(a) On September 18, 1998 Health Canada announced a strategy to address the concerns of Canadians regarding hepatitis C. As part of this strategy, a commitment of $50 million over 5 years was made for the development and implementation of a new hepatitis C program.
Health Canada officials consulted with stakeholder groups, the provinces and the territories, medical and research organizations and individuals across the country living with or affected by hepatitis C (persons living with or caring for someone who has hepatitis C) and the organizations that represent them to identify needs and to seek guidance on designing the various components of the new hepatitis C program.
Following these consultations, a new unit in Health Canada, the hepatitis C division, has been created to ensure federal capacity to respond to the challenges and needs posed by hepatitis C. This division has a mandate: to act as focal point for a population health approach to hepatitis C: to build knowledge and provide evidence by fostering research initiatives; to increase awareness and capacity; to develop prevention strategies and support initiatives, and to ensure that Canadians who have been infected through blood do not incur out-of-pocket expenses for medical treatment.
The Program is now in operation. Program expenditures to date total $650,543. The breakdown of these expenditures and projected expenditures for 1999/2000 are as follows:
First year funding was profiled at approximately $6 million in recognition of the need to develop and staff the program and to develop funding frameworks and accountability measures. Internal expenditures to date are principally for salaries.
A public document describing the hepatitis C disease prevention, community-based support and research program will be released in the near future.
A program advisory group (PAG) of representatives from key stakeholder groups has been created.
On July 7, 1999 Health Canada and the Medical Research Council announced a joint $18 million research initiative. A joint advisory committee on research made up of clinicians, researchers, the private sector, Canadian Blood Services/Héma Québec and representatives from key stakeholders' groups has been formed. Twenty-eight research proposals have been received and are under consideration.
A survey questionnaire to obtain baseline data has been developed and is being administered by the regional offices.
Funding guidelines for three national level stakeholders (i.e. the Hepatitis C Society of Canada, the Canadian Hemophilia Society and the Canadian Liver Foundation) were released in July and applications from these organizations for operational funds are currently being assessed. Some of the activities proposed by these stakeholders include the enhancement of 1-800 lines, volunteer needs assessment, newsletters to provide information on hepatitis C, and the development of information and organization development sessions at the national, regional and local levels.
The funding guidelines for prevention and community-based support for the regional and local levels are now available. Staff in the regional offices of the Health Promotion and Programs Branch of Health Canada are administering this funding. In partnership with stakeholders, staff will also establish regional priorities for funding.
Projects initiated and/or supported under the care and awareness component currently include:
Dissemination of treatment guidelines for hepatitis C which were recently developed by the Canadian Association for the Study of the Liver (CASL). These guidelines provide treating physicians with the best available evidence and will help to ensure consistency of treatment for all Canadians. It is available on the CASL website (http://www.ihsc.on.ca/casl/) and will be distributed to all physicians in the future. Their address is: Canadian Association for the Study of the Liver; c/o President, Dr. Sam Lee, Division of Gasteroenterology; University of Calgary; Health Science Centre; Room 1721, 3330 Hospital Drive; Calgary, Alberta, T2N 4N1, telephone (403) 220-3245, fax (403) 270-0995;
The development of a physician document-patient handout by the Canadian Liver Foundation. The handout will be provided to all general practitioner and family doctors in Canada to support the treatment of infected persons and provide “first contact” information for those persons diagnosed with hepatitis C;
A Canadian Association for the Study of the Liver (CASL) steering group meeting for a Hepatitis C Network for Research and Treatment was held on October 28, 1999, supported with funding from Health Canada;
A request for proposals for treatment guidelines for pregnant women is ready to be tendered; and
Funding guidelines for national projects under the care and awareness component have been finalized and are currently available.
(b) The federal government is working hard with the provincial and territorial governments to implement this $300 million special transfer. While no funds have been transfered to date, we are anticipating that the money will start to flow shortly.