Federalism and Public Health Research

The new International Health Regulations focus on public health capacities and networks to prevent and control outbreaks of infectious diseases, including pandemics. 

The Intergovernmental Relations Project is aimed at helping governments and the public to better understand the effects of different types of intergovernmental public health regimes on the public interest.

Federalism and Public Health

The New International Health Regulations - International Component

The State of National Governance Relative to the New International Health Regulations Workshop
​September 20-21, 2006 - IDRC Boardroom, Ottawa, Ontario

The IHR focus on public health capacities and networks to prevent and control outbreaks of infectious diseases, including pandemics. The Ottawa Workshop focused on the adequacy of existing and proposed national (or federal) governance systems to effectively implement the new International Health Regulations (IHR), which came into force in June 2007.

Kumanan Wilson, Barbara von Tigerstrom, and Christopher McDougall
Protecting Global Health Security Through International Health Regulations: Requirements and challenges [PDF 165 KB]
Canadian Medical Association Journal, Volume 179, Number 1, July 1, 2008.

Kumanan Wilson, Christopher McDougall, David P Fidler and Harvey Lazar.
Strategies for Implementing the New International Health Regulations in Federal Countries
World Health Organization Bulletin. Volume 86, Number 3, March 2008.

Kumanan Wilson, Christopher McDougall, and Ross Upshur.
The New International Health Regulations and the Federalism Dilemma [PDF 1.3 MB]
Public Library of Science (PLoS) Medicine, Volume 3, Issue 1, January 2006.

Kumanan Wilson.
Pandemic Threats and the Need for New Emergency Public Health Legislation in Canada [PDF 174 KB]
Healthcare Policy, Volume 2, Number 2, 2006.

Kumanan Wilson and Harvey Lazar.
From SARS to Avian Flu - Why Ottawa Must Lead Canada's Response [PDF 103 KB]
Policy Options, February 2006

Kumanan Wilson and Harvey Lazar.
Planning for the Next Pandemic Threat: Defining the Federal Role in Public Health Emergencies [PDF 157 KB]
IRPP Policy Matters, Volume 6, Number 5, November 2005

Kumanan Wilson.
A Canadian Agency for Public Health: Could it work? [PDF 170 KB]
Canadian Medical Association Journal. Volume 170, Number 2, January 20, 2004.

Kumanan Wilson, Jennifer McCrea-Logie, and Harvey Lazar.
Understanding the Impact of Intergovernmental Relations on Public Health: Lessons from Reform Initiatives in the Blood System and Health Surveillance [PDF 91 KB]
Canadian Public Policy, Volume 30, Number 2, 2004. 

Kumanan Wilson, David P. Fidler, Christopher W. McDougall, and Harvey Lazar.
Establishing Public Health Security in a Postwar Iraq: Constitutional Obstacles and Lessons for Other Federalizing States [PDF 164 KB]
Journal of Health Politics, Policy and Law 2009 34(3):381-399.

Kumanan Wilson, Christopher McDougall and Alan Forster
The Responsibility of Healthcare Institutions to Protect Global Health Security [PDF 321 KB]
Healthcare Quarterly, 12(1) 2009: 56-60.

Kumanan Wilson
Securing The Public Health Realm: Re-Invisioning Canada's Role in the New Century [PDF 319 KB]
The Health File, Options Politiques, Juillet-Août 2009.

  • International Health Regulations (2005)
  • "Germs, Governance, and Global Public Health in the Wake of SARS" by David Fidler
  • "The New International Health Regulations and the Federalism Dilemma" by Kumanan Wilson, et al.
  • "From International Sanitary Conventions to Global Health Security: The New International Health Regulations" by David Fidler
  • "Global Public Health Surveillance under New International Health Regulations" by Michael Baker and David Fidler
  • "The New International Health Regulations: An Historic Development for International Law and Public Health" by David Fidler and Lawrence Gostin
  • "Globalization of Health Insecurity: The World Health Organization and the New International Health Regulations" by Obijiofor Aginam
  • "Globalization of Infectious Diseases, International Law and the World Health Organization: Opportunities for Synergy in Global Governance of Epidemics" by Obijiofor Aginam

Christopher McDougall
University of Toronto
Tel: (416) 340-4800 x 4254
Fax: (416) 595-5826

Intergovernmental Relations Project - Domestic Component

In recent years considerably more attention has been devoted to governance in health care than to governance in public health. Nevertheless, this is a very active time for national initiatives in the area of public health in Canada. Clarification of the roles and responsibilities of federal, provincial and local governments in public health activities is vital to ensure successes in these initiatives that should translate into large health benefits and to prevent failures that often evolve into high profile events.


  • Describe the role of different orders of government in a purposeful sample of public health case studies (e.g., water quality, blood safety, air quality, food safety, health surveillance, immunization policy, public health security, and disease migration) and identify gaps and overlaps in these roles
  • Determine the variations in intergovernmental relations that exist in the case studies
  • Determine the strengths and weaknesses of the various combinations of intergovernmental relations
  • Determine the characteristics of a public health problem that make it amenable to a particular type of intergovernmental relationship
  • Provide recommendations on mechanisms to improve existing intergovernmental relations to achieve policy objectives.


Harvey Lazar and Tom McIntosh have advanced a model for describing, evaluating and comparing federal-provincial relations based on the extent of interdependence between the two orders of government and the presence or absence of a hierarchical relationship. Our hypothesis is that their model can be usefully adopted and modified to describe intergovernmental relations in public health and incorporate a third (local) level and potentially a fourth (supranational) level.

Based on the above objectives, a series of Working Papers have been produced. They can be found at the Public Health Series 2008 working papers - scroll down to the Public Health Series 2008. In addition to the Working Papers, the project has also led to other publications as listed below.

Published Papers

Related Papers

Newspaper Articles

  • Wilson K, Lazar H. A bug in Canada’s ear. Globe and Mail web exclusive comment. June 15, 2007.
  • Wilson K. Canada must prepare for new rules for fighting pandemics. Medical Post February 2006;42:17.