Federalism and Public Health Research 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. The workshop included experts from Australia, Brazil, Canada, China, France, India, Russia, USA and WHO. The workshop was organized by the Public Agency of Canada; Institute of Intergovernmental Relations, Queen's University; The Centre for Global Studies, University of Victoria; and University of Toronto Joint Centre for Bioethics. IHR Proceedings Report (1.2 MB) As research papers developed based on the Ottawa workshop and its follow-up are available through the links below. Papers/Publications Kumanan Wilson, Barbara von Tigerstrom, and Christopher McDougallProtecting Global Health Security Through International Health Regulations: Requirements and challenges 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 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 Healthcare Policy, Volume 2, Number 2, 2006. Kumanan Wilson and Harvey Lazar.From SARS to Avian Flu - Why Ottawa Must Lead Canada's Response Policy Options, February 2006 Kumanan Wilson and Harvey Lazar.Planning for the Next Pandemic Threat: Defining the Federal Role in Public Health Emergencies IRPP Policy Matters, Volume 6, Number 5, November 2005 Kumanan Wilson.A Canadian Agency for Public Health: Could it work? 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 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 Journal of Health Politics, Policy and Law 2009 34(3):381-399. Kumanan Wilson, Christopher McDougall and Alan ForsterThe Responsibility of Healthcare Institutions to Protect Global Health Security Healthcare Quarterly, 12(1) 2009: 56-60. Kumanan WilsonSecuring The Public Health Realm: Re-Invisioning Canada's Role in the New Century The Health File, Options Politiques, Juillet-Août 2009. Background Materials 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 We gratefully acknowledge the support of the following sponsors: Public Health Agency of Canada (PHAC) Canadian International Development Agency (CIDA) Canadian Institutes of Health Research (CIHR) International Development Research Centre (IDRC) Institute of Intergovernmental Relations - Queen's University Centre for Global Studies - University of Victoria Joint Centre for Bioethics - University of Toronto For additional information or inquiries, please contact: Christopher McDougall University of Toronto Tel: (416) 340-4800 x 4254 Fax: (416) 595-5826christopher.mcdougall@utoronto.ca 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. Our 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. Objectives/Hypothesis Objectives 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. Hypothesis 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. Papers 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 Wilson K. "The Role of Federalism in Health Surveillance: A Case Study of the National Health-Surveillance "Infostructure." In Social Union Study of the Canadian Health System: Introduction and Overview edited by Duane Adams 2001: 208-236. Wilson K. Pandemic threats and the need for new emergency legislation in Canada. Healthcare Policy / Politiques de Santé 2006;2:35-42 Wilson K, MacLennan C. Federalism and Public Health Law in Canada. Opportunities and Unanswered Questions. Health Law Review 2005:14;3-13. Wilson K, Lazar H.. Policy Matters 6 (5). Planning for the next Pandemic Threat: Defining the Federal Role in Public Health Emergencies. Wilson K. The Complexities of Multi-Level governance in public health. Canadian Journal of Public Health 2004;95:409-411 Wilson K, McCrea-Logie J, Lazar H. Understanding the impact of intergovernmental relations on public health: Lessons from reform initiatives in the blood system and health surveillance. Canadian Public Policy 2004;30:177-194 Wilson, K. The Canadian Agency of Public Health. Could it work? Canadian Medical Association Journal 2004;170:222-3. Related Papers Wilson K, McDougall C, Fidler DP, Lazar H. Strategies for Implementing the new International health regulations in decentralized states- Bulletin of the World Health Organization Attaran A, Wilson K. Legal and Epidemiological Justification for Federal Authority in Public Health Emergencies. McGill Law Journal 2007;52:381-414. McDougall C, Wilson K. Canada’s Obligations to Global Public Health Security under the Revised International Health Regulations. Health Law Review 2007;16:25-32. Wilson K, MacDougall C, Upshur R. The new international health regulations and the federalism dilemma. PLoS Med 2006;3(1): e1. Mills EJ, Singh R, Ross CP, Ernst E, Wilson K. Impact of Federal Safety Advisories on Health Food Store Advice. Journal of General Internal Medicine 2004;19:269-272. Deber R, McDougall C, Wilson K. Public health through a different lens. Healthcare Papers 2007;7(3):66-71. Wilson K, Singer PA. Travel advisories and pandemics. Human Security Bulletin (Human Security and Health edition). July, 2006. Wilson K. Can Canada’s two levels of government get it together? Diplomat and International Canada. 2006;3:14-17. Wilson K, Lazar H. From SARS to Avian Flu – Why Ottawa must lead Canada’s response. Policy Options 2006; February:31-38. 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.