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Five-Year Priorities for Action

Determinants and Disparities
Building Public Health Capacity | Fulfilling our Mandate

Strategic Objective 1:
Anticipate and respond to the health needs of Canadians

Delivering on Policy and Programming Priorities

Meeting Major Public Health Challenges:

The Agency will remain flexible to address emerging public health issues and will continue to look for opportunities to address common risk factors and take advantage of integrated platforms. However, we will make significant inroads on a number of public health challenges related to chronic and infectious disease.

The impact of an uncontrolled outbreak of any infectious disease would be significant and serious. Governments, stakeholders and citizens would look to the Agency to take a leadership role in protecting Canadians. Domestically and globally, there are significant concerns related to pandemic influenza and emerging infections. Given concerns stemming from the risks associated with an outbreak of avian and/or pandemic influenza, $1 billion was allocated to federal departments and agencies in Budget 2006 to strengthen preparedness. PHAC will take a leadership role with other federal departments, provincial/territorial governments, and stakeholders to carefully manage these resources to enhance and maintain an all-hazards approach. This means that many of the things we would do to prepare for an influenza pandemic would also be useful in the event of a different type of uncontrolled outbreak of infectious disease or public health emergency, such as a natural or man-made disaster.

 

 

As we saw during SARS, public health is brought to the forefront in times of crisis, when infection control becomes a primary means of reducing the impact of an emerging infectious disease. The federal government plays a key role in reducing the threat of emerging infectious diseases, in conjunction with provincial, territorial, and local governments. As such, PHAC will ensure that its all-hazards approach allows it to provide leadership in detecting and identifying potential sources of infectious disease outbreaks and reducing and preventing the spread of emerging and or re-emerging infectious diseases.

We will continue to manage the Federal Initiative on HIV/AIDS, support Canada-wide action, and sustain a global response, while remaining responsive to shifts in the epidemic and forging new and collaborative relationships to address its emerging issues. PHAC will partner with the Bill & Melinda Gates Foundation to support the Canadian Vaccine Initiative, a new effort to speed up the development of an HIV/AIDS vaccine and address critical research gaps.

Although Canadians tend to associate the work of the Agency with infectious disease prevention and health protection, PHAC has an equally important role to play in addressing injuries and chronic diseases, which account for the majority of deaths and disease in Canada. Given the important role of obesity in chronic diseases, such as diabetes and cardiovascular disease, the Agency will work “upstream” to develop a policy framework and action plan on obesity in partnership with stakeholders. The plan will include the development of knowledge and expertise in this emerging area of concern, and will focus on how best to intervene and prevent obesity.

The Agency realizes that physical health is only one component of health. At least one in five people will be affected by mental illness during their lifetime. Preserving and promoting mental health among Canadians contributes to healthy families, productive workplaces and nurturing communities. The Agency will augment its capacity to address mental health and mental illness and develop a policy framework and action plan focussed on developing information and knowledge, providing effective public health advice concerning effective interventions, and liaising with the new Canadian Mental Health Commission.

 

 

 

Addressing Determinants and Disparities:

The health of certain groups of Canadians continues to be much poorer than the health of the overall population. PHAC will place a high priority on mobilizing efforts across sectors to address public health disparity and influence the determinants of health.

To address the significant health disparities experienced by Aboriginal Canadians, PHAC will increase its capacity in this area and develop a strong Aboriginal public health policy. Currently, the First Nations and Inuit Health Branch of Health Canada provides public health programming and services to on-reserve First Nations communities and the Inuit. Provincial/ territorial governments provide programming and services to off-reserve First Nations and other Aboriginal populations, including the Inuit. PHAC provides some programs to off-reserve First Nations and other Aboriginal populations, including the Métis, and there are Aboriginal components in a number of PHAC’s programs, but the need for an over-arching strategic policy on Aboriginal public health is clear. In this analysis, one area of particular concern is the need for better data and information on the health of Aboriginal populations, which will need to be addressed as part of a broader framework. To develop this Aboriginal public health policy and assume a greater role in developing and delivering Aboriginal public health programs across Canada, PHAC will launch and maintain collaborative relationships with national and regional Aboriginal organizations and other federal departments.

PHAC has also identified the importance of child health and development in its five-year plan, given the health disparities experienced by certain groups of children (e.g., Aboriginal children and children living in poverty) as well as the significant impact of early childhood development as a key determinant of health. In addition, a priority on children is appropriate given that unintentional injury is the leading cause of death, morbidity and disability among Canadian children and youth. There are a number of programs in the Agency that currently address child health. It is important that we assess this work in light of evolving needs and priorities for Canadian children, current evidence, and Agency directions. As such, we will develop a comprehensive policy for child health and development, focussing on the development of knowledge and tools.

 

 

 

Although upstream interventions are needed on child health, the Agency also recognizes that the aging of Canada’s population continues to increase. An aging population brings with it serious concerns with regard to the prevalence of chronic disease, the incidence of injury and the disproportionate vulnerability of this group to the consequences of public health emergencies. A comprehensive strategy on seniors and healthy aging will focus on emergency preparedness, injury prevention, mental health and active aging.

While placing a priority on addressing the needs of certain populations, the Agency also recognizes that the impact of the environment is a key health issue and priority of governments and Canadians. PHAC will develop a strong and comprehensive policy and program response on the public health impacts stemming from the environment (e.g., infectious disease risks associated with climate change, food contaminant/zoonosis risks, chronic disease and environmental hazards, etc.). We will enhance our partnerships with Health Canada, Environment Canada, Agriculture and Agri-Food Canada and non-governmental partners to allow a strong public health contribution to the broader environment agenda.

Our priorities on addressing public health disparity and influencing the determinants of health cannot be restricted to Canada alone. Global public health is in Canada’s interest. A reduced global disease burden strengthens global health security and protects Canadians against many current and emerging public health threats. In keeping with this interest, the Agency will work to strengthen the government’s policy coherence related to global public health and consider its impact on other areas, such as migration health. This work will involve international leadership and participation in strategic international initiatives to promote approaches to addressing the determinants of health and to build capacity in global public health systems.

 

 

 

Building Public Health Capacity:

There are significant challenges associated with traditionally weak and limited public health capacity in Canada. The Agency will continue working in partnership with stakeholders and other governments to develop strategies to address gaps in public health capacity in order to enhance our ability to take action on major health issues and respond to potential public health emergencies.

As a first step, the Agency needs to augment its efforts to monitor the human, financial, program, policy, research and legal dimensions of public health capacity. The establishment of better mechanisms for monitoring public health capacity (e.g., developing benchmarks and markers of performance) will result in more effective strategies to address weaknesses and fill the gaps. PHAC will also place a priority on collaborating with other levels of government to fill gaps in public health human resources, both within the Agency and in other jurisdictions, and on working with partners to provide leadership in the areas of training and skills development, core competencies, accreditation, and recruitment and retention policies.

The availability of safe and effective vaccines plays a major role in public health capacity. By preventing disease, immunization reduces pressures on the health care and public health systems, by reducing outbreaks of infectious disease, outpatient visits, hospitalizations and long-term disabilities. But there are gaps in terms of the equitable and timely access to safe and sustainable vaccines across the country. PHAC will place a priority on demonstrating leadership toward a federal approach to new vaccine research, development, production and supply, and program monitoring and evaluation in Canada and around the world. To support this work, the federal government has announced an increase in federal funding to support the construction of the International Vaccine Centre, a high-containment animal research facility that will expand domestic capacity for pre-clinical vaccine research on pathogens that affect both animals and humans.

The Agency will develop a robust National Health Emergency Management System in collaboration with federal partners, provinces and territories, and social assistance/relief agencies. The System will be seamless and comprehensive and will include development of an Incident Management System, bringing together tried and true operating procedures with the personnel who are trained and exercised to implement these procedures in the event of an emergency. Enhancements will be made to the National Emergency Stockpile System, ensuring that sufficient supplies of appropriate and modern products and materials are available in the event of a public health emergency.

 

 

 

Fulfilling our Mandate:

In order to deliver on these priorities and fulfill our mandate, PHAC needs to be in a position to exert influence and leadership in the broader public health environment. The ability to lead and influence will be enhanced when the Agency has a strong reputation as a world leader in public health and a high degree of credibility with citizens, other governments and stakeholders. Reputation and credibility stem from effectiveness. PHAC will demonstrate its effectiveness by delivering on its priorities and by reporting on results to Canadians.

The Agency will also demonstrate effectiveness by ensuring that the most timely, precise and accurate public health advice is available to stakeholders, Canadians and the international community. For example, we will strive to ensure that the CPHO’s annual report, a requirement stipulated in the Agency’s enabling legislation, is viewed as an evidence-based, highly anticipated and respected publication providing leadership on public health issues.

 

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