CIHR ramps up pace of organizational change while continuing to push for long-term funding commitment

While the Canadian Institutes of Health Research (CIHR) continues to press the federal government for a long-term funding commitment, it is making profound changes to its governance structure and activities to better encompass the grand experiment in health research launched 16 months ago. Armed with a far broader mandate than its predecessor, the Medical Research Council, the aim is to marshal the enthusiasm of health researchers and its various stakeholder groups, and to establish a collaborative and integrated national health research agenda upon which to build.

In a textbook case of form following function, structural change is all pervasive at CIHR as the new agency adapts to the new approach conceived for Canadian health research.

During a late-summer retreat of its governing council, agreement was reached in a variety of areas, ranging from strategies and priorities to issues of evaluation and accountability (see chart). Also approved is a strategic outlook document produced by CIHR president Dr Alan Bernstein which outlines four key areas designed to focus the strategic initiatives of CIHR’s 13 institutes over an 18-month time horizon. The document will be released in the near future.

In an interview with RE$EARCH MONEY, Bernstein explains that CIHR is at the centre of a remarkable period for Canadian health research and must make the necessary changes to harness its benefits socially and economically. But to achieve its objectives, he asserts that the time is ripe for the government to follow through on its commitment to the so-called $1-billion solution — allocating 1% of the cost of health care to health research.

“Health research is experiencing a scientific revolution. Two tectonic plates are colliding and CIHR can play a catalytic role,” he says. “I still feel strongly that CIHR and the research community have a three-year rolling budget. That was my understanding in taking the position,” he says. “As Canada gets more interested in the government’s innovation agenda, we have to go beyond 12-month pieces…Research agencies make three- to five-year commitments and we have a major cash flow problem that will only be solved by increasing our budget.”

CLINICAL RESEARCH CENTRE OF EXCELLENCE

One of the most significant initiatives now under discussion is the creation of a Centre of Excellence in Clinical Research, which would serve as a mechanism for attracting, supporting and retaining clinical researchers across the health spectrum. Budget dependent, the program would provide for infrastructure needs beyond what CIHR typically covers and has particularly high potential in areas such as pharmacogenomics and gene-based diagnoses.

“We know how do to it but we need the facilities. In the area of early-stage clinical trials Canada is under represented,” says Bernstein. “It would be expensive and support things such as databases and support staff, by providing what currently falls between the cracks.”

BLOCK TRAINING GRANTS

Another major program now in development is a training initiative in which block training grants would be awarded to a group of investigators. Explicitly targeting capacity building in health research, the training program would provide grants of $300,000-500,000 for a six-year period at a cost of $10-15 million annually. CIHR would contribute approximately $4 million while the individual institutes would secure the balance from stakeholder partners.

The first round of competition is now underway, with 150 full applications being considered. Provincial, charity and industrial partnerships are being lined up at the national level and a start date for the program is anticipated next spring.

“Up to now, there has been funding for students, fellowships and grants for principal investigators. The downside of that approach is that it loses the programmatic aspects. They’re not strategic or interdisciplinary,” says Bernstein. “Block training grants are like a hunting licence to go out and get the very best. It allows the best teams to recruit the best young people from around the world. We hope this will leverage international support.”

Less dynamic but no less important is the internal re-organization of CIHR. Recommendations of an Organizational Steering Committee have been accepted and are now being implemented to provide the agency with a structure to support its mandate. The new organizational design is focused on three broad portfolios: research, knowledge transition, partnerships and communications, and organizational affairs. Bernstein says the simpler structure will help in overseeing CIHR’s constellation of 13 research institutes by endorsing a networking model that acknowledges that it is a virtual organization with many partners.

“Darcy Thompson, the evolutionary biologist, was the first to state that form follows function, and form at CIHR has to change. The staff is getting energized and we hope to complete the process by next July,” says Bernstein. “The portfolio leaders are in place and now we need to get control of our activities. The mindset is changing.”

CIHR is also working to integrate a new part of its mandate — knowledge transition. The governing Council has asked that a framework be developed, taking into consideration communication and branding issues, as well as the four key objectives outlined in the forthcoming strategic outlook document.

“The surge in hunger for new science has policy makers reeling from the new technologies and their cost,” says Bernstein. “There are a lot of issues around knowledge transition and it’s part of our mandate which the Medical Research Council never had.”

CIHR will also be holding a national summit with universities next spring, to discuss a national integrative health research agenda and explore how integrative research can be aligned with academic incentive systems and career advancement.

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