This document released on loosefiles wordpress.comee Samuel To Lucie OlsonHC-SCIGCICA@HWC Godefroy/HC-SCIGCICA ‘Sentby Joelle Cousineau Beth Junkins/HC-SC/GC/CA@HWC eee Subject Re: Fw: WHA 2009: Minister Aplukkaa's Bilateral Meetings and Related Events (FD inp) Lucie, ‘Thanks for this - I'm fine with your input. Regards, Samuel Samuel B. Godeffay, PhD. Director General / Directeur général Food Directorate - HPFB / Direction des aliments- DGPSA. Health Canada / Santé Canada Tel Tél: (613) 957-1821 Facsimile/Télécopicur: (613) 957-1784 Lucie Olson/HC-SC/GCICA, Lucie Olson/HC-SCIGCICA 2009.05-04 12:55 PM To. Sameena Khan/HC-SCIGC/CA@HWC c= Kimberly Empey/HC-SCIGC/CA@HWC, Matt FolalHC-SC/GCICA@HWC, Beth JunkinstHC-SCIGCICA@HWC, Samuel Godefoy/HC-SCIGCICA@HWC, Chris PalmeriIC-SCIGCICA@HWC Subject Re: Fw: WHA 2009: Minister Aglukkaa's Bilateral Metings and Related Events (FD input) Hi Sameena, 1 was abit difficult provide comment earlier oa, as FD had not seen some ofthe new input from PPIAD on branch level issues. Further fo Mat’ revisions below, I would like to provide the following comments on behalf of | the FD. Trnoted in your original request that directorates’ input should be DG approved, however, given tight timelines and relatively minor extent of our input, !am submitting it directly to you. 1 have ce'd FD DGisenior ‘management for ther info and any comments they may wish to add Regards, Lacie 000001$.15(1) = In BN for Mexico and the one forthe US, SPP is mentioned é level of current engagement, at least activites related to food safety, as the FD is not aware of much taking place in well over one year. Ifengagement is minimal across HC and PHAC, then the text regarding SPP in both aotes For instance, in note for Mexico, suggest revise sentence saying .."IC and PHAC are involved in SPP workplans" to ..]HC and PHAC have been involved. =In BN for China, there is some inaccuracy in food safety section at end of note, as itis inferred that melamine was ‘a food additive which is not the case, It's nat even a food chemical. Suggest following correction based ca info available on Chinese wet "On February 28, 2009, National People's Congress Standing Committee passed a new food safety law. The law pays special attention to chemicals in food-additives, which were at the centre of a tainted milk scandal lat year. The new law stipulates ban on all chemicals and materials other than authorized additives in food productiondeclares- that no-additives-willhe-ellowed unless proven-safe. The new law will go into effect on June 1, 2009." ~In BN for UK, FD would like to add at end of background section a short section as follow: “MOU between UK Food Standard Agency and HC's Food Directorate ‘In 2006, a Memorandum of Understanding (MOU) between the Food Standards Agency and the Food Directorate was signed. The MOU establishes a voluntary arrangement forthe exchange of information and work sharing initiatives on risk assessments and ris management options on food regulatory matters of mutual intrest. The ‘current activities under this MOU pertain to chemical safety, however the potential to expand the scope to include enhanced cooperation on nutrition issues is under discussion." If there is a need for a speaking point on this topic, the following text is suggested: "We are pleased that food safety officials in Health Canada and the UK Food Standard Agency have strengthen their ‘working relationship through the establishment of an MOU in 2006. Health Canada recognizes the imporiance of ‘working with the international food regulator community to address global food safety challenges, and work undertaken under this MOU will no doubt contribute to our respective international objectives in the area of food safety." Matt Folz/HC-SC/GCICA Matt Fola/HC-SCIGCICA 2009-05-04 11:27 AM To Kimberly Empey/HC-SCIGCICA@HWC © Lucie Olson/HC-SCIGCICA@HWC, Sameena KhawHC-SCIGCICA@HWC Subject Re: Fw: WHA 2009: Minister Aglukkag's Bilateral Meetings and Related Events[} For the most part, both documents look pretty good from my point of view. I've attached both documents with additions in blue. Matt MEXICO Memo Bat Min May2009\2 PPIAD} upd WHA CanUS Bilt Mistrial Memo (PPIAD} wod ‘000002Matt Folz Senior Policy Analyst, International & Partnerships Division Policy, Planning and International Affairs Directorate (PPIAD) Health Products and Food Branch, Health Canada 613.957.6677 matt_folz@he-sege.ca Sameena Khan/HC-SCIGCICA, ‘Sameena Khan/HC-SCIGCICA To. Matt FolzHC-SCIGCICA@HWE, Lucie 2009.05.02 08:42. AM Olson HC-SCIGCICA@HWC Subject Fw: WHA 2009: Minister Aglukkaq's Bilateral Meetings and Related Events ‘Thanks for confirming that FD is preparing feedback on some of the notes, By way of this emi, I will ask Matt Folz to let you know what text is being proposed for both the US and Mexico-related briefing notes. Ifyou have comments on any other notes, please let me know. Sameena Khan, MA. Senior Poticy Analyst, International Affairs Policy, Planning and International Affairs Directorate Health Products and Food Branch, Health Canada Analyste principal des politiques des affaires internationales Direction des politiques, de la planification et des affaires internationales Direction générale des produits de la santé et des aliments www healtheanadage.ca ‘www santecanada ge.cal Tel: (613) 957-6202 Fax: (613) 954-9981 ~~ Forwarded by Semeena KhawHC-SC/GC/CA on 2009-05-02 08:31 AM = Lucie Olson/HC-SC/GCICA 2009-05-01 03:21 PM To Samecna Khan/HC-SCIGCICA@HWC Suhjeet Re: WHA 2009: Minster Aglukha's Bilateral Meeting and oe — Related Events} — Hi Sameena, Justa heads up thatthe FD will have comments on some of the briefing notes. Regarding the BN for the blat with the US, there isa section on product safety, and input is being sought from HPEB. Is PPIAD planning to aéd some text re meeting earlier this week with FDA? FD was considering adding a few words re synergies betweenFood and Consumer Safety Action Plan and US Food Protection Plan. Pls let me know what type of input PPIAD is preparing ‘on that section, if any, in order to avoid duplication. ‘000003Thanks, Lucie Olson AJAssociate Director Interagency and International Program Director General Office Food Directorate Health Products and Food Branch, Health Canada 200 Tunney's Pasture Driveway (P.L. 0702C1) Ottawa, Ontario, KLA 012 ‘Tel: (613) 957-0906 Fax: (613) 941-3537 ‘e-mail: lucie_olson@he-se.ge.ca Sameena KhanHIC-SC/GCICA, cy 24, Sameena Khan/HC-SC/GCICA To 2009.04.30 11:11 AM Subject Dear Colleagues, Sina Muscati/HC-SC/GCICA@HWC, Jacob Ponter/HC-SCIGCICA@HWC, Mike WardHC-SCIGCICA@HWC, Rita Beregszaszy/HC-SC/GCICA@HWC, Mare Legrand HC-SCIGCICA@HWC, My-Yen ‘YuHC-SCIGCICA@HWC, Migs Chultem/HC-SC/GCICA@HWC, Winnie Pang/HC-SCIGCICA@HWC, Loretta Wong/HC-SC/GC/CA@HWC, Merry Bujaki/HC-SC/GCICA@HWC, Louise Dery/HC-SCIGC/CA@HWC, Lucie Olson/HC-SCIGCICA@HWC, Cynthia Boy@HC-SC/GCICA@HWC, Marion 1 HaaHC-SC/GC/CA@HWC, Ann Ellis]HC-SCIGCICA@HWC Matt Fol2iHC-SCIGCICA@HWC, Kimberly Empey/HC-SCIGCICA@HWC, Brenda CzichHC-SCIGCICA@HWC WHA 2009: Minister Aglukkag’s Bilateral Meetings and Related Events Please find below the draft briefing notes to prepare the Minister for meetings at the WHA 2009. PPIAD will input ‘where general information from HPFB is being sought and/or confirmed in these drafts. However, your review is. censure is included. — very much appreciated as there may be information missing or perhaps some information that you would like to In the event that I do not hear from you by Spm tomorrow, I will assume that you are fine with this email being sent to you for your information only. If your Directorate may wish to add or provide additional themes or details to any of the briefing notes, please note: ‘© Style, Timeline (note DG approval by May 4) and Considerations are outlined below. ‘© Please email or phone me by cob tomorrow to give me a heads up. We just received these documents last night, so apologies in advance for these tight timelines. Thanks, ‘00004‘Sameena Khan, M.A, Senior Policy Analyst, International Affairs Policy, Planning and International Affairs Directorate ‘Health Products and Food Branch, Health Canada Analyste principal des politiques des affaires internationales Direction des politiques, de la planation et des affaires internationales Direction générale des produits de la santé et des aliments www healthcanada ge.ca www santecanada.ge.ca/ Tel: (613) 957-6202 Fax: (613) 954-9981 Jayne Simms-Dalmotas Original Message From: Jayne Simms-Dalmotas Sent: 2009-04-29 08:38 PM EDT ‘To: Jamie Baker, Garry Aslanyan; Brenda Czich; Kimberly Empey; Greg Loyst; Jackie Thome; christian sylvain@cihr-irse.ge.ca; Robert Asare-Danso; Martha Vaughan; Wayne Lepine Ce: John Topping; Gloria Wiseman; Sandra Black; Daniel Harmen Meester; Carolina Seward; Kate Dickson; Daniel Pang; Melissa Ramphal; Jennifer Rae; Rita Gratton; Lenore Rayner Subject: WHA 2009: Minister Aglukkag's Bilateral Meetings and Related Events Hello Everyone, ‘As mentioned in John Topping's note of April 23, Minister Aglukkag will be attending the World Health Assembly in Geneva from May 17th to 19th, 2009. International Affairs Directorate, SPB, has developed draft briefing notes and talking points for her bilateral meetings with other Health Ministers, as well as for a number of events involving Health Ministers. We are asking for your assistance in the review and completion of briefing notes for these ‘meetings, Please see below for relevant details: 1. First Drafts of Briefing Notes and Speaking Points have been in LAD for the following possible bilaterals/meetings (Lead Officer in brackets): United States (Daniel Meester) Mexico (Carolina Seward) China (Daniel Pang) Brazil (Kate Dickson) Dinner hosted by Australia, attended also by US and United Kingdom and possibly China (Jayne Simms Dalmotas) Roundtable with Caribbean countries (Kate Dickson) Chile (Understood that Jamie Baker/PHAC will prepare the first draft and circulate) © UK (layne Simms Dalmotas) Draft notes are attached below for your review and input= Pleuse-feel free to contact the lead officers directly for more information, or to discuss your comments, ‘As mentioned by John in the previous email, the following approach has been recommended: 2. Style and Approach ¢ TAD staff have met with the Ministerial Briefing Unit about the writing style for these notes. We have been instructed (o make notes succinct and free of jargon. It has been stressed that speaking notes should be written in ‘a way to ensure that they can be casily delivered verbally. We ask that you also follow these guidelines with ‘your revisions o our draft notes. © As this is our Minister’ first WHA, our approach will be less likely to focus on “iritanis" in any of these bilateral relationships and more on relationship building. We are happy to work with you to determine whether ‘000005proposed issues are appropriate for a Ministerial bilateral or should be raised through at a different mechanism, Please keep in mind that meetings will likely be approximately 20 minutes in length and may have multiple subjects. 3. Timeline ‘Draft notes sent to you by end of day on Wednesday, April 29 Input on any notes relevant to your Agencies/Branches by noon, Monday May 4. Input requires [Director General approvals (We had intended to forward these to you by end of day April 24, but the events of he past few dayrsset us back somewhat. We are well aware that many of you are also doing extra duty these days and may not be able to focus on these notes as easily as normal. To be fr, we are also extending the deadline for reccivin your input ~ to May 4. Please let us know if there is anything we can do to facilitate getting your feedback, suchas possibly discussing the notes with you over the phone.) 4. Other Considerations Due to the Minister's availability and time schedules, the confirmed lst of meetings is likely to be rrace limited than the list above. However, in order to be prepared, we are proceeding with notes based on the above list. We try o anticipate accurately the possible subjects in our draft notes. However, if there are subject smissing that you feel should be included, please include relevant text accordingly, bearing in mind that the typical bilateral meeting is only 20 minutes. Immediately following the World Health Assembly, Minister Aglukkag will be travelling to France fora one-day program, focussing mostly on (I) Arctic issues, in particular the health of Northern peoples. and (2) on Alzheimer's esearch. We will lso be working with a number of you on that program in the comings day. ‘Thank you very much for your support. Please feel free to contact me or any of the officers if you have questions. Jayne WHA Can.US Blat Mister Hemo.wpd [MEXICO Memo_Bat_Min_May20082.wpd WHA CHINA BistralAnr28.wpd TAB _ BRAZIL Memo_Bl_MinTemporao_May2009.wpd WHA AUS Denner. draft 29Ap 09 mpd. Memo_Biat_Carbbean_Apdi2003. pd WHA UK Biot deft 2340 09.0pd ‘000006Jayne Simms-Dalmotas Senior Program Manager/ Gestionnaire principale de programme International Affairs Directorate/ Direction des affaires internationales Health Canada/Samté Canada Tel: (613) 957-7298 Fax: (613) 952-7417 Jayne, Simms-Dalmotas@hhe-se.ge.ca 000007POSSIBLE BILATERAL MEETING WITH DR. JOSE ANGEL CORDOVA VILLALOBOS, MEXICAN SECRETARY OF STATE FOR HEALTH WHA®2 - May 2009 Strategic Objectives of the Meeting To strengthen the bilateral relationship between Canada and Mexico in the health sector and to discuss trilateral cooperation in North America. To discuss the swine flu outbreak and implications for Canada in terms of assistance and regional cooperation To discuss the Canada-Mexico Policy Dialogue on Indigenous Health, which was postponed due to the outbreak. If raised, to lea about the proposed Mesoamerican Public Health System, a regional public health cooperation initiative among Central American governments, and Mexico's involvement. SCENARIO: You will be meeting with Dr. Cordova, Secretary of State for Health of Mexico. You will be accompanied by.... The meeting will last approximately 20 minutes. Secretary... will likely be joined by BACKGROUND INFORMATION: Bilateral relations between Canada and Mexico are longstanding and extensive (Tab X). Health, Canada has had an ongoing relationship with the Secretariat of Health in o. In January 1998, both governments signed a Memorandum of Understanding (MOU). In 2004, the two governments signed a Letter of Intent (LOT) to renew bilateral relations and replace the MOU, which had expired (Tab X). Issues highlighted in the LOI include communicable and non communicable diseases; health human resources; health equity and health care of indigenous people; mental health; health research; environmental health; health policy development; health. systems management and financing. Health Secretary Cordova met with former Health Minister Tony Clement during the XVII International AIDS Conference (AIDS 2008) in Mexico City in August 2008 and was ‘000008accompanied by the Chief Public Health Officer (CPHO), Dr. David Butler Jones. For the World Health Assembly (WHA), the following issues of mutual interest have been identified as topics for discussion: ‘The swine flu outbreak ‘The status of the Canada-Mexico Policy ‘Dialogue on Indigenous Health Trilateral Cooperation on Health Mesoamerican Public Health System ‘The status of the Letter of Intent (if asked). weRene 1. The Human Swine Flu Outbreak [PHAC] Please provide background on the situation, keeping in mind that the discussion will tate place in mid-May. 2. The Canada-Mexico Policy Dialogue on Indigenous Health [ENIHB INPUT] On May 8 - 10, 2006, the first joint activity under the Canada-Mexico Letter of Intent (LOI) (and reflected as an SPP initiative) was a workshop on Aboriginal Health in Merida, Mexico. Indigenous representatives from both countries participated in discussions on health equity and the provision of health care to indigenous peoples. Ongoing interest in the area of indigenous health led to further discussions between the First Nations and Inuit Health Branch (FNIHB) and their counterparts, who have agreed to focus their joint activities for 2008-2009 in the areas of healthy communities, traditional medicine and matemal-child health. A Canada-Mexico Policy Dialogue on Indigenous Health was scheduled to take place in Canada ‘on May 5 to 8, 2009, but was postponed due to the swine flu outbreak in Mexico. The Policy, Dialogue will now likely take place in the fall, ideally in Duncan, British Colombia, whee ______ originally planned. As the second joint activity and follow-up to.the Merida meeting, the poliey- ———— dialogue will focus on the themes of Healthy Communities, Traditional Medicine/Cultural Competency, Governance, Tuberculosis, and Maternal and Child Health and will include site visits to local communities... Expected outcomes... 3. Trilateral Cooperation in Health [GHSI_ HPFB, HECSB, CFIA INPUT NEEDED} - text should be shortened... ‘The Health Portfolio has been actively involved in the Security and Prosperity Partnership ‘000009(SPP), a forum for cooperation on economic and security issues between Canada, the United ‘States and Mexico. Health Canada and the Public Health Agency of Canada are involved as the ‘SPP work plans include various health-related initiatives, primarily in the areas of pandemic preparedness, food safety, indigenous health, and the safety of pharmaceutical products. With the arrival of a new US administration, the status of the SPP structure remains unclear. However, a key message for any meeting with Mexican officials would be that regardless of the formal structures that will be established at the Leaders' level, cooperation between our countries will continue to be part of our regular business. Canada, the United States and Mexico will have an ongoing need for strong cooperation. In 2004, the Trilateral Cooperation Charter was signed between the Health Products and Food Branch, the US Food and Drug Administration, and the Mexican Secretariat’s Federal Commission for the Protection against Sanitary Risks (COFEPRIS). It is an important vehicle for North American regulators to share safety information and collaborate on issues of common interest regarding drugs, biologics, medical devices, food safety and nutrition. By providing a framework for cooperation in these areas, the Charter contributes to the SPP objective on safe food and products. In 2008, the Charter entered into a process to address how the three countries can better work together, including how to move forward on initiatives and enhancements. This process has also considered the implications of member countries’ product and food safety action plans for the trilateral process and activities. A revised Trilateral Charter was signed/will be signed in April 2009 [HPEB TO CONFIRM}. Related to the Trilateral Cooperation Charter, Mr. Miguel Toscano Valasco, Mexico's newly appointed Federal Commissioner of COFEPRIS (the Federal Commission for the Protection against Sanitary Risks) visited Ottawa on November 27 and 28, 2008, to meet with government officials at Health Canada and the Canadian Food Inspection Agency (CFIA) to learn about Canada’s regulatory processes in food, drugs and pesticides, as well as identify areas of mutual interest, The delegation was also interested in obesity, tobacco regulations and marketing as well as legislation on alcohol use. 4. The Mesoamerican Public Health System [INPUT FROM PHAC AND CIDA NEEDED] In 2001, Mexico and Central American leaders initiated the Puebla-Panama Plan (PPP) as a mechanism for increased economic integration and investment in the sub-region. In June 2008, afier a Heads of State Meeting in Villahermosa, Mexico, Mexican President Calderén announced that the PPP, renamed the Mesoamerican Integration and Development Project, or Project Mesoamerica, would now work toward advancing integral development, expanding its cooperation mechanisms to include projects in social development, including housing and 000108.15(1) In 2001, Mexico and Central American leaders initiated the Puebla-Panama Plan (PPP) as a mechanism for increased economic integration and investment in the sub-region. In June 2008, after a Heads of State Meeting in Villahermosa, Mexico, Mexican President Calderén announced that the PPP, renamed the Mesoamerican Integration and Development Project, or Project Mesoamerica, would now work toward advancing integral development, expanding its cooperation mechanisms to include projects in social development, including housing and health. At the meeting, leaders supported a proposal for a Mesoamerican Public Health System to increase cooperation on common health issues including: matemal and child health, ‘communicable diseases such as dengue and malaria, vaccination programs, and nutrition. ‘Mexico has played a leadership role thus far. Contributions toward the project are expected from Spain, the Inter-American Development Bank (IDB), the Pan American Health Organization (PAHO), the Bill and Melinda Gates Foundation, and the Fundacion Carlos Slim. Given the recent nature of this proposal, Canada would like to Jeam more about progress on the Mesoamerican Public Health System and Mexico's role in the initiative. ssessseeceeebeneeneneeses [AS CANADA BEEN APPROA THIS Te HA: 5. The status of the Letter of Intent (LOD) In October 2004, the Ministry of Health of Mexico and Health Canada signed a Letter of Intent (LOD to renew bilateral relations and replace the 1998 MOU, which had expired. Issues highlighted in the LOI include communicable and non-communicable diseases; health human resources; health equity and health care of indigenous people; mental health; health research; environmental health; health policy development; health systems management and financing. Bilateral activities in indigenous health have been particularly strong under the LOI. ‘When Health Secretary Cordova met with Minister Clement and Dr. David Butler Jones during the XVI International AIDS Conference (AIDS 2008) in Mexico City in August 2008, areas of cooperation within a renewed MOU/LOI between Canada and Mexico were tentatively proposed — ‘They included: updating the content of sexual education curricula; exchanging experiences with regard to the safety and efficacy of pharmaceuticals produced outside of Canada (data shering and verification of findings); good manufacturing practices and collaboration on product and food safety, and; the exchange of information with the National Microbiology Laboratory (NML). No follow-up discussions have occurred with regards to the LOI. As noted above, the LOL highlights specific health issues of interest; Article 2(i) also allows for cooperation in “health topics of mutual interest” therefore there are limited (ceremonial) benefits to re-opening, 000011negotiations to expand specific reference to areas of cooperation. Current bilateral relaiions are strong and additional activities can be subsumed under the current LOI, resulting in a Lighter administrative burden, Next Steps: This bilateral meeting is primarily intended as a meet and greet with Secretary Cordova. It is an opportunity for you to learn about our activities to date and to assess future areas, for cooperation. TABS Speaking Points Bibliography Bilateral Relations Letter of Intent (LOI) Prepared by: Carolina Seward Tel: (613) 941-2951 Org. International Affairs Directorate, Health Canada Date: April 23, 2009 Approved by: Consulted with: 000012Speaking Points Good morning Dr. Cordova. It is a pleasure to meet you. I know my predecessor, Minister Clement, was very enthusiastic about our relations with Mexico and I am excited to learn more about Mexico’s health priorities and discuss our collaboration. Outbreak ... [PHAC] I was sorry to hear that the Canada-Mexico Policy Dialogue on Indigenous Health had to be postponed. I think this is a very important area of cooperation and we look forward to working with your officials to find an alternative date. Tfraised: The Mesoamerican Public Health System is a fairly new initiative. I understand Mexico is playing a leadership role. Can you tell me more about the project and progress to date? How will it impact and interact with your own domestic public health system? Ifasked: — I will ask my officials to assess the Letter of Intent (LOI). Our bilateral activities under the current LOI are strong. What do you feel are the Benefits of renewing the LOI? 000013,Key Recent Bilateral Activities TABX Hospital Capacity Building Since 1995, the Children’s Hospital of Eastern Ontario (CHEO) has been partnering with a small paediatric hospital in Oaxaca, Mexico, the “Hospital de la Ninez Oaxaquena” (HINO). in 2006, the partnership expanded to include three additional hospitals in Guadalajara and Guerrero through support from the PAHO-Canada Biennial Workplan (BWP) Funds, jointly managed by the International A fairs Directorate of Health Canada and PAHO. This cooperation is demonstrating improved training, capacity building and integration between these hospitals in Mexico. It may also provide a model that CHEO can replicate in enhancing integration between Ontario hospitals. Its success has led to a formal agreement with PAHO to further enhance cooperation between the hospitals; Dr. Roses, the Director of PAHO, met with CHEO during her visit to Ottawa in early April. Laboratory Capacity Building [PHAC] Canada and Mexico are cooperating on the area of laboratory diagnostic capabilities. Mexico also has an interest in learning more about the Canadian Network for Public Health Intelligence (CNPHI), a web based resource which collects and shares public health information resources and expertise with local, regional and national health officials to improve public health alerting and response. Canada is also working with Mexico to develop computer-based tools to improve its surveillance and investigation of foodborne illness outbreaks, based on Camada’s PulseNet, a virtual electronic network of federal and provincial public health laboratories. Finally, Mexico has expressed interest in linking into the Laboratory Response Network, which provides an integrated network of US and Canada laboratories in response to biological and chemical terrorism and to other public health emergencies. ‘This initiative will likely be developed over the long-term, with an initial focus on improving Mexican laboratory capacity so that Mexico can receive the necessary accreditation to take part in the Network. HIV/AIDS (needs to reflect how we worked with Mexico] As a previous host in 2006, Canada provided significant technical and financial support to the XVII International AIDS Conference (AIDS 2008) hosted by Mexico in August 2008. AIDS 2008 was the first to be held in Latin America and brought together over 25,000 participants, including 12,500 registered delegates and 3000-media, to promote the interaction of scierce, ——— community and leadership, in the global response to HIV/AIDS. Under the theme “Universal Action Now!”, AIDS 2008 called for a renewed commitment from the international community to strengthen the scale up of HIV prevention, treatment, care and support programmes worldwide, with the aim of providing universal access to these services by 2010. The conference also continued ongoing work toward achieving the Millennium Development Goals — which includes the target of halting and reversing the spread of HIV by 2015. 00014BILATERAL MEETING WITH KATHLEEN SEBELIUS. SECRETARY OF HEALTH AND HUMAN SERVICES, UNITED STATES OF AMERICA Date: TBD Location: TBD WHA@2 - May 2009 Strategic Objectives of the Meeting To build an amicable relationship between you and Secretary Sebelius To learn about American priorities for health care reform and how these reforms may impact Canada, To identify possible areas of Canada-US health cooperation with the new administration SCENARIO: ‘You will be meeting with Secretary Kathleen Sebelius. You will be meeting in room You will be accompanied by __. The meeting will last approximately 20 minutes. Seoretary Sebelius will likely be joined by BACKGROUND INFORMATION: Key Areas of Canada-US Health Cooperation Canada-US working relationships span the entire Health Portfolio, Health Canada, PHAC, and CIHR-all-share deep links-with-various US government bodies including the Department of ———— Health and Human Services (HHS), Centres for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the US Food and Drug Administration (USFDA) and the Consumer Product Safety Commission (CPSC). These relations are based on both informal ties and established formal bilateral ties including Memoranda of Understanding (MOUs), Letters of Intent (LOIs), and collaboration in various multilateral fora, 000015Regulatory Frameworks (INPUT REQUIRED FROM HECS, HPFB) Canada and the US closely collaborate to maintain and enhance the compatibility of their respective regulatory regimes in the areas of health, food and consumer product safety. An MOU ‘was negotiated in 2005 between HECS and the US Consumer Product Safety Commission for the purpose of sharing information in regards to risk management, regulations, emergency management, and public health and safety. Recent activities include Moreover, an MOU was also negotiated in 2003 between HPFB and the US Food and Drug Administration for the purpose of exchanging information in regards to the regulation of therapeutic products. Recent activities include _ Health Security INPUT REQUIRED FROM PHA), Canada and the US cooperate closely with Mexico in a Security and Prosperity Partnership (SPP) signed in 2005. SPP health commitments include, . Recent cooperative activities include : Canada and the US also work collaboratively through the Global Health Security Initiative (GHSI). Launched by the US in 2001, the GHSI provides a forum for like-minded countries to exchange information and coordinate actions to strengthen global health security and respond to the health threats posed by international biological, chemical and radio-nuclear events. The work of the GHSI includes a focus on: risk assessment and communications; emergency preparedness and response planning; improving linkages among laboratories; medical countermeasures to address chemical, biological and radio-nuclear threats; and, sharing of information on emerging health security risks. Recent GHSI activities include Indigenous Health (INPUT REQUIRED FROM FNIHB) Canada and the US cooperate in the area of Indigenous health by sharing research and best practices on Indigenous health issues including healthy lifestyles and access to health services in remote communities. This relationship is governed by an MOU on Indigenous Health (2007- 2012), and includes working groups on maternal and child health and suicide prevention. Recent activities include Health Research (INPUT REQUIRED FROM CIHR) Canada and the US also collaborate on health research and ensure the complementarity of their respective research agendas. CIHR and the US National Institutes of Health (NIH) are partners in the Grand Challenges in Global Health Initiative, which funds research for 14 grand challenges to improve health in the developing world. Moreover, Canada’s Cancer Stem Cell Consortium (CSCC) has recently developed a partnership with the California Institute for Regenerative Medicine (CIRM) for the purpose of cooperating in regards to cancer stem cell research. Other recent initiatives include 00016‘The New American Administration: Transitions and Priorities With the arrival of the Obama administration, the top priority in the health field will be health care reform. Two key pieces of legislation have already been passed. In February 2009, President Obama signed into law the Children’s Health Insurance Reauthorization Act (formerly SCHIP), which provides increased funding to expand coverage to a significant number of children not covered by employer-sponsored health insurance schemes. Also in February 2009, President Obama signed the American Recovery and Reinvestment Act (ARRA), an omnibus $787b bill that includes a number of health provisions. Such provisions included US$85b for Medicaid health insurance coverage, US$19b for electronic health records and health information technology, US$500m for Indian health services, US$1b for health promotion and healthy living, and US$1.1b for comparative clinical effectiveness. Health Insurance President Obama has proposed a National Health Insurance Exchange mechanism through which Americans would choose between a number of plans that meet government-mandated criteria, including a new public health insurance plan that will compete with private plans. Privete insurers are wary of this proposal as they fear that the public plan may undercut them in the marketplace. The public health insurance plan remains a source of intense debate. Public Health (INPUT REQUESTED FROM PHAC Its highly likely that the new administration will maintain strong domestic and international efforts for emergency preparedness and response. The White House's plan for homeland security makes reference to promoting “international efforts to develop new diagnostics, vaccines and ‘medicines that will be available and affordable in all parts of the world.” (..) Moreover, the impact of the recent swine flu outbreak has raised the profile of public health... (PHAC input) Product Safety INPUT FROM HPFB?) Itis highly likely that the new administration will maintain efforts to improve the safety of ‘imported food, pharmaceuticats/active ingredients and consumer products. Import safety Wasa = priority under the Bush administration, and the USFDA has recently opened offices in China, Belgium, Costa Rica and India. It is worth noting that President Obama introduced a food safety bill in 2008, which was seen as an carly indication of what his administration may undertake in this area. It called for increased surveillance, inspection capacity and coordination acrost government. During the primary season, President Obama also proposed to double the budget of the Consumer Product Safety Commission, 000017Family Planning and Health Research (INPUT FROM CIHR?) In January 2009, the new administration overturned restrictions on funding for international ‘groups that support family planning. In March 2009, President Obama also removed previous restrictions on federally-funded human embryonic stem cell research through an Executive Order, especially affecting the parameters of funding provided by the National Institutes of Health (NIH). During his inaugural address, President Obama stated that his administration would “restore science to its rightful place and wield technology’s wonders to raise health care’s quality and lower its cost.” Comparative Effectiveness Research (INPUT FROM HPFB?) ‘The new administration is strongly considering the implementation of a new, centralized body to evaluate and coordinate comparative effectiveness research in regards to pharmaceuticals and medical procedures. This could involve the government conducting or sanctioning research as to which drugs and procedures are most effective, and using the evidence garnered to regulate which drugs and procedures will be covered through Medicare and Medicaid, and possibly in private health insurance. Funding for such an endeavour was passed through ARRA, though it must be noted that it mandated “clinical effectiveness” research rather than “cost effectiveness” research. Proponents argue that such a body would increase efficiency and reduce redundancies; critics argue that it would stifle innovation and undermine personalized care. Next Steps: This bilateral meeting is primarily intended as an opportunity for you to meet Secretary Sebelius, lay the foundations for an amicable working relationship, and assess future areas for cooperation. Prepared by: Dan Meester Consulted with: Tel: (613) 941-0112 Approved by: Org. International Affairs Directorate, Health Canada Date: April23, 2009 re — : 00018SPEAKING POINTS: It’s a pleasure to meet you, Secretary Sebelius [se-BELL-ee-us]. I’m certainly looking forward to a productive relationship with your new administration. As you know, the US and Canada have a long history of cooperation in health, and T’'m looking forward to building on that relationship. As the US begins its health care reform process, please be aware that if you're interested in any aspect of the Canadian health care system, I would be happy to arrange for experts to meet and exchange information. As you know, Canada and the US have been working together closely on issues surrounding health, food and consumer product safety. Could you give usa sense of what the new administration’s priorities may be in this area? /HECS / HPFB INPUT?] [QUESTION / COMMENT FROM PHAC RE: PUBLIC HEALTH / HEALTH SECURITY] I'm from Nunavut, so as you can imagine I was very pleased to learn about our ongoing cooperation in indigenous health. How do you foresee our cooperation moving forward in this area ? [FNIHB INPUT?] 00019Biography: Secretary Kathleen Sebelius Kathleen Sebelius, former governor of Kansas, is currently serving as the Secretary of Health and Human Services in the United States. Secretary Sebelius’ nomination was confirmed by the Senate on April 28, 2009 bya vote of 65-31 Secretary Sebelius was first elected to the Kansas House of Representatives in 1986. In 1994 she left the House and won an election to become the state insurance commissioner. She refused to take campaign contributions from insurers and has been credited with reducing the influence of the insurance industry over the agency Secretary Sebelius was elected governor of Kansas in 2002, and re-elected in 2006. As a Democrat, she has developed a strong reputation as a moderate in a Republican-leaning state, persuading Republican Mark Parkinson to be her running-mate in the 2006 elections. In 2005, Time magazine named her one of the nation’s top five governors for eliminating USS1.1 billion in debt that she inherited from the previous administration. Sebelius’ priorities as governor of Kansas have included job-creation and economic growth; ensuring quality education for every Kansas child; protecting Kansas families and communities; improving access to quality, affordable health care; and taking advantage of the state’s renewable energy assets. Sebelius was bor in Cincinnati, Ohio and earned a Master of Public Administration (MPA) degree from the University of Kansas. She has been married to her husband Gary, a federal magistrate judge, for 34 years. They have two sons named Ned (born 1982) and John (born 1985); Ned is attending Georgetown Law School, and John is a graduate of the Rhode Isiand School of Design. 000020POSSIBLE BILATERAL MEETING WITH DR. JOSE ANGEL CORDOVA VILLALOBOS, MEXICAN SECRETARY OF STATE FOR HEALTH WHA@2 - May 2009 Strategic Objectives of the Meeting To strengthen the bilateral relationship between Canada and Mexico in the health sector and to discuss trilateral cooperation in North America. To discuss the swine flu outbreak and implications for Canada in terms of assistance and regional cooperation To discuss the Canada-Mexico Policy Dialogue on Indigenous Health, which was postponed due to the outbreak. If raised, to learn about the proposed Mesoamerican Public Health System, a regional public health cooperation initiative among Central American governments, and Mexico's involvement. SCENARIO: You will be meeting with Dr. Cordova, Secretary of State for Health of Mexico. You will be accompanied by.... The meeting will last approximately 20 minutes. Secretary..... will ikely be joined by BACKGROUND INFORMATION: Bilateral relations between Canada and Mexico are longstanding and extensive (Tab X). Health Canada has had an ongoing relationship with the Secretaria Ith in Mexico. In January 1998, both governments signed a Memorandum of Understanding (MOU). In 2004, thetwo_ governments signed a Letter of Intent (LOI) to renew bilateral relations and replace the MOU, which had expired (Tab X). Issues highlighted in the LOI include communicable and non- communicable diseases; health human resources; health equity and health care of indigenous people; mental health; health research; environmental health; health policy development; health systems management and financing. Health Secretary Cordova met with former Health Minister Tony Clement during the XVII International AIDS Conference (AIDS 2008) in Mexico City in August 2008 and was 000021accompanied by the Chief Public Health Officer (CPHO), Dr. David Butler Jones. For the World Health Assembly (WHA), the following issues of mutual interest have been identified as topics for discussion: 1. The swine flu outbreak The status of the Canada-Mexico Policy Dialogue on Indigenous Health Trilateral Cooperation on Health ‘Mesoamerican Public Health System ‘The status of the Letter of Intent (if asked). yen 1. The Human Swine Flu Outbreak [PHAC] Please provide background on the situation, keeping in mind that the discussion will take place in mid-May. 2. The Canada-Mexico Policy Dialogue on Indigenous Health [ENIHB INPUT] On May 8 - 10, 2006, the first joint activity under the Canada-Mexico Letter of Intent (LOI) (and reflected as an SPP initiative) was a workshop on Aboriginal Health in Merida, Mexico, Indigenous representatives from both countries participated in discussions on health equity and the provision of health care to indigenous peoples. Ongoing interest in the area of indigenous health led to further discussions between the First Nations and Inuit Health Branch (FNIHB) and their counterparts, who have agreed to focus their joint activities for 2008-2009 in the areas of healthy communities, traditional medicine and maternal-child health. ‘A Canada-Mexico Policy Dialogue on Indigenous Health was scheduled to take place in Canada on May 5 to 8, 2009, but was postponed due to the swine flu outbreak in Mexico. The Policy Dialogue will now likely take place in the fall, ideally in Duncan, British Colombia, where originally planned._As the second joint activity and follow-up to the Merida meeting, the policy dialogue will focus on the themes of Healthy Communities, Traditional Medicine/Cultural Competency, Governance, Tuberculosis, and Maternal and Child Health and will include site visits to local communities. ... Expected outcomes.... 3. Trilateral Cooperation in Health [GHSI, HPFB, HECSB, CFIA INPUT NEEDED] - text should be shortened... The Health Portfolio has been actively involved in the Security and Prosperity Partnership 000022(SPP), a forum for cooperation on economic and security issues between Canada, the United States and Mexico. Health Canada and the Public Health Agency of Canada are involved as the SPP work plans include various health-related initiatives, primarily in the areas of pandemic preparedness, food safety, indigenous health, and the safety of pharmaceutical products With the arrival of a new US administration, the status of the SPP structure remains unclear. However, a key message for any meeting with Mexican officials would be that regardless of the formal structures that will be established at the Leaders' level, cooperation between ourcountries will continue to be part of our regular business. Canada, the United States and Mexico will have an ongoing need for strong cooperation. ‘The Trilateral Cooperation Charter has been in place since 2004 between the United StatesFood and Drug Administration (FDA), Canada’s Health Products and Food Branch (HPFB) and Mexico’s Federal Commission for Protection from Sanitary Risks (COFEPRIS). It provides a framework for collaboration between the participants to protect and promote the health of residents of North America. The Trilateral Cooperation forum has supported important public health work in the areas of compliance, health fraud, emergencies and laboratories. ‘The Cooperation is an important vehicle for North American regulators to share safety information and collaborate on issues of common interest regarding drugs, biologics, medical devices, food safety and nutrition. By providing a framework for cooperation in these areas, the Charter contributes to the SPP objective on safe food and products. In 2008, the Charter entered into a process to address how the three countries could better work together, including how to move forward on initiatives and enhancements. Asa result, anew design has streamlined the operational structure, as well as the Charter itself, into a general high- evel arrangement to the enable participants to collaborate more effectively on public health and product safety issues. This process has also considered the implications of member courtries' product and food safety action plans for the trilateral process and activities. The revised Trilateral Charter was signed/will be signed in the summer of 2009. Related to the Trilateral Cooperation Charter, Mr. Miguel Toscano Valasco, Mexico’s nevly -appointed-Federal- Commissioner of COFEPRIS (the Federal Commission for the Protection against Sanitary Risks) visited Ottawa on November 27 and 28, 2008, to meet with govemment officials at Health Canada and the Canadian Food Inspection Agency (CFIA) to lear about, Canada’s regulatory processes in food, drugs and pesticides, as well as identify areas of mutual interest, ‘The delegation was also interested in obesity, tobacco regulations and marketing as well as legislation on aleohol use. 4. The Mesoamerican Public Health System [INPUT FROM PHAC AND CIDA NEEDED} 000023.15(1) health. At the meeting, leaders supported a proposal for a Mesoamerican Public Health System to increase cooperation on common health issues including: maternal and child health, communicable diseases such as dengue and malaria, vaccination programs, and nutrition. Mexico has played a leadership role thus far. Contributions toward the project are expected from Spain, the Inter-American Development Bank (IDB), the Pan American Health Organization (PAHO), the Bill and Melinda Gates Foundation, and the Fundacion Carlos Slim. Given the recent nature of this proposal, Canada would like to lean more about progress on the Mesoamerican Public Health System and Mexico’s role in the initiative. ietesneteteeneeenesnteeees HAS CANADA BEEN APPROACHED ON THIS PROJECT? CIDA & PHAC 5. The status of the Letter of Intent (LOI) In October 2004, the Ministry of Health of Mexico and Health Canada signed a Letter of Intent (LOD) to renew bilateral relations and replace the 1998 MOU, which had expired. Issues highlighted in the LO! include communicable and non-communicable diseases; health human resources; health equity and health care of indigenous people; mental health; health research; environmental health; health policy development; health systems management and financing. Bilateral activities in indigenous health have been particularly strong under the LOI. When Health Secretary Cordova met with Minister Clement and Dr. David Butler Jones during the XVII International AIDS Conference (AIDS 2008) in Mexico City in August 2008, areas of cooperation within a renewed MOU/LOI between Canada and Mexico were tentatively proposed. They included: updating the content of sexual education curricula; exchanging experiences with regard to the safety and efficacy of pharmaceuticals produced outside of Canada (data sharing and verification of findings); good manufacturing practices and collaboration on product and food safety, and; the exchange of information with the National Microbiology Laboratory (NML). No follow-up discussions have occurred with regards to the LOI. As noted above, the LOL highlights specific health issues of interest; Article 2(i) also allows for cooperation in “health topics of mutual interest” therefore there are limited (ceremonial) benefits to re-opening negotiations to expand specific reference to areas of cooperation, Current bilateral relations are strong and additional activities can be subsumed under the current LOI, resulting in a lighter administrative burden. ‘00024Next Steps: This bilateral meeting is primarily intended as a meet and greet with Secretary Cordova. It is an opportunity for you to learn about our activities to date and to assess future areas for cooperation. TABS Speaking Points Bibliography Bilateral Relations Letter of Intent (LOD) Prepared by: Carolina Seward Consulted with: Tel: (613) 941-2951 Approved by: Org. Intemational Affairs Directorate, Health Canada Date: April 23, 2009 ‘00025Speaking Points Good morning Dr. Cordova. It is a pleasure to meet you. I know my predecessor, Minister Clement, was very enthusiastic about our relations with Mexico and I am excited to learn more about Mexico’s health priorities and discuss our collaboration. Outbreak ... [PHAC] I was sorry to hear that the Canada-Mexico Policy Dialogue on Indigenous Health had to be postponed. I think this is a very important area of cooperation and we look forward to working with your officials to find an alternative date. The revised Trilateral Cooperation Charter was recently signed (?)[HPFB]... Ifraised: The Mesoamerican Public Health System is a fairly new initiative. I understand Mexico is playing a leadership role. Can you tell me more about the project and progress to date? How will it impact and interact with your own domestic public health system? Ifasked: I will ask my officials to assess the Letter of Intent (LON). Our bilateral activities under the current LOI are strong. What do you feel are the benefits of renewing the LOI? ‘000026Key Recent Bilateral Activities TAB X Hospital Capacity Building Since 1995, the Children’s Hospital of Eastern Ontario (CHEO) has been partnering with a small paediatric hospital in Oaxaca, Mexico, the “Hospital de la Ninez Oaxaquena” (HNO). In 2006, the partnership expanded to include three additional hospitals in Guadalajara and Guerrero through support from the PAHO-Canada Biennial Workplan (BWP) Funds, jointly managed by the International Affairs Directorate of Health Canada and PAHO. This cooperation is demonstrating improved training, capacity building and integration between these hospitals in Mexico. It may also provide a model that CHEO can replicate in enhancing integration between Ontario hospitals. Its success has led to a formal agreement with PAHO to further enhance cooperation between the hospitals; Dr. Roses, the Director of PAHO, met with CHEO during her visit to Ottawa in early April. Laboratory Capacity Building (PHAC] Canada and Mexico are cooperating on the area of laboratory diagnostic capabilities. Mexico also has an interest in learning more about the Canadian Network for Public Health Intelligence (CNPHD), a web based resource which collects and shares public health information resources and expertise with local, regional and national health officials to improve public health alerting and response. Canada is also working with Mexico to develop computer- based tools to improve its surveillance and investigation of foodborne illness outbreaks, based on Canada’s PulseNet, a virtual electronic network of federal and provincial public health laboratories. Finally, Mexico has expressed interest in linking into the Laboratory Response Network, which provides an integrated network of US and Canada laboratories in response to biological and chemical terrorism and to other public health emergencies. This initiative will likely be developed over the long-term, with an initial focus on improving Mexican laboratory capacity so that Mexico can receive the necessary accreditation to take part in the Network. HIV/AIDS (needs to reflect how we worked with Mexico] As a previous host in 2006, Canada provided significant technical and financial supportto the XVII International AIDS Conference (AIDS 2008) hosted by Mexico in August 2008. AIDS. 2008 was the first to be held in Latin America and brought together over 25,000 participants, including 12,500 registered delegates and 3000 media, to promote the interaction of science, community and leadership, in the global response to HIV/AIDS, Under the theme “Universal Action Now!”, AIDS 2008 called for a renewed commitment from the international community to strengthen the scale up of HIV prevention, treatment, care and support programmes worldwide, with the aim of providing universal access to these services by 2010. The conference also continued ongoing work toward achieving the Millennium Development Goals — which includes the target of halting and reversing the spread of HIV by 2015. 000027BRIEFING NOTE Meeting with Dr CHEN Zhu, Minister of Health, China WHAO2 - May 2009 Strategic Objectives of the Meeting . To meet with Minister Chen Zhu and personally reconfirm the invitation to attend the Canada-China Policy Dialogue. SCENARIO You will have a pull-aside meeting with China’s Minister of Health, Dr CHEN Zhu, at the reception hosted by Dr Margaret Chan, Director General of the World Health Organization. BACKGROUND: Bilateral Cooperation: Canada’s engagement with China has been identified by the Government of Canada as one of its four foreign policy priorities (along with Afghanistan, the Americas, and India). ‘The Canada-China health relationship is based on a long-standing cooperation with the Chinese Ministry of Health dating back to the 1995 signing of the Memorandum of Understanding (MOU) on health cooperation between the Health Portfolio and the Ministry of Health in China. Under the Plan of Action (PoA) 2005-2008, the Health Portfolio has been working closely with its counterpart agencies in China to strengthen and maintain this engagement. The 2009-2011 PoA is scheduled to be signed June 2009 The overarching 2009-2011 PoA will promote collaboration in the areas of health policies and regulations (including health products, food, health care, human resources), health research, public health emergencies, healthy lifestyles (including health promotion and education and tobacco control), and health supervision. In addition, various Branches and ‘Agencies have PoAs and MOUs with China to foster collaborative work at a technical level. 000028In addition, the Health Portfolio currently has a Minister Counsellor (a health expert from the Public Health Agency of Canada) posted at the Canadian Embassy in Beijing for one year. His presence in China helps to provide the Health Portfolio with earlier access to information on evolving health issues in China and to promote Canada and China relations. Multilateral Cooperation: Canada and China are engaged in various multilateral fora such as the World Health Organization, World Health Assembly, Asia-Pacific Economic Cooperation (AP EC), Intemational Conference on Harmonization, and the Global Harmonization Task Force. It provides an opportunity for Canada to gain a better understanding of China’s policies, standards, guidelines, and requirements, as well as the ability to meet and build relationships with expert counterparts. Canada China Policy Dialogue and The Canada-China Joint Committee on Healtl The Canada-China Policy Dialogue (CCPD) is a key vehicle for advancing Canada’s and China’s international health priorities through a strengthened bilateral relationship. Canada’s objectives for the CCPD are to advance knowledge and partnership on key priorities, particularly regarding health systems strengthening and reform, food, infectious diseases, primary health care and rural and remote health, as well as to strengthen our bilateral cooperation with China. As part of the November 2007 visit to Beijing the two Ministers signed the Terms of Reference for the Canada-China Joint Committee on Health (CCJCH). The CCJCH serves as a forum for discussing both technical and policy related health matters, and to ensure cohesion and coordination between the many Canadian and Chinese deparments and agencies working on health issues. The inaugural CCJCH took place on April9, 2008, in Beijing and the second CCJCH meeting is scheduled for June 19, 2009. China’s Health Reform In January 2008, Minister Chen announced the implementation of “Healthy China2020,” a policy package designed to have publicly-funded universal health care available for all Chinese by the year 2020. The four major areas of reform are: (1) strengthening the public health service system; (2) strengthening the medical service system; (3) establishing a universal medical insurance system; and (4) establishing a medicine supply assurance system. ‘000029In October 2008, the Chinese Ministry of Health signed an MOU with the city of Chongqing. Chongqing is one of four municipalities in China to enjoy provincial-level status and is now the pilot site for China’s health care reform. In January 2009, China’s Cabinet passed a long-awaited health care reform plan. The plan promised to spend 850 billion yuan (123 billion U.S. dollars) from 2009-2011, increasing government spending from 1.9% to 3% of the GDP. The goal of the plan is to ensure that 90% of urban and rural residents enjoy basic medical coverage by the end of 2011. Tn March 2009, Health Canada received a delegation from China’s Health Economic Institute (CHE). The CHE] is the policy think-tank and research centre of the MOH, and is responsible for research, formulation and assessment of health policies in China. The objective of the visit was to lear of Canada’s experience in establishing national health policies and to discuss potential collaborative health policy research projects with Canadian partners. Food Safety On February 28, 2009, National People's Congress Standing Committee passed anew food safety law. The law pays special attention to food additives, which were at the centre of a tainted milk scandal last year. The new law declares that no additives will be allowed unless proven safe. The new law will go into effect on June 1, 2009. ‘This law includes: the need to enhance the Chinese system for monitoring and supervision; a set of national standards for food safety; severe discipline for offenders; and a system for food recall. China's State Council, (Cabinet), will set up a food safety commission to strengthen the country’s food monitoring system. Prepared by: Daniel Pang Consulted with: Tel: 613 948 4341 Org. International Affairs Directorate Date: April 23, 2009 000030SPEAKING POINTS FOR MEETING WITH CHINA’S MINISTER OF HEALTH, CHEN ZHU: + Lam very pleased to meet you to continue China and Canada’s long standing cooperation. I have been looking forward to meeting you, and am happy that I am finally able to do so. + Health is an area of high priority for both Canada and China. Continuing to strengthen collaboration in this area will contribute to the better health of not only of our citizens, but of the global population. + I would like to express my enthusiasm for the upcoming Canada-China Policy Dialogue, June 18 to 19. . Tam delighted that you will open the Policy Dialogue with me, and that we will sign the renewed Plan of Action for 2009 to 2011. The Policy Dialogue will strengthen our countries relationship in the health sector. + I believe our two countries can gain substantially from on-going cooperation. We both have much to share and learn as we strengthen our efforts to provide Canada’s and China’s citizens with quality, timely and affordable health care. RESPONSIVE LINES ONLY: WHA/Taiwan It is in Canada’s strong interest that Taiwan participate in technical activities of the WHO Meaningful participation in the WHO need not require membership in the organisation. 000031POSSIBLE BILATERAL MEETING WITH DR. JOSE GOMES TEMPORAO MINISTER OF HEALTH FOR BRAZIL Date: May _, 2009, from to Location: __, Palais des Nations, Geneva WHA®2 - May 2009 Strategic Objective of the Meeting To strengthen the bilateral relationship between Canada and Brazil in the health sector. To sign the Memorandum of Understanding Between the Department of Health of Canada and the Ministry of Health of the Federative Republic of Brazil on Health Sector Collaboration in Health. SCENARIO: You will be meeting with Minister Temporao and his advisor, You will be accompanied by Glenda Yeates, Karen Dodds, Jane Billings, Bersabel Ephrem, Gloria Wiseman, Dani Shaw. The meeting will last approximately 30 minutes. Minister Temporio will likely be joined by 000032BACKGROUND INFORMATION: Canada-Brazil Relations: Brazil is the largest and most populous country of the Americas and has shown acapacity to demonstrate hemispheric leadership. It is the 11" largest economy globally, and Canada’s 3" largest export market in the Americas. The Government of Canada’s Americas Strategy was launched in 2007. Canada-Brazil cooperation is at the centre of three priorities of the Canadian Government: i) Americas Strategy, ii) Global Commerce Strategy; and iii) Global and Multilateral Issues. Relations between Brazil and Canada have strengthened over the past two years, as demonstrated by separate trips to Brazil by Minister Mackay, and the Governor General, Michaelle Jean in 2007, and Minister Lawrence Cannon in February, 2009. Canada’s Deputy Ministers also visited Sao Paulo, Rio de Janeiro and Brasilia, and the Amazon region in March, 2009. Negotiation of an MOU in Health, 2007 - 2008 The idea of signing an MOU in health began in August 2007, when Minister Tony ‘Clement and his Brazilian counterpart, Minister Jose Gomes Temporio met in Buenos Aires. In 2008, a draft MOU on health was negotiated with the Brazilian Ministry of Health, and approved by all ADMs of the Health Portfolio in September 2008 in anticipation of a visit of President Lula to Canada, However, the visit was postponed owing to the federal election. The new proposed date for the visit is September 2009. However, DFAIT has informed JAD that President Lula’s visit is not yet confirmed. Therefore, another opportunity to sign the MOU should be sought. This opportunity will be during the World Health Assembly in Geneva in May 2009. (To be confirmed shortly) The MOU seeks to establish a joint committee to monitor and report on progress and to decide upon a workplan, including specific initiatives, deliverables and expected results to be jointly developed. Areas of cooperation include: human health resources; health equity and health care of indigenous people; regulation of health products; mental health; tobacco control; telehealth / telemedicine; obesity, social determinants of health, and public health communications/risk communications. (See Appendix A - MOU in Health). ol 000033,Cooperative Activities in Health with Brazil 2008-2009 Bilateral activities in health which have occurred between Brazil and Canada between September 2008 and May 2009 include: i) In October, 2008, the Brazilian head of eHealth Strategy Development, and the Director of Indigenous Health (FUNASA) attended the annual meeting of the Canadian Society of Telemedicine (CST-SCT) and the International Society for Telemedicine and eHealth (ISfTeH) Conference. Followup cooperation activities between our counterparts are now underway. ii) The National Coordinator of the Indigenous Health at FUNASA attended the Global Indigenous STOP-TB Expert Meeting in November 2008, in Toronto. iii) In December 2008, a meeting of partners on the health human resources cooperation occurred in Washington, D.C. A followup meeting was held in Jamaica on January, 2009. iv) In March 2009, during the visit of the Deputy Ministers to Brazil, Deputy Minister Rosenberg and CPHO, Dr. David Butler Jones met with senior health officials including: - Mr. Eduardo Barbosa, Special Advisor to the Minister of Health on international health issues, - Mr. Wanderley Guenka, Director of FUNASA, (the National Foundation responsible for indigenous health issues), and - Dr. Luiz Fernando Bescow, Acting Executive Secretary of Health. Issues discussed included the signing of the draft MOU; mental health programs for remote indigenous communities; training of multi-disciplinary teams for primary and basic health care; and public health practices. v) Mr. Rosenberg also met with Mr. Dirceu Raposo de Melo, Director-President of the National Health Surveillance Regulatory Agency (ANVISA). Mr. Rosenberg invited the Director-President to the Fourth Meeting of Chief Regulatory Agencies Officers, 1o be held in Ottawa in October 2009. Other topics covered included: - drug patents and their impact on public health and equity of access to medicines; - - knowledge sharing on regulatory approaches to hospital infections. Next Steps: Health Canada will continue to consult with the Canadian Ambassador in Brazil, and the Brazilian Ambassador in Canada with respect to implementation of selected activities within the workplans. Al 000034Appendix A - Speaking Points Appendix B - Memorandum of Understanding in Health between the Government of Canada and the Government of Brazil Prepared by: Kate Dickson , FNIHB, HPFB, HECSB, PHAC, CIHR Tel: (613) 948-9409 Consulted wit Approved by: Org. International Affairs Directorate, Health Canada Date: 000035,Appendix A SPEAKING POINTS: [am very pleased to have the opportunity to meet with you. As you know, the Government of Canada regards Brazil as a key strategic partner in the Americas. I understand there is a possible visit to Canada by President Lula in September of this year. I look forward to that visit which will serve to further strengthen the relations between Brazil and Canada, . Lam delighted that our respective governments have negotiated this MOU as a mechanism to address health issues of common interest and concern. Deputy Minister Rosenberg and Chief Public Health Officer Butler Jones thoroughly enjoyed the opportunity to meet with senior officials from the Ministry of Health during their trip to Brazil last March. Common areas of interest discussed included mental health programs for remote indigenous communities; training of multi-disciplinary teams for primary and basic health care; and public health practices. Since the negotiations on the MOU were concluded in September 2008, health officials from Canada and Brazil have been working with their Brazilian counterparts in the development of workplans on key themes such as health human resources, regulation of health products, indigenous health, telehealth, health promotion, obesity, and cancer prevention. With the signing of the MOU, as agreed, we will establish a joint committee to monitor and report on progress of the workplans. 000036DINNER MEETING HOSTED BY AUSTRALIA’S AMBASSADOR, Date: May 17, 2009, from (time) to (time) Location: (tbe) , Geneva WHA62 - May 2009 Strategic Objectives of the Meeting + To meet the Ministers of Health from Australia and China, and the Secretaries of Health from the United Kingdom and the United States, over dinner, in a relaxed setting, that will help foster relationship-building. + Toagree that our countries are already collaborating successfully on many fronts, through both multilateral and bilateral fora, and that Ministers want to encourage further collaboration on mutual health priorities and concerns. . To possibly raise, for discussion, the shared interest in providing better health care to remote communities and in ensuring the health of vulnerable populations. SCENARIO: * You will attend this dinner at (time), following your informal briefing with senior officials and a brief rest period at your hotel. You will be accompanied by Associate Deputy Minister Glenda Yeates, and your Chief of Staff, Dani Shaw. You will be met in the hotel lobby and driven to X. The dinner meeting will last approximately two hours (TBC). The other participants at this event will be: - the Australian Ambassador (host); - The Honourable Nicola Roxon, Minister of Health and Ageing for Australia; - The Honourable Alan Johnson, Secretary of State for Health for the United Kingdom; - Dr. CHEN Zhu, Minister of Health, People’s Republic of China; - Kathleen Sebelius, Secretary of Health and Human Services, United States of America. BACKGROUND INFORMATION: * Information on when each Minister or Secretary was appointed to their current position. 000037Canada-Australia Policy Dialogue The first Canada-Australia Policy Dialogue on Health took place in Sydney, Australia in August 2007, following an agreement by former Health Minister Tony Clement and former Australian Minister of Health and Ageing, Tony Abbott, to hold the Policy Dialogue. Minister Clement led a delegation that included senior officials of the federal Health Portfolio, as well as three non-government representatives. Canada and Australia agreed that the strategic objectives of this health policy dialogue were: -to identify and explore common health issue: - to forge effective and sustained relationships; ~ to share best practices and lessons learned; and, - to jointly seck effective solutions to health challenges. This first Canada-Australia Policy Dialogue focussed on the following three key areas of discussion: (1) wait times/access to health care; (2) cancer strategies; and, (3) health and the environment. Canada and Australia have much in common, which means they can leam from each other, For example, to improve wait times and access to health care, Canada and ‘Australia each recognize the need to address the critical areas of health human resources, health systems improvements, and measuring and reporting on wait times and access. Both are confronted with the increasing personal, economic and social burden of cancer, ‘making it imperative to find better strategies for both prevention and treatment. As well, the issue of health and the environment is of mutual importance, in part because of the need to be able to reassess hundreds of chemicals in light of today’s more stringent regulatory standards. In his concluding statement, Minister Clement pointed out that the Policy Dialogue had laid a good foundation for long-term collaboration on these and other health issues. He extended an invitation to the Australian Minister to come to Canada for the second Canada Australian Policy Dialogue. It was suggested that the second Policy Dialogue on health might focus on the health of Indigenous peoples, as well as rural and remote health care, Given the Australian elections in the fall of 2007 and the Canadian elections in the fall of 2008, no date was set as yet for this second Policy Dialogue. Rural and Remote Health Care Governments in remote areas, especially in Norther Regions, face many health care delivery challenges similar to those experienced in rural areas, including the reeruitment and retention of an adequate supply of health professionals, the uptake and 000038a implementation of new "e-health" technologies, and the ongoing struggle to promote healthy living and prevent illness rather than just treating sick people. + However, health care delivery challenges in the North are exacerbated by expansive geography, low population density, inadequate transportation infrastructure, and higher costs. In fact, average health expenditures per capita in the territories are nearly double national per capita health expenditures. In other words, territorial governments spend twice as much as provinces to provide comparable levels of health services. + Also contributing to the high cost of health care delivery in the territories is the increased demand placed on health systems by the territories’ Aboriginal population (50% of all residents), which tends to experience poorer health status than other population groups, including rates of chronic illness, communicable disease, and substance abuse that are much higher than Canadian averages. + When a service is not available within the community, a physician or community health nurse refers the patient to an altemate health facility, generally the regional or territorial hospital. Medical travel is an integral component of each territory's insured health care services and a common experience for northern residents. Medical travel referrals in the territories are based on each community's capacity to provide certain health services or procedures. If the patient requires specialized treatment or diagnostic services not available within the territory, he/she is transfered to an out-of-territory health facility (in Vancouver, Edmonton, Winnipeg, or Ottawa). . Each territorial government is continually working to provide more and better health services "in-territory.” The objective of reducing reliance on out of territory medical travel is shared by all three territories and each territory has made progress in introducing new health services over the past several years, such as a dialysis program in Yellowknife and expanding midwifery / birthing services in Nunavut. Health of Vulnerable Populations . Improving Indigenous health is a critical area identified in the Canada-Australia Joint Letter of Intent for future cooperation, Australia and its First Nations people may be interested to learn about the British Columbia First Nations Tripartite Health Plan as a mode! for improving health service delivery, including in rural and remote areas, reducing the gaps in health status between First Nations and other British Columbians, and strengthening the role of First Nations in decision-making regarding the health of their peoples 0000384 + Available evidence indicates that Australia’s Opal Fuel initiative which developed a fuel alternative with a low level of toxicity, to prevent and treat solvent sniffing, could be an effective intervention that would complement existing solvent abuse activities in Aboriginal communities in Canada. (PHAC and FNIHB to update and provide further input) Prepared by: Jayne Simms-Dalmotas Org. International Affairs Directorate, Health Canada Tel. (613) 957-7298 Date: April 29, 20008 Consulted: Approved by: ‘000040TALKING POINTS DINNER MEETING HOSTED BY AUSTRALIA’S AMBASSADOR Date: May 17, 2009, from (time) to (time) Location: (tbe) , Geneva WHA@2 - May 2009 + Lwish to thank the Australian Ambassador for extending this invitation to us. Itis rare that we have an opportunity to get together in a relaxed setting, without a precise agenda. + As youmay know, I am still relatively new to my position. I was appointed as Canada’s Minister of Health in October 2008. So, I especially appreciate this chance to become acquainted with each of you and to exchange ideas. If appropriate to raise: Rural and Remote Health: + Coming from the Territory of Nunavut in Northem Canada, I am well acquainted with the challenges of health care delivery in rural and remote areas of the country. Our problems are no different from those of many rural areas. For example, we have difficulty attracting and keeping enough health care workers. And we are constantly trying to promote good health — to keep people healthy, rather than always treating them after they become ill. + It is just that our challenges are much bigger. They are compounded by the vast distances between places, the smaller population, the fact that people have to travel farther to get health care, the poor roads, and the high costs for everything. + When ahealth service is not available locally, people have to travel to another community. For specialized services, people may have to travel great distances or even fly to a larger centre in the South. + We are constantly trying to provide more and better health services in these remote and Northem regions. For example, in the past several years, we have been able to introduce a dialysis program in Yellowknife and expand midwifery/birthing services in Nunavut. 000041+ The new “e-health” technologies, such as tele-health, are certainly helping to overcome some problems. It means that a doctor in the South can review X-rays of a patient in the North the same day they are taken, It also means a doctor can view the patient and have a conversation with this person, as though they were right there in the doctor’s office. But this technology is only beginning to be introduced, and is not widely available. I would be interested in hearing about your experiences with health care in rural and remote areas and what you are doing to improve services. Vulnerable Populations: Possible speaking points to follow. Prepared by: Jayne Simms-Dalmotas Org. International Affairs Directorate, Health Canada Tel.: (613) 957-7298 Date: April 29, 20008 Consulted: Approved by: 000042POSSIBLE ROUNDTABLE MEETING/LUNCHEON WITH MINISTERS OF HEALTH OF CARIBBEAN COUNTRIES Date: May 18, 2009 from 11:30 to 12:00 pm. Location: Palais des Nations, Geneva WHA®2 - May 2009 Strategic Objective of the Meeting To strengthen joint collaboration on the establishment of the Caribbean Public Health Agency through the consolidation of the five Caribbean Regional Health Institutions. To congratulate Trinidad and Tobago on the successful outcomes of the Summit of the Americas, April 17-19, 2009 and discuss the implications of Summit commitments. To identify broader opportunities for further collaboration with Caribbean countries on issues of mutual interest linked to the Government of Canada’s Americas strategy. SCENARIO: ‘You will be meeting with Ministers of Health of Trinidad and Tobago, Jamaica, St. Lucia, Guyana, and Barbados. (TBC) ‘You will be accompanied by Colin Carrie, Glenda Yeates, Jane Billings, Karen Dodds, Dani Shaw, Bersabel Ephrem, Gloria Wiseman and Christine Reissmann. The meeting will last approximately a half hour. Background: Canada has a long-standing and extensive relationship with the countries of the Caribbean, Strengthening this relationship is a foreign policy priority under the Government of Canada’s Americas Strategy. Topics of discussion for the round table luncheon will include: {) the recent Summit of the Americas, and its health implications; ii) cooperation in the establishment of the Caribbean Public Health Agency; iii) broad areas for further cooperation between Canada and the Caribbean. 000043‘The Summit of the Americas, April 2009 On April 17 to 19, Trinidad and Tobago successfully hosted the Fifth Summit of the Americas in Port of Spain, where Heads of State from across the Americas, including Prime Minister Harper, signed a Declaration of Commitment on “Securing Our Citizens’ Future by Promoting Human Prosperity, Energy Security and Environmental Sustainability”. Trinidad and Tobago, as the host country, set the agenda for the Summit in consultation with other countries and regional stakeholders and emphasised the need to make the Summit process more relevant and effective. Canada has been strongly engaged in the Summit process and the negotiations on the Declaration of Commitment, which includes eight paragraphs on health on the following issues: access to health services, child and neonatal mortality, non-communicable diseases (this is a significant issue in the Caribbean), surveillance of non-communicable diseases, illicit drugs, reproductive health, mental health, community based health and essential medicines, nutrition (both obesity and malnutrition), communicable diseases, and HIV/AIDS and other STIs. Caribbean Public Health Agency (CARPHA) To ensure the safety and health security of Canadians at home and in the Caribbean Region, the Public Health Agency of Canada (PHAC) is supporting the Caribbean Community (CARICOM) in the creation of the Caribbean Public Health Agency (CARPHA). CARPHA involves the integration of five existing regional health institutions into a single self-administered integrated health agency, under the CARICOM governance structure by 2010. To date, PHAC's contribution has been through ongoing policy and technical support through its membership on the CARPHA Advisory Committee and participation at a series of meetings of the CARICOM Ministers of Health in 2008 and 2009. CARICOM has recently requested a PHAC grant for $400,000 over two fiscal years. The purpose of this grant is to strengthen the CARPHA Project Management Team in order to ensure a seamless and efficacious transition of the five Caribbean regional health institutions into CARPHA. Issues for discussion may include: how the Caribbean countries envision the transition process, for example: i) the functioning of the management steering committee; ii) the current political commitment and; iii) the financial sustainability of CARPHA. Recent Canadian Cooperation in the Caribbean 2008-2009 + In December 2008, the Population Health Fund (PHF) at PHAC allocated $961,630 to PAHO for 2009 for the project: “Strengthening policy and partnership processes for prevention and control of chronic diseases in Central and South America”. Thisis part of ‘Canada’s response to support the Caribbean Heads of State meeting to discuss policy options for tackling non-communicable diseases in September 2007. e PAHO was recently granted CAD $486,333 from DFAIT’s Counter Terrorism Capacity Building Fund (CTCB) over two years (2009-2010) for the project Occupational Health and Infection Prevention in Healthcare Facilities: Preparing for biological and bioterrorism events in Trinidad and Tobago. Canadian partners include: the University of British Colombia (UBC), the Vancouver Coastal Health Authority (VGH) and the ‘00044British Columbia Centre for Disease Control (BCCDC). + Health Canada’s International Health Grants recently approved $60,000 to the Canadian Association of Schools of Nursing (CASN) and the Pan-American Health Organization, Office of Caribbean Program Coordination (PAHO-OCPC) to initiate the first stage of collaboration on developing a standardized approach to nursing and midwifery education in the Caribbean. : In Guyana, the PAHO-Canada Biennial Workplan Funds (BWP) have supported the development and implementation of a national mental health policy through the University of Dalhousie over the past three years, To date the cooperation has witnessed the completion of the Guyana National Mental Health Plan. It has involved the development of a new mental health curriculum for health professional training programs. Cooperation in 2009, will focus on strategies for suicide prevention. + With BWP funds Canada, in cooperation with Brazil, Jamaica, and PAHO, is participating in the formation of a Consortium for Health Human Resources! Needs- Based Health Workforce Planning in the Caribbean. The cooperation envisages the establishment of a Centre of Excellence for HHR planning in Jamaica to serve the wider Caribbean with support from the University of Dalhousie and Health Canada, Appendix A Speaking Points Appendix B - Biographies of Ministers of Health attending Appendix C - Background on CARPHA and the Five Regional Health Institutions Prepared by: Kate Dickson Tel: (613) 948-9409 Consulted with: Approved by: Org. International Affairs Directorate, Health Canada Date: April 29, 2009 000045,Appendix A Speaking Points Tam very pleased to have the opportunity to meet with you. As you know, the Government of Canada regards the Caribbean as a key strategic partner in the ‘Americas, and we have a long history of cooperation among us. Prime Minister Harper recently attended the Summit of the Americas, and visited Jamaica. He also enjoyed his visit to Barbados last year. A prioritiy theme for Canada and the Caribbean is our common objective to tackle non-communicable diseases. I am pleased that my Government is supporting the Caribbean initiative to combat and reduce non-communicable diseases that was spearheaded by the meeting of Heads of Governments in September 2007. Lalso wish to congratulate Minister Narace for your country’s recent hosting of the Summit of the Americas in Trinidad and Tobago. I understand there were eight paragraphs in the Declaration specifically on health, which is a welcome achievement. Canada is pleased to have been invited to participate as a partner in the establishment of the Caribbean Public Health Agency (CARPHA). I welcome a discussion on how your respective countries envision the transition process toward the establishment of CARPHA. What are the hurdles being encountered? How may Canada continue to support the process in concrete terms? 00046POSSIBLE BILATERAL MEETING WITH THE UNITED KINGDOM SECRETARY OF STATE FOR HEALTH, THE RT HON ALAN JOHNSON Date: May x, 2009, from (time) to (time) Location: Room ____, Palais des Nations, Geneva WHA@2 - May 2009 = Strategic Objectives of the Meeting To meet Secretary of State Johnson and acknowledge the value of Canada’s and the United Kingdom’s collaboration on health issues in various multilateral fora, including the World Health Assembly and the Global Health Security Initiative. To recognize that the United Kingdom and Canada continue to collaborate successfully on a number of health initiatives, such as the work of the Commission on the Social Determinants of Health. To express interest in learning more about the United Kingdom’s experience with developing health strategies, in particular the UK’s “Global Health Strategy” and the health promotion strategy, “Campaign for Life”. SCENARIO: ‘You will meet Secretary of State Al Johnson at (time), following your meeting with (name), (title). Accompanied by Deputy Minister Rosenberg, Dani Shaw, Karen Dodds and Gloria Wiseman you will walk from Room ### to Room ### in the Palais des Nations (approximately # minutes). The meeting will last approximately 20 minutes. Secretary of State Johnson will likely be joined by (name). BACKGROUND INFORMATION: ol The Rt. Honourable Alan Johnson was appointed UK Secretary of State for Health in June 2007 under the government of Prime Minister Gordon Brown. A short biographical note is attached (Tab Xe). rity Initiative The UK is an active member of the Global Health Security Initiative. The UK co-chairs the pandemic influenza and the risk management and communications working groups, and is actively engaged in all other working groups. They will host the Ninth Ministerial on Global Health Security Initiative in London in December 2009. 0000472 Current topics of discussion include medical countermeasures, radio-nuclear and chemical events, risk assessment and communications. The GHSI is also looking at ‘engaging in new issues such as the impacts of climate change on health (as supported by the UK), and food safety. ‘ommission on Social Determinant Ith ‘The United Kingdom has been very active in the World Health Organization’s Commission on the Social determinants of Health and is among leading countries in cross goverment action to reduce health inequalities. The UK views Canada as a key ally in securing commitment from WHO member countries to support this work. ‘Canada contributed to the Commission on Social Determinants of Health (CSDH) through participation in country partner work; providing financial support to three knowledge network hubs, which synthesized global knowledge on globalization and health, early child development and health systems; by supporting the participation of Canada’s Commissioner; and by identifying policy approaches for addressing determinants of Indigenous Peoples’ health. As key contributors, Canada and the UK are committed to ensuring successful appropriate follow-up to the report and recommendations of the WHO Commission on Social Determinants of Health (CSDH) within Canada and at the WHO. Since the establishment of the Commission, Canada has made significant strides towards building foundations for health inequalities reduction. For example, Canada’s Chief Public Health Officer, Dr. David Butler-Jones, focussed his first report on the state of public health in Canada (Date 2008) on health inequalities and how they are being addressed through action on determinants of health. Canada is also engaging with key non-governmental and private sector partners, to identify ways to use the evidence and practice surfaced by the Commission to reduce health inequalities in Canada. ‘The National Health Service’s “High Quality Care For All” In 2008 Lord Darzi published “High Quality Care For All”, This was the final report of the National Health Service’s Next State Review, a year-long review involving extensive consultation with clinicians, staff and public stakeholders. For the past 10 years, the ‘National Health Service (NHS) has focussed on building capacity. Following this investment on resources, attention is tuming to ensuring delivery of high quality c frontline staff. re by 000483 Emphasis is on patient safety by eliminating hospital acquired infections and avoidable accidents. There is also concern for the spectrum of quality of care from the effectiveness of the clinical procedure to the treatment that the patient receives in relation to their quality of life. It is also about the patient’s experience with the NHS, ensuring that they are treated with dignity, compassion and respect in a well managed environment. ¢ United Kingdom’s Global Health Strategy Unites In 2008, the UK released “Health is Global: A UK Government Strategy 2008-13,” outlining goals to address global health issues across government and in partnership with other countries and agencies. Endorsed by UK Prime Minister Gordon Brown, it aims to hold government and public agencies accountable for their individual impacts on global health, Ten guiding principles underpin the strategy, such as “doing no harm”, “working in partnership” and “basing policies on sound evidence”. The strategy focuses on five areas for action: global health security, improved health delivery systems, effective international health organizations, increasing the health benefits of trade, and strengthening the development and use of evidence. Three features set it apart from the Health Portfolio’s international health strategy: 1) public engagement in the development and implementation of the strategy; 2) health impact assessments for Cabinet decisions to ensure policy coherence, and 3) an independent monitoring and evaluation process. ‘The strategy provides an opportunity for further collaboration with the UK to advance common global health interests and goals, and to learn from each other. dom’s “Campaign for Life” Strat PHAC 1o provide information. Prepared by: Jayne Simms-Dalmotas Org. International Affairs Directorate, Health Canada Tel. (613) 957-7298 Date: April 29, 2009 Consulted: Approved by: ‘00049TALKING POINTS FOR A POSSIBLE BILATERAL MEETING WITH THE UNITED KINGDOM SECRETARY OF STATE FOR HEALTH, THE RT HON ALAN JOHNSON: Date: May x, 2009, from (time) to ( Location: Room e) Palais des Nations, Geneva WHA@2 - May 2009 General: + Itis a pleasure to have the opportunity to meet with you. I’m looking forward to continuing the productive relationship in health that Canada has long enjoyed with the United Kingdom. + Lam pleased that our countries collaborate on many issues and priorities through a number of multinational fora, such as the Global Health Security Initiative. We work together successfully on many fronts, as is demonstrated through our joint work on the Commission on the Social Determinants of Health. Global Health Security Initiative + We are pleased that the UK is such an active partner in the Global Health Security Initiative. I unerstand that you co-chair the working group on pandemic influenza and another on risk management and communications, so you play a prominent role in this important forum, + Lalso know that you have offered to host the Ninth Ministerial meeting in London in December of this year. Since Canada runs the Secretariat for the GHSI, we certainly appreciate the solid support that your country provides. on Social Deter ants of Heal! + As you know, Canada is very committed to ensuring a successful follow-up to the World Health Organization's Commission on the Social determinants of Health. Canada supports the plan to farther engage and support countries in sharing knowledge and direct learning from action on determinants of health inequalities. + We recognize the strong leadership that your country has provided on this initiative. We are interested in continuing to collaborate with the United Kingdom and other countries to promote knowledge and action to reduce health inequalities. ‘000050The United Kingdom’s Global Health Strategy To be added. ‘anada’s Population Health Strategy and The United Kingdom’s “Campaign for Life” Strategy To be added. Jayne Simms-Dalmotas International Affairs Directorate, Health Canada (613) 957-7298 April 29, 2009 Consulted: Approved by: 000051