The Public Health Agency of Canada should be the primary source of information for the public during a crisis such as the current nationwide listeriosis outbreak, says a commentary in an upcoming issue of the Canadian Medical Association Journal.
During the current crisis, in which meat tainted with the Listeria bacteria has been linked to the deaths of 17 people, Canada's chief public health officer has not been the lead voice to inform the public, the writers say.
Rather, the federal agriculture minister and the president of Maple Leaf Foods, the company linked to the outbreak, have been the faces of the outbreak for both the media and the public.
According to recommendations in a Health Canada report issued after the 2003 SARS outbreak in Ontario, the country's chief public health officer should be "the leading national voice for public health, particularly in outbreaks and other health emergencies," according to the commentary.
The critique is written by Dr. Kumanan Wilson, the Canada Research Chair in Public Health Policy and Jennifer Keelan of the University of Toronto's Dalla Lana School of Public Health.
Canada's Chief Public Health Officer, David Butler-Jones, has "not been particularly visible," Wilson told CTV.ca in an interview.
"There's a reason why we want our public health officials and our public health office to be in the lead on public health issues. When you have that situation, you are less likely to make other kinds of compromises for other reasons. The primary goal will be to improve public health."
Wilson said there are a few reasons why the public health officer might take a backseat to other government officials during a health crisis.
The Public Health Agency of Canada Act allows the chief public health officer to issue annual reports to Parliament and to communicate directly with the public concerning public health issues.
However, the public health chief is a deputy minister, who can be relieved of his or her duties at any time, Wilson said.
Therefore, whoever fills that post may be reticent to speak freely about government policies, be they public health policies or those of other government departments.
"So obviously if he or she is very concerned about what's happening in another ministry or in another jurisdiction and they speak out against the government policies, their ongoing employment may not be guaranteed," Wilson said.
However, he cautioned that the position should not operate so independently of the federal government that officials leave the public health officer entirely out of the loop.
As well, the public health agency should have a budget protected from cutbacks.
The federal government has a vested interest in allowing public health officials to speak freely, Wilson and Keelan wrote.
"Messaging concerning the competence of government oversight and the effectiveness of its policies with respect to preserving the health security of its population could be influential on the decisions of the electorate. This raises the question of the degree of independence of the chief public health officer, especially during specific points in the political cycle."
Inspection plans a concern
Wilson's and Keelan's commentary was released a day after an editorial, also published in the CMAJ. Titled "Listeriosis is the least of it," the editorial challenged the Harper government's decision to download meat inspection duties to the industry itself.
The editorials, signed by doctors and the journal's editors, also pointed out that current Canadian guidelines for Listeria are less stringent than in other countries.
For example, Health Canada allows up to 100 Listeria bacteria per gram in ready-to-eat foods at the beginning of the product's shelf life.
In contrast, the United Nations and the World Health Organization allow 100 bacteria per gram, but at the end of a product's shelf life.
The United States does not allow any Listeria bacteria to be found in food products.
The editorial called for a full-scale, independent inquiry into the listeriosis outbreak.
"Future food-borne epidemics of listeriosis are certain," the authors wrote. "A full-scale public inquiry into the major failings of Canada's food inspection system is necessary to protect Canadians from future epidemic threats, and the Canadian public should settle for nothing less than that. This will be the first and most important step toward making our food chain safer."
