Pan-Canadian Public Health Network Annual Report 2015-2016
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Pan-Canadian Public Health Network Annual Report 2015-2016Footnote 1
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Table of Contents
- Strategic Objective #1: Promote Healthy Living and Reduce Health Inequalities
- Strategic Objective #2: Prevent and Control Persistent and Emerging Infectious Disease
- Strategic Objective #3: Prepare for and Respond to Public Health Emergencies
- Strategic Objective #4: Build Public Health Infrastructure and Organizational Supports
- Other Key Initiatives
This is the eighth report on the contributions and achievements of the Pan-Canadian Public Health Network (PHN) as it continues to assist governments and other public health partners to collectively advance work on Canada’s public health priorities. This report provides an overview of key activities and accomplishments from April 1, 2015 to March 31, 2016.
The PHN was established by Canada’s F/P/T Health Ministers in 2005 in response to various public health events and evidence that highlighted an urgent need to develop a comprehensive, integrated and responsive system for intergovernmental coherence and collaboration in the field of public health. The PHN is a key intergovernmental mechanism which exists to:
- Strengthen and enhance Canada's public health capacity;
- Enable F/P/T governments to better work together on the day-to-day business of public health; and
- Anticipate, prepare for and respond to public health events and threats.
As it carries out its duties, the PHN strives to remain respectful of the authority and jurisdiction of each F/P/T government to manage public health operations within its own domain. The PHN takes a collaborative approach to public health that is not only critical during public health emergencies – but also to assisting jurisdictions across Canada in gaining a stronghold on public health issues, such as obesity and other chronic and communicable disease.
I. Reporting on 2015 - 2016 PHN Key Areas of Focus and Deliverables
Over the 2015-2016 period, the Network carried out work under the below four 2014-2017 Strategic Objectives. Activities for each of these areas are described in the following sections.
Strategic Objective #1: Promote Healthy Living and Reduce Health Inequalities
Building on the 2013 progress report, the PHN released Towards a Healthier Canada – 2015 Progress Report on Advancing the F/P/T Framework on Healthy Weights. The report includes profiles of significant healthy weights initiatives underway and quantitative indicators that are being monitored for progress (healthy weights, healthy eating, physical activity, and supportive environments). It also illustrates collaboration between F/P/T Ministers of Health and/or Healthy Promotion/Healthy Living and F/P/T Ministers responsible for Sport, Physical Activity and Recreation. Future action will explore opportunities to improve policy coordination and joint action to advance healthy weights among various relevant governmental and non-governmental sectors.
Mental Health Promotion
Efforts were supported in enhancing data collection and surveillance for a better understanding of the state of mental health in Canada by contributing an F/P/T lens to the Public Health Agency of Canada’s Positive Mental Health Surveillance Indicator Framework for Adults. Further, a complete set of adult indicators were adopted to inform decisions on future F/P/T mental health promotion initiatives, and support ongoing work in individual jurisdictions. Future work will focus on additional consultations with the Public Health Agency of Canada to complete the positive mental health indicator measurements for Canada’s children and youth, and to develop respective messaging on the positive mental health state of Canadians.
Building on previous work of governmental and non-governmental experts in injury prevention, an Injury Prevention Dashboard (select promising and best practices across jurisdictions focused on seniors’ falls and sport- and recreation-related injuries) was completed. This resource, based on a set of performance indicators for provinces and territories, is intended to support enhanced governmental and stakeholder knowledge coordination in these, as well as other related, injury prevention areas. Understanding the experiences of jurisdictions can assist in not only reducing workload and building on what works, but in leveraging the involvement of multi-stakeholder groups as partners in advancing injury prevention efforts.
Contributing to Canada’s efforts to understand and reduce health inequalities, the PHN, in collaboration with the Public Health Agency of Canada, Statistics Canada, and the Canadian Institute for Health Information, undertook the Pan-Canadian Health Inequalities Reporting Initiative. This initiative produced the first systematic statistical portrait of health inequalities in Canada, which will strengthen health inequalities monitoring and reporting in Canada, and strengthen the capacity of jurisdictions to take action, individually and collaboratively, by consolidating and making available data to address important health questions. The new data tool and knowledge generated will also support federal and provincial and territorial engagement with other sectors to address the social determinants of health and health inequalities.
Strategic Objective #2: Prevent and Control Persistent and Emerging Infectious Disease
National Immunization Strategy (NIS)
Significant achievements were made in pursuit of National Immunization Strategy recommendations. A Vaccine Supply and Risk Management report was developed and included recommendations that support reliable and equitable access to affordable, good quality vaccines in order to meet public health objectives for the prevention and control of infectious diseases. The recommendations will support jurisdictions in strengthening risk based measures for security of supply, by continuing to enhance the vaccine Bulk Purchasing Program aimed at preventing and mitigating supply risks, and ensuring timely and well-coordinated responses in the event of shortages or recalls.
A report on Improving Vaccine Acceptance and Uptake in Canada was also developed which lays out recommendations to address issues of vaccine hesitancy and the challenges of achieving levels of vaccine coverage necessary for effective protection of Canadians against vaccine-preventable diseases. The recommendations incite a call to action, enhanced capacity, and targeted investments in acceptance and uptake. It focuses on four complementary initiatives: improving coverage data, designing effective tools and interventions, bridging gaps from knowledge to action, and strengthening institutional capacity to improve uptake.
Antimicrobials are essential for the prevention, control and treatment of infectious disease in both humans and animals. Antimicrobial resistance (AMR) remains a complex multi-sectorial issue with cross-jurisdictional implications for human health care, public health, food safety, food production, animal health care and environmental protection sectors.
A report Antimicrobial Resistance Surveillance Data Requirements for Priority Organisms was developed and identified the priority AMR surveillance data metric requirements needed for priority AMR organisms. The report provides general recommendations regarding national AMR surveillance that will help to support a robust Pan-Canadian AMR surveillance system. A second report entitled Report to the Communicable and Infectious DiseaseSteering Committee: Antimicrobial Stewardship was developed and included recommendations for key components needed to increase stewardship for the optimal and prudent use of antimicrobials in human health.
In addition to these reports, a dedicated AMR governance structure will be established to lead the development of a pan-Canadian framework and action plan. Consistent with a One Health approach, the governance structure includes federal, provincial and territorial representatives with expertise in public health, health care and agri-food/agriculture. The two reports will be shared with the appropriate task groups in the new governance structure to inform their work and development of recommendations.
West Nile Virus
A systematic literature-based review was conducted to assess the effectiveness of mosquito control methods currently used in Canada for reducing the risk of human West Nile Virus (WNV) infection. The review concluded that there is agreement between the opinions of mosquito control experts and published experimental studies: mosquito control methods used to prevent human WNV disease are effective in immediately reducing larval or adult mosquito populations in treated sites. Evidence that effects on mosquito populations are sustained over short time scales is convincing, and several studies provided evidence of a reduction in infection rates of vector species following treatment. The report, however, also concluded that current evidence is insufficient to allow for robust assessment of the impact of mosquito control activities on the prevention of human cases of WNV.
Strategic Objective #3: Prepare for and Respond to Public Health Emergencies
Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector
The Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector (CPIP) is an F/P/T guidance document that outlines how jurisdictions will work together to ensure a coordinated and consistent health-sector approach to pandemic preparedness and response. The CPIP consists of a Main Body, which outlines overarching principles, concepts, and shared objectives, as well as a series of technical annexes that include more detailed operational plans on specific issues.
Two annexes were finalized: the Surveillance Annex outlines Canada’s pandemic surveillance strategy and provides surveillance-specific operational and technical guidance for the health sector; and the Laboratory Annex provides recommendations to Canadian influenza testing facilities on laboratory testing, surveillance, data collection, communication and pandemic preparedness and planning.
Preparedness and Response Planning for Ebola Virus
The threat of the Ebola virus entering Canada posed a need for coordinated F/P/T preparedness and response planning across the health sector. The Special Advisory Committee (SAC), consisting of senior technical and policy leaders in public health across Canada, provided leadership, coordination and public health advice to the F/P/T Deputy Ministers on matters related to Ebola preparedness and response planning. Towards late 2015, with the number of cases starting to decrease and remaining pieces of work nearing completion, the SAC undertook a lessons learned exercise to inform future events and to identify strengths and areas for improvement of SAC collaboration during Ebola preparedness and response. Based on this exercise, advancements in many areas are already underway, including the development of a concept of operations to support the Regional Collaborative Treatment Approach to the treatment and Ebola Virus Disease in Canada. SAC members will continue to discuss next steps following this exercise.
Strategic Objective #4: Build Public Health Infrastructure and Organizational Supports
Multi-Lateral Information Sharing Agreement
The Multi-lateral Information Sharing Agreement (MLISA) is a legal agreement that establishes standards on sharing, usage, disclosure and protection of public health information among Canadian jurisdictions for infectious diseases and public health emergencies of international concern. MLISA came into force on October 4, 2014. To date, the Government of Canada and a majority of provincial and territorial governments have signed on to MLISA.
Governance for MLISA resides with the MLISA Table of Representatives, which was established in March 2015. The MLISA Table of Representatives reports to the Conference of F/P/T Deputy Ministers of Health (CDMH) through the PHN Council. The first annual report for MLISA was completed in Spring 2016 and describes the activities of the Table of Representatives.
Development of the MLISA Technical Annexes, which will outline the details of the information to be shared between jurisdictions, has been initiated.
Federated System for Public Health Surveillance
Work continued on the development of a Blueprint for a Federated System for Public Health Surveillance in Canada. The Blueprint is a comprehensive policy guidance document consisting of a vision for surveillance and an action plan for enabling the development and implementation of an infrastructure for more effective F/P/T collaboration on public health surveillance in Canada. The action plan identifies five priority action areas, including: Governance, Ethics, Information Sharing, Standards, and Demonstrating Success. The first phase of implementation will focus on Governance and Ethics, as work in these areas will inform the remaining priorities.
Other Key Initiatives
Indigenous Public Health
The PHN continued to reach out to National Indigenous Organizations (NIOs) to build and maintain relationships, as well as strengthen the inclusion of an Indigenous perspective within the work of PHN. Building on previous engagement, the Co-Chairs met with three NIOs to discuss respective public health priorities and ongoing engagement opportunities. These discussions will help inform the development of a PHN-wide First Nations, Inuit and Métis public health engagement strategy.
Public Health and the Environment
In June 2011, F/P/T Deputies directed the PHN to hold regular thematic discussions on issues related to health and the environment. The objective for these discussions is to share information on and discuss emerging environmental public health issues in Canada. PHN Council participated in two thematic discussions jointly with the Council of Chief Medical Officers of Health during 2015‑2016 which focussed on protecting people from wildfire smoke and the health impacts of climate change.
Preparedness and Response Planning for Welcoming Syrian Refugees
The SAC structure was used to communicate plans in preparation for the arrival of over 25,000 Syrian refugees throughout winter 2015-16. F/P/T jurisdictions collaborated to ensure stability and safety for new individuals and families integrating into Canadian communities, and to be prepared to respond to any serious medical conditions that could put the health of Canadians at risk. Council of Chief Medical Officers of Health members continue to engage on experiences with refugees’ resettlement and long-term integration.
II. Looking Ahead
Looking ahead to fiscal year 2016-17, the PHN will continue to respond to F/P/T Minister and Deputy Minister direction and ensure the Network remains an effective and efficient mechanism for governments to work together to improve the health of Canadians and to strengthen the public health system.
The PHN Strategic Objectives and Priorities will continue to shape PHN work. In addition to longer-term workplan items that will continue into fiscal year 2016-17, it is anticipated that the following new areas will be included in the next workplan: reviewing diagnostic guidelines and standardizing approaches for Lyme disease, establishing new PHN strategic priorities for the 2017‑2020 period, reassessing the current approach to reporting on progress on healthy weights and examine key policy areas to move forward collectively, and further exploring opportunities to advance collective action in the area of mental health promotion.
The PHN will continue to refine its business operations, build relationships and enhance communication within the public health community, taking advantage of opportunities to partner where appropriate, and increase utilization of the online data sharing portal - the Canadian Network for Public Health Intelligence.
- Footnote 1
Based on its interests, Quebec plans to participate only in working groups for the protection of public health and to share information and best practices.
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