CIHR seeking firm funding commitment as momentum builds at Canada's premier health research funding agency

After just six months of operation, the structure and direction of the Canadian Institutes of Health Research (CIHR) has taken a giant leap forward with the appointment of 13 scientific directors (SDs) to head up its fledgling Institutes. The SDs were chosen from a field of 130 candidates and were immediately charged with developing strategic plans in conjunction with their respective stakeholder communities and advisory boards, which will be named within weeks.

With the announcement of the SDs, the CIHR is generating rapid momentum that requires a clear and expeditious commitment of future funding support by the federal government if it is to be properly sustained and exploited. With just over one year remaining in its initial three-year funding envelope, the Institutes are about to embark on strategic initiatives that will extend years into the future. Yet the long-term planning required to achieve the ambitious goals established for the CIHR will be more difficult without an indication of funding levels.

With the new FY beginning April 1/01, CIHR will have a budget of approximately $480 million at its disposal, up $110 million from this FY and roughly double the budget of the Medical Research Council (MRC) three years ago. The federal government has indicated that it is prepared to fund the organization at much higher levels, but has yet to provide details.

"Growing our budget to what (Health) minister (Alan) Rock has said publicly several times now - $1 billion, the 1% solution - that's still the reasonable, necessary and responsible target," says CIHR president Dr Alan Bernstein.

"What we have to do now is get a commitment from government beyond April 1st (2001) so that these strategic initiatives will grow at the national level, competitive funding will grow and our broadened mandate will be realized... It would be wonderful to know as soon as possible what our budget is going to be in FY02-03 and FY03-04, then our council could plan appropriately. What you don't want to do is start a program and then have to stop it or shrink it back. That's not what Parliament had in mind with this bold transformative vision."

In a wide ranging interview with RE$EARCH MONEY, Bernstein outlined the first steps in the realization of CIHR as the central engine for Canadian health research. That involves moving beyond the model of its predecessor - the MRC - to one with many more players engaged in new types of relationships intended to make health research more integrative, relevant and effective. He says Canada has never had the appropriate collaborative, science-driven vehicle to launch strategic initiatives involving the traditional medical research community working with a wide range of other disciplines, as well as the provinces, private sector, voluntary health sector and others.

CIHR's evolution is also occurring at a time when an unprecedented number of new funding bodies have appeared on the health research landscape. And it's happening in the midst a new era in health research globally with an accent on multidisciplinary activity at a much larger scale than in the past. "The big, hot new area are increasingly going to involve big teams. The blurring between investigator initiated research and strategic initiated research is going to continue," says Bernstein. "It's a pooling, a sharing, and strategic decision-making about where it makes sense (to put resources), rather than get dragged into it after the fact. This is happening internationally and we should be increasingly proactive."

KEY SENIOR ADVISORS

To ensure that CIHR becomes a vibrant, dominant player with the capability of overseeing and coordinating the growing number of players in the field, Bernstein has appointed several experts with key horizontal responsibilities. Dr Charlyn Black is already in place as a senior advisor in the areas of knowledge transfer and knowledge management, developing complementary research activities between CIHR, the Canadian Institute of Health Information and other relevant players. She will soon be joined by Dr Reneé Lyons, who has been appointed as an advisor on rural health and rehabilitation research issues. Other senior advisors will soon be added in the areas of ethics and international issues, and others will be announced as the organization builds its operational and policy capacity.

"What I'm hoping is to stir the pot in these areas. In some ways, not having Institutes devoted to these areas makes them even more important, because they're not segregated off," says Bernstein. "It's a new century, the science has changed and that's why I agreed to take this position. I think this is the right time to do this kind of integrative approach to health research."

With a current staff complement of slightly more than 100, CIHR will also be adding new positions increasing the depth of its policy capacity, as well as bolster the personnel devoted to strategic partnerships. But Bernstein says the immediate priority is th get the Institutes up and running so that strategic initiatives can be launched.

"I'm an experimentalist and I think the best way we will learn how to run CIHR is to make mistakes, to actually do it and see what works and see what doesn't, rather than sitting back and developing strategic plans for the next six months," he asserts "Let's go. There's a pent-up demand there that I think we can realize."

Beginning April 1, each Institute will receive $3.5 million, with approximately $1 million devoted to operational requirements and the remainder is meant as "an initial installment" on strategic initiatives. Bernstein says the funds represent about six months worth of funding, with additional funds to be released late in 2001. To start, each Institute will receive exactly the same amount of funding, although each is free to seek partnership contributions.

"There are clearly differences in the size of the research communities but these are our 13 children and we love them equally," he says. "They're all the same age and they should get the same allowance. It eliminates the politicking that would go on. They can augment their budgets with partnerships of course, and they will."

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