Public Health Agency of Canada 2015–16 Report on Plans and Priorities

Section I: Organizational Expenditure Overview

Organizational Profile

Appropriate Minister: The Honourable Rona Ambrose, P.C., M.P.

Institutional Head: Krista Outhwaite

Ministerial portfolio: Health

Main legislative authorities: Public Health Agency of Canada ActFootnote i, Department of Health ActFootnote ii, Emergency Management ActFootnote iii, Quarantine ActFootnote iv, Human Pathogens and Toxins ActFootnote v, Health of Animals ActFootnote vi, and the International Health RegulationsFootnote vii.

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.

Organizational Context

Raison d'être

Public health involves the organized efforts of society to keep people healthy and to prevent illness, injury, and premature death. The Public Health Agency of CanadaFootnote viii (the Agency) has put in place programs, services and policies that protect and promote the health of all Canadians. In Canada, public health is a responsibility that is shared by all three levels of government in collaboration with the private sector, non-governmental organizations, health professionals and the public.

In September 2004, the Agency was created within the federal Health PortfolioFootnote ix to deliver on the Government of Canada's commitment to increase its focus on public health in order to help protect and improve the health and safety of all Canadians and to contribute to strengthening public health capacities across Canada.

Responsibilities

The Agency has the responsibility to:

  • Contribute to the prevention of disease and injury, and to the promotion of health;
  • Enhance surveillance information and expand the knowledge of disease and injury in Canada;
  • Provide federal leadership and accountability in managing national public health events;
  • Strengthen intergovernmental collaboration on public health and facilitate national approaches to public health policy and planning; and
  • Serve as a central point for sharing Canada's public health expertise with international partners, and to translate international knowledge and approaches to inform and support Canada's public health priorities and programs—for example, by participating in international working groups to develop new public health tools to protect, mitigate and respond to emerging public health threats.

Strategic Outcome(s) and Program Alignment Architecture (PAA)

  • 1. Strategic Outcome: Protecting Canadians and empowering them to improve their health
    • 1.1 Program: Public Health Infrastructure
      • 1.1.1 Sub-Program: Public Health Capacity Building
      • 1.1.2 Sub-Program: Public Health Information and Networks
      • 1.1.3 Sub-Program: Public Health Laboratory Systems
    • 1.2 Program: Health Promotion and Disease Prevention
      • 1.2.1 Sub-Program: Infectious Disease Prevention and Control
        • 1.2.1.1 Sub-Sub-Program: Immunization
        • 1.2.1.2 Sub-Sub-Program: Infectious and Communicable Disease
        • 1.2.1.3 Sub-Sub-Program: Food-borne, Environmental and Zoonotic Infectious Disease
      • 1.2.2 Sub-Program: Conditions for Healthy Living
        • 1.2.2.1 Sub-Sub-Program: Healthy Child Development
        • 1.2.2.2 Sub-Sub-Program: Healthy Communities
      • 1.2.3 Sub-Program: Chronic (non-communicable) Disease and Injury Prevention
    • 1.3 Program: Health Security
      • 1.3.1 Sub-Program: Emergency Preparedness and Response
      • 1.3.2 Sub-Program: Border Health Security
      • 1.3.3 Sub-Program: Biosecurity
    • Internal Services

Organizational Priorities

Organizational Priorities
Priority TypeFootnote 1 Strategic Outcome(s) and/or Program(s)
1. Strengthened public health capacity and science leadership Previously committed to 1.1, 1.2, 1.3
Description
Why is this a priority?

The Agency provides national leadership to strengthen public health and science to support effective decision making, public health practices and interventions, and an integrated, evidence-based public health system.

What are the plans for meeting this priority?

  • Strengthen formal mechanismsFootnote 2 of the public health system through information sharing with the provinces and territories; and
  • Adopt emerging technologies and connect research and evidence to disseminate information and tools that promote good health, prevent disease, and injury.
Priority Type Strategic Outcome(s) and/or Program(s)
2. Leadership on health promotion and disease prevention Previously committed to 1.1, 1.2
Description
Why is this a priority?

The Agency provides leadership and takes action to address the burden of illness associated with risk factors, multiple chronic diseases and an aging population, as well as the social, economic and environmental conditions that affect Canadians' health status and can increase the potential for disease. By providing a stronger evidence base to inform important health issues and their determinants, the Agency works to improve population health and well-being and help reduce health inequalities.

What are the plans for meeting this priority?

  • Prevent and control the emergence and spread of antimicrobial resistance (AMR);
  • Prevent and control infectious diseases including pandemic, respiratory, blood-borne, vector-borne, and vaccine-preventable diseases;
  • Continue to leverage innovative multi-sectoral partnerships to promote healthy active living,Footnote x and reduce sports and recreation-related injuries;
  • Support safe and healthy communities by investing in new initiatives to help prevent family violence and respond to the needs of victims; sharing information through the Stop Family ViolenceFootnote xi Web site; and coordinating the Family Violence InitiativeFootnote xii; and
  • Help prevent suicide by implementing the Federal Framework for Suicide Prevention.
Priority Type Strategic Outcome(s) and/or Program(s)
3. Enhanced Public Health Security Previously committed to 1.1, 1.2, 1.3
Description
Why is this a priority?

All governments must continue to collaborate to protect the health and safety of Canadians within a context of globalization, environmental change and scientific discovery. The Agency plays an important role in helping to support public health security through emergency preparedness and response, border health security, and biosecurity (i.e., the regulation of pathogens and toxins).

What are the plans for meeting this priority?

  • Strengthen emergency preparedness and response capacity, including deployable resources (e.g., mobile laboratories and personnel), through a coordinated, all-hazards, risk-based approach;
  • Enhance border health security by addressing the risks for travellers departing and entering Canada;
  • Reduce risks to the health and safety of Canadians posed by activities involving human pathogens and toxins; and
  • Help advance the development of medical countermeasures, including those for Ebola.Footnote xiv
Priority Type Strategic Outcome(s) and/or Program(s)
4. Excellence and innovation in management Previously committed to Internal Services
Description
Why is this a priority?

Effective management, engagement, collaboration, teamwork and professional development are all essential to a high-performing organization that achieves its intended outcomes. Recognizing this, the Agency is committed to a rigorous pursuit of excellence, innovation and continuous improvement in the design and delivery of programs and services.

What are the plans for meeting this priority?

  • Maintain compliance with the Treasury Board of Canada Secretariat Policy on Internal Control;
  • Advance the application of the Performance Management initiative and the Canada School of Public Service learning model as part of an overall talent management strategy to support and sustain a culture of high performance;
  • Execute the Multi-Year Diversity and Employment Equity Plan to support a diverse workforce; and
  • Implement Workplace 2.0 to create a modern workplace that will attract, retain and encourage public servants to work smarter, greener, and healthier.

Risk Analysis

Key Risks
Risk Risk Response Strategy Link to PAA
1) Pandemic, including but not limited to influenza

There is a risk that the Agency may not be able to effectively monitor, detect early, or coordinate a response to infectious disease outbreaks, or that effective medical countermeasures may not be available.

External Conditions:

  • Globalization (trade, travel, etc.);
  • Climate change;
  • Limited market share in vaccines; and
  • Little influence on global research and innovation.

Internal Conditions:

  • Timely access to science-based information; and
  • Capacity to broker national approaches and technologies to respond to outbreaks.
In support of reducing risk, the Agency will:
  • Enhance measures to enable more reliable, timely and efficient supply of vaccines, including response to shortages, recalls, and quality or safety issues;
  • Collaborate with stakeholders to develop and validate laboratory technologies and novel methods to better detect and respond to emerging respiratory pathogens; and
  • Engage international stakeholders to maximize global response efforts.

Performance Measures:

  • Progress in managing risk will be assessed through the Corporate Risk Profile (CRP) process which regularly monitors risk treatments and controls; and
  • Specific indicators are under development for the risk treatments.
1.1, 1.2, 1.3
2) Antimicrobial Resistance (AMR)

There is a risk that the absence of a comprehensive national action plan may exacerbate the growing impact of AMR on the health and well-being of Canadians.

External Conditions:

  • Decline in effectiveness of antimicrobials;
  • Unpredictability of AMR infections; and
  • Knowledge and appropriate use among consumers, health professionals, and agri-food sectors.

Internal Conditions:

  • Surveillance/research data; and
  • Keeping abreast with other countries.
In support of reducing risk, the Agency will implement the Federal Framework on AMR, including:
  • Lead the development of a pan-Canadian strategy on AMR with federal/provincial/territorial (F/P/T) partners;
  • Engage international collaborators on a Global Action Plan on AMR; and
  • Improve integration and reporting of surveillance data through the Canadian AMR Surveillance System.

Performance Measures:

  • Progress in managing risk will be assessed through the CRP process which regularly monitors risk treatments and controls; and
  • Specific indicators are under development for the risk treatments.
1.1, 1.3
3) Food-Borne Diseases

There is a risk that the Agency may not receive all relevant, integrated information to inform early interventions, and that partners will not be aware of the information generated by the Agency in a timely manner required to prevent illness.

External Conditions:

  • Food consumption patterns;
  • Raw and minimally processed foods;
  • Climate change; and
  • Globalization.

Internal Conditions:

  • Enhanced stakeholder engagement;
  • Enhanced surveillance activities; and
  • Laboratory technology.
In support of reducing risk, the Agency will:
  • Engage PulseNet Canada and provincial/territorial (P/T) food-borne epidemiology partners to support timely information sharing and to develop a genomics roadmap that will support the implementation of genomic technology; and
  • Strengthen surveillance and improve coordination with P/T networks to enable integrated data collection and analysis to support earlier detection of risks related to food-borne illness.

Performance Measures:

  • Progress in managing risk will be assessed through the CRP process which regularly monitors risk treatments and controls; and
  • Specific indicators are under development for the risk treatments.
1.1, 1.2, 1.3
4) Vector-Borne Zoonotic Infectious Diseases

There is a risk that health care and economic costs of vector-borne disease may increase without a national approach to monitor and assess these diseases and to enable the implementation of prevention and control measures.

External Conditions:

  • Environmental change;
  • Expanded geographic range; and
  • Traditional surveillance approaches.

Internal Conditions:

  • Public health system;
  • Healthcare professional capacity; and
  • Level of awareness to detect/respond.
In support of reducing risk, the Agency will:
  • Work with stakeholders to monitor the emergence and impact of vector-borne pathogens in Canada through laboratory-based testing and surveillance;
  • Continue to implement the Action Plan on Lyme diseaseFootnote xv to pilot novel approaches in order to promote awareness and prevention of Lyme disease; and
  • Build on the results of the Action Plan on Lyme disease to develop a model that can be applied to other vector-borne diseases.

Performance Measures:

  • Progress in managing risk will be assessed through the CRP process which regularly monitors risk treatments and controls; and
  • Specific indicators are under development for the risk treatments.
1.1, 1.2
5) Chronic Disease

There is a risk that the Agency's ability to provide timely and relevant analysis of chronic disease risk and trends over time will be reduced due to data gaps affecting analysis of the factors/conditions that determine risk for chronic diseases or protective factors.

External Conditions:

  • Effective interventions to promote health, and to reduce chronic diseases and injuries; and
  • Dependence on external partners to provide data.

Internal Conditions:

  • Shift in science focus to understand, test, and disseminate information on effective interventions;
  • Upstream surveillanceFootnote xvi to effectively monitor and enable action; and
  • Mobilize and leverage multi-sectoral collaborations.
In support of reducing risk, the Agency will:
  • Continue expanding surveillance systems to include a broader range of diseases, injuries, conditions, risks, protective factors and health determinants, with a priority emphasis on mental health and mental illness, and on physical activity, sedentary behaviour, and sleep;
  • Collaborate with Statistics Canada, the Canadian Institute for Health Information, and the Pan-Canadian Public Health Network to support open data objectives and report on health inequality indicators; and
  • Continue to use the Agency's chronic disease indicator framework as the basis for reaching consensus among data generating partners on critical data requirements and metrics.

Performance Measures:

  • Progress in managing risk will be assessed through the CRP process which regularly monitors risk treatments and controls; and
  • Specific indicators are under development for the risk treatments.
1.2

The Agency operates within a dynamic and complex environment where domestic and international public health challenges continually evolve, highlighting the importance of ongoing planning and preparedness for public health. The multi-jurisdictional nature of public health also means that the Agency must work closely with domestic and international stakeholders to respond to situations and to build on lessons learned.

The risksFootnote 3 identified in the table above are drawn from the Agency's 2013–15 CRP and represent those risks which were ranked as having the highest likelihood of significant impacts on the achievement of the Agency's objectives, and the most important potential health and safety consequences for Canadians in the event of a failure of any risk response strategy.

Planned Expenditures

Budgetary Financial Resources (dollars)
2015–16
Main Estimates
2015–16
Planned Spending
2016–17
Planned Spending
2017–18
Planned Spending
567,152,421 567,152,421 550,391,749 549,313,361
Human Resources (Full-time Equivalent — FTEs)
2015–16 2016–17 2017–18
2,488 2,465 2,460
Budgetary Planning Summary for Strategic Outcome(s) and Program(s) (dollars)
Strategic Outcome(s), Program(s) and Internal Services 2012–13 Expenditures 2013–14 Expenditures 2014–15 Forecast Spending 2015–16 Main Estimates 2015–16 Planned Spending 2016–17 Planned Spending 2017–18 Planned Spending
Strategic Outcome 1 : Protecting Canadians and empowering them to improve their health
1.1 Public Health Infrastructure 137,453,765 132,987,799 139,694,677 114,621,598 114,621,598 115,053,125 115,053,125
1.2 Health Promotion and Disease Prevention 315,767,073 305,929,930 360,182,082 297,110,496 297,110,496 292,633,451 292,583,451
1.3 Health Security 59,951,642 73,097,007 64,424,507 59,776,240 59,776,240 47,883,186 46,937,103
Subtotal 513,172,480 512,014,736 564,301,266 471,508,334 471,508,334 455,569,762 454,573,679
Internal Services Subtotal 106,483,749 109,482,900 104,061,299 95,644,087 95,644,087 94,821,987 94,739,682
Total 619,656,229 621,497,636 668,362,565 567,152,421 567,152,421 550,391,749 549,313,361

The 2014–15 Forecast Spending increased from the previous year expenditures primarily due to temporary funding for Ebola Preparedness and Response Initiatives to Protect Canadians at Home and Abroad; and the Agency making the final payment of $49.7 million to provinces and territories under the Hepatitis C Health Care Services Program. In parallel, expenditure reductions were achieved through streamlined administration; travel; and professional services as well as administrative efficiencies in delivering grants and contributions programs.

Planned Spending for 2015–16 is less than 2014–15 Forecast Spending primarily due to the Agency making the final payment of $49.7 million to provinces and territories under the Hepatitis C Health Care Services Program and the sunsetting of $4.9 million for the Aboriginal Head Start in Urban and Northern Communities Program's Strategic Fund coupled with the funding decrease of $3.8 million for the Pandemic Vaccine Fill Line project as it nears completion. In addition, temporary funding for Ebola Preparedness and Response Initiatives to Protect Canadians at Home and Abroad is reduced by $17.5M between 2014–15 and 2015–16. Finally, 2014–15 contains $16.4M of Operating Budget Carry Forward from the previous fiscal year. The 2015–16 amount has not been determined and is not included in the 2015–16 reference levels.

The reduction in Planned Spending from 2015–16 to 2016–17 is primarily related to the sunsetting of the temporary initiative to support the Government of Canada's Provision of Essential Federal Services to the Toronto 2015 Pan American and Parapan American Games; the Automated External Defibrillators and Associated Training in Recreational Hockey Arenas Initiative; the Travelling Public Program; and the temporary funding for Ebola Preparedness and Response Initiatives to Protect Canadians at Home and Abroad.

The figures cited in this report do not reflect any decisions that the government may make to renew programs and invest new funds through Parliament. Therefore, total resources that will be available for certain programs may be higher than currently reported.

The Government of Canada reassesses priorities, as required, and some programs that are set to sunset will be considered for renewal and may in fact be renewed.

Alignment of Spending With the Whole-of-Government Framework

Alignment of 2015–16 Planned Spending With the Whole-of-Government-Framework Spending AreaFootnote xxv (dollars)
Strategic Outcome Program Spending Area Government of Canada Outcome 2015–16 Planned Spending
Protecting Canadians and empowering them to improve their health 1.1 Public Health Infrastructure Social Affairs Healthy Canadians 114,621,598
1.2 Health Promotion and Disease Prevention Social Affairs Healthy Canadians 297,110,496
1.3 Health Security Social Affairs A Safe and Secure Canada 59,776,240
Total Planned Spending by Spending Area (dollars)
Spending Area Total Planned Spending
Economic Affairs N/A
Social Affairs 471,508,334
International Affairs N/A
Government Affairs N/A

Departmental Spending Trend

Departmental Spending Trend Graph - Graph data in following table
Departmental Spending Trend
Actual Spending Forecast Spending Planned Spending
2012–2013 2013–2014 2014–2015 2015–2016 2016–2017 2017–2018
Sunset Programs - Anticipated 0 0 0 4,858,287 7,769,081 7,769,081
Statutory 44,340,612 43,823,211 45,419,197 43,718,110 42,691,346 42,629,858
Voted 575,315,617 577,674,425 622,943,368 523,434,311 507,700,403 506,683,503

The changes in Planned Spending are primarily associated with issuing the final payment for the Hepatitis C Health Care Services Program in 2014–15; receipt of temporary funding for Ebola Preparedness and Response Initiatives to Protect Canadians at Home and Abroad; and the sunsetting of some temporary Agency programs over the next three years.

The Government of Canada reassesses priorities, as required, and some programs that are set to sunset will be considered for renewal and may in fact be renewed.

Estimates by Vote

For information on the Agency's organizational appropriations, please see the 2015–16 Main Estimates on the Treasury Board of Canada Secretariat website.Footnote xxvi


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