James Brooks

I am the Director of the AMR Division within the Centre for Communicable Disease and Infection Control at the Public Health Agency of Canada. I have worked as an infectious disease consultant for 20 years and am currently a Lecturer in the Department of Medicine at the University of Ottawa. In 2004, I joined the public service to study emerging retroviruses with the goal of protecting the blood supply. Specifically, post Krever Inquiry, I developed a test for simian viruses that could be transmitted from monkeys/apes to humans. During my early work in the federal government, I demonstrated infection of humans with simian retrovirus and championed the development of deferral policies for blood donation. While chief of the National Laboratory for HIV Genetics, my team introduced new testing technology that was adopted globally through collaboration with the WHO. In response to the Ebola epidemic in West Africa, I was deployed on two occasions to a mobile Ebola diagnostic laboratory. Currently I direct a national AMR/AMU surveillance with integration of antimicrobial stewardship and IPC programs. Revisiting my original interest in emerging viruses, I am now conducting SARS-CoV-2 surveillance in wastewater with partners at the National Microbiology Laboratory. I remain clinically and academically active in the Department of Medicine at the Ottawa Hospital.

I have worked in academia, clinically and for a provincial public health unit. During my career within the public service, I have experienced both the best that the federal government can offer and also some of the challenges. Developing an international, mandate driven program for HIV drug resistance testing is an example of the opportunities that exist within a federal government organization. This program was successful because of support from senior management and relative independence from shifting peripheral policy decisions. Developing and deploying this program required courage from senior management to allow scientists to collaborate and grow.

Challenges in the public service, and PHAC specifically, is chiefly related to the loss of strong medical leadership. When I was part of LCDC, the management stream for public health was established with physicians who had trained and practised in medicine and then chose a career in public health. Post H1N1 there has been a steady decline in physicians – especially those with clinical depth – from the Public Health Agency. Some of this change was due to retirements but much of this attrition was active in response to a change in philosophy within the public service. The division between policy experts and technical experts became the rule for most programs within of the Agency. The lack of respect for expertise, and the failure to mentor strong medical leadership at the program level, has created a void within the Agency. Looking forward, I believe that there is an unprecedented opportunity for renewal in the health portfolio within the government. Now is the time for growth and leadership of health groups to ensure that organizations within the government are prepared for the next health emergency.