STRATEGIC HORIZONS

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1 PUBLIC HEALTH AGENCY OF CANADA STRATEGIC HORIZONS PROTECTING CANADIANS FROM ILLNESS

2 TO PROMOTE AND PROTECT THE HEALTH OF CANADIANS THROUGH LEADERSHIP, PARTNERSHIP, INNOVATION AND ACTION IN PUBLIC HEALTH. Public Health Agency of Canada Également disponible en français sous le titre : Horizons stratégiques This publication can be made available in alternative formats upon request. Her Majesty the Queen in Right of Canada, 2013 Publication date: May 2013 Cat.: HP55-1/2013E-PDF ISBN: Pub.:

3 TABLE OF CONTENTS PREAMBLE INTRODUCTION WHO WE ARE: THE PUBLIC HEALTH AGENCY OF CANADA WHERE WE ARE GOING: THE NEXT FIVE YEARS Strengthened health promotion and disease prevention leadership Strengthened public health capacity and science leadership Enhanced public health security Excellence and innovation in management MOVING FORWARD: BEYOND THE HORIZON STRATEGIC HORIZONS I

4 II STRATEGIC HORIZONS

5 PREAMBLE Public health issues can emerge quickly and unexpectedly, and the Public Health Agency of Canada must remain flexible and responsive in its ability to address any unforeseen events. However, there are also long-term trends in public health that require dedicated attention if the Agency is to make a difference. Strategic Horizons is intended to guide the overall planning of Agency activities by focusing efforts on key directions and priorities. Strategic Horizons describes a five-year course for delivering on the Agency s mandate, priorities, and commitments to Canadians. Agency staff and partners are encouraged to embrace opportunities over the next five years for continuing to build a strong and healthy Canada for current and future generations. Through a collective effort, Agency staff can make sure that we continue to have a Public Health Agency that makes a significant contribution to improving the health of all Canadians. INTRODUCTION Health and access to strong and effective health care continue to be among the highest priorities for Canadians. Since its inception in September 2004, the Public Health Agency of Canada has grown into an organization that provides critical leadership and action on domestic public health issues and on the international stage. As demonstrated during the H1N1 pandemic in 2009, the Agency has positioned Canada to better respond to new and emerging health threats. As the Agency has evolved in delivering its mandate, it has elevated and advanced public health issues at the national and international levels. The Agency has also brought leadership and focus to planning for and responding to domestic public health concerns such as pandemic influenza, and health risks such as childhood obesity. With a strong record of national leadership and expertise, the Agency is poised to continue to make substantial contributions to public health in Canada and internationally. It is now time to take stock of the Agency s work to date and set the course for the next five years. The public health landscape is continually evolving and becoming increasingly complex. The Agency s work going forward will need to be guided by a solid evidence base to inform its decision-making, with leading edge science and innovative approaches to addressing public health challenges. Partnerships will be key as public health challenges are cross-sectoral and cross-jurisdictional. Helping Canadians stay healthy and safe throughout their lives is a driving force behind our activities at the Agency. To achieve this end, the Agency will focus on advancing a number of key priorities under the following strategic directions over the next five years: Strengthened health promotion and disease prevention leadership Strengthened public health capacity and science leadership Enhanced public health security Excellence and innovation in management Strategic Horizons will guide the overall planning of Agency activities. It will establish the context for organizational priorities outlined in the Report on Plans and Priorities (RPP); and through the RPP, Program Alignment Architecture (PAA), and other planning tools, the Agency will identify targets and deliverables to link our strategic directions with the concrete actions needed to deliver them in the coming years. Through the annual Departmental Performance Report (DPR), the Agency will report on its progress in achieving the key priorities set out here in Strategic Horizons by demonstrating tangible results. The Agency s Executive Committee will re-evaluate the key priorities annually and adjust them as required to ensure that the Agency continues to anticipate and respond to the health needs of Canadians in meeting the four strategic directions. STRATEGIC HORIZONS

6 WHO WE ARE: THE PUBLIC HEALTH AGENCY OF CANADA The Public Health Agency of Canada was created within the federal Health Portfolio 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 the health care system. The Agency employs a wide range of professionals including public health specialists, physicians, scientists, technicians, communicators, administrators, policy analysts and planners. Staff members are located in offices, labs and field positions across the country. The Agency has the responsibility to: contribute to the prevention of disease and injury, and to the promotion of health; enhance the quality and quantity of surveillance data and expand the knowledge of disease and injury in Canada; provide federal leadership and accountability in managing public health emergencies; serve as a central point for sharing Canada s expertise with the rest of the world and for applying international research and development to Canada s public health programs; and strengthen intergovernmental collaboration on public health and facilitate national approaches to public health policy and planning. STRATEGIC OUTCOME Protecting Canadians and empowering them to improve their health PUBLIC HEALTH The practice of public health is about preventing disease and optimizing health. Public health focuses on promoting and supporting the health of the population through programs, services and policies, rather than treating the illnesses and injuries of individuals, which falls to the healthcare system. It involves collaborative action across many sectors of society to identify and reduce health threats. Public health helps people live longer, healthier lives and contributes to a prosperous society. Public health is a cross-jurisdictional responsibility. All levels of government as well as a range of public health stakeholders have a role to play in contributing to public health in Canada. This is done through a variety of public health functions such as surveillance, health promotion, disease and injury prevention, and emergency preparedness and response. 2 STRATEGIC HORIZONS

7 THE FEDERAL ROLE IN PUBLIC HEALTH Since the Lalonde Report of 1974, it has been recognized that there is a federal role in public health to promote overall health and well-being, including efforts to prevent both infectious and chronic diseases. It is also widely accepted that the federal government has a role to take action on public health issues of national concern to protect, maintain and improve the health of Canadians. While the federal government has a particular responsibility in the event of national health emergencies, there are many public health issues of national concern that may not constitute an emergency. In both cases, the most effective initiatives are those where the federal government works in collaboration with the provinces and territories, and others involved in providing health care to Canadians. Federal efforts add value and complement other jurisdictions activities by providing National Leadership (e.g. setting national standards and guidelines; coordinating national efforts); Critical Mass (e.g. public health science capacity housed at federal laboratories; surge capacity in the event of an emergency); Economies of Scale (e.g. building on existing investments and capacity); and Public Good Investments (e.g. sharing and communicating Agency knowledge within the domestic and international public health communities). PUBLIC HEALTH AGENCY OF CANADA VALUES The Public Health Agency of Canada s Values and Ethics Code became effective on April 2, 2012, and is a key document to achieving management excellence within the Agency. Abiding by the code is a condition of employment and its purpose is to support Agency staff in their daily work, strengthen the ethical culture, and contribute to public confidence in the integrity of all public servants. The Agency s organizational values are: Respect for democracy Respect for people Integrity Stewardship Excellence In addition to the Agency s values, it has fostered a culture in which decisions and actions are based on the best available evidence. In accordance with the Agency s federal role, its actions must be founded in leadership and vigilance; leadership in terms of supporting action on public health at a national level and acting on issues of concern to all Canadians, and vigilance in terms of following through on the course it sets and reporting back on progress. In turn, the Agency must not only learn from its experiences, but must also translate the information that it collects and manages into useful knowledge for the benefit of decision-makers and stakeholders. Sustainable development is also an important facet of the Agency s organizational culture. The Agency is committed to supporting and contributing to the Federal Sustainable Development Strategy as public health is an outcome of sustainable development. We recognize that social, economic and environmental conditions play an important role in determining the state of human health and that these factors need to be considered in the Agency s decision-making. Public Health Agency of Canada National Headquarters in Ottawa, ON STRATEGIC HORIZONS

8 STRATEGIC HORIZONS STRATEGIC DIRECTIONS KEY PRIORITIES TO ACHIEVE STRATEGIC DIRECTIONS VISION Healthy Canadians and communities in a healthier world MISSION To promote and protect the health of Canadians through leadership, partnership, innovation and action in public health Strengthened health promotion and disease prevention leadership Strengthened public health capacity and science leadership Enhanced public health security Excellence and innovation in management Enhance collaborative efforts on the promotion of positive mental health, the prevention of mental illness and suicide prevention, specifically intervention research and identifying best practices Strengthen collaborative engagement to promote healthy weights and prevent obesity, particularly among children Prevent and control persistent and emerging infectious diseases through targeted prevention initiatives (e.g. antimicrobial resistant organisms and food-borne illness) Enhance public health surveillance of non-communicable (chronic) disease risk factors, maternal and child health, injuries and infectious diseases Strengthen the formal mechanisms of the public health system through enhanced information sharing, partnerships and guidelines Foster, promote and strategically manage surveillance, science and research to support public health decisions and actions, including implementing the Framework for Science and Research Excellence Strengthen emergency preparedness and response capacity through a coordinated, all hazards, risk-based approach Reduce risks to the health and safety of the public posed by activities involving human pathogens and toxins Enhance border health security through a more integrated approach to reduce the risk of communicable disease transmission Strengthen strategic investments and partnerships that contribute to public health sustainability across Canada, including the North Efficient and effective business practices that empower staff to better support the Agency s operations and program delivery Manage through innovation and transformation, promote organizational learning, value corporate knowledge and expertise, and learn from performance For more information on the Public Health Agency of Canada s five-year strategic plan, please visit the Agency s Intranet site. STRATEGIC OUTCOME Protecting Canadians and empowering them to improve their health

9 WHERE WE ARE GOING: THE NEXT FIVE YEARS Over the next five years, the Agency will continue to assess and refine the way it fulfill its roles and responsibilities to find new and better ways of delivering public health programs of value to Canadians. This will be put into action through a number of transformative changes that will be apparent both internally and externally. Agency staff and management will be active participants in streamlining its operations and making them more efficient, while the Agency s stakeholders and partners will see a renewed focus in the way it does business. To support this transformation, the Agency s efforts will focus on key priorities within the context of its broader strategic directions. Where the strategic directions reaffirm our vision and mandate, the key priorities represent specific goals reflective of the public health needs of Canadians and are consistent with our strategic outcome of protecting Canadians and empowering them to improve their health. A population health approach and equity analysis will be used systematically in planning the specific focus of these key priorities. By providing a stronger evidence base for taking on important health issues and their determinants, the Agency works to improve population health and well-being and reduce health inequalities. Application of these approaches will include assessing how health status varies across populations and understanding how the determinants of health have direct and indirect consequences on health outcomes. In addition, the Agency will take a life course approach to shape its activities. This approach helps identify and interpret trends in the health of the population from birth to end of life, including the important transitions between life stages. This allows for the development of appropriate interventions, programs, and policies that help Canadians lead healthy lives. STRATEGIC DIRECTIONS Strengthened health promotion and disease prevention leadership Strengthened public health capacity and science leadership Enhanced public health security Excellence and innovation in management KEY PRIORITIES TO ACHIEVE STRATEGIC DIRECTIONS Enhance collaborative efforts on the promotion of positive mental health, the prevention of mental illness and suicide prevention, specifically intervention research and identifying best practices Strengthen collaborative engagement to promote healthy weights and prevent obesity, particularly among children Prevent and control persistent and emerging infectious diseases through targeted prevention initiatives (e.g. antimicrobial resistant organisms and food-borne illness) Enhance public health surveillance of non-communicable (chronic) disease risk factors, maternal and child health, injuries and infectious diseases Strengthen the formal mechanisms of the public health system through enhanced information sharing, partnerships and guidelines Foster, promote and strategically manage surveillance, science and research to support public health decisions and actions, including implementing the Framework for Science and Research Excellence Strengthen emergency preparedness and response capacity through a coordinated, all hazards, risk-based approach Reduce risks to the health and safety of the public posed by activities involving human pathogens and toxins Enhance border health security through a more integrated approach to reduce the risk of communicable disease transmission Strengthen strategic investments and partnerships that contribute to public health sustainability across Canada, including the North Efficient and effective business practices that empower staff to better support the Agency s operations and program delivery Manage through innovation and transformation, promote organizational learning, value corporate knowledge and expertise, and learn from performance STRATEGIC HORIZONS

10 Strengthen collaborative engagement to promote healthy weights and prevent obesity, particularly among children STRENGTHENED HEALTH PROMOTION AND DISEASE PREVENTION LEADERSHIP Enhance collaborative efforts on the promotion of positive mental health, the prevention of mental illness and suicide prevention, specifically intervention research and identifying best practices Positive mental health is a critical factor in ensuring the overall health and wellbeing of Canadians. Mental illnesses affect people of all ages, education, income levels and cultures and place a significant toll on families, communities and the healthcare system. In their lifetime, 20% of Canadians will personally experience a mental illness. Suicide is also a significant public health issue among all age groups and regions, and is the leading cause of death among young people ages Mental illnesses have a direct impact on the Canadian economy, both in terms of lost productivity and health care costs. Over the next five years, the Agency will enhance public health capacity to address mental health and suicide through support and collaboration on research and best practices in promoting positive mental health and preventing suicide, including public education and enhanced awareness among Canadians. This effort will span promotion and prevention; surveillance and monitoring; knowledge development and exchange; and research functions. The Agency s activities will also be linked to aspects of its children s, seniors and healthy living programs. Emphasis will be on enhancing multi-sectoral collaboration among federal departments, enhancing relations with key stakeholders to advance efforts, and exploring opportunities in working with provinces and territories. The number of Canadians who are overweight and obese continues to grow, with considerable concern surrounding increasing numbers of children and youth who are overweight or obese more than one-in-four despite the significant momentum that has been created to address this issue and its contribution to major chronic diseases. The obesity epidemic is the result of a number of societal changes which have made progressive and lasting changes to people s lifestyles in relation to healthy eating and physical activity. Obesity costs the Canadian economy billions of dollars each year. Over the next 5 years, the Agency will engage key stakeholders to reduce the rates of childhood obesity as guided by Curbing Childhood Obesity: an F/P/T Framework for Action to Promote Healthy Weights. With a focus on health promotion throughout the life course of Canadians, investments will target the relationship between healthy living and healthy weights and align efforts with other sectors (e.g. sports, physical activity, and recreation). A key emphasis will be on further enhancing multi-sectoral collaboration and the development of multi-faceted public policy responses through the expansion of successful initiatives, increased coordination across F/P/T governments, and increased joint leadership across sectors. Prevent and control persistent and emerging infectious diseases through targeted prevention initiatives (e.g. antimicrobial resistant organisms and food-borne illness) Infectious diseases pose ever-present risk to the health of Canadians. In response, the Agency will contribute to the promotion of health and the prevention and control of infectious diseases, to the improvement in the health of those infected and to the development of infectious disease health policy. Key activities will include providing expert advice to inform public health interventions, pandemic preparedness, surveillance, outbreak investigation management and surge capacity, and innovation in science and technology, human health advancement, policy development and integration against a range of target diseases. The Agency will take an integrated approach addressing multiple diseases when there are 6 STRATEGIC HORIZONS

11 synergies in common risk factors and vulnerable populations rather than handling them separately. For example, grants and contributions solicitation and programming can be combined and integrated for greater efficiency. STRENGTHENED PUBLIC HEALTH CAPACITY AND SCIENCE LEADERSHIP Enhance public health surveillance of noncommunicable (chronic) disease risk factors, maternal and child health, injuries and infectious diseases The Agency recognizes the need for a robust and integrated surveillance regime to support its needs and those of its partners to inform public health decisionmaking. Surveillance efforts will be focussed on activities that are aligned with the Agency s federal role and where the information is essential to public health monitoring and action. The Agency will also work with its partners to advance a collaborative or systems approach to surveillance in order to minimize duplication of efforts and maximize the public health benefit of surveillance information. Strengthen the formal mechanisms of the public health system through enhanced information sharing, partnerships and guidelines The Agency will further refine its role in building public health capacity in Canada through ongoing focus on provincial and territorial public health needs and requirements. The Public Health Network will continue to prove a valuable mechanism for working in partnership with stakeholders and other levels of government on issues that are relevant to multiple jurisdictions. Work in the Agency s regional operations will focus on federal public health functions such as public health capacity building, emergency preparedness and response, and knowledge development, exchange and transfer. Foster, promote and strategically manage surveillance, science and research to support public health decisions and actions, including implementing the Framework for Science and Research Excellence In tandem with enhanced surveillance on areas of importance to public health, the Agency s Chief Health Surveillance Officer will help to focus and advance surveillance efforts through a strategic approach to managing surveillance activities across the Agency. The Agency s science and research activities play a critical role in providing timely and credible evidence to support strategic decision-making, and these remain key priorities for the Agency. Through the Framework for Science and Research Excellence, the Agency will further focus the federal role in public health science and research, clarify its leadership, and continue to base its policies and programs on sound evidence and scientific information. The Agency will better integrate its program, policy and science functions, and strengthen its governance structures to enable it to make more strategic choices about science and research activities and improve its science reporting. Agency laboratory operations will focus on core, high priority laboratory activities, while preserving the capacity to respond to new and emerging health issues and to supplement Canadian laboratory capacity when needed. This will mean, among other things, exploring more integrated management of Agency laboratories. ENHANCED PUBLIC HEALTH SECURITY The Public Health Agency of Canada currently undertakes a number of activities related to health security: emergency preparedness and response including pandemic preparedness, biosecurity and border health security. In the next five years, the Agency will work to articulate its health security activities in an overall policy frame and strategy. Strengthen emergency preparedness and response capacity through a coordinated, all hazards, risk-based approach On behalf of the Health Portfolio, the Agency serves as the federal focal point for coordinating emergency management activities with significant public health implications. Over the next five years, the Agency will continue to enhance its ability to effectively plan for and respond to natural disasters and health security threats, coordinate inter-jurisdictional mutual aid, and provide surge capacity to provinces and territories. To enhance national coordination of emergency response, the Agency will work with provinces and territories to develop a Pan-Canadian All Hazards Health Emergency Response Plan. The plan will clarify roles and responsibilities for response and include practical guidance for communications and decision making during emergencies when more than one jurisdiction is implicated. STRATEGIC HORIZONS

12 The Agency will also collaborate with provinces and territories to implement an Operational Framework for Mutual Aid Surge Requests for Health Care Professionals. The Operational Framework offers guidance to a common approach for the urgent sharing of doctors and nurses across jurisdictions during emergencies. This framework also outlines common principles and jurisdictional responsibilities which complement existing emergency management systems. To improve surge capacity, the Agency will take a more strategic approach to the management of the National Emergency Stockpile System (NESS), to ensure that the inventory remains relevant and responsive to the risk environment. Reduce risks to the health and safety of the public posed by activities involving human pathogens and toxins The Agency will establish and maintain a comprehensive pathogen control framework that will embrace the principles of regulatory renewal, including enhanced service delivery and reduced administrative burden for regulated parties. The federal responsibility for the regulation of both animal and human pathogens will be consolidated into a single program within the Agency. Currently human pathogens are regulated by the Public Health Agency of Canada while animal pathogens are regulated by the Canadian Food Inspection Agency. This program consolidation will be supported by a single biosafety standard and streamlined processes resulting in reduced regulatory burden and improved service delivery. The Agency will also consult on, develop and implement a new risk-balanced program and regulatory framework for the Human Pathogens and Toxins Act that will include a new licensing program for laboratories and facilities working with human pathogens and toxins in Canada. As Canada s national biosafety authority, the Agency will also strengthen Canadian, North American and global biosafety, biocontainment and biosecurity through strategic international leadership which is plan-driven and flexible in the face of changing national and international needs. Enhance border health security through a more integrated approach to reduce the risk of communicable disease transmission A Border Health services program will be established at the Agency by integrating the Quarantine Program and Health Canada s Travelling Public Program which are responsible for reducing the risk of communicable disease importation and exportation through humans, conveyances, and cargo. This will enhance capacity at the border to detect and respond to health risks, improve surge capacity should a public health emergency occur at the border, and provide improved and streamlined services for stakeholders. Public health security is a priority under international initiatives such as the Canada-U.S. Beyond the Border Initiative and the North American Plan for Animal and Pandemic Influenza, revised in 2012, which is a trilateral agreement between Canada, the U.S. and Mexico. One of the key areas of cooperation, and where the Agency will focus its efforts, includes strengthening health security partnerships through existing mechanisms for cooperation on health emergencies, and enhancing collective preparedness and response capacity to a range of health security threats including influenza pandemics. 8 STRATEGIC HORIZONS

13 EXCELLENCE AND INNOVATION IN MANAGEMENT Strengthen strategic investments and partnerships that contribute to public health sustainability across Canada, including the North Grants and contributions remain a powerful tool for making a difference at the community level while building public health capacity. The Agency will improve the way that it administers its grants and contributions programs to reduce the burden on recipients for accessing funding and reduce the administration costs for the Agency. At the community level, the Agency will also better integrate its efforts with those of other public health service providers and improve the relevance of our community programs through improved partnerships resulting in better service delivery to recipients. As a means of bolstering capacity in jurisdictions in need of assistance, an Agency office will be opened in Iqaluit, Nunavut, by fall 2013 to strengthen public health capacity across the territories as required. While the initial investment will be up to three public health professionals including a public health nurse, a policy analyst, and an emergency preparedness coordinator, the Agency may invest more in the future as it continues to identify areas of greatest need in collaboration with territorial colleagues. Efficient and effective business practices that empower staff to better support the Agency s operations and program delivery To continue providing high quality public health programming, research, and advice, the Agency needs to ensure that its people have the necessary operational, management, and organizational supports. The Agency will build on its culture and values by continuing to improve the management of its operations and people. A valued and skilled public health workforce within the Agency is critical to ensuring that it continues to show leadership in serving Canadians and the Minister of Health with clear, high quality, and well-respected public health advice. Manage through innovation and transformation, promote organizational learning, value corporate knowledge and expertise, and learn from performance The Agency will continue to strengthen the management of its programs and its relationships within the Health Portfolio and with external partners. The Agency embarks on this key priority in collaboration with Health Canada by combining support services in the areas of communications, human resources, information management and technology, audit and evaluation, emergency preparedness and response, financial management, accounting, facilities management and procurement. Given existing synergies between the Public Health Agency and Health Canada in managing international affairs and consistent with the consolidation of internal services, the Agency and Health Canada have merged the international affairs function into a Health Portfolio Office of International Affairs to serve both organizations equally. With the global nature of public health and the speed at which diseases from one part of the world can travel to another, this change will further strengthen Health Portfolio engagement in international fora and engagement on emerging public health issues. This work will be guided by the Global Health Framework for the Public Health Agency of Canada s International Activities STRATEGIC HORIZONS

14 MOVING FORWARD: BEYOND THE HORIZON Beyond the next five years, the Agency will continue to need to be prepared to address new and emerging public health issues. One way to do this is through the use of scenario analyses and other foresight activities. This approach applied to complex public health issues can identify major drivers and trends that are likely to impact public health over the next years. This makes for a more broadly informed, stronger and resilient Agency that is better positioned to adapt when faced with constantly shifting trends and forces both domestically and globally. By focusing its work on a series of strategic directions in accordance with its public health roles while keeping an eye on the future, the Public Health Agency of Canada will continue to maintain public confidence in its activities, guidance, and advice, as well as continue to be seen as a valued contributor by national and international public health partners. The Agency will work closely with its provincial and territorial counterparts to advance key priorities and ensure a continued coordinated approach to public health issues. Recent research identified a range of major drivers that may impact public health over the next several years, and the Agency is using these for future planning and decision-making. Due to the complexity of public health, it is necessary to consider drivers such as economic stability, social and cultural landscapes, governance structures and food-water interdependencies, and how these might influence population health and the actions of the Agency. Other specific drivers that would have an impact on the Agency include: the Canadian public health role in responding to international demands and needs and the negotiation of that role in the global context; public trust in institutions; and the global movement of carriers (people, animals, plants, and products). These, along with others identified over the next five years, will help the Agency to better prepare for and plan within an everchanging world. Emergency Operations Centre, National Microbiology Laboratory in Winnipeg, MB 10 STRATEGIC HORIZONS

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