Ontario scores big with six awards in CFI's Research Hospital Fund competition

$1.1 billion worth of research infrastructure

The Canada Foundation for Innovation (CFI) has announced the winner of its Research Hospital Fund (RHF) more than five years after it was created to deal with a severe shortage of medical research space across the country. Eight infrastructure projects out of a field of 28 applicants were funded with $554.5 million, of which six are located in Ontario (see chart on page 2).

CFI funds 40% of each project, meaning the total value of the research infrastructure funding in the latest competition is worth nearly $1.1 billion, representing the largest single infusion of research hospital infrastructure funding in Canadian history. Yet the size of the competition and the fact that no proposal west of Hamilton was successful indicates a continuing need for this type of funding.

"This is a unique opportunity unless the government decides to allocate (additional) funds ... There were seven or eight other proposals that were highly meritorious and if we had extra funds we would have funded them," says CFI president and CEO, Dr Eliot Phillipson, adding that the absence of any awards in Western Canada is a factor of competition criteria. "The competition is based on excellence and merit. Provincial, institutional and geographic formulas are not part of the consideration."

Ironically, Ontario's success comes despite the provincial government's refusal to provide matching funding for winning proposals. The University Health Network in Toronto received more than $92 million to establish an advanced therapeutics research platform across three hospitals and five sites. The 60% of the project not covered by CFI will be obtained from a variety of hospital and private sector sources.

"It will come mostly from our foundation and through in-kind discounts from suppliers over several years," says Dr Christopher Paige, UHN's VP research. "This is capacity building with a very applied clinical outlook. For stem cell research we will have GMP production facilities for engineered tissues. The scale-up and GMP approach is a research project in itself and may be unique in Canada."

complex proposal process

At UHN, 85 people worked on the RHF grant proposals, reflecting the size and complexity of putting together RHF applications. Phillipson says this was one of the factors that contributed to the delay in undertaking the competition.

"This was a once-in-a-generation opportunity so we had to give the institutions considerable time to develop their applications," he says. "Some provinces said they would not match and that reluctance has continued. The institutions had to satisfy us that they have the other 60% of the funding they need."

Each proposal was subjected to a three-stage review process involving more than 350 reviewers and scrutiny by integrative review groups and an international assessment committee.

The RHF funded specific themes within the proposals that related to each institution's strategic plans, resulting in some proposals that were only partly funded. "The applications didn't all have to stick together in one neat package but that had to be part of a larger strategic plan," says Phillipson.

The eight successful projects received $426.6 million, with the remainder ($127.9 million) provided to help institutions pay for operating and maintenance associated with the projects. Phillipson says the additional operating funding was an unintended consequence of the long delay in holding a competition. "The original RHF did not include the 30%. That was a positive side effect of the long delay. It is interest generated by the original RHF funding," he says.

The latest competition is actually the second under the RHF, which was funded outside the normal Budget cycle in early 2003. A much smaller competition was held in 2004 which provided $57 million for 11 projects. It closely followed a major innovation competition and was limited to research hospitals which were successful in that competition and required funding beyond the scope of the innovation program.

UHN's Paige says the RHF funding is critically important in his hospitals' pursuit of seven foundational themes and serve as recognition of the fundamental role research hospitals play in Canadian health research. Last year, Paige wrote an article for the Canadian Medical Association Journal in which he said that "the most serious gap in the political knowledge base is the very fact that hospitals have become the driving force in health research".

"Nearly 70% of health research happens in hospitals and they need the attention of government. Infrastructure is important and the federal government and the provinces have turned it around in the past 10 years," he says. "Now we need operating dollars. We're not quite in balance yet (and) the RHF does not answer the balancing problem. It's a terrific program but is doesn't get to the most important thing which is stable funding for indirect costs and the full cost of research. Governments have to address this if they really want to achieve the research-based economy we all want and talk about."

clinical research initiative competition

The RHF competition also included awards made under the joint CFI-CIHR Clinical Research Initiative (CRI). Run in parallel with the major RHF competition, five major teams were successful and shared in nearly $100 million in funding.The Canadian Institutes of Health Research provided $49.4 million to support research, staff and materials and networking. The CFI contributed $16.5 million through the RHF which covers 40% of eligible infrastructure costs. Three of the successful clinical research teams received funding from both CIHR and CFI while the remaining two only received CIHR funding, as they did not require infrastructure support.

The award decisions were made in March but have not been publicly announced. Neither CFI or CIHR can comment due to a prohibition on speaking to the media during an election campaign.

The CRI was first announced with considerable fanfare three years ago with a proposed budget of up to $320 million over five years (R$, July 22/05). CIHR was positioning the joint program as a key component of its nascent commercialization strategy. A joint statement was issued at the time which said: "There is a pressing need and an immense opportunity to strengthen clinical research in Canada and to ensure the timely transition of research results."

At this time, however, no further CRI competitions are being planned, due mainly to a lack of financial resources.

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