United Front

A proposed health research council could bring Ontario more funding, and unify a diverse community.

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By Amber Lepage-Monette

Though it is the most populated province, with the highest number of researchers, Ontario receives less per capita funding than other provinces that have health research organizations, according to the Ontario Health Research Alliance (OHRA) (Toronto, ON).

For 2000-01, the Canadian Institutes of Health Research (CIHR) (Ottawa, ON) reported it provided approximately $143,896,000 in both research grants and personnel awards to Ontario, $106,495,000 to Quebec and $43,401,000 to Alberta. Based on provincial population data from Statistics Canada for 2001, that means the per capita funding received by Quebec and Alberta was 16 per cent and 14.8 per cent higher, respectively, than the funding received by Ontario.

Put another way, Ontario received $12.09 per person, while Quebec and Alberta, both smaller provinces population-wise, received $14.40 and $14.20 per person, respectively.

This type of discrepancy is why many are calling for an Ontario health research council.

While this recent push to establish such an organization may be strong, it isn’t new. Back in the early 1990s, then deputy minister of health Michael Decter worked to create such a council.

When it comes to the importance of having such an organization and the reasoning behind his efforts, Decter is clear.

“I think that the provinces that have health research councils do a much better job of focusing their public sector research money and linking, it in a partnership, to money outside government, so I think they can be very effective organizations,” he says.

Decter currently serves as chair of the Health Council of Canada (Toronto, ON), which was created in 2003 as a result of the First Ministers’ Health Accord, and is mandated to monitor and report on the progress of efforts to renew the Canadian health-care system.

Though Decter says his previous efforts did receive widespread support from the health community, the initiative didn’t take flight in part because of a lack of government participation.

“It wasn’t a priority for them,” he says. “So it did not happen at that time, which I thought was a missed opportunity.”

Best Efforts
Over a decade later, that missed opportunity has found new support from the OHRA.

Established in 2000, the OHRA is currently calling for a health research council in Ontario, and is doing its best to get representatives within the research community involved in establishing such an organization.

“The major initiative is building on the word alliance,” says Gordon Gow, chair of the OHRA.

“Trying to get all the interested parties that are concerned with health research to come to the same table to talk about the common problems of what are we doing, where are we going — the focusing of it, the direction of it — so that it’s not knee-jerk reactions when people decide we should invest in this form of health research as opposed to another,” he says.

Though the council’s role will eventually evolve, in the initial stages Gow sees it serving as a type of consultant to government on how funds should be spent.

“We could bring all of these scientists together, and they operate on a peer review basis for everything they do . . . then we would be able to provide government with a more solid peer review of what is good science and what is not good science in many fields,” he says.

Though he foresees the council eventually becoming a funding agency, as is the case with similar provincial organizations, Gow says the key at this stage of the game is ensuring the council is properly established.

The OHRA has consulted with existing health research organizations in other provinces in an effort to gain advice and acquire ammunition to defend its position. Several representatives from these organizations have written letters to Gow supporting the OHRA’s efforts, highlighting how their provinces have benefited.

“Since the establishment of AHFMR, Alberta’s share of federal health research funds has grown considerably,” writes Kevin Keough, PhD, president and CEO of the Alberta Heritage Foundation for Medical Research (Edmonton, AB), “from five per cent of the Medical Research Council’s (MRC) annual funding ($5 million in 1980) to 12 per cent of the CIHR annual funding (approximately $70 million in 2004).”

The Nova Scotia Health Research Foundation (Halifax, NS) echoes those thoughts in a letter written by CEO Krista Connell.

“The impact on the province of Nova Scotia’s share of federal research funding has been significant. Since 2000-01, the province’s share of CIHR funding has increased from $7.5 million to $15.8 million in 2004-05, or 109 per cent,” she writes.

The Fonds de la recherche en Santé du Québec (FRSQ) (Montreal, QC) notes benefits beyond funding increases, writes president and CEO Dr. Alain Beaudet, PhD.

“Forty years of provincial public funding have thus resulted in a highly organized, dynamic public system of research centres, groups and networks, which currently comprises more than 200 investigators and 3,000 students in Quebec’s hospitals and universities,” he writes. “A common denominator to all of FRSQ’s funding initiatives is that they aim at complementing, rather than duplicating, federal programs.”

While an increase in funding is a persuasive argument for having such a council, Gow points to what he feels is a more important issue for Ontario — how current funds are being spent.

“One of the things that we lack tremendously in Ontario — we’ve got lots of research going on, but we’ve got very little data on exactly where that’s being spent and applied,” he says.

Gow says that agencies such as the CIHR, the Canada Foundation for Innovation (Ottawa, ON) and Genome Canada (Ottawa, ON) put a lot of money into Ontario through grants, but there is currently no database that shows where this money is going and how it is being used.

By not having this information readily available, he says, Ontario doesn’t even have the data it needs to argue for more funding from federal agencies, even if it wanted to.

“Go find where they’re doing particular research on imaging for proteins, and you probably wouldn’t be able to find it in Ontario that easily,” he says. “But you could make one phone call to Kevin Keough out there in Alberta, or Aubrey Tingle out at (the Michael Smith Foundation for Health Research, Vancover, BC), or Alain (Beaudet) in Quebec and they’d be able to say, OK, here are the people working on that right now.”

Decter argues that a health research council in Ontario will also provide a singular research representative that could produce important benefits aside from funding.

“Ontario’s research enterprise ranks well if you look at it on a global scale,” he says, “and therefore, if you’re going to go after big global opportunities for either major pieces of research infrastructure or a big ramp-up in clinical research activity . . . you need to be able to present a bit of a united front to go after the big ones.”

Working Together
For now, Gow and the OHRA have been able to bring all of the relevant parties to the table in an effort to get them discussing the issues and moving toward the development of a health research council.

But with so many different groups all working toward their own goals, the feasibility of establishing a council is still up in the air.

“Is that sustainable? I hope so,” Gow says. “The only way it can really be achievable is if they all stay at the table, and leave their biases at the door, and they all speak with one voice.”

As others have learned in the past, creating a health research council is not as easy as it sounds. Ontario is at a disadvantage, Decter says, thanks to its size and the amount of research and research funding already taking place.

“The individual research enterprises — something like the research foundation of the Hospital for Sick Children, or the Lunenfeld at (Mount) Sinai — are quite large in their own right. They have been very successful,” he says. “So in many of the smaller provinces, the rationale for creating a council was there wasn’t that much happening, and the council is intended to spur things to happen.

“Ontario has almost the opposite problem — it has a huge amount going on, and sometimes I think some people might see a council as competing or blocking, rather than necessarily aiding, their efforts.”

Gow agrees that the only way to keep interested parties working together is to ensure the goal of the proposed council is clear.

“I think as people start to work together they (will) find out that this isn’t robbing them of other sources of funding,” he says. “Therefore, we can all work together and we can actually complement each other and work across our boundaries.”