Building from a Blueprint

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By Patricia Nicholson

The Canadian Institutes of Health Research (CIHR) (Ottawa, ON) has released the strategic plan that will direct its activities over the next five years.

Known as the Blueprint, Investing in Canada’s Future: CIHR’s Blueprint for Health Research and Innovation recognizes the importance of health research to Canada’s economic growth, as well as to the well-being of Canadians.

“We deliberately made it an ambitious plan both in terms of science and also in terms of the funding required, because as a country I think we need to set ambitious plans for where we want to be in science, technology, commercialization. I think that’s been one of our shortcomings as a nation,” says CIHR president Alan Bernstein, PhD.

“We haven’t had a Nobel Prize in medicine since Banting and Best almost 100 years ago now. So I think we need to set our sights high, and we need to reach out and attract young people, people from abroad. And the only way you do that is, I think, with exciting science and exciting plans and visions of where you want to go.”

The Blueprint is intended to guide CIHR’s shift from its initial role as a granting agency to its new capacity as an internationally recognized health research agency.

“That actually was part of the vision for CIHR going back to when we were created — that we wouldn’t simply be a granting council. So the creation of the 13 institutes as part of the family of CIHR I think is a representation of that shift,” Bernstein says. “They don’t review grants at all. Their role is to create communities under their mandate and to develop strategic plans and strategic initiatives.”

He uses the CIHR’s ability to react to the SARS outbreak as an example of that difference.

“A granting council, I would submit, wouldn’t know how to respond to that. A granting council would say, well, we’re waiting to receive some grants, and we’ll review them in good time,” he says.

“Whereas we issued an RFA through our Institute of Infection and Immunity and asked for proposals within a week, and reviewed them and sent out the notices on the Web four days later,” Bernstein explains. “So we’re funding the major vaccine groups, the antivirals and the diagnostics team. And that was done in a total of 11 days after we decided we needed to do something and found some money to actually do it.”

This, he says, is a big change compared with the way the CIHR’s predecessor organization, the Medical Research Council of Canada (MRC), was able to respond to health crises.

“Going back to the ’80s when HIV/AIDS broke out . . . the MRC actually had some difficulty being proactive about HIV/AIDS,” Bernstein says. “I think we’ve learned a lot in the last three years about what does it mean to be a research agency, to be proactive as opposed to being reactive.”

That change is partly due to the changes in the nature of health research over the past decade.

“There are so many things now that require much more planning from the top down because of their costs, because of the number of different people involved, because of the nature of the science,” Bernstein says.

He adds that although a lot of top-down planning is required, the system also works from the other direction.

“Going back to my SARS example, the research community was actually pressuring me to do something. That’s a sea change from what happened — or what would have happened — with HIV/AIDS 10 or 15 years ago . . . the odd person would have gone into it out of interest and gradually over 10 years you’d build up a new community. But there wasn’t a kind of sense of either responsibility or opportunity,” Bernstein says.

The transformation of the research climate includes “the change in the sort of sociology of the research community, a change in our mandate, a change in sensitivity and awareness of all of us about being responsive,” he says. “I think there’s just a general sensitization to what’s relevant to society’s needs — it could be SARS, it could be commercialization — right across the whole waterfront.”

The Blueprint establishes five broad strategic directions for the next few years:

- strengthening Canada’s health research communities;
- addressing emerging health challenges and developing national research platforms and initiatives;
- developing and supporting a balanced research agenda that includes research on disease mechanisms, disease prevention and cure, and health promotion;
- harnessing research to improve the health status of vulnerable populations; and
- supporting health innovations that contribute to a more productive health system and prosperous economy.

Some of the goals of the strategy are to achieve outstanding research, to develop and sustain excellent researchers in innovative environments, and to transform health research into action and innovation that will strengthen health care and contribute to economic growth. Knowledge transfer and commercialization of research are significant parts of the plan, Bernstein says.

“In Blueprint, we call for a doubling. Actually, I think it’s more than a doubling if you fold in neighbouring programs that relate to those commercialization activities,” he says of funding for knowledge transfer.

“The distinction between doing fundamental science and doing science that starts you down the commercialization pipeline is blurring,” Bernstein explains. “If someone finds a disease gene in a lab that we’re funding — we fund a lot of that kind of work — and then they want to find a molecule that affects the activity of the protein that’s coded for by the disease gene. Is that fundamental research, or is that actually the first step to commercialization and finding a drug?

“I would submit it’s both. And that’s a change. Again, 10 or 15 years ago there was a real gulf between what you did in an academic lab and what companies did. And I think increasingly — at least at the biotech level — there’s almost a complete blurring,” Bernstein says, adding that many of CIHR’s programs are designed to address both needs. He uses the Proof of Principle Initiative as an example.

“The proof of principle program has been received extremely positively by the research community, by the tech transfer community at universities and hospitals and by the venture capital community,” he says. “So that program — we’ve been running it now for two years — has been great in terms of allowing researchers to add some value to their discoveries both from a scientific point of view, but also, obviously, to add value before they go out to raise venture capital. And if it does both — to me, that’s exactly what I want to see.”

Commercialization of research is a theme that has become more prevalent in recent months, even emerging in February’s speech from the throne. Bernstein credits that attention to the major investments the federal government has made in research over the last seven years.

“It’s a sea change and it has been fabulous. And — I think reasonably — now they want to see a return on that investment,” Bernstein says. “They’ve never done it as charity; they’ve done it as an investment. So I’m not surprised, I think it’s appropriate, and I think it’s our role and the research community’s role and the universities’ and hospitals’ role to respond to that.”

Commercialization, though, must work in tandem with a strong research pipeline, Bernstein says.

“One of the things I’ve stressed here in Ottawa: you’re not going to get good commercialization — and certainly a biotech industry — without a world-class scientific community,” he says. “So I think we’d be shortsighted to lose sight of the fact that we have to continue to invest and build up a really world-class research activity.”

Those conditions are part of the reason Canada is now viewed internationally as a country to emulate, Bernstein says.

“Five years ago we were all pointing to the U.S. as what we should be doing,” he says. “I was at a meeting in Sweden on funding for medical research, and I think the rest of the world has decided they’re never going to catch up to the U.S. level of funding. So who’s the next best model of funding? It’s Canada now. I was quite struck just by the reaction of the European countries to my presentation. They were just so blown away by what we’re doing as a nation, how we’re doing it, what’s the payoff so far, how it’s working. We are definitely viewed as the model in the world.”

CIHR is awarding $580 million in health research grants in 2003/04 — more than double the amount of its awards budget in 1999/2000, its first year of operation. The Blueprint calls for an increase in CIHR’s total budget from $621 million in 2003/04 to $1 billion by 2007/08. Bernstein says the Blueprint is a long-term plan, and that he can’t predict when its funding goals might become reality.

“I’m not sure how much — if any — we can expect in this budget given the fiscal situation. I’m looking over the long term. We’ve had a spectacular growth over the last three-and-a-half years. So the last year of the MRC in 1999, its budget was $260 (million). Our budget three-and-a-half years later now is $620 (million). It has been spectacular,” Bernstein says. But he adds that there is still work to be done.

“It’s not where it should be at the end of the day. I want it to continue to grow toward that billion, but this is a long-term thing.”