Results at a Glance: Evaluation of the Public Health Agency of Canada’s Food-borne and Water-borne Enteric Illness Activities 

Program context

The ultimate goal of the Public Health Agency of Canada's (PHAC) food-borne and water-borne enteric illness activities is to protect people in Canada from food/water-borne enteric illnesses. Objectives are:

• Stakeholders have access to evidence-informed knowledge, tools, protocols, and expertise to respond to outbreaks of food/water-borne illnesses;
• Stakeholders take informed actions to prevent and respond to food/water-borne enteric illnesses and antimicrobial resistance; and
• People in Canada are aware of food/water-borne enteric illnesses and preventative measures, and take informed actions to protect themselves from food/water-borne illnesses, including antimicrobial-resistant infections.

Budget: $96.65 M over five years

Evaluation Approach

This evaluation examined the performance and efficiency of PHAC's food-borne and water-borne enteric illness activities from 2017-18 to 2021-22.

• document and file review
• literature review
• key informant interviews
• financial data review

What the evaluation found

Overall, PHAC's food/water-borne enteric illness activities are functioning effectively. PHAC is providing information, tools, and expertise to support the work of stakeholders to prevent, detect, and respond to food/water-borne illnesses. There is evidence that PHAC's work has contributed to decision-making and led to policy and regulatory changes that ultimately help protect people in Canada. For example, there has been a consistent decline in cases of Salmonella infection in Canada, one of two leading food-borne illnesses in the country. This is partly because of improvements in outbreak detection and source identification due to PHAC's implementation of whole genome sequencing technology. This work influenced a federal industry directive that supported changes in industry practices related to frozen raw breaded chicken products.

In light of the evolving food/water-borne illness environment, continued work is needed to address new emerging pathogens, as well as antimicrobial resistance and antimicrobial use in food sources. In addition, although PHAC has provided timely information for Canadians, the evaluation noted that the clarity and accessibility of public communications could be improved, particularly with regard to Public Health Notices.

This is the third evaluation over the past decade outlining that PHAC has an efficient and effective approach for food/water-borne enteric illness activities. Guiding documents and processes are well developed, clarify mandates, define roles and responsibilities, and provide guiding practices. To ensure that this program continues to be successful in the future, addressing challenges associated with IM/IT barriers and inadequacies will be important. Furthermore, maintaining human resource capacity, and using fully the operational business support provided to navigate cumbersome staffing and procurement processes will also be important to increase efficiency and resource use.

Recommendations

1. Examine public communications activities, including Public Health Notices, with a view to implement best practices to optimize accessibility, usefulness and understanding of public health messaging.
2. Identify, prioritize and implement options to address operational challenges related to:
   • improving IM/IT systems and support for the program, including for existing initiatives (e.g., interactive data visualization), and finding a replacement for Bionumerics software; and
   • procurement and staffing, including optimizing use of business operations support provided to the program.
3. Identify and prioritize options to expand surveillance activities to provide stakeholders with the data, information and tools to better address:
   • emerging enteric pathogens, which are likely to become an increasing risk due to climate change; and
   • ongoing increases in foodborne antimicrobial resistance and options to reduce the need for antimicrobial use in animals in Canada.