The Chief Public Health Officer's Report on the State of Public Health in Canada 2013 – A message from Canada's Chief Public Health Officer

A Message From Canada's Chief Public Health Officer

When I was a child in the late 1950s, hospitals in Canada were filled with kids suffering from the complications of vaccine-preventable infections, including polio. Parents greatly feared the threat of this crippling illness which affected thousands of Canadians. To everyone's great relief, a vaccine was developed by Jonas Salk, and the disease was eventually eradicated in our country and most of the world.

When I think back to my childhood, the idea of eliminating a disease was a somewhat foreign concept. Then, through advances in medicine, a little shot in the arm–or better yet a few drops in the mouth or on a sugar cube–and we were suddenly immune to a range of diseases. It was a miracle. It is also one of the greatest success stories in public health. However, this success runs the risk of making us complacent. I am concerned that the gains we have made in battling infectious diseases may be lost if we do not redouble our efforts and ensure we stay focused on infectious diseases and the health of Canadians.

We are in a constant struggle to protect ourselves from the potentially harmful, complex and unseen world of microbes. But not all microbes are harmful. We are surrounded by billions of microbes and we interact with them in important ways: they live on our skin, in our digestive tract, in our mouth and nose and on every imaginable surface. Microbes are often associated with disease, but most are harmless or even beneficial to our health. Nevertheless, some do pose serious risks to health.

Canada has made advancements in combating the more harmful micro-organisms. There have been improvements in the conditions necessary to build resilience to infectious diseases, such as adequate income, food security, acceptable housing, access to education and early childhood care. In addition, the introduction of vaccines to prevent illness, the discovery and therapeutic use of antibiotics to treat deadly diseases, and advances in surveillance and epidemiology have also contributed to how well and long we live. But despite all our progress, our ability to overcome infectious diseases remains, at best, limited.

In March 2003, Canada was part of a global SARS outbreak that claimed 44 Canadian lives. Since then, the Government of Canada has taken great strides–including the creation of the Public Health Agency in 2004–to improve how it protects Canadians from infectious disease outbreaks and public health emergencies. Over the past nine years, the Agency has taken a leadership role in working with its public health partners to strengthen Canada's capacity to prepare for and respond to infectious disease outbreaks and public health emergencies. We have put new structures in place to improve how governments work together, developed comprehensive plans to prepare for public health emergencies, and enhanced our alert systems and disease prevention and management capabilities. The Agency's approach is to plan for all types of threats by using tools that can be shared with its partners and adapted to the nature and magnitude of the event. In our fight against infectious diseases, we must recognize that our preconceptions about them may need to be challenged or reassessed.

We must also be prepared for new and emerging infectious threats that can come from various sources such as nature, or even from the intentionally harmful acts of others. Although we do our best to prevent and control the spread of infection in our environment, outbreaks continue to occur. In response, the Agency has developed protocols and networks to identify outbreaks and to ensure that we are able to respond effectively. The Agency has both scientific experts who are available to guide our response and medical supplies that can be deployed to aid Canadians during an outbreak.

Within this report, I describe how infectious diseases influence public health and the health status of Canadians. I also discuss the role that all Canadians can play in preventing and controlling infectious diseases in their homes and communities. Since not all infectious diseases could possibly be covered in one report, I have chosen a limited number of topics that I feel warrant greater discussion and awareness.

As you read this report, I hope you ask yourself the same questions I ask myself every day in my role as Canada's Chief Public Health Officer:

• Are we taking the necessary steps to protect ourselves and our communities?
• Are there additional ways we can participate in reducing infectious diseases?
• What more can be done?
• Who else can we work with to better address the challenges that still remain?

While we have made great progress, challenges remain and work is ongoing. It is clear to me that continuous improvement in public health–by everyone–will be required throughout the 21st century to sustain our impressive record of battling infectious diseases.

Dr. David Butler-Jones