Canada’s Public Health systems have long been characterized by the “Boom & Bust” cycle of crisis-induced investments followed by sustained budget cuts. As a result, they were severely underprepared and under-resourced in responding to the COVID-19 pandemic. This research aims to generate evidence to support the adoption of sustainable Public Health system financing models. Our case study analysis compares a province with sustained Public Health funding (British Columbia) to one that has sharply reduced its funding over the past decade (Nova Scotia). We conducted jurisdictional reviews, drawing on academic and grey literature, to compile information on Public Health expenditure trends and a description of the Public Health budget-setting processes. We also interviewed key informants involved in various stages of the decision-making process in each province.
Appropriate funding is required to rebuild Public Health systems post-pandemic and strengthen preparedness for future public health emergencies. Yet evidence suggests governments will likely continue prioritizing short-term responsive policy over longer-term, upstream solutions. Our study aims to inform future reforms by identifying sustainable models of Public Health financing.