
Recent graduate, Carleton University's Institute of Political Economy

Elikem Tsamenyi, PhD candidate, Dalhousie University

Public health and preventive medicine resident, University of British Columbia
PhD candidate, Norman Paterson School of International Affairs, Carleton University
Rebecca Jensen, doctoral candidate, University of Calgary, Centre for Military and Strategic Studies
These five essays were selected as winners of the 2018 Defence and Security Essay Competition, organized by the Balsillie School of International Affairs (BSIA) and the Centre for the Study of Security and Development (CSSD) at Dalhousie University.
The competition invited junior scholars to reflect on future defence and security challenges for Canada: What are they and how should they be tackled? Their responses — published below — highlight the range of challenges Canada faces today, and the range of innovative ideas and critical thinking Canada’s young scholars have to offer.
Essays
- Canada’s Arctic defence needs new partners
- Fitting Military Tactics to Strategy: The need for a Canadian approach to ‘operational art’
- Fragile States: Still a major threat to Canadian security and defence
- Canada should broaden its ‘grey zone’ defences
- Time for Canada to invest in global health security
Canada’s Arctic defence needs new partners
— Carter Vance, recent graduate, Carleton University's Institute of Political Economy
One of challenges which has most vexed Canadian defence policymakers since Confederation has been the matter of how to maintain territorial sovereignty. Specifically, these challenges are related to the vast territorial sweep of the country and the fact that much of its claimed territory is sparsely populated. For much of the post-World War II period, this concern was framed in terms of a Cold War-based threat coming from the Soviet Union.
The times, as is it often said, have changed, with incursions on Arctic sovereignty becoming a much more regular, and more fraught, occurrence. For instance, in 2017, the People’s Republic of China mapped a shipping route through the Northwest Passage under the guise of a research vessel. In the current environment, where countries with longstanding interests in the Arctic have been joined by upstart players, most prominently China, the situation is considerably more dynamic and multifaceted than the old Cold War power politics.
In part, the recent concerns in the Arctic are still based in essential matters of territorial control and the exercise of sovereignty in a military sense. However, with climate change rendering more of Arctic navigable as ice levels decline, there are additional economic pressures at play. Chinese officials have estimated that being able to navigate shipments through the Passage could reduce their shipping times to certain locations currently accessed via the Northern Sea Route by up to 20 percent. It is little surprise, then, that China has recently declared, as a policy matter, that they consider themselves a “near-Arctic state” and have announced intentions to develop a “Polar silk road” for shipping of goods.
At the same time, the NATO alliance structure which has traditionally been the bedrock of Canada’s security policy has been under strain from both political and economic pressures. True, joint military exercises have continued and there has been some progress in terms of member states approaching the de jure 2 percent of GDP defence spending requirements. Bearing that in mind, it is nevertheless the case that the United States seems willing to break with previously establish orthodoxies. In other words, the NATO security umbrella is not, in and of itself, the iron-clad guarantee it once was.
Considering this new reality, Canada should pursue a different approach to sovereignty in the Arctic in the future, which emphasizes collaboration with non-traditional actors. This is not to say that the country should merely, as some have suggested, “give up” on the project of maintaining an active military presence. Appropriate investments should be continued in upgrading both naval and other military capacity within the Arctic region. However, a purely military approach to security will quickly run into a tenability problem, and mistakes projection of force as the sole baseline of meaningful sovereignty.
When it comes to China, Canada should be willing to engage with it as a partner, within certain parameters. The research and economic interests within the Arctic shared between the countries could create the basis for mutual agreements on appropriate uses of, for instance, the Northwest Passage or clear guidelines on when and where territorial encroachments will be treated as a sovereignty matter. Such agreements could be linked to discussions with China on other issues, such as trade. For instance, Canada could offer to collaborate on joint research missions in the Arctic in exchange for China modifying its terms on progressive elements within trade pacts. This approach, if successful, would have the effect of diversifying Canada’s regional security partners, providing extra assurances given the instability of traditional alliances.
“Canada could offer to collaborate on joint research missions in exchange for China modifying its terms within trade pacts.”
Some will object to such proposals on grounds that China is not a trustworthy actor and that providing openings to engagement will inevitably result in their being leveraged to nefarious ends. Certainly, there is a real risk of economic espionage or politically-motivated debt trapping stemming from China’s actions in the region. However, the fact is that China is already heavily invested in the Canadian economy, most prominently in communications technology and natural resources. It is better to offer an open hand for engagement, with the necessary protections in place, so that future Chinese actions in Canada’s Arctic will be on terms that we control. Such a stance also provides a better guarantee of future security by reducing grounds for conflict, given the difficulties facing NATO.
There must also be investments in the viability of Northern communities from an economic and social perspective. The security of Canada’s Arctic will only be viable in a long-term sense if the communities most affected are both internally secure and feel meaningfully attached to Canada as a whole. The federal government must therefore pursue a more collaborative relationship in terms of both defence and economic development with Indigenous communities in the relevant areas. This is partially a matter of increasing meaningful community attachment to Canada, and therefore allowing actors such as the Canadian Rangers to perform their intended “eyes and ears” function. As well, greater federal investment could head off sovereignty risks stemming from investments by overseas actors in Arctic infrastructure related to natural resources. Defence investments must be properly leveraged to create local economic opportunities and greater efforts must be made to ensure a military presence more reflective of, and sensitive to, local culture and demographics. Developing a more collaborative relationship along these lines will also allow Canadian policymakers to benefit from local knowledge when engaged in long-term planning.
The upgrades to the CFS Alert base, announced in August, 2018, and the service weapons of the oft-neglected Rangers are a good start in terms of concrete security investments. However, these are part of only one piece of what should be seen as a tripartite plan for the Arctic. Investments to maintain and upgrade a physical military presence are important so as not to have sovereignty unduly eroded. They are not a singular solution, though, and need to be paired with pragmatic engagements with relevant international actors (especially those we may not get along with in other respects) and with investments in the human security and sustainability of local communities.
The context of Arctic security has too often been framed as pure matter of military force projection. This sort of thinking reflects an antiquated understanding of the challenges Canada faces in the Arctic and fails to consider the economic and human dimensions of the security environment. John Diefenbaker once famously outlined a vision for the Canada’s North as a dynamic, essential part of the national project. Sadly, for a variety of reasons, this vision was left unrealized with its implementation plans highly truncated. For the sake of both security and prosperity, the time to revisit and revise this vision, considering changed global circumstances, is now.
Carter Vance is a recent graduate of Carleton University's Institute of Political Economy whose work has appeared with such outlets as the Carnegie Council for Ethics in International Affairs and The Smart Set. He has worked as a policy analyst and researcher for governmental and non-profit entities in Canada, the United Kingdom and Indonesia.
Fitting Military Tactics to Strategy: The need for a Canadian approach to ‘operational art’
— Rebecca Jensen, PhD candidate, University of Calgary’s Centre for Military and Strategic Studies
Over 12 years, the Canadian military involvement in Afghanistan cost 162 lives, more than 10 times as many wounded, and $18 billion in direct costs. While the tactical capabilities of the Canadian Armed Forces were widely praised, it is unclear what benefit Canada or Afghanistan realized for this steep investment of blood and treasure.
“Operational art” is the term used in defence circles to describe the alignment of tactical accomplishments with strategic ends, since tactical victories alone, as coalition forces have learned in Afghanistan, do not ensure success. The development of a more rigorous approach to operational art in the CAF would help to shrink the gap between tactical accomplishments and strategic stagnation in future conflicts, particularly in coalition missions involving stabilization and development elements.
Operational art connects tactical activities to strategic objectives. Principle elements include the coordination of tactical efforts in space and time to achieve national goals, as well as the balancing of resources and risk. Fighting as part of a coalition, and in complex contingency operations that include elements of stability operations and conventional warfighting, makes the practice of operational art more difficult, as it increases the factors shaping inputs, the environment, and desired outcomes. In particular, it requires coalition members to account for, if not balance, coalition and national objectives, which may differ or even be at odds with each other.
The Canadian army adopted much US thinking about operational art in the 1980s. Confronted by a conflict in Afghanistan very different from that for which it had trained, the CAF reacted similarly, grafting American doctrine and perspectives onto the army’s existing thought and practices. Given the need for rapid adaptation in Afghanistan within an US-dominated coalition effort, this graft made had a pragmatic logic to it, but in the longer term, it is no substitute for the development of organic Canadian thought on the planning and conduct of war.
The publication of Land Operations by Canada’s director of army doctrine in 2008 represented an important step in that direction. Crucially, it recognized the complexity of wars like Afghanistan, and the centrality of relationships with other services, nations, and agencies. However, the emphasis on particular end states, and the dualism implicit in the siloing of fires and influence operations, which take place on the physical and psychological planes respectively per the manual, is reductive and linear. When termination criteria include objectives as subjective and complex as a “stable and legitimate host government,” the military can more helpfully plan for progress toward that state than be charged with achieving a particular result. While some military activities will be more concerned with influence than maneuver and vice versa, it is similarly unproductive to prompt the military to be aware of the physical and psychological planes. Not only are the moral and the material affected by any action, they are frequently irreducibly interconnected.
“A particularly Canadian operational art would allow the CAF’s contributions to coalition efforts to be more effective.”
Further, while Land Operations is written to enhance interoperability and mutual comprehension with major partners, particularly American, British, and Australian forces, it lacks awareness of the substantial historic, strategic, and cultural differences among these states and Canada. The US will be the major partner in most foreseeable Canadian military missions, and understanding its perspective on operational art (and being able to work within that framework) is vital. Of necessity, though, US planning involves expeditionary capabilities, the ability to fight in two or more theatres simultaneously, and human, financial, and hardware resources orders of magnitude greater than those available to Canada. American air and sea capabilities are also significantly more developed, such that the effects-based approach in US doctrine is developed around those domains to an extent not possible for Canadian forces.
The British and Australians have less dramatically different militaries, but the former is in close proximity to one major potential theatre if the NATO-Russia conflict escalates, while the latter is a regional power able to act autonomously in nearby conflicts. Neither is true of Canada. At the most abstract level, these differences may not lead to substantial divergence in operational art among these militaries. When it comes to the application of doctrine to military operations, significant differences in resources, strategic imperatives, and institutional culture become more relevant. A particularly Canadian operational art would allow the CAF’s contributions to coalition efforts to be more effective, while playing to and enhancing the strengths of Canada’s military.
Canada has never deployed its military except as part of a greater alliance, a situation that is unlikely to change. Much recent work on coalition warfare emphasizes the danger to overall mission accomplishment from divergent strategic priorities and cultures amongst coalition members. The usefulness of a junior partner to a coalition, though, is a function of its interoperability and its quality. A Canadian school of operational art must enhance interoperability with partners leading a coalition. To increase the quality of the Canadian contribution, though, it must reflect Canadian strategic priorities, institutional culture, and the capabilities of the CAF, while contributing to coalition’s objectives.
Finally, an effective Canadian school of operational art must address the harmonization of military and civilian capabilities. The conflicts in which the CAF are likely to fight will involve significant elements of stabilization and development, in which the CAF can best serve as a partner or facilitator, not the sole or even major agency in the effort. Many factors contributed to the disappointing outcome in Afghanistan, but the lack of coherence in the civilian and military components of operations there was one factor. Clear thinking and guidelines about the role for the military in civilian led development and humanitarian activities will increase the effectiveness of Canadian military and civilian efforts, and make them together more than the sum of their parts, rather than working at cross-purposes.
Rebecca Jensen is a doctoral candidate at the University of Calgary’s Centre for Military and Strategic Studies, and a dissertation fellow at Marine Corps University.
Fragile States: Still a major threat to Canadian security and defence
— Elikem Tsamenyi, PhD candidate, Dalhousie University
A cursory look over today’s international security landscape reveals a multiplicity of complex security threats facing Canadian interests. Obvious traditional state-based security challenges form only an aspect of the multifaceted nature of the current security setting. There are other, less obvious but indeed severe security threats that are no longer in the news but that also pose serious challenges to Canada’s security: state fragility in the developing world.
Discussions on fragile states are often limited and specific to North and sub-Saharan Africa because the region has a disproportionately high number of states considered to be fragile. These fragile states pose tangible security and stability issues for Canada’s interests here at home and abroad. A proactive, sustained and long-term engagement with both African partners (specifically the African Union, or AU) and other allies is therefore the best way to effectively tackle state fragility and its resultant security problems.
What does state fragility mean exactly? It refers to a state that is particularly vulnerable to both internal and external shocks, with high susceptibility to political, social and economic crisis. It describes states in distress which generally lack the ability to function effectively. Accordingly, fragile states are characterised by economic misery, corruption, poor rule of law and generally weak security. They are therefore largely unstable, with a divided population within a weak and fractured social fabric. In spite of progress by many states in Africa since achieving independence, several others continue to struggle with issues of state weakness and fragility. This is reflected in numerous security and stability challenges including civil wars, domestic and international terrorism, international crime and massive refugee crises. Examples include the Democratic Republic of Congo (DRC), Central African Republic (CAR), Libya, Mali, Malawi, Somalia, Sudan and South Sudan.
Within these fragile states, the mixture of tenuous social structures and weak institutions results in poor governance, porous borders (allowing free flow of illicit drugs and weapons), unrepresentative political institutions and vast ungoverned spaces which are susceptible to capture by violent, non-state actors and criminal groups. Consequently, fragile states face increased risks of legitimacy crises, civil strife and political instability. These effects are evident in Mali, Somalia, Libya, etc., with the emergence of violent actors that directly challenge and compete for state power, leading to massive displacement of citizens.
Why must Canada be concerned by state fragility in faraway Africa? Fragile states are indeed not only lethal for their citizens and immediate neighbours; they represent a threat to world peace and stability. The problem of state fragility in Africa affects Canada’s security interests. Canada’s security is closely linked to international security in the same way its economy is closely connected to the global economy. The effects of the massive refugee crisis from disintegrating, fragile states, as well as the increasing threats and activities of radical extremist groups, affect Canadian interests at home and abroad. The fact that illegal border crossings into Canada by foreign nationals seeking asylum quadrupled from 459 per night to 2,351 between 2017 and 2018 shows just one example of how trouble from failing states in far flung parts of the world can quickly become a Canadian issue. Consequently, Canada must rightly perceive the issue of state fragility as a challenge for domestic and international security.
There are short and long term solutions. In the short term, Canada can contribute significantly towards UN and AU peace building and peacekeeping efforts in Africa. This is crucial because the UN is overstretched and the AU and other sub-regional bodies do not possess the requisite resources in the face of increasing indifference of other global powers. Canada stands in a unique position to contribute meaningfully to peace building in Africa because it is without the usual ‘colonial baggage’ associated with other external actors and so is considered a much more trustworthy partner.
Current trouble spots on the continent (DRC, CAR, Mali, the Horn of Africa, Libya, the Lake Chad region) must, as a necessity, be resolved. Ottawa should commit to resolving these on-going conflicts in Africa as a short-term goal. This would require an even greater commitment to true partnership building by investing in efforts that “rely on the UN and continental organizations to handle crises and conflict [situations]” in these weak and failing states. In the interim, efforts have to be directed toward curtailing impacts of current conflicts in Africa. Indeed, this approach is not new to Canadian foreign policy, but it has in recent times fallen out of favour with policy makers. With significant in-roads onto the continent’s troubled spots by extremist groups including Al-Qaida in Africa, ISIS, Boko Haram, and Al-Shabaab, who are poised to continue exploiting these unstable conditions, the stakes could not be any higher for global security. Thus, Canada’s recent efforts toward re-engagement with the African continent (starting in Mali), after almost a decade of diminished interest, have been lauded as welcome developments for organizations and governments in Africa.
“Canada stands in a unique position because it is without the usual ‘colonial baggage.’”
Issues of state fragility obviously cannot be addressed overnight. In the longer term, Canada’s security policies should be directed towards capacity building aimed at real economic and political development in Africa. The main proposal here is to induce state stability in trouble spots in Africa by the securitization of development. Securitization of development here simply refers to the need to put a security lens on development assistance Canada provides to African states. Through this lens, Canadian foreign assistance to Africa would have to be based on security imperatives deduced on a case-by-case basis (as a ‘one size fits all’ approach which treats all fragile states as identical, may not be effective in these circumstances). Canada would therefore require a coherent, long-term policy focusing on conflict prevention, early warning and effective response to conflict. A fruitful area would be investment in the training and capacity building of African peacekeeping practitioners and forces. Institutions such as the Kofi Annan International Peacekeeping Training Centre (KAIPTC) offer such training, but lack adequate logistical and financial backing. This could be a fruitful area for Canadian influence.
For real impact, Canada must incorporate evolving, context based challenges with deep, long-term local partnership in its approach to tackling African state fragility. Such partnerships must aim to support strengthening home-grown institutions geared towards anticipating and responding to conflict situations. Accordingly, efforts by the AU to tackle conflict and insecurity on the continent can be augmented by Canada’s sustained financial, logistical and technical support. Accordingly, helping the AU build capacity, train its peacekeeping forces, help with defence planning, command and control, and generally assisting with the construction of a capable African security regime, would be an ideal starting point. This requires a consistent African policy from Ottawa that transcends inter-party politics (independent of any political party controlling Parliament Hill), and perceives Africa’s security ultimately as an investment in Canadian security. These proposals may generate skepticism (rightly so) from most Canadians, especially after Canada’s role and experiences in Afghanistan. The good news in Africa however is that, the AU, since 2002, has started to take real ownership of African security and development challenges and so with real support and commitment of capable partners such as Canada, there is cause to be optimistic.
Originally from Ghana, Elikem Tsamenyi is a current PhD candidate in the Department of Political Science at Dalhousie University. He is interested in issues of African development & security governance mechanisms.
Canada should broaden its ‘grey zone’ defences
— Marshall Palmer, PhD candidate, Norman Paterson School of International Affairs, Carleton University
As revelations continue to emerge concerning the depths of Russian interference in the domestic politics of Western democracies, Canadians should take stock of our own vulnerability to foreign meddling.
Indeed, signs of Russian interference are already present. A United States congressional probe, released in 2018, found that the Kremlin-affiliated ‘Internet Research Agency’ sought to inflame the debate surrounding the construction of the Keystone XL pipeline. Another study revealed a wider Russian focus on Canada. Twitter-bots spread rumours and stoked hysteria around the 2016 Quebec City Mosque shooting, the issue of asylum seekers, and Ottawa’s policy towards Syria. Even Canadian sport was targeted, with bots tweeting false information about athletes refusing to stand for the national anthem at NHL games, mirroring a similar (but real) controversy in the National Football League.
It is Canada’s good fortune that these efforts remained a side-project for the Kremlin, and that their impact was negligible. However, as the consequences of Russian interference in the 2016 US election become increasingly appreciated, Canadian officials have found it essential to prepare a robust defence.
Russia acts this way because it has an intense interest in sowing discord between members of the North Atlantic Treaty Organization (NATO). It also aims to individually weaken NATO members by the stoking the flames of internal dissent. As an authoritarian state, Russia is additionally threatened by the transnational appeal of liberal democracy. By exacerbating political relations between and within democracies, Russia hopes to showcase to its own population the necessity of an authoritarian political system.
To achieve these goals, Moscow acts in the ‘grey zone’ of state competition. This is an area outside the realm of acceptable interstate relations but below the threshold of armed conflict. It can cover light propaganda efforts, of the type seen in Canada, to more systematic attempts to sway elections, like that experienced in the 2016 US presidential election. At its most extreme, it can include outright criminal interference, bribery, blackmail, and even assassination. By exploiting both technical and social vulnerabilities, these operations shape the political environment towards a certain outcome. At the moment, Russia is the main practitioner of grey zone operations, but adversaries that could appear on the horizon — China, for example — will certainly be keen on using similar methods. Indeed as long as our American ally remains the predominant military force on the planet — and it will be for some time — our comparatively weaker adversaries will continue to compete in the grey zone.
“As long as our American ally remains the predominant military force, our adversaries will continue to compete in the grey zone.”
The good news is that Ottawa has already begun to confront this problem. Canada’s latest defence policy, Strong, Secure, Engaged, identified the grey zone as an emergent security threat. Canada’s Communications Security Establishment (CSE) published its own study of ‘influence operations’ in mid-2017. The report found that Canada is not immune to cyber intervention, identifying the media, political parties, and individual politicians as especially vulnerable. The report furthermore concluded that ‘it is highly probable that cyber threat activity against democratic processes worldwide will increase in quantity and sophistication over the next year, and perhaps beyond that.’
Both documents outline important steps towards countering grey zone threats, and the government has taken this issue seriously. The 2018 budget devoted hundreds of millions towards bolstering our defences. The high levels of Canadian society will therefore be primed and on the lookout for foreign intervention ahead of the 2019 election and beyond.
Unfortunately, however, these efforts do not fully cover all of our bases. Both documents reflect the bureaucratic biases of their sponsoring establishments, leading them to neglect focusing on vulnerabilities within one other key constituency often targeted by grey zone campaigns: society at large. As the CSE acknowledges itself in its conclusion, grey zone operations are often successful because they “take advantage of deeply rooted human behaviours and social patterns, and not merely technological vulnerabilities.” A proper defence must address this critical social element, not only among elite organizations but within wider society.
What makes this vulnerability so challenging is that it is organic. It exists independent of foreign actors, although it is easily exploitable by them. It is rooted within cognitive flaws relating to how humans process information and construct belief. Consider the growing numbers of people who buy into conspiracy theories, like anti-vaccination or the emergent QAnon theory in the US. Material like this — which divides governments from the people — is a ripe target for foreign actors. And indeed Russia is already taking advantage of the opportunity.
A forward-thinking resiliency policy must therefore tackle the tendency within society that allows fringe conspiracy theories to reach politically significant levels of followers or even become mainstream. It has to include an educational component, designed to better how the next generation approaches incoming information. A greater emphasis needs to be placed in teaching techniques of critical thinking. This must be combined with top-down efforts to shed light on the origins and potential biases of online sources, and on the agendas of state-owned media, like Russia Today. Such an approach would foster a resilient citizenship, one inoculated against the threat of destabilizing domestic populists and foreign actors seeking to take advantage of them.
Canada is geopolitically blessed to be surrounded by three ocean-sized moats and to have our only land neighbour be simultaneously the most powerful state on the planet and our closest ally. Unlike other states, we do not face major traditional threats. Yet because of this advantage, our adversaries will attempt to weaken us in untraditional ways. Operations in the grey zone will almost certainly increase in the coming years. Our nation is prepared to defend our elite institutions, but a comprehensive defence must also focus on building an organic resiliency towards the type of natural but flawed thinking within society that makes us a target in the first place. Canada is lucky to have been forewarned of this vulnerability. The supreme responsibly of government demands a robust and generational response to this most pressing defence and security challenge.
Marshall Palmer is currently completing his PhD at the Norman Paterson School of International Affairs at Carleton University. He is a former NATO security analyst and holds degrees in International Relations from the London School of Economics and the University of Oxford.
Time for Canada to invest in global health security
— Jesse Kancir, public health and preventive medicine resident, University of British Columbia
The importance of health security to Canada cannot be overstated. Whether it is antimicrobial resistance, bioterrorism, or the spread of disease from global transportation and migration, there is enormous potential for significant human, social, and economic impact. Consider, as an example of the seriousness of health security threats, that the Spanish Flu in 1918 ravaged populations by killing upwards of 50 million people, estimated to surpass the 40 million deaths over the entirety of World War I. One hundred years later, the threats of health security are increasing and need to be considered as a critical, ongoing defence challenge.
While Canada’s experience with Severe Acute Respiratory Syndrome (SARS) in 2003 led to a massive re-organization and strengthening of national public health infrastructure, pandemics do not respect jurisdictions and require a collaborative international approach to preparation and response. On this front, current global public health infrastructure is weak. To help mitigate these threats in the twenty first century, Canada should commit to increasing overseas development assistance focused on threat response, training of an appropriate health workforce, and in strengthening global public health and primary care systems.
ODA and global leadership
Canadian overseas development assistance (ODA) stands as the lowest percentage of GDP overall among G7 countries, fuelling a report by the House of Commons Standing Committee on Foreign Affairs and International Development for an increase in funding of ODA to 0.7 of gross national income by 2030. Simultaneously, eventually-abandoned budgetary cuts in the United States to Center for Disease Control (CDC) funding for 2019 has shown how dependent the global health community is on the institution. Channelling more financing to projects in the Global Health Security Agenda (an international partnership of governments, IGOs, and NGOs dedicated to health security) would lessen the dependency on the US in a time when the country’s willingness to participate in multilateral institutions is lessening. A focus on health security as a foreign policy objective would also strengthen Canada’s image as the current federal government looks to develop a more active leadership role in global affairs.
Health workforce training and health system strengthening
Strengthening the public health workforce is a critical way of improving responses to infectious disease outbreaks. Out of SARS was born the Public Health Agency of Canada’s Canadian Field Epidemiology Program, which has the ability to specifically train a global work force focused on detecting and responding to acute health threats. Further, the diplomatic spat in 2018 between Canada and Saudi Arabia with threats of withdrawing Saudi medical residents from Canada revealed just how much capacity there is in our system for training international medical graduates. Over time, were medical schools and federal and provincial funders willing to do so, Canada could help train an international health workforce in public health, infectious diseases, and primary care able to respond to emerging threats in high-need countries, rather than selling these seats to high-paying foreign governments. Canadian medical education — considered an international gold standard — could be used to significantly improve health security.
“Were medical schools and federal and provincial funders willing to do so, Canada could help train an international health workforce.”
This training capacity could also be focused on health system strengthening. Strengthening of health systems is critical to preventing pandemics and improving responses. Untapped strengths in this area might include Royal College International or the Besrour Centre, both international branches of the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada, respectively, with an aim of advancing specialty and primary care globally. Combined, focusing on both workforce development as well as health systems could powerfully advance the health security agenda, drawing on unique Canadian strengths.
Implications for local and global equity
Finally, committing to health security internationally would come with a particular responsibility to act domestically, as well. With tuberculosis rates in Northern Canada 300 times that of other Canadians, focusing on disease outbreak would surely require the federal government to meet its pledged targets of 2030 for eliminating tuberculosis. It remains a blot on our national healthcare conscience that rates of a treatable disease like TB could remain so high amongst us. Health security, then, is also a matter of domestic reconciliation. This final point reveals the importance of health security as an important tool for advancing equity, especially among the world’s vulnerable. Disease disproportionately affects the poor, and focusing on health security ultimately is a matter of justice.
The opportunities for leadership in global health security are many. So, too, are the threats. SARS, Ebola, H1N1: disease outbreak since the beginning of the twenty first century has repeatedly taught us the importance of advancing health security. Viruses will mutate, bacteria will become resistant, and pandemics will significantly threaten population health. Reducing the potential impact of an outbreak, however, is a choice, and should be a critical focus for Canada.
Jesse Kancir is a public health and preventive medicine resident at the University of British Columbia, with graduate training in health economics from the LSE, and in public policy from the University of Cambridge. He has previously served as policy advisor to former Minister of Health Jane Philpott, and served on the boards of several national medical organizations, including the Association of Faculties of Medicine of Canada and the Canadian Medical Association.