Public Health Agency of Canada 2013–14 Report on Plans and Priorities
Section II – Analysis of Programs by Strategic Outcome
Strategic Outcome
The Agency's strategic outcome is Protecting Canadians and empowering them to improve their health. How long Canadians live in good health is determined by factors including personal and family lifestyle risk factors, environmental and genetic factors, technological advances, social determinants, availability and quality of health care, and public health practices and initiatives at the federal, provincial, territorial (F/P/T), and local levels of government. The Agency works with governmental and nongovernmental stakeholders to positively affect the factors of health listed above.
A key population health indicator produced by Statistics Canada to measure health is the health-adjusted life expectancy (HALE), which is a more comprehensive indicator than that of life expectancy because it introduces the concept of quality of life. HALE is the number of years in full health that an individual can expect to live given the current morbidity and mortality conditions. It can be used to measure the burden of disease and injury, risk factors in the population, and the performance of public health efforts. It is not only a measure of quantity of life but also a measure of quality of life, and provides information for use by the Agency and other domestic and international organizations in public health research, policy development, and practice.
| Indicators | Results |
|---|---|
| Health-adjusted life expectancy (HALE) at birth | For 2005/2007, Statistics Canada reported HALE at birth as: Footnote 1 Women – 71.2 |
| Health-adjusted life expectancy (HALE) at birth between the top-fifth and bottom-fifth income groups | For 2005/2007, Statistics Canada reported the difference, in years, in HALE at birth between the top-fifth and bottom-fifth income groups as: Women – 7.6 |
In working to achieve its strategic outcome, the Agency has developed four Programs with expected results, performance indicators, and targets supported by financial and human resources as shown below.
Program 1.1 Public Health Infrastructure
| Program | Sub-program |
|---|---|
| 1.1 Public Health Infrastructure | 1.1.1 Public Health Capacity Building |
| 1.1.2 Public Health Information and Networks | |
| 1.1.3 Public Health Laboratory Systems |
Program Description:
1.1 Public Health Infrastructure – This program strengthens Canada's public health workforce capability, information exchange, federal/provincial/territorial networks, and scientific capacity. These infrastructure elements are necessary to support effective public health practice and decision-making in Canada. Working with federal, provincial and territorial stakeholders and within existing collaborative mechanisms, the program supports planning for and building consensus on strategic and targeted investments in public health infrastructure, including training, tools, best practices, standards, and mechanisms to facilitate information exchange and coordinated action. Public health laboratories provide leadership in research, technical innovation, reference laboratory services; surveillance; outbreak response capacity; and national laboratory coordination. Through these capacity-building mechanisms and scientific expertise, the Government of Canada facilitates effective coordination and timely public health interventions which are essential to having an integrated and evidence-based national public health system. Key stakeholders include local, regional, provincial and national public health organizations, practitioners and policy makers, researchers and academics, professional associations and non-governmental organizations.
| Total Budgetary Expenditures (Main Estimates) 2013–14 | Planned Spending | ||
|---|---|---|---|
| 2013–14 | 2014–15 | 2015–16 | |
| 133.1 | 135.1 | 124.5 | 124.5 |
The increase in planned spending in 2013–14 is due to the renewal of funding to enhance the Government of Canada's ability to prevent, detect and respond to outbreaks of food-borne illness. Spending will decrease in 2014–15 as the Genomic Research and Development Initiative sunsets and Budget 2012 savings measures are implemented. Budget 2012 savings measures will streamline surveillance activities and publications without affecting program delivery.
| 2013–14 | 2014–15 | 2015–16 |
|---|---|---|
| 778 | 753 | 753 |
| Expected Result(s) | Performance Indicator(s) | Target(s) |
|---|---|---|
| Canada has public health system capacity to manage domestic public health emergencies of international concern | Level of Canada's compliance with the public health capacity requirements outlined in the International Health Regulations | Level 3: AdvancedFootnote 2 Baseline is 2.5 in June 2012 |
| Canada is able to use highly specialized laboratory technologies to identify and characterize pathogens in support of public health surveillance and investigation of disease outbreaks | The number of pathogens for which molecular typing is offered by national laboratories | Baseline by December 31, 2012 |
Planning Highlights:
The following planning highlights represent the Agency's key priorities for the Public Health Infrastructure Program and its Subprograms. Additional information, including Sub-program descriptions and performance information, is available on the Agency's Web site.
Building Public Health Infrastructure
- Increase Canadian public health workforce capacity by developing skills, applied training and placement opportunities to address public health issues.
- Address Canada's need for enhanced public health skills/capacity by continuing to support the provision of competency-based learning products.
- Increase the Canadian capacity to respond to public health events by developing and delivering applied training, and placing public health officers and field epidemiologists with partner organizations to respond to identified public health needs, including mobilizations.
- Strengthen the Agency's presence in the North to better support public health capacity building efforts and improved health outcomes for Northerners.
Public Health Information and Networks
- Strengthen Canada's public health laboratory science, integrated disease surveillance capabilities (e.g., Canadian Network for Public Health Intelligence), and technical capacity to support public health decision-making, including enhanced and timely public health interventions, and responsiveness to public health threats (e.g., food-borne illness, measles).
- Support the development of multi-jurisdictional approaches to addressing public health infrastructure and surveillance issue priorities identified by the Public Health Network Council.
- Develop and deliver the Chief Public Health Officer's Annual Report on the State of Public Health in Canada.
- Develop approaches to population health analyses on emerging global realities and under-recognized diseases for effective decision-making.
- Work with our partners to strengthen the reporting of population and public health indicators to help Canadians receive more integrated population health information.
Public Health Laboratory Systems
- Continue to strengthen genomic technologies to determine the molecular epidemiology and evolution of priority infectious diseases.
- Conduct applied and discovery research, develop innovative tools and provide laboratory-based surveillance to manage key public health risks in support of Agency priorities such as determining the risk of emerging zoonotic infectious disease risks through diagnostic testing of mosquitoes, ticks and other zoonotic disease vectors in Canada such as influenza, West Nile virus, and SARS to inform public health policies.
- Expand the national capacity to rapidly detect and link food-borne outbreaks to their sources through the use of highly specialized DNA fingerprinting techniques (e.g., PulseNet surveillance system).
- Strengthen the ability to provide timely, highly specialized biocontainment laboratory services, including genomic technologies, to enable public health professionals to address emerging public health risks including monitoring drug-resistance in bacteria and viruses, and carrying out strain surveillance to evaluate vaccine effectiveness (e.g., HPV, measles, influenza, invasive pneumococcal disease, pertussis.).
Program 1.2 Health Promotion and Disease Prevention
| Program | Sub-program | Sub-sub-program |
|---|---|---|
| 1.2 Health Promotion and Disease Prevention | 1.2.1 Infectious Disease Prevention and Control | 1.2.1.1 Immunization |
| 1.2.1.2 Infectious and Communicable Diseases | ||
| 1.2.1.3 Food-borne, Environmental and Zoonotic Infectious Diseases | ||
| 1.2.2 Conditions for Healthy Living | 1.2.2.1 Healthy Child Development | |
| 1.2.2.2 Healthy Communities | ||
| 1.2.3 Chronic (non-communicable) Disease and Injury Prevention |
Program Description:
1.2 Health Promotion and Disease Prevention – This Program aims to promote better overall health of the population—with additional focus on those that are most vulnerable—by promoting healthy development among children, adults and seniors, reducing health inequalities, and preventing and controlling chronic and infectious diseases. Working in collaboration with provinces and territories, the program develops and implements federal aspects of frameworks and strategies (e.g., Curbing Childhood Obesity: A Federal, Provincial and Territorial Framework for Action to Promote Healthy Weights, national approaches to addressing immunization, HIV/AIDS) geared toward promoting health and preventing disease. The program undertakes common primary public health functions of health promotion, surveillance, science and research on diseases and associated risk and protective factors to inform evidenced-based frameworks, strategies, and interventions. It also undertakes health promotion and prevention initiatives, working with stakeholders to prevent and mitigate chronic disease and injury, and to help prevent and control infectious disease.
| Total Budgetary Expenditures (Main Estimates) 2013–14 | Planned Spending | ||
|---|---|---|---|
| 2013–14 | 2014–15 | 2015–16 | |
| 308.2 | 311.7 | 350.4 | 295.5 |
The increase in planned spending in 2013–14 over the Main Estimates figure is due to the renewal of funding to enhance the Government of Canada's ability to prevent, detect and respond to outbreaks of food-borne illness. In 2014–15, planned spending will increase and subsequently decrease in 2015–16 as the Agency will issue the final payment for the Hepatitis C Health Care Services Program. This increase is partially offset by the sunsetting of the Lung and Neurological Diseases Initiative and savings measures announced in Budget 2012. These measures will reduce management and administration, travel and professional services, and streamline surveillance activities and publications. In addition, the Agency will improve the efficiency of grants and contributions administration by integrating efforts at the community level with those of other providers and by streamlining and consolidating programs with common risk factors or target populations.
| 2013–14 | 2014–15 | 2015–16 |
|---|---|---|
| 897 | 848 | 835 |
| Expected Result(s) | Performance Indicator(s) | Target(s) |
|---|---|---|
| Diseases in Canada are prevented and mitigated | Percent reduction over the next 3 years in the rate of indexed infectious diseases | 2% (for entire 2011 to 2014 period) |
| Percent change in rate of key chronic disease risk factors | Government of Canada targets for reduction of risk factors in consideration of Federal/Provincial/Territorial (F/P/T) contexts and recommended global and regional voluntary targets by March 31, 2014, following finalization of the World Health Organization (WHO) and Pan American Health Organization's (PAHO) monitoring frameworks for NonCommunicable Diseases |
Planning Highlights:
The following planning highlights represent the Agency's key priorities for the Health Promotion and Disease Prevention Program, its Sub-programs, and its Sub-sub-programs. Additional information, including Sub-program and Sub-sub-program descriptions and performance information, is available on the Agency's Web site.
Disease Prevention and Control
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(Theme I: Addressing Climate Change and Air Quality)
Reduce the risks associated with infectious diseases and public health threats related to climate change, as part of the Adaptation Theme of the Government's Clean Air Agenda through collaboration with federal, provincial and territorial as well as international stakeholders.
- Enhance infectious disease monitoring by assessing performance of the real-time Measles and Rubella Surveillance pilot as a model for other areas to support timely integrated surveillance in keeping with national and international measles and rubella elimination goals.
- Develop timely and comprehensive guidance and information on immunization approaches and products approved in Canada, to assist the Agency and its stakeholders in making informed decisions concerning immunization strategies.
- Engage federal departments, and provincial/territorial governments through the Public Health Network, to improve practices in tuberculosis prevention and control as well as address underlying risk factors associated with tuberculosis among Aboriginal peoples and foreign-born individuals.
- Collaborate with stakeholders to revise the existing Respiratory Illness Outbreak Protocol Response to coordinate, investigate and control severe respiratory outbreaks in Canada.
- Increase knowledge of health care professionals and enhance awareness of Canadians on the prevention and treatment of diseases and health hazards resulting from rising global population mobility by providing timely assessments of health risks and evidence-based recommendations, as well as establishing partnerships to address population mobility risk factors.
- Enhance surveillance tools to strengthen the government's ability to detect and identify causes of food-borne illness and respond to food-borne illness outbreaks.
- Strengthen coordination and capacity, including surge capacity, to respond to multi-jurisdictional food-borne illness outbreaks.
- Integrate approaches to reduce health inequalities through coordinated efforts on common risk factors of community associated infections and related chronic diseases.
Conditions for Healthy Living
- Assess knowledge gaps in mental health promotion, develop tools for use by public health professionals, and coordinate federal suicide prevention efforts, including addressing the risk factors for suicide.
- Develop oral health promotion approaches to improve oral health outcomes, particularly within Nunavut.
- Scale up best practices in healthy childhood development to improve the overall social, mental, and physical health of children (aged 0-6) and their parents who participate in the Agency's community-based approaches.
- Pilot an expansion of the Aboriginal Head Start in Urban and Northern Communities Program to more children and their families in Nunavut.
- Strengthen approaches to disease prevention and control by broadening the scope of HIV and Hepatitis C funding programs to include co-morbidities, mental illness, aging, and determinants of health.
Chronic (non-communicable) Disease and Injury Prevention
- Increase safety awareness to reduce injuries, including sports- and recreation-related injuries in children and youth, and advance knowledge surrounding seniors' falls by updating and disseminating the Report on Seniors' Falls in Canada.
- Complete the National Population Study on Neurological Conditions, including Multiple Sclerosis, to fill information gaps on risk factors and the health and economic impact of these conditions on Canadians.
- Review data source standards and their reporting feasibility to align the Agency's autism surveillance system with the information needs of organizations supporting families and individuals affected by autism.
- Foster partnerships amongst provinces, territories and public and private sector organizations to work together on healthy living and chronic disease prevention initiatives to reduce the risks that are common to major chronic diseases, including unhealthy eating, physical inactivity, obesity and smoking.
Program 1.3 Health Security
| Program | Sub-program |
|---|---|
| 1.3 Health Security | 1.3.1 Emergency Preparedness and Response |
| 1.3.2 Border Health Security | |
| 1.3.3 Biosecurity |
Program Description:
1.3 Health Security – This Program takes an all hazards approach to the health security of Canada's population, which provides the Government of Canada with the ability to prepare for and respond to public health issues and events. This program seeks to bolster the resiliency of the population and communities, thereby enhancing the ability to cope and respond. To accomplish this, its main methods of intervention include actions taken through partnerships with key jurisdictions and international partners. These actions are carried out through the implementation and maintenance of International Health Regulations and through the administration and enforcement of legislation, including the Emergency Management Act, the Quarantine Act, the Human Pathogens and Toxins Act and the Human Pathogens Importation Regulations.
| Total Budgetary Expenditures (Main Estimates) 2013–14 |
Planned Spending | ||
|---|---|---|---|
| 2013–14 | 2014–15 | 2015–16 | |
| 47.7 | 48.9 | 43.2 | 46.3 |
Planned spending in 2013-14 increases as compared to the Main Estimates figure due to new funding to streamline government import regulations and border processes for commercial trade. The decrease in planned spending in 2014–15 is due to Budget 2012 savings measures as well as the completion of the replenishment of the National Antiviral Stockpile. Budget 2012 savings measures relate to reductions in management and administration, travel and professional services, and partnerships with other departments to provide consolidated services for emergency management, border health services, and pathogen control. In 2015–16, temporary funding is received to support the Government of Canada's Provision of Essential Federal Services to the Toronto 2015 Pan American and Parapan American Games.
| 2013–14 | 2014–15 | 2015–16 |
|---|---|---|
| 231 | 237 | 237 |
| Expected Result(s) | Performance Indicator(s) | Target(s) |
|---|---|---|
| Canada has the partnerships and regulatory frameworks to prevent, prepare for and respond to threats to public health | Percent of partnerships with key jurisdictions and international partners in place to prepare for and respond to public health issues and events | 80% |
| Percent of Government of Canada's health emergency and regulatory programs implemented in accordance with the Emergency Management Act, the Quarantine Act, the Human Pathogens and Toxins Act and the Human Pathogens Importation Regulations | 80% |
Planning Highlights:
The following planning highlights represent the Agency's key priorities for the Health Security Program and its Sub-programs. Additional information, including Sub-program descriptions and performance information, is available on the Agency's Web site.
Emergency Preparedness and Response
- Improve emergency response capacity by collaborating with provinces and territories to implement an Operational Framework for Mutual Aid Surge Requests for Health Care Professionals, and by taking a more strategic approach to the management of the National Emergency Stockpile System (NESS) to enable the inventory to remain relevant and responsive to the risk environment.
- Strengthen Canada's emergency preparedness and response capacity by renewing the Strategic Emergency Management Plan and the Canadian Pandemic Influenza Plan, and enhancing national coordination through the clarification of roles and responsibilities for response, including practical guidance for communications and decision-making during emergencies.
- Strengthen the capacity for a 24/7 integrated situational awareness network by fostering partnerships with key stakeholders in order to facilitate decision-making for the Health Portfolio in response to domestic emergencies and/or events including those with international dimensions.
Border Health Security
- Develop a comprehensive health security framework that articulates the Agency's strategic and coordinated approach to preparing for and responding to any hazard that impacts the health security of Canadians.
- Enhance border health security to reduce the risk of communicable disease importation and exportation through humans, conveyances and cargo by consolidating functions with Health Canada to establish an Office of Border Health Services within the Agency.
- Reduce the impacts of shared health security risks through expanded bilateral collaboration that enhances biosecurity and pathogen control, and interoperability of emergency management and response systems in the context of the Canada-US Beyond the Border Health Security Action Plan.
Biosecurity
- Streamline administrative processes and mechanisms to facilitate regulatory compliance for biosecurity in Canada.
- Develop policy instruments, including regulations where essential, to support the implementation of the Human Pathogens and Toxins Act.
Program 2.1 Internal Services
| Program | Sub-program | Sub-sub-program |
|---|---|---|
| 2.1 Internal Services | 2.1.1 Governance and Management Support | 2.1.1.1 Management and Oversight |
| 2.1.1.2 Communications | ||
| 2.1.1.3 Legal | ||
| 2.1.2 Resource Management Services | 2.1.2.1 Human Resource Management | |
| 2.1.2.2 Financial Management | ||
| 2.1.2.3 Information Management | ||
| 2.1.2.4 Information Technology | ||
| 2.1.2.5 Travel and Other Administrative Services | ||
| 2.1.3 Asset Management Services | 2.1.3.1 Real Property | |
| 2.1.3.2 Material | ||
| 2.1.3.3 Acquisitions |
Program Description:
This Program supports the Agency's strategic outcome and all of its Programs. Internal services are groups of related activities and resources that are administered to support the needs of programs and other corporate obligations of an organization. These groups are Management and Oversight Services, Communications Services, Legal Services, Human Resources Management Services, Financial Management Services, Information Management Services, Information Technology Services, Real Property Services, Materiel Services, Acquisition Services, and Travel and Other Administrative Services. Internal services include only those activities and resources that apply across the Agency and not those provided specifically to a program.
| Total Budgetary Expenditures (Main Estimates) 2013–14 | Planned Spending | ||
|---|---|---|---|
| 2013–14 | 2014–15 | 2015–16 | |
| 90.2 | 90.9 | 79.8 | 79.3 |
| 2013–14 | 2014–15 | 2015–16 |
|---|---|---|
| 615 | 611 | 611 |
Planning Highlights:
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. The creation of this new Partnership was motivated by a joint desire to:
- reduce the overhead costs of internal services by consolidating capacity from the two organizations into shared functions that will benefit from the strengths and perspectives of both parties;
- bring a more "whole of portfolio" perspective to the work of both organizations;
- enable both organizations to structure their NCR and regional operations in more cost effective ways; and
- foster innovation in management and service delivery for the benefit of both organizations.
Health Canada provides the following internal services to the Agency: human resources, internal financial services, real property, communications, information management / information technology, and security. Planning highlights for these internal services can be found in Health Canada's RPP. Internal services provided to Health Canada by the Agency include emergency management, international affairs, internal audit services, and evaluation services.
Internal Service Improvement
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Identify innovative ways to streamline internal processes and operations in order to improve program effectiveness and results.
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(Theme IV: Shrinking the Environmental Footprint – Beginning with Government)
Support the Federal Sustainable Development Strategy through the implementation of the Agency's 2011-2014 Sustainable Development Strategy.
Federal Sustainable Development Strategy
The Public Health Agency of Canada is a participant in the Federal Sustainable Development Strategy (FSDS) and contributes to the Greening Government Operations (GGO) targets through Program 2.1 Internal Services.
(Theme IV: Shrinking the Environmental Footprint – Beginning with Government)
The Agency contributes to the following target areas of Theme IV of the FSDS:
- Green Buildings
- Greenhouse Gas Emissions
- Surplus Electronic and Electrical Equipment
- Printing Unit Reduction
- Paper Consumption
- Green Meetings
- Green Procurement
- Reporting on the Purchase of Offset Credits
For additional details on the Agency's GGO activities, please see the supplementary information tables.
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