In November 2002, a deadly new disease known as severe acute respiratory syndrome (SARS) appeared in Guangdong, China and, by February 2003, it had spread to five continents. Over 8,000 people worldwide were stricken and 774 died. Although in Canada researchers quickly sequenced the coronavirus responsible for the disease, 44 Canadians died, as it mainly infected health care workers and their families. Centred in Toronto, Canada’s largest and most multicultural city, the outbreak demonstrated not only the continuing importance of strong local public health disease control measures but also the potential for conflict between the federal and provincial governments. As the three reports on the outbreak indicated, effective communication and clear lines of activity are essential to combatting contagious diseases. But the outbreak also revealed the impact of health service cuts in the 1990s and the lack of health care personnel available to respond to crises. In response to the reports, the federal government created the Public Health Agency of Canada. Begun in 2004 as a junior ministry of state, the unit now reports to the Minister of Health. The Agency is responsible for communicable disease control and emergency preparedness, pandemic planning, health promotion and chronic disease prevention, injury prevention, and public health practice and regional organization.