ARCHIVED - Assisted Human Reproduction Canada - Report

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Minister's Message

It is my pleasure to present the 2011-2012 Report on Plans and Priorities for Assisted Human Reproduction Canada (AHRC), the federal regulatory agency that was established to protect and promote the health, safety, dignity and rights of Canadians who use or are born of assisted human reproduction (AHR) technologies.

On December 22, 2010 the Supreme Court of Canada rendered its opinion on the constitutionality of certain sections of the AHR Act. That opinion confirmed the role of the Government of Canada in relation to the prohibited activities set out in the Act and of informing all Canadians on matters relating to AHR, including risk factors associated with infertility, while finding that provisions yet to be brought into force relating to licensing and collection of health reporting information belong to the provinces and territories.

The Government of Canada will continue the judicious use of its funds in ensuring that its activities are carried out in a cost effective manner. Authorized spending projections included in this RPP are subject to revisions following the Government of Canada's deliberations about the manner of oversight of those provisions of the AHRC Act which are in force in light of the Supreme Court of Canada's opinion on December 22, 2010. In 2011-2012, the Government of Canada will take steps to meet its continuing responsibilities under the Act, as well as advancing the health, safety, dignity and rights of Canadians building their families through assisted reproductive technologies and of those born from such technologies.

Section I - Departmental Overview

Raison d'être and Responsibilities

In vitro fertilization, which resulted in the birth of the first baby born from such assisted reproductive technology in 1978 has since enabled millions to build their families. Since that scientific breakthrough, various forms of reproductive technology have quickly evolved, some of which can pose health and safety risks to patients, donors, and children born of assisted human reproduction (AHR) and may challenge Canadians' values and ethical standards.

In 1993, the Royal Commission on New Reproductive Technologies, called on the Government of Canada to ban activities such as human cloning, payment for sperm or eggs and commercial surrogacy and to establish an Agency to provide a safe and ethical framework for AHR activities and related research in Canada. In 2006, Assisted Human Reproduction Canada (AHRC) was established under the Assisted Human Reproduction Act (AHR Act). 

Assisted Human Reproduction Canada is responsible for implementing and enforcing the AHR Act. Part of the Government of Canada Health Portfolio, it reports to Parliament through the Minister of Health. The Agency's objectives are to protect and promote the health, safety, dignity and rights of Canadians who use or are born of assisted human reproductive technologies. It fosters an environment in which ethical principles are applied in all matters related to AHR while promoting scientific advances that benefit Canadians. It also serves as a national centre of expertise on AHR and a focal point for information about reproductive technologies for policy makers, health professionals, patients and all Canadians. Furthermore, the Agency is a single, centralized, integrated pan-Canadian organization that keeps abreast of research and innovations in AHR thus promoting the healthiest and safest technologies for Canadians who will build their families using AHR.

As the 2010 Speech from the Throne noted, "regardless of profession or trade, of industry or region, Canadians have always striven toward a common objective - to make a home and nurture a family." Canadians who turn to AHR to achieve this objective can rely on AHRC to give them the accurate, unbiased information relating to assisted reproductive technologies in order to assist them in making informed choices; and they can take comfort that its facilitation of the uptake of best practices by clinics and professional associations across the country can play a critical role in protecting their health - and the health of the Canadian population.

On December 22, 2010 the Supreme Court of Canada (SCC) rendered its opinion regarding the constitutionality of certain sections of the AHR Act.  As a result, provisions that relate to the prohibitions under the Act - including the prohibition on sex selection, commercialization of an individual's reproductive capabilities and the requirement for the donor's consent to use their gametes or in vitro embryos remain constitutional. The Supreme Court's decision recognizes the need for, and enforcement of, the prohibitions, reinforces the importance of work with the AHR community in Canada to assist them with adhering to the principles and provisions of the AHR Act and the provision of information to all Canadians on issues relating to AHR and infertility.

It is important to note that the vast majority of the Agency's work to date to enhance public education and leverage higher professional standards is consistent with the SCC decision. For example, through knowledge sharing and moral suasion, the Agency catalyzed a concrete commitment from the two key professional bodies to decrease the rate of AHR-associated multiple births in Canada.  This commitment is public, comes with clear benchmarks and targets, and is sustainable with the ongoing secretariat support provided by AHRC.  Knowledge transfer is also key for patients and the general public; there are many misconceptions, for example, about the causes of infertility and about AHR-related health risks.

To gain further insight, AHRC-sponsored research under Statistics Canada’s most recent Canadian Community Health Survey revealed that the infertility rate in Canada has doubled (16% vs. 8%) over the past two decades. This finding underscores the pervasiveness of reproduction-related challenges confronting Canadians and the need for a centre of expertise to which they can obtain credible and evidence-based information on various aspects of reproductive technologies.

As the Government of Canada considers the SCC decision, AHRC continues to:

• Serve as a national Centre of Expertise on assisted human reproduction (AHR) operating as a single, centralized, integrated, pan-Canadian organization. AHRC will keep abreast of research and innovations in AHR, promote the safest and healthiest technologies for Canadians who will build their families using AHR and increase the application of knowledge for society leading to improved health outcomes;
  
  
• Promote compliance with and enforce the AHR Act related to the prohibitions;
  
  
• Monitor and evaluate scientific and clinical developments within Canada and internationally on AHR;
  
  
• Transfer knowledge to health professionals and provide educational materials to inform patients and the general public on aspects of AHR, particularly risk factors associated with infertility as well as AHR technology options;
  
  
• Liaise with other jurisdictions, professional bodies, patient groups and other associations with an interest in the quality, safety and ethical practices of AHR, to share and promote adoption of best practices across the country; and
  
  
• Engage stakeholders and monitor AHR issues related to health, safety, dignity and rights.
  
  
• Provide advice to the Minister of Health on matters relating to AHR.

These activities contribute to the Government of Canada’s whole-of-government framework commitment to "Healthy Canadians" by helping to maintain and improve Canadians' health.

Strategic Outcome and Program Activity Architecture (PAA)

In advancing this progressive mandate, the Agency is striving to achieve the following strategic outcome:

The chart bellow illustrates Assisted Human Reproduction Canada's complete framework of program activities, which roll up and contribute to progress toward the Agency's strategic outcome.

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PAA Crosswalk

AHRC sought, and received approval from Treasury Board, to amend its Program Activity Architecture (PAA) to ensure that a statutory part of the Agency's ongoing work related to Knowledge Transfer is included in the PAA. This facilitates transparency and reporting, thereby supporting accountability to Canadians. The guiding principles set out in the AHR Act are built into all of AHRC's strategic directions and action items related to assisted human reproduction. This reflects the importance of integrating ethical considerations into all aspects of the Agency's work, in keeping with the objective set out in Section 22 of the AHR Act "to foster the application of ethical principles."

Planning Summary

Since its inception, AHRC’s expenditures have been well below its annual parliamentary allocation of $10.5 million. While AHRC is authorized to spend $10.5 million, the Agency anticipates its expenditures will be less than $5 million for 2011-12.

The following table summarizes AHRC's total authorized spending for the next three fiscal years. Note that the Agency received no funding under Canada's Economic Action Plan.

The Agency has been authorized to staff 44 employees (FTEs). This table summarizes AHRC’s total authorized human resources for the next three fiscal years. The Agency anticipates to staff approximately 15 employees (FTEs) in 2011-12.

Note: The Treasury Board authorized spending for the Fiscal Year 2010-11 is $10.5 million, yet the Agency forecasts to spend approximately:

• Regulatory Compliance Program: $1.5 million
• Knowledge Transfer Program: $1.4 million
• Internal Services: $2.4 million
• Total: $5.3 million:

Contribution of Priorities to Strategic Outcome

Risk Analysis

In a field as complex and fast-changing as assisted human reproduction, AHRC inevitably faces both challenges and opportunities that can adversely or positively impact its ability to achieve the organization's strategic outcome. What remains constant is that the extraordinary rate of change in the field of assisted human reproduction poses health and safety risks to Canadians who use or are born of assisted human reproductive technologies.

It is essential that Canada keeps pace with these developments, continually scanning the horizon to identify the latest scientific developments and their health implications, developing credible, evidence-based health information and liaising with other jurisdictions engaged in these issues, domestically and internationally, to reduce the risks to Canadians' health and safety such that these technologies are used in a way that reflects the values and ethics of Canadians.

A number of external forces point to the need for continued vigilance in promoting compliance with the AHR Act. There has been a doubling of the infertility rate in Canada over the past two decades which is mirrored in the increasing demand for AHR options among Canadians. Growing numbers of AHR users are travelling to foreign destinations to access AHR services, which presents both health risks for patients and their offspring and health costs for Canadian society.

The rapid evolution in technological advances also presents ethical and social challenges for many Canadians, stressing the importance of integrating ethical considerations into AHR activities. Canadians want assurance that these technological innovations are consistent with their values. Achieving a balance that upholds Canadians' ethical standards and which promotes the rights and dignity of AHR users and offspring is paramount. 

An increased focus on knowledge transfer is all the more important in light of the recent ruling by the Supreme Court of Canada regarding federal areas of jurisdiction related to AHR. Other parties will need to address Canadians expectations for oversight in the field of AHR that falls outside of federal jurisdiction. As a national centre of expertise AHRC can offer support and share best practices to these interested parties.

As the Government of Canada considers the SCC decision, the Agency will continue to leverage the Science Advisory Panel's expertise and conduct environmental scanning as well as focus resources on short term projects to monitor science and the international environment. AHRC will fortify its international partnerships to enhance knowledge exchange and best practices through activities such as the Collaborative Discussion on Cross-Border Reproductive Care. It will also establish mechanisms and networks to provide guidance and facilitate best practices that promote the rights and dignity of those who use or are born of AHR technologies, as well as increasingly integrate ethical considerations, aligned with Canadians' values, into its science, compliance and outreach activities.

Upholding the AHR Act, AHRC will address the publics' expectations as AHRC manages its program activities and resources. The Agency will continue to liaise with stakeholders, including AHR professionals, to promote compliance with and enforce the AHR Act and to transfer knowledge on the latest developments in AHR. It will put a special emphasis on outreach activities aimed at patient groups to obtain feedback on the requirements for, and content of, public information material and provide educational materials to inform patients and the general public about the prohibitions, AHR technologies, and infertility risks.

As such, AHRC will serve as a national Centre of Expertise on assisted human reproduction (AHR) operating as a single, centralized, integrated, pan-Canadian organization. AHRC will keep abreast of research and innovations in AHR and promote the safest and healthiest technologies for Canadians who will build their families using AHR. This will increase the application of knowledge for society leading to improved health outcomes.

AHRC continues to manage its human resource needs in a flexible and responsive manner, while facing the same challenges as other small Agencies of attracting and retaining skilled and specialized staff. Monitoring on a quarterly basis of its Integrated Business, Human Resource Plan and Resource Strategy enables AHRC to respond to the evolving needs of the organization. Implementation of its Knowledge Management Strategy allows the Agency to retain corporate memory and knowledge as it undergoes transition. Diligent resource and operational planning will ensure the continued efficiency and effectiveness of the Agency.

In addition, AHRC is committed to continuing the judicious use of its funds by ensuring that its activities are carried out in a cost-effective manner through prudently utilizing resources within the health portfolio and monitoring value added in relation to expenditures.

AHRC developed an Interim Corporate Risk Management Plan to identify the risks and mitigate operational challenges. The Risk Management Plan is monitored and updated regularly to respond to changing circumstances.

Expenditure Profile

AHRC adheres to prudent fiscal management principles, and intends to spend less than its authorized $10.5 million for the 2011-12 Fiscal Year to achieve the expected results of its program activities in order to attain its strategic outcome. It is projected to spend approximately $5 million with a staff complement of approximately 15 FTEs.

The figure below illustrates the Agency’s authorized funding level from its inception in 2006-07 through to 2013-14. For the 2006-07 to 2009-10 period, the actual spending includes all Parliamentary appropriations.

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Estimates by Vote

For information on our organizational votes and/or statutory expenditures, please see the 2011-12 Main Estimates publication. An electronic version of the Main Estimates is available at http://www.tbs-sct.gc.ca/est-pre/20112012/me-bpd/toc-tdm-eng.asp

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