Seite - 165 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

165Good Governance: Institutions, Processes, and People Medical Officers of Health [CMHOs]); those responsible for coor- dination (for example, Cabinet committees); and those that deliver accountability (for example, parliamentary committees). Of course, there is much overlap in function across these three. Federations such as Canada, Belgium, the U.S., and Switzerland have the advantage of experimentation across provinces and cities but also experience the friction costs of collaboration.3 While each juris- diction may be sovereign in its own domain, complexity necessitates some measure of coordination. Inter-jurisdictional operations and sharing of information requires informal, relationship-based meta- institutions to facilitate exchange and joint delivery. Although the federal system may be fractured and fragmented, these institutions of collaboration and coordination provide mechanisms of exchanging ideas and delivering collective action in the form of initiatives such as physical distancing measures and income transfers. Operational Organizations There are several operational organizations that are delivering ser- vices like testing and tracing as part of the COVID-19 response. Such institutions include the Chief Medical Officers of Health, Ministers of Health and other portfolios and their Deputy Ministers, the pub- lic service at large, hospitals and their administrators, engineers, front line workers (for example, orderlies, nurses, and doctors), as well as Canadian Blood Services and HemaQuébec, and pan-Cana- dian health organizations such as the Canadian Institute for Health Information and the Canadian Agency for Drug and Technologies in Health. These institutions are essential to ensuring success in fighting a pandemic. Prior to SARS, federal public health authorities were located in Health Canada and other departments such as Agriculture Canada. The SARS post-mortem identified the need to draw together public health functions from across government to form the relatively independent Public Health Agency of Canada (PHAC).4 We have been 3. For a constructive view of federalism, see David Robitaille, this volume, Chapter A-4. For a more contrarian and cynical view, see Amir Attaran & Adam R Houston, this volume, Chapter A-5. 4. National Advisory Committee on SARS and Public Health, Learning  from  SARS:  Renewal of Public Health in Canada, by David Naylor et al, Catalogue No H21- 220/2003E (Ottawa, ON: Health Canada, October 2003).