Canadian Institutes of Health Research officially launched by Royal Assent replacing the Medical Research Council

The timing is a little off, but the Canadian Institutes of Health Research (CIHR) is now a reality having passed through both the House of Commons and the Senate before receiving Royal Assent on April 14. Coming two weeks after its projected start date, the official creation of Canada's new vehicle for funding medical and health research caps a dizzying two-year campaign to transform the way in which the medical research community interact with the health care system, the economy and society at large.

More money, a diversity of players, greater expectations and a looming crisis in health care are all conspiring to raise the bar for the CIHR. The new body is slated to receive ever increasing funding over the next several years to $500 million on top of funding currently received by the Medical Research Council (MRC). In the meantime there's a phenomenal amount of work to do, assembling talent, establishing structures, developing programs and initiating research projects that live up to the lofty ideals CIHR's creators have attached to it.

Speaking at a recent dinner celebrating the 40-year legacy of the MRC, Dr Henry Friesen, the MRC's president and the architect behind the vision, described CIHR as a "preposterous idea". And it likely appeared so to many in government and the medical community when it was first publicly floated in the spring of 1998. During that presentation, Friesen credited Dr Louis Siminovitch and Dr Charles Hollenberg with the original conception, and Dr Calvin Stiller with making the first initial breakthrough in government acceptance of doing things differently.

There were many others who played pivotal roles, but the CIHR is clearly Friesen's creation, having marshaled it through months of divisive debate and intense brokering as chair of its Interim Governing Council (IGC). It caps his 10-year tenure as head of the MRC and he is now handing over the reins to another leader who will be selected through a competitive process in the coming months. The presidency has attracted 25 nominations which was whittled down to a short-list and handed off to the Minister of Health and the Prime Minister's Office for final consideration. The 20-person governing council drew an astounding 400+ nominations. Friesen will stay on as chair of the IGC until the new appointments are made and he will then return to his native Manitoba. He has been asked to sit on the board of Genome Canada and rumours abound that he may actually become its chair.

"I'm looking forward to a more leisurely-paced lifestyle," said Friesen in an interview with RE$EARCH MONEY. "I will be associated with the University of Manitoba and I will try to be helpful to the research community with a high level of advice and support. My 10 years with the Medical Research Council were good years and difficult years. It's nice to finish when the trajectory is up."

Institute creation an urgent priority

Institute creation has been a particularly high priority for the IGC, which has spent several months gathering the views and preferences of the public, and the health and research communities. The IGC has assembled its recommendations and it will be up to the new governing council to choose the focus of the 8-12 institutes that will get the CIHR ball rolling.

"Let's start modestly. It's far easier to extend than contract," says Friesen. "There's been a considerable convergence of views on what the institutes should be."

With the creation of CIHR and the financial commitment made to date, government funding of medical research in Canada is growing at a faster rate than the US, UK and France, further bolstered by a commensurate increase in provincial funding. But Friesen contends it must go much higher if Canada is to develop the research capacity required to build a truly world-class health system and industry.

"A one billion CIHR is possible and defensible," Friesen stated in his MRC legacy dinner speech - an amount determined by allocating 1% of health care costs to medical and health research. "Speed wins," he asserted, adding that the challenge to the new governing council is to demonstrate sufficient progress by the fall of 2001 to give the Minister of Health ammunition to convincingly argue for increased funding.

In an address at the same event Health minister Allan Rock said that health research funding will be double 1998 levels by FY01-02 and that $500 million is merely a "point of departure" if the institutes can prove themselves.

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