Health research is essential for a cost-effective, innovative and sustainable health-care system. Research provides the raw material for innovations in health delivery, clinical treatments and health promotion. Research also provides hospitals and other institutions with opportunities to attract and retain outstanding caregivers and administrators, who are both agents of change and teachers and role models for the next generation.
Hospitals are ideally positioned to lead evidence-based change in the health-care system. As institutions rooted deeply in the community, hospitals are both agents of change and custodians of tradition.
There are two major drivers currently fuelling change within the health-care system: first, the desire by government to contain costs while maintaining the principle of universal access and second, the current revolution in health research that is transforming our insights into the molecular basis of health and disease, and the interplay between our genes and the psychosocial, economic, and environmental determinants of health.
The creation of the Canadian Institutes of Health Research (CIHR) on June 7, 2000, launched a genuine transformation in Canada’s health research enterprise. With a broad vision and a mandate to excel in the creation of new knowledge right across the health research spectrum and to turn research into action, CIHR is moving quickly across all aspects of our mandate.
Thirteen Institutes, each with a Scientific Director and an Institute Advisory Board, have launched strategic plans and new initiatives, which are being funded at a value this year of $140 million (after less than $50 million – just two years ago!). The number of funded researchers is up by over 25 per cent, and the average value of grants in open competition has increased by 40 per cent.
CIHR’s Institute of Genetics, led by Dr. Rod McInnes, has launched several major new initiatives, and in October will be holding a national summit to help chart its course for the coming years.
One of the dozen or so entirely new programs that CIHR has launched is the creation of 19 Community Alliances for Health Research (CAHRs). Dr. Daniel Gaudet, from the Université de Montréal, is leading ECOGENE-21, a Chicoutimi-based, multidisciplinary CAHR within the community OF Saguenay-Lac-St-Jean. ECOGENE-21 is working with the community to understand the challenge of inherited disease, approach the ethical, legal, social and clinical issues of genetic disease, and integrate this thinking into public health programs and clinical services, including prevention and screening.Genes contain the information to make proteins, the molecules in our body that catalyze biochemical reactions, provide structure and power to our organs and muscle, and serve as messengers between and within cells.
Just as genomics is the system-wide study of all our genes, proteomics takes a systemic approach to study the complex protein networks in our body. Understanding the networks and the literally tens of thousands of protein-protein interactions is the key to understanding the molecular basis of human biology and designing the next generation of new drugs.
Dr. Tony Pawson, a CIHR Distinguished Investigator and Director of Toronto’s Samuel Lunenfeld Research Institute of Mount Sinai Hospital, is a world leader in this exciting new research field. His research, and that of other colleagues at the Lunenfeld, has formed the basis for MDS Proteomics Inc., a major new biotech spin-off.
In Manitoba, CIHR-funded Dr. John Wilkins is also taking a proteomics approach to identifying proteins and interacting protein networks that regulate how cells of our immune system migrate to sites of infection and inflammation. Delineating this mechanism may open new therapeutic approaches to the treatment of autoimmune diseases and transplant rejection.
Our 13 Institutes have also launched a new Strategic Training Initiative in Health Research. Designed to catalyze new, multidisciplinary approaches to training, this new program exemplifies what CIHR is all about. For example, in British Columbia, CIHR is funding six training programs in partnership with the Michael Smith Foundation for Health Research, including training in transplantation, bioinformatics, community partnership research, health informatics, health research ethics, and neurobiology and behaviour.
Our Institutes of Genetics, and Health Services and Policy Research, have recognized that new developments in genetics will increasingly have an impact on our health care system and on Canadians. Accordingly, they are partnering with the Federal/Provincial/Territorial Coordinating Committee on Genetics and Health to identify and prioritize emerging issues.
These two Institutes have also brought together members of both the genetics and health services research communities to begin to bridge the gulf between academic disciplines and have issued a call for proposals designed to bring together geneticists, health services researchers and policy-makers to formulate and address the new research and policy issues arising from this science.
These are exciting times Ñ characterized by a profound revolution in health research, and major shifts in our health-care system. Genetics has become the common language of the biomedical world, permeating literally every aspect of today’s science and increasingly becoming centre stage in the clinic and in population and public health discussions.
Hospitals are ideally positioned to both lead and implement important change, as community-based institutions with responsibility for patient care, research and education. Hospitals are true partners with CIHR in this transformation, providing a strong, innovation-based footing for Canada’s health care system in the 21st century.