PHAC on the International Scene
CLIVE ADDY
© 2014 FrontLine Security (Vol 9, No 2)

ROLES AND RESPONSIBILITIES
The Public Health Agency of Canada (PHAC) was created in 2004 within Health Canada to help protect and improve the health and safety of all Canadians and to strengthen the health care system. Public health in Canada is a shared responsibility between all three levels of government in collaboration with the private sector, non-government organizations, health professionals and the public. At its outset, the challenge of the H1N1 bird flu epidemic was well handled under the guidance of its highly-respected Dr. David Butler-Jones, Canada’s first Chief Public Health Officer.

To maintain its currency and pertinence, PHAC must maintain a broad and current base of medical and public health information with sound national and international links to alert us all to potential threats. Germs and diseases, we must remember, are immune to our borders, governance, rules and legislative terms of reference.

THE INTERNATIONAL STRATEGY AND NETWORK
Health Canada, and PHAC therefore, is now well established as part of the Global Public Health Intelligence Network (GPHIN) which “serves as an early warning global surveillance system disseminating information on global public health events through a secure website, on real-time 24/7 basis”. This accurate and timely information network is vital to Health Canada’s Centre for Emergency Preparedness and allows the broad and detailed public health information to be disseminated across Canada and throughout our Health Portfolio (www.phac-aspc.gc.ca/portfolio-eng.php).

As well, the information provided by the Global Public Health Intelligence Network supports the necessary rapid response programs to handle identified emergencies with such resources as the World Health Organization’s Global Alert and Response Teams.
On the international level, one must also mention Health Canada’s role with its Counter-Terrorism Coordination and Health Information Networks (CTCHIN) responsible for providing accurate and current information and counsel to all relevant agencies, as well as collaborating and sharing with international agencies on:

  • Health issues related to chemical, biological, radiological and nuclear( CBRN) events;
  • Specific emergency management issues;
  • Latest research, policies, programs, training, literature and conferences on CBRN issues;
  • General health preparedness and response information for the public.

At this higher level, in May of this year, Canada, the US and Mexico signed a Declaration of Intent to coordinate their Health Emergency Public Communications. This tri-lateral agreement is intended to allow all to share public communication plans, statements and other communication products related to health emergencies prior to public release; and apprise other authorities, depending on the type of emergency, with their respective governments when the declaration is invoked.

Formal exchange of this information is made through the PHAC’s CANADA HEALTH PORTFOLIO OPERATIONS CENTER. This centre is the hub for the Minister of Health who is responsible for maintaining and improving the health of Canadians.

IN CANADA
As already mentioned, the key audience and contributing advice to the Minister of Health is the group known as the HEALTH PORTFOLIO which comprises Health Canada, the Public Health Agency of Canada, the Canadian Institutes of Health Research, the Hazardous Materials Information Review Commission, the Patented Medicine Prices Review Board and Assisted Human Reproduction Canada. The Health Portfolio consists of approximately 12,000 full-time equivalent employees and an annual budget of over $3.8 billion.

In April 2012, PHAC committed to developing milestones for the National Office of Health Emergency Response Teams. This was followed up with its participation in a Health Surge Capacity Task Group to develop an Operational Framework for Mutual Aid Requests (OFMAR). This framework provides tools to address surge capacity requests for registered nurses and physicians from other jurisdictions to work in familiar types of clinical settings. Though dealing specifically with nurses and doctors, it does not preclude mutual exchange of other health care professionals. This framework was officially endorsed in Dec 2013. The “Framework” is being expanded to address other mutual aid needs.

One need only visit the Health Canada and the PHAC websites to appreciate the currency and breadth of information that is handled daily by its Operations Centre.

For instance, on the matter of the return of a Canadian team from West Africa for isolation and observation reported on 28 August of this year, the Public Health Agency advised the Canadian Press that it “remains committed to the effort to control the Ebola outbreak in West Africa and will send another team to restart the lab operation at Kailahun after appropriate steps are taken to ensure a safe living environment for the scientists.”

One should also browse the mandated Annual Reports from the Chief Public Health Officer to understand the breadth and depth of the work being done daily on our behalf over the last decade. (www.phac-aspc.gc.ca/cphorsphc-respcacsp/index-eng.php)

At the provincial and regional and municipal levels we are equally well served. For example, looking to the future, the Chief Medical Officer of Health for Ontario, Dr. Arlene King, MD MHSc, FRCPC, stated in her 2012 review that:

“WE MUST:

  • Educate the public and health care providers about infectious diseases;
  • Improve scientific literacy;
  • Reinvigorate Ontario’s immunization system;
  • Reduce sexually transmitted and blood-borne infections;
  • Reduce health care-acquired infections;
  • Discourage the inappropriate use of antibiotics;
  • Improve information and knowledge systems; and
  • Reduce preventable diseases by continuing to address modifiable risk factors that put people at risk of bad outcomes from infectious diseases, such as tobacco use and harmful alcohol use: and by promoting healthy environments both natural and built.”

These words reflect much of what is repeated in the National Annual Reports from our national CPHO.

Much has happened in this last decade since PHAC was formed. The visible leaps in improvements to our health care system and our ability to mitigate and respond in time to health threats in Canada have played an important role in ensuring our overall security. As our population ages and we depend more on immigration for our growth these challenges will grow along with us.
WE MUST be ready.

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Clive Addy is the Executive Editor of FrontLine Security.
(PHAC public affairs staff provided information and data for this article)
© FrontLine Security 2014

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