CIHR seeks 76% budget boost to realize long-standing target for health research

1% of $170 billion in health care costs

The Canadian Institutes of Health Research (CIHR) is seeking a major boost to its current budget to implement a new strategic plan that runs from 2010 to 2015. CIHR president Dr Alain Beaudet says the health research agency's budget needs to grow to $1.7 billion over the next five years— a 76% increase equivalent to 1% of the current $170-billion tab for health care in Canada. The plan is slated for release this week.

Such an increase would allow a greater emphasis on fundamental and translational research, international collaboration, new programs targeting post-doctoral students and new investigators and areas requiring special attention (chronic diseases, Aboriginal health, dementia).

The budget ramp-up — if approved — would occur over the duration of the plan and support CIHR's objective of making the Canadian health research environment more dynamic and fully aligned with national social and economic priorities. .

"I'm totally convinced that the economic rebound is linked to the knowledge economy and that's where we have to invest. Now is the time to invest in science," says Beaudet, who succeeded Dr Alan Bernstein last year to become the organization's second president (R$, March 27/08). "My aim is to go for at least 1% and 1% is $1.7 billion. With that money we could implement a patient-oriented research strategy, we could be international leaders in Alzheimer's research and lead an international coalition, we could have proper support for young investigators and the proper level of support for our (research) stars."

The 1% target is a longstanding objective stretching back to the inception of CIHR and beyond. Among those who have championed the 1% target are Dr Henry Friesen, president of CIHR's precursor, the Medical Research Council, Conservative senator Dr Wilbert Keon as a member of the Standing Senate Committee on Social Affairs, Science and Technology and Alan Rock in his capacity as Health minister in government of Jean Chrétien.

CIHR's strategic plan — the first since its formation in 2000 — establishes four directions (see chart) built upon the four pillars of health research: biomedical, clinical, health systems and services. The overarching blueprint will be augmented by annual implementation plans to demonstrate progress on how objectives are being met.

post-doc support

For the upcoming Budget, CIHR is making several requests to support what are considered the key thrusts of the new strategic plan. That includes new programs to support post-doctoral students, young and new investigators entering the CIHR system for the first time, more substantial support for so-called star researchers to allow them to compete competitively on the international stage, and leadership of an international consortium focused on Alzheimer's. Funds will also be requested for an overhaul of CIHR's suite of commercialization programs including proof-of-concept funding.

"It's an older program but we want to re-vamp it, make it more nimble and put more money into it … We're really upstream so it's a question of gestation and making sure that people are aware of the importance of doing that (proof-of-concept). There are all sorts of ways to do that and get partners on board," says Beaudet. "We can't do everything at the same time so in the next five years we've identified five priorities and these priorities will be the areas where we will be launching strategic initiatives."

The need to provide greater support for those in advanced post-secondary training has prompted CIHR to propose additional support for post-doctoral students. Beaudet says the first task is to distinguish the different training required for doctoral and post-doctoral students and craft a program that meets the needs of those in the final stages of preparing for a career in health research.

"We've done very well particularly for masters and and doctorates but we are not doing enough to attract post-docs in this country both from Canada and abroad," he says. "Post-docs are absolutely integral to the health research enterprise. You can't get a job in academia in health research without a post-doc ... We're talking about running a lab, being able to write review papers and grant applications, manage people and human resources and manage the money that goes with it — all things that are the preparation for running your own show."

Beaudet says CIHR would also like to look at its peer review system with the view to making it more responsive to researchers entering the system and those proposing breakthrough research programs. While the peer review system is working well, he says there's always room for changes to make it more effective at supporting excellence in all areas that comprise the four pillars of the health research enterprise.

"We should develop a means to support out-of-the-box thinking and innovation better than we do ... We tend to invest more in incremental research than breakthrough research because it's easier to do and because of a certain inherent conservatism," he says. "We believe in peer review. It's not perfect, it's human and I still think it's the best system but you have to make sure it works extremely well."

Perhaps one of the most promising aspects of the new strategic plan is its emphasis on interdisciplinarity and international collaboration. The plan places greater emphasis on interaction with the other granting councils as well as organizations such as Genome Canada, Canada Foundation for Innovation, Canadian Health Services Research Foundation and the International Development Research Centre.

On the international front, CIHR wants to follow up its collaboration with California-based stem cell researchers and participation in the Global Health Alliance for Chronic Diseases with a major initiative into Alzheimer's disease and related dementias.

"We'll need new money for that ... I'm getting countries on board and they are responding incredibly favourably," says Beaudet. "They realize that by tackling it together it will go faster and further and there's going to be a lot of savings by investing jointly. They're ready to put money on the table so if I want to be credible I have to be able to put money on the table as well."

R$