The COVID-19 pandemic significantly stressed the science-policy interface due to its rapid evolution, substantial health, social, and economic impacts, and the constantly evolving evidence base. The World Health Organization declared COVID-19 a public health emergency and a global pandemic in 2020. Canada's first case was confirmed in January 2020. By December 2021, Canada had experienced significant infections and deaths, disproportionately affecting vulnerable populations. Various public health measures were implemented, including lockdowns, border closures, and vaccination campaigns. Canada's federal science advice landscape for public health emergencies was shaped by the 2003 SARS and 2009 H1N1 outbreaks. These events highlighted issues with expertise availability, surge capacity, and rapid evidence generation to inform government decisions. The decentralized nature of Canada's federation makes it an interesting case study on mobilizing science advice in a pandemic, where the federal government develops guidance while subnational governments implement measures. This paper aims to identify opportunities for strengthening federal science advice in Canada by documenting the pre-pandemic advisory bodies and their evolution during the first two years of the COVID-19 pandemic.

The paper draws on existing literature on science advice mechanisms, specifically focusing on the Canadian context and lessons learned from previous public health emergencies like SARS and H1N1. It references reports and inquiries into these outbreaks, highlighting recurring challenges in accessing and utilizing scientific expertise during crises. The literature establishes the importance of evidence-informed decision-making in public health emergencies and explores various models for structuring and coordinating science advisory bodies within federal governments. The authors also reference literature on the decentralized nature of Canada’s federal system, the roles and responsibilities of federal and subnational governments in health policy, and models for intergovernmental collaboration.

This study employed a jurisdictional descriptive case study methodology, relying on a literature review of publicly available documents. The review encompassed primary sources (government technical reports and guidance) and secondary sources (peer-reviewed articles). The search covered the period from the 2003 SARS outbreak to December 2021, using iterative snowballing techniques. Local public health experts were consulted to ensure the completeness of the information gathered. The analysis identified key advisory bodies involved in evidence generation, brokerage, communication, and decision-making. Bodies were included if their advisory relationship with the federal government was established in the literature. The findings are structured to first describe the pre-pandemic federal science advice ecosystem and then analyze how these bodies mobilized and evolved during the COVID-19 pandemic response. The discussion section situates these findings within the broader literature on science advice and offers policy recommendations.

Canada's pre-pandemic science advice ecosystem for public health was largely shaped by the SARS and H1N1 outbreaks. The federal Health Portfolio, overseen by the Minister of Health, included Health Canada, CIHR, and PHAC. PHAC, established in 2004, plays a central role in pandemic response, with the CPHO advising the Minister of Health and the Cabinet. The PHN facilitated collaboration between federal and subnational governments. The Science Portfolio, under the Minister of ISED, included ISED, NRC, NSERC, SSHRC, and Statistics Canada. The OCSA was created in 2018 to advise the federal government on science policy. The COVID-19 pandemic significantly expanded the federal science advice ecosystem. Pre-existing bodies like NACI and the PHN SAC played critical roles. New collaborations emerged between the Health and Science Portfolios and other departments (e.g., using behavioral scientists to improve messaging). Several new advisory bodies were formed: the PHAC External COVID-19 Modeling Expert Group, the Pan-Canadian Health Data Strategy Expert Advisory Group, and the COVID-19 Testing and Screening Expert Advisory Panel (Health Portfolio); the COVID-19 Expert Panel, Expert Group on Health Systems, and Expert Group on Modeling Approaches (Science Portfolio). Large research partnerships were funded to collect primary data (CanCOGeN, CoVaRR-Net, CITF), and initiatives like CanCOVID and COVID-END supported rapid evidence syntheses. The pandemic revealed a lack of horizontal coordination mechanisms for science advice at the federal level. While the DSA Network was established to address this, it's unclear if it ensured effective interdepartmental engagement. The interplay between federal and subnational authorities also adds complexity. Although existing pandemic plans emphasized evidence-informed decision-making, the pandemic highlighted gaps in coordinating science advice across sectors and in the independence of advisory bodies.

The ad-hoc nature of Canada's science advice response to COVID-19 raises concerns about pandemic preparedness and future emergencies. The study highlights instances of duplicated efforts and the need for better horizontal coordination of science advice across federal departments. The existing PHN structure focuses primarily on vertical coordination between federal and subnational health authorities, neglecting horizontal coordination across sectors at the federal level. The establishment of new advisory bodies like the COVID-19 Vaccine Task Force in the Science Portfolio suggests a need for logistics-oriented federal advice on vaccine procurement and distribution, which was previously handled mainly by subnational authorities. The COVID-19 response demonstrated the need for better institutionalization of science advice. Institutionalization, understood as establishing formalized structures for science-policy interaction, is crucial for resilience against political and contextual changes. The paper discusses various proposed approaches to institutionalizing science advice in Canada, including creating a federal agency dedicated to centralizing and coordinating science advice for health emergencies. This approach is supported by global evidence, with studies from various countries pointing to the need for a standing national authority for science advice on health security.

Canada's COVID-19 response highlighted the challenges in procuring and coordinating science advice within its complex federal structure. While the engagement of departments beyond the health sector is a positive development, the need for institutionalization of science advisory bodies for public health is clear. Future pandemic preparedness efforts should focus on establishing mechanisms for better coordination and collaboration between federal departments and between federal and subnational authorities. This should include addressing concerns about independence of science advisors and handling conflicts of interest effectively. Further research is crucial to evaluate different institutional arrangements for optimal science advice in public health emergencies, addressing the independence of advisory bodies and the role of subnational structures.

The study relies on publicly available data; thus, informal pathways for science advice or international knowledge exchanges might have been missed. The focus on federal science advice limits insights into subnational structures. The ongoing nature of the pandemic prevents definitive conclusions about the response's effectiveness. The difficulty in assessing evidence-informed policymaking using publicly available information highlights a need for qualitative research with primary data collection. The study acknowledges the disproportionate impact of the pandemic on vulnerable groups but lacks a detailed analysis of advice content for those groups.