LEADERS’ FORUM REVEALS NEED FOR INNOVATION IN HEALTH RESEARCH

By The Leaders’ Forum Steering CommitteeWhen 120 health research leaders gathered in Ottawa, Ont. this past fall for the two-day Leaders’ Forum for Health Research in Canada, the importance of innovation — and in particular, the potential of biotechnology — emerged as a key theme.

The Conference Board of Canada defines innovation as “a process through which economic or social value is extracted from knowledge through the generation, development and implementation of ideas to produce new or improved products, processes and services.”

To stay on the cutting edge of innovation, Canada’s health research enterprise faces many critical challenges, including more effective partnerships and more funding.

There are many constituencies within the health research community: government research agencies, hospital-based health research institutes, regional health authorities, universities, health charities, scientific societies, private industry, health professional and research advocacy groups. Representatives of these different constituencies agree they need to work together more efficiently and effectively.

“The federal government has seeded many programs in the last five to six years, and increased its investment many-fold,” says Sally Brown, executive director and CEO of the Heart and Stroke Foundation of Canada (Ottawa, ON). “Now we need to look at the whole picture — the interactions among and between these programs. We need to co-ordinate infrastructure investments with capacity building in people, and also co-ordinate direct operating support for research in both of these areas.”

“The value of innovation and research must be understood,” says Russell Williams, president of Canada’s Research-based Pharmaceutical Companies (Ottawa, ON). “To ensure support, we will need to build networks and employ communications strategies to instil passion.”

Krista Connell, CEO of the Nova Scotia Health Research Foundation (Halifax, NS), agrees.

“Partnering will produce the best results,” she says. “Through partnering, we can better understand complex issues and produce better programs.”

The need for greater collaboration is closely tied to funding issues. Although health research in Canada has enjoyed average annual increases of 21 per cent over the past five years, for Canada to remain competitive internationally, all stakeholders must make further financial commitments. At the same time, recipients need to work together better.

“There are too many programs, funding is spread too thin, and indirect costs are rising,” says Michael Julius, PhD, vice-president of Research at Sunnybrook and Women’s College Health Sciences Centre (Toronto, ON). “We’ve made a good start, but we must follow through and develop integrated funding programs that accommodate the full cost of research. Strategic partnerships with the private sector, whose R&D initiatives align with those academic can facilitate achieving this goal and at the same time actually drive discovery.”

The Promise of Biotechnology
Nowhere is the need for strategic partnerships more crucial than in biotechnology.

“About 35 per cent of new drugs are biotech developments,” says Dr. C. Thomas Caskey, CEO and president of Cogene Biotech Ventures (Houston, TX).

“Therapeutics are an important part of our health-care system. Opportunities to develop solutions to problems now exist because we’ve moved into new technologies and have a new set of knowledge. The return on initial investment is low, but if you don’t take action, you lose the opportunity.”

For Caskey, Canada has the potential to be a major player in biotechnology, but it would take much planning, including more strategic alliances. “Many requirements for performance, such as world-class discovery programs, licensing, startup facilitation and resources, reside in the academic community,” he said. “However, academics may not have the management skills. And another necessity — progressive funding — is definitely not available in academia.”

So who is going to write the cheques for licensing and startups? Scientists need to adopt an entrepreneurial spirit, Caskey says. “Every faculty member at MIT has at least one company,” he notes.

Caskey also points out that Canada trains many international scientists, who return to their home countries. “Why can’t Canada do the same thing?” he asks. “Why can’t you recruit Canadian scientists who have been trained abroad?”
Caskey argues Canada should follow Ireland’s lead by expanding and centralizing the search for corporate development facilities. It should conceive and implement a formula for venture capital-administered investment funds.

“What needs to happen,” he says, “is more investment in research in cancer, diabetes and cardiovascular disease.”

Getting the Message Out
“Most policy-makers agree that health research contributes to a dynamic, innovative and cost-effective health system in Canada,” said Dr. David J. Hill, chair of the Council for Health Research in Canada (CHRC) (Ottawa, ON), one of the event’s 24 sponsors.
The problem: most Canadians do not yet see the connection between health research and benefits to the health-care system.
Hill points out that health research has contributed immensely to easing the burden of disease and promoting the well-being of Canadians. It leads to discoveries about the factors that increase the probability of illness or enhance recovery. Canadian researchers, for example, are learning how environmental factors such as air and water quality, as well as social factors such as poverty, unemployment and lifestyle choices, can affect our susceptibility to disease.

“Today’s investments in health research and development are tomorrow’s savings in health-care spending,” Hill says. Estimates show that, for each dollar spent on new medicines, hospital savings amount to $4.44. Investments in health R&D in Canada provide the necessary resources to fight the burden of disease on the health-care system. For example, new antiretroviral medicines have significantly reduced costly hospital expenses associated with HIV/AIDS.

Canadian health R&D also generates significant economic returns through licensing revenues (estimated at 16 cents per dollar spent on health R&D), and plants the seeds for new private companies, which can attract and retain highly qualified personnel.

“Polls show that Canadians place a high value on health, the health-care system and economic and social prosperity,” says Alan Bernstein, PhD, inaugural president of the Canadian Institutes of Health Research (Ottawa, ON) — another of the forum’s key sponsors.

“Health research is at the nexus of all those imperatives. To maintain research excellence, we must bridge the gap between what we know and what we do,” he says.

Hill adds that, “We still have a long way to go, both in terms of funding and capacity building, to ensure health research continues to support discovery, create new knowledge and generate innovation.”

A PLAN FOR ACTION
The Leaders’ Forum for Health Research in Canada wrapped up with concrete steps for action grouped in specific themes:
Develop plans and strategies
     Establish an action group to develop a strategic plan, and create road maps for health research priorities, youth empowerment and funding harmony.
Achieve sustainable,
long-term funding
     Increase long-term funding to health research by advocating for the creative use of the taxation system to increase charitable giving; allocate a portion consistent with international standards (one to three per cent) of health-care budgets to health research; and reorient a portion of profits of private sector for reinvestment in health research.
Harmonize funding
     Establish a co-ordinated and collaborative process across agencies and foundations for streamlining applications and approvals, including uniform rules (or a research technical standard) to encompass common c.v. templates, review processes and ethical frameworks.
Improve regulation
     Establish Canada as the world leader in clinical trials by ensuring the process efficient, effective and ethical. Review the current regulatory framework affecting the distribution and use of new drugs and treatments.
Developing human capacity
     Develop a comprehensive, national health research education and training program (aimed at a variety of audiences including primary, secondary, PhD and MD); initiate a new, multi-pronged approach (involving new policies and programs) to encourage young investigators; change institutional structures to enable trans-disciplinary research, team creation and a seamless approach; treat the need to define a sustainable attractive career path for health scientists from all disciplines as a matter of urgency.
Gaining public and political support
     Link health research outcomes to the health-care system at all levels. Transform the health research agenda from being an expenditure to being an investment.
     Develop a communication strategy and social marketing campaigns by celebrating the successes and value of health research, and by maintaining and sustaining consistent, co-ordinated messaging to all levels of government and the public based on a clear, forceful, future-oriented vision (improve health through knowledge).
     Establish a permanent working relationship with governments through the National Science Advisor to the Prime Minister in accordance with the recent First Ministers’ health accord.
Improve reporting of
outcomes and accountabilities
     Demonstrate the impact and effective distribution of research dollars, through, among other things, the creation of an accountability metric (outcomes, values, indicators).
In addition to specific themes, participants identified the need to establish a national co-ordinating council that would act as a single portal for programs, advocacy and information.
In the wake of the forum, the Steering Committee is reviewing the action plan to propose a strategy. This includes finalizing a vision statement and developing common messages for the health research community.
“The forum was a first step towards creating momentum for action in the health research community,” says Deborah Gordon El-Bihbety, CHRC president and CEO and chair of the Leaders’ Forum Steering Committee. “Now we have to build on the results to make sure they bear fruit.”