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Section II - Analysis of Program Activities
by Strategic Outcome

Strategic Outcome 1:

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Maintaining the accessibility and sustainability of Canada's health system is a shared responsibility, and Health Canada plays a significant role.  As a partner and leader in Canada's health system, we work closely with provincial and territorial governments, as well as health organizations and other stakeholder groups.  We continually examine new and innovative approaches and responses to the health priorities and needs of Canadians.

Serving as a partner, an enabler, an innovator, a knowledge broker and a proponent of transparency, we play a role in supporting the sustainability of Canada=s health system.  To Canadians, sustainability means the availability, maintenance and advancement of key attributes of Canada's public funded health system such as accessibility, efficiency and effectiveness.  In the face of perpetually shifting and growing health system demands, we develop policies in support of a sustainable health system for Canadians.

Program Activity: Canadian Health System

Financial Resources ($ millions)
2009-10	2010-11	2011-12
305.1	295.1	296.1

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
327	328	328

This program activity provides strategic policy advice on health care issues such as improved access, quality and integration of health care services to better meet the health needs of Canadians wherever they live or whatever their financial circumstances. The objective is pursued mindful of long-term equity, sustainability and affordability considerations. It is also pursued in close collaboration with provinces and territories, health professionals, administrators, other key stakeholders and citizens.

Improved access, quality and integration of health services administration is achieved through investments in the health system and in health system renewal. For instance, it is achieved by assisting provinces and territories to reduce wait times for essential services, working with provinces and territories to ensure the principles of the Canada Health Act are respected, developing health information and health measures for Canadians, meeting the health and health access needs of specific groups, such as women and official language minority communities, and by ensuring the implementation of agreements between federal/provincial/territorial ministers of health.

The program serves to identify key policy issues, trends and implications concerning pharmaceuticals, e.g., their use, cost and, accessibility.  It also contributes significantly to the advancement of federal/provincial/territorial policy priorities.

In addition to providing advice on research ethics issues, on potential impacts of new and emerging technologies on the health system and the health of Canadians, the program also monitors and reviews federal health legislation to ensure it responds to the evolving needs of Canadians with a goal to protect and improve their safety and health.

Expected Results of Program Activity:

Improved health care system planning and performance, including wait times reduction

Enhanced capacity of governments and stakeholders to support health system planning

Awareness and understanding among health sector decision-makers and the public of the factors affecting accessibility, quality and sustainability of Canada's health-care system and the health of Canadians

Performance Indicators:	Targets:
Reports and analyses related to issues such as wait times reduction, health human resources planning, and provision of chronic, palliative and continuing care are used to improve the health care system	Increased awareness and knowledge of new approaches, models and best practices related to health care renewal
Governmental and stakeholder engagement activities (e.g., meetings, workshops, conferences, program and policy proposals)	Increased collaboration and consultation between governments and stakeholders to advance key health care issues
Publication of information that raises awareness and understanding of the factors affecting accessibility, quality and sustainability of Canada's health-care system and the health of Canadians	Timely and accessible health research and information on priority health issues available to Canadians

Planning Highlights:Health Canada continues to support activities that promote appropriate planning and management of Health Human Resources to help ensure Canadians have access to the health providers they need.  Specific initiatives include development of a common national assessment for International Medical Graduates , which aims to harmonize the tools utilized across the country for the assessment of International Medical Graduates and bring a level of national consistency to this process.  Another initiative is focussed on a thorough review of undergraduate medical education in Canada based on current and future needs in order to promote excellence in patient care.  In addition, nine pilot projects aim to improve the retention and recruitment of nurses and the overall quality of the work life of nurses.  Each project is a collaboration of the provincial nurses’ unions, the provincial government and an employer who have committed both in-kind and financial support for the overall project.

Under the Official Languages Health Contribution Program we will increase the number of health professionals able to provide services in official language minority communities.

As announced in Budget 2009, an additional $500 million was committed to Canada Health Infoway to support the goal of having 50% of Canadians with an electronic health record by 2010.  In addition, this funding will be used to speed up the implementation of electronic medical record systems for physicians and integrated points of service for hospitals, pharmacies, community care facilities and patients.

Benefits for Canadians: Health Canada contributes towards the success of the health care system serving Canadians, particularly with respect to improving access, quality and integration of health care services.

Program Activity: Canadian Assisted Human Reproduction

Financial Resources ($ millions)
2009-10	2010-11	2011-12
1.5	1.5	1.5

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
8	8	8

This program activity implements the Assisted Human Reproduction Act, whose objective is to protect and promote human health, safety, dignity and human rights in the use of assisted human reproduction technologies. It develops policies and regulations in the area of assisted human reproduction. The science of assisted human reproduction evolves rapidly and, as a result, the program activity engages stakeholders on an ongoing basis to find a balance between the needs of patients who use these technologies to help them build their families, the children born from these technologies and the providers of these services with health and safety as the overriding factors.  The goal of the policies and regulations is to develop a responsive regulatory regime which is a leader both domestically and in the international assisted human reproduction community, and reflects the objectives put forward in the Assisted Human Reproduction Act. The program activity gathers input from stakeholders, including the provinces, to ensure a pan-Canadian approach.

Expected Results of Program Activity:

Increased input of Canadian stakeholders on assisted human reproduction technologies

Increased knowledge of the application of assisted human reproduction procedures in Canada

Increased number of assisted human reproduction regulations to protect the health and safety, dignity, and rights of Canadians using assisted human reproduction technologies

Health and safety risks related to assisted human reproduction technologies addressed

Performance Indicators:	Targets:
Stakeholder and advisory panel involvement and engagement	Increased stakeholder coordination and consultation on key assisted human reproduction issues to support and advance regulatory development
Monitoring, collection, and analysis of relevant and current information in assisted human reproduction practices leading to the development of evidence-based policy documents	Improved monitoring and awareness of assisted human reproduction practices leading to an increased number of evidence-based policy documents to support regulatory development
Reports and supporting documentation on relevant issues addressed through appropriate regulations and other instruments developed to enforce the Assisted Human Reproduction Act	Assisted Human Reproduction regulations and other instruments to protect the health, safety, dignity, and rights of Canadians using assisted human reproduction technologies and children born from the use of these technologies

Planning Highlights: Comprehensive regulations are well underway on such issues as: the conduct of controlled activities regarding the use of own gametes for own reproductive use, including Health Reporting Information; the reimbursement of expenditures; adverse event reporting and counselling services; and reimbursement of expenditures. Policy work is continuing on regulations governing third party use.

After considering the recent opinion of the Quebec Court of Appeal, the Government has brought an appeal before the Supreme Court of Canada regarding the constitutionality of certain provisions of the Assisted Human Reproduction Act.  Out of respect for the authority of the Supreme Court of Canada in matters of constitutional law, Health Canada will not pre-publish regulations until the question before the Court has been resolved.

Benefits for Canadians: Health Canada supports the Canadians utilizing the assisted human reproduction sector through development of policies to inform responsive regulatory frameworks and regulations as developed through ongoing stakeholder consultations.

Program Activity: International Health Affairs

Financial Resources ($ millions)
2009-10	2010-11	2011-12
23	22.9	22.9

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
30	30	30

Health Canada works internationally through leadership, partnerships and collaboration to fulfill its federal mandate of striving to make Canada's population among the healthiest in the world.  International Affairs serves as the Department’s focal point to initiate, coordinate, and monitor departmental policies, strategies, and activities that help promote Canadian priorities and values on the international health agenda.  Global health issues transcend borders and require concerted international efforts and actions. Strategic and effective partnerships with key health partners such as the World Health Organization and the Pan American Health Organization are critical to advance Canada’s international health priorities and to contribute towards preparing and responding to global health threats.

The international affairs program activity strives to share Canada's best policies and practices with other countries, and assists in obtaining relevant information and innovative practices through bilateral and multilateral engagement.

This program activity delivers strategic policy advice on international health issues to the Minister of Health, senior management and the Health Portfolio, including appropriate representation at international fora concerning the health portfolio.

Expected Results of Program Activity:

Increased knowledge and understanding of current and emerging international health issues;

Enhanced multilateral, bilateral, regional and intersectoral collaboration on current and emerging international health issues of priority to Canada;

Influence the international health agenda in a manner that supports Canada's health priorities, foreign policy and development objectives.

Performance Indicators:	Targets:
Strategic engagement with stakeholders and other governments (e.g. consultations and outreach activities with key stakeholders and international partners)	Increased awareness and knowledge of new approaches, models and best practices related to international health priority issues
Number of new collaborations with key stakeholders on current and emerging international health issues of priority to Canada	Increased strategic engagement in international meetings, conferences and fora; and an increased number of Canadian representatives on the boards or committees of key international health organizations
Number of multilateral, bilateral negotiations or agreements that Health Canada leads or supports in order to advance Canada's health priorities	An increase in the number of resolutions or policy positions introduced by Health Canada which reflect Canadian priorities, and policy objectives and an increase in the number of international agreements, treaties or memoranda of understanding which advance Canada's health priorities

Planning Highlights: Health Canada will focus on the following major activities during the 2009-10 fiscal year in order to increase our knowledge and understanding of current and emerging international health issues. These activities will enable Canada to influence international health agenda in a manner that supports our health priorities, foreign policy and development objectives.

• Health Canada will continue to foster collaboration and effectively engage with key international multilateral organizations such as the World Health Organization , the Pan American Health Organization , the Asia-Pacific Economic Cooperation , as well as the Global Health Security Initiative on a range of health issues.  These collaborations help to build strategic linkages with particular regions and to engage other members on health issues of interest and priority to Canada.  These collaborations also facilitate the exchange of information and best practices globally. 
• Health Canada will also further bilateral collaborations and forge new bilateral relationships with key countries and regions of interest and priority to Canada. The Department will continue to work with key partners such as the United States and European Union and will enhance relationships with emerging economies such as China and Brazil through the development of implementation of bilateral agreements and policy dialogues.
• To influence international health policies in a manner that supports Canada's health priorities, foreign policy and development objectives, Health Canada will continue to provide integrated and strategic policy advice in the development and implementation of coherent Canadian positions for key international negotiations (such as treaties, Memoranda of Understanding) and participation in international meetings and fora.  The Department will also continue participating in high-level international delegations, as well as coordinate visits to Canada by international delegations. This ensures a coherent policy agenda and supports an integrated approach to policy development across the Government of Canada.

Benefits for Canadians: Health Canada collaborates with international health partners to promote the priorities and values of Canadians and to promote and protect the health of Canadians.

Strategic Outcome 2:

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Under this strategic outcome, Health Canada is committed to promoting and protecting the health and safety of Canadians.  The Department achieves this outcome by working towards reducing health risks to Canadians from health products and food and providing information so Canadians can make informed decisions and healthy choices.

Activities under this strategic outcome include the evaluation and monitoring of the safety, quality, and effectiveness of thousands of drugs, vaccines, medical devices, natural health products and other therapeutic products available to Canadians. It also includes the evaluation and monitoring of the safety and nutritional quality of food. Other activities include evaluating and monitoring the safety, quality and efficacy of veterinary drugs administered to food-producing and companion animals, as well as promoting their prudent use and setting standards for such use. Lastly, the Department also undertakes activities related to the promotion of health and well-being of Canadians by developing nutritional policies and standards such as Canada's Food Guide and by providing information to the public in newsletters such as It's Your Health.

In 2009-10, under this strategic outcome, there will be a particular focus on a key departmental and Government of Canada initiative, implementing the five-year Food and Consumer Safety Action Plan.  This horizontal initiative is aimed at modernizing and strengthening Canada’s safety system for food, health and consumer products in response to recent high-profile incidents involving a range of health products and food (e.g., the global withdrawal of Vioxx).

Program Activity: Health Products

Financial Resources ($ millions)
2009-10	2010-11	2011-12
146.4	146.5	145.7

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
1,778	1,802	1,827

It is under the Health Products Program Activity that a broad range of health protection and promotion initiatives affecting the everyday lives of Canadians are undertaken. As the federal authority responsible for the regulation of health products, Health Canada evaluates and monitors the safety, quality and efficacy of drugs (human and animal), biologics, medical devices, and natural health products, based on authorities provided by the Food and Drugs Act and Regulations, as well as the Department of Health Act.

Under this program activity, the Department also provides timely, evidence-based and authoritative information to key stakeholders, including-but not limited to-health care professionals such as physicians, pharmacists and practitioners (e.g., herbalists, naturopathic doctors, Traditional Chinese Medicine practitioners) and members of the public, to enable them to make informed decisions and healthy choices.

Expected Results of Program Activity:

By 2013, implementation of the five-year Food and Consumer Safety Action Plan

Reduced exposure to Health Risks related to Health Products

Increased ability to monitor and identify safety concerns before they arise

Increased industry awareness and knowledge of regulatory requirements

Safer use of health products by consumers and health professionals

Increase the safety, quality and efficacy of health products imported into and/or manufactured in Canada

Increased knowledge of post-market drug safety and effectiveness to inform decisions

Reduction in prohibited and unapproved health products entering Canada

Enhanced capacity of Health Canada and industry to identify and respond to risk issues

Active Prevention

Performance Indicators:	Targets:
Number of reports on pharmacovigilance plans received	By 2013, increasing trend in reported pharmacovigilance plans
Number of Risk Management and Mitigation Plans received	By 2013, increasing trend in reported Risk Management and Mitigation Plans
Number of pre-submission meetings held per year	In 2007, 56 pre-submission meetings with industry were held for biologic and radiopharmaceutical drugs and approximately 65 pre-submission meetings in 2008. We anticipate an equal amount or an increase in pre-submission meetings for biologics and radiopharmaceuticals in 2009-10. In 2007, 132 pre-submission meetings with industry were held for pharmaceutical drugs and approximately 94 pre-submission meetings in 2008. We anticipate an equal amount or an increase in pre-submission meetings for pharmaceuticals drugs for 2009-10.
Number of Product Monographs made available to the public	In 2009-10, we anticipate to have reached an estimated posting of 2000 Product Monographs on the Health Canada website

Targeted Oversight

Performance Indicators:	Targets:
Percentage of Active Pharmaceuticals Ingredients firms inspected that are compliant with Good Manufacturing Practices	By 2013, we anticipate an increase in number of Active Pharmaceuticals Ingredients firms inspected that are compliant with Good Manufacturing Practices
Number of firms inspected that are compliant with Good Manufacturing Practices requirements for Active Pharmaceutical Ingredients	By 2013, we anticipate an increase in the number of firms inspected that are compliant with Good Manufacturing Practices for Active Pharmaceutical Ingredients
Number of Centres/Partners participating in the Drug Safety and Effectiveness Network	Drug Safety and Effectiveness Network coordinating infrastructure to be established in 2009-2010 Ten centres/partners participating in Drug Safety and Effectiveness Network by 2011-2012
Number of consumers aware of risks associated with health products imported for personal use	By 2013, increased number of consumers that are aware of risks associated with the importation of non-compliant health products
Number of import alerts resulting in detecting/stopping non-compliant health products at the border	By 2013, we anticipate an increased number of import alerts that will help stop non-compliant health products at the border and prevent high risk health products from entering the Canadian marketplace
Percentage of hospitals compliant with mandatory adverse reaction reporting	By 2013, increasing trend in reported adverse reactions from hospitals
Number of Periodic Safety Update Reports received	By 2013, increasing trend in reported Periodic Safety Update Reports

Planning Highlights: Health Canada is committed to promoting the health and safety of Canadians by helping ensure safe and effective health products in the Canadian marketplace. To improve results under this program activity and enhance health product safety for Canadians, the Food and Consumer Safety Action Planwas launched in 2008. In its role as federal regulator, Health Canada reviews clinical trial applications for health products to help ensure the studies are properly designed and that participants will not be exposed to undue risk; reviews scientific information to evaluate the safety, efficacy and quality of health products, reviews information that the manufacturer intends to provide to health care practitioners and consumers about health products; provides Canadians with science-based information they need to make informed choices; and monitors and reviews health product safety and effectiveness information as it becomes available to ensure the benefit/risk balance remains acceptable. These activities contribute to the three pillars of the Action Plan, namely active prevention, targeted oversight and rapid response.

A key component of the Action Plan is the proposed modernization of the Food and Drugs Act, which is 50 years old. Specifically, modernization would include a comprehensive and proactive approach that focuses on the lifecycle of a product; addressing safety gaps regarding the manufacture, sale, and importation of counterfeit and unsanitary health products; addressing issues such as misrepresentative health claims, labelling, adulteration of ingredients, and the emergence of new safety information; and providing greater authority to protect Canadians' health.

Further, as part of the Action Plan, the Department will push ahead on three distinct tracks:

Active Prevention:Health Canada will initiate regulatory change to include regulatory oversight of the manufacturing of active pharmaceutical ingredients to improve the safety, quality and efficacy of health products.  To increase awareness and compliance with regulatory requirements, it will enhance the capacity to engage in pre-submission meetings with industry, including the ability to better document, track, monitor and evaluate the exchange of information (these meetings provide an opportunity for the drug submission sponsor to obtain feedback regarding areas of concern prior to filing a submission).  Also, as part of the lifecycle approach, Health Canada will work to increase the development and review of pharmacovigilance plans and risk-mitigation management plans to generate better and new information concerning health products during the pre- or post-market phases.  The pharmacovigilance plan is a plan requested by Health Canada from the manufacturer to allow for the lifecycle product monitoring once on the market. A Risk and Mitigation Plan for a product will provide additional specific assurance the manufacturer has measures in place to react and act quickly if new information concerning the product emerges once on the market.

Targeted Oversight: Health Canada's ability to make and support admissibility decisions at the border as they relate to health products will be strengthened through the establishment of a national border integrity program. This program will include, among other initiatives: a national standardized process for the handling of health products at the border; establishment of service standards between Canada Border Services Agency and Health Canada; and, undertaking public education activities to inform Canadians of risks associated with the importation of non-compliant health products. In addition, Health Canada will enhance the program to re-evaluate the overall safety of health products in a systematic manner at pre-established post-authorization times through the review of documents summarizing the worldwide safety experience of a health product. The Department will continue to work with its partners to enhance reporting of adverse drug reactions through the Hospital-Based Mandatory Reporting project for Adverse Drug Reactions. With the proposed amendments to the Food and Drugs Act, Health Canada will have the authority to request the reports from Hospitals. In the absence of these legislative authorities, Health Canada will continue requesting the reports from the hospitals on a voluntary basis.

Canada is partnering with the Canadian Institutes of Health Research to establish the Drug Safety and Effectiveness Network. The Network will enhance national research capacity to produce post-market evidence on the safety and effectiveness of drugs to inform pharmaceutical decision-making across the health care system.

Rapid Response: Health Canada, through modernized legislation, for the first time, would have the authority to recall a health product. In addition, it would be equipped to compel the communication of safety risks to Canadians.

Benefits for Canadians: This program activity will contribute to protecting Canadians from undue risks associated with health products by minimizing factors that pose health risks to Canadians while maximizing the safety provided by a strong regulatory system. It also provides information to Canadians so that they can make informed decisions about their health.

Program Activity: Food and Nutrition

Financial Resources ($ millions)
2009-10	2010-11	2011-12
60.9	62.9	63.1

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
573	585	589

The Food and Nutrition program activity establishes policies, regulations and standards related to the safety and nutritional quality of food.  Food safety and nutritional quality standards are enforced by the Canadian Food Inspection Agency. The legislative framework for food is found in the Food and Drugs Act and Regulations, the Canadian Food Inspection Agency Act and the Department of Health Act.

This program activity also promotes the nutritional health and well-being of Canadians by collaboratively defining, promoting and implementing evidence-based nutrition policies and standards.  As a focal point and authoritative source for nutrition and healthy eating policy and promotion, the program activity disseminates timely information to Canadians and stakeholders, enabling them to make informed decisions and healthy choices.

Expected Results of Program Activity:

Reduced exposure to Health Risks related to Food and Nutrition

Increased level of informed choices/healthy decisions related to food and nutrition

Establishment of regulatory and non-regulatory measures to address immediate areas of concern

Performance Indicator:	Targets:
Level of Stakeholder and Public Awareness	Health Canada anticipates over 2,000,000 requests for the 2007-08 Canada’s Food Guide, over 1,000,000 visits to the Food Guide website and over 500,000 website users creating personalized PDF files using the My Food Guide Online tool Efforts to increase consumer awareness of the Nutrition Label will continue and in 2009-10, Health Canada anticipates over 5,500 visitors using the Interactive Nutrition Labelling Quiz Health Canada will continue to strengthen capacity building by interpreting and sharing results from the Canadian Community Health Survey 2.2, Nutrition Focus In 2009/2010, Health Canada plans to release products based on the Canadian Community Health Survey data (e.g., Eating Habits of Aboriginal Peoples off reserve – children and adults) and will also submit for publication articles on the nutrient intakes of children, teens, young and older adults as well as pregnant women
Number of regulatory amendments, policies and guidelines developed (as part of the Active Prevention pillar of the Food and Consumer Safety Action Plan)	Health Canada will develop and publish: Regulatory Amendments: ­ Enhanced Labelling for Food Allergens and Gluten Sources and Added Sulphites - Canada Gazette Part II; ­ Addition of Vitamins and Mineral Nutrients to Food (Food Fortification) - Canada Gazette Part I; ­ Amendments to Food Additive Tables - Canada Gazette Part I and/ or Canada Gazette Part II Policies: ­ Policy on E. coli O157:H7 and O157:NM Contamination of Raw Ground Beef and its Precursor Materials; ­ Update to Policy on Listeria monocytogenes in Ready-to-Eat Foods; ­ Allergens update policy for precautionary statement; ­ Policy on Health-Related Claims about "Probiotic" Microorganisms in Foods Guidelines: ­ Guideline on Plant and Mushroom Products Packed in Oil; ­ Updated criteria for E. sakazakii in powdered infant formula; ­ Guidance Document for Preparing a Submission for the Authorization of Food Health Claims; ­ Guidance Document -- Classification of Products at the Food -- Natural Health Product Interface
Number of educational tools developed (as part of the Active Prevention pillar of the Food and Consumer Safety Action Plan)	Health Canada will also develop and disseminate: education tools: Risk communication material on the microbial safety of fresh produce; Guidance on the preparation of powdered infant formula in the home and hospital/care settings
Proportion of Health Risk Assessments for acute health risks communicated to stakeholders within service standards (as part of the Rapid Response pillar of the Food and Consumer Safety Action Plan)	90% within 24-48 hours
Proportion of Health Risk Assessments related to health risks of lesser severity communicated to stakeholders within service standards (as part of the Rapid Response pillar of the Food and Consumer Safety Action Plan)	90% within 5-10 days

Results under this program activity will also be improved through continuing efforts in the context of the Food and Consumer Safety Action Plan. More specifically, under the Active Prevention pillar of the Action Plan, Health Canada will strengthen standard setting and regulations. It will focus on gaps and emerging areas of safety concern around allergens, natural toxins, emerging food borne pathogens, and bioactives in food. The Department will publish the final regulatory amendments on food allergen labelling in Canada Gazette II, and will update its current policy on Listeria monocytogenes in Ready-to-Eat Foods as well as publish its revised guidelines for E-coli 0157 on raw ground beef products. In addition, it will continue to lead the way toward better understanding of food safety risks, including those associated with exposure to melamine in the food supply in support of Health Canada's risk assessment and standard setting activities.

Under the Rapid Response pillar of the Food and Consumer Safety Action Plan, the Department will improve targeted risk communication and focus on an education campaign for the safety of priority foods (e.g., produce, foods containing natural toxins).

This program activity will contribute to the protection of Canadians from unsafe foods and will foster conditions enabling Canadians to make informed decisions about their health.

Strategic Outcome 3:

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Health Canada is responsible for assessing and acting on many elements of day-to-day living that have impacts on the health of Canadians. These include drinking water safety, air quality, radiation exposure, substance use and abuse (including alcohol), consumer product safety, tobacco and second-hand smoke, workplace health, and chemicals in the workplace and in the environment. We are also engaged in chemical and nuclear emergency preparedness; inspection of food and potable water for the travelling public; and health contingency planning for visiting dignitaries.

Much of this work is governed through legislation including the Canadian Environmental Protection Act, 1999, the Controlled Drugs and Substances Act, the Hazardous Products Act, the Tobacco Act, the Food and Drugs Act, the Radiation Emitting Devices Act, the Quarantine Act, the Pest Control Products Act and others.

Departmental efforts on sustainable development will include continued implementation of the Department's Sustainable Development Strategy IV and the development of new departmental policy and procedures for the Cabinet Directive on Strategic Environmental Assessment of Policy, Plan and Program Proposals.

Program Activity: Sustainable Environmental Health

Financial Resources ($ millions)			Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12	2009-10	2010-11	2011-12
153.3	146.8	122.2	810	794	689

The environment is a key determinant of the health of Canadians. Health Canada will promote and protect the health of Canadians by identifying, assessing and managing health risks posed by environmental factors in living, working and recreational environments. The scope of activities includes: research and collaboration on drinking water quality, air quality, contaminated sites, toxicology and climate change; clean air programming and regulatory activities; risk assessment and management of: chemical substances, microbiological contaminants, environmental noise, environmental electromagnetic frequencies, products of biotechnology and products of other new and emerging technologies (including nanotechnology); solar ultraviolet radiation; preparedness for nuclear and environmental disasters as well as working with the passenger conveyance industry to protect the travelling public.

The Chemicals Management Plan is managed jointly by Health Canada and Environment Canada.  Under the Chemicals Management Plan , activities taken to regulate chemicals are being taken in an integrated fashion across Canada.  Activities associated with the Plan include: the implementation of a national monitoring system; the development of risk management performance agreements with industry sectors; and the strengthening of the assessment and management of environmental health risks, including those posed by pharmaceuticals, consumer products, personal care products, cosmetics, and food.  Enhanced communications and outreach activities will allow Canadians to make better informed decisions about limiting their exposure to potential hazards.

Expected Results of Program Activity:

Timely regulatory system response to new and emerging health risks related to chemicals or substances that are harmful to human health or the environment, and environmental risks to health.

New and emerging health risks related to chemicals or substances that are harmful to human health or the environment are identified, assessed and managed.

Canadians are knowledgeable, understand and involved in environmental health issues.

Performance Indicators:	Targets:
Proportion of regulatory activities addressed within service standards/target	To be set after baseline is established in 2011
Time period within which serious health risks are brought into a risk management regime
Percentage of the target population aware of environmental health issues

Planning Highlights: Approximately 200 substances were identified as high-priority in 2006 under Canada's world-leading categorization of legacy chemicals.  The assessment of these high-priority substances will continue to be announced every three months in batches of 15 to 30, which will undergo risk assessment and risk management action as warranted. Assessment of new substances will also continue.

In cooperation with Environment Canada, opportunities to strengthen the Canadian Environmental Protection Act, 1999 will be examined, including any follow up to recommendations made by the House and Senate committees in 2007 and 2008 and integrating the In-commerce List of Food and Drug Act Substances.

Benefits for Canadians: The environment has an important impact on human health. Working in concert with Environment Canada, Health Canada works to protect the health of Canadians from environmental risks. The Chemical Management Plan is designed to protect the health and environment of Canadians by assessing and managing the risks associated with chemical substances.

Program Activity: Consumer Products

Financial Resources ($ millions)
2009-10	2010-11	2011-12
25.6	34	35

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
213	265	279

Health Canada identifies, assesses, manages and communicates to Canadians the health and safety risks associated with consumer products, cosmetics and radiation emitting devices. This is achieved through research, risk assessments and the development of risk management strategies to minimize the exposure of Canadians to potentially hazardous products. Also included are regulatory monitoring and compliance activities as well as information, education and guidance aimed at both industry and the public. Relevant acts include: consumer products (Hazardous Products Act), cosmetics (Food and Drugs Act) and radiation emitting devices (Radiation Emitting Devices Act).

In accordance with the Government of Canada’s commitment to Strengthen and Modernize Canada’s system for health, consumer and food products to protect the health of Canadians, Health Canada worked with other key federal departments to develop Canada's new Food and Consumer Safety Action Plan.  The Action Plan proposes new legislation that will enable the government to respond faster to protect the public when a problem occurs.  The proposed legislation will emphasize industry's responsibilities for the safety of the consumer products they put into the marketplace, and provide stronger and more flexible regulatory backstops such as mandatory reporting of injuries, illnesses and defects, and mandatory product recalls.  Health Canada will also work with key trading partners (and other countries) to strengthen cooperation and dialogue on issues related to consumer products (including cosmetics) and radiation emitting devices.

Expected Results of Program Activity:

Increase effective use of standards by industry and improved compliance with product safety obligations

Better informed consumers properly selecting and safely using products

Responsive and proactive, risk-based product safety regulatory framework

Performance Indicators:	Targets:
Percentage of inspected registrants/firms/users who are compliant/ non-compliant with product safety obligations	By 2013, decreasing trend in reported product safety adverse health incidents.  (Baseline to be established by 2010)
Number of incidents reported of improper/unsafe use of consumer products	By 2013, decreasing trend in number of reported incidents incidents (Baseline to be established by 2010)
Percentage of product safety issues addressed by the new Canada Consumer Product Safety Act and its regulations (has not yet been re-tabled in parliament)	By 2013, target is 100% of issues addressed

Planning Highlights: The centrepiece of the Action Plan on consumer products is the proposed new Canada Consumer Product Safety Act, which will provide new and modern authorities, including a new ‘general prohibition’ provision that will allow Health Canada to take action with respect to any consumer product in Canada that poses a danger to the health or safety of the public. The Canada Consumer Product Safety Act will also include new authorities to require suppliers to keep records to facilitate tracing their products to their sources and to order product recall if necessary.

The Action Plan also includes activities to support implementation of amendments planned over the next 18-24 months to the Cosmetic Regulations of the Food and Drug Act to clarify and strengthen their contribution to consumer product health and safety.

Benefits for Canadians: The federal government is responsible for promoting the health and safety of Canadians. A key part of this role is ensuring that the consumer products used by Canadians are safe for their health. The Food and Consumer Safety Action Plan will bolster Canada's regulatory system by amending or replacing outdated health and safety legislation with new legislative regimes that respond to modern realities, and by enhancing safety programs in areas where modern legislative tools already exist. The Action Plan will modernize Canada's regulatory system to enable it to better protect Canadians from unsafe consumer products in the face of current realities and future pressures.

Program Activity: Workplace Health

Financial Resources ($ millions)
2009-10	2010-11	2011-12
23	21.4	21.3

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
340	340	340

This program activity provides services to support the occupational health of the federal public servants. As a secondary activity, it also provides health contingency planning for Internationally Protected Persons and their family members (e.g., visiting dignitaries, members of the Royal family) and others when they are visiting Canada.

In addition, there are also other programs listed in this Program Activity, namely dosimetry services (the measurement of personal, occupational exposure to radiation); and Workplace Hazardous Materials Information System, a national hazard communication standard including worker education, inspector training and standards for cautionary labels.

Expected Results of Program Activity:

Timely system response to public service employees with psycho-social health problems

Internationally Protected Persons are protected during regular visits, major events and PM-led events from risks to their health

Support to departments which enables adherence to Acts, regulations and guidelines

Timely response to critical incidents involving public service employees

Performance Indicators:	Targets:
Percentage of public service employee clients' psycho-social problems dealt with within service standards	70% (represents the current Industry standard)
Percentage of visits/events without serious health related incidents for Internationally Protected Persons or for Canadian Public Servants	100%

Planning Highlights: Health Canada will continue to assess the environmental conditions of federal workplaces impacted by natural or man-made events. These assessments will determine if the workplace is safe for reoccupation and resumption of operations following a critical incident.

In the coming year, Health Canada will provide emergency preparedness and response capacity for the Vancouver Winter Olympics in 2010 thus contributing to the success of this event.

Benefits for Canadians: This activity supports the government of Canada's objective of Healthy Canadians by ensuring Canada has a well-functioning and healthy public service which, in turn, provides timely and adequate services to Canadians. It also contributes to the objective by working with partners to prevent the potential spread of diseases that could be carried by foreign dignitaries during their visits to Canada.

Program Activity: Substance use and abuse

Financial Resources ($ millions)
2009-10	2010-11	2011-12
138.7	137.9	137.7

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
460	465	465

Through regulatory, programming and educational activities, Health Canada seeks to improve health outcomes by reducing and preventing tobacco consumption and combating alcohol and drug abuse.

Through the Tobacco Act, Health Canada regulates the manufacture, access, labelling, and promotion of tobacco. Health Canada is also the lead for the Federal Tobacco Control Strategy, the objectives of which are to: reduce the prevalence of Canadian youth who smoke; to increase the number of adult Canadians who quit smoking; to reduce the prevalence of Canadians exposed to daily second hand smoke; to examine the next generation of tobacco control policy in Canada; to contribute to the global implementation of tobacco control; and to monitor and assess contraband tobacco activities.

Through the Controlled Drugs and Substances Act and its regulations Health Canada regulates the possession, production, and importing and exporting of controlled substances and precursor chemicals. In addition, Health Canada administers the licensing and authorizations processes to enable stakeholders, such as industry and research institutes, to conduct activities with these substances. Health Canada is a partner in the government's anti-drug strategy which includes: prevention programming aimed at youth; facilitating access to treatment programs; compliance and enforcement activities related to controlled substances and precursor chemicals; and, increased resources for drug analyses services commensurate with the increase in law enforcement resources.

Expected Results of Program Activity:

The overall goal of the Tobacco Control Strategy is to reduce overall smoking prevalence from 19% (2006) to 12% by 2011

Reduced use and abuse of drugs

Continued provision of high-quality evidence for law enforcement

Increased compliance with legislation and regulations

Increased awareness and understanding of illicit drugs and harmful health and social effects associated with illicit drug use

Strengthened evidence-informed substance abuse treatment systems and services

Performance Indicators:	Targets:
Smoking prevalence rate in % of the Canadian Population.	12% (Canadian Tobacco Use Monitoring Survey)
Prevalence rates of drug use and abuse	To be set after baseline is established in 2010
Number/nature of injuries and/or environmental risk caused by unsafe handling of chemicals noted by Drug Analysis Service personnel;
Rates of compliance with policies and regulations
Level of awareness about harmful health and social effects associated with illicit drug use
Extent to which the Drug Treatment Funding Program has contributed to and strengthened, evidence-informed substance abuse treatment systems and services

Planning Highlights: The program activity seeks to reduce the prevalence of substance use and abuse and to reduce the health and safety risks associated with tobacco consumption and controlled substance use through the authority of the Tobacco Act, the Controlled Drugs and Substances Act, the Federal Tobacco Control Strategy, and the National Anti-Drug Strategy.

• The program activity supports the departmental strategic outcomes through regulatory, research and policy leadership, programming, and educational activities. This work results in increased awareness and compliance with relevant legislation and regulations for tobacco and controlled substances and precursor chemicals.
• Expected results are high-level, long-term results that will not be achieved on a yearly basis. Annual reporting will lead up to the longer-term results. Performance Measurement and Evaluation Strategy will be developed to outline the process and timelines for establishing appropriate targets and measuring results.

Benefits for Canadians:The Government of Canada has a long standing commitment to reducing the serious and adverse health effects presented by the use and consumption of tobacco products and controlled substances. This approach continues to contribute to safer and healthier communities and Canadians.

Program Activity: Pesticide Control

Financial Resources ($ millions)
2009-10	2010-11	2011-12
45.1	47.0	47.1

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
577	588	588

To help prevent unacceptable risk to people and the environment, and facilitate access to sustainable pest management tools, Health Canada, through the Pest Management Regulatory Agency , regulates the importation, sale and use of pesticides under the federal authority of the Pest Control Products Act and Regulations.

Protecting human health and the environment is a key priority for Health Canada and scientific assessment of risk is the foundation for Health Canada’s activities related to the Pest Control Products Act and its regulations.

Health Canada through the Pest Management Regulatory Agency conducts pre-market assessments of risks to human health and the environment from potential exposure to proposed uses of chemical and biological pesticide products.  An assessment of data which demonstrates the value of the product for the proposed use is also conducted prior to making a regulatory decision.

The evaluation of new products ensures that Canadians have timely access to new pesticide products and new uses of pesticide products which do not present unacceptable risk to human health and to the environment and which can demonstrate value.

The re-evaluation of older products ensures that only those older pesticides that meet modern standards remain registered.  The Pest Control Products Act requires older pesticides to be re-evaluated on a 15-year cycle to reduce risks to human health and the environment.

Expected Results of Program Activity:

Canadians have timely access to new pesticides/pesticide uses that meet standards of value, acceptable human health and environmental risk;

Only those older pesticides that meet modern standards remain registered;

Registrants, vendors and users comply with the Pest Control Products Act and its regulations; and

Canadians have access to and are using reduced risk and low risk products and risk reduction strategies.

Performance Indicators:	Targets:
Pre-market reviews and regulatory decisions on new pesticide products and new uses of pesticide products completed within performance timelines that meet international standards	90% of reviews completed within performance timeline targets
Re-evaluation assessments completed within commitments under the Chemicals Management Action Plan	90% of older registered pest control products have undergone a full review in the last 15 years
Delivery of the National Pesticides Compliance Program including associated investigations / enforcement responses	80% of compliance programs and enforcement activities delivered and reported according to timelines
Development of new transition strategies to use of lower risk pesticides.	Increased availability of reduced risk and low risk pesticide products
Number of user groups engaged in risk reduction strategies	Increased engagement of stakeholder groups in the development of new transition strategies

Planning highlights: Health Canada will work closely with international partners to exchange and compare evaluation and risk assessment processes and to encourage adoption of science innovations through direct cooperation with other jurisdictions. International joint reviews and work sharing of proposed new pesticide products will facilitate Health Canada making regulatory decisions on new active ingredients in the same time frame as decisions in other jurisdictions.

The Pesticide Regulation Program will collaborate with other programs in Health Canada, Health Portfolio members and Environment Canada to achieve re-evaluation targets established through the Government of Canada's Chemicals Management Plan. Health Canada will re-evaluate older pesticides currently available on the market to determine if their continued use is acceptable in consideration of modern scientific approaches and standards

Health Canada will add programs and activities aimed at actively preventing safety issues by working with consumer product manufacturers to ensure systems are in place to assure product integrity, and target situations considered to represent higher risk such as vendors of pesticides who may not be fully informed of regulatory requirements. Health Canada will respond rapidly where action is required through investigation and appropriate enforcement responses.

To provide Canadians with access to, and information on, reduced risk and low risk products, Health Canada will work with Agriculture and Agri-Food Canada to develop and implement policies to support sustainable pest management.

Benefits to Canadians: This program activity will contribute to reducing health and environmental risks from pesticides by ensuring that only those pesticide products that meet standards of value and acceptable human health and environment risks are allowed on the market. It also provides information to Canadians so that they can make informed decisions about pesticide use.

Strategic Outcome 4:

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Health Canada delivers a range of health services to First Nations and Inuit.  A range of primary care services are provided in approximately 200 First Nations communities, largely in rural or remote areas where access to provincial health care services is limited.  In addition, home and community care services are provided in approximately 600 First Nations communities.  Health Canada supports a range of community-based health programs, focusing on children and youth, mental health and addictions, and chronic disease and injury prevention. The Department also delivers a range of public health programs with a focus on communicable disease control, including tuberculosis, HIV/AIDS and vaccine-preventable diseases, and environmental health and research.  The Non-Insured Health Benefits Program provides approximately 800,000 eligible First Nations and Inuit with a limited range of medically necessary health-related goods and services not provided through private insurance plans, provincial/territorial health or social programs or other publicly funded programs.

Program Activity: First Nations and Inuit Health

Financial Resources ($ millions)
2009-10	2010-11	2011-12
2, 361.3	2,222.4	1,970.5

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
2, 124	1, 940	1,866

The objective of First Nations and Inuit health program activity is to improve health outcomes, by ensuring the availability of, and access to, quality health services, and by supporting greater control of the health system by First Nations and Inuit.

Through a number of ongoing and new initiatives Health Canada will foster:

• First Nations and Inuit Community Programs
• First Nations and Inuit Health Protection and Public Health
• First Nations and Inuit Primary Care
• Non-Insured Health Benefits (Supplementary) for First Nations and Inuit
• Governance and Infrastructure Support to First Nations and Inuit Health System

Expected Results of Program Activity:

Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Performance Indicators: Life expectancy (at birth, on and off reserve) • Birth weight • Mortality • Diabetes Rates • Suicide Rates

Incidents of Tuberculosis • Non-Insured Health Benefit (NIHB) Client utilization rates • Non-Insured Health Benefit Client Safety Improvements

Planning Highlights: To achieve the expected result, Health Canada plans to undertake the following activities:

• Aided by additional investments of $305 million recently announced by the Government, the Department will continue to work with the provinces and First Nations organizations to strengthen current programs, improve health outcomes for First Nations and Inuit individuals, and move toward greater integration with provincial and territorial health systems. Through the Aboriginal Health Transition Fund, the Department will support the integration of federally and provincially funded health services and the adaptation of provincial and territorial health programs to meet the unique needs of all Aboriginal peoples.
• Health Canada will also work to implement another key commitment announced by the Government in Budget 2009: $135 million for the construction and renovation of health services infrastructure benefitting First Nations, including health clinics and nurses’ residences. More than 40 new projects and approximately 230 remediation projects will be completed over the next two years.
• Health Canada will work to improve Mental Health and Addictions programming through pilot testing of four to five mental wellness teams in partnership with the Mental Health Commission of Canada and Provinces and Territories. It will also continue efforts to modernize addictions services by increasing access, quality, and effectiveness through regional needs assessments and research guided by an expert panel, accreditation and certification activities. Progress of these activities will be measured by tracking the number of mental wellness teams implemented, status of the regional needs assessments, progress of research around effective addictions services, number of new treatment centre accreditations, and the percentage of addictions workers certified or in the certification process. Key targets for 2009-10 include completion of regional needs assessments, 70% of workers certified or in the certification process, and the accreditation of three new treatment centres.
• The Department will build the evidence base towards the renewal of the Aboriginal Diabetes Initiative, the Maternal and Child Health Program, the National Aboriginal Youth Suicide Prevention Strategy, and the Labrador Innu Comprehensive Healing Strategy. Progress towards this activity will be measured primarily through progress of evaluations of program relevance and effectiveness, performance reports and special studies centering on Mental Health and Addictions, Children and Youth, and Chronic Disease and Injury Prevention programming. Key targets for 2009-10 include the completion of a Children's program cluster evaluation and the initiation of work to evaluate mental health and addictions and chronic disease and injury prevention programming.
• Health Canada will continue to assist communities to build capacity to monitor all distribution systems with five or more connections, cisterns and community wells as per the Guidelines for Canadian Drinking Water Quality. It will continue to enhance the Quality Assurance/Quality Control national monitoring program and the review process for water and wastewater project proposals from a public health perspective, and lead the development and implementation of a National Wastewater Program. It will develop public awareness materials, tools and procedures to address waterborne illness threats on-reserve and a recruitment and retention strategy for Environmental Health Officers and Community-based Drinking Water Monitors. In 2009-10, Health Canada aims to increase by the number of distribution systems with five or more connections that meet the monitoring requirements as per the Guidelines for Canadian Drinking Water Quality.
• Health Canada will support Indian and Northern Affairs Canada in the consultation process with First Nation communities, regional First Nation organizations and provincial/territorial governments on the creation of a federal legislative framework for drinking water and wastewater on reserve. For 2009-10, Health Canada will work towards completing a successful engagement process for the proposed legislative framework.
• Work on the Aboriginal Health Human Resources Initiative/Health Careers will continue in 2009-10 to implement health human resources strategies that responds to the unique needs and diversity among Aboriginal peoples, increase the number of Aboriginal students in health career studies, retain health workers in Aboriginal communities and produce health care workers who are better able to respond to the needs of Aboriginal people and provide health care services in a more culturally competent manner. In 2009-10 it is expected that at least 350 students will receive health careers bursaries and scholarships, 73 post-secondary educational institutions will have Aboriginal health student support programs and the mid-term program review will be completed.

Benefit for Canadians: Health Canada contributes to better health outcomes by delivering a range of programs and services to address the health needs of First Nations and Inuit. Through a range of primary care services, community-based health programs, public health programs and Non-Insured Health Benefits, the Department contributes to reducing gaps in health status between First Nations and Inuit and other Canadians.

Additional information on various FNIHB programs is available on page 36, Section III.

Program Activity: Internal Services

Financial Resources ($ millions)
2009-10	2010-11	2011-12
303.1	292.6	291.4

Human Resources (Full-time Equivalents)
2009-10	2010-11	2011-12
2,674	2,616	2.598

Program Activity Summary & Planning Highlights:

Corporate Services is engaged throughout Health Canada as a service provider, enabler and custodian to support Departmental activities and initiatives and to ensure the best value for Canadians. Key areas of work include an integrated planning process, utilizing risk-based strategies and result-based tools taking into account the Management Accountability Framework, in the areas of human resources, finances, real property, security and information management and technology.  The Strategic Policy Branch also provides a number of internal policy services in support of departmental and Health Portfolio priorities in the areas of: health care, science policy, emerging issues, Parliamentary relations and Cabinet affairs, regulatory and legislative issues, and focal point for intergovernmental affairs.

Initiatives

Highlights of Internal Services activities are showcased through several priorities.  Enterprise HR and its Talent Management Framework is Health Canada's premier strategy and transformational initiative for maximizing our investment in people at all levels and in all areas of expertise (such as the Scientific and Technology community).  The Talent Management Framework aims at refocusing human resources practices and aligning them with business goals and talent needs; and improving organizational performance through the active recruitment, engagement, development and retention of employees. Success has also been demonstrated in the Department's alignment to the Government of Canada's IT Shared Services agenda. Real Property activities support the Department's objective to achieve savings by maximizing efficiencies, as well as optimizing the use of space, and the development of a framework to provide a cohesive departmental approach to the custodianship of Health Canada's real property portfolio.  With respect to strengthening the department's strategic policy capacity, Health Canada will continue to work with internal and external partners to define research priorities, including tools and data, establish mechanisms for ongoing collaboration between researchers and policy makers, and identify opportunities for integrating research into policy-making

These Internal Services highlights can be linked to the Clerk's priorities for Public Service renewal. These activities have contributed to the alignment of result orientated practices and goals within Health Canada.

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