This page has been archived.
Information identified as archived on the Web is for reference, research or recordkeeping purposes. It has not been altered or updated after the date of archiving. Web pages that are archived on the Web are not subject to the Government of Canada Web Standards. As per the Communications Policy of the Government of Canada, you can request alternate formats on the "Contact Us" page.
Public health focuses on the well-being of an entire population rather than that of an individual. It includes a range of efforts to keep people healthy and out of the hospital - such as immunization, healthy eating and physical activity programs as well as infection control measures in hospitals, along with detection activities, laboratory testing and regulation that support action during infectious disease outbreaks and emergencies.
In other words, public health emphasizes health promotion, disease prevention and safety for entire populations and high-risk subgroups, and not just the treatment of disease. For example, tobacco control significantly reduces lung cancer rates. Similarly, healthy weight and fitness programs reduce the need for joint replacements, thus reducing surgery wait times. By helping keep Canadians healthy, public health can relieve some of the pressure on the health care system and contribute to our high quality of life.
Changes in Canadian society have resulted in shifts in consumption patterns as well as living and working conditions, some of which have the potential to intensify key risk factors for leading chronic diseases in Canada and to impose significant economic and social costs. For example, it is estimated that over 1 million Canadians have become obese in recent years; this is a significant risk factor for chronic and infectious diseases.
Infectious diseases (e.g. tuberculosis, HIV/AIDS, hepatitis, foodborne and waterborne infections) also impose significant social and economic costs on Canadians. These costs can be controlled, in part, through activities aimed at detecting and identifying potential sources of infectious disease outbreaks and at reducing and preventing the spread of such diseases.
Environmental, social and economic factors play an important role in the spread and prevalence of both chronic and infectious disease. Public health increasingly addresses these underlying conditions in order to improve health outcomes and to control health costs. Such an approach is what SD is about.
In 1987, the United Nations-mandated World Commission on Environment and Development (also known as the Brundtland Commission) defined sustainable development as “development that meets the needs of the present without compromising the ability of future generations to meet their own needs.” This definition has been widely adopted, including by the Government of Canada.
Several other definitions of SD also exist. Some focus on the three social, economic and environmental “pillars” of development; others are rooted in various principles (see Appendix 3 for list drawn from the Auditor General Act); others still emphasize the notion of capital stocks (SD depends on the maintenance of adequate stocks of human, social, environmental, financial and manufactured capital). At the heart of most of these definitions are the principles of human well-being, participatory approaches, a long-term perspective, integrative decision-making, prevention and precaution, and equity. The Auditor General Act specifically mentions that protecting the health of Canadians is related to SD.
As illustrated in Figure 1, public health and SD are closely interrelated; both emphasize the need to think about the long term, to work in partnership with others and to integrate environmental, social and economic factors in decision making. Public health is both an indicator and a determinant of economic development - SD cannot occur without a healthy population, and the health of the population cannot be maintained without a healthy environment (HC, SDS 2007).
Research by the World Health Organization (WHO) has shown that investing in human health is a powerful means to encourage economic growth, protect the environment and reduce poverty (WHO, 2001). Investments in clean water or immunization programs, for example, consistently yield economic benefits greater than their costs. Conversely, unsustainable patterns of production and consumption, underdevelopment, environmental degradation and the breakdown of social networks can all adversely affect public health (WHO, 2002). SD is therefore key to improving public health, since factors that drive disease are often linked to unsustainable forms of development such as persistent social inequality, pollution and resource degradation.
Governments and policy makers are increasingly recognizing the central importance of health not only to sustainable development but also to human security. Health is now becoming a high priority on the global development agenda. And by health, we mean health promotion and not just the prevention and treatment of disease.
Dr. Ala Alwan, keynote address, 2nd Global Health and Care Forum, May 2006, International Federation of Red Cross and Red Crescent Societies
Canada has played a leading role in the development of the population health approach for over 30 years. In 1974, the Lalonde Report, entitled A New Perspective on the Health of Canadians, gave rise to a number of highly successful, proactive health promotion programs, which increased awareness of the health risks associated with certain personal behaviours and lifestyles (e.g. smoking, alcohol, nutrition, fitness).
In 1986, the Ottawa Charter for Health Promotion expanded on the Lalonde Report, by focusing on the broader social, economic and environmental factors or “determinants” that affect health. In 1989, the Canadian Institute for Advanced Research (CIAR) introduced the population health approach, proposing that individual determinants of health do not act in isolation: it is rather the complex interaction among the entire range of individual and collective factors that can have a far more significant effect on health. For example, unemployment can lead to social isolation and poverty, which in turn influences psychological health and coping skills. Together, these factors can then lead to poor health.
In 1994, the federal, provincial and territorial Ministers of Health officially endorsed the population health approach. Unlike traditional health care, which deals with individuals one at a time when they become ill, population health strategies aim to improve the health of an entire population and reduce inequalities in health status between groups . Population health is concerned with the living and working conditions that affect people's health, the conditions that enable and support people in making healthy choices, and the services that promote and maintain health. This approach recognizes that there is more to health than a good health care system.
The need to make the connections between health, wealth, place, behaviour and biology is increasingly understood by the public policy community, both within and outside the health system. Nevertheless, taking action on a wide spectrum of factors known to influence health requires participation from those sectors whose work affects key determinants of health. Health sector workers must continue to forge new relationships with groups not normally associated with health, but whose activities may have an impact on health.
The determinants of health include economic and social status, social support networks, education and literacy, employment and working conditions, the social environment, the physical environment, personal health practices and coping skills, healthy child development, biology and genetics, health services, gender and culture. These determinants can be grouped according to the social, economic and environmental dimensions of SD, as follows:
Public health is emerging as a critical international issue with economic, security and development dimensions. More and more, the mandate of public health agencies has to be delivered in a global context. Increased trade and personal travel spread diseases (e.g. SARS) faster than ever before. Large scale environmental trends (e.g. climate change) create new threats to human health. Economic restructuring as a result of closer international integration or technological change can lead to job losses or greater economic insecurity, a key social determinant of health. PHAC has an important role to play in managing the impact of these challenges to public health and thus in Canada's SD.
In essence, a population health approach consists of:
Health Canada, Population and
Public Health Branch,
The Population Health Template: Key Elements and Actions That Define a Population Health Approach, 2001
Public health capacity-building, both nationally and internationally, also plays an important role in SD. For example, PHAC is involved in strengthening the public health infrastructure, developing tools needed for informed decision making, increasing the public health knowledge base, improving current practices to meet current needs, and paving the way for the effective and efficient delivery of public health services in the future.
As a member of the federal Health Portfolio, PHAC works closely with Health Canada to develop further understanding of the links between health and the environment. Both organizations recognize the critical relation among human health, the physical environment and the economy. They agree that :
PHAC contributes to our understanding of the relation between health and the environment through its public health research, interventions and capacity building. Particular examples include:
Adapted from Health Canada, Climate Change Office, 2005.
The Agency is also leading by example both domestically and internationally through the development of knowledge and intersectoral policy initiatives. For example, the new National Collaborating Centre for Determinants of Health will contribute to a better understanding of the ways in which the determinants of health can be more effectively addressed to prevent disease and other health problems. Some of these initiatives (e.g. Healthy Living) represent truly national commitments as they involve the federal government working closely with its provincial and territorial counterparts and other stakeholders. Some (e.g. programs for children) respond to international commitments Canada has made while others (e.g. support to the World Health Organization Commission on the Social Determinants of Health) will ensure that new knowledge from the international scene is disseminated and appropriately integrated into Canadian policy.
Under this strategy, the Agency will build on these relationships and initiatives to achieve measurable progress in selected areas, as described in more detail below.
PHAC has developed its Sustainable Development Strategy on the basis of:
Results of PHAC Internal Issues Scan
Consultation with selected stakeholders. PHAC invited selected stakeholders, including federal, provincial and municipal authorities, academics, health associations and non-governmental organizations (NGOs) to comment on a discussion paper that provided the basis for the SDS.
Government-wide coordination initiatives:
Office of Green Government Operations (OGGO): Public Works and Government Services Canada's OGGO has developed government-wide priorities related to the energy use of buildings (to optimize the reduction of greenhouse gas [GHG] emissions), procurement (to maximize the use of procurement to advance governmental SD objectives) and vehicles (to optimize the reduction of GHG emissions and air contaminants).
The Public Health Agency of Canada has identified a number of activities, related to the delivery of its mandate, that support progress toward achieving the federal SD goals. These activities and commitments are identified with a leaf symbol (). More information on the federal SD goals and on work to green government operations is available on Internet at www.sdinfo.gc.ca/.
Commissioner of the Environment and Sustainable Development (CESD): In this second and more comprehensive SDS, PHAC has been mindful of comments made in the past by the CESD and the expectations she has articulated concerning the design and management of effective strategies.
PHAC capacities and priorities: PHAC is a new agency and needs to set up the systems and capacity to integrate SD into its programs. This SDS therefore includes explicit commitments to develop and put in place knowledge, tools and management systems to support its SD initiatives. This reflects one of the Agency's six strategic priorities over the next three years, as indicated in its 2006-2007 Report on Plans and Priorities: “Develop and enhance the Agency's internal capacity to meet its mandate.”
The aspirations and concerns of Canadians:
In the Health Goals for Canada (see Appendix 4), Canadians have articulated their aspirations for a country that meets its people's basic needs (social and physical environment), facilitates belonging and engagement, supports healthy living and provides a strong system for health.
The Public Health Agency of Canada's discussion of the public health outcomes that support SD and its suite of SD targets reflects many of the aspirations and concerns of Canadians for their health and well-being.
PHAC's vision of what it wants to help achieve in the long term is “Healthy Canadians and communities in a healthier world.” This same vision guides its SDS.
The SDS is structured around three goals:
Goal 1: Incorporate SD considerations into the
planning and implementation of Agency activities1;
Goal 2: Ensure that the Agency conducts its operations in a sustainable manner; and2
Goal 3: Build capacity to implement Goals 1 and 2.3
Given PHAC's mandate and role, this goal will be the central element of the Strategy. The Agency's grants and contributions programs, for example, offer an important vehicle through which to promote community capacity building. In its first SDS, Health Canada modified the guidelines for one of its contribution programs, the Population Health Fund (now administered by PHAC), to permit funding of projects related to SD. This led to financing for a number of projects, especially in Quebec, that link environmental, social and economic objectives, for example green roofs to reduce the “heat island” effect in downtown Montréal and to provide food gardens to low-income people, and the twinning of daycare centres with organic food suppliers to provide chemical-free food to young children.
Under Goal 1, Agency activities will contribute to the Government-wide priority of building sustainable communities and to the Agency's mandate to improve the health status of Canadians through preventive and collaborative approaches.
The Agency is already active in greening its operations. In this round of SDSs, every federal department and agency is expected to play a role in respect of three Government-wide priorities. PHAC can do little about one of these priorities - to reduce air emissions from vehicles - because it operates very few of them. PHAC intends, therefore, to focus on green purchasing options, hazardous waste management and resource efficiencies in the operation of its buildings. It has identified measurable results in each of these areas.
Over the last decade, the Canadian Science Centre for Human and Animal Health (Winnipeg) and the Laboratory for Foodborne Zoonoses (Guelph) have implemented the following measures to make their operations more sustainable:Electricity savings
Environmentally friendly practices
All departments and agencies have articulated goals around internal capacity in their early strategies, and many continue to do so. Building internal capacity is an essential foundation for all SD-related activities. It reflects the Agency's sixth strategic goal in its 2006-2007 Report on Plans and Priorities, “Develop and enhance the Agency's internal capacity to meet its mandate.”
PHAC defines capacity building as having three components: knowledge, tools and management systems. Achieving this third goal will not only reinforce internal Agency capacity to promote SD but will also integrate the latter more closely with healthy public policy. Within this context, PHAC will also be building its capacity to contribute to a federal SDS. (See Appendix 5 for the linkages between PHAC targets and federal goals and objectives.)
Objectives and Targets
The objectives and targets that support these goals are identified and discussed, sometimes in an abbreviated form, in the pages that follow. The complete targets are listed in Table 1. The targets, and their indicators, are current examples of Agency activities that support SD. During the three-year Strategy, the Agency will, however, further assess the relevancy of the targets with a view to strengthening the linkages between the targets and SD.
The targets under Goal 1 demonstrate ways in which PHAC's policies and programs, as currently planned, will support SD for the next three years. Though these targets have been developed for the purposes of this report, the Minister and the Agency retain the capacity to amend the targets as government policy warrants.
The Population Health Fund (PHF) focuses its grants and contributions on addressing the determinants of health in order to increase community capacity for action and collaboration in this area. The Fund targets both national and regional community organizations working with high-risk populations and priority health issues. The objectives of the Fund are:
This target will support the integration of SD principles into one of the Agency's programs.
Since 2002, PHF projects funded by PHAC's Quebec Region have focused on the development of healthy and sustainable communities through the following objectives:
By documenting the effectiveness of their projects and submitting supporting evidence to PHAC on their impacts on public health, recipients of PHF grants and contributions will help the Agency learn about the effectiveness of interventions that focus on SD.
A changing climate is affecting the vectors of many infectious diseases and triggering extreme weather events, which in turn trigger public health emergencies. Changing infectious disease patterns and extreme weather events can also have negative social and economic effects.
Health Canada and PHAC are collaborating on the Canadian Climate Change and Health Vulnerability Assessment 2007. Health Canada committed in its 2007-2010 Sustainable Development Strategy (SDS 2007) to better prepare Canadians and health professionals to deal with potential health impacts associated with a changing climate. PHAC's target complements Health Canada's by helping PHAC staff take into account the health implications of a changing climate in policy and program development.
The increasing presence of antibiotic-resistant organisms
(informally called “superbugs”) is of great concern to
both medical providers and the general public. Health officials are
warning that the propagation of “superbugs” in
hospitals and in communities is a worldwide problem that is rapidly
increasing. To tackle this situation, the National
Microbiology Laboratory, together with the Canadian
Nosocomial Infection Surveillance Program, the Canadian Public
Health Laboratory Network and other federal partners, will track
the horizontal spread of antimicrobial resistance mechanisms as
well as emerging clones with increased virulence in the Canadian
population. The project will study the following organisms:
methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile
(C. difficile), Pseudomonas, Enterobacteriaceae, Escherichia coli (E.Coli), Klebsiella, Salmonella,
Shigella, vancomycin-resistant Enterococcus (VRE), Acinetobacter and Neisseria gonorrhoeae.
This project will help develop knowledge about the spread of infectious diseases and ultimately help prevent them and reduce the human and economic costs associated with them. In addition, it will form part of Canada's contribution to WHO's Global Strategy for Containment of Antimicrobial Resistance.
The rise of bacterial resistance to antimicrobial agents has led to more expensive treatment, longer hospitalization of patients and an increase in death rates. Resistance has developed due to the prevalent use of antibiotics, vulnerability and complex interactions. The widespread use of antibiotics and other antimicrobial agents has led to hospital- and community-acquired diseases caused by antimicrobial-resistant pathogens. A recent study found that up to 20% of Staphlococcus areaus (Staph A) and 1 in 20 E. coli infections in intensive care unit patients are virtually untreatable. Often the most vulnerable people within the community are the socially underprivileged: for example, overcrowding in conjunction with poor sanitation and hygiene can lead to the spread of disease.
Antimicrobial-resistant pathogens can be transmitted as a result of interactions between humans, animals and the environment. One example of these interactions is antibiotic use in agriculture. Antibiotics (usually mixed in with animal feed) are routinely given to animals for early prevention of disease and as growth promoters. The wide-scale use of antibiotics in food animals (for example, chickens, cattle and salmon) generates a large reservoir of antibiotic genes in the ecosystem, and some of these genes cause resistance to drugs. An enormous amount of waste is generated by these animal and fish farms. The waste has a potential to contaminate soil and water, and in turn allow the superbugs to enter the food chain. Recent literature from Taiwan reported that researchers had identified the same type of vancomycin-resistant Enterococcus in both retail chicken carcasses and humans, suggesting animal-to-human transmission.
This project will help prevent the spread of infectious diseases and therefore reduce the human and economic costs associated with them.
Enteric (gastro-intestinal) and zoonotic (of animal origin) diseases have a significant effect on the quality of life, and cause lost work days to the economy. The translation of new knowledge from research, and the integration of surveillance data from multiple sources, provide information to build health risk models, and to prioritize appropriate interventions for disease prevention and control.
Through multidisciplinary and transdisciplinary collaborations,
the Laboratory for Foodborne
Zoonoses conducts research, surveillance, health risk modelling, and knowledge synthesis and translation activities. Based on the knowledge created, the LFZ provides expertise and advice on health outcomes and develops integrated approaches to public health risks associated with infectious diseases arising from the interface between humans, animals and the environment (with particular reference to gastro-intestinal diseases).
This target will contribute to cost savings through the development of interventions for the prevention and control of enteric diseases, improve quality of life, and support policy development addressing environmental issues, such as prudent use of antimicrobial agents in the agri-food industry and on-farm management practices to prevent the spread to humans of diseases from animals, food, water and the environment.
In recognition of the reality that some children and families are at higher risk for poor health outcomes, the Agency offers three community-based programs with multiple partners at all levels: local, provincial/territorial and national.
These community-based programs promote children's rights and supportive environments, and contribute to the development of healthy and sustainable communities, families and children. This current target reflects commitments to healthy child development made in previous Health Canada SDSs and Canada's commitment to the United Nations Convention on the Rights of the Child.
In 2005-2006, the Agency reached an agreement with participating provinces and territories on the pan-Canadian Healthy Living Strategy. This agreement specifies targets to increase by 20% the proportion of Canadians who participate in physical activity, eat healthily and have a healthy weights by the year 2015. The Healthy Living Strategy targets contribute to the development of healthy and sustainable communities.
Target 1.2.5 expands the focus of a previous PHAC commitment made in Health Canada's SDS 3, Target 1.3.1, “to promote awareness and engagement of Canadians in active transportation.” PHAC will also continue to contribute to the Transport Canada-led intiative on active transportation.
The Strengthening Public Health System Infrastructure Task Group was created in 2004 to build on recommendations from the report of the National Advisory Committee on SARS and Public Health (Naylor Report) as well as other reports. Among the recommendations, one stressed the need to put in place strategies and programs that can address our ability to strengthen the capacity and competency of the public health workforce. This includes putting in place strategies and programs that increase training capacity by providing financial support for individuals and employers so that practitioners can engage in training.
In October 2005, the Joint Task Group on Public Health Human Resources prepared a pan-Canadian framework for public health human resource planning entitled Building the Public Health Workforce for the 21st Century. This framework stressed the need to develop a public health human resources approach based on skills and competencies, instead of disciplines and professions. One point it emphasized was the need to work with education programs and enhance the capacity to carry out public health research and education.
Both sustainable development and the development of public health have a wide range of possible directions. The long-term emphasis in both approaches places greater demands on the public health workforce. Implementation of this target will help address the capacity, competency and the current shortage of skilled public health workers in Canada.
“Green procurement” refers to the purchase of products and services that have a lesser effect on human health and the environment than competing products or services that serve the same purpose. The new government Green Procurement Policy came into effect on April 1, 2006. The objective of this policy is to advance the protection of the environment and support SD by integrating environmental performance considerations into the procurement decision-making process, resulting in more environmentally responsible planning, acquisition, use and disposal practices in the federal government.
This target contributes to environmental protection by enhancing PHAC purchasers' knowledge of green procurement practices and increasing their ability to incorporate SD into their daily operational practices. It also supports the government-wide goal of 100% of materiel managers and procurement personnel having received green procurement training by 2010.
Implementation of this target will move PHAC toward the use of more environmentally friendly office equipment through purchases of products that meet ENERGY STAR standards and toward more sustainable use of that equipment. This target contributes to environmental protection by ensuring that PHAC office equipment meets energy standards and is operated according to environmentally friendly approaches.
A green procurement baseline will identify areas where the purchase of green products or services could be increased while a green procurement tracking system, if feasible, would allow the Agency to track changes in its green procurement patterns. Implementation of this target will reduce the environmental impact of PHAC procurement.
Travel has environmental consequences in terms of greenhouse gas emissions and waste production. Agency staff make travel decisions every day for themselves: travel to work, travel to meetings, travel within a region, travel across Canada and travel to international destinations. Its staff also make decisions that can influence travel decisions made by Agency partners and stakeholders. Examples of green travel options include, but are not limited to, videoconferencing; telecommuting; using green modes of transportation (walking, biking, public transportation); staying at hotels that conserve water and energy and reduce waste; and respecting community well-being.
PHAC can demonstrate ecological responsibility by choosing travel options that conserve water and energy and reduce the production of solid waste. The Agency can also demonstrate social responsibility by offering green alternatives to travel to partners and stakeholders, particularly those in rural and remote areas, or by holding or participating in events that can benefit local communities. Implementation of this target will reduce the environmental impact of PHAC travel.
The safe management of hazardous waste is an integral part of laboratory operations for PHAC. The hazardous waste produced within its laboratories is composed of biological, chemical and radioactive materials. Due to its hazardous nature, this waste cannot be disposed of in the municipal waste stream. PHAC manages its hazardous waste in order to minimize its impact on the environment, humans and property while reducing the risk of releases and contamination to land, air and water.
Monitoring changes in the generation of hazardous materials and in the disposal of waste will help to ensure that PHAC meets its legal obligations and will provide a tool for long-term planning. The database or databases created will facilitate a review of the hazardous materials being produced and allow the Agency to investigate what disposal methods are available as well as to promote disposal that is less harmful to the environment.
Federal building property and facility managers play a significant role in helping the federal government meet its environmental stewardship responsibilities in the area of energy efficiency. PHAC occupies office space in five buildings and laboratory space in two buildings in the National Capital Region. The Agency is custodian of two laboratory buildings and one office facility. PHAC also occupies office space at 16 additional sites across Canada. As Agency laboratories range from containment level 2 and 3 facilities to a level 4 laboratory with specialized requirements for environmental control and containment, its energy requirements are high. There remain, however, opportunities for energy efficiency improvement.
During the design of a new construction or a renovation, goals have to be established for the overall energy consumption of the laboratory building or renovated area. Energy efficiency improvements may be achieved with regard to heating, cooling, pumps, fans or lighting.
Throughout the building management project cycle, PHAC commits to repair and replace building equipment as required, to replace equipment with more energy-efficient models and to monitor progress through annual building performance reviews. Accordingly, Building Management Plans for PHAC's custodial buildings will be reviewed annually to ensure that planned projects, where applicable, will reduce energy consumption. PHAC will also report annually on the effectiveness of preventive maintenance and building improvements on use of non-renewable resources; building performance, in terms of energy and utilities management, will be compared to the baseline data of 2005-2006. Workload and extreme weather fluctuations will be monitored, as they will have an impact on energy and utilities consumption.
Because the National Microbiology Laboratory (Winnipeg) is housed in a new building, most of the currently possible energy efficiency improvements have been achieved. However, the Laboratory for Foodborne Zoonoses (Guelph), in an older building, shows more potential for improvement.
Implementing this target will reduce the environmental impact of the Agency's operations.
In order to increase resource efficiencies in the operation of leased or rented buildings, PHAC will:
Implementing this target will further reduce the environmental impact of the Agency's operations.
PHAC will put the systems in place to meet the requirements of the Cabinet Directive on the Environmental Assessment of Policy, Plan and Program Proposals. Ensuring that the environment is a consideration in policy and funding requests will enhance the environmental sustainability of PHAC initiatives.
As revealed in surveys conducted in preparation for this strategy, most PHAC staff have never had the opportunity to explore in a substantive way how their work relates to SD. According to social marketing principles, people normally pass through three stages in order to take action on new issues: first they develop understanding, then commitment, and finally they take action. This target advances the first step, acquiring understanding; in addition, it will improve PHAC's capacity to plan to enhance SD and realize the contribution that SD makes to public health.
The Agency's Sustainable Development Policy will articulate such matters as its SD vision, core values and beliefs; the nature and scope of its interest in SD; the principles which will guide future SDSs; mechanisms for coordination with other parties; and overarching commitments to transparency, partnership, review and continuous improvement. The Policy will serve as an important internal and external communications vehicle of the Agency's approach to SD and will guide the development and management of future strategies. This target will help the Agency integrate SD into its policies, programs and management systems.
Quality information is key to SD and to sustainable health systems. PHAC's Geographic Information Systems infrastructure is of particular value to public health decision-makers for visualizing, analyzing and communicating new knowledge about the outcomes of their decisions. As of July 2005, more than 200 professionals from over 90 public health groups across Canada were networked through this tool. For example:
The implementation of this target will enable PHAC and its partners to geo-reference environmental, social and economic data when planning public health interventions.
This target contributes to ensuring that PHAC management has the information it needs to make decisions regarding SD and implementation of the SDS.
To ensure that the SDS is effective and influences the Agency's programs, the Agency must ensure that SD becomes fully integrated into its planning processes. As a result SD considerations will be addressed at the same time as all others in the Agency's management processes. PHAC will, therefore, incorporate its SD commitments into its strategic, business and human resources plans.
PHAC will review its internal budgetary processes to ensure that they reflect its commitment to SD. The purpose of such reviews will be to ensure that budget decisions continue to support and even enhance SD.