Publications

2018
Flood, C.M., et al., 2018. Universal Pharmacare and Federalism: Policy Options for Canada, Montreal: Institute for Research on Public Policy. PDF
Gopinathan, U. & Hoffman, S.J., 2018. Institutionalising an evidence-informed approach to guideline development: progress and challenges at the World Health Organization. BMJ Global Health. Article
Hoffman, S.J., 2018. How King St. pilot project is improving our health. The Toronto Star. Article
Hoffman, S.J. & Bernstein, A., 2018. Fighting the flu: We need a new kind of intelligence. The Globe and Mail. Article
Hoffman, S.J., Rogers Van Katwyk, S. & Baral, P., 2018. Monitoring Global Progress on Addressing Antimicrobial Resistance: Analysis report of the second round of results of AMR country self-assessment survey 2018, Geneva, Switzerland: World Health Organization (Food and Agriculture Organization of the United Nations, World Organization for Animal Health, World Health Organization). PDF
Habibi, R. & Hoffman, S.J., 2018. When Obstacle Becomes Opportunity: Legalizing Cannabis in the Context of the United Nations Drug Control Treaties. Ottawa Law Review.
Groux, G.M.N., Hoffman, S.J. & Ottersen, T., 2018. A Typology of Scientific Advisory Committees. Global Challenges. ArticleAbstract
The era of evidence‐informed decision‐making has seen increased use of the scientific advisory committee (SAC) to provide decision‐makers with scientific advice, despite limited evidence of the effectiveness or best strategies for designing these committees. In this study, an in‐depth review of academic and gray literature is undertaken to outline the global landscape of SACs. The development of a typology is also undertaken that categorizes SACs along six dimensions: 1) sector, 2) level of operation, 3) permanence, 4) target audience, 5) autonomy, and 6) nature of advice. It is found that SACs differ profoundly in each of these dimensions and provide examples demonstrating this variation. The landscape and typology can help decision‐makers understand the key elements of SAC design and reform, and the results will also inform future research on the design and effectiveness of SACs. With SACs expected to promote evidence‐informed decision‐making, it is imperative that the design of these committees themselves is guided by evidence.
Fafard, P., et al., 2018. Contested roles of Canada’s Chief Medical Officers of Health. Canadian Journal of Public Health. ArticleAbstract
The roles and responsibilities of Canada’s Chief Medical Officers of Health (CMOHs) are contested. On the one hand, they are senior public servants who confidentially advise government on public health matters and manage the implementation of government priorities. On the other hand, CMOHs are perceived as independent communicators and advocates for public health. This article analyzes public health legislation across Canada that governs the CMOH role. Our legal analysis reveals that the presence and degree of advisory, communication, and management roles for the CMOH vary considerably across the country. In many jurisdictions, the power and authority of the CMOH is not clearly defined in legislation. This creates great potential for confusion and conflict, particularly with respect to CMOHs’ authority to act as public health advocates. We call on governments to clarify their preferences when it comes to the CMOH role and either amend the relevant statute or otherwise find ways to clarify the mandate of their CMOHs.
Gopinathan, U., et al., 2018. Global governance and the broader determinants of health: A comparative case study of UNDP's and WTO's engagement with global health. Global Public Health. Article
Rogers Van Katwyk, S., Jones, S.L. & Hoffman, S.J., 2018. Mapping Educational Opportunities for Healthcare Workers on Antimicrobial Resistance and Stewardship Around the World. Human Resources for Health . Article
Hoffman, S.J. & Cole, C., 2018. Defining the Global Health System and Systematically Mapping its Network of Actors. Globalization and Health. Article
Fafard, P. & Hoffman, S.J., 2018. Rethinking Knowledge Translation for Public Health Policy. Evidence and Policy. Article
Nixon, S.A., et al., 2018. Canada’s Role in Global Health: Supporting Equity and Global Citizenship as a Middle Power. The Lancet. Article
2017
Hoffman, S.J., 2017. Canada should not legalize cannabis until it withdraws from the UN Drug Control Treaties. Centre for International Governance Innovation. Article
Hoffman, S.J., 2017. Canada Should Not Legalize Cannabis Until It Withdraws from the UN Drug Control Treaties. Centre for International Governance Innovation. Article
Rogers Van Katwyk, S., et al., 2017. Government policy interventions to reduce human antimicrobial use: protocol for a systematic review and meta-analysis. Systematic Reviews , 6 (256) , pp. 1-10. PDFAbstract

Background

Antimicrobial resistance (AMR) is a recognized threat to global public health. Increasing AMR and a dry pipeline of novel antimicrobial drugs have put AMR in the international spotlight. One strategy to combat AMR is to reduce antimicrobial drug consumption. Governments around the world have been experimenting with different policy interventions, such as regulating where antimicrobials can be sold, restricting the use of last-resort antimicrobials, funding AMR stewardship programs, and launching public awareness campaigns. To inform future action, governments should have access to synthesized data on the effectiveness of large-scale AMR interventions. This planned systematic review will (1) identify and describe previously evaluated government policy interventions to reduce human antimicrobial use and (2) estimate the effectiveness of these different strategies.

Methods

An electronic search strategy has been developed in consultation with two research librarians. Seven databases (MEDLINE, CINAHL, EMBASE, CENTRAL, PAIS Index, Web of Science, and PubMed excluding MEDLINE) will be searched, and additional studies will be identified using several gray literature search strategies. To be included, a study must (1) clearly describe the government policy and (2) use a rigorous design to quantitatively measure the impact of the policy on human antibiotic use. The intervention of interest is any policy intervention enacted by a government or government agency in any country to change human antimicrobial use. Two independent reviewers will screen for eligibility using criteria defined a priori.

Data will be extracted with Covidence software using a customized extraction form. If sufficient data exists, a meta-analysis by intervention type will be conducted as part of the effectiveness review. However, if there are too few studies or if the interventions are too heterogeneous, data will be tabulated and a narrative synthesis strategy will be used.

Discussion

This evidence synthesis is intended for use by policymakers, public health practitioners, and researchers to inform future government policies aiming to address antimicrobial resistance. This review will also identify gaps in the evidence about the effectiveness of different policy interventions to inform future research priorities.

Rogers Van Katwyk, S., Jones, S. & Hoffman, S.J., 2017. Mapping educational opportunities and resources for health-care workers to learn about antimicrobial resistance and stewardship, World Health Organization. PDF
Lamontagne, F., Hoffman, S.J. & et al, 2017. Evidence-Based Guidelines for Supportive Care of Patients with Ebola Virus Disease. The Lancet online-first. ArticleAbstract
The 2013–16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive care to patients admitted to Ebola treatment units. Key recommendations include administration of oral and, as necessary, intravenous hydration; systematic monitoring of vital signs and volume status; availability of key biochemical testing; adequate staffing ratios; and availability of analgesics, including opioids, for pain relief.
Tejpar, A. & Hoffman, S.J., 2017. Canada’s Violation of International Law during the 2014–16 Ebola Outbreak. Canadian Yearbook of International Law , 54 , pp. 1-18. Abstract
Hoffman, S.J. & Prado, M.M., 2017. The Concept of an International Institutional Bypass. Special Issue of the American Journal of International Law , 111. PDFAbstract
The rapid proliferation of international institutions has been a defining feature of the postwar international architecture. Since the end of the Second World War, the international system has seen the creation of thousands of international treaties and organizations that have established rules governing a multitude of issues that range from international security to human rights, and from international trade to the environment.

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