partners such as Health Canada, provinces and territories, PHAC also monitored safety signals and no new safety issues were identified in 2023–24.

In February 2024, the Agency presented results from a study on routine childhood immunization during the COVID-19 pandemic at the Health Canada Science Forum. The results demonstrated that the COVID-19 pandemic disrupted access to routine childhood immunization, with one in four parents or guardians reporting having missed or delayed a vaccination appointment. Additionally, from December 2023 to January 2024, PHAC conducted an internal study on ways to communicate public health uncertainty by fostering and maintaining trust and minimizing susceptibility to mis- and disinformation. The findings included best practices to teach science and data literacy to the public by expressing empathy.

Furthermore, during the 2024 Health Canada Science Forum, PHAC presented results from a survey that found high levels of mental health literacy (MHL) among a representative and diverse sample of people living in Canada. The study also identified other important gaps, barriers and predictors of mental well-being and its results directly informed program planning, communications and funding decisions to conduct additional research and further analyze the available MHL evidence.

Results achieved

Identification of emerging threats

Multiple viruses, including influenza (flu), respiratory syncytial virus (RSV), measles, invasive group A streptococcal (iGAS) disease and SARS-CoV-2 (COVID-19) circulated simultaneously in 2023–24. PHAC improved coordination of respiratory virus surveillance and data sharing to support a timely response to the fall respiratory virus season, including advice on protection and decision-making to people in Canada, through the Respiratory Virus Surveillance Integration Team and strengthening existing respiratory disease surveillance operations and capacity. The Agency also established the LAB-Epi Linkage working group to enhance federal, provincial and territorial data sharing and surveillance for respiratory viruses and vaccine preventable diseases. LAB-Epi Linkage also identified limitations in current policy, infrastructure and strategic coordination as the group developed recommendations for specific applications, criteria and mechanisms, which ultimately strengthened public health surveillance of emerging public health threats to people living in Canada.

In 2023–24, PHAC supported the Canadian Pediatric Society with an enhanced surveillance pilot project on pediatric RSV to prepare for new treatments and vaccines as well as reduce the burden of RSV in children living in vulnerable situations. The Agency also developed a comprehensive outbreak module in the System for Outbreak and Level of Activity Reporting and monitored outbreaks due to respiratory viruses, including priority pathogens such as RSV, the flu, COVID-19 and other seasonal respiratory viruses. As a result, this initiative increased understanding of the impact of these viruses when occurring simultaneously or affecting disproportionately impacted populations.

Additionally, in 2023, PHAC assessed and communicated emerging public health threats and documented actions across the Agency via its Coordinated Threat Assessment (CTA) process. The CTA used a standardized methodology with program engagement and communication across PHAC by engaging the Scientific Committee on Coordinated Threat Assessment (SCCTA). In 2023–24, 144 public health threats were assessed using a standardized methodology and these threats were shared during 85 of PHAC's Executive Committee Daily meetings. The impact of this work was exemplified in October 2023, when the Agency collaborated with other federal partners and recognized a joint threat related to an increase of active tuberculosis cases in individuals seeking asylum in Canada.

Furthermore, in 2023–24, PHAC expanded its capacity to identify new and concurrent pathogens of national and international concern by launching Canada's Parasite Outbreak Detection and Response, the first genomic surveillance system for parasites in the gastrointestinal tract. This pilot system was instrumental in PHAC's swift responses to food-related outbreaks in the past year.

Providing national and international science leadership

In 2023–24, the Agency demonstrated science-driven leadership in the field of infectious diseases, and worked with national and international partners to detect, investigate and monitor infectious disease trends. This included supporting clinical decision-making, experimental vaccines and treatments, advancing testing and diagnostic methods, as well as guiding and supporting public health programs, risk assessments, preparedness and interventions. For example, by leveraging partnerships established during the COVID-19 pandemic, PHAC led the External Modelling Network for Infectious Diseases which fostered ongoing collaboration in infectious disease modelling and helped preserve lessons learned to enhance readiness for future public health threats.

PHAC also demonstrated science leadership by launching the avian influenza A(H5Nx) expert panel in October 2023. This panel developed research priorities and convened experts from various federal departments and agencies, scientists from provinces and territories, academic researchers and other experts. PHAC also built its capacity and ability to measure pandemic risks posed by public health threats with the creation of two new products: a rapid risk assessment of avian influenza A(H5N1) and a pandemic risk scenario analysis of the influenza A(H5Nx) virus and other related future novel viruses. Both tools were developed in collaboration with federal, provincial and territorial partners from multiple sectors and informed pandemic preparedness, monitoring, surveillance and risk communication activities. These tools also helped identify knowledge gaps and research needs, which informed the prioritization exercise conducted by the Panel.

Moreover, to demonstrate science excellence, the Agency's Federal Surge Laboratory Network provided national laboratory leadership and readiness to respond to emerging threats. For instance, the Network facilitated collaborative activities, which were instrumental during the response to the avian influenza virus outbreak. In addition, PHAC organized timely public health interventions to address the emergence of Shigella flexneri, an acute infectious food and waterborne disease, in under-housed and homeless populations and E. coli in daycare centres. Furthermore, the Agency tracked and assessed COVID-19 variants of concern by using genomic sequencing and bioinformatics services. PHAC initiated weekly Nowcast estimates of near-term COVID-19 variant proportions, which were published on the Canadian COVID-19 dashboard. This initiative improved the accuracy of the interval data formerly published on a two-week basis. By enhancing situational awareness through improved data curation and public availability, PHAC strengthened its genomic surveillance capabilities in monitoring circulating COVID-19 variants.

In collaboration with international partners, PHAC provided essential expertise and services to lower and middle-income countries lacking Containment Level 4 laboratories. For instance, the Agency assisted in building capacity for high-containment facilities and enhanced regional capabilities to address public health emergencies and emerging zoonotic viral diseases. This included partnerships with Global Affairs Canada and the Institute Pasteur in Laos to strengthen diagnostic testing and biosafety in the Association of Southeast Asian Nations region. The Agency also worked to include the centralization of a biobank for clinical samples of the Ebola virus in Sierra Leone. These efforts strengthened global public health and provided regional capacity to address public health threats and keep people living in Canada safe.

Reducing the impact of foodborne illness outbreaks

PHAC supported people living in Canada by reducing the impact of foodborne illness outbreaks via educational and awareness activities, monitoring and reporting, as well as preparedness and response efforts. In January 2024, PHAC led the modernization of national case definitions for gastrointestinal diseases caused by pathogens, following consultations with laboratory experts, epidemiologists and federal, provincial and territorial partners. This initiative allowed culture independent diagnostic tests and new laboratory methods to be incorporated into the national case definition, which provided guidance and consistency across Canada in how gastrointestinal disease cases are reported. This supported the accurate monitoring of disease trends and outbreak detection and response, for now and in the future.

The Agency also examined public communication activities such as public health notices to establish best practices and optimize accessibility, usefulness and understanding of public health messaging. An example illustrating the Agency's public communication activities includes messaging developed for an outbreak of Salmonella infections. These infections were linked to specific brands of cantaloupes and resulted in PHAC issuing a public health notice and seven updates, publishing social media posts and conducting six national media interviews. The Agency also proactively sent communications to provincial and territorial authorities for distribution to daycares and retirement residences in their jurisdictions. During this outbreak, PHAC's webpages on Salmonella infections were visited more than 60,000 times, thus contributing to a reduced risk of contracting the infection for people living in Canada.

Increasing awareness and reducing the impact of zoonotic diseases

In 2023–24, PHAC led prevention, preparedness and response efforts to reduce the impact of zoonotic diseases by detecting, assessing and responding to emerging and ongoing zoonotic threats using a One Health approach. For instance, the Agency led the One Health and Zoonoses Community of Practice and collaborated with public health and animal health colleagues from across Canada to share information on zoonotic priority issues, including avian influenza, rabies, mpox and One Health best practices.

To increase awareness of zoonotic diseases to the public and health professionals, PHAC re-branded its Lyme and other tick-borne diseases email subscription list into a Zoonoses Bulletin, which provided monthly updates on PHAC's zoonoses activities. PHAC also developed and implemented seasonal social media plans to share content regarding tick and mosquito bites, as well as other zoonotic disease prevention content for people living in Canada to receive timely, seasonally appropriate and culturally sensitive public health information. Additionally, the Agency updated its online Lyme disease resources, which included educational materials teaching people in Canada how to protect themselves against this disease. PHAC also launched continuous advertising and marketing campaigns specifically targeting individuals living in high-risk areas via advertisements on the web, social media content, television content for children, teacher resources and an interactive online exhibit.

PHAC provided seasonal surveillance data for humans, horses, wild birds and mosquitoes by developing a dashboard for vector-borne diseases. The Agency also increased capacity within the research community to generate knowledge and improve Lyme disease diagnosis and treatment by providing $750,000 in funding to the Canadian Lyme Disease Research Network. Furthermore, PHAC improved its ability to assess risks of zoonotic diseases for people across Canada by collaborating with multisectoral partners to develop a One Health Approach to Risk Assessment (OHARA) Framework. The OHARA Framework expanded the Agency's capacity to understand and act on current and future public health risks and events by integrating data, evidence and expert advice from multiple areas of influence on human health. In doing so, the Framework improved the Agency's ability to protect the health of people in Canada from adverse public health risks and events, and in line with the One Health approach, to assist other departments in improving the health of the animals, plants and ecosystems on which public health depends.

Providing evidence-informed public health guidance

PHAC generated evidence-informed public health guidance to mitigate the community transmission of infectious diseases and support policy development, ran lessons learned exercises and improved future pandemic preparedness and response. In 2023–24, PHAC expanded its research activities on infectious diseases to provide knowledge and evidence to guide public health action in Canada. For instance, in June 2023, the Agency dedicated funding for the Canadian Water Network to launch a new wastewater-based surveillance program to facilitate wastewater monitoring across the country. This program supported public health practitioners in interpreting the findings of wastewater-based surveillance data for their communities. Overall, this initiative and others helped the Agency provide evidence-informed public health guidance and advice to provinces, territories, stakeholders and public health professionals to inform decision-making.

Addressing the impacts of tuberculosis

Tuberculosis (TB) is a serious, preventable, and curable illness that disproportionately impacts people experiencing health inequities across Canada. To highlight the Agency's efforts to combat TB to date, in February 2023, PHAC completed an Evaluation of the Public Health Agency of Canada's Tuberculosis Activities 2015–16 to 2020–21. The evaluation listed four recommendations for PHAC to improve coordination, communication and clarity regarding TB activities, which were fully implemented in 2023. To address these recommendations, PHAC established governance structures to improve coordination with stakeholders, updated TB surveillance approaches, and revised and implemented current frameworks to monitor progress and achievements of TB activities for continuous improvement.

In addition, PHAC monitored and reported on national active TB cases and drug resistance trends. In collaboration with Indigenous and territorial partners, the Agency also mobilized epidemiological, laboratory and logistical resources to support a 10-week community-wide screening in Pangnirtung, Nunavut. As a result, 94% of the key population in the Inuit Tapiriit Kanatami were screened for TB.

To provide critical data on the disease's evolution, transmission and severity, and to inform future targeted interventions and public health policies regarding TB, PHAC detected over 60 samples of a new variant of Mycobacterium tuberculosis. This was accomplished in collaboration with public health partners in Alberta and British Columbia, as these samples were found primarily in human specimens from those two provinces.

Internationally, PHAC participated at the United Nations High Level Meeting on TB in September 2023 to reaffirm Canada's commitment to the implementation of the 2030 Agenda for Sustainable Development including the urgent need to accelerate domestic and international efforts towards universal access to quality, equitable countermeasures for TB prevention, diagnosis, treatment and care, and comprehensively addressing social determinants of health.

PHAC integrated SGBA Plus considerations in the research and development of vaccines and therapeutics. PHAC used SGBA Plus analyses to identify and reach priority populations in its initiatives to promote vaccination and vaccine confidence, as well as its actions to support access, guide and monitor vaccine safety, effectiveness and coverage.

For instance, immunization advice published by PHAC placed a strong emphasis on establishing vaccine equity, which was also a consideration when developing vaccine guidance for the National Advisory Committee on Immunization's (NACI) mandate. SGBA Plus considerations were also included in the review and development of all NACI statements. In 2023–24, NACI also adopted the use of gender inclusive language related to pregnancy and breastfeeding.

To further integrate SGBA Plus in its work to prevent, control and reduce the spread of infectious diseases among people who live in Canada, in 2023–24, PHAC provided financial support to community-driven projects and initiatives, for the purposes of promoting and raising public awareness of infectious diseases, with the Vaccine Community Innovation Challenge. The projects funded by this Challenge built and maintained vaccine confidence within communities and focused on priority populations and targeted regions where the uptake of COVID-19 vaccine boosters was low. These populations and regions included Indigenous Peoples, racialized communities, newcomers to Canada, persons with disabilities and youth. In 2023–24, the Infectious Disease and Climate Change Fund also fully integrated SGBA Plus considerations into funding documents, such as application forms, guides, evaluation forms and its performance measurement and reporting templates, and strongly encouraged Indigenous organizations to apply.

Additionally, PHAC prioritized SGBA Plus by funding initiatives with the Immunization Partnership Fund, targeting the development of tailored interventions at the local, regional and national levels. These gender-balanced and inclusive initiatives provided direct benefits to people living in Canada who were disproportionately impacted by vaccine preventable illnesses. These targeted groups included Black, Indigenous, and other racialized people, as well as priority populations including healthcare providers, older adults, children and youth, pregnant women and people, members of the 2SLGBTQIA+ community and other underserved or marginalized populations.

Consistent with SGBA Plus principles, PHAC identified mechanisms to improve the collection of appropriate factors across epidemiological products and funding programs. For example, a wide array of sociodemographic and socioeconomic information from participants was collected in the Health, Attitudes and Behavioural Insights Tracker (HABIT) study, including low-income people, Indigenous Peoples, newcomers, Black people and members of the 2SLGBTQIA+ community. Oversampling of priority populations in this study allowed for further disaggregation of data by under-reported groups, such as people living with a disability, people living in less populated provinces and living in Northern Canada.

In addition, to highlight the importance of disaggregated data, PHAC supported the HIV and Hepatitis C Community Action Fund (CAF) and the Harm Reduction Fund (HRF) programs that incorporated SGBA Plus considerations, prioritized community engagement and focused on priority populations. Projects funded under the CAF and HRF were reviewed by committees comprised of individuals from key populations, people living with HIV, researchers and front-line workers. As a result, various regions, genders, ages, populations, expertise and experience were represented on the committees, and the funded projects considered how intersecting identities for target groups as well as social determinants of health impacted health inequities, which allowed programs to adopt tailored approaches and produce greater impacts.

In 2023–24, PHAC collected data concerning knowledge, attitudes and beliefs from its immunization coverage survey respondents. PHAC launched several new national surveillance surveys that assessed vaccine status, intent to vaccinate and vaccine hesitancy as well as knowledge, attitudes, beliefs and behaviours for various vaccine-preventable diseases within disproportionately impacted populations (e.g., parents and guardians who are recent immigrants, urban Indigenous Peoples, healthcare workers, members of the 2SLGBTQIA+ community, men who have sex with men). Results from these surveys informed public health vaccination programs, prevention strategy initiatives and funding decisions.

PHAC partnered with the Interdisciplinary Centre for Black Health from the University of Ottawa to implement the COVID-19 Vaccine Coverage in Black Communities Survey. This project provided previously unknown data on vaccination status, vaccine hesitancy, beliefs associated with trust and distrust of vaccines, as well as intent to vaccinate among Black communities in Canada. With this partnership, PHAC published a study on COVID-19 vaccine confidence and need in Black individuals in Canada in February 2024, as well as published an additional study on factors impacting vaccine mistrust among Black individuals in Canada in April of 2024.

In 2023–24, PHAC contributed to SDG 3: Ensure healthy lives and promote well-being for all at all ages by supporting numerous programs and initiatives that integrated cultural competencies and social determinants of health to improve health outcomes for people who live in Canada. Such initiatives included those funded under the HIV and Hepatitis C CAF, the HRF and the Immunization Partnership Fund (IPF). Specifically, the IPF invested nearly $10 million in 55 community-driven projects that were equity-promoting, culturally safe and evidence-informed. These projects used unique and tailored approaches that addressed underlying factors, including geographical and logistical barriers as well as cultural safety, which influence health disparities and inequities within communities to build vaccine confidence, access and uptake. These projects resulted in over 17,500 vaccinations received by priority populations. PHAC also supported the UN's goal to reduce tuberculosis (TB). PHAC facilitated access to newer first-line therapies for TB infections such as rifapentine through the Urgent Public Health Needs mechanism. PHAC is working collaboratively with Health Canada to manage TB drug shortages and explore ways to improve access to critical TB medications in Canada, including in the North. Additionally, PHAC supported requests for assistance from provinces and territories to help with prompt management of TB outbreaks and conducted national surveillance to monitor trends in TB rates and outcomes, including monitoring trends in resistant strains of TB.

PHAC also supported global vaccine equity with the donation of surplus COVID-19 vaccines. By May 2023, the Government of Canada donated more than 201 million doses, including 46.6 million doses which were donated to COVAX and more than 3.7 million doses donated directly to countries via bilateral agreements. Canada also provided financial contributions to COVAX towards the purchase of the equivalent of 150.7 million vaccine doses for low- and middle-income countries.

To contribute to SDG 17: Strengthen the means of implementation and revitalize the global partnership for sustainable development, the Agency released the Pan-Canadian Action Plan on Antimicrobial Resistance. This five-year (2023–27) blueprint coordinates an accelerated pan-Canadian preparedness and response to address AMR across the One Health spectrum. Building on previous experiences, health professionals, the agriculture industry, researchers and many other groups and sectors in Canada made progress towards detecting, understanding and acting against AMR. Leading this One Health approach, PHAC increased efforts to implement concrete activities that support the priority actions in this action plan.

More information on PHAC's contributions to Canada's Federal Implementation Plan on the 2030 Agenda and the Federal Sustainable Development Strategy can be found in the 2023 to 2027 Departmental Sustainable Development Strategy.

PHAC advanced innovative wastewater monitoring to detect and track novel pathogens, thus contributing to enhanced public health action. Expanding the network and increasing sequencing capacity allowed PHAC to collect and sequence almost 16,000 SARS-CoV-2 (COVID-19) samples from wastewater in 2023–24, which significantly improved variant tracking across Canada from previous years. Collaborations with provincial, academic and industry partners further extended surveillance to two additional Canadian international airports.

In 2023–24, PHAC supported the ongoing implementation of the Biomanufacturing and Life Sciences Strategy in collaboration with Innovation, Science and Economic Development and Health Canada. This initiative strengthened Canada's pandemic readiness by strategically investing in biomanufacturing and life sciences ecosystem. Specifically, the Canada Biomedical Research Fund and Biosciences Research Infrastructure Fund launched the second phase of an integrated funding competition. This $574 million investment focused on innovative research, training and infrastructure development to enhance Canada's pandemic preparedness and response to emerging threats. PHAC also established partnerships with four project funding recipients to advance public health goals more effectively.

PHAC collected case reports on adverse events following immunization from provincial and territorial partners in the Canadian Adverse Events Following Immunization database. The Agency used this data to signal adverse events that may require more in-depth investigation. Based on this data, PHAC updated the reported side effects for COVID-19 immunization in 2023–24. The Agency also explored the possibility of using technological advancements in automation to streamline the intake and processing of data related to adverse events following vaccination.

PHAC developed an open-source signal detection prototype that uses advanced data processing and artificial intelligence to scan and analyze over 100,000 articles across dozens of languages daily using AI, use advanced visualizations to detect signals and use geo-coding and mapping to highlight priority locales. This prototype would allow public health professionals to use AI to quickly answer questions based on libraries of news articles, automate notifications to flag threats to analysts 24/7 and save time and energy to allow skilled epidemiologists to spend more time on analysis and action.

PHAC also expanded its behavioural science research focus and examined drivers of misinformation among youth as well as identified and assessed strategies to lower susceptibility to misinformation. Exploring facilitating and impeding factors for vaccine confidence and uptake, this work reviewed evidence-informed approaches to help design behavioural interventions to boost COVID-19 vaccination and improve confidence in routine immunizations

Furthermore, PHAC led the development of quality improvement strategies that promote antimicrobial stewardship practices related to testing and treating urinary tract infections in long-term care homes. The protocol was pilot-tested in a single long-term care home in 2023 and has since been extended to eight additional long-term care homes across five provinces.

• Description
• Progress on results
• Resources required to achieve results
• Related government-wide priorities
• Program inventory

Results achieved

In 2023–24, PHAC progressively scaled down COVID-19 response activities, such as vaccine and therapeutic procurement and distribution, rapid testing, medical supply logistics (e.g., deployment of personal protective equipment), sero-surveillance and the Immunization Partnership Fund. This scaling down of activities also included the demobilization of border testing, travel and quarantine measures and the Safe Voluntary Isolation Sites Program.

Integrating lessons learned from the COVID-19 pandemic response into forward planning on preparedness

In 2023–24, the Agency integrated lessons learned from the COVID-19 pandemic into PHAC's future pandemic preparedness, building on engagements with provinces and territories on a broad range of public health issues (e.g., climate change, opioid crisis, etc.). The Agency integrated lessons learned from COVID-19 and other crises in its work on emergency planning and preparedness by launching a renewed Health Portfolio Emergency Response Plan (HP ERP). The renewed HP ERP, which represents the most significant update to the Plan since 2013, focused on how future preparedness and response efforts could be enhanced. The renewed plan provides Health Portfolio partners with a standardized framework to guide future public health event responses and defined a cyclical review process to maintain relevance and effectiveness. The plan also better defines activation levels and authorities, details smoother transitions between initial escalation and de-escalation, optimizes engagement of key partners and resources when supporting an event response and introduces science and health equity considerations.

Leveraging the findings of the Office of the Auditor General report on COVID-19 vaccines published in December 2022, the VaccineConnect digital system was used to closely monitor inventory management and distribution. These monitoring activities, coupled with communication with jurisdictional partners and suppliers, permitted the early identification of 201 million surplus vaccines which were later distributed to other countries to promote global vaccine equity.

To support forward planning on applying a population health approach to emergencies, the Chief Public Health Officer (CPHO) published her 2023 annual report titled Creating the Conditions for Resilient Communities: A Public Health Approach to Emergencies. This report fostered national and international dialogue among stakeholders on the importance of integrating a health promotion approach and equity considerations into emergency prevention and mitigation, response, and recovery. The report also included a set of tools and approaches for applying health promotion and equity frameworks for emergency management procedures. PHAC published a set of knowledge gaps and research needs as a companion resource to this report, providing actionable recommendations for knowledge generation to improve the evidence base for implementing recommendations made by the CPHO. It informed a catalyst grant funding opportunity by the Canadian Institutes for Health Research (CIHR).

To advance emergency management response and literacy at the Agency and support public health preparedness, training courses for the Incident Management System (IMS) response were developed alongside five micromodules explaining the major response roles of the IMS. In partnership with provinces and territories, work was also initiated to update the Health Portfolio Strategic Emergency Management Plan and the Federal, Provincial, and Territorial Public Health Response Plan for Biologic Events. To support public health authorities in the mitigation, preparedness, response and recovery to human health risks associated with wildfires, PHAC created a toolkit for Public health authorities on Wildfires in August 2023.

Further building on lessons learned from the COVID-19 pandemic, PHAC contextualized health risks for diverse audiences by providing more accessible and inclusive messages. The Agency also increased public resilience to mis- and disinformation with more evidence-based information about the risk and preventative measures people could take to protect themselves and their loved ones. These improvements to risk communications were accomplished by providing additional training to risk communicators in the Health Portfolio.

As part of the COVID-19 lessons learned, the Agency developed webpages to provide health care professionals and people in Canada with information and additional resources on post COVID-19 condition (i.e., long COVID). The Agency also conducted or funded several reviews on this work including reviewing prevalence of symptoms, risk factors and prevention measures for post COVID-19 condition.

PHAC also strengthened its presence on the global stage by collaborating with international partners on forward planning for Pandemic Prevention, Preparedness and Response (PPPR) and recovery to threats, including pandemics. In 2023–24, PHAC represented Canada at the first ever United Nations General Assembly high-level meeting dedicated to PPPR. As a result, PHAC, along with other Member States, adopted a new Political Declaration on PPPR that called for stronger international collaboration at the highest levels of government to better prevent, prepare for and respond to pandemics.

In addition, PHAC worked with its United States and Mexico counterparts to update the North American Preparedness for Animal and Human Pandemics Initiative, in consultation with other Canadian federal departments and agencies, to strengthen collaboration to address health security threats across the continent. Moreover, through the Global Public Health Intelligence Network (GPHIN), PHAC engaged with the WHO Hub for Pandemic and Epidemic Intelligence to strengthen the Epidemic Intelligence from Open Source platforms.

Strengthening surge support capabilities and improving public health intelligence capacity

In 2023–24, PHAC improved public health intelligence capacity and Canada's readiness for the next public health emergency by strengthening the Global Public Health Intelligence Network (GPHIN). Improvements to the GPHIN included increasing the resources to conduct public health event-based surveillance, established a new mechanism to effectively share event-based surveillance signals with other surveillance programs in PHAC, and the ongoing work to modernize the GPHIN platform. The Agency also conducted comprehensive reviews and improvements to a number of GPHIN products (e.g., the Early Warning Notifications, and the newly launched Emerging Issues Reports). For example, the improvements to the Early Warning Notifications enabled PHAC to establish a mechanism to improve notifications of forthcoming issues. PHAC's epidemiologists receive early warning of signals which enable them to begin their assessment of risks for Canadians and define response measures as needed more promptly. The GPHIN also established connections with partners across Canada and the world to ensure timely information sharing of ongoing and emerging potential public health threats to support global public health surveillance and emergency preparedness and response.

PHAC strengthened the National Emergency Strategic Stockpile (NESS) in 2023–24 including medical countermeasures (e.g., vaccines, therapeutics, personal protective equipment, biomedical devices) and essential social service supplies (e.g., cots, blankets) to provide materials to support provinces and territories during public health emergencies. This included the onboarding NESS warehouses onto a modernized warehouse management system and ongoing advancement of multi-year investment plan for niche MCMs for chemical, biological, radiological and nuclear threats. To further strengthen this capacity and to respond to the findings of the Auditor General's Report on Securing Personal Protective Equipment and Medical Devices, PHAC began developing the NESS Comprehensive Management Plan, which took into consideration relevant findings from past audits, evaluations and lessons learned, as well as findings from engagement sessions with key partners and stakeholders. This plan outlines strategic goals and associated action items for the NESS to foster improved pan-Canadian readiness to respond effectively and equitably to future public health emergencies.

Moreover, the Agency completed and published six risk assessments to inform public health professionals and support planning and decision-making for people living in Canada and Canadians abroad. PHAC also built on and expanded evidence support system activities established during the pandemic. This work included horizontal evidence synthesis coordination resulting in 24 evidence reviews on a wide range of priority public health topics.

To strengthen surge support capabilities, PHAC also funded two additional fellows to join the cohort of five in the accredited Canadian Field Epidemiology Program set to begin in fall 2024. The program provides field-based training in applied epidemiology and outbreak investigation and mobilizes participants to investigate and respond to urgent public health problems in response to epidemiologic requests for assistance received by PHAC from public health partner organizations across Canada.

Providing on-site expertise and advice

PHAC provided expertise and strengthened Canada's public health workforce and professional networks by working with public health partners. In 2023–24, the Canadian Public Health Service supported over 30 Public Health Officers (PHOs) in areas such as surveillance of the re-emergence of syphilis, the ongoing impact of substance-related harms in Canada, the monitoring of vaccine adverse events following immunization, and advancement of national mortality surveillance. This work supported the provincial and national response to substance-related harms. Overall, these PHO placements advanced federal public health priorities and addressed both ongoing and emerging public health needs across the country.

Results achieved

Enhancing PHAC's oversight and engagement with Canadian laboratories working with or intending to work with human pathogens and toxins

In 2023–24, Canada had an increase in the number of organizations building new or upgrading existing high-containment facilities, due in part to federal investments in the domestic biomanufacturing and life sciences sectors via the 2021 Biomanufacturing and Life Sciences Strategy (BLSS). As a key regulator of these sectors, PHAC raised awareness and promoted compliance with regulatory requirements by proactively engaging with these organizations during the development and planning of these facilities.

Furthermore, in 2023–24, PHAC determined high rates of compliance among Canadian facilities regarding the conditions of their Pathogen and Toxin Licences, as well as identified deficiencies and provided corrective measures to prevent serious health and safety risks to people living in Canada. Specifically, the Agency conducted a total of 165 inspections (up 15% from 2022–23) using a combination of on-site and virtual approaches. This resulted in the Agency meeting or exceeding its annual inspection targets with regards to compliance with the HPTA, the Human Pathogens and Toxins Regulations (HPTR), and with the applicable sections of the Health of Animals Act (HAA) and the Health of Animals Regulations (HAR). Canadian facilities corrected 99% of identified deficiencies with established timelines, which demonstrated their commitment to biosafety and biosecurity to keep Canadians safe. All inspection summaries are available online on Open Government.

PHAC also launched the Baseline Containment Assessment (BCA) for new organizations applying for licences to operate lower containment facilities to more appropriately understand applicable regulatory requirements. The BCA is a comprehensive review of an organization's first Risk Group 2 licence application, providing an avenue for communication and guidance for applicants.

Moreover, PHAC supported regulated parties and stakeholders in identifying and mitigating biosafety and biosecurity risks and fulfilling their HPTA and HPTR obligations by providing a range of guidance and tools.

Modernizing Canada's regulatory framework for human pathogens and toxins

To support Canada's biomanufacturing safety regulations, PHAC completed a thematic consultation with a broad range of partners and stakeholders. In keeping with the Government of Canada's commitment to greater transparency and accountability, PHAC summarized feedback and outlined how the information gathered during the consultation process will be integrated in the development of the HPTR amendments in a What We Heard report. Additionally, PHAC determined the possible costs and benefits of the proposed regulatory amendments and established the overall impacts across all regulated parties by conducting stakeholder pre-consultations in fall 2023.

Modernizing regulatory operations

The Integrated Suite of Tools for Operational Processes (iSTOP) is the primary case management system used to support PHAC's compliance monitoring, verification and enforcement activities under the HPTA/HPTR. It includes a public-facing Biosecurity Portal that enables nearly 2,000 regulated parties to securely exchange information with PHAC and fulfill their obligations under the HPTA/HPTR. In 2023–24, PHAC worked to migrate the modernized iSTOP system and data to the cloud by March 2025. This work included developing an evergreen risk mitigation plan informed by consultation with internal stakeholders and Health Canada.

Advancing global health priorities in biosafety and biosecurity

PHAC provided experience and expertise to advance global health priorities and manage risks associated with biosafety and biosecurity incidents. PHAC launched several initiatives that included capacity development, sharing best practices with international partners, and providing expert review and advice as a member of the WHO Collaborating Centre for Biosafety and Biosecurity. Furthermore, under PHAC's leadership and with the support of Global Affairs Canada's Weapons Threat Reduction Program, the International Experts Group of Biosafety and Biosecurity Regulators (IEGBBR) published the IEGBBR Model of Standardized Regulatory Practices for Biosafety and Biosecurity Incidents. This model was developed as a capacity-building tool for the international community to improve and standardize incident reporting systems.

Additionally, the Agency worked to address Canada's international polio commitments. In 2023–24, PHAC chaired the first International National Authority for Containment group for poliovirus containment to advance global priorities under the WHO's Global Poliovirus Eradication Initiative. The Agency increased alignment with international containment requirements and reduced the number of Canadian facilities storing poliovirus materials. PHAC also provided best practices to help prepare for, detect and control poliovirus, as well as defined roles and responsibilities for a coordinated response across the country by publishing Guidance for the response and management of a poliovirus event or outbreak in Canada.

Results achieved

Identifying and mitigating public health risks related to travel

To mitigate health risks for Canadians travelling internationally and reduce the risks of imported infectious diseases, PHAC developed and posted relevant, timely and evidence-informed travel health information and advice on travel.gc.ca. In addition to maintaining and updating travel health content on destination Travel Advice and Advisories pages on travel.gc.ca and Canada.ca, PHAC posted seven new travel health notices, two new outbreak monitoring alerts and over 50 other travel health advice product updates. Travel health content was also shared on PHAC's social media platforms, with over 330 posts covering a wide range of topics on vaccination, insect bite prevention, mass gatherings, sun safety, food safety, cruises, travelling with children and travelling while pregnant. PHAC also developed proactive messaging and communication products to promote travel health, including at ports of entry throughout Canada.

Additionally, PHAC collaborated with stakeholders to develop and share travel health messaging. This messaging was informed by public opinion research, which assessed the attitudes of 3,200 Canadian participants travelling internationally, as well as an intercept survey assessing audience demographics and their needs and use of the health content on travel.gc.ca. Moreover, PHAC improved reach, accessibility and breadth of travel information shared with underserved populations by developing a comprehensive three-year outreach strategy (2023–26) centered around working with both internal and external stakeholders.

PHAC also facilitated healthcare professionals' support of their patients' decision-making on prevention and treatment of infectious diseases and health hazards that may be encountered when travelling abroad. This was accomplished by supporting the Committee to Advise on Tropical Medicine and Travel (CATMAT), an expert advisory body, in developing evidence-informed travel health guidelines for healthcare professionals. In 2023–24, CATMAT updated the Appendix 1 of malaria on transmission and recommended preventive measures by geographical area. Healthcare professionals can access these guidelines on Canada.ca as well as through their appropriate networks.

PHAC engaged key stakeholders, including port authorities, other government departments and health authorities, with its Travelling Public Program. PHAC also provided guidance on the application of inspection guidelines or acts with cruise ships, engaging with new and current cruise ship operators in its work to address travel-related public health risks.

Furthermore, PHAC worked with provincial and territorial Health Emergency managers to develop Communicable Disease Response Plans at seven airports of entry and address the wake of measles cases in Québec. Moreover, in 2023–24, PHAC collaborated with provincial, academic and industry partners to further extend wastewater surveillance to two additional Canadian international airports, for a total of three airports. With coverage now encompassing over 70% of international air passengers entering Canada, the program improved the early detection of COVID-19 variants prior to clinical detections in communities.

Managing travel-related public health risks for transportation of people and ancillary services

PHAC conducted potable water, food and sanitation inspections of conveyances and their ancillary services for regulation compliance. In total, 468 inspections were conducted and 97% of these inspections met public health requirements. These inspections provided an opportunity to enhance the industries' knowledge of public health requirements and provided a safe travel environment for passengers.

In 2023–24, PHAC integrated SGBA Plus considerations in the development of biosafety and biosecurity guidance, resources and tools. For instance, PHAC identified specific populations at increased risk when developing resources that described the hazardous properties of a human pathogen and provided guidance on working safely with these agents in a laboratory setting. Additionally, inclusive language and diverse representation in imagery was considered in the development of all training materials published on the PHAC Training Portal. Some courses also underwent specific SGBA Plus review to ensure that content integrated health equity considerations throughout. Additionally, PHAC reviewed licensing-related communication templates, website content and Biosecurity Portal content to assess inclusive language.

Building on the CPHO 2023 Report Creating the Conditions for More Resilient Communities: A Public Health Approach to Emergencies, PHAC's regional operations capitalized on opportunities to share practices for equity-driven emergency preparedness and response within the Agency and across the country. These best practices highlighted the importance of integrating health promotion, including equity considerations, and building approaches tailored to priority populations into emergency policies, plans and procedures as well as when prompting local responses to calls to action. These events elicited encouraging outcomes, such as municipalities in Nova Scotia considering a Vulnerable Sector Registry in relation to their equity in emergency preparedness and response work.

The Agency also worked to address the needs of priority populations during emergencies. For instance, the toolkit for public health authorities on wildfires in Canada published in August 2023 considered a wide range of social determinants of health, such as age, sex, gender and socioeconomic status, that influenced the health outcomes of various population groups experiencing wildfires. In addition, the COVID-19 pandemic exposed inequalities experienced by disproportionately impacted populations in Canada.

For SDG 3, Target 3.d: Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks, PHAC provided technical expertise and capacity-building tools to other countries to enable them to enhance their respective biosafety and biosecurity oversight frameworks and meet International Health Regulations commitments. PHAC also helped improve biosafety and biosecurity indicators for international benchmarking exercises.

For SDG 5: Achieve gender equality and empower all women and girls, PHAC actively promoted gender equality and parity in international settings by advocating for the importance of incorporating gender equity in current and future health security work at the Agency.

As part of the targets to achieve SDG 6: Ensure availability and sustainable management of water and sanitation for all, PHAC administered the Potable Water on Board Trains, Vessels, Aircraft and Buses Regulations by conducting inspections and assessments on international and interprovincial airplanes, trains, cruise ships, ferries and buses to protect the health and safety of travellers. These inspections confirmed that passenger transportation operators were compliant with the Regulations, that the water they transported was safe for travelling public consumption, and that any required actions were addressed in a timely manner.

More information on PHAC's contributions to Canada's Federal Implementation Plan on the 2030 Agenda and the Federal Sustainable Development Strategy can be found in our 2023 to 2027 Departmental Sustainable Development Strategy.

In 2023–24, work was initiated on the development of a new nationally coordinated training and learning tool with an updated course curriculum for Environmental Health Officers (EHOs). A comprehensive training needs analysis was conducted to determine the work tasks and the associated knowledge, skills and competencies required by EHOs. Based on this analysis, the existing training materials were reviewed to identify gaps and requirements for updates to define the course curriculum requirements for EHOs.

PHAC collaborated with the National Research Council (NRC), domestic partners and international committees to strengthen the national scientific testing capacity for medical equipment and supplies. This work aimed to increase the availability of sustainable testing services which could be leveraged by the National Emergency Strategic Stockpile (NESS). Furthermore, the NESS further developed its quality management system, which provided PHAC with a quality framework for decision-making in the critical areas of procurement, quality control and quality assurance of medical countermeasures.

• Description
• Progress on results
• Resources required to achieve results
• Contracts awarded to Indigenous business

• Spending
• Funding
• Financial statement highlights
• Human resources

Overall spending within the Agency trended downward in most areas over the last three years. This trend is primarily attributable to the gradual reduction of COVID-19 response activities

The Health Promotion and Chronic Disease Prevention core responsibility experienced growth in spending since 2021–22 primarily as a result of increased investments in mental health support such as the Distress Line Equity Fund and the 9-8-8: Suicide Crisis Helpline. Additional investments were also made in 2023–24 towards the Dementia Strategic Fund.

Under the Infectious Disease Prevention and Control core responsibility, a decrease in spending occurred in 2023–24 primarily due to reduced procurement of COVID-19 therapeutics and the demobilization of border travel and COVID-19 testing services. Additionally, decreases also occurred in the following areas: supporting provinces and territories for costs incurred to implement the COVID-19 proof of vaccination, the Immunization Partnership Fund and the Sero-Surveillance Consortium. These reductions were partially offset by increases for the mpox outbreak response, investments in COVID-19 vaccines, establishing an agile, resilient and adaptive workforce, the Pan-Canadian Vaccine Injury Support Program, the HIV and Hepatitis C Community Action Fund and Combatting Antibiotic-Resistance Bacteria.

Under the Health Security core responsibility, a significant decrease in spending was observed in 2023–24 compared to previous years primarily due to the demobilization of border travel and quarantine measures and reduced procurement of medical supplies and equipment, including personal protective equipment.

Spending for Internal Services in 2023–24 is consistent with 2022–23 and continues to play a key role in the Agency's ability to respond to potential public health threats and events. The increase of actual spending over planned is primarily due to the renewal of funding received during the year that supports an agile, resilient and adaptive workforce.

A significant and gradual reduction in future planned spending for each of the Agency's core responsibilities and internal services is expected due to the expiration of budgetary authorities for the Surveillance and Risk Assessment initiative at the end of 2024–25 and the gradual expiry of budgetary authorities to establish an agile, resilient and adaptive workforce until 2026–27.

In addition, decreases in planned spending for Health Promotion and Chronic Disease Prevention reflect the reduction and expiry of temporary budgetary authorities for the Centre for Aging and Brain Health Innovation, Mental Health of those Most Affected by COVID-19, 9-8-8: Suicide Crisis Helpline and ParticipACTION.

Decreases in planned spending for Infectious Disease Prevention and Control decreases are due to the gradual expiry of temporary budgetary authorities for the procurement of COVID-19 vaccines by the end of 2026–27. This reduction is partially offset with an increase in funding for the procurement of influenza vaccines from 2025–26 to 2026–27.

Decisions on the renewal of initiatives with expiring budgetary authorities will be made in future budgets and reflected accordingly in subsequent Estimates and Departmental Plans.

Canada is signatory to the WHO's International Health Regulations (2005). PHAC charges fees to recover costs relating to inspections conducted on international maritime vessels and issuing Ship Sanitation Certificates and Ship Sanitation Exemption Certificates. These activities help fulfil Canada's obligations under the International Health Regulations (2005). Fees are charged in accordance with Canada's Service Fees Act. In 2023–24, PHAC collected $0.9 million in fees from the inspection of maritime vessels.

From 2021–22 to 2022–23, the Agency noted a decrease in expenditures related to its COVID-19 response primarily due to a reduction in spending for the procurement and distribution of COVID-19 vaccines, rapid test kits, the procurement of medical supplies and equipment, including personal protective equipment, border testing and travel measures, and surge capacity to sustain the Agency's pandemic response. This was partially offset by the increase in spending for the acquisition in COVID-19 therapeutics, the procurement of domestic influenza and pediatric vaccines, outbreak management of mpox, promotion and support of mental health, and the implementation of the surveillance and risk assessment initiative.

In 2023–24, the Agency observed a further decrease in spending primarily due to a reduction in the level of activity in the following elements of the COVID-19 response:

• The procurement of COVID-19 therapeutics;
• Border testing and travel measures;
• The COVID-19 Proof of Vaccination Fund; and
• Medical supplies and equipment, including personal protective equipment.

This reduction in spending was partially offset by increases in the following areas:

• Response to the outbreak of mpox in Canada;
• The procurement and distribution of COVID-19 vaccines;
• The surveillance and risk assessment initiative; and
• Promotion and support of mental health.

The Agency also experienced a decrease in statutory spending in 2023-24, primarily in the COVID-19 Proof of Vaccination Fund which compensated provinces and territories for maintaining proof of COVID-19 vaccinations for people in Canada. In 2023–24, allocations of payments were made for seven of the remaining provinces and territory.

Planned expenditures decline from 2024–25 to 2026–27 and this is mainly attributed to the gradual expiry of temporary budgetary authorities related to the surveillance and risk assessment initiative, for the three digit suicide crisis line to provide support for emotional distress and suicide prevention, the procurement of COVID-19 vaccines, to establish an agile, resilient and adaptive workforce, and for reductions as part of the refocussed government spending announced in Budget 2023.

Decisions on the renewal of initiatives with expiry of temporary budgetary authorities will be made in future budgets and reflected accordingly in subsequent Estimates and Departmental Plans.

Table 11.1 compares 2023–24 actual results with planned results in the 2023–24 Departmental Plan. The 2023–24 planned results information is provided in PHAC's Future-Oriented Statement of Operations and Notes 2023–24.

The 2023–24 financial statements show that the Agency's total expenses and net costs of operations before government funding and transfers increased by $685.2 million over the 2023–24 planned results.

The increase is due to the additional funding received during the fiscal year, which was not reflected in the 2023–24 Departmental Plan, and relate to expenditures for activities including:

• Canada's three-digit suicide prevention and emotional distress line (9-8-8);
• Support for an agile, resilient, and adaptive workforce;
• Support for a renewed Canadian Drugs and Substances Strategy; and
• Safe Restart Agreement for federal investments in testing, contact tracing and data management.

In addition, the Agency increased the provision for valuation adjustments due to expired, obsolete, surplus or damaged inventory. Revenues earned in 2023–24 increased by $10.9 million over planned. The variance is primarily due to an increase in gains on foreign exchange valuations on disbursements and the disposal of crown capital assets.

Table 11.2 compares 2023–24 actual results with 2022–23 actual results. Highlights of the 2023–24 financial statements reflect the Agency's efforts to address emerging public health concerns, including mental health, and show the ongoing ramp-down of the Agency activities in the government's COVID-19 response. Total expenses and net cost of operations before government funding and transfers increased by $660.2 million over the previous fiscal year. The following events contributed to an increase in the cost of operations:

• Implementation of the three-digit suicide prevention and emotional distress line (9-8-8);
• Promoting and supporting positive mental health in people in Canada;
• Strengthening Canada's surveillance and capacity to detect, understand, and act (DUA) on public health threats; and
• Responding to the outbreak of mpox in Canada.

Lastly, the Agency increased the provision for valuation adjustments due to expired, obsolete, surplus or damaged inventory. The increases are offset by decreases in the following:

• Reduced procurement of COVID-19 therapeutics, medical supplies and equipment and personal protective equipment;
• Demobilization of border travel and testing services; and
• Reduced COVID-19 surveillance activities.

Revenues earned in 2023–24 increased by $7.6 million as compared to the previous year. The variance is primarily due to an increase in gains on foreign exchange valuations on disbursements and the disposal of Crown capital assets.

The 2023–24 planned results information is provided in Public Health Agency of Canada's 2023-24 Future-Oriented Statement of Operation (unaudited).

The Agency's net financial position decreased over the previous year primarily due to:

• A decrease in inventory of COVID-19 therapeutics and vaccines, and medical supplies and equipment, including personal protective equipment as a result of reduced levels of procurement compared to previous years, ongoing transfers to provinces and territories, divestment and other adjustments.

This decrease was partially offset by:

• Increases in the procurement and inventories of certain medical countermeasures and supplies;
• Inventory transfer of COVID-19 rapid tests from Health Canada; and
• Increase of prepaid expenses for medical countermeasures.

Total net liabilities were $369,346,653, a decrease of $64,715,509 (15%) over the previous year's total. The reduction is mainly due to decreased temporary short-term liabilities and accounts payable at year-end. These short-term liabilities are largely funded by the amount included in due from the Consolidated Revenue Fund asset account in Figure 3.

Total net assets (including non-financial assets) decreased by $1,134,918,733 since 2022–23 to a total of $3,150,619,926. The variance can be primarily attributed to:

• A decrease in inventory of COVID-19 pharmaceuticals and vaccines, medical supplies and equipment, including personal protective equipment as a result of reduced levels of procurement compared to previous years, ongoing transfers to Provinces and Territories, and divestments and other adjustments.

This decrease was partially offset by:

• Increases in the procurement and inventories of certain medical countermeasures and supplies;
• Inventory transfer of COVID-19 rapid tests from Health Canada; and
• Increase of prepaid expenses for medical countermeasures.

In the wake of the COVID-19 pandemic, the Agency experienced a significant shift in its operational demands, leading to an increase in full-time equivalents compared to pre-pandemic staffing levels.

From 2021–22 to 2022–23, the increase in full-time equivalents observed in Health Promotion and Chronic Disease Prevention, Infectious Disease Prevention and Control, and in Internal Services were primarily to support and sustain the COVID-19 response and for the implementation of the surveillance and risk assessment initiative.

From 2022–23 to 2023–24, the Agency's full-time equivalents decreased, primarily in the Health Security core responsibility, where a significant decrease is observed since its peak in 2021-22, due to the removal of all COVID-19 entry restrictions for those entering Canada. Further decreases were also observed in the surge capacity to support the COVID-19 response and to support assessments for Afghans and Ukrainians coming into Canada.

The planned full-time equivalents from 2024–25 to 2026–27 reflect an update to the previously reported full-time equivalents reported in the Agency's 2024–25 Departmental Plan.

The Agency's planned FTEs will gradually decrease in 2024–25, nearing a return to pre-pandemic staffing levels by 2026–27. The decrease in FTEs from 2024–25 to 2026–27 within each core responsibility and internal services is mainly due to the expiration of budgetary authorities related to pandemic measures and the Surveillance and Risk Assessment initiative in 2024–25.

Appropriate ministers:

• The Honourable Mark Holland, P.C., M.P.
  Minister of Health
• The Honourable Ya'ara Saks, P.C., M.P.
  Minister of Mental Health and Addictions and Associate Minister of Health
• The Honourable Carla Qualtrough, P.C., M.P.
  Minister of Sport and Physical Activity
• Institutional head: Heather Jeffrey
  Ministerial portfolio: Health

Enabling instruments: Public Health Agency of Canada Act,Department of Health Act, Emergency Management Act,Quarantine Act, Human Pathogens and Toxins Act, Health of Animals Act,Federal Framework on Lyme Disease Act, and Federal Framework for Suicide Prevention Act.

Year of incorporation / commencement: 2004

Other: In June 2012, the Deputy Heads of Health Canada and the Public Health Agency of Canada signed a Shared Services Partnership Framework Agreement. Under this agreement, each organization retains responsibility for a different set of internal services and corporate functions. These include: human resources; real property; information management/information technology; security; internal financial services; communications; emergency management; international affairs; internal audit services; and evaluation services.

Mailing address:

Public Health Agency of Canada
130 Colonnade Road
Ottawa, ON K1A 0K9
Telephone: 1-844-280-5020

Websites: Public Health Agency of Canada

appropriation (crédit)

Any authority of Parliament to pay money out of the Consolidated Revenue Fund.

budgetary expenditures (dépenses budgétaires)

Operating and capital expenditures; transfer payments to other levels of government, departments or individuals; and payments to Crown corporations.

core responsibility (responsabilité essentielle)

An enduring function or role performed by a department. The intentions of the department with respect to a core responsibility are reflected in one or more related departmental results that the department seeks to contribute to or influence.

Departmental Plan (plan ministériel)

A report on the plans and expected performance of an appropriated department over a 3-year period. Departmental Plans are usually tabled in Parliament each spring.

departmental priority (priorité)

A plan or project that a department has chosen to focus and report on during the planning period. Priorities represent the things that are most important or what must be done first to support the achievement of the desired departmental results.

departmental result (résultat ministériel)

A consequence or outcome that a department seeks to achieve. A departmental result is often outside departments' immediate control, but it should be influenced by program-level outcomes.

departmental result indicator (indicateur de résultat ministériel)

A quantitative measure of progress on a departmental result.

departmental results framework (cadre ministériel des résultats)

A framework that connects the department's core responsibilities to its departmental results and departmental result indicators.

Departmental Results Report (rapport sur les résultats ministériels)

A report on a department's actual accomplishments against the plans, priorities and expected results set out in the corresponding Departmental Plan.

fulltime equivalent (équivalent temps plein)

A measure of the extent to which an employee represents a full personyear charge against a departmental budget. For a particular position, the fulltime equivalent figure is the ratio of number of hours the person actually works divided by the standard number of hours set out in the person's collective agreement.

government-wide priorities (priorités pangouvernementales)

For the purpose of the 2022–23 Departmental Results Report, government-wide priorities are the high-level themes outlining the government's agenda in the November 23, 2021, Speech from the Throne: building a healthier today and tomorrow; growing a more resilient economy; bolder climate action; fight harder for safer communities; standing up for diversity and inclusion; moving faster on the path to reconciliation; and fighting for a secure, just and equitable world.

horizontal initiative (initiative horizontale)

An initiative where two or more federal departments are given funding to pursue a shared outcome, often linked to a government priority.

Indigenous business (entreprise autochtones)

For the purpose of the Directive on the Management of Procurement Appendix E: Mandatory Procedures for Contracts Awarded to Indigenous Businesses and the Government of Canada's commitment that a mandatory minimum target of 5% of the total value of contracts is awarded to Indigenous businesses, a department that meets the definition and requirements as defined by the Indigenous Business Directory.

non-budgetary expenditures (dépenses non budgétaires)

Net outlays and receipts related to loans, investments and advances, which change the composition of the financial assets of the Government of Canada.

performance (rendement)

What a department did with its resources to achieve its results, how well those results compare to what the department intended to achieve, and how well lessons learned have been identified.

performance indicator (indicateur de rendement)

A qualitative or quantitative means of measuring an output or outcome, with the intention of gauging the performance of a department, program, policy or initiative respecting expected results.

plan (plan)

The articulation of strategic choices, which provides information on how a department intends to achieve its priorities and associated results. Generally, a plan will explain the logic behind the strategies chosen and tend to focus on actions that lead to the expected result.

planned spending (dépenses prévues)

For Departmental Plans and Departmental Results Reports, planned spending refers to those amounts presented in Main Estimates.

A department is expected to be aware of the authorities that it has sought and received. The determination of planned spending is a departmental responsibility, and departments must be able to defend the expenditure and accrual numbers presented in their Departmental Plans and Departmental Results Reports.

program (programme)

Individual or groups of services, activities or combinations thereof that are managed together within the department and focus on a specific set of outputs, outcomes or service levels.

program inventory (répertoire des programmes)

Identifies all the department's programs and describes how resources are organized to contribute to the department's core responsibilities and results.

result (résultat)

A consequence attributed, in part, to a department, policy, program or initiative. Results are not within the control of a single department, policy, program or initiative; instead, they are within the area of the department's influence.

Sex and Gender-Based Analysis Plus (SGBA Plus) (analyse comparative fondée sur le sexe et le genre plus (ACSG Plus))

The Government of Canada's Health Portfolio uses SGBA Plus to develop, implement, and evaluate the Health Portfolio's policies, programs, and initiatives. SGBA Plus is an analytical, intersectional approach used to assess how factors such as sex, gender, age, race, ethnicity, socioeconomic status, disability, sexual orientation, cultural background, migration status, and geographic location interact and intersect with each other and broader systems of power. Conducting this analysis helps us to understand how intersecting identity factors, histories, power relations, distribution of resources and individuals' lived realities contribute to differences in accessing health-related resources and health outcomes. Applying SGBA Plus enables the Health Portfolio to formulate responsive and inclusive health research, policies, services, programs and other initiatives to promote greater health equity.

statutory expenditures (dépenses législatives)

Expenditures that Parliament has approved through legislation other than appropriation acts. The legislation sets out the purpose of the expenditures and the terms and conditions under which they may be made.

target (cible)

A measurable performance or success level that a department, program or initiative plans to achieve within a specified time period. Targets can be either quantitative or qualitative.

voted expenditures (dépenses votées)

Expenditures that Parliament approves annually through an appropriation act. The vote wording becomes the governing conditions under which these expenditures may be made.