Health Canada 2023-24 Departmental results report

Core responsibility 1: Health care systems

In this section

• Description
• Program inventory
• Resources required to achieve results
• Progress on results
• Details on results
• Key risks
• Related government-wide priorities

Description

Health Canada provides national leadership to support and encourage sustainable and adaptable health care systems that ensures access for Canadians^{Footnote 1} to appropriate and effective health care services.

This includes modernizing health care systems to meet a broader range of needs in a timely manner and improving the affordability and accessibility of pharmaceuticals. The Department's grants and contribution programs allow Health Canada to work with funding recipients and stakeholders to advance a wide variety of health priorities. These contribution programs fall into 3 broad categories:

• Those that address major national health priorities or health issues that cut across multiple core responsibility 1 departmental results.
• Health promotion programs where community organization participation is essential for success.
• Research projects that further the development of knowledge, policy, or program delivery.

Program inventory

Health care systems is supported by the following programs:

• Responsive Health Care Systems
• Healthy People and Communities
• Quality Health Science, Data and Evidence

Additional information related to the program inventory for Health care systems is available on the Results page on GC InfoBase.

Resources required to achieve results

Complete financial and human resources information for Health Canada's program inventory is available on GC InfoBase.

Progress on results

This section presents details on how the department performed to achieve results and meet targets for Health care systems. Details are presented by departmental result.

Tables 2 and 3: Targets and results for Health care systems

These tables provide a summary of the target and actual results for each indicator associated with the results under Health care systems.

Additional information on detailed results and performance information for Health Canada's program inventory is available on GC InfoBase.

Details on results

The following section describes the results for Health care systems in 2023–24 compared with the planned results set out in Health Canada's departmental plan for the year.

In this section

• Expanding access to oral health services
• Departmental result 1: Canada has modern and sustainable health care systems
• Departmental result 2: Canadians have access to appropriate and effective health services

Expanding access to oral health services

Recognizing that oral health is an important part of Canadians' overall health and well-being, Health Canada continued to expand access to oral health care. Not all Canadians are able to access oral health care due to cost. Canadians with lower family incomes are less likely to have private dental insurance, have the highest level of oral health problems, and the most difficulty accessing oral health care.

In 2023-24, the interim Canada Dental Benefit (CDB) continued to help children under the age of 12 access dental care. The benefit was a tax-free, upfront payment to help lower costs for dental care for eligible families, with an adjusted family net income of less than $90,000 per year without access to a private dental insurance plan. Since its launch in December 2022 to March 31, 2024, over 431,000 children have been helped by the benefit through more than $400 million in benefit payments. The CDB continued to support families until June 2024, after which eligible parents and caregivers were able to begin applying for the Canadian Dental Care Plan for children under the age of 18.

In December 2023, Health Canada launched the long-term Canadian Dental Care Plan (CDCP) to support Canadian residents with an adjusted annual family net income of less than $90,000 without access to dental insurance. The CDCP covers a wide range of oral health services that keep teeth and gums healthy and prevent and treat oral health care issues and diseases. Using a phased approach starting with seniors, more than 1.7 million eligible Canadian seniors from across the country had signed up by the end of March 2024 to begin receiving care in May 2024. Applications opened to eligible adults with a valid disability tax credit certificate and children under 18 in June 2024 and will open to all remaining eligible Canadian residents in 2025. Once fully implemented, the CDCP will help ease financial barriers to accessing oral health care for up to nine million Canadian residents who do not have access to dental insurance.

To communicate information on the eligibility of Canadians to the CDB and CDCP and the programs themselves, in 2023-24, Health Canada developed and distributed public educational materials that achieved the following results:

• The Canada.ca/dental webpages provide clear and accessible information. These pages were viewed 31.3 million times for the CDB and 26.2 million times for the CDCP.
• The Department developed a CDB promotional toolkit that included factsheets in twelve different languages, a poster, and social media content. The CDCP Stakeholder Toolkit also provided information to various stakeholders when it launched in December 2023. It included factsheets, FAQs, posters, social media content, as well as promotional and informational materials for providers.
• Health Canada launched national advertising campaigns for both the CDB and CDCP:
  • Aimed at reaching parents of children under 12 years old, the CDB campaign ran from July to October 2023 and generated over 104 million impressions and 450,000 visits.
  • The CDCP campaign included web banners on popular websites, search engine marketing, and print advertisements. As of March 31, 2024, these generated over 43 million impressions and over 1.6 million web content visits.

The Government of Canada, through Public Services and Procurement Canada, awarded the contract to administer the CDCP to Sun Life in December 2023. In 2023-24, in collaboration with Health Canada, Sun Life created a public website for both oral health providers and members, a dedicated call centre, and dedicated Sun Life administration teams for all aspects of the CDCP. As part of the contract with Sun Life, Indigenous companies were required to be considered when sub-contracting work, and as a result, 1 of the 3 selected companies to provide client support assistance is Indigenous-owned.

Health Canada worked closely with oral health professional associations to ensure the success of the CDCP. In addition, the Department advanced oral health priorities with each provincial and territorial (P/T) government and continues to work closely with each jurisdiction to understand how the CDCP will intersect with existing dental programs, which vary across all thirteen jurisdictions.

Health Canada hosted 26 information sessions on the CDCP between December 2023 to March 2024 with oral health professionals, P/T governments, and various advocacy and community organizations. As of March 31, 2024, almost 5,000 oral health providers had confirmed their participation in the CDCP through Sun Life and this number continued to grow significantly. As of the launch of care in May 2024, more than 10,000 providers had signed up to participate.

In choosing to participate, oral health providers are playing an important role in advancing more equitable access to oral health care and towards improving health outcomes in Canada. Some oral health providers may choose not to formally sign up as a CDCP provider but would still like to provide care to CDCP clients. As of July 2024, oral health providers who agree to direct bill Sun Life for services provided were able to treat CDCP clients on a claim-by-claim basis. This allows CDCP clients to see any oral health provider they choose for their care, if the provider agrees to direct bill Sun Life for services provided under the plan. As of September 2024, about 21,000 oral health providers were participating in the CDCP, either by formally signing up or by using the claim-by-claim method.

Ongoing monitoring of access to oral health care in Canada is important. To help fill gaps in oral health data access and to help Health Canada measure the impact of its efforts, the Department worked with Statistics Canada to collect data on the oral health status of Canadians through the Canadian Oral Health Survey. The findings from this survey are anticipated to be published in 2024-25.

Finally in 2023-24, to build on the establishment of the Oral Health Access Fund, Health Canada engaged with over eighty key experts and organizations in oral health to help inform inaugural funding priorities. These included academics, advocacy organizations, Indigenous organizations, professional associations, as well as representatives from P/Ts and oral health training schools. The Fund will complement the CDCP and aims to expand access to oral health care by supporting projects that reduce or remove non-financial barriers to accessing oral health care for targeted populations.

Departmental Result 1: Canada has modern and sustainable health care systems

Health Canada works closely with P/Ts, domestic and international organizations, health care providers, and other stakeholders to develop and implement innovative approaches that improve the efficiency, effectiveness, and sustainability of Canadian health care systems while also improving integrated health care for Canadians. The Department also conducts research, analysis, and policy work in support of modernizing the health care system. Further, Health Canada funds community and other third-party organizations to test new approaches to improve health services delivery.

In this section

• Working together to improve health care for Canadians
• Expanding access to family health services and team-based primary care
• Supporting Canada's health workforce and ensuring it is positioned to meet current and future needs
• Improving access to mental health and wellness supports, substance use programs and services
• Modernizing Canada's health system by utilizing digital health and ensuring that Canadians have access to their own electronic health information
• Helping Canadians age with dignity, closer to home, with access to home care, long-term care, and palliative care
• Building resilience for future health emergencies, leveraging lessons learned from the response to the COVID-19 pandemic

Working together to improve health care for Canadians

To ensure that Canadians can access health care where and when they need it, the Government of Canada provides financial contributions to P/Ts to support publicly funded health care systems. The Working Together to Improve Health Care for Canadians Plan, provided close to $200 billion over 10 years to strengthen Canada's universal public health care system, including increases through the Canada Health Transfer, delivered through Finance Canada, and funding from Health Canada for bilateral agreements with P/Ts. One of these increases was an immediate, unconditional $2 billion Canada Health Transfer top-up to P/Ts to help address immediate pressures on the health care system, especially in pediatric hospitals, emergency rooms, and surgical and diagnostic backlogs, including elective surgical procedures that were postponed. In 2023-24, the Government of Canada reached bilateral agreements with all 13 P/Ts to advance the following shared health priorities:

• Expanding access to primary and team-based care.
• Supporting Canada's health workforce and reducing backlogs.
• Improving access to mental health and wellness support, as well as substance use programs and services.
• Modernizing Canada's health system by expanding the use of data and digital health.

The Working Together to Improve Health Care for Canadians Plan also included funding to help Canadians age with dignity, closer to home, by supporting efforts to improve access to home and community care, services, supporting workforce improvements for long-term care, and applying long-term care standards. Health Canada funded this work through the Aging with Dignity agreements, signed with all P/Ts. This work is an extension of the priorities outlined in the Common Statement of Principles on Shared Health Priorities and flows the remaining $2.4 billion from Budget 2017 for home and community care ($6 billion over 10 years). It also included $3 billion over 5 years (from Budget 2021) to improve the quality and safety of long-term care.

As part of the Working Together to Improve Health Care for Canadians Plan, work is now also underway to provide $1.7 billion in funding to P/Ts to increase the wages of personal support workers and related professions' and to support other recruitment and retention measures for them. This funding will be provided through an amendment to existing Aging with Dignity agreements.

Funding agreements are flexible to address unique, P/T jurisdiction-specific needs based on their populations and geographies. As part of these agreements, P/Ts have developed action plans that outline how they will spend funds and monitor progress. To offer additional transparency, Health Canada worked with P/Ts to include targets for indicators in the action plans, which P/Ts will report on annually.

Recognizing the significant disparities in Indigenous health outcomes, as part of these agreements, the Government of Canada and P/Ts also committed to meaningful engagement and collaboration with Indigenous partners^{Footnote 2} to support improved access to quality and culturally appropriate health care services. The Government of Canada and P/Ts have also committed to working with the Canadian Institute for Health Information (CIHI) to collect, use, and share health information and to inform Canadian residents annually of progress to improve the health care system. In collaboration with P/Ts, CIHI is leading a process to refine and expand the 8 common indicators on shared health priorities. CIHI released an initial snapshot of these indicators in August 2023.

Lastly, the Plan includes $350 million in funding that began to flow in 2023-24 to support a ten-year renewal of the Territorial Health Investment Fund, in recognition of medical travel and the higher cost of delivering health care in the territories. Territorial Health Investment Fund agreements have been signed by all 3 territories.

Expanding access to family health services and team-based primary care

Transforming the delivery of family health services will help Canadians access the care they need. This will include expanding team-based primary care, supporting providers to work effectively within teams, and better leveraging virtual care.

Through the Working Together action plans, most P/Ts are using federal funds to build on ongoing efforts to expand interdisciplinary team-based care. Some highlights include Alberta's investments to increase access to primary care by expanding team-based care, Ontario's creation of additional interdisciplinary primary care teams with a focus on communities of greatest need, and Prince Edward Island's plan to establish up to thirty patient medical homes across the province.

Some P/Ts are focusing on overcoming gaps in rural and underserved communities. For example, Nova Scotia is expanding an Indigenous patient navigation program, and Nunavut plans to advance health outcomes for its Inuit population by delivering culturally relevant primary care services, provided in Inuktitut.

Investments through bilateral agreements also focused on support for team-based models of care and modern digital tools to strengthen the coordination and integration of care. Appropriate use of virtual care also helps improve access to family health services and many P/Ts included virtual care in their action plans. For example, Nova Scotia and New Brunswick are using virtual care to improve access for residents without a regular primary care provider.

Supporting Canada's health workforce and ensuring it is positioned to meet current and future needs

Canada's health workforce is fundamental to a sustainable health care system. Health care professionals provide treatment, services, and advice, and can include physicians, pharmacists, dental hygienists, and nurses, among others. To address the challenges faced by health professionals and increase their numbers in communities that need them the most, in 2023-24 Health Canada:

• Funded Health Workforce Canada, a new independent organization established with the support of the Canadian Institute for Health Information that brings together health workforce experts to learn from each other and help ensure health workers are there to provide the care people in Canada need. In 2023-24, Health Workforce Canada recruited staff and established its governance structure, engaged with stakeholders in setting its strategic objectives, vision and mandate, and began work on key deliverables including a health human resources dashboard and data modelling/forecasting plans.
• Developed and launched, in partnership with the nursing community across Canada, the Nursing Retention Toolkit: Improving the Working Lives of Nurses in Canada, a resource "by nurses, for nurses". The Toolkit contains successful retention strategies that have been implemented across Canada and provides a retention framework for employers, organizations, and health system administrators.
• Worked with P/T governments, regulators, and health system partners to advance F/P/T commitments to support and integrate internationally educated health professionals and support labour mobility.
• Expanded partnerships and engagement with professional associations, unions, universities, and colleges. For example, Health Canada sought advice from the Coalition for Action on the Health Workforce. Also, the Department is funding the Medical Council of Canada to operate and expand the National Registry of Physicians, which will help provide a more detailed understanding of the number of physicians in each province and territory. This will enable decision makers to better plan for future workforce needs, will enhance labour mobility, and support health professionals to work where they are most needed.
• Collaborated with the Canadian Institute for Health Information and Statistics Canada to provide P/Ts with workforce data to support decision-making. For example, as requested by the F/P/T Health Ministers, Health Canada initiated a study on education and training supply and demand for health care professions to meet the future short- and long-term health care needs of Canadians.
• Worked with international partners to develop a framework for the ethical recruitment of internationally educated health professionals, including in the context of health emergencies.

Improving access to mental health and wellness supports, substance use programs and services

Health Canada continued to collaborate with a wide range of partners so that Canadians can access mental health and substance use services that are evidence based, trauma-informed, and culturally appropriate.

For example, the Department finalized standards, guidelines, and resources in September 2024 for use by P/Ts, health organizations and other key stakeholders in their efforts to provide high-quality and equitable care for Canadians: Integration of mental health and substance use (MHSU) in primary care, digital MHSU apps, integrated MHSU services for complex needs, substance use treatment centres, and the substance use workforce.

The Department continued to work with P/Ts, Indigenous communities, and stakeholders to develop and expand the Integrated Youth Services (IYS) that provide a "one-stop shop" of integrated services for youth in the community, which can include peer support, mental health and primary care support and employment counselling, and support for navigating these systems of care. In 2023-24, a total of 92 IYS hubs were operational and 51 were in development.

In 2023-24, Canada continued to play an active role in advancing momentum on global mental health by endorsing the United Nations, G7, and G20's integration of physical and mental health and addictions in the delivery of a primary health care framework and universal health coverage. Canada also worked with international partners to advance mutual interests related to mental health, including via Canada's lead on the Asia Pacific Economic Cooperation Sub-Working Group on Mental Wellness and at the Canada-led APEC session on Digital Health on Mental Health and Healthy Ageing.

In 2023-24, Health Canada provided $14.25 million to the Mental Health Commission of Canada to advance key priorities, including suicide prevention, the integration of MHSU supports, population-based initiatives, and engagement strategies. For more information on Health Canada's efforts to support the Mental Health Commission of Canada see the transfer payment program supplementary information table.

The Department also provided $11 million to the Canadian Centre on Substance Use and Addiction in 2023-24 to address substance use in a coordinated way at the national level to improve access for prevention, harm reduction, and treatment services. For more information on Health Canada's efforts to support the Canadian Centre on Substance Use and Addiction see the Substance Use and Addictions Program transfer payment program supplementary information table.

In 2023-24, the Wellness Together Canada virtual portal continued to provide free, immediate, 24/7 access to mental health and substance use supports and services to all people in Canada for the final year of funding provided under Budget 2022. In 2020, the portal was launched to fill an urgent and acute need for mental health supports at the onset of the COVID-19 pandemic – an extraordinary global public health crisis. In 2022 new content was added referencing P/T resources, as well as pages with resources for people impacted by 2023 wildfires in the Northwest Territories and British Columbia. From 2020 to April 2024, over 4.38 million individuals across Canada accessed the portal. The portal's companion app, PocketWell, was downloaded over 60,000 times in 2023-24. As the emergency phase of the pandemic drew to a close, the Government of Canada transitioned away from Wellness Together and PocketWell, and Canadians can now access information on mental health resources, supports, and services through the new Canada.ca/mental-health page.

The Department promoted mental health and substance use resources and services found on Canada.ca/mental-health via a national advertising campaign called Get Help Here. This campaign was designed to motivate people in Canada to access various services through the Department's website. The campaign generated more than 886,000 visits to the website.

Modernizing Canada's health system by utilizing digital health and ensuring that Canadians have access to their own electronic health information

Canadians should be able to access their own electronic health information and benefit from it being shared among their health professionals. Canadians expect their health information to be easily and securely accessible to them and their health care providers through modern and digitally connected health care systems, built with the strongest privacy standards.

As part of the Working Together to Improve Health Care for Canadians Plan, F/P/T governments are working closely to improve the way health data is collected, shared, and used to benefit Canadians. Specifically, they agreed to focus on 5 data-related commitments to:

• Collect and share high-quality and comparable depersonalized information to measure progress being made through common indicators to improve health care for Canadians.
• Adopt common interoperability standards guided by the Pan-Canadian Interoperability Roadmap to better connect health care systems and allow Canadians and their health care providers to securely access electronic health information to improve care.
• Promote alignment between P/T health data policies and legislative frameworks for consistent approaches to health information management and stewardship that maintains appropriate privacy protections.
• Advance common principles for the management of health data through endorsement of a Pan-Canadian Health Data Charter that reaffirms a commitment to a person-centered, ethical approach to health data, public engagement, equity, and Indigenous data sovereignty.
• Collect and share public health data to support Canada's preparedness and response to public health events.

Since the Working Together plan was announced in February 2023, F/P/T governments have endorsed:

• The Pan-Canadian Interoperability Roadmap, led by Canada Health Infoway with support from the Canadian Institute for Health Information and Statistics Canada. It outlines the path forward for connecting care with health data and digital tools through common standards that enable safe and secure access to health information that can flow easily between different parts of the health care system.
• A health data governance structure to continue to guide this work, under the accountability of F/P/T Health Ministers.
• A Joint F/P/T Action Plan on Digital Health and Health Data and a Pan-Canadian Health Data Charter focused on the priorities of the health data commitments in October 2022 by Health Ministers (except Québec). The Charter outlines guiding principles for the disclosure, access, and use of health data. It also highlights the importance of promoting and preserving Indigenous data sovereignty.

Further, under the leadership of the Canadian Institute of Health Information, F/P/T governments have come together to refine and identify common indicators that will be used to measure the progress being made by the significant investments in health care.

In 2023-24, the Department engaged a range of stakeholders (health IT vendors, P/Ts, health care professional associations, key subject matter experts, First Nations, Inuit, and Métis organizations) on how to accelerate the adoption of pan-Canadian interoperability requirements to support access, exchange, and use of electronic health information, including the use of potential federal legislative mechanisms. Overall, feedback was generally supportive and helped inform the development of Bill C-72, the Connected Care for Canadians Act which was introduced in Parliament on June 6, 2024.

Investments in Pan-Canadian Health Organizations

In 2023-24, Health Canada continued to work closely with organizations that directly contribute to health system modernization. The Department supported these organizations through a variety of transfer payments (i.e., grants and contributions). Supplementary information tables on Health Canada's transfer payment programs provide additional information. Specific highlights of these investments included:

• $75.7 million to the Contribution to Canada Health Infoway to advance priority initiatives including the Interoperability Roadmap that will enable digital health systems to connect with each other, ultimately improving quality of care, and expanding the use of PrescribeIT, the primary e-prescribing solution in Canada.
• $128 million to the Contribution to the Canadian Institute for Health Information to accelerate improvements in health data collection, management, and standards development including advancements in workforce data, establishing common data standards to support the Interoperability Roadmap, reporting on shared health priority indicators, and modernizing health systems data to be timely, linked, comprehensive, and representative of Canada's diverse population.
• $38.7 million to the Canadian Agency for Drugs and Technologies in Health, now known as Canada's Drug Agency, to strengthen the effective management of drugs and non-drug technologies.
• $25.1 million to Healthcare Excellence Canada through the Contribution to Improve Health Care Quality and Patient Safety to encourage innovation and catalyze change to support large-scale health system improvement.

These efforts enable governments, health care providers, stakeholders, and patients to have access to better information on the performance of Canadian health systems and provide information on the cost-effectiveness of drugs and technologies to support evidence-based decision-making. For example, Canada's Drug Agency published Guidance for Reporting Real-World Evidence on use, safety, and effectiveness of a drug, medical product or technology, and implemented a framework to enhance transparency regarding clinical trials. In addition, a 2024 evaluation of the Pan-Canadian Health Organizations found that they have made individual and collective progress towards their shared goals of enhancing health system capacity, changing the behaviour of health care decision makers, and supporting improvements in health systems. The organizations demonstrated flexibility by pivoting to pandemic response activities while also demonstrating continued work to advance longstanding initiatives.

Helping Canadians age with dignity, closer to home, with access to home care, long-term care, and palliative care

Health Canada continued to help Canadians age with dignity, closer to home, with access to home care, long-term care, and palliative care. Significant federal funding is being provided to P/Ts through Aging with Dignity Funding Agreements (2023-24 to 2027-28). In 2023-24, P/Ts signed agreements, with action plans outlining how they will use federal investments to improve home and community care (including palliative care) and long-term care to help ensure seniors get the care they deserve. Through the Health Care Policy and Strategies Program, the Department also continued to invest in projects targeted for formal and informal caregivers and health care professionals to build palliative care capacity in primary care and to equip family caregivers with the skills and resources needed to care for elderly loved ones at home.

Home care

The Department is committed to supporting programs and services that seniors need to live independently in their homes and communities for as long as possible. This includes improving access to home and community care (including palliative care) through Aging with Dignity agreements with P/Ts, consistent with the Common Statement of Principles on Shared Health Priorities. In 2023-24, the National Seniors Council, which served as the Expert Panel on Supporting Canadians Aging at Home, examined measures, including a potential aging at home benefit to further support Canadians who wish to age at home or in their community. The recommendations included in the Expert Panel's final report will inform the Government of Canada's approach to helping Canadians age at home and in their communities.

Long-term care

Health Canada continues to support individuals who wish to age at or closer to home and to improve the standard of care in their long-term care facilities. In 2023-24, the Department signed Aging with Dignity agreements with P/Ts that include $3 billion over 5 years from Budget 2021 to help P/Ts and health care organizations make improvements to quality and safety and workforce stability in their long-term care facilities.

Over the 5 years of the agreements, funding will support P/Ts to strengthen compliance and enforcement activities, including accreditation and regular inspections. For example, British Columbia is using the funding to expand capacity for licensing oversight and quality improvement, and Nova Scotia is taking action to increase compliance with service standards. Saskatchewan is adding front line care staff, and Nunavut is advancing certified training for staff. Additionally, funding will support workforce capacity and stability.

Finally, in 2023-24, in collaboration with Employment and Social Development Canada, the Department conducted an online public consultation and a series of roundtable discussions to support the Government of Canada's commitment to develop a Safe Long-Term Care Act, which is intended to ensure that all Canadians get the care they deserve, while respecting P/T jurisdiction. The engagement garnered wide-ranging and highly informative perspectives from over 5,000 people in Canada. Participants spoke to priorities including access to high quality and inclusive long-term care services, quality of life for residents, supporting the long-term care workforce, access to home care supports, and transparency and accountability in long-term care. Health Canada will use this feedback to help identify themes and principles to inform the Act.

Palliative care

Palliative care helps address the needs of people living with serious illness and their loved ones, improving their quality of life. In 2023-24, Health Canada continued to enhance access to quality palliative care by implementing the 5 priorities of its Action Plan on Palliative Care. The Department continued its multi-year education campaign on palliative care including awareness tools such as testimonial-based video ads, campaign page, fact sheets, infographics, an interactive quiz, posters, brochures, and podcast/audio ads and stories from families with lived experiences. The campaign received over 20 million impressions, 1.6 million video views, and 81,000 visits to Canada.ca webpages.

Health Canada also advanced projects to improve access to palliative care for persons experiencing homelessness or who are vulnerably housed, raised awareness of advance care planning, and made resources more universally accessible for Canadians with disabilities. To support improved access to palliative care in Indigenous communities, the Department, in collaboration with Indigenous Services Canada, supported Indigenous-led community engagement and capacity building on palliative and end-of-life care with First Nations, Inuit, and Métis organizations.

Lastly, in December 2023, Health Canada published a report on the state of palliative care in Canada. Using data provided by the Canadian Institute for Health Information, it showed that more people are receiving some form of palliative care (58% in 2021-22 vs 52% in 2016-17), and more people are dying at home with palliative support compared to 5 years ago (14% in 2021-22 vs. 7% in 2016-17), while identifying gaps that remain. It also included recommendations to further the Action Plan's priorities, such as: advancing education and training, including mentorship and experiences for health care provider students; continuing palliative care research; developing and adopting precise palliative care indicators; using a cultural sensitivity and age-appropriateness lens, and continuing to look for ways to integrate palliative care across various settings.

Building resilience for future health emergencies, leveraging lessons learned from the response to the COVID-19 pandemic

In 2023-24, Health Canada, following on lessons learned from the COVID-19 pandemic, increased its capacity to better respond and to support others in responding to health emergencies. The Department established an internal health emergency coordination office to maintain its readiness, help build resilience in Canada's health sector, and help protect the safety and well-being of people in Canada during health emergencies requiring a federal response. The office includes a centralized secretariat as the Departmental point of contact for emergency management working with the Public Health Agency of Canada, federal partners, P/Ts, and other stakeholders.

Also in 2023-24, Health Canada, working with the Public Health Agency of Canada and Innovation, Science and Economic Development Canada partners, consulted with over thirty industry, health and research stakeholders, non-governmental organizations, and Canadian and international experts on how best to organize Canada's readiness efforts for years to come. This was in response to Budget 2023 direction to explore new ways to be more efficient and effective when developing and producing medical countermeasures, including vaccines, therapies, and diagnostic tools that would be required for future health emergencies. Stakeholders underscored the need for a mission-driven focal point that would provide sustained, expert, and integrated attention to the domestic life sciences sector. Health Canada continues to work with its partners to put this advice into action.

In response to lessons learned from the COVID-19 pandemic, Health Canada continued to engage in several international processes to better prevent, prepare for, and respond to future pandemics. This included a World Health Organization process to amend and modernize International Health Regulations (2005) using a legally binding instrument, to strengthen the global capacity to prepare for and respond to health emergencies. The Department also worked with the Intergovernmental Negotiating Body to draft and negotiate a pandemic agreement to enhance global pandemic prevention, preparedness, and response.

Throughout negotiations, Canada championed the use of inclusive language and advocated for measures such as strengthening health systems and the health care workforce. The Department also held stakeholder engagements with over 115 partners who shared their views and expertise on issues in the pandemic agreement.

In addition, Canada continued to advance global health security, health equity, and global health governance with bilateral (e.g., US, UK, France, and European Centres for Disease Control) and multilateral partners. This includes the January 2024 World Health Organization Executive Board meeting and the September 2023 Pan-American Health Organization Executive Committee meeting, during which Canada endorsed a plan to apply COVID-19 lessons learned.

Back to Expanding access to oral health services.

Departmental Result 2: Canadians have access to appropriate and effective health services

In this section

• Improving affordability and accessibility of pharmaceuticals
• Working with the province of Prince Edward Island through the Improving Affordable Access to Prescription Drugs Program
• Strengthening and defending the core principles of the Canada Health Act
• Improving equitable access to care and addressing racism and discrimination in health care
• Supporting the safe and consistent implementation of medical assistance in dying
• Ensuring healthy people and communities
• Continuing to advance the Biomanufacturing and Life Sciences Strategy
• Continuing to advance key horizontal science policy and research initiatives

Improving affordability and accessibility of pharmaceuticals

Since new innovative drugs are expensive and costs continue to rise, some Canadians have difficulty accessing affordable prescription medications. To improve access, affordability, and appropriate use of medications for Canadians, Health Canada announced 2 major initiatives in 2023-24: the creation of Canada's Drug Agency and the introduction of national pharmacare legislation. Health Canada also continued work under the National Strategy for Drugs for Rare Diseases, including activities to support collaborative governance, data infrastructure, research on rare diseases, and to lay the groundwork for agreements that will make funds available for new and enhanced services. In 2023-24, the Department also continued to support Pediatric Drug Action Plan implementation, and helped Prince Edward Island improve affordable access to prescription drugs.

Creation of Canada's Drug Agency

In December 2023, following extensive engagement with P/Ts, Indigenous partners, patient advocates, and international leaders in pharmaceuticals management, Health Canada announced the creation of Canada's Drug Agency (CDA). The Agency will provide the dedicated leadership and coordination needed to make Canada's drug system more sustainable and better prepared for the future, helping Canadians achieve better health outcomes. The CDA is being built from the Canadian Agency for Drugs and Technologies in Health (CADTH), expanding existing functions (health technology assessment, post-market safety, and effectiveness) to include new work streams including:

• Improving the appropriate prescribing and use of medications for better patient health and to support system sustainability.
• Increasing pan-Canadian data collection and expanding access to drug and treatment data, including real-world evidence data to better support patients, inform health decisions, and enable robust system data analytics.
• Reducing drug system duplication and lack of coordination that causes expensive inefficiencies and pressures.

In 2023-24, Health Canada advanced work with key partners to support the development of new CDA functions, and CADTH's transition to the CDA.

Introduction of legislation for the first phase of national universal pharmacare

In February 2024, the Government of Canada introduced Bill C-64, An Act respecting pharmacare to advance national universal pharmacare. Bill C-64 proposes principles for the implementation of national universal pharmacare and describes the Government of Canada's intention to work with P/Ts to provide universal, single-payer coverage for a number of contraceptive and diabetes medications. Doing so will improve health equity, affordability, and potentially have long-term savings for the health care system.

Contraceptive care providers have identified cost as the most significant barrier to access these medications and populations such as women, people with low incomes, and young people are disproportionally affected by the lack of coverage.

Diabetes is one of the most common chronic diseases affecting Canadians and 1 in 4 people with diabetes have reported not following their treatment plan due to cost. Improving access to medications will help improve the health of 3.7 million Canadians living with diabetes and can reduce the risk of serious life-changing health complications such as blindness or amputations. Diabetes disproportionately affects certain populations in Canada, including First Nations and Métis people, and people of African, East Asian, and South Asian descent have higher rates of Type 2 diabetes compared to the general population.

National Strategy for Drugs for Rare Diseases

Rare diseases impact many Canadians, yet innovative treatments can be costly. In 2023-24, as part of the first-ever National Strategy for Drugs for Rare Diseases, Health Canada worked with P/Ts towards the development of a common framework for bilateral agreements. These agreements will make funds available to improve access to new and emerging drugs, support enhanced access to existing drugs, and support screening and diagnosis for rare diseases. This will help patients with rare diseases have access to affordable treatments as early as possible, for a better quality of life.

The National Strategy for Drugs for Rare Diseases also aims to broaden treatments and services for rare diseases, build national governance with a supporting data infrastructure, and invest in critical rare disease research. In 2023-24, achievements included the launch of an Advisory Group to support the implementation of the National Strategy from a patient-centered perspective. Strategy partners at Canada's Drug Agency and the Canadian Institute for Health Information launched an interactive public drug plan and formulary tool, released a Pan-Canadian Prescription Drug Data Landscape Report, established a newborn screening advisory panel, identified case studies and a methodology for assessing and exploring feasibility of linking registry data to administrative data, and launched an open call for funding to support efforts to improve the quality and usability of real-world data from rare disease registries.

Pediatric Drug Action Plan

To address challenges in accessing safe and effective health products for children and youth, the Department continued to implement the Pediatric Drug Action Plan. In 2023-24, Health Canada launched the Pediatric Study Submission Pilot, asking drug sponsors to voluntarily provide a pediatric development plan for drugs that details any ongoing or planned pediatric studies as part of certain submissions for market authorization. The aim of this pilot is to increase access to information relevant to pediatric populations and to align with international standards.

The Department also created a Pediatric External Reference Group to support the development of the National Priority List of Pediatric Drugs. Made up of experts from the pediatric medical and pharmacist community across Canada, the reference group provided the Department with expert advice and helped Health Canada engage with the broader professional community. Following a 60-day targeted consultation with pediatricians and pharmacists across Canada, Health Canada received over nine hundred nominations for consideration on the list. After screening the nominations to ensure that they were compliant with the nomination criteria, the Department provided one hundred and nineteen drugs to the reference group for their review and prioritization.

Working with the province of Prince Edward Island through the Improving Affordable Access to Prescription Drugs Program

In 2023-24, Health Canada continued to work with the province of Prince Edward Island (PEI) to support their efforts in providing residents with increased access to affordable prescription drugs under the Improving Affordable Access to Prescriptions Drugs Program. Since December 2023, PEI has expanded access to over 100 medications to treat a variety of conditions, including cancer, heart disease, migraine, pulmonary arterial hypertension, multiple sclerosis, and psoriasis, as well as medications in the treatment of mental health and addictions. In June 2023, PEI's $5 copay program reduced copays for almost 60% of medications regularly used by Island residents and included eligible medications used for heart disease, diabetes, and mental health covered under public drug programs. As of March 2024, PEI residents have saved over $2.8 million in out-of-pocket costs under the $5 co-pay program. The High-Cost Drug Program was also modified to remove barriers making the program available to all income levels. In addition, in July 2023, PEI adjusted the Catastrophic Drug Program to lower the annual cap on the amount of money a household spends on eligible medications.

Strengthening and defending the core principles of the Canada Health Act

The Department monitored changes in the delivery of health care to ensure that insured services under the Canada Health Act remain covered regardless of how care is provided or who is providing care. In 2023-24, Health Canada reduced Canada Health Transfer payments to P/Ts by over $79 million due to patients being inappropriately charged for medically necessary services in 2021-22. The majority of charges, over $72 million, were for medically necessary diagnostic imaging services at private clinics.

Under the Reimbursement Policy, P/Ts have the opportunity to be reimbursed for any deductions to their Canada Health Transfer provided they carry out a Reimbursement Action Plan that demonstrates they have eliminated the patient charges and the circumstances that led to them. In March 2024, 6 provinces (British Columbia, Alberta, Manitoba, Ontario, Quebec, and Newfoundland and Labrador), received reimbursements totalling over $90 million, for multiple years of deductions. This included reimbursement of deductions taken under the Diagnostic Services Policy totalling over $83 million. These reimbursements demonstrate the successful implementation of both the Diagnostic Services and Reimbursement policies.

Improving equitable access to care and addressing racism and discrimination in health care

In 2023-24, Health Canada continued to invest in programs and organizations that directly supported access to appropriate and effective health services for Canadians. Addressing racism in health care and the specific health care needs of populations such as Indigenous Peoples, people living in Canada's territories, official language minority communities, and Canadian thalidomide survivors continued to be a priority. Results in 2023-24 included:

• Funding projects to address systemic anti-Indigenous racism and/or discrimination in Canada's health systems including the Ontario Native Women's Association whose project, Mindimooyenh Indigenous Women's Health Curriculum, resulted in the development, piloting, and expansion of a culturally relevant curriculum focused on Indigenous women's health across the lifecycle.
• Supporting territorial efforts to innovate and transform their health care systems and to ensure Northerners have access to the health care they need. In 2023-24, Yukon announced plans to use a share of its funding to establish a new Yukon health authority, which would represent a significant step towards creating an effective, efficient, integrated, and people-focused health care system based on equity and responsiveness.
• Continuing to help ensure that considerations related to the vitality of English-speaking communities in Quebec and French-speaking communities elsewhere in Canada (known as official language minority communities (OLMCs)) are included in all Departmental initiatives, when appropriate. In addition, in 2023-24, Health Canada provided funding under its Official Languages Health Program to educational institutions, community groups and networks, and P/Ts to help improve access to OLMCs.
• Contributing to meeting the lifetime needs of Canadian thalidomide survivors by helping pay for specialized surgeries, home and vehicle adaptations not covered by P/T health care plans, and some ongoing costs such as attendant services and physiotherapy. In 2023-24, Health Canada supported 126 Canadian thalidomide survivors to age with dignity.

Supporting the safe and consistent implementation of medical assistance in dying

In 2023-24, Health Canada continued to collaborate with partners to support the implementation of medical assistance in dying (MAID) legislation in a consistent and safe manner across all jurisdictions in Canada, while also seeking to protect priority populations. Achievements included:

• Released the fourth federal Annual Report on MAID in Canada, which provides a comprehensive picture of the implementation of MAID in Canada.
• Extended the temporary exclusion of eligibility for MAID for persons suffering solely from mental illness for 3 years, until March 17, 2027. This provides more time for P/Ts to prepare their health care systems, including the development of policies, standards, guidance, and additional resources to assess and provide MAID in situations where a person's sole underlying medical condition is a mental illness. It also provides practitioners with more time to participate in training and become familiar with available supports, guidelines, and standards.
• Continued work with P/Ts to support the safe and consistent delivery of MAID across the country and research to guide policy work around the evolution of MAID in Canada.
• Funded the development and release of MAID resources for health professionals including providing ongoing support to develop and deliver a national accredited training curriculum to support practitioners in their assessment and delivery of MAID.
• Continued engagement with Indigenous Peoples to understand views on MAID and palliative care. This included 9 Indigenous-led community engagement projects, an online survey, and 17 dialogue sessions. Results will be summarized in a "What We Heard" report in 2025.
• Released a government response in June 2023 to accompany the second report of the Special Joint Committee on MAID, Medical Assistance in Dying in Canada: Choices for Canadians.
• Continued monitoring of MAID, including advising practitioners and P/Ts of regulatory changes in data collection and reporting. As part of the expansion of data collection, data related to race, Indigenous identity, and disability are expected to help provide data about any individual or systemic inequality or barriers in the context of MAID.

Ensuring healthy people and communities

To foster a strong and effective public health care system, Health Canada supported the development of inclusive, innovative, and people-centered health care solutions to improve the health of those who have a greater risk of experiencing a health care issue, or who are facing barriers in accessing health care services adapted for distinct needs. The Department collaborated with partners and communities to test solutions and address population needs. Funding recipients worked directly with health practitioners, decision makers, and health organizations to develop, refine, and share specialized knowledge, skills, and tools designed to improve health care services for priority populations. In 2023-24, results related to priorities for combatting cancer, improving access to sexual and reproductive health services, supporting organs, tissues, and blood systems, and addressing chronic pain priorities in included:

• Supported the Canadian Partnership Against Cancer to advance cancer control from prevention and early diagnosis through to survivorship and end of life care; supported Ovarian Cancer Canada's OvCAN initiative, Advancing New Treatments to Improve the Survival of Women with Ovarian Cancer to address gaps in knowledge about effective prevention, screening, and treatment options for ovarian cancer; and supported the Terry Fox Research Institute to support the expansion of its Marathon of Hope Cancer Centres Network, a national network of cancer centres working collaboratively to advance precision medicine in cancer research.
• Improved access to sexual and reproductive health services by supporting community-based organizations like Action Canada that expanded support for individuals accessing abortion and sexual health care. In 2023-24, Action Canada's Access Line received 5,876 calls (up by 12% since 2022-23) and 155 clients were supported on a variety of sexual and reproductive health matters (a 55% increase compared to 2022-23).
• Contributed to safe, effective, accessible, and responsive organ, tissue, and blood systems by providing funding to Canadian Blood Services, supporting a pan-Canadian organ donation and transplantation governance framework, and a pan-Canadian organ donation and transplantation data and performance reporting system.

Continuing to advance the Biomanufacturing and Life Sciences Strategy

The Department has continued to work with Innovation, Science and Economic Development Canada, the Public Health Agency of Canada, and the Canadian Institutes of Health Research to advance the Biomanufacturing and Life Sciences Strategy as announced in June 2021. The Strategy aims to increase national capacity to manufacture critical vaccines, therapeutics, and other life-saving medicines, focusing on growing a strong and competitive domestic life sciences sector, ensuring Canada's readiness for future pandemics or other health emergencies. One of the Strategy's key initiatives is the Agile Licensing regulatory proposal.

As part of the Strategy's collaboration pillar, in 2023-24 Health Canada:

• Engaged internationally to explore opportunities for regional manufacturing capacity, in support of global manufacturing capacity and engaged with bilateral partners, such as the United States, the United Kingdom, and South Korea to advance mutual interests in support of the Strategy, and signed an MOU with Denmark, which includes exchanges and cooperation on life sciences.
• Consulted with experts to help inform how best to organize Canada's long-term pandemic readiness efforts, the Government of Canada's role in the build-out of biomanufacturing capacity, and the track record of such investments.

Additionally, in collaboration with federal partners, Health Canada supported the implementation of the Government of Canada's investment of $2.2 billion through Budget 2021 to advance 5 pillars of the Strategy, including the areas research, skills and talent development, infrastructure, and clinical trials.

Continuing to advance key horizontal science policy and research initiatives

In response to the Report of the Advisory Panel on the Federal Research Support System (the Bouchard Report), Health Canada and Innovation, Science and Economic Development Canada worked to review the panel's findings and recommendations on how to better support Canada's research ecosystem and enable Canadian researchers to support a strong research ecosystem that fosters new ideas, breakthroughs, and advancements that will improve Canadians' health, well-being, and prosperity.

The Strategic Science Fund, a joint initiative with Innovation, Science and Economic Development Canada, aims to enhance Canada's science, technology, and innovation excellence by leveraging the expertise and resources of independent, third-party science and research organizations including those with a health focus. In 2023-24, the Fund supported 24 applicants in its inaugural competition. The successful third-party science and research organizations are conducting internationally competitive, cutting-edge research on topics like health care and quantum computing and translating research and knowledge into action in important areas that will improve the health, economic, and social well-being of Canadians now and in the future.

Back to Departmental Result 1: Canada has modern and sustainable health care systems.

Key risks

Information on Key risks is available on Health Canada's website.

Related government-wide priorities

Gender-based analysis plus

More information about Sex- and Gender-based Analysis Plus is available in the Gender-Based Analysis Plus Supplementary Information Table.

United Nations 2030 Agenda for Sustainable Development and the UN Sustainable Development Goals

More information about Health Canada's contributions to Canada's Federal Implementation Plan on the 2030 Agenda and the Federal Sustainable Development Strategy can be found in Health Canada's Departmental Sustainable Development Strategy.

Core responsibility 2: Health protection and promotion

In this section

• Description
• Program inventory
• Resources required to achieve results
• Progress on results
• Details on results
• Key risks
• Related government-wide priorities

Description

Health Canada works with domestic and international partners to assess, manage, and communicate the health and safety risks and benefits associated with health and consumer products, food, chemicals, pesticides, environmental factors, tobacco and vaping products, cannabis, and controlled substances.

Program inventory

Health protection and promotion is supported by the following programs:

• Pharmaceutical Drugs; Biologic and Radiopharmaceutical Drugs; Medical Devices; Natural Health Products
• Food and Nutrition
• Air Quality; Climate Change; Water Quality; Health Impacts of Chemicals
• Consumer Product Safety; Workplace Hazardous Products
• Tobacco Control; Controlled Substances; Cannabis
• Radiation Protection
• Pesticides
• Health Canada Specialized Services

Additional information related to the program inventory for Health protection and promotion is available on the Results page on GC InfoBase.

Resources required to achieve results

Complete financial and human resources information for Health Canada's program inventory is available on GC InfoBase.

Progress on results

This section presents details on how the department performed to achieve results and meet targets for Health protection and promotion. Details are presented by departmental result.

Tables 5, 6, and 7: Targets and results for Health protection and promotion

These tables provide a summary of the target and actual results for each indicator associated with the results under Health protection and promotion.

Additional information on detailed results and performance information for Health Canada's program inventory is available on GC InfoBase.

Details on results

The following section describes the results for Health protection and promotion in 2023–24 compared with the planned results set out in Health Canada's departmental plan for the year.

In this section

• Departmental result 3: Canadians have access to safe, effective, and quality health products
• Departmental result 4: Canadians are protected from unsafe consumer and commercial products and substances
• Departmental result 5: Canadians make healthy choices

Departmental result 3: Canadians have access to safe, effective, and quality health products

In this section

• Modernizing regulatory oversight and increasing regulatory agility for drugs and medical devices
• Applying real-world evidence to support regulatory decision-making
• Incorporating regulatory flexibilities to address urgent public health needs during future public health emergencies
• Preventing and mitigating the impact of drug and other health product shortages
• Providing timely access to health products
• Promoting access to new and emerging technologies
• Acting to prevent and control antimicrobial resistance

Modernizing regulatory oversight and increasing regulatory agility for drugs and medical devices

Health Canada continued to advance its multi-year Regulatory Innovation Agenda with the goal of making the federal regulatory framework more agile and responsive. Using the lessons learned from temporary measures implemented in response to the pandemic, the Department continued to progress on commitments described in the Health and Biosciences Regulatory Review Roadmap and the Agri-food and Aquaculture Regulatory Review Roadmap. Health Canada has advanced several initiatives to help regulate the risks, benefits, and uncertainties of more diverse and complex products as described below.

Modernizing regulatory oversight

The Department worked towards amending Food and Drug Regulations, Medical Devices Regulations, and Natural Health Products Regulations to give Health Canada more tools to manage risks once products are on the market.

The Department proposed to update existing recall requirements and modernized reporting requirements to increase the effectiveness of medical device and drug recall frameworks in Canada. In June 2023, the Department also amended the Food and Drugs Act, extending the authorities under the Protecting Canadians from Unsafe Drugs Act (also known as Vanessa's Law) to natural health products. This allows Health Canada to take more action if a serious or imminent risk to health is identified with a natural health product, including the ability to recall unsafe natural health products.

Health Canada also worked toward improving the transparency of Canadian clinical trial information, requiring the submission of disaggregated data from clinical trials within drug marketing applications, and modernizing the clinical trial regulations. For example, in 2023-24 the Department continued to develop a proposal to provide proportional risk-based oversight and greater regulatory flexibility over the lifecycle of the trial. Public comments will be sought in 2025 when the regulations are published. In 2023-24, Health Canada began developing a clinical trials search portal and an associated guidance document, to replace the existing Clinical Trials Database.

In 2023-24, the Department continued to work with industry to help implement the improved natural health product labelling regulatory requirements, which are intended to help Canadians make safe and informed choices. Health Canada also conducted Public Opinion Research on Canadian consumers' current level of knowledge, attitudes, and behaviours with respect to self-care products including natural health products, non-prescription drugs, and health products containing cannabidiol. The results of the Public Opinion Research contribute to Sex- and Gender-Based Analysis Plus program data to better understand the impacts of the Department's policies and programming on specific populations in Canada and will be used to inform future policy and regulatory approaches including the Self-Care Framework, which aims to use a risk-based approach to regulatory oversight of self-care products.

In May 2023, the Department consulted with Canadians and industry stakeholders on a proposal to introduce a cost recovery framework for natural health products. Currently, natural health products are the only class of health products for which Health Canada does not recover a part of the costs it incurs to provide regulatory and oversight services to industry. Expanding cost recovery to natural health products is an important step to support the program's long-term sustainability. In March 2024, the Department published an updated proposal for further industry engagement.

The Department also finalized new Biocides Regulations that create a single regulatory framework for biocides (i.e., surface sanitizers, disinfectants, and surface sanitizers for use in food premises). The framework introduces a pathway for authorization based on decisions from foreign regulators, starting with the United States Environmental Protection Agency. This will encourage companies to bring their biocides to the Canadian market without compromising safety. These new regulations are accompanied by amendments to the Fees in Respect of Drugs and Medical Devices Order, which will allow Health Canada to continue to charge fees to examine applications to sell or change biocides and to monitor biocides on the Canadian market.

In November 2023, the Department consulted with consumers, industry stakeholders, and health professionals on a proposal to modernize the regulations for foods for special dietary use and infant foods. Health Canada will use the comments received to inform the development of proposed regulations for these foods which are expected to be published in spring 2026.

The Department also continued to work with hospitals to increase awareness of the hospital mandatory reporting regulations. As part of this effort, Health Canada launched a new mandatory hospital reporting dashboard, which provides a summary of statistics on the medical device incidents and serious adverse drug reactions reported by hospitals across Canada.

Increasing regulatory agility for drugs and medical devices

In 2023-24, the Department continued to advance its Agile Licensing for Drugs and Medical Devices proposal to support a more agile, risk-based approach for drugs and medical devices, while also reducing the regulatory burden. Stakeholders were generally supportive of the proposed changes to the Food and Drug Regulations and Medical Devices Regulations, and their feedback will be considered as the regulations and guidance documents are finalized. The final regulations are currently targeted for publication in fall 2024, which will enable the implementation of a more modern regulatory framework for drugs and medical devices. This will enhance safety through the expansion of post-market terms and conditions, while supporting innovation and growth, by addressing some long-standing barriers identified by industry.

In support of modern, agile, and innovative compliance and enforcement approaches for health products, Health Canada continued to adopt virtual and remote tools for inspections where appropriate. For example, the Department has determined under which circumstances a remote inspection for Good Manufacturing Practices would be appropriate and under which circumstances an on-site presence remains critical. The Department worked with international partners to explore how remote inspections might improve oversight in foreign inspections and how international regulators can further enhance collaborations to strengthen collective oversight. This included participating in the International Coalition of Medicines Regulatory Authorities collaborative hybrid inspection pilot. This pilot program combined on-site inspectors in the facility with remote inspectors to conduct a hybrid inspection where multiple international regulators were interested in inspecting a particular manufacturing facility. The Department also improved data, analytics, and risk management tools in support of data-driven decision-making at regulatory oversight by improving Health Canada's ability to prioritize actions, and tools to automate certain tasks.

Applying real-world evidence to support regulatory decision-making

Real-world evidence is evidence regarding the use, and potential benefits or risks, of a health product that is gathered after a product is on the market. Health Canada continued to apply real-world evidence to improve post-market oversight of prescription drugs in Canada and to inform decision-making for COVID-19 drugs and vaccines. The Department collaborated with partners to advance learning and develop guidance for reporting real-world evidence, for example, the Canada's Drug Agency Guidance for Reporting Real-Word Evidence to Support Decision-making that was published in May 2023. As Health Canada noted, this guidance promotes the use of high-quality real-world data and real-world evidence in drug development and regulatory decision-making across the drug product life cycle. It also emphasizes the importance of transparent and comprehensive reporting of real-world evidence studies.

Health Canada also worked to further align real-world evidence use across the drug life cycle, for example, through its continued role as co-chair of the Real-World Evidence Steering Committee.

Additionally, Health Canada, in collaboration with the European Medicines Agency and the United States Food and Drug Administration, developed an International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use reflection paper to help harmonize real-world evidence terminology and principles for using real-word data in pre-market regulatory submissions. This is expected to improve the quality of evidence presented in pre-market regulatory submissions and support better decision-making.

Finally, the Department enacted an interim order to maintain oversight of single-ingredient ephedrine and pseudoephedrine natural health products. These products pose a risk of misuse and diversion, including as precursors in the illegal production of the controlled substance methamphetamine.

Incorporating regulatory flexibilities to address urgent public health needs during future public health emergencies

In 2023-24, Health Canada advanced plans to incorporate regulatory agilities piloted during the COVID-19 pandemic into regulatory frameworks to address urgent public health needs during future public health emergencies. For example, Health Canada consulted stakeholders on a proposed expansion of the COVID-19 requirements under the Food and Drug Regulations to address new and emerging public health emergencies.

In January 2024, new regulations came into force that broadened the scope of the Medical Devices Regulations to apply to future public health emergencies for which there is an urgent need. This work concluded a series of regulatory measures introduced since 2020 that provided access to COVID-19 medical devices, which included 3 interim orders and permanent regulations for COVID-19-specific medical devices. These amendments will ensure that Canadians have faster access to medical devices in the case of a future public health emergency, without having to put interim orders and transitional regulations into place.

The Department continued to prioritize its scientific review of drugs, vaccines, and medical devices for urgent public health needs, and as part of its continued efforts to be open and transparent, published high-level summaries of the evidence it has reviewed to support these authorizations. Regulatory Decision Summaries and Summary Basis of Decision documents were published for the vaccines approved to target the COVID-19 Omicron XBB.1.5 variants. Subsequent post-authorization activities were published within the Summary Basis of Decision for these vaccines to provide updated information on their safe and effective use.

Finally, the COVID-19 pandemic highlighted the importance of international collaboration during public health emergencies to be able to make regulatory decisions on critical health products more quickly. In 2023-24, as part of the European Medicines Agency OPEN initiative on COVID-19 and through the ACCESS work-sharing consortium, the Department had access to information from trusted international partners on COVID-19 medicines, which promoted knowledge sharing and contributed to public trust in vaccines and therapeutics.

Preventing and mitigating the impact of drug and other health product shortages

In partnership with P/Ts and a range of stakeholders including international organizations, industry, patient advocates, and health care groups, Health Canada continued to mobilize efforts to alleviate the impacts of drug shortages on Canadians. In 2023-24, the Department worked to identify, prevent, manage, and mitigate shortages of critical drugs such as an emergency drug used to treat severe hypoglycemia in patients with diabetes and a drug used to treat adults with type 2 diabetes.

Health Canada continued to prohibit the distribution of certain drugs outside Canada if it could lead to or exacerbate shortages domestically, as demonstrated by Health Canada's response to Florida's bulk importation plan. The Department engaged with senior officials in federal and state governments of the United States to make Canada's position clear. The Department also published industry guidance on relevant regulations and reached out proactively to establishment licence holders to ensure that they were aware of their regulatory obligations.

The Department broadened stakeholder engagement to better understand the impact of shortages on priority populations such as children and Indigenous Peoples, by considering available data including Sex- and Gender-Based Analysis Plus information to determine population groups that may have been disproportionately impacted by Tier 3 drugs shortages during 2023-24.

Health Canada worked to detect potential drug shortages earlier to provide time to implement mitigation and prevention efforts. Initiatives included regular engagement with P/T counterparts, active monitoring of supply and demand signals, and increased efforts in expanding stakeholder engagement initiatives (e.g., meeting with medical stakeholder groups such as the Canadian Pediatric Society).

The Department consulted stakeholders and the public on improving access to drugs and other health products and published a report highlighting stakeholder feedback through 4 themes: improved communication and transparency, agile regulatory toolbox, greater supply chain visibility, and enhanced response to changes in supply and demand. This consultation informed the development of Health Canada's plan to address health product shortages, 2024 to 2028. This Plan proposes a series of actions to help build resilience against health product shortages and protect people in Canada from the worst effects of shortages.

Market authorization holders must report drug shortages and give notice of discontinuation via the Drug Shortages Canada website. As a result, a total of 968 drugs were reported to be in shortage, with 48 being identified as national and critical drug shortages, which have the highest impact on patients and the health care system. Health Canada worked collaboratively with stakeholders to resolve these critical drug shortages and mitigate their impacts. Specific actions included allowing the importation and sale of foreign-authorized drugs and extending the shelf-life of specific lots of drugs.

In partnership with P/Ts and stakeholders, the Department continued to play a leadership role in addressing national medical device shortages to help ensure that Canadians had access to the devices they need. Manufacturers of Class I to IV medical devices and importers of Class l medical devices reported medical device shortages and discontinuations for devices on the List of Medical Devices - Notification of Shortages. Health Canada also encouraged voluntary reporting to identify new or emerging shortages, determine trends in the medical device supply chain, and any areas of risk of concern for shortages. The Department assessed these reports and published shortages and discontinuations on Medical device shortages: List of shortages and discontinuations, while continuing to work with stakeholders to ensure an adequate supply of medical devices in Canada for critical national shortages. Health Canada received and assessed 84 shortage and 55 discontinuation reports.

Providing timely access to health products

In 2023-24, the Department reviewed the safety, efficacy, and quality of pharmaceutical and biologic drugs, medical devices, and natural health products. This ensured access to health products, while Health Canada builds expertise to assess new technologies.

The Special Access Program continued to enable health care professionals to request, in emergency situations, medical devices and drugs not yet authorized for use in Canada. In 2023-24, Health Canada piloted an electronic tool (eSAP) to allow a small group of health care professionals to submit applications electronically, view the status of their applications, and receive decisions electronically via their mobile devices. Additional system refinements to address user needs will help inform feasibility assessment for full implementation.

In 2023-24, the Department also continued to allow for flexibility in early phase clinical trials for cannabis and psychedelic drugs to generate high-quality evidence that can be used to better understand the health risks and benefits of their use for therapeutic purposes. Health Canada approved 25 cannabis and psychedelic drug clinical trial applications. Increasing the availability of authorized drugs provides Canadians with a greater selection of therapeutic options to meet their health needs and high-quality research also helps guide practitioners in making evidence-based decisions when prescribing drugs to patients.

The Department performed post-market surveillance of drugs and health products, such as publishing risk communications and conducting proactive monitoring of health product advertising. For example, a potential for leakage was identified with certain lots in some fluid-solution intravenous bags. The Department quickly communicated with health care professionals to inform them of potential issues and measures to mitigate safety risks and prevent product shortage. In 2023-24, Health Canada also completed a three-year proactive monitoring project that took action against false, misleading, and deceptive advertising of health products and medical devices in relation to COVID-19 claims.

Access to veterinary drugs is important for animal owners and food producers. In 2023-24, the Department consulted on revised guidance documents for industry to ensure the technical and safety requirements are clear. Also, Health Canada continued to strengthen its joint/simultaneous review processes for veterinary drugs, and for the first time, approved a veterinary drug in partnership with the United Kingdom.

The Department also continued to explore how using selected foreign regulators' approvals would support the authorization of select drugs currently not available on the Canadian market.

Promoting access to new and emerging technologies

Scientific and technological advances are accelerating the pace of innovation in health care, leading to the development of innovative health products. To keep pace with scientific advances, in 2023-24 Health Canada established a new gene therapy regulatory research laboratory to build capacity and expertise to assess new technologies such as advanced artificial intelligence and machine learning algorithms, telerobotics, 3D printing, and gene editing.

In 2023-24, Health Canada's research laboratory collaborated to conduct regulatory research on cell and gene editing. Its' research program addressed knowledge gaps and potential challenges with future gene editing therapeutic approaches. Activities included publications; participating in clinical trial application and new drug submission meetings with sponsors; internal presentations to build reviewer capacity and external presentations with stakeholders to share knowledge and build capacity; and establishing research collaboration with external partners. These efforts were aimed at advancing the field of gene editing and cell-based products to support robust regulatory frameworks. In addition, the Department:

• Published a draft guidance on pre-market considerations for machine learning-enabled medical devices.
• Continued to participate with other key regulatory and industry stakeholders in The Council for International Organizations of Medical Sciences' artificial intelligence working group to develop consensus and best practices for using artificial intelligence in the field of pharmacovigilance.
• Consulted its Scientific Advisory Committee on Digital Health Technologies on the use of generative artificial intelligence in health care and post-market monitoring of machine learning-enabled medical devices.
• Continued to co-chair the International Medical Device Regulators Forum Software as a Medical Device Working Group, resulting in the publication of a draft document on the use of software in medical devices.
• Worked with the U.S. Food and Drug Administration and the U.K.'s Medicines and Healthcare Products Regulatory Agency to publish Guiding Principles for machine learning in medical device technologies.

Advanced Therapeutic Products (ATPs) are drugs, medical devices, or a combination of both that are so complex or distinct that they significantly challenge Canada's current regulatory system. The legislative framework for ATPs allows the Department to regulate these products in a flexible and risk-based manner. In 2023-24, Health Canada continued to explore the candidacy of various product classes for the ATP framework. This work supported timely access for patients while optimizing safety and benefits, as well as strengthening innovation in the health and biosciences sector. For example, the ATP framework process steered the first potential candidate, adaptive machine learning medical devices, to a viable regulatory solution within the existing regulations. While the solution was not an ATP candidate, the objective of the framework and its regulatory barrier assessment process remains the same: ensuring that patients in Canada have access to drugs and medical devices that are safe, effective, and of high quality, regardless of the market access pathway used.

Additionally, 2 other candidates were worked on in 2023-24, fecal microbiota therapy and chimeric antigen receptor (CAR-T) products manufactured at point of care, for which an in-depth analysis occurred and related options are being considered for 2024-25.

As a result of consultations on the draft guidance document for the ATP framework, direction shifted from a guidance document to an InfoHub to enhance the stakeholder experience.

Acting to prevent and control antimicrobial resistance

Antimicrobial resistance (AMR) continued to be an urgent issue for the health of humans, animals, and our shared environment. The June 2023 release of the Pan-Canadian Action Plan on AMR (2023-27) was a key milestone in Canada's response to AMR. The Plan is the culmination of significant F/P/T collaboration, and its 10 shared priorities will guide multi-sectoral and multi-jurisdictional efforts. Additionally, in response to the October 2023 Office of the Auditor General's report on AMR, the Department developed a management response and action plan and continued to work with the Public Health Agency of Canada, partners, and stakeholders to implement and monitor AMR activities. In 2023-24, Health Canada:

• Verified the compliance of selected wholesalers of prescription in-feed drugs with regulatory requirements for the sale and manufacture of prescription medicated feeds.
• Continued efforts to raise awareness of AMR, including developing educational material on the appropriate use of antimicrobials.
• Released the antimicrobial reserve list which indicates which antimicrobial drugs should only be used as last-resort options to preserve their effectiveness.
• Prioritized the review of labels of medically important antimicrobials for use in animals with unspecified or prolonged durations of use.
• Published the 2022 Veterinary Antimicrobial Sales Highlights Report in collaboration with the Public Health Agency of Canada that summarizes antimicrobial sales data to inform antimicrobial surveillance and stewardship.
• Continued to facilitate access to low-risk veterinary health products that improve health and wellness in animals so there is less need for routine use of antimicrobials. In total, 375 veterinary health products were notified from April 2023 to March 2024.
• Prioritized the review of applications for rapid testing devices for humans that can distinguish between types of infections and/or antibiotic resistant genes.
• Actively engaged with international partners, including the Transatlantic Task Force on Antimicrobial Resistance and the newly formed Regulatory Agencies Global Network against AMR, to accelerate action in the fight against AMR.

Back to Departmental Result 2: Canadians have access to appropriate and effective health services.

Departmental Result 4: Canadians are protected from unsafe consumer and commercial products and substances

In this section

• Reducing substance use-related harms and addressing the dangerous, synthetic illegal drug supply and overdose crisis
• Managing the health risks of chemicals in the home, the workplace, and the environment
• Supporting the safety of consumer products and cosmetics
• Strengthening pesticide regulation and transparency
• Protecting Canadians from radiation

Reducing substance use-related harms and addressing the dangerous, synthetic illegal drug supply and overdose crisis

Canada continued to experience an unrelenting rate of overdose deaths and substance-use related harms, largely due to the dangerous, illegal synthetic drug supply that is unpredictable and increasingly toxic. National data shows that 44,592 apparent opioid toxicity deaths were reported between January 2016 and December 2023.

In 2023-24, Health Canada renewed the Canadian Drugs and Substances Strategy, the federal government's comprehensive response to substance-use related harms, including the dangerous, illegal synthetic drug supply and overdose crisis. This public health and public safety-focused strategy covers a broad range of legal and illegal substances, including tobacco, cannabis, alcohol, opioids, and other controlled substances. The Strategy was informed by consultations with people across Canada, along with findings from the Expert Task Force on Substance Use on how to strengthen a public health approach to substance use. The Strategy's goal is to minimize the impact of substance use-related harms for individuals, families, and communities and is based on 4 interconnected elements: prevention and education, substance use services and supports, evidence, and substance controls, such as law enforcement and regulation. The renewed Strategy introduced the principle of equity, alongside principles of compassion, collaboration, and comprehensiveness to help guide federal actions to address the overdose crisis and the complex factors that contribute to substance-related harms, including links with mental health, housing, economic insecurity, and chronic pain, among others. The strategy puts the Department's guiding principles into concrete terms – including supporting culturally appropriate, equitable supports and services for all Canadians – informed by data and evidence.

Guided by the Canadian Drugs and Substance Strategy, Health Canada's Substance Use and Addictions Program continued to support organizations at community, regional, and national levels. In 2023-24, Health Canada invested over $130 million in 254 projects that focused on substance use prevention, harm reduction, and treatment related to opioids, stimulants, cannabis, alcohol, tobacco, and vaping products.

The Department also continued to support greater access to services offering pharmaceutical grade alternatives to the illegal synthetic drug supply, with the goal of reducing drug overdoses. In 2023-24, Health Canada supported 29 prescribed alternatives pilot projects, worked to build the evidence base around prescribed alternatives, and engaged with key stakeholders. These projects included a range of service delivery projects, research/knowledge transfer and exchange projects, and a National Safer Supply Community of Practice.

Health Canada continued to support policies and approaches that divert people who use drugs away from the criminal justice system and toward appropriate health service and social supports, while maintaining public safety. Health Canada continues to establish specific legislative exemptions to support provision of health services and to ensure P/Ts continue to have the flexibility needed to manage the overdose crisis in their communities. In addition to existing, renewed, and amended class exemptions, 4 new class exemptions were issued in 2023-24. These exemptions provided practitioners, nurses, and air ambulance paramedics with greater authority to use certain controlled substances, which ensures that those health professionals can fully exercise their duties and protect the health of Canadians.

The Department also monitored national trends in the use of alcohol, psychoactive pharmaceuticals, and illegal drugs. Results in 2023-24 included the release of the 2021-22 Canadian Student Tobacco, Alcohol and Drugs Survey, the Canadian Postsecondary Education Alcohol and Drug Use Survey, and the Public Awareness of Alcohol-related Harms Survey results. Further, data collection for the 2023 Canadian Alcohol and Drugs Survey was completed.

Harm reduction measures, such as supervised consumption sites and urgent public health need sites, which are temporary locations that can be set-up rapidly in a specific community or region, are an integral part of the Government of Canada's strategy to address the overdose crisis. As of March 31, 2024, 38 supervised consumption sites and 18 urgent public health need sites were operating across the country. As of May 2024, these supervised consumption sites received over 4.8 million visits, responded to over 58,000 overdoses, and made over 515,000 referrals to health and social services.

The Department strengthened its collaboration with partners and agencies such as the British Columbia Centre on Substance Use, Toronto's Drug Checking Service, and Quebec's Groupe de recherche et d'intervention psychosociale in support of harm reduction initiatives. Health Canada worked with these key stakeholders to refine its support for drug checking services at supervised consumption services. The Department analyzed 815 drug samples from supervised consumption sites for toxic substances like fentanyl to help improve drug checking techniques so those using the sites could make more informed choices when it comes to substance use.

Health Canada also worked closely with international partners to coordinate a global approach to address the public health and public safety risks of synthetic drugs, through the Commission on Narcotic Drugs and the Global Coalition to Address Synthetic Drug Threats.

Health Canada continued to invest in public education to prevent, reduce, or delay substance use by raising awareness of substance use-related harms, including the harms and barriers caused by stigma, and ways to reduce them. The Department continued to reach higher-risk populations - including men 20-59 years of age working in physically demanding trades, secondary students, and young adults to reduce the stigma associated with seeking help. Results included:

• The Know More Opioids awareness program aimed at engaging teens and young adults on the facts surrounding opioids, ways to reduce risks, and the harms of stigma. Between April 2023 and March 2024, over 8,000 teens and young adults were engaged through high school and post-secondary awareness programs.
• The Ease the Burden advertising campaign continued to target men in physically demanding trades, to reduce the stigma of asking for help and promoting substance use resources on Canada.ca. Campaign tactics included web banners, video and audio ads, search engine marketing and digital out-of-home billboards with geo-targeting at construction sites and unions. This campaign had substantial reach with more than 107 million impressions across tactics and 19.6 million video completions. The campaign led to a 63% increase in clicks to resources on the Get Help with Substance Use page compared to the pre-campaign period and 22% reported sharing the information on how to get help for opioid addiction that resulted in an increase from 17% in 2022-23.

The Department continued to promote, monitor, verify, and enforce compliance with the Controlled Drugs and Substances Act and its Regulations and provided analytical services and intelligence on controlled substances for public health purposes. Achievements included:

• Delivering timely and reliable information such as Drug Notifications, Drug Summary Reports, and various reports on substances of interest to Canadian law enforcement agencies, public health partners, and the public.
• Inspecting 242 controlled substances and precursor chemicals licensed dealers and following up on 7 compliance verifications where potential concerns were identified.
• Inspecting 122 pharmacies and following up on an additional 199 compliance verifications to mitigate the risk of diverting controlled substances to the illegal market.
• Successfully expanding the Department's reach to ensure that pharmacies comply with legal requirements by providing 25 information sessions to this sector and holding 20 meetings with regulatory partners.

Health Canada also took action to address the public health and public safety risks of new emerging substances. For example, in August 2023, a group of new fentanyl precursors was added to the Controlled Drugs and Substances Act, enabling law enforcement to continue to restrict illegal importation, distribution, and use of these chemicals, which are used illegally to produce fentanyl.

Managing the health risks of chemicals in the home, the workplace, and the environment

Health Canada continued to work to reduce illness and injury by decreasing exposure to harmful chemicals and pollutants and by supporting the safety of chemicals.

Amendments to the Canadian Environmental Protection Act, 1999 were passed in June 2023 via Bill-S-5, Strengthening Environmental Protection for a Healthier Canada Act. These amendments marked the first major reform of the Act in more than 20 years. Changes included recognizing a right to a healthy environment in federal law for the first time in Canada, and strengthening the foundation for chemicals management, including recognizing the need to replace, reduce, or refine the use of vertebrate animal testing when assessing the risks that substances may pose to human health and the environment. Other amendments included:

• Establishing authorities to account for the cumulative effects of harmful chemicals and their effects on populations who may be disproportionately impacted.
• Placing greater emphasis on transparency and accountability and committing to implement the United Nations Declaration on the Rights of Indigenous Peoples, recognizing the role of science and Indigenous knowledge in decision-making.
• Recognizing that every individual in Canada has a right to a healthy environment, as provided under the Canadian Environmental Protection Act, 1999.

As per the Act, the Department continued to identify and manage the risks of chemical substances to protect the health of people in Canada. Specifically, Health Canada conducted research, monitoring, and surveillance (including biomonitoring) and risk assessments on chemical substances and biotechnology products in collaboration with international partners, where appropriate. The Department advanced research on per-and polyfluoroalkyl substances, as well as the toxic effects of these and other substances, such as bisphenols and other endocrine disruptors, and monitored the health impacts of environmental chemicals through follow-up studies like the Maternal-Infant Research on Environmental Chemicals Research Platform.

In partnership with Environment and Climate Change Canada, Health Canada continued to assess the risks of new and existing substances, with 290 new substances assessed before they were imported into or manufactured in Canada and approximately 99% (4,326 substances) of total planned assessments of existing substances completed by the end of March 2024. Other achievements included:

• Developing risk management actions for new and existing substances deemed to be potentially harmful to human health or the environment.
• Leading Canada's input into a robust voluntary Global Framework on Chemicals - For a Planet Free of Harm from Chemicals and Waste, a global framework for the sound management of chemicals and waste, adopted by the Fifth International Conference on Chemicals Management in September 2023.

The 2024 horizontal evaluation of the Chemicals Management Plan found that the Plan's risk management activities and compliance, promotion, and enforcement actions served to reduce human and environmental exposures.

Health Canada continued to raise public awareness about the health risks of chemicals and pollutants that may be found in and around the home via the Healthy Home Campaign. The Department used interactive tools to inform the public about potential risks from harmful chemicals and the actions they can take in and around their homes to protect their health. In 2023-24, this resulted in over 290,000 unique web visits on the Department's Healthy Home related web pages and in Healthy Home information being shown to the Department's social media followers over 750,000 times. The inaugural episode of the Department's new Healthy Canadians podcast also featured Radon as a topic and was the highest performing episode of the season.

In 2023-24, Health Canada continued to conduct research and invest in Canadian academic research to better understand the potential effects of microplastics on human health and to support the Government of Canada's agenda for reducing plastic waste. Achievements included:

• Developing methods to identify the types and characteristics of microplastics in outdoor air, indoor air, and human cells and tissues.
• Establishing funding agreements with McGill University, Memorial University, and the University of Toronto to begin researching the long-term health risks of microplastics.
• Developing methods to better assess microplastics in food, beginning studies on titanium dioxide, and, as part of the Canadian Total Diet Study, continuing to monitor chemical contaminants transferred from food.
• Continuing to collaborate with Environment and Climate Change Canada and other departments to advance a circular plastics economy for Canada, including publishing a notice for the federal plastic registry to create an inventory of data and developing a global legally binding instrument on plastic pollution.

Since 2007, nationally representative biomonitoring data have been collected through the Canadian Health Measures Survey (CHMS), for which Heath Canada leads the environmental chemical component. The levels of environmental chemicals are reported for the Canadian population and disaggregated by age and sex. In 2023-24, the CHMS continued collecting information on the gender identity of respondents and a new potentially disproportionately impacted sub-population (1-2 years of age). In August 2023, the Canadian Biomonitoring Dashboard was launched on the Health Infobase platform. The dashboard shows levels of environmental chemicals in the Canadian population, as measured through the CHMS. New and updated environmental chemical biomonitoring fact sheets were also released in August 2023 to provide additional contextual information for the general public on the health impacts of specific chemicals and their use in Canada (e.g., DEET, glyphosate, per-and polyfluoroalkyl substances).

To mitigate risks posed by workplace hazardous products, Health Canada continued to conduct hazard assessments, collaborate with F/P/T partners on the enforcement of appropriate labelling and communication of hazards, and undertake outreach activities to increase awareness of the Hazardous Products Act and its Regulations. These efforts were informed and supported by international cooperation, including through implementation of revised editions of the Globally Harmonized System of Classification and Labelling of Chemicals, participation in the United Nations Sub-Committee of Experts on the same topic, and in the Canada-U.S. Regulatory Cooperation Council.

Health Canada also continued to develop and modernize policies and operational procedures pertaining to workplace hazardous products under the Hazardous Products Act and the Hazardous Materials Information Review Act and its Regulations. For example, the Department improved its review of applications from industry seeking to protect confidential business information under the Hazardous Materials Information Review Act and advanced plans to extend hazard communication requirements to consumer products used in workplaces.

Health Canada continued to investigate food contaminants such as mercury and bisphenols using the Canadian Total Diet Study and other targeted studies. Working with F/P/T partners, the Department mitigated health risks of contaminants in food not sold at retail, but that are traditionally consumed by certain groups (e.g., Indigenous hunting/gathering of foods) by issuing consumption advice for groups at risk. Health Canada further worked with industry to ensure best practices are being followed during food processing and continued to update the regulatory maximum levels for chemical contaminants in food. It published consumer advice and information for Canadians on several additional topics related to food chemical safety, such as educational material for persons with food allergies.

Health Canada updated its guidance on the use of recycled materials in food packaging applications to assist recyclers, manufacturers, and sellers of plastic materials in determining the safety and acceptability of post-consumer recycled plastics for this purpose. The use of recycled materials is a Government of Canada priority, as part of Canada's goal of zero plastic waste by 2030. Additionally, with new food packaging technologies coming to market every day such as use of recycled and compostable materials, this presents new exposures of potentially harmful chemicals to Canadian consumers. To improve oversight, the Department is investigating the implementation of a mandatory submission program for food packaging to replace the current voluntary system.

In 2023-24, the Food and Drugs Act was amended as part of Bill S-5 to incorporate an environmental purpose into the Act. These amendments included the expansion of the Minister of Health's regulation making authority to allow for the creation of environmental regimes for products regulated under the Act and the addition of environmental risk management provisions for authorized therapeutic products. Health Canada also continued to develop policy to support the development of an enhanced environmental regulatory regime for drugs under the Act.

Supporting the safety of consumer products and cosmetics

The Department continued to mitigate risks posed by unsafe consumer products and cosmetics by updating policy and operational procedures, as necessary, and conducting risk assessments, compliance and enforcement, and outreach activities. For example, in 2023-24, Health Canada notified people in Canada of 271 consumer product and cosmetic recalls, 75 of which were coordinated as joint recalls with the United States and/or Mexico.

Health Canada further strengthened legislative and regulatory requirements pertaining to consumer products under the Canada Consumer Product Safety Act and to cosmetics under the Food and Drugs Act. This included amendments to the Carriages and Strollers Regulations, and pre-publishing proposed amendments to the Tents Regulations, Toys Regulations, and Textile Flammability Regulations under the Canada Consumer Product Safety Act. Additionally, Health Canada consulted stakeholders on proposals to address certain human health hazards of concern in consumer chemical products and certain hazards in toys. The Department continued to work towards introducing new labelling requirements for certain fragrance allergens in cosmetics, and in 2023-24, advanced the Food and Drugs Act was amended to ban cosmetic testing on animals, supporting animal welfare while protecting health and safety.

Health Canada examined ways to address enforcement challenges resulting from the growing global marketplace and the increasing prevalence of e-commerce. For example, the Department identified opportunities to address challenges in applying and enforcing the Canada Consumer Product Safety Act and its Regulations for consumer products sold online, which included publishing guidance for online sellers, and in September 2023 launched the Canadian Product Safety Pledge, a voluntary commitment to Health Canada by certain online sellers to strengthen and improve the safety of consumer products and cosmetics sold online.

Strengthening pesticide regulation and transparency

In 2023-24, Health Canada continued to implement the Pest Control Products Act and its Regulations by using a science-based assessment process to review and authorize new pesticides for use in the Canadian market, re-evaluate registered pesticides against current scientific standards, and conduct compliance and enforcement activities. The Department also registered 326 new pesticide products (which included 26 biopesticides) and completed 17 re-evaluations to ensure these products continue to meet the latest scientific standards for health and environmental protection.

In January 2024, the Department consulted with Canadians and interested stakeholders on a proposal to update the post-market cost recovery fees for pesticides. Health Canada will update the proposal based on feedback received prior to publishing it in fall 2024.

In addition, Health Canada continued efforts to transform Canada's pesticide regulatory system to improve protection of human health and the environment, provide proportional risk-based oversight, apply real-world evidence and independent advice to better inform pesticide decisions, and improve its transparency. Accomplishments in 2023-24 included:

Enhancing human health and environmental protection through modernized business processes

• Streamlined processes for evaluating low risk pesticides and developed a tool to monitor and reduce the re-evaluation backlog.
• Consulted on the continuous oversight of pesticides to enhance the Department's ability to respond more proactively to protect both public health and the environment.

Increasing the use of independent data and independent advice for better-informed pesticide review decisions

• Established agreements with P/Ts, Indigenous organizations, conservation authorities, watershed alliances, and academics to gather water samples for a pilot water monitoring program for pesticides. Data generated through this pilot is available through the Open Government Portal and Water Monitoring for Pesticides: Dashboard.
• Completed 2 surveys to obtain information on pesticide usage related to fruits and ornamentals as well as general pesticide use.
• Published a draft Framework for Pesticide Water Monitoring in Canada for consultation in March 2024 to support the design of a national program to monitor pesticide levels in Canada's lakes, rivers, and groundwater.
• Continued to engage with Environment and Climate Change Canada on potential effects of pesticides on wildlife and species at risk.
• Continued developing a Pesticide Use Framework to support the systematic gathering of post-market pesticide use information and data.
• Consulted partners, including technical working groups and a pilot study on pesticide use for selected fruit and ornamental crops to continue development of a Pesticide Use Framework to support gathering information on post-market pesticide use. For more information see What We Heard Report.
• Consulted the Science Advisory Committee on Pest Control Products on various science questions to support evidence-based decision making on pesticides.

Improving transparency and helping Canadians better understand how pesticides are regulated in Canada

• Released 9 plain language pesticide regulatory decisions to provide more insight on how the Department conducts assessments and makes decisions.
• Piloted a secure USB key process for stakeholders and the public to provide remote access to review confidential test data on pesticides.
• Implemented a new process, form, and instructions to inform stakeholders of applications for pesticide maximum residue limits on imported food commodities.
• Improved the Department's Pest Management Regulatory Agency web pages to make them more accessible; published a series of online pesticide science resources to further explain pesticide regulatory review considerations, processes and decisions; and, updated other web content such as the public registry to make it easier to access.
• Improved transparency of the pesticide review process, as of April 2023, by disclosing the name of registrants at the time that the review process is initiated.
• Published the Pest Management Regulatory Agency Annual Report 2022-23 highlighting performance and activities over the past year.
• Issued a notice to the public on a proposal to strengthen the regulation of pest control products in Canada. Feedback will be used to further improve legislation and processes related to pesticides.

Protecting Canadians from radiation

Health Canada continued to monitor, advise, and report on exposure to radiation that occurs both naturally and from human-made sources under the authority of relevant acts and regulations. In 2023-24, as part of the Federal Nuclear Emergency Plan, the Department participated in 8 nuclear emergency training, drills and exercises. Health Canada also coordinated with F/P/T and international partners to confirm that emergency preparedness plans are ready for execution in the event of a nuclear emergency. The International Atomic Energy Agency conducted an Emergency Preparedness Review which found that Canada has made significant progress in developing and revising emergency arrangements since the last review in 2019. Additional achievements in 2023-24 included:

• Advanced efforts to provide reliable and accessible radiation data to Canadians daily and during a nuclear emergency by increasing the density of the Canadian radiation monitoring stations and by publishing the environmental radiation data from the network in near real-time to the Government of Canada's Open Maps platform.
• Pre-published Regulations Amending the Radiation Emitting Devices Regulations (Laser Products) relating to the import and sale of laser products to provide better protection for Canadians and help reduce injuries.
• Developed information and advice for Canadians and stakeholders on the safety of radiation emitting devices, such as updated content on Canada.ca on noise to inform people in Canada about potential health risks from sound and how to manage those risks.

Back to Departmental Result 3: Canadians have access to safe, effective, and quality health products.

Departmental result 5: Canadians make healthy choices

In this section

• Regulating and supporting Canadians, particularly youth, in making informed decisions about cannabis, vaping, and tobacco
• Regulating tobacco products, including becoming the first country in the world to require health warnings on individual cigarettes
• Promoting healthy eating
• Modernizing the regulatory oversight of food including its packaging and labelling
• Ensuring the safety and nutritional quality of the Canadian food supply
• Advancing climate change adaptation measures

Regulating and supporting Canadians, particularly youth, in making informed decisions about cannabis, vaping, and tobacco

The purpose of the Cannabis Act is to protect public health and public safety - in particular, the health of youth by restricting their access to cannabis - while providing adults with legal access to regulated products and reducing illegal activities involving cannabis. On March 21, 2024, the Ministers of Health released the final report of the Legislative Review of the Cannabis Act which contained 54 recommendations and 11 observations to strengthen and improve the administration of the Act. Health Canada has since began analyzing the recommendations to determine next steps.

The Department issued licences and permits under the Act, and in 2023-24, granted an additional 139 licences for the cultivation, processing, and sale of cannabis for medical purposes, 64 licences for research, analytical testing, and/or cannabis drug, and 71 for industrial hemp. The Department also granted 2,452 import and export permits.

Health Canada's 2023-24 results related to cannabis fall under the following themes:

Compliance

In 2023-24, the Department undertook over 1,759 compliance promotion activities (e.g., emails, calls, letters), reviewed a total of 22,820 notices of new cannabis products and undertook compliance promotion action for 5.6% of these due to potential non-compliance with the Cannabis Act and its Regulations, investigated over 1,036 cannabis complaints, and made 262 referrals to law enforcement for possible enforcement action.

In 2023-24, Health Canada assessed 37% of current cannabis licence holders and conducted 840 compliance and enforcement activities. These assessments were conducted using a risk-based approach, which continues to be reviewed and refined based on inspection data. The Department inspected 420 cannabis licence holders and resulted in an industry compliance rate of 95%. The Department also actioned 100 compliance verifications, undertook 35 cannabis compliance promotion sessions, collected 113 cannabis product samples for laboratory analysis and monitoring, and conducted 160 inspections at personal and designated production sites, and 10 inspections at licensed analytical testing laboratories.

Regulating and Promoting a Diverse Commercial Cannabis Industry

Measures undertaken by Health Canada to strengthen the cannabis framework in 2023-24 included:

• Leveraged stakeholder comments on potential amendments to the Cannabis Regulations to develop proposed regulatory amendments, which were shared for public comment in spring 2024.
• Continued to provide reasonable access to cannabis for medical purposes resulting in 15,726 active registrations at the end of 2023-2024.
• Strengthened the integrity of the medical access framework by inspecting personal and designated production sites and assessing evidence received from law enforcement investigations.
• Requested additional evidence from health care practitioners to substantiate high daily authorization amounts in the medical access program.

Health Canada took several measures to promote a diverse and competitive cannabis industry in 2023-2024 by reducing barriers, improving guidance, and enhancing outreach including:

• Engaged Indigenous, Black, and other racialized communities to explore ways to address the challenges and barriers faced by these communities.
• Collected demographic information to better understand who is applying for cannabis licences.
• Released new guidance and updated webpages to include more information on micro-class licences and support compliance with the Cannabis Act and its Regulations.
• Supported Indigenous-affiliated applicants and licence holders resulting in an increase in Indigenous-affiliated applications, licences, and licence amendments.
• Continued to publish Cannabis Inspection Data in a timely manner to promote transparency to the public and industry with regards to inspection activity.

Health and safety

Health Canada's Science Advisory Committee on Health Products Containing Cannabis published its final report in July 2022. The report focused on cannabidiol (CBD) and provided advice on the standards for health products containing CBDs, including the conditions under which these products would be suitable for use without practitioner oversight. In 2023-24, Health Canada analyzed the feedback received from stakeholders and industry regarding a potential framework for non-prescription health products containing CBD.

The Department continued to closely monitor the public health and safety impacts of the Cannabis Act. Health Canada monitors, collects, and analyzes scientific evidence and data on cannabis and conducts research and surveillance on cannabis; and monitors, assesses and publicly reports on adverse reactions and communicates potential health risks of cannabis use to Canadians through public reports. In 2023-24, the Department:

• Published the results of the 2023 Canadian Cannabis Survey and in collaboration with Statistics Canada, the results of the 2023 National Cannabis Survey.
• Conducted Public Opinion Research on cannabis and published 2 research papers on cannabis related trends since legalization and on serious and life-threatening events associated with cannabis in children and youth.
• Launched the Cannabis Data Gathering Program in 2023-24, to collect information on the composition of cannabis products available on the Canadian market.

Prevention and promotion

To support Canadians in making informed decisions about cannabis, Health Canada developed and launched public education programs, national campaigns, and issued social media messaging for youth, young adults, and parents/guardians. In 2023-24, some of the public education focused on reaching priority populations (e.g., youth and young adults, pregnant people, breastfeeding people, 2SLGBTQI+ populations, parents, older adults, health professionals, and school communities) with a particular focus on higher risk behaviours.

In 2023-24, Health Canada continued outreach on the national campaign on accidental poisonings in children from edible cannabis products primarily targeting parents and guardians of young children. The campaign aimed to raise awareness about the harms associated with pediatric poisonings; inform parents and caregivers what a poisoning looks like and what to do; and to educate Canadians on preventative measures. This included the development of a new poster and distribution of a brochure on how to help prevent cannabis poisoning in children to childcare centers, daycares, tourist and recreational locations, and health care professionals.

The Department also used evidence-based public education and awareness campaigns and in-school programs focused on the risks associated with cannabis use on mental health and brain function to help youth make informed choices. These included:

• Updates to the cannabis and mental health webpage to provide information on how cannabis can impact mental health and brain function, particularly when it comes to daily or near daily use, and to provide lower risk use tips to enable them to make informed decisions about their health. Additionally, in March 2024, Health Canada worked with 4 social media influencers to reach young adults to raise awareness about the impact of cannabis use on mental health and brain function. The campaign received 136,000 views and an engagement rate more than double industry standard.
• New, in-school educational programs, including All About Cannabis, and an updated version of Pursue Your Passion, designed for students in grades 7-12, focusing on the health and safety risks of cannabis use, and its effect on mental health and brain function. Combined, these 2 presentations were delivered to 9,718 students. In addition, the Pursue Your Passion teacher-led online presentation was adapted for Indigenous audiences. The presentation was translated into Plains Cree and Eastern Ojibway, with updated imagery to reflect the audience.
• Get the Facts, a program that educates students in grades 4-6 on the risks of using alcohol, cannabis, tobacco, and vaping products. The program provides students with the foundational building blocks to influence behaviour later in life. The virtual presentation was delivered to 1,246 students in its March 2024 inaugural pilot.

Taking action on reducing tobacco use and addressing youth vaping

In 2023-24, Health Canada aimed to reduce tobacco use through Canada's Tobacco Strategy and continued to address the pressing issues caused by ongoing high rates of youth vaping.

The Department launched the second review of the Tobacco and Vaping Products Act to assess whether progress is being made towards achieving the tobacco-related objectives of the Act and whether the federal response, from a legislative perspective, is sufficient in addressing tobacco use in Canada. Canadians had the opportunity to provide input on several topics related to reducing tobacco use in Canada through a public consultation. The analysis shows that while Canada has made progress towards achieving the purpose of the legislation to address tobacco-related death and disease, there are several potential areas for action. The final report from the review was tabled on June 17, 2024 in both houses of Parliament.

In cooperation with other F/P/T partners and key stakeholders, new or ongoing measures to reduce tobacco use and address youth vaping included:

• Published Vaping Products Reporting Regulations that require manufacturers to disclose information about their sales and the ingredients used in their vaping products to Health Canada. Timely access to this data will help the Department develop policies and regulations to better protect people from the health risks of vaping and nicotine addiction, especially young persons and people who do not smoke.
• Monitored national trends in vaping and smoking, using Sex- and Gender- Based Analysis Plus via surveys such as the 2021-22 Canadian Student Tobacco, Alcohol, and Drugs Survey, the 2022 Canadian Tobacco and Nicotine Survey, and the Canadian Community Health Survey from 2001 to 2022 and conducted the 2022-23 Vaping Panel public opinion research project to better understand youth and young adult use of vaping products. Collected information will inform future regulatory and policy initiatives.
• Inspected websites where advertising or promotion of vaping products is accessible to youth; inspected retailers, manufacturers, and importers of vaping products, including approximately 1,600 gas and convenience stores, and over 250 specialty vaping establishments to assess compliance with product packaging, labelling, promotion, and nicotine concentration requirements.
• Analyzed over 300 vaping products to determine nicotine concentrations, ensured compliance with vaping product labelling regulations and published the results of compliance and enforcement activities.
• Raised public awareness of the potential harms associated with vaping, particularly for youth, through the Consider the Consequences marketing program, an online educational module for classroom or community settings to inform teens on the harms and risks of vaping. This resulted in approximately 15,900 sessions and 26,100 web page views.
• Tested the online and in-school I Quit for Me, youth smoking and vaping cessation program, resulting in approximately 950 copies of the guide distributed and over 1,400 visits to the online resource. The results of the pilot will help Health Canada to assess the effectiveness of this cessation support resource ahead of broader implementation.
• Raised public awareness of effectiveness of quit smoking supports through the Tools for Smoke-Free Life advertising campaign, including testimonials from 6 Canadians on how they quit smoking, resulting in over 30 million impressions, over 6.5 million completed video views and over 132,000 website clicks.
• Explored how to modernize the Pan-Canadian Quitline Initiative and developed voluntary smoking cessation standards for health care organizations, in collaboration with P/Ts and other stakeholders such as the University of Ottawa Heart Institute and the Canadian Partnership Against Cancer.
• Published a Notice of Intent to address risks of youth appeal and access to nicotine replacement therapies, such as nicotine pouches.

Regulating tobacco products, including becoming the first country in the world to require health warnings on individual cigarettes

The Government of Canada is committed to increasing public awareness of the harms of tobacco use as cigarette smoking is the leading preventable cause of disease and premature death in Canada. In 2023-24, the Government of Canada announced the new Tobacco Products Appearance, Packaging and Labelling Regulations. These are the first regulations in the world to require the display of health warnings directly on tobacco products such as cigarettes. The regulations also update and extend the health warnings that are displayed on packages to all tobacco products on the retail market. These regulations support the Government of Canada's continued efforts to help adults who smoke to quit, to protect youth and non-tobacco users from nicotine addiction, and to further reduce the appeal of tobacco. The regulations came into force on August 1, 2023, and will be implemented through a phased approach.

In 2023-24, additional measures related to tobacco included:

• Proposed amendments to the Tobacco and Vaping Products Act to enable the fixing of fees or charges and related compliance and enforcement tools to implement a cost recovery framework for tobacco and vaping products. This framework will help minimize the cost burden on taxpayers of funding federal tobacco control-related activities.
• Inspected tobacco products for packaging and labelling requirements at over 2,000 gas stations and convenience stores.
• Inspected 17 tobacco manufacturers resulting in the testing of 32 samples for cigarette ignition propensity, leading to one stop sale and one stop distribution, and 30 samples were tested for prohibited additives none of which were found to be non-compliant.
• Sampled 60 products to verify compliance with requirements under the Tobacco Products Appearance, Packaging and Labelling Regulations.

Promoting healthy eating

Health Canada provides information on healthy eating that is inclusive of Canada's diverse population. In 2023-24, the Department continued to advance its Healthy Eating Strategy, which aims to curb the rising burden of obesity and chronic disease by making healthier choices easier for people in Canada. In support of restrictions on the marketing of foods that contribute to excess intakes of sugars, sodium, and saturated fat to children, the Department sought feedback from stakeholders to inform a draft regulatory framework restricting food advertising to children on television and digital media. Webinars were held to explain the proposed policy and industry stakeholders were surveyed to determine the potential cost of implementing the proposed regulations.

The Department continued to track the state of food and beverage advertising in Canada, working with Canadian and international experts. Monitoring advertising to children supports evidence-informed nutrition policy, while studying its impact. Results demonstrated that advertisers reach children and teens in many settings, using many techniques, and showed that most of this advertising undermines healthy eating.

The Department helped people increase their knowledge and use of Canada's food guide in their everyday lives by:

• Promoting the Canada food guide's kitchen, an immersive web experience that supports people in applying the healthy eating recommendations, and whose pages received over one million views. In 2023-24, Health Canada released new recipes and articles to support people in developing foods skills.
• Developing new healthy eating resources on timely topics such as how to use food labels, ways to save money while making healthier choices at the grocery store, 3 new videos to help teens make water their drink of choice, and promoting this content on social media and in the food guide e-newsletter.
• Providing stakeholders and the public with resources and tools to support healthy eating and food guide awareness and education through the monthly e-newsletter, which provides subscribers with timely healthy eating recommendations and direct links to web content based on monthly themes. In 2023-24, subscribership increased by approximately 13%.
• Collaborating with stakeholders to further integrate the dietary guidance into policy, programs, and resources. For example, Health Canada collaborated with the Guelph Family Health Study at the University of Guelph to develop recipes for a cookbook to promote cooking more often and limiting highly processed foods. These recipes increase awareness and use of the food guide amongst families.

To instill long-lasting healthy eating habits, children and youth were key target audiences for Health Canada's educational and awareness efforts. For example, as part of its food guide friendly initiative, the Department pilot-tested the implementation of principles for healthy eating that organizations can apply to improve their food environment. In 2023-24, 6 post-secondary institutions participated in the pilot and committed to provide foods more aligned with Canada's Food Guide. Health Canada also collaborated with the Canadian Parks and Recreation Association to raise awareness of the importance of healthy eating in the recreation sector. This included online learning sessions with participants from across Canada.

To promote further reduction in products with the highest sodium content, Health Canada continued to encourage the food processing sector to achieve the targets set in the Voluntary Sodium Reduction Targets for Processed Foods, 2020-25. In 2023-24, the Department gathered data that will be used to assess interim progress toward meeting the sodium reduction targets in select staple food categories.

Health Canada published guidance for industry on the front-of-package nutrition symbol labelling to help them implement the new front-of-package labelling regulations.

Modernizing the regulatory oversight of food, including its packaging and labelling

The current structure of food regulations under the Food and Drugs Act limits Health Canada's ability to respond to advances in science and technology and creates difficulties for industry to bring innovative products to market. In 2023-24, Health Canada used modern regulatory tools to address these challenges. Specifically, the Department:

• Continued to develop guidance to address emerging food technologies, such as cellular agriculture and gene editing.
• Continued to consult on and modernize Health Canada's Lists of Permitted Food Additives, for example pre-published Regulations amending certain regulations concerning Food Additives and Compositional Standards, Microbiological Criteria and Methods of Analysis for Food in November 2023 to modernize the oversight of microbiological criteria and food additives.
• Developed an awareness initiative on the new supplemented foods labelling elements so consumers can use this information to make informed food choices. Between December 2023 and March 2024, the Department issued 30 social media posts on supplemented foods that were shared with social media followers over 158,000 times and had 2,200 interactions.

Ensuring the safety and nutritional quality of the Canadian food supply

Health Canada works with other jurisdictions and international organizations, industry, and consumers to establish policies, regulations, and standards related to the safety and nutritional quality of all food sold in Canada. In 2023-24, the Department continued to educate the public about the importance of safe food handling, selection, and preparation practices to reduce foodborne illnesses and adverse reactions to food allergens in Canada. More than 4 million Canadians have foodborne illness each year, so as a proactive initiative to promote understanding, in 2023-24 Health Canada launched a multifaceted food safety marketing campaign on various social media platforms. The Department targeted specific populations with a variety of products such as:

• A food safety course for school-aged children.
• An online course for health professionals and educators.
• A safe recipe style guide that provides recipe writers, food journalists, and chefs with easy and flexible ways to incorporate food safety tips into their recipes. Research has shown that when food safety instructions are incorporated directly into recipes, consumers are more likely to follow them.
• A Food Safety marketing campaign targeted to parents and guardians designed to introduce safe food handling habits as norms in everyday life. The national advertising campaign achieved 30.9 million advertising impressions with an average video completion rate on YouTube of 88.2%, surpassing the target of 61.5%.
• The Safe Food Handling for Pregnant Women guide was updated to use inclusive language in both digital and printed versions.
• Monthly social media plan including X, Facebook, and LinkedIn posts on a specific food safety theme.

Health Canada continued to conduct toxicology research on flame retardant and human-made chemical contaminants in food, with a focus on refining the threshold levels that may pose risks to females versus males, infants, and pregnant people. Research was published on chemical contaminants in food, including an Extended One-Generation Reproductive Toxicity Study on mice that predicts impacts on pregnancy.

The Department continued to work with stakeholders to ensure fortified foods are safe and nutritionally adequate. In July 2023, the Department published a Notice of intent to permit the vitamin D fortification of yogurt and kefir that are made from dairy products. In June 2024, the Department reviewed and analyzed comments received and published a marketing authorization permitting the addition of Vitamin D to yogurt and kefir, 2 foods whose consumption is increasing, which will create new options for meeting daily vitamin D requirements.

Advancing climate change adaptation measures

Health Canada supported the health sector and people in Canada in preparing for and adapting to the impacts of climate change. In 2023-24 this included increasing knowledge and capacity by:

• Supporting P/Ts and health regions with developing Heat Alert and Response Systems (HARS) and Heat Emergency Management Plans and working to update Health Canada HARS guidance to help health regions and communities across Canada prepare for and respond to extreme heat.
• Featuring Health Canada spokespeople in over 50 media interviews and articles on wildfires to provide information and education on topics such as how to prepare for wildfires and how to protect yourself from the health effects of wildfire smoke.
• Publishing social media posts on health protective advice to reduce exposure to wildfire smoke.
• Supporting scientific research and guidance on extreme heat to protect Canadians from extreme heat and improve heat resiliency across Canada, including research to better understand the impacts of heat on disproportionately impacted populations such as older adults and people living with schizophrenia.
• Collaborating with Environment and Climate Change Canada to advance the Health and Wellbeing component of Canada's National Adaptation Strategy, aimed at reducing risk and building climate-resilient communities.
• Advancing international discussions on climate and environmental impacts on health, including at the 28th United Nations Climate Change Conference of the Parties, where health took center stage with the inaugural Health Day.

To address climate-related health issues, including heat-related illness, air quality, and food safety, Health Canada delivered adaptation programs such as the Protecting Canadians from Extreme Heat Program and the HealthADAPT Program. In 2023-24, both programs supported health authorities across Canada in creating climate-resilient and low carbon health systems, for example, Health Canada's Heat Community of Practice hosted 2 webinars, supporting public health professionals across Canada to learn and share best practices in protecting the health of Canadians from extreme heat events. The HealthADAPT Community of Practice, a national network hosted by Health Canada that facilitates collaboration amongst stakeholders and the sharing of best practices related to climate change and health adaptation, hosted 7 meetings in 2023-24.

Back to Departmental Result 4: Canadians are protected from unsafe consumer and commercial products and substances.

Key risks

Information on Key risks is available on Health Canada's website.

Related government-wide priorities

Gender-based analysis plus

More information about Sex- and Gender-based Analysis Plus is available in the Gender-Based Analysis Plus Supplementary Information Table.

United Nations 2030 Agenda for Sustainable Development and the UN Sustainable Development Goals

More information about Health Canada's contributions to Canada's Federal Implementation Plan on the 2030 Agenda and the Federal Sustainable Development Strategy can be found in Health Canada's Departmental Sustainable Development Strategy.

Internal services

In this section

• Description
• Resources required to achieve results
• Details on results
• Key risks
• Contracts awarded to Indigenous businesses

Description

Internal services help departments meet their corporate obligations and deliver its programs. There are 10 categories of internal services: management and oversight services; communications services; legal services; human resources management services; financial management services; information management services; information technology services; real property management services; materiel management services; and acquisition management services.

Resources required to achieve results

The complete financial and human resources information for Health Canada's program inventory is available on GC InfoBase.

Details on results

Health Canada's greatest strength is an engaged, empowered, and well-equipped workforce with employees who have the competencies (including science and regulatory skill sets), tools, and opportunities to pursue excellence in program and service delivery.

The Department continued to support government-wide goals of the Public Service Renewal through initiatives that foster inclusivity, agility, and resilience.

In this section

• Building a healthy, diverse, and inclusive workforce including ensuring a representative workforce and supporting career growth for equity-deserving groups
• Advancing accessibility
• Supporting innovative programs and services to deliver results for Canadians
• Enabling a safe and productive workforce with access to modern tools and facilities
• Providing people in Canada with inclusive, timely, and evidence-based communications

Building a healthy, diverse, and inclusive workforce including ensuring a representative workforce and supporting career growth for equity-deserving groups

Health Canada remained committed to its ongoing response to the Clerk's Call to Action on Anti-Racism, Equity, and Inclusion in the Federal Public Service, the Clerk's Call to Action Forward Direction Message to Deputies, the Deputy Ministers' Commitments on Diversity and Inclusion, and the President of the Treasury Board's Priorities for actions to increase diversity and inclusion in the public service. The Department aimed to ensure a work environment where all employees feel safe and are treated with respect, dignity, and fairness, with a representative workforce and support for the career growth of equity-deserving groups.

In 2023-24, the Department created a Black, Racialized, and Equity-Deserving Communities and an Indigenous Recruitment Team to continue to meet the Department's representation goals. As of April 1, 2024, Health Canada exceeded workforce availability targets for all 4 employment equity groups with workforce representation figures of 2.7% for Indigenous Peoples (compared to workforce availability of 2.6%); 9.3% for persons with disabilities (compared to workforce availability of 8.5%); 65.9% for women (compared to workforce availability of 60.4%); and 32.7% for racialized persons, as defined by the Census (compared to workforce availability of 19.2%). The Department also demonstrated its commitment to increase the representation of Black employees, increasing workforce representation from 4.4% in April 2021 to 5.0% by March 2024.

Additional achievements included:

• Re-launched the Equitable Access to Language Training Program to further improve uptake amongst Black, racialized, and Indigenous employees, as well as employees with disabilities.
• Implemented the Mentorship Plus program to encourage leadership development, with emphasis on supporting equity-deserving groups, by pairing 182 mentees with 111 mentors to provide career guidance, and 32 protégés with 23 senior executive sponsors to provide high potential candidates with support in acquiring skills and competencies for progression to the executive cadre. 85% of mentees and 67% of protégés reported that their mentor provided them with meaningful feedback and recommendations to support their development.
• Continued to address systemic racism, harassment, and discrimination towards employment equity groups, by promoting inclusive governance practices that emphasized senior management responsibilities and the role of employees in promoting an accessible, equitable, inclusive, and safe workplace for all.
• Invested over $800,000 to support 15 paid positions to support networks such as the Indigenous Employees Network, the Black Employees Matter Network, and the Persons with Disabilities Network. In addition to these funded positions, network executive committee members dedicate up to 5 hours weekly to support network activities.
• Continued implementation of the findings of the Internal Anti-Racism Listening Sessions as they relate to recruitment, onboarding, and retention. For example, Health Canada established a team to develop and implement Indigenous Cultural Competency policies, protocols, and to create training materials. The Department also offered employees more flexibility in using a chosen name that is displayed in corporate systems.
• Launched the Health Canada Human Resources Data Hub to promote enhanced transparency on disaggregated Employment Equity data. Since its launch in July 2023, groups such as human resources professionals, senior executives, and employee networks have accessed the hub nearly 1,200 times. The data is used to inform decision making, program discussions, and advancing recommendations of Clerk's Call to Action on Anti-Racism, Equity, and Inclusion in the Federal Public Service.
• Updated its Framework for Science and Research Excellence to reference applying an anti-racism lens to science and research processes which will help to eliminate racism or bias in science workplaces (laboratories and offices), methodologies and the application of science findings through policies and programs.
• Strengthened its values and ethics framework in response to the Deputy Ministers' Task Team on Values and Ethics Report to the Clerk of the Privy Council.

In 2023-24, Health Canada collaborated with Indigenous Services Canada to support the participation of Indigenous employees in the Indigenous Career Management for Employees program. A total of 3 Indigenous Health Canada employees earned a spot in the program to support their career and leadership development. Additionally, Health Canada's Indigenous Employees' Network worked with senior management to discuss a how to support candidates interested in applying to the Indigenous Management Development Program which will launch in fall 2024. Health Canada also appointed an Indigenous Career Navigator in June 2023, who provided career advice to Indigenous employees and supported managers looking to hire and develop Indigenous employees. By March 2024, the Career Navigator made 292 contacts and provided guidance and support via 68 consultations, 40 for Indigenous employees and 28 for managers.

Health Canada continued to foster a safe and respectful workplace for all. Achievements included:

• Continued to offer mandatory training for employees and managers to foster a respectful environment and to prevent harassment and violence in the workplace. As of March 31, 2024, 81.6% of employees and 59.1% of managers had completed the training.
• Incorporated training on emotional intelligence in the workplace in executive leadership development programs.
• Provided over 3,000 in-house language training opportunities for employees to support bilingualism in the workplace.

Health Canada's Mental Health and Wellness in the Workplace Strategy reaffirms the Department's commitment to building an organizational culture centered on psychological health and safety. Health Canada's repositories of information, such as The Mental Health Toolkit, connect all employees with information and resources. To highlight the practical applications of psychological health and safety in the workplace, in 2023-24 the Department launched the Mental Health Handbook, designed with a multi-dimensional approach to help employees understand how to support themselves and others.

The Centre for Ombuds, Resolution and Ethics continued to offer employees, at all levels, a safe space to share experiences and explore options, recourse, and resources for resolving any work-related issues or concerns without fear of reprisal. The Centre continued to raise awareness of systemic issues and trends to people with the authority to act and fostered collaborative approaches to managing workplace conflicts. In addition, it offered a range of services in conflict resolution including topics such as emotional intelligence, tools for communication, and values and ethics. In its continuous efforts to improve employees' knowledge on values and ethics, the Centre took steps to renew Health Canada's Values and Ethics Code by developing a new code of conduct to guide employees in all activities related to their professional duties. This work responds to the Clerk's request to foster a renewed conversation on values and ethics across the Government of Canada. The new code of conduct will be launched by fall 2024.

Health Canada's Employee Assistance Program (EAP) provides services to employees and their immediate family members in more than 90 federal departments and agencies. In 2023-24, the Department improved access to the EAP by promoting Live Chat and other digital wellness resources (e.g., web-based platforms such as LifeSpeak and Torchlight), via approximately 200 presentations and nearly 300 social media posts. Health Canada also improved how the EAP is experienced by equity-deserving groups. For example, as part of Budget 2023's An Action Plan for Black Employees in the Public Service, the Department:

• Targeted recruitment efforts to ensure a sufficient roster of Black counsellors were available to meet the needs of Black Public Servants and their immediate family members. In 2023-24, an additional 19 self-identified Black counsellors were recruited, bringing the total to 61 self-identified Black counsellors.
• Collected self-identity data from contracted counsellors to meet clients' requests for specific counsellor identity factors, training and/or experience. By the end of 2023-24, self-identification survey completion rates improved by 23%.
• Implemented training for EAP staff, focusing on employees directly engaged with clients and counsellors, to help ensure the delivery of anti-racist, culturally competent, and trauma-informed services.

Internal communications

The Department conducted a thorough review to update and improve internal communications, making sure they align with Health Canada's goals and priorities and that they effectively reached staff. This data-driven project strengthened efficiency and effectiveness by improving processes and reallocating resources to focus on strategic planning and responding to organizational needs, such as messages and events for the Deputy Heads. The monthly newsletter was also revitalized to highlight the people and teams behind major Departmental initiatives. Results in 2023-24 included 46 Deputy Minister messages, 10 Newsletters, 5 events, and 11 speeches.

Advancing accessibility

The Accessible Canada Act requires that all organizations under federal responsibility publish an Accessibility Plan every 3 years that outlines how they will identify, remove, and prevent barriers in their policies, programs, and services.

In 2023-24, Health Canada continued to advance its 2022-25 Accessibility Plan by taking action to meet its responsibility as part of the Government of Canada's goals to make Canada barrier-free by 2040. Achievements included:

• Developed performance indicators to measure the Department's improvements to accessibility in the areas of employment; the built environment; communications; information technologies; design and delivery of programs and services; procurement; transportation; and culture.
• Increased recruitment and representation of persons with disabilities and continued to focus on hiring Health Canada's share of the Government of Canada's commitment of 5,000 new hires of persons with disabilities by 2025 in support of the Accessibility Strategy for the Public Service of Canada. The Department hired 133 employees with disabilities, exceeding the hiring target of 116.
• Launched the Accessibility Hub, where employees can access accessibility resources, learn about best practices, and submit feedback.
• Held a virtual event with 1,500 participants for International Day for Persons with Disabilities in December 2023 to promote culture change in the workplace, helping the Department's employees recognize and rethink accessibility issues at work.

Additionally, Health Canada released its first Accessibility Progress Report in December 2023, charting the progress made within the first 8 months of 2023 to remove barriers in priority areas. In keeping with the Accessibility Strategy for the Public Service of Canada, which aims to build the Public Service into a model of an inclusive and accessible employer, Health Canada consulted and collaborated with its Persons with Disabilities Network to address barriers in the Department. Themes emerged around access to training, internal resourcing support, subject matter expertise, and accommodation requests.

Supporting innovative programs and services to deliver results for Canadians

Innovation remains at the core of Health Canada's culture, systems, and processes. The Department's Solutions Fund empowered employees to create and lead innovative and experimental projects. The aim of the Fund is to improve services to Canadians, enhance departmental operations and functionality, and deliver greater value to taxpayers.

In 2023-24, Health Canada funded 7 projects aimed at exploring, testing, and comparing the impacts and effects of emerging technologies and enhanced social policy. These activities spanned various areas including digital and data transformation, robotic process automation, artificial intelligence, diversity, equity, and inclusion, policy, and service delivery. Highlights include:

• Project Apollo testing a digital game-based learning prototype on environmental health with students to determine whether it can be used to positively influence behaviour change around environmental health hazards in Canadian youth. Students were consulted in 2023-24 and testing will begin in 2024-25. Results will be shared in 2025-26.
• Project Deconstructing Unconscious Bias exploring the presence of unconscious biases and systemic racism within the Consumer Product Safety Program. Insights generated have reinforced the Department's commitment to implementing equity-based approaches when developing and delivering science-based activities. Findings will be validated in 2024-25 with results expected to be released in 2025-26.

Enabling a safe and productive workforce with access to modern tools and facilities

Health Canada continued to collaborate across the Health Portfolio to encourage and support the modernization and security of the workforce in 2023-24 by:

• Providing employees access to secure and modern tools and facilities that meet the requirements for accessibility as per the Accessible Canada Act.
• Advancing the strategic use of data as an asset through the Department's Data Strategy in alignment with the 2023-26 Data Strategy for the Federal Public Service.
• Establishing a Departmental Digital Strategy, driven by the Open Science Action Plan, to support the modernization of services by using digital capabilities.
• Supporting workforce safety and productivity across the core public administration through the Public Service Occupational Health Program's delivery of occupational health services.

Achievements in 2023-24 included:

• Continued to align the Department's financial, materiel, and grants and contributions management systems with the Government of Canada Digital Comptrollership Program.
• Initiated the renewal of Health Canada's real property portfolio strategy to meet the Department's scientific and regulatory needs, with approval expected by fall 2024.
• Implemented Health Canada's Open Science Action Plan and Framework for Science and Research Excellence to ensure the Department's science is transparent and accessible for all Canadians. This included developing a Data Inventory, consulting with scientists to identify their digital and data infrastructure needs and experimenting with archival storage management for large-volume, low-velocity science data.
• Enhanced awareness of cyber-security by equipping employees with tools to identify cyber threats/risk, conducting phishing simulation campaigns, and introducing a new email banner to flag emails from external parties.
• Continued to implement M365 collaboration tools such as Booking, Stream, and Power BI, and developed a plan to rollout additional capabilities.

Health Canada also continued to explore new technologies such as artificial intelligence to remain agile in delivering its programs and services. For example:

• Established an Advanced Analytics and Artificial Intelligence Community of Practice to provide support and visibility for experiments and to track use.
• Tested an artificial intelligence prototype search engine for natural health products.
• Developed and delivered a digital literacy education pilot on Digital Transformation, Digital Product Management, Agile, and Outcome-Driven Decision Making.

Providing people in Canada with inclusive, timely, and evidence-based communications

Health Canada provided inclusive, timely, and evidence-based information, through an array of digital and traditional communication methods, to people in Canada to help them make informed decisions on their health and safety. The Department leveraged communication platforms and services to provide trusted, accurate, accessible, and culturally appropriate information that puts all people in Canada first in its design and functionality, this included publication of 98 news releases and 42 statements along with 46 Ministerial events, 2,580 responses to media enquiries and 133 media interviews on Departmental activities and issues. Further, Health Canada ensured visibility and awareness of the Department's actions and priorities through daily postings on social media accounts. These channels saw more than 10,000 posts seen over 53 million times. Health Canada's content is also shared with Canadians via health-themed webpages on Canada.ca, advertising, events, and by leveraging partnerships.

In 2023-24, Health Canada delivered evidence-based and innovative public awareness campaigns on issues such as food safety, tobacco cessation, Canadian Dental Care Plan, Canada Dental Benefit, palliative care, cannabis, and opioids, and worked with P/Ts and stakeholders on multiple priorities, as described in core responsibility 1 and 2.

Risk communications

The COVID-19 pandemic brought about new challenges such as the rapid spread of mis- and disinformation. Lessons learned from the pandemic included ensuring that risk messages are timely, build trust, and reach intended audiences. Health Canada developed a plan to strengthen risk communications knowledge and capacity through the following actions:

• In early 2024, the Department partnered with Canadian Food Inspection Agency to commission research on the State of Health Risk Communications, which included a review of a decade of academic research and literature to identify evidence-based best practices.
• Health Canada provided additional training to risk communicators in the health portfolio through a four-part risk communications seminar series.
• The Department enhanced its engagement with local, federal, and international partners, to share evidence-based risk communications principles in preparation for future health emergencies.

Healthy Canadians podcast

In November 2023, Health Canada and the Public Health Agency of Canada launched a joint Healthy Canadians Podcast on YouTube and all major podcast platforms. The first of its kind for the Department, the podcast is the latest addition to the Healthy Canadians suite of channels. The first season:

• Consisted of 9 episodes ranging from 15 to 30 minutes that featured discussions on interesting health and public-health related topics, such as radon in homes, with Departmental subject-matter experts and external guests.
• Resulted in approximately 7,000 plays and over 400 hours of consumption with 5,200 episode views on YouTube and more than 1,500 plays on other podcast platforms, such as Spotify and Apple Podcasts.

Key risks

Information on Key risks is available on Health Canada's website.

Contracts awarded to Indigenous businesses

Government of Canada departments are to meet a target of awarding at least 5% of the total value of contracts to Indigenous businesses each year. This commitment is to be fully implemented by the end of 2024-25.

Health Canada is a phase 3 department and is aiming to achieve the minimum 5% target by the end of 2024-25.

As part of the strategy to increase opportunities for Indigenous businesses, Health Canada has implemented the following measures:

• Continued development, analysis, and dissemination of quarterly reports to senior management, contracting authorities, branch planners, and business owners to monitor progress towards the target.
• Evergreened intranet resources with information for business owners and contracting authorities on commitments, policy requirements, and strategies to increase opportunities for Indigenous businesses.
• Required new hires to take the mandatory course, Indigenous Considerations in Procurement (COR409), offered by the Canada School of Public Service.
• Integrated the examination and analysis of planned procurements with departmental planning processes prior to the start of the fiscal year to support early identification of potential opportunities for Indigenous businesses.
• Continued participation in inter-departmental working groups and meetings to develop guidance and share best practices.
• Updated departmental checklists, guidance, and tools to require more robust file documentation of information on Indigenous capacity and consideration of potential procurement opportunities for Indigenous businesses.
• Continued efforts to increase awareness with business owners, contracting authorities, and senior management.

In addition to the significant initiatives undertaken above, Health Canada's internal governance Terms of Reference were updated to include additional oversight on whether Indigenous opportunities were considered as part of the procurement strategy.

Spending and human resources

In this section

• Spending
• Funding
• Financial statement highlights
• Human resources

Spending

This section presents an overview of the department's actual and planned expenditures from 2021–22 to 2026–27.

Graph 1 presents how much the department spent in 2023–24 to carry out core responsibilities and internal services.

Text description of graph 1

The figure illustrates Health Canada's actual spending in 2023–24 by core responsibility.

Core responsibility 1 (78.5%) $5,369,628,448

Core responsibility 2 (13.8%) $945,883,667

Internal services (7.7%) $526,781,104

Analysis of actual spending by core responsibility

Core responsibility 1 supports the national health care system in providing contributions and transfer payments to P/Ts as well as funding to universities and organizations to reinforce and improve health care for Canadians. Of the total spending for core responsibility 1 for 2023 –24, 90% was utilized for Working Together to Improve Health Care for Canadians, home, supportive care and mental health initiatives. As per Budget 2023, the Canadian Dental Care Plan initiative was launched to help ease the burden of dental expenses on families; and as a result, accounted for an additional 7% of expenditures for this core responsibility.

For core responsibility 2, Health Canada works with domestic and international partners to assess, manage, and communicate the health and safety risks and benefits associated with health and consumer products, food, chemicals, pesticides, environmental factors, tobacco and vaping products, cannabis, and controlled substances. As part of Health Canada's mandate, and its supporting acts and regulations, the Department notably reviews and evaluates products, and issues establishment and right-to-sell licences. In 2023-24, 50% of the funding associated with core responsibility 2 was spent towards pharmaceutical, biological and radiopharmaceutical drugs, medical devices, radiation protection, and pesticides (of which 40% was recovered through external fees). In addition, 36% of the core responsibility 2 funding was used for controlled substances, cannabis, and tobacco programs (of which 42% was provided to P/Ts, universities, and other non-profit organizations by way of contribution funding).

Internal services provided support to Health Canada's program areas, as well as administrative services to the Public Health Agency of Canada through the Shared Services Partnership. For example, these services were used for the management of information technology, provision of communications services, financial and human resources services, and assistance in procurement of items to facilitate efficiencies and cost effectiveness for the department and agency.

Budgetary performance summary

Analysis of the past three years of spending

At the outset of the 2023-24 fiscal year, Health Canada's planned spending was $4,100.2 million. Additional in-year funding received for Treasury Board approved initiatives increased Health Canada's total authorities to $7,537.5 million. The additional authorities received during 2023-24 relates mainly to Working Together to Improve Health Care for Canadians, the Canadian Dental Care Plan, technical adjustments, and the Canadian Drugs and Substances Strategy.

The overall decrease in actual expenditures from 2021-22 to 2022-23 is mainly due to the winding down of Health Canada's response to the COVID-19 pandemic.

The increase in actual expenditures in 2023-24 is mainly due to funding received in-year for Working Together to Improve Health Care for Canadians.

More financial information from previous years is available on the Finances section of GC Infobase.

Analysis of the next three years of spending

For the 2024-25 to 2026-27 fiscal years, total planned spending does not include funding that could potentially be provided from future Supplementary Estimates and technical adjustments.

The increase in planned spending in 2025-26 is mainly due to another funding level increase for the Canadian Dental Care Plan. This increase is partially offset by the expiry of budgetary authorities for the renewal of the federal framework for the legalization and regulation of cannabis in Canada. The funding level for the department in 2026-27 fiscal year remains consistent to 2025-26.

For the expiry of budgetary spending authorities, the Department would have to request funding for these initiatives for future years.

More detailed financial information from previous years is available on the Finances section of GC Infobase.

Funding

This section provides an overview of the department's voted and statutory funding for its core responsibilities and for internal services. For further information on funding authorities, consult the Government of Canada budgets and expenditures.

Graph 2 summarizes the department's approved voted and statutory funding from 2021–22 to 2026–27.

Text description of graph 2

The figure illustrates Health Canada's approved funding trend from fiscal year 2021–22 to fiscal year 2026–27 where funding, in millions of dollars, is shown on the vertical axis, and time period, in fiscal years, is shown on the horizontal axis.

Health Canada's actual approved funding is as follows (in millions):

• Fiscal year 2021–22: Total 6,045; Voted 5,016; Statutory 1,029
• Fiscal year 2022–23: Total 4,322; Voted 2,848; Statutory 1,474
• Fiscal year 2023–24: Total 6,842; Voted 6,276; Statutory 566

Health Canada's planned approved funding is as follows (in millions):

• Fiscal year 2024–25: Total 8,678; Voted 8,398; Statutory 280
• Fiscal year 2025–26: Total 9,526; Voted 9,354; Statutory 172
• Fiscal year 2026–27: Total 9,506; Voted 9,335; Statutory 171

Analysis of statutory and voted funding over a six-year period

For voted authorities, the decrease for 2022-23 was mainly due to the winding down of Health Canada's response to the COVID-19 pandemic, then increased in 2023-24 due to additional funding received in-year for Working Together to Improve Health Care for Canadians and an increase in funding for the Canadian Dental Care Plan. Voted authorities increased again in 2024-25 and 2025-26 due to the implementation of the Canadian Dental Care Plan, which is partially offset in 2025-26 by the expiry of budgetary authorities for the renewal of the federal framework for the legalization and regulation of cannabis in Canada.

For statutory funding, the increase for 2022-23 was primarily for the procurement of critical and time-sensitive additional COVID-19 rapid tests. For 2023-24 there was a decrease due to the expiry of these authorities related to COVID-19 which was partially offset by payments pursuant to the Dental Benefit Act. For 2024 ‒25 there is a planned decrease for the payments pursuant to the Dental Benefit Act and for 2025-26 and 2026-27 statutory funding returns to pre-pandemic levels for primarily covering public servants' employee benefit plans.

For further information on Health Canada's departmental voted and statutory expenditures, consult the Public Accounts of Canada.

Financial statement highlights

Health Canada's complete financial statements (unaudited) for the year ended March 31, 2024, are available online.

The 2023–24 planned results information is provided in Health Canada's Future-Oriented Statement of Operations and Notes 2023-24.

The Department's total expenses in 2023-24 were $7,197.6 million.

There was an increase of total expenses of $2,763.8 million when comparing actual results against planned results for 2023-24. This is primarily a result of the following:

• An increase in transfer payments to P/Ts for Working Together to Improve Health Care for Canadians and for Strengthening Canada's Home and Community Care and Mental Health.
• An increase in dental benefit payments pursuant to the Dental Benefit Act.

When comparing year-over-year expenses, there was an increase of $3,556.4 million. The significant changes were:

• An increase in transfer payments to P/Ts for Working Together to Improve Health Care for Canadians and for Strengthening Canada's Home and Community Care and Mental Health.
• An increase in dental benefit payments pursuant to the Dental Benefit Act.
• An increase in salaries and employee benefits related to the signing of new collective agreements with several collective bargaining units resulting in increases in pay rate, retroactive payments and lump sum payments, as well as increments for inflation and step increases.

The Department's total revenues were $407.7 million in 2023-24 representing an increase of $122.9 million from planned results and a decrease of $4.4 million from the prior year actual revenues. The year-over-year variance is primarily a result of revenues from the Shared Service Partnership agreement with the Public Health Agency of Canada, which had increased temporarily in previous years to provide support for pandemic-related activities such as communications. This decrease is offset by an increase in revenues of a regulatory nature following annual fee increases in accordance with Section 4(1) of the Fees in Respect of Drugs and Medical Devices Order.

Transferred operations represent the costs associated with the responsibility, care and custody of COVID-19 rapid testing devices which was transferred to the Public Health Agency of Canada, effective February 19, 2024. The $1,508.6 million decrease in the cost of these operations reflects the winding down of pandemic response activities, and in particular, the cost of providing rapid testing devices.

Total net liabilities were $2,326.6 million at the end of 2023-24, representing an increase of $1,853.4 million from the previous year. This variance is resulting from a number of factors at the end of fiscal year 2023-24, including contributions payable to P/Ts for Shared Health Priorities, as well as amounts payable to Sun Life Assurance Company of Canada for administrative services related to the Canadian Dental Care Plan.

The year-over-year increase in total net financial assets of $1,846.9 million is primarily a result of an increase in amounts due from the Consolidated Revenue Fund, which is reflective of the increase in accounts payable noted above.

Total non-financial assets were $168.8 million at the end of 2023-24, representing a decrease of $158.3 million from the previous year. This decrease reflects primarily the transfer of responsibility, care and custody of COVID-19 rapid testing devices to the Public Health Agency of Canada in accordance with a memorandum of understanding, including the stewardship responsibility for the inventory, effective February 19, 2024.

Human resources

This section presents an overview of the department's actual and planned human resources from 2021-22 to 2026-27.

Analysis of human resources over the last three years

The increase in actual FTEs for 2022-23 is mainly due to Strengthening the Capacity and Transparency of the Pesticide Review Process.

The increase in FTEs for 2023-24 is mainly due to additional resources required for the Canadian Dental Care Plan and in-year resources received for the Canadian Drugs and Substances Strategy and Strengthening Environmental Protection for a Healthier Canada.

Analysis of human resources for the next three years

The calculation of the planned FTE figures is based on programs using their full revenue authority.

The decrease in planned FTEs in 2025-26 is mainly due to the expiry of budgetary authorities in 2024-25 for the renewal of the federal framework for the legalization and regulation of cannabis in Canada, which is partially offset by an increase in resources for the Canadian Dental Care Plan.

The decrease in planned FTEs in 2026-27 is mainly due to the Government of Canada's refocus on government spending and the expiry of budgetary authorities in 2025-26 for the National Strategy for Drugs for Rare Diseases.

For expiring budget authorities, the Department will have to request funding for these initiatives for future years.

Corporate information

Departmental profile

Appropriate minister(s):

The Honourable Mark Holland, P.C., M.P.
and The Honourable Ya'ara Saks, P.C., M.P.

Institutional head:

Greg Orencsak

Ministerial portfolio:

Health

Enabling instrument(s):

Assisted Human Reproduction Act, Canada Consumer Product Safety Act, Canada Health Act, Cannabis Act, Controlled Drugs and Substances Act, Dental Benefit Act, Dental Care Measures Act, Department of Health Act, Food and Drugs Act, Hazardous Materials Information Review Act, Hazardous Products Act, Pest Control Products Act, Radiation Emitting Devices Act, Tobacco and Vaping Products Act.

List of Acts and Regulations

Year of incorporation / commencement:

1913

Departmental contact information

Mailing address:

Serena Francis
Assistant Deputy Minister / Chief Financial Officer
Health Canada
Assistant Deputy Minister Office
200 Eglantine Driveway, Tunney's Pasture
Ottawa, Ontario K1A 0K9

Telephone:

613-295-8651

Email:

serena.francis@hc-sc.gc.ca

Departmental results framework

Health Canada's Departmental results framework and program inventory of record for 2023-24 are shown below.

Text description

Legend:
R: Result
I: Indicator

The figure illustrates Health Canada's approved Departmental Results Framework and Program inventory for 2023–24.

The Departmental Results Framework groups Health Canada's Core Responsibilities into two categories, all supported by Internal Services. These categories are (1) Health Care Systems and (2) Health Protection and Promotion, each of which are delivered through multiple programs in the Program inventory. Each core responsibility has departmental results and several indicators associated with it.

Departmental Results Framework

Core responsibility 1: Health care systems

• R1: Canada has modern and sustainable health care systems
  • I1: National health expenditure as a percentage of Gross Domestic Product
  • I2: Real per capita health expenditure
  • I3: Drug spending as a percentage of Gross Domestic Product
  • I4: Percentage of family physicians using electronic medical records
• R2: Canadians have access to appropriate and effective health services
  • I5: Percentage of Canadians (aged 15+) with a mental disorder who have expressed that they have an unmet mental health care need
  • I6: Percentage of Canadians (aged 18+) who have expressed that they have an unmet need for access to home care services
  • I7: Percentage of Canada Health Act compliance issues addressed within 24 months of identification

Program inventory under Core responsibility 1 (from one to three) as follows:

1. Responsive Health Care Systems
2. Healthy People and Communities
3. Quality Health Science, Data and Evidence

Core responsibility 2: Health protection and promotion

• R3: Canadians have access to safe, effective and quality health products
  • I9: Percentage of human new drug decisions issued within service standards
  • I10: Percentage of Risk Management Plan reviews for new drug decisions completed within service standards
  • I11: Percentage of domestic drug companies deemed to be compliant with manufacturing requirements under the Food and Drugs Act and associated regulations
• R4: Canadians are protected from unsafe consumer and commercial products and substances
  • I12: Percentage of domestic consumer product recalls communicated to Canadians in a timely manner
  • I13: Percentage of actions taken in a timely manner to protect the health of Canadians from substances found to be a risk to human health
  • I14: Percentage of pre-market pesticide submission reviews that are completed within service standards
• R5: Canadians make healthy choices
  • I15: Percentage of Canadians (aged 15+) who are current cigarette smokers
  • I16: Percentage of youth (grades 10-12) who report frequent (daily to weekly) cannabis use in the past 30 days
  • I17: Percentage of Canadians who use dietary guidance provided by Health Canada

Program inventory under Core responsibility 2 (from four to twenty) as follows:

4. Pharmaceutical Drugs
5. Biologic and Radiopharmaceutical Drugs
6. Medical Devices
7. Natural Health Products
8. Food and Nutrition
9. Air Quality
10. Climate Change
11. Water Quality
12. Health Impacts of Chemicals
13. Consumer Product Safety
14. Workplace Hazardous Products
15. Tobacco Control
16. Controlled Substances
17. Cannabis
18. Radiation Protection
19. Pesticides
20. Health Canada Specialized Services

Internal Services

Supplementary information tables

The following supplementary information tables are available on Health Canada's website:

• Details on transfer payment programs
• Gender-based analysis plus
• Response to parliamentary committees and external audits
• Horizontal initiatives
• United Nations 2030 Agenda and the Sustainable Development Goals

Federal tax expenditures

The tax system can be used to achieve public policy objectives through the application of special measures such as low tax rates, exemptions, deductions, deferrals and credits. The Department of Finance Canada publishes cost estimates and projections for these measures each year in the Report on Federal Tax Expenditures. This report also provides detailed background information on tax expenditures, including descriptions, objectives, historical information and references to related federal spending programs as well as evaluations and GBA Plus of tax expenditures.

Definitions

List of terms

appropriation (crédit)

Any authority of Parliament to pay money out of the Consolidated Revenue Fund.

budgetary expenditures (dépenses budgétaires)

Operating and capital expenditures; transfer payments to other levels of government, departments or individuals; and payments to Crown corporations.

core responsibility (responsabilité essentielle)

An enduring function or role performed by a department. The intentions of the department with respect to a core responsibility are reflected in one or more related departmental results that the department seeks to contribute to or influence.

Departmental Plan (plan ministériel)

A report on the plans and expected performance of an appropriated department over a 3year period. Departmental Plans are usually tabled in Parliament each spring.

departmental priority (priorité)

A plan or project that a department has chosen to focus and report on during the planning period. Priorities represent the things that are most important or what must be done first to support the achievement of the desired departmental results.

departmental result (résultat ministériel)

A consequence or outcome that a department seeks to achieve. A departmental result is often outside departments' immediate control, but it should be influenced by program-level outcomes.

departmental result indicator (indicateur de résultat ministériel)

A quantitative measure of progress on a departmental result.

departmental results framework (cadre ministériel des résultats)

A framework that connects the department's core responsibilities to its departmental results and departmental result indicators.

Departmental Results Report (rapport sur les résultats ministériels)

A report on a department's actual accomplishments against the plans, priorities and expected results set out in the corresponding Departmental Plan.

Full-time equivalent (équivalent temps plein)

A measure of the extent to which an employee represents a full person-year charge against a departmental budget. For a particular position, the full-time equivalent figure is the ratio of number of hours the person actually works divided by the standard number of hours set out in the person's collective agreement.

gender-based analysis plus (GBA Plus) (analyse comparative entre les sexes plus [ACS Plus])

An analytical tool used to assess support the development of responsive and inclusive how different groups of women, men and gender-diverse people experience policies, programs and policies, programs, and other initiatives. GBA Plus is a process for understanding who is impacted by the issue or opportunity being addressed by the initiative; identifying how the initiative could be tailored to meet diverse needs of the people most impacted; and anticipating and mitigating any barriers to accessing or benefitting from the initiative. GBA Plus is an intersectional analysis that goes beyond biological (sex) and socio-cultural (gender) differences to consider other factors, such as age, disability, education, ethnicity, economic status, geography (including rurality), language, race, religion, and sexual orientation.

government-wide priorities (priorités pangouvernementales)

For the purpose of the 2022–23 Departmental Results Report, government-wide priorities are the high-level themes outlining the government's agenda in the November 23, 2021, Speech from the Throne: building a healthier today and tomorrow; growing a more resilient economy; bolder climate action; fight harder for safer communities; standing up for diversity and inclusion; moving faster on the path to reconciliation; and fighting for a secure, just and equitable world.

horizontal initiative (initiative horizontale)

An initiative where two or more federal departments are given funding to pursue a shared outcome, often linked to a government priority.

non-budgetary expenditures (dépenses non budgétaires)

Net outlays and receipts related to loans, investments and advances, which change the composition of the financial assets of the Government of Canada.

performance (rendement)

What a department did with its resources to achieve its results, how well those results compare to what the department intended to achieve, and how well lessons learned have been identified.

performance indicator (indicateur de rendement)

A qualitative or quantitative means of measuring an output or outcome, with the intention of gauging the performance of an department, program, policy or initiative respecting expected results.

plan (plan)

The articulation of strategic choices, which provides information on how a department intends to achieve its priorities and associated results. Generally, a plan will explain the logic behind the strategies chosen and tend to focus on actions that lead to the expected result.

planned spending (dépenses prévues)

For Departmental Plans and Departmental Results Reports, planned spending refers to those amounts presented in Main Estimates.

A department is expected to be aware of the authorities that it has sought and received. The determination of planned spending is a departmental responsibility, and departments must be able to defend the expenditure and accrual numbers presented in their Departmental Plans and Departmental Results Reports.

program (programme)

Individual or groups of services, activities or combinations thereof that are managed together within the department and focus on a specific set of outputs, outcomes or service levels.

program inventory (répertoire des programmes)

Identifies all the department's programs and describes how resources are organized to contribute to the department's core responsibilities and results.

result (résultat)

A consequence attributed, in part, to an department, policy, program or initiative. Results are not within the control of a single department, policy, program or initiative; instead they are within the area of the department's influence.

Indigenous business (entreprise autochtones)

For the purpose of the Directive on the Management of Procurement Appendix E: Mandatory Procedures for Contracts Awarded to Indigenous Businesses and the Government of Canada's commitment that a mandatory minimum target of 5% of the total value of contracts is awarded to Indigenous businesses, a department that meets the definition and requirements as defined by the Indigenous Business Directory.

statutory expenditures (dépenses législatives)

Expenditures that Parliament has approved through legislation other than appropriation acts. The legislation sets out the purpose of the expenditures and the terms and conditions under which they may be made.

target (cible)

A measurable performance or success level that a department, program or initiative plans to achieve within a specified time period. Targets can be either quantitative or qualitative.

voted expenditures (dépenses votées)

Expenditures that Parliament approves annually through an appropriation act. The vote wording becomes the governing conditions under which these expenditures may be made.