Question Period Note: Global Public Health Intelligence Network (GPHIN)

In the fall of 2020, the Minister of Health announced an independent review of the Public Health Agency of Canada’s Global Public Health Intelligence Network (GPHIN). The final report was published on July 12, 2021. In addition, the Auditor General’s Report 8 – Pandemic Preparedness, Surveillance, and Border Control Measures was released in March 2021, and includes a recommendation relating to GPHIN.

RESPONSE
• The Government of Canada’s top priority is the health and safety of Canadians, and we are committed to improving Canada’s early warning system for potential emergencies, including pandemics.
• That is why, last year, this government requested that an Independent Review Panel undertake a review of the Global Public Health Intelligence Network (GPHIN).
• The Panel’s recommendations were publicly released in July 2021, and will be used to support PHAC in determining how this global public health surveillance system can continue to best serve Canadians and the international community.
If pressed for details on the final report
• The final report provides recommendations on the role and purpose of GPHIN, its organization and flow of information, and technology considerations going forward.
• The recommendations relate to a range of topics, from international and domestic partnerships to advice on the next generation of public health intelligence systems, and the future of surveillance tools.
• The Independent Panel confirmed that GPHIN was never shut down. GPHIN provided early warning of COVID-19 to Canadian public health professionals, and continues to operate as Canada’s event-based public health surveillance system.

About GPHIN
The Public Health Agency of Canada’s (PHAC) Global Public Health Intelligence Network (GPHIN) is an open-source early-warning and situational awareness system for potential chemical, biological, radiological and nuclear public health threats worldwide, including outbreaks of infectious disease. GPHIN users include non-governmental public health agencies and organizations, as well as government authorities who conduct public health surveillance. GPHIN’s products and services are freely available to eligible users. GPHIN is an important contributor to the World Health Organization’s (WHO) Epidemic Intelligence from Open Sources.

GPHIN consists of two critical components:
• an Information Management Tool that uses machine learning and natural language processing to automatically collect and filter data from multiple open sources; and
• a professional multidisciplinary team of analysts that reviews and refines the filtered data, and also monitors additional open sources to scan for signals of potential public health threats.

Every day, the GPHIN system automatically collects about 7,000 articles, half of which are filtered out before the GPHIN analysts conduct their daily review of the remaining 3,500 articles in nine languages (Arabic, Farsi, English, French, Portuguese, Russian, Spanish, and simplified and traditional Chinese). Articles are collected from open sources, and are validated and assessed for inclusion in reports, including the GPHIN Daily Report. This report goes directly from GPHIN to Canadian public health practitioners at the federal, provincial, territorial and regional levels, including senior management at PHAC and other government departments.

In addition to the Daily Report, on an ad-hoc and “as required” basis, GPHIN develops and distributes what is known as an “Alert” – an email with a highlighted article about a health event of potential interest that is sent to international and domestic subscribers. Such alerts do not include a risk assessment or recommendations for specific actions or responses.

Independent Review of GPHIN
In the fall of 2020, the Minister of Health requested an independent review of GPHIN. This review considered:
• the capabilities of the existing system;
• its role in detecting and informing PHAC’s response to COVID-19, and in global and domestic public health surveillance;
• opportunities to improve the system; and
• the future of Canada’s global health surveillance system, including advice on the next generation of intelligence systems and lessons learned from COVID-19, so that the Government of Canada is well positioned to respond to future public health events.

The Panel members, Margaret Bloodworth (Panel Chair), Dr. Paul Gully, and Dr. Mylaine Breton, were selected based on their collective expertise in public health, governance, health security, and intelligence.
The final report was published online on July 12, 2021, and the 36 recommendations therein relate to:
• the role and purpose of GPHIN, including articulating its role and functions as part of PHAC's public health surveillance activities, extending its partnerships and subscriber outreach, and regularly evaluating its processes and products;
• organizational considerations and flow of information, including establishing a new Risk Assessment Office at PHAC, linking GPHIN to PHAC's broader surveillance activities, and training and recruiting GPHIN staff; and
• technology, such as incorporation of additional social media and other new sources of data, platform improvements, and advice on the next generation of public health intelligence systems.

Auditor General Report on Pandemic Preparedness, Surveillance, and Border Control Measures
The Office of the Auditor General of Canada (OAG) tabled a report in Parliament on March 25, 2021 titled COVID-19 Pandemic: Report 8 – Pandemic Preparedness, Surveillance, and Border Control Measures. This included an audit of PHAC’s and the Canada Border Services Agency’s pandemic response. The report notes that GPHIN Alerts play a key role in early warning, and that overall, PHAC quickly mobilized and adapted its response as the pandemic progressed.

With regard to GPHIN, the following recommendation was made: “The Public Health Agency of Canada should appropriately utilize its Global Public Health Intelligence Network monitoring capabilities to detect and provide early warning of potential public health threats and, in particular, clarify decision making for issuing alerts.”

The OAG audit found that no alert was issued when news of an unknown pneumonia was first reported, when the virus had spread outside of China, or when domestic cases were first suspected and confirmed.
• PHAC officials confirmed that by the end of December 2019, other international sources had already shared news of the virus and therefore it was unnecessary for GPHIN to issue an alert.
• GPHIN did issue daily reports about the new virus to Canadian partners (including federal, provincial, and territorial public health officials) starting on December 31, 2019, and thus performed its key function of providing early warning within Canada.

The OAG report also notes that the approval process for issuing alerts changed in 2018, after which the number of alerts decreased significantly.
• PHAC officials confirmed this change was to ensure appropriate awareness of, and response to, emerging issues, but GPHIN subscribers were not informed of this operational change in alert reporting.
• In recognition of the need for clear decision-making processes, a standard operating procedure was put in place in fall 2020 regarding the issuance of GPHIN alerts.

In response to the Auditor General’s recommendation, and the recommendations from the GPHIN Independent Review, PHAC will make further improvements to GPHIN, including the alert process.

Key Facts
• GPHIN analysts conduct daily review of more than 3,500 articles in nine languages (Arabic, Farsi, English, French, Portuguese, Russian, Spanish, and simplified and traditional Chinese).
• In addition to the Daily Report, on an ad-hoc and “as required” basis, GPHIN develops and distributes what is known as an “Alert” – an email with a highlighted article about a health event of potential interest that is sent to international and domestic subscribers.
• Such alerts do not include a risk assessment or recommendations for specific actions or responses.