Diabetes Policy Review - Report of the Expert Panel

Evolution of the Strategy

1999 Canadian Diabetes Strategy

In 1999, the Government of Canada inaugurated the Canadian Diabetes Strategy with a budget of $115 million over five years (with an extension until March 2005) in order to better utilize the resources and expertise available across the country to address the complex health problem of diabetes.

The 1999 Strategy was managed by Health Canada and consisted of four interrelated components:

• National Diabetes Surveillance System;
• Prevention and Promotion;
• Aboriginal Diabetes Initiative; and
• National Coordination.

National Diabetes Strategy Consultations

One of the key goals of the 1999 Canadian Diabetes Strategy was to support the development of a national diabetes strategy. To achieve this goal, the Canadian Diabetes Strategy funded the first National Symposium on Diabetes held in Montreal in February 2001. This symposium brought together 250 participants who represented a broad range of professionals and organizations to work towards a consensus on gaps in the prevention and control of diabetes. Participants confirmed broad support for the development of a national strategy for diabetes prevention and control and recommended action in five key areas: prevention, care, education, research and surveillance.

Following the symposium, Health Canada established the Coordinating Committee for the National Diabetes Strategy with a mandate to develop a national diabetes strategy and oversee its implementation. The Coordinating Committee consisted of representatives from the federal government, all provincial/territorial governments, national Aboriginal organizations and the Diabetes Council of Canada which was made up of national non-governmental organizations and national associations of pharmacists and pharmaceutical companies. The Coordinating Committee formed five expert working groups to revise the draft recommendations developed at the Montreal symposium on each of the five key areas for action. The working groups undertook research and consultation, and developed draft recommendations which were reviewed at the second National Symposium held in Winnipeg in May 2003.⁴³

As a result of these extensive consultations, the Coordinating Committee identified the six strategic areas they felt need to be addressed in the new Strategy. These strategic areas are as follows:

• Strategic Area #1: Support the development of healthy public policy;
• Strategic Area #2: Provide community-based health promotion and prevention programs;
• Strategic Area #3: Provide accessible health services for the prevention of diabetes in high-risk individuals and optimal diabetes detection and management;
• Strategic Area #4: Develop human resource capacity and enhance the education of those who provide diabetes prevention and management programs and services;
• Strategic Area #5: Conduct research and evaluation, and support knowledge exchange; and
• Strategic Area #6: Enhance surveillance.

Renewed Canadian Diabetes Strategy

The Public Health Agency of Canada was established in September 2004 to strengthen the federal government's ability to protect the health and safety of Canadians. In the federal government's February 2005 budget, the Public Health Agency of Canada was operationalized and given the responsibility for the implementation of the Healthy Living and Chronic Disease initiative, formerly the Integrated Strategy on Healthy Living and Chronic Disease, which included a renewed Canadian Diabetes Strategy. One of the Public Health Agency of Canada's first priorities was the creation of a Public Health Network with the provincial and territorial governments, which coincided with the disbanding of the Coordinating Committee for the National Diabetes Strategy. A formal role for non-governmental organizations was extinguished.

The Canadian Diabetes Strategy was renewed for an additional five years in the February 2005 budget. The renewed Strategy was designed to form the federal government's contribution toward a national diabetes strategy, and has primary focus on:

• Prevention of diabetes among high-risk populations;
• Early detection of type 2 diabetes; and
• Management of types 1 and 2 diabetes.

The main targets of the activities under the renewed Canadian Diabetes Strategy include: populations who are at higher risk of developing diabetes (e.g., those who are overweight, obese or have pre-diabetes); individuals who are over age 40; those with high blood pressure and high cholesterol or other fats in the blood; those with a family history of diabetes; and those of certain high-risk ethnic populations.

The renewed Strategy (non-Aboriginal components) has been allocated $90 million over five years ($18 million per year), under the Healthy Living and Chronic Disease initiative. The Healthy Living and Chronic Disease initiative is managed by the Centre for Chronic Disease Prevention and Control within the Public Health Agency of Canada. The Aboriginal Diabetes Initiative component was renewed with a budget of $190 million over five years under the First Nations and Inuit Health Branch within Health Canada.

The renewed Canadian Diabetes Strategy has six components:

• Leadership, Coordination and Strategic Policy Development;
• Community-Based Programming;
• Public Information;
• Knowledge Development and Exchange;
• National Diabetes Surveillance System; and
• Monitoring and Evaluation.

Federal funding for Diabetes-related Research

While not a part of the renewed Canadian Diabetes Strategy, several federal agencies fund diabetes-related research. These include the Canadian Institutes for Health Research, the Canada Foundation for Innovation, the Natural Sciences and Engineering Research Council of Canada and the Social Sciences and Humanities Research Council. In addition, there are other research organizations which are provided federal funding for diabetes-related study, for example, Genome Canada.

Innovation

The federal government has initiated investment, through Canada Health Infoway (Infoway), to advance the use of technology in Canada's health care system. Infoway is a federally-funded, independent, not-for-profit organization whose members are Canada's 14 federal, provincial and territorial Deputy Ministers of Health. Infoway supports collaborative change to accelerate the use of electronic health information systems and electronic health records across the country.