A group of top scientists concerned about the decline of the federal pandemic early warning system in the years before COVID-19 emerged have proposed relocating the operation to a university where it can work independently of government.
The proposal is aimed at restoring the Global Public Health Intelligence Network to its former status as an internationally respected pandemic surveillance system. Documents outlining the plan were submitted to an independent panel in Ottawa that is reviewing the system’s future.
According to the documents, GPHIN would work with the World Health Organization and be based at the University of Ottawa’s Bruyère Research Institute. The university and the WHO back the idea, says the proposal, which was reviewed by The Globe and Mail.
“We propose the creation of a Canadian-based WHO collaborating centre for global health intelligence,” the proposal states. Such a move “would provide a new, stable and cost-effective environment for the future management of GPHIN.
“GPHIN must be guaranteed freedom from government influence or interference. To achieve independence of any future government influence, bias or interference, GPHIN must be situated outside of government.”
A Globe and Mail investigation last year found that GPHIN’s capabilities had been allowed to erode over the past decade as priorities within the government changed, and senior officials in the Public Health Agency of Canada (PHAC) sought to deploy its resources elsewhere.
Some of the core functions of the system, which provided crucial intelligence before and during the 2003 SARS crisis and 2009 H1N1 outbreak, were silenced in 2018 and 2019. With no pandemic threats apparent, management in the department sought to shift resources to areas that didn’t involve outbreak surveillance.
The proposal to partner with the WHO is being led by Ron St. John, a former top federal epidemiologist who helped create GPHIN in the 1990s, and other current and former top federal scientists. If it succeeds, the operation would run as a non-profit, funded in part by the federal government, and also able to seek science and technology grants from other sources, which it currently cannot do.
That new funding would be used to rebuild GPHIN’s operations and expand the system’s technical capabilities, taking some of the financial burden off the government, the documents say. GPHIN’s annual budget is around $3-million, and federal documents show it lacked the resources needed to update or grow its surveillance capacity, particularly as the system was allowed to erode.
The proposal argues that the environment needed to properly run the pandemic early warning system no longer exists inside Public Health, due to a drain of scientific and medical expertise over the past decade.
“Meeting these principles and operational conditions is not possible within the current managerial environment that exists in PHAC,” the document states. “We cannot wait for these changes to happen, as waiting will result in irreversible degradation of GPHIN and further depriving users within the global public health surveillance community of an essential tool to detect and monitor public health threats.”
WHO collaborating centres around the world are a way for member countries to contribute resources to the WHO by offering skills or technology they have. The Bruyère Research Institute is already home to one such collaborating centre, which focuses on technology used to track global health equity.
At one time, GPHIN provided the WHO with as much as 20 per cent of its epidemiological intelligence, according to Ottawa’s records. The proposal documents say GPHIN would remain one of Canada’s key contributions to the WHO, with the government providing funding for the system’s analysts to work.
Health Minister Patty Hajdu ordered an independent review in September of how PHAC handled the system after a Globe investigation last summer detailed many of the problems.
A report by the Auditor-General of Canada issued two weeks ago also found that the federal government did not use the pandemic early warning system appropriately in the early days of the COVID-19 outbreak, and that GPHIN failed to issue alerts. This contributed a series of faulty risk assessments as the virus began to spread around the world.
The independent review is expected to issue its final report in May, and the government won’t comment on its progress.
This is not the first time the idea of a WHO collaborating centre has been proposed for GPHIN. The proposal documents say the WHO has supported the idea since the SARS crisis, and has held talks on the subject six times, but those negotiations never came to fruition.
In 2005, talks were put on hold amid management changes inside Public Health. In 2009, similar discussions were halted due to the H1N1 outbreak. In 2012, another proposal was frozen during the Harper government’s deficit reduction plan. Similarly, talks in 2013, 2017, and 2018 never progressed due to internal restructuring in the Public Health Agency that resulted in management changes, and no further steps were taken.
The push to rebuild GPHIN comes at a time when other countries have identified the need to build their own early warning systems to help the international community detect major threats early and better contain outbreaks. The U.K. government and the Biden administration in the United States have signalled plans to bolster such capacities in recent months. An independent review examining the WHO’s pandemic preparedness is also expected to highlight the importance of such systems in its final report, expected this spring.
The epidemiologists behind the proposal say they want to restore Canada’s leadership in pandemic early warning and detection.
“GPHIN has achieved world-wide recognition as a rapid provider of accurate information regarding a variety of global events of public health importance,” the proposal says. “Future versions of GPHIN must build on and maintain this pre-eminent position. It’s Canadian origin and Canadian support during its lifetime is recognized and should be retained.”
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