The first year: Laying down the foundation
A year of research achievements
Creating synergies through partnerships
Strategic initiatives
Building Canada's new economy for the 21st century
Looking to the future
Dear Parliamentarian,
One year ago, Parliament recognized the importance of a vibrant, internationally competitive and strategic health research initiative. The creation of the Canadian Institutes of Health Research (CIHR) will help realize a vision of health and prosperity for Canadians.
Canadians care deeply about our health care system; it is both a source of national pride and a symbol of national identity. But there is no doubt that our health care system must change, and change profoundly, in order to maintain that pride and identity.
But as surely as we can say our health system must change, so can we assert that, in the coming years, health research will be the major driver of that change. Recent and ongoing advances in our understanding of the human genome, together with our growing appreciation of the complex interplay between genetic, social, and environmental factors that establish our susceptibility to disease, will transform our health care system over the next 10 to 20 years.
By bringing together all four pillars of health research: biomedical, clinical, health services and systems, and population health research, CIHR is taking an integrated approach to the health issues that concern Canadians and creating the knowledge that will transform our health care system and translate into better health for Canadians.
The creation of CIHR positions Canada as a world leader in the international revolution that is making the 21st century "the century of health research".
Over the past year, we have put in place the structures and the programs that are transforming the Canadian health research enterprise. I am pleased, on behalf of the Governing Council of CIHR, to provide you with this publication, the first in an ongoing series that demonstrates the results that are being achieved with public funding. With your continued support, our successes will help make Canada an international leader in ensuring better health for its citizens, a strengthened health care system, and a growing economy.
Alan Bernstein, PhD, FRSC
President, Canadian Institutes of Health Research
The Canadian Institutes of Health Research was officially launched on June 7, 2000. Since then, CIHR has evolved at a rapid pace, beginning with the identification of 13 institutes on July 25, 2000.
Researchers from across the country, and from across the four pillars of health research - basic biomedical, clinical, health systems and services, and population health research - are supported through 13 "virtual" institutes, linked by their common interest in creating new knowledge and pursuing excellence.
CIHR funds more than 5,000 researchers in universities, teaching hospitals, and research institutes across Canada, and supports the training of thousands of outstanding young people in health research every year. CIHR's budget for 2001-2002 is $477 million. This commitment on the part of the Government of Canada will allow Canada to attract and retain its best and brightest scientists and to remain internationally competitive in today's knowledge-based economy.
In December 2000, 13 internationally recognized researchers were named as Scientific Directors of the institutes, charged with developing strategic research agendas to fulfill each institute's mandate. They are assisted in their tasks by the 218 members of Institute Advisory Boards, representing all areas of the health research community, including researchers, research users, the public and private sectors, voluntary health organizations, and patient groups and individual citizens.
Human Stem Cells: Opportunities and Challenges
CIHR is committed to fostering the discussion of ethical issues and the application of ethical principles to health research. Currently, there are no regulations specifically designed to address stem cell research. Canadian researchers need a legal and ethical framework within which they can explore this growing field of health research, an area that holds tremendous potential for treating many serious diseases.
In the fall of 2000, CIHR convened an international team of researchers and ethicists to discuss both the exciting opportunities and the ethical issues around the use of human embryonic stem cells. In March, 2001, CIHR issued their discussion paper and is seeking feedback on the recommendations as a basis for future policy.
Building Canada's Health Research Community
In January 2001, the results of CIHR's first competition were announced. In total, 478 research projects were approved, ranging from large community-linked and multi-disciplinary health research projects, to investigator-initiated proposals, to multi-centre clinical trials and equipment grants. Thanks to the increased funding provided to CIHR, the size of grants in this competition increased by 20 per cent and the number of grants by 10 per cent - just a first step in CIHR's promise to provide internationally competitive support to researchers right here in Canada. Two months later, in March 2001, CIHR awarded 407 training and salary awards to Canada's outstanding and up-and-coming researchers.
A CIHR Profile in Excellence: Dr. Rémi Quirion
As Scientific Director of the Institute of Neurosciences, Mental Health, and Addiction, Rémi Quirion will lead a national effort to support research to enhance mental health, neurological health, vision, hearing, and cognitive function, and to reduce the burden of related disorders through prevention strategies, screening, diagnosis, treatment, support systems, and palliation. Dr. Quirion has made the Douglas Hospital Research Centre, affiliated with McGill University, a premier research facility in Canada in the fields of neurosciences and mental health. His research has focused on understanding the relationships between the abnormalities in the brains of people with Alzheimer's, molecular and pharmacological features of neuropeptide receptors and their role in memory, pain, and drug dependence; and models of schizophrenia. Dr. Quirion also takes a major interest in training the next generation of scientists.
Canadian health researchers have an international reputation for excellence. From François Auger, founder of the Laboratory for Experimental Organogenesis (LOEX) at Laval University, who has grown skin, blood vessels, ligaments, and cartilage in his lab, thereby helping people with severe burns to survive, to the University of Toronto's Martin Yaffe, who has developed a digital mammography machine which gives a clearer image of breast tissue, allowing small tumours and other early signs of cancer to be identified earlier, CIHR-funded investigators have made the research breakthroughs that result in better health outcomes for Canadians.
Today, more than ever, the health problems facing Canadians are complex, and their solutions require a problem-based, interdisciplinary approach. CIHR is investing $80 million over the next five years to support 29 multi-disciplinary research teams. These teams bring together nearly 600 researchers, representing more than 100 institutions and 242 partners in five countries. Here is just a sample of the research discoveries and new ventures of the past year:
Diabetes and Canada's Aboriginal population
A CIHR Profile in Excellence: Alastair Cribb
A CIHR Scholar and member of the Governing Council of CIHR, Alastair Cribb analyzes drugs at the molecular level to find out why humans and animals experience adverse side effects - anything from skin rashes to fatalities. He and his research team at the University of Prince Edward Island are concentrating on sulfonamides, anticonvulsants, and anti-inflammatory drugs in their attempt to unravel the genetic differences between individuals that influence susceptibility to drug and chemical toxicity. He looks forward to a day when people hold "genetic credit cards" to let physicians know the safest and most effective drugs for each patient.
Canada's aging population and rural health
Child health and development
With autism, the earlier treatment starts, the better. About half of all children with autism spectrum disorders (ASD) who receive intense behavioural therapy during their preschool years perform the same as their peers on test scores by school age. Diagnosing ASD is difficult, however, and often doesn't happen until a child is school-aged, when intervention is less effective. An interdisciplinary team of researchers under the leadership of Jeanette Holden, of Queen's University, is attempting to identify genes related to ASD, in the hope that a combination of genetics and early developmental assessments will allow children at risk of developing ASD, because another child in the family has already been diagnosed with autism, to be identified by the time they are six months old. Very high risk infants will be treated to see if this can prevent the development of ASD.
Achieving optimum health and well-being for children is a complex task, requiring input from many different perspectives. Camil Bouchard, from the Université de Québec à Montréal, is bringing together university researchers, medical experts, public health researchers and promoters, stakeholders, and community researchers in an effort to improve the health and well-being of children living in urban, suburban, and rural communities in the Montreal area, and to provide support for local resources and citizens working in those communities.
Injuries, many of which are intentional and most of which are preventable, are the leading killer of young people aged 12-19 in both Canada and the United States. But while considerable attention has been given to preventing typical childhood injuries, the same is not true of injuries specific to youth. The Healthy Youth Community Alliance for Health Research, led by Bonnie Leadbeater of the University of Victoria, is focusing on preventing risks for youth injuries by identifying health risks and by investigating health-promotion strategies designed specially for both normally developing and high-risk youth.
Young people participating in hockey, whether recreational or competitive, are at risk for head injuries, an issue of growing concern for players, parents, and the volunteer and government organizations that support hockey. David Goodman, of Simon Fraser University, is heading a Community Alliance for Health Research directed at reducing mild head injuries by quantifying how often they occur in youth hockey; developing assessment tools and guidelines for return to play; and developing and implementing prevention programs. Their work will have benefits for the health of all youth hockey players, as well as being applicable to other sporting activities such as rugby, figure skating, and snowboarding.
Peter Coyte and his colleagues at the University of Toronto find that children hospitalized with ear infections are much less likely to need further surgery if they undergo a two-part procedure that combines the removal of the adenoid glands and the insertion of tubes into the ears than if they just have tube surgery. Their research could save Canada's health care system more than $300 million each year.
Jacques Drouin, of the Clinical Research Institute of Montréal (IRCM), discovers a gene that, when mutated, causes a hormone deficiency at birth that results in severe hypoglycemia and death in affected children. Affected children can now be identified by molecular diagnostic techniques and rapidly treated with replacement hormone therapy to ensure their normal development.
A CIHR Profile in Excellence: C. May Griffith
As people age, their corneas tend to deteriorate. C. May Griffith is helping people to see again. Dr. Griffith and her team at the University of Ottawa Eye Institute have successfully constructed an artificial cornea, the transparent sheath that covers the eye and protects it from the surrounding environment. While her discovery still needs extensive testing, it could lead to human transplants in the not-too-distant future and could eliminate the need for live animals in testing the toxicity of new drugs and other substances that are potentially irritating to the eye.
A CIHR Profile in Excellence: Patrick Lee
As a highly respected virologist and cancer biologist at the University of Calgary, Patrick Lee has championed the development of reovirus as a potential treatment for cancer. Reovirus, like all viruses, self-propagates and multiplies when it attaches itself to a host cell. With ordinary viruses, they can cause sickness due to infection. Reovirus, though, kills cancerous host cells and leaves healthy cells alone. Using reovirus is a novel approach to treating cancer, and Dr. Lee says he and his team stumbled on it quite accidentally. Human trials of reovirus, in the form of a drug called Reosyn, began in May 2000; if successful, Reosyn could be used to fight malignant breast, lung, and neck tumours.
Women's health
Women who carry mutations in one of the two genes known to dramatically increase susceptibility to breast cancer will be able to make more informed choices about prevention and screening, thanks to a project called INHERIT BRCAs - the Interdisciplinary Health Research International Team on Breast Cancer. The project brings together a team of 16 researchers from seven institutions in Canada and abroad led by Jacques Simard of Laval University to examine the impact of testing on long-term quality of life, how people comply with screening recommendations, and how they utilize the health care system as a result of the testing. The team is also examining concerns related to the legal and socio-ethical implications of genetic testing, including issues of confidentiality and discrimination, such as access to insurance.
Throughout their adult lives, women are more likely than men to experience stress and overwork as a result of their multiple care and work responsibilities. Little is known, however, about how this affects their health. Carol Amaratunga, from Dalhousie University, together with the Maritime Centre of Excellence for Women's Health and the Nova Scotia Advisory Committee on the Status of Women, are leading an innovative and collaborative Community Alliance for Health Research to better understand the connections between women's paid and unpaid work and their health. Their work will encourage innovative approaches to how our society structures our work and caregiving roles.
A CIHR Profile in Excellence: Christiane Poulin
Christiane Poulin calls herself a smalltown doctor with a good sense of community values. As an associate professor of epidemiology and community medicine at Dalhousie University, Dr. Poulin is studying substance abuse among youth at four Nova Scotia schools. She wants to reorient drug education to focus on teaching young people about drug risks, thereby reducing their involvement with harmful drugs. As a medical doctor, Dr. Poulin found she couldn't stop teenagers from abusing drugs. As an epidemiologist, she can address drug addiction at its source. She is also investigating the abuse of ritalin among children.
A CIHR Profile in Excellence: Judes Poirier
McGill University's Judes Poirier was featured on the front page of the Wall Street Journal and named "Neuroscientist of the Year" by Québec Science for his discovery that apolipoprotein E, a protein that transports cholesterol to the brain, is also genetically linked to the most common form of Alzheimer's disease. Dr. Poirier found that 80 per cent of people with sporadic Alzheimer's had low levels of Apo E4, one of the forms in which apolipoprotein exists in the human body. His discovery has made it easier to track people who carry the gene for the most common form of Alzheimer's disease, to better assess their chances of contracting it. He is now testing new drugs that could raise levels of Apo-E in susceptible people. As Dr. Poirier points out, if we could delay the onset of the disease by five years, we would eliminate half the cases.
The creation of CIHR has sparked momentum to develop a national strategic health research agenda that brings together all partners in the health research process. All levels of government, the voluntary health sector, and the private sector are working together to better respond to the health needs and priorities of Canadians. CIHR partners help to identify research priorities and frame the relevant research questions, and they contribute financially to the answering of these questions, building on the Government of Canada's own investment in health research. CIHR and its partners together invest in excellence and transfer the results of new-found knowledge back to the constituencies that each partner serves.
In the past year, CIHR has developed several innovative partnerships:
The CIHR difference lies in making strategic choices and decisions and about taking a directed approach to answer specific questions. Each of CIHR's 13 institutes is charged with developing a strategic research plan that will fill in research gaps and build capacity in its field. Since the Institutes' Scientific Directors were appointed, they have been consulting widely with researchers, research funders, and research users to determine priority areas for Institute Strategic Initiatives. Several Strategic Initiatives are already underway:
A CIHR Profile in Excellence: Tony Pawson
Tony Pawson, a CIHR Distinguished Investigator and Acting Director of the Samuel Lunenfeld Research Institute of Mount Sinai Hospital in Toronto, is one of the world's leading experts in the new science of proteomics, or how our proteins interact to make our bodies function normally. This research will be the foundation for the development of a whole new generation of 21st century drugs. In addition to receiving virtually all of Canada's highest awards for research, Dr. Pawson has received in the past three years alone the Heinecken Prize from the Royal Academy of the Netherlands and the Pezcoller International Award from the American Association for Cancer Research.
CIHR plays an important role in supporting Canada's economic prosperity in the 21st century:
Success in the commercial arena depends critically on research and innovation. Academic research is the wellspring that drives the growth and success of the biotechnology sector.
Public investment is critical to the generation of commercial growth. From training the next generation of researchers, to providing competitive levels of funding and providing the required infrastructure support, to placing resources into technology transfer and intellectual property expertise, public investment is the fuel that powers the engine of job creation and growth in the knowledge-intensive economy of the 21st century.
In Canada, CIHR-funded research has resulted in exponential growth in the life sciences. Today, the life sciences account for 86,000 jobs in Canada, a figure that is forecast to grow to more than 130,000 jobs by 2003. Already, there are more than 100 publicly listed Canadian health-related companies with a market value of close to $15 billion.
Canada's biotechnology sector, the growth sector of the new economy, is the second-largest in the world, in no small part due to CIHR investments. At the University of British Columbia alone, CIHR investments have led to the creation of more than 20 private companies that have created almost 750 jobs for highly trained Canadian researchers and scientists. Among them is Quadra Logic Technologies, which is developing photofrin, an anti-cancer drug that works by sensitizing cancer cells so that they can be destroyed by a safe form of radiation.
One of the most exciting developments in this area has been the growth of Micrologix Biotech. This Vancouver-based company, also a spin-off from a UBC grant, is testing cationic peptides as a way to prevent infections from catheterization, based on the work of Bob Hancock at the University of British Columbia. Some five million catheters are inserted into patients every year. They can be infected even before they enter the body, and can start infections in the body once inserted. With no similar products available, Micrologix's product is being fast-tracked through clinical trials by the FDA in the United States and is expected to be on the market within the next couple of years. In the meantime, Micrologix has grown from one employee to 40, and its market capitalization of $300 million is set to rise ten-fold once the product is ready for market.
Across the country, CIHR investments have led to many more significant commercial spin-offs:
The link between investment in health research and a strong and growing economy is clear. Every $1 million invested in health research creates approximately 60 jobs, while contributing to Canada's success in the knowledgebased economy of the 21st century.
The 21st century is the Century of Health Research, and CIHR is a bold and innovative approach for ensuring Canada is a major player on the international stage. Through our virtual institutes, we are integrating health research efforts to create the greatest possible results for our health research investment.
The first year of CIHR has been an exhilarating combination of establishing structures, involving people in widespread public consultations on health research issues, developing programs, and, above all, supporting the research discoveries that will make a difference for Canadians.
Visit http://www.cihr.gc.ca/ to keep up with the latest health research breakthroughs, and to find out about forthcoming strategic initiatives, new partnerships, and other exciting developments as CIHR continues on its journey to make Canada an international leader in health research.