Question Period Note: National Emergency Strategic Stockpile Management

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Issue
The Public Health Agency of Canada (PHAC) manages the National Emergency Strategic Stockpile (NESS) to support provinces and territories when their own resources are insufficient. The NESS continuously works with provincial and territorial governments to assess the ongoing needs for medical equipment and supplies to proactively identify and mitigate gaps as required.

Key Messages
• Stockpiles of supplies are maintained in the National Emergency Strategic Stockpile and are deployed in response to urgent requests for assistance from provinces and territories.
• The National Emergency Strategic Stockpile works closely with provinces and territories to assess ongoing surge requirements, and to proactively identify and mitigate gaps, as required.
If pressed on NESS response to the COVID-19 pandemic
• In response to the intense level of global competition for medical equipment and supplies in March 2020, the Public Health Agency of Canada, via the National Emergency Strategic Stockpile, entered into the bulk procurement of medical equipment and supplies on behalf of provinces and territories.
• Over the course of the COVID-19 pandemic, the NESS distributed over two billion units of medical equipment and supplies, including personal protective equipment, vaccine ancillary supplies, and biomedical equipment.
• With the stabilization of global supply chains, provincial and territorial reliance on the NESS has decreased, returning the federal stockpile to its surge capacity mandate.

If pressed on NESS response to the Alberta wildfires
• In response to a request for assistance by the province of Alberta, and in consultation with provincial and local authorities, the Public Health Agency of Canada has secured and coordinated the delivery of supplies requested by Alberta.
• These supplies include cots, blankets, ward boxes, and disposable sheets, and will support local efforts in emergency response to the wildfires threatening communities in Alberta.
If pressed on domestic PPE manufacturing
• The following percentages of commodities procured by the Public Health Agency of Canada in response to the COVID-19 pandemic are domestically manufactured:
o Approximately 70% of N95 respirators. This percentage accounts for the 2 multi-year contracts with AMD Medicom and 3M Canada.
o 50% of surgical masks. This percentage accounts for the multi-year contract with AMD Medicom.
o 100% of face shields.
o 25% of disposable gowns.

If pressed on NESS divestment of surplus assets
• The National Emergency Strategic Stockpile divests of surplus assets in accordance with Treasury Board policies.
• Divestment considerations include:
o Transfer to other federal partners, as well as provinces and territories;
o Sale through the Government of Canada’s GCSurplus platform; and,
o Donation, both domestic and international, through the Government of Canada’s GCDonate platform.
• Divestment through recycling and disposal is only considered once all other options have been exhausted.
• Divestment efforts will not compromise the National Emergency Strategic Stockpile’s capacity to respond to public health events that could arise in Canada.
• One example of a recent divestment was the donation of ventilators to the Maple Hope Foundation. This is a Canadian not-for-profit organization that works to provide medical relief in the Ukraine.
• Assets posted on the GCDonate platform are available to:
o Registered charities and non-profit organizations across Canada;
o Municipal and provincial governments;
o Indigenous Peoples;
o Other national governments;
o Treaty organizations of which Canada is a member; and
o The United Nations.
If pressed on the development of a comprehensive management plan for the future of the NESS
• The Public Health Agency of Canada is committed to enhancing its preparedness for future public health emergencies, including working on improvements for the management of the National Emergency Strategic Stockpile.
• The Agency continues to identify and implement incremental improvements to the National Emergency Strategic Stockpile through efforts to respond to public health emergencies such as COVID-19 and Mpox.
• The Agency has committed to completing a comprehensive management plan for the National Emergency Strategic Stockpile. The plan will provide a roadmap for systematic and agile transformation with the overall objectives of improving readiness to respond to future pandemics and other emergencies and driving continuous improvement.

NESS Mandate
The fundamental basis underpinning federal emergency management and the NESS is that provincial, territorial and local governments are prepared to respond in a reasonable manner to the most common emergencies in their jurisdictions.

As such, the federal government’s role in stockpiling emergency health assets is twofold:
• To provide surge capacity support to provinces and territories at their request when their own resources are not sufficient
• As the sole provider of certain assets, for example, costly and rarely used vaccines or antidotes, required for rare public health emergencies

NESS Funding
To support the response to COVID-19, NESS spent $5 billion for the procurement of PPE, vaccine ancillary supplies, medical equipment and supplies, and for logistics and warehousing. An additional $65.5 million has been approved for ongoing funding for medical countermeasures.

Budget 2022 provided $50 million in 2022-23 to support the operations of the NESS. This funding was used to maintain critical medical supplies, including personal protective equipment, to support the continued response to public health events and other emergencies.

Life-cycle Management
Taking into account lessons learned from the COVID-19 pandemic, PHAC will develop a comprehensive management plan for the NESS that will focus on capacity and readiness of the NESS to support responses to future public health emergencies. This will include a focus on key areas such as optimizing operations, including logistics and life-cycle management; enhancing infrastructure and systems; working closely with the provinces and territories and other key partners to strengthen Canada’s overall preparedness; and conducting ongoing analysis on asset requirements.

Made-in-Canada Ventilators
As a result of ISED’s Call to Action, the Government of Canada identified five Canadian companies capable of manufacturing made-in-Canada ventilators in support of the fight against COVID-19.

As the evidence and public health guidance evolved, ventilator use was de-emphasized for the treatment of COVID-19 patients. To respond to the shift in treatment practices and anticipated demand, the Government of Canada worked with Canadian suppliers to identify opportunities to reduce the volumes ordered.

OAG Audit
The Office of the Auditor General (OAG) undertook a performance audit on the Government of Canada’s ability to meet the needs of provinces and territories, and the healthcare sector, for PPE and medical devices to respond to the COVID-19 pandemic. The audit period covered January 2020 through August 31, 2020, and implicated the PHAC, PSPC, and HC.

Overall, the OAG found that PHAC, PSPC, and HC helped to meet the needs of provincial and territorial governments for PPE and medical devices during the pandemic. The report does however highlight that as a result of long-standing unaddressed problems with the systems and practices in place to manage the NESS, PHAC was not as prepared as it could have been to respond to the needs of provinces and territories for PPE and medical devices.

PHAC and HC have both committed to addressing the recommendations from the OAG as per the set deadlines on the Management Response Action Plan.

• The NESS contains supplies that provinces and territories can request in emergencies, such as infectious disease outbreaks, natural disasters, and other public health events, when their own resources are exhausted. The stockpile includes a variety of items such as personal protective equipment (PPE); biomedical equipment (e.g. ventilators); pharmaceuticals; and social service supplies, such as beds and blankets.