Last month, First Ministers reached an historic agreement to strengthen Canada's health system. Included in this 10-year plan was a clear recognition of the importance of science and innovation - both in accelerating the pace of discoveries and in converting these discoveries into new treatments, technologies and practices that improve health care, promote health and treat disease.  This plan includes continued investments in research and health innovation.

Likewise with science. Significant investments over the past decade have yielded an unprecedented number of exciting discoveries that, if properly nurtured, can improve health, drive evidence-based change in our health system, and increase Canada's economic prosperity.

Understanding the health economy

Research is the raw resource that fuels the health economy and is the engine of change in our health system. Health-related companies, including biotech and medical devices, are responsible for more than $20 billion in revenues each year. Our challenge is to keep the economic benefits of Canadian discoveries in Canada, while exporting the health benefits around the world.

Training is needed to help researchers and entrepreneurs better manage the economics of health research, including technology assessment, business planning, marketing and investment options.  Programs that catalyze cultural change and that bridge the divides between the scientific, entrepreneurial and health delivery sectors are essential for national success. That is why the Canadian Institutes of Health Research (CIHR) has proposed creating Centres of Health Innovation whose overall mission will be to bring all sectors together to bridge the gap between what we know and what we do.
 
Since its inception in 2000, CIHR has developed a coherent suite of programs designed to help our universities, research hospitals and researchers navigate the rocky road from discovery to market.

For example, our Proof-of-Principle (POP) program is yielding exciting results. Introduced only three years ago, the program fills an important gap in the commercialization pipeline, enabling health researchers to develop their intellectual property to the point where later stage funding can be secured.

One success story is Neurologist Dr. Neil Cashman. Two years ago, Dr. Cashman received $100,000 from CIHR's POP program to develop a vaccine against prion or mad cow disease. The corporate partner in the research, Caprion Pharmaceuticals of Montreal, now plans to go public and anticipates having an animal vaccine for BSE (bovine spongiform encephalopathy) commercially available within three years.

Attracting investment for products still in the pipeline is never easy. Venture capitalists have become more cautious following the boom and bust of the telecommunications sector. Discovering a gene related to a particular disease is no longer enough. Venture capitalists now want to see details about the protein and small molecules - prerequisites for developing a drug, which still must go through exhaustive animal testing and human clinical trials.

To help bridge this gap, CIHR is establishing a National Network for Chemical Biology. University researchers and small biotech companies will use the network to screen libraries of small molecules to identify new drug candidates. It will move drug candidates to the private sector more easily, while also assisting small companies that lack this expertise in-house.

Strengthening clinical research

Canada has great strengths in clinical research, going back to 1921 when Banting and Best discovered insulin.  Since then, Canadian clinical research has provided the world with advances in the treatment of heart attacks, cancer, arthritis and many other diseases.

For example, a new drug discovered and evaluated in clinical studies at the University of British Columbia has resulted in a cure for macular degeneration, the most common form of blindness in adults. Manufactured in Canada by QLT Inc. of Vancouver, Visudyne® has been used in more than 250,000 patients worldwide. 

The queue for evaluating discoveries is growing, while Canada's capacity to conduct clinical trials is shrinking. We do not have enough health practitioners to carry out the work, primarily because the training is longer, the job prospects less stable and the pay lower than for those who are solely clinicians.

Other countries, including the U.S. and the U.K., face similar challenges and are investing heavily to strengthen their clinical research capacity. Similar measures are needed in Canada.

That is why CIHR is coordinating a national public-private coalition to develop a major national initiative in clinical research. We propose improved training and career support for clinician researchers and the development of national networks of clinical research centres that would focus on areas of strategic importance to Canada.

Research is critical to sustaining and strengthening Canada's health system.  It is the engine that drives evidence-based change in new models of health care delivery. 

Research and innovation must not only be an integral part of any plan for health care reform, it must be the centerpiece. The recognition by our First Ministers of the importance of research is explicit acknowledgment that true and lasting change will only come from evidence-based change and sustained activities in support of health innovation.

Dr. Alan Bernstein, O.C., FRSC
President, Canadian Institutes of Health Research