In June 2006, the Canadian Institutes of Health Research (CIHR) made public the Year 5 - International Review Panel Report, 2000-2005 prepared by the International Review Panel (IRP), which conducted CIHR's first external review.
The Panel applauded CIHR for what has been accomplished to date, noting that Canada is setting an example to the world. Indeed, the announcement, in March this year, of the intent to reorganize funding arrangements for health research in the U.K., is testimony to the compelling vision of CIHR. Not surprisingly, many of the Panel's observations echoed comments that we receive time and again from researchers, for example about the complexity and number of our programs and the consequent strain on the peer review system.
Given the complexity of the issues raised by the Panel's observations and the potential impact on CIHR's stakeholders, I indicated in my first message on this subject (June 28, 2006) that we would take the time necessary to deliberate and reflect on each of the observations before taking action. I also assured you that in developing our response, we would be seeking broad input.
During its August 24-25 Retreat, Governing Council (GC) had the opportunity to reflect at length on the IRP's observations. CIHR's senior management and Institute Scientific Directors also had the opportunity to review GC's discussions, as well as discuss and propose possible changes to the current structure, at the September Research Priorities and Planning Committee (RPPC) meeting.
We recently initiated discussions with the research community about some of the steps we are contemplating to respond to the Report's observations. I met with the Chairs and Scientific Officers (SO) of our peer review committees on September 27, 2006, as part of their annual meeting. I sought their views on the following issues: how to improve Peer Review, solutions to our financial constraints, including the possibility of shifting to a single Open Competition a year. Details follow below:
It seems inescapable that, given this important role played by SDs in creating a strategic vision for CIHR and their emerging role as advocates for both Institutes and related panels, SDs should now be given further responsibility to oversee the panel activity in their scientific area. It would also seem reasonable that a future role for SDs might be to form the core of the central committee replacing the Research Priorities and Planning Committee (RPPC) responsible for the allocation of the whole research budget. Such a committee would resolve the important outstanding issue of accountability and responsibility for funding decisions and its alignment with the strategy endorsed by the GC.
(Year 5 - International Review Panel Report, 2000-2005, p 30)
One important direction suggested by the IRP was the creation of a single research and knowledge translation (KT) committee to account for all research-related decision-making within CIHR, including allocation of the budget. The IRP also suggested that Governing Council devolve some of its responsibilities down to this new Committee.
GC has had the opportunity to reflect on these observations at length and determined that the creation of a single research and KT committee is the right direction for CIHR. They have asked CIHR management to establish this new Committee, which would be responsible for overseeing both CIHR's open grants and strategic programs, including knowledge translation.
Work is currently underway to define the terms of reference for this new Research and KT Committee (RKTC), which will combine the work of the current Standing Committee for Oversight of Grants and Awards Competitions (SCOGAC) and Research Priorities and Planning Committee (RPPC) in one body.
The bridging of the divide between the Institutes and CIHR's open competitions will be an important step forward in creating a more integrated approach to all of our research and Knowledge Translation programs.
An explosion of new initiatives, new panels and new funding streams has also put a very considerable pressure on the peer review system and we were told that researchers are now suffering from significant review fatigue. Ensuring that panels are supplied with high quality and senior scientists is apparently proving difficult and the changing of panels due to potential conflicts of interest makes these problems even more difficult. The small size and short duration of some grants, the establishment of a large number of new grants committees and the presence of committees that see few proposals suggests that the peer review system is perhaps not being optimally managed. There appears to be no open and transparent process for the establishment of new panels, nor does there appear to be clear criteria or process for their evaluation and, in the event that a particular panel is no longer needed, how this decision is to be reached. There have been many new panels established and none eliminated in the past six years.
These challenges associated with the peer review panel system illustrate some of the current risks associated with rapid growth and increased complexity. It would be timely for this important activity within the CIHR to be reviewed and possibly restructured.
(Year 5 - International Review Panel Report, 2000-2005, p 23)
The Research and Knowledge Translation Committee (RKTC) will need to tackle fundamental issues to address quickly the strain on CIHR's peer review system, an area of improvement suggested by the IRP. Much work has been done, and continues to be done, to improve the current CIHR Peer Review system. That work is important, but, in my view, "tweaking" the system will likely get us only so far. I believe that, as a community, we must begin a serious exploration of alternative approaches and consider the possibility of more profound changes. I am not advocating any particular approach, only that it is imperative that we now begin a dialogue about the sustainability of our peer review system.
During the recent Chairs and SOs meeting, we began a discussion on how CIHR's Peer Review System might be achieved. As we move forward, it is important to remember that peer review is absolutely key to identifying those grant applications that are addressing the most exciting and important questions, and that have the highest likelihood of achieving their objectives. At the same time, peer review is only a means to an end: our ultimate objective is not just excellence in peer review, but excellence in the research and Knowledge Translation that we fund.
One far-reaching change that we have only recently begun to consider is a transition to a single, annual operating grant competition. With a single competition, CIHR would be better positioned to streamline peer review, improve planning and budgeting and better integrate with targeted programming.
Such a move would, of course, reduce the number of opportunities for funding through CIHR but would not reduce our total investment in operating grants. We realize that this is not a decision to be taken lightly. However, from a peer review perspective, re-review of unsuccessful grants re-submitted only days after decision from one competition to the next have become an increasing reality.
Obviously, this would be a very significant decision and we must make it with full input from the community on the pros and cons from all perspectives. CIHR's senior management and Institute Scientific Directors are currently reviewing options, including transition plans and impacts.
The Chairs and SOs meeting is the first public forum in which I have raised this possibility. We need to hear your reactions early in our deliberations. I invite you to share your thoughts on this and on other solutions you might have to meeting the challenge of increasing demand, pressures on the peer review system, and how best to support Canadian health research.
Simultaneously with examining the Operating Grants Program, we have also been discussing the need to better integrate targeted programming, streamline our planning and budgeting and focus on larger and fewer initiatives. I invite your comments on the number and range of RFAs currently available to the research community and your suggestions of ways of focusing our RFA opportunities.
CIHR has been funding infrastructure (equipment, research resources and maintenance) in an inconsistent manner over the past years. This unpredictability has caused growing unease in the research community and has caused budgeting and planning difficulties at CIHR. This issue was discussed at the last RPPC and there was agreement that CIHR needs to implement a consistent strategy for equipment funding. This strategy will be developed in the coming weeks and shared with the research community.
Your engagement is all the more important as we enter a period where the growth in CIHR's budget may be slower than it has been over the past six years and where application pressure - with increasing numbers of applications and in the ever-increasing quality of the applications - is expected to continue to far outstrip CIHR's ability to keep pace.
As I have stated many times in discussions with the research community, while CIHR has received steady and remarkable increases in its budget since our inception six years ago, federal appropriations to CIHR has not yet reached the one billion dollars mark. As such, with much of our money tied up in forward commitments, and a budgetary increase in 06-07 that was less than the cost of inflation, there is precious little new money for new grant proposals and renewals.
Next year (07-08), we are not planning for a significant budget increase, and so the constraints on our ability to fund the number of grants and their dollar value will remain. Without a significant budget increase from the federal government in the next fiscal year, we will have available only about 2/3rds of the funds for new investments compared to what we have this year. It is clear that some difficult decisions will need to be made. We need your guidance, advice, and support as we begin to define our approach to meeting this challenge.
Finally, I cannot emphasize enough the importance of your engagement in reporting publicly on the value of health research. As researchers, we have an obligation to report to Canadians about the research we are conducting and how it is contributing to building a stronger Canada. I encourage you to contact your local MP to inform them about your CIHR research and how you are making a difference in what matters to Canadians.
I encourage you to thank them for their support over the past six years and for their continued support going forward. Despite our current financial constraints, it's well to remember two things: First, CIHR's direct base budget has increased from $275M in the last year of the MRC (1999) to $723M in 2006/07. As well, if university indirect costs now associated with CIHR research support are also included (they are in the U.S. NIH figures) the direct and indirect support for health research through CIHR has increased from $275M in 1999 to $825M in 2006, a 3-fold increase in just 7 years. And second, as a result of this increase, the number of investigations now being supported by CIHR has more than doubled. Most importantly, the quality and impact of the health research now being carried out - from yeast proteomics to wait times to palliative care research to clinical trials on diabetes prevention - Canadian health research is increasingly having impact on the global scientific health community, on Canadians and the Canadian economy. Tell MPs about how CIHR support is allowing you to make discoveries, advance science and knowledge, provide new insights and understanding into health, the prevention of disease, the strengthening of Canada's health care system, the development of new public policy, or economic growth.
Everything we know about knowledge-based economies, global competitiveness, productivity and health, tells us that investments in research are one of the wisest, efficient, and most prudent investments any society can make. Only governments will fund the long term research that eventually lead to more effective health delivery, new treatments, new public awareness, and new jobs.
As we begin this next exciting phase in the evolution of CIHR, I invite you to share your thoughts on all of the issues that I have raised, as well as any others that are of concern. We would also appreciate any feedback on communications with your local MPs. We would appreciate receiving written comments sent to the VP Research Office at VPResearch@cihr-irsc.gc.ca by noon on Tuesday, November 21st, 2006.
Good luck in your research!
Dr. Alan Bernstein, O.C., FRSC
President, Canadian Institutes of Health Research
