York University Professor Steven Hoffman is among a cohort of Canadian scholars to author a special report for The Lancet that examines Canada’s system of universal health coverage and role in global health.
The two papers, authored by leading scholars, indicate the Canadian government must match its public declarations with concrete action on issues such as disparities between Indigenous and non-Indigenous peoples’ health, health system reform, and flagging levels of overseas aid, if it is to renew its legacy of leadership in health.
The paper was published on Feb. 23, at the start of the country’s 2018 Presidency of the G7. The analysis is accompanied by commentaries from Prime Minister Justin Trudeau and Jane Philpott, minister for Indigenous Services, who lay out Canada’s vision for global health and gender equality, along with the country’s plans to improve Indigenous health and wellbeing.
For this series, Hoffman led the sections on Canada’s role in global health research.
Hoffman is the director of the Global Strategy Lab, a professor of global health, law, and political science at York University, and the scientific director of the Canadian Institutes of Health Research’s (CIHR) Institute of Population & Public Health. He is one of Canada’s most influential scholars in global health governance, law and policy, having served as an advisor to several national governments, the UN and the WHO.
While most of the series focused on Canada’s role more broadly, his contribution to the study included data analysis of CIHR funding for global health research.
“This series shows that Canada has an important opportunity to improve global health – both at home and abroad,” said Hoffman. “As a middle power, Canada needs to build on its strengths, identify its niche, and direct its limited global health resources to those areas. That is the way our country will have the greatest impact.”
The lead authors of the two commissioned papers are University of Toronto’s Danielle Martin, associate professor of family and community medicine, and Stephanie Nixon, professor of physical therapy.
Martin and her co-authors argue that reform is needed for Canada’s universal health-care system to recommit to and deliver on its founding principles of equity, solidarity, and co-stewardship.
While urgent medical and surgical care is generally timely and of high quality, they say, wait times for elective care have been a lightning rod. One in three Canadians must wait more than two months for a specialist referral, far higher than many Organization for Economic Co-operation and Development (OECD) countries. Canada also faces an aging population, growing multiculturalism and urbanization, and a geographical vastness that makes the delivery of health care to rural and remote communities especially challenging.
Similarly, on the global stage, researchers call for bold, strategic action to realize its vision of being a progressive force for health. Canada has a long history of strong engagement and leadership in global health, leveraging its assets as a middle power to build consensus and advance health equity.
“When it decides to take a leadership role, Canada has a proven track-record of making a world of difference. I hope Canada seizes the opportunity it has today to take a global leadership role in global health,” said Hoffman.
As well, the authors outline the urgent tasks facing all levels of Canadian society to address unacceptable Indigenous health disparities. These include improving the social determinants of health, addressing intergenerational trauma, supporting new models of self-governance, and ensuring that Indigenous peoples are among the ranks of health providers and leaders in Canada.
“York University is well-positioned to lead in global health research given the strength of the University’s faculty in this area, its interdisciplinary way of working, progressive mandate, pioneering undergraduate program in global health, and the new Dahdaleh Institute that brings it all together,” said Hoffman.