Annual Conference of Federal-Provincial-Territorial Ministers of Health

The greatest known emerging health threat that we face as a global community is pandemic influenza, which can emerge very rapidly and become widespread, affecting the entire globe.

Currently, avian influenza H5N1 has the most potential to become a pandemic. It has affected many species of birds and animals and the World Health Organization (WHO) now considers it to be endemic in Asian poultry. Since 2003, there have been 100 confirmed human cases of avian flu and more than 60 deaths. Scientists agree the number of humans affected by the virus is an indication of its potential to mix with human influenza virus creating a new strain with the ability to transmit directly from human to human. With no resistance to this new strain, the virus could spread rapidly and result in significant illness, death and social disruption.

Three influenza pandemics have occurred in the last century, and scientists recognize that another is inevitable. While it is impossible to predict when a pandemic will occur, advance planning and preparation is critical in order to minimize the impact of this new virus on individuals and communities across Canada.

Canada was one of the first countries in the world to develop a national plan to manage the risk of a pandemic influenza. The Canadian Pandemic Influenza Plan (http://www.phac-aspc.gc.ca/cpip-pclcpi/index.html), released in February, 2004, was developed by federal, provincial and territorial governments together with more than 200 health experts. The plan outlines actions to be taken by the various levels of government, so that a coordinated response that protects the health of Canadians is implemented in the event of a pandemic, including risk assessment and communication to Canadians. The continued development of these plans will aid improvement in the general level of preparedness in Canada to confront other emerging infectious diseases. As well, provinces and territories have developed their own response plans including disease surveillance, operational planning, and limited stockpiling of antivirals.

The Public Health Agency of Canada, and provincial and territorial governments, continually monitor the threat of a pandemic influenza. They will adapt and revise their plans as the situation evolves and new knowledge becomes available.

Vaccines are the most effective public health tool to fight an influenza pandemic. Vaccines provide immunity against the influenza virus but cannot be produced until the pandemic strain of influenza has emerged. In the meantime, it is important that Canada builds vaccine production capacity in the event of a pandemic. That is why the Government of Canada has put in place a ten-year contract with a domestic manufacturer. The contract includes a pandemic readiness component to strengthen production capacity and pandemic vaccine production. In addition, the Government of Canada has committed $34 million over five years to assist in the development and testing of a prototype (“mock”) pandemic influenza vaccine.

Until a vaccine is available, antivirals will be an important part of our response to a pandemic.
Combined, federal, provincial and territorial governments currently have approximately 40 million capsules of oseltamivir, enough to treat four million people. Specifically, governments currently own 35 million capsules, with another five million on order.

Antivirals, however, are limited in their effectiveness and, therefore, are only one part of our overall strategy. They alone cannot be relied on to reduce the impact.

Providing leadership and collaborating on these types of issues at an international level is a cornerstone of Canada’s preparedness. Canada continues to work multilaterally to build mutually beneficial partnerships in addressing the global threat of a pandemic influenza. Canada is in active discussion with the World Health Organization (WHO) and our partners in the G7 plus Mexico on the appropriate measures to slow down or contain an initial outbreak of a novel virus that could cause a pandemic.

Over the past few years, Canada has provided continuous support to the World Health Organization and the countries affected by avian influenza. For example, Canada continues to provide technical assistance to Vietnam to help with H5N1 avian influenza diagnosis, and has provided public health expertise in WHO consultations in Thailand, Vietnam and China.

In September, 2005, Canada announced a five-year, $15-million project to strengthen the capacity of public health systems in Southeast Asia and China to detect and respond effectively to emerging infectious diseases. The Canada-Asia Regional Emerging Infectious Diseases (CAREID) Project will focus on assisting the region in improving surveillance and outbreak investigation and response, strengthening lab systems, increasing preparedness and improving effective communications and public education. The project is the result of meetings and consultations with international partners, as well as a mission to the region to assess their capacity needs to combat emerging infectious diseases currently underway.

In October, 2005, Canada will host an International Meeting of Ministers of Health to facilitate international collaboration in pandemic preparedness. The meeting will provide a forum for identifying priority actions in the global response to a pandemic influenza. Ministers will discuss four key themes:

• Intersectoral collaboration on the animal-human health interface
• Risk communication and assessment
• Development, supply and access to vaccines and antivirals
• Surveillance and capacity building.