Oh No Canada
Kudos to Ms. McLellan, not only for her committment to take a lead role in this effort, but to make good on a promise. In October, the National Advisory Committee on SARS and Public Health in Canada, and its author, Dr. David Naylor of The University of Toronto released a scathing 234-page report that accused federal health authorities of being practically invisible, and not properly delegating leadership roles that were required to properly manage the crisis. At the time, McLellan was Federal Health Minister and was quoted as saying:
I would like to move quite quickly…It's not possible to say the timeframe here. But I am very much committed to ensuring it is reviewed quickly and acted upon.Quick action indeed. The structure of this ministry assures that in the event of a future health crisis, a federal infrastructure exists that can be deployed to manage the situation.
Dr. Naylor also suggested that better communication and coordination between federal and provincial authorities could more effectively combat such outbreaks in the future. Given this goal, it would seem logical that a similar authority be established on a provincial level. Just yesterday, recommendations were tabled by a committee in the Province of Ontario to establish just such an authority that would create some distance between "public health and the political process." This is all very good news and suggests that Canada is really stepping up to confront issues of public safety and emergency preparedness head on.
The success or failure of this program will be closely monitored by authorities south of the border. Although America is to be commended for being so proactive in establishing Homeland Security, senior policy makers have thus far failed to adequately incorporate health emergencies into its realm. Just two weeks ago, the Center for Disease Control (CDC) in Atlanta released a report stating that America is still ill equipped to battle a major outbreak of SARS, and last week a report funded by the Trust for America's Health came to the conclusion that most states are unprepared for a biochemical terrorist attack or other public health care emergency. On a state to state basis, the report found that only 9 or 50 states met more than half of the 10 preparedness targets, and none met more than seven.
The major problem here is not only the tendancy for these emergencies to receive 'yo-yo' funding at best (the bulk of this comes from the CDC), but the fact that key agencies that should be better coordinated in their efforts, still operate within distinct organizational cylinders. Clearly, there is still a great deal of "white space" that exists between CDC and Homeland Security, and only until this is better managed, will authorities be fully prepared.
Good luck to Anne McLellan and her Ministry - the effects of their collective efforts could very well have impacts not only within Canada but beyond.