National Presentation Template
Workshop:
The State of National Governance Relative to the
International Health Regulations (2005)
Ottawa, Canada, 20-21 September 2006.
Background: Political Structure
& Public Health Governance
• the governance structure: Parliamentary
Confederation of Provinces and Territories.
• All clinical and public health activities are
the responsibility of the provinces and
territories (exception: Quarantine Act which
is federal)
Background: Flowchart
• major public health institutions involved in
complying with the requirements of the IHR 2005:
– Federal: Public Health Agency of Canada (National
Focal Point)
• Pan Canadian Public Health Network (PHN) - integration
mechanism between Federal and P/T
– Provincial/Territorial: Ministries of Health
– Local/Municipal: Departments of Health/Public Health
Background:
National Core Capacities
Levels Where Activities Are Performed
Activity
Detection and notification of cases
Collection and consolidation of case data
Analysis and interpretation
Investigation of cases & confirmation of diagnosis:
• Epidemiologist
• Clinician
• Laboratory
Feedback
Dissemination
Response/Intervention
National Regional Local
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IHR negotiation & approval
• Agreements under development
– Information sharing
• key changes to existing statutory law, and/or
implementation regulations, at national or
regional levels required to effectively
comply with the IHR 2005
– under discussion
Development of surveillance
systems
• Does the federal/national government have the
authority to mandate the development of
surveillance capacities to those required by the
IHR 2005?
– No
• If not, what mechanisms will the federal/national
government utilize to ensure meeting surveillance
requirements of the IHR 2005?
– Long standing precedence for information sharing
– Information sharing agreement under discussion
– Could use spending power
Response to a PHEIC
• Does the federal/national government have
clear jurisdictional authority to act on a
public health emergency of international
concern (PHEIC), as defined by the IHR
2005?
– All PHEIC are local events
– Long standing collaborative environment
– Federal jurisdiction responsible for
international notification
Coordination of reporting and
response requirements
• How does your country plan to organize compliance with
the IHR 2005 among the different levels of affected
government?
– Consensus processes already underway
• What agreements (formal or de facto) currently exist
between levels of government concerning key IHR related
issues?
– Long standing collaborative environment
• What interfaces (e.g. administrative mechanisms) exist
now or are being planned for communication between
orders of government?
– Well established reporting/communications systems in place
Financing and/or Cost Sharing
• describe how costs will be shared across
levels of government
– Each jurisdiction responsible for own
costs
Comparing Strategies
• What potential challenges to communication and collaboration
between orders of government do you anticipate?
– No major challenges anticipated
• What strategies would you utilize to overcome these obstacles? What
are the pros and cons of the strategies identified?
– PHN is the mechanism to enhance communication/collaboration
• What mechanisms exist for dispute avoidance and resolution? Are new
administrative institutions or mechanisms needed?
– See above
• Do the IHR 2005 serve as a useful framework for public health legal
renewal/reform? Pros & Cons?
– Work is underway to harmonize public health law across Canada and the
IHRs will facilitate those discussions
Summary & conclusions
• Please list 3 key governance challenges to implementing the IHR 2005
– Surveillance capacity at all levels.
– Capacity at ports of entry.
– F/P/T cooperation and collaboration
• What expectations do you have of the WHO/donors/other agencies for
implementation assistance in overcoming these obstacles?
– None
• How important is external (technical/legal/financial) assistance for
your successful implementation of the IHR 2005?
– Not important
Optional topics to consider
• Are there human rights challenges that may create
obstacles to implementation of the IHR in your
country? None
• Could any of the governance obstacles to IHR
implementation require your country to issue a
reservation? No
• Will your country’s implementation strategy be
formally or informally linked with those of other
countries? Yes e.g. USA