Concerns are growing that avian influenza could become a pandemic, resulting in possible widespread lockdowns and potential social as well as economic consequences similar to what occurred during COVID-19. 

As cases rise, some argue the United States is repeating the mistakes it made in 2020, making this the perfect time to reinvent Canada’s capacity to respond to this crisis and prevent future pandemics. 

One solution is a “deep prevention” approach that involves averting pandemics by preventing zoonotic pathogens from spilling over from animals to humans in the first place rather than responding after outbreaks. This is particularly important given the increase in frequency and severity of emerging infectious diseases, with 70 per cent of them originating from animals.  

Deep prevention entails a “one-health” approach – human, animal and environmental – to respond to challenges that require concerted action and that impact multiple policy areas.  

Whole-of-government approaches (i.e., policies and actions that are co-ordinated and coherent across the government) enable the implementation of deep pandemic prevention and preparedness. 

However, this requires political will and a commitment to assess strengths, weaknesses, opportunities and threats, as well as to develop policies, legislation and strategies supported by continuous financing. These are all issues that Ottawa, the provinces and territories must address to implement a “one-health” approach. 

The problem is growing 

New coronaviruses continue to emerge in animals, demonstrating the need for vigilant monitoring of human, animal and environmental data through co-ordinated surveillance systems to allow intervention at the source of zoonotic spillover. 

Similarly, antimicrobial resistance – an infectious disease characterized as a “silent pandemic” – also requires integrated cross-sectoral surveillance systems guided by shared governance, including principles of collaboration and co-ordination across multiple levels and sectors, outcome-oriented management, political sustainability, accountability, transparency and equity.  

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While preventing infectious-disease spillover from animals to humans poses significant challenges, the cost of prevention is significantly less than responding to a pandemic. Even marginal preventative gains are cost-effective. 

The most significant obstacle to implementing such a deep-prevention approach, however, is gaining political buy-in because the benefits of preventing zoonotic spillover are either invisible or evident only long after governments have come and gone from power, as happened with COVID-19. 

Federal strategy has many goals but misses the key point 

While both proactive and reactive strategies are necessary, proactive strategies are less common because the imperative seems greater for governments to respond to crises rather than proactively addressing risks to prevent potential catastrophes.  

For example, in 2021, the federal government released its biomanufacturing and life-sciences strategy, which seeks to advance pandemic readiness by strengthening Canada’s capacity to produce vaccines, therapeutics and other countermeasures domestically. 

Its central priorities are: 

• a co-ordinated governance structure spanning multiple federal departments and agencies; 

• investment in academia and research;  

• strengthened supply chains by supporting and investing in firm development and growth; 

• building strategic alliances and diversifying trade partners; 

• expansion of existing public research and manufacturing centres to support pandemic preparedness; 

• update of regulatory systems to be more agile and responsive.  

A new agency, Health Emergency Readiness Canada, was recently launched within Innovation, Science and Economic Development Canada to serve as the focal point for implementing these goals. 

The strategy addressed criticism regarding gaps in Canada’s supply chain and dependence on foreign companies, which led to a lack of personal protective equipment to meet the needs of health-care professionals during COVID-19 , as well as concerns regarding the ineffectiveness of the national emergency strategic stockpile due to a lack of co-ordination between Ottawa, the provinces and territories. 

However, Canada’s approach to pandemic preparedness – defined by its focus on strengthening domestic capacity to create vaccines, therapeutics and personal protective equipment – is a downstream plan. It aims to contain infection from affecting a wider population only after it has emerged.  

The limitations of this approach may be seen through the curtailment just months before COVID-19 emerged of the Global Public Health Intelligence Network, which monitors global developments with the potential to create disease outbreaks. Canada might have experienced less morbidity and mortality from COVID-19 if the network’s surveillance, early warning and response capacities had been maintained and leveraged instead. 

Ottawa further took a downstream approach by phasing out the funding of various surveillance and response activities. 

The 2022 fall economic statement phased out funding of key surveillance programs over the next four fiscal years. This includes ensuring the safety of air travel, COVID-19 border-testing operations and COVID-19 procurement in 2023-24; funding National Research Council pandemic technology programs in 2024-25; enhancing African swine-fever prevention and preparedness measures in 2025-26; and regulating animal imports in 2026-27.  

Similarly, the 2022 federal budget phased out funding of the emergency stockpile after 2022-23, and reduced surveillance and risk assessment funding for the Public Health Agency of Canada after 2024-25. 

In addition, relevant federal departments and agencies – Agriculture and Agri-Food Canada; the Canadian Food Inspection Agency; the Canadian Institutes of Health Research; Environment and Climate Change Canada; Fisheries and Oceans Canada; Health Emergency Readiness Canada; and the Public Health Agency of Canada – undertake one-health and pandemic-preparedness activities with no apparent formal or informal co-ordination mechanism.  

Institutional changes enable deep-prevention approach 

Governance systems must be reimagined to unite the fragmented responses to global health challenges. Rather than create another silo, Ottawa should create a one-health branch within Health Emergency Readiness Canada staffed “on loan” with representatives from other departments.  

This arrangement would enable them to contribute to the new branch while staying in their home departments their remaining time – reporting vertically to their respective ministers as well as horizontally to the new branch.  

This would foster the communication, co-ordination and collaboration necessary to address complex issues in a timelier manner while also integrating one-health concepts and strategies within their home departments. 

Potential synergies include the development of medical countermeasures informed by surveillance that detects and notifies the federal government about novel pathogens and emerging diseases, as well as co-ordinated funding for one-health and pandemic-preparedness research set out in the strategy with similar financing as provided by federal research funding agencies. 

Ottawa might also consider development and implementation of a one-health strategy that defines targets, methodologies, guidelines, tools, and accountability for deliverable activities including timelines. This would strengthen the capacity of the new branch to aid in establishing a whole-of-government approach that guides and incorporates non-health stakeholders.  

Focusing solely on downstream preparedness accepts some level of risk and vulnerability that is partly avoidable. Even marginal efforts toward deep prevention will complement and strengthen downstream interventions, such as those enabled by the technological focus of the government’s biomanufacturing and life-sciences strategy.  

A one-health action plan would also better articulate Canadian interests, needs, strengths and weaknesses clearly and consistently. For pandemic prevention, this entails identifying ideal and alternative outcomes based on tradeoffs, costs and acceptability. 

It is imperative to ensure that Canadian public policies are coherent, co-ordinated and converge around these interests and needs to better address the next pandemic. 

Just as SARS created momentum to establish the Public Health Agency of Canada in 2004, COVID-19 (SARS CoV-2) could hasten establishment of the one-health branch and strategy that is imperative to address risks on the horizon. 

A reorientation to a whole-of-government approach would address a key gap in Canadian public-health policy while strengthening the development and implementation of current priorities that better protect Canadians from future pandemics. 

The authors would like to thank Tarra Penney for her feedback and guidance on previous versions of this article.