Back in the CIHR
It’s been awhile since posting anything about the Canadian Institutes of Health Research but given there are no other distractions today, November 6th, it seems a good time to do some tallying.
Firstly, kudos to CIHR for running the once cancelled “Spring 2020” Project Grant competition over the Summer. Looking back, this will go down as the single most important contribution that CIHR could make to mitigating the impact of the pandemic. It could have been very different but completing this competition was critical to many health researchers, across the country, along with those who were able to choose to extend by a year rather than submit a renewal. Thanks also to the many reviewers who exchanged windowless Marriott meeting rooms and boiled eggs for review from home activities. We’re now in the midst of the Fall Project Grant competition and subsequent competitions will be back to the usual schedule. It can’t be overstated how important reliable, consistent timing of funding competitions is. Bravo!
There are 2,364 applications in the current Project Grant round but it isn’t just the principal investigators who are watching, it’s the postdoctoral fellows and graduate students who are looking in the mirror every day and doubting their decision to pursue a research career. This is a generation that was already second guessing its options as science was being questioned, growth was stumbling and the future of biomedical and health research was beginning to look grim. Over the next decade, some 30% of current professors will retire (despite the removal of mandatory retirement ages — there was a lag but it’s now pretty much absorbed). Thousands of opportunities should become available — though don’t count on them. The impact of the pandemic on university revenues, the switch to on-line learning and the inevitable decline in international tuition growth (one of the main drivers by which universities and colleges have offset atrophy of provincial grants) make for a toxic brew for budget planning of many institutions. There will be blood and this will likely come through reduced hiring due to the usual brick wall (and expense) of downsizing tenured positions.
Still, CIHR is back on the rails and I for one, cannot thank their leadership and staff enough. Indeed, the constraints of working within a government bureaucracy became very apparent over the Summer as staff had to bow to bandwidth limitations, use of Microsoft Teams (which is still the Ford Edsel of video apps) for “security issues” that, apparently were not a concern for the Rest Of The World’s funding agencies (NIH, ERC, etc. are Zoomers).
It would also be remiss to overlook the head shave of Adrian Mota who had earned the working title of “Excutive VP and Wild Man of Borneo” at CIHR. Mr. Mota (who, it should be noted, is legitimately the Mr. Fixit of CIHR back office machinations, without whom we’d be waiting on funding decisions for longer than Arizona voters) subjected himself to on-live-video hair removal in September in aid of CHEO and raised over $6,300! Unfortunately, based on a sighting in early November, it looks like there has been significant regrowth , necessitating another depilatory event. Also tip of the hat to Dr. Danika Goosney who not only took the dog clippers to the aforementioned Mr. Fixit but also has a day job running half of NSERC. I mean, with all the cybersecurity threats, all you’d have to do is cut the wifi at their residence in Ottawa and Canadian science would go dark.
But I digress. My main topic is the CIHR strategic plan (ruh-roh, thought that had fallen off the radar?). CIHR is required by mandate to perform a 5 yearly strategic planning process to lay out a frame work of priorities for the following 5 years. [clench teeth] These haven’t always gone well [/clench teeth]. Unfortunately for CIHR, the year for the next strat plan coincided with the year of the living dead, 2020. There was at least a year of planning, stakeholder consultation, meetings (yes, in freaking person meetings for those with residual memories of the before times) and drafting.
The plan was to release the masterpiece sometime in June of 2020. It’s a fairly safe bet to say that the graphics had been compiled, the quality of glossy paper selected and the cover images chosen just before the 🦠 hit the fan in March. If said cover art involved splashes of blood and splatter, then theoretically it could still see the light of day. However, the contents are going to be about as useful to us over the next 5 years as my granddaughter’s Santa list (she has a long list).
CIHR hasn’t said too much publically about the 2020 Strat Plan but what it has said suggests a, perhaps understandable, mindset of “carry on chaps, we just need a few touch ups”. After all, an expletive ton of work was put into this document, representing the consolidation of the disperate thoughts of thousands of people not exactly known for falling into line. Who knew? Scientists have opinions! What has been said is that there will be an addendum, or something to that effect, that provides context for the impact of the pandemic since the drafting of the plan, adding some additional colour.
M’kay, that would be akin to attaching an ice fig leaf to a part of the statue of David’s anatomy. You can still see what’s underneath and it’ll be forgotten in a few hours. You might legitimately say that the planning work done over the past 20 months or so is still important and the ideas remain valuable. For sure! But that is not the point. I’ve seen drafts and am supportive. But, you know, COVID-19.
SARS-CoV-2 (apparently also known as the Trump virus) has fundamentally changed the course of the next 5-10 years. Yes, the 1918/19 flu was quickly followed by the roaring Twenties, but that, to be frank, was a very different world. In 2020, the planet has had an overdue and rude awakening. We are slowly realising that Covid-19 is something we will need to learn to live with for at least a couple more years, effective vaccine or not. In addition, the public’s deference to science has changed. Trust in scientists has been shaken. There’s a significant and growing fraction that is disproportionately affected — and it’s largely not us. Scientists in general, and in particular epidemiologists, infectious disease and public health experts, are increasingly being seen as privileged party poopers. Worse, those most affected, along with a politically motivated minority of self-defined “freedom fighters” who struggle to breath through thin fabric but seemingly have no issue with an increasingly warming planet that’s belching smoke from forest fires, note that the very experts who call for restrictions and lock-downs are still being paid, whereas their own jobs and businesses are evaporating.
In other words, we are entering a long, cold winter that will severely rattle societal make-up and norms. Case counts are increasing in Canada and are clearly not under control. In europe, as well as the smouldering carcass previously known as the United States, the virus is running rampant. A new administration will take the reins there in January — after 10 more weeks of abject neglect and denial. Canada, it hardly needs to be said, is not immune. We are a few weeks behind Europe. Nothing, nada, nought that we are doing now provides any confidence that we will avoid their fate. Moreover, the more we try to suppress the virus, the more resistance to it there will be, along with increased social division. This will inevitably be reflected in a building of resentment to government and demands for change. Nevermind the vulnerable, the devastating deaths, the debilitating effects of long term health impairments in those who survive. So with that backdrop, do we really think the public or, for that matter politicians, will turn to the 2020 CIHR strategic plan and think, “All righty then, now there is a plan that assures me that Canada’s premier health research agency is on top of the challenges!”
No.
I am sure that nothing I or anyone else says now can change the CIHR Strategic Plan, per se, but I would suggest that that current document be quietly posted so that the wholesome ideas therein are placed into the record — and as a reminder of the way we were but no longer are. Rather than stapling on an addendum or inserting electron density images of the virus on every other page, the agency should engage in a process reflective of the new realities we will face. The pandemic was entirely predictable, except in its timing. That is a text book failure of health research and policy. We should have been prepared but we weren’t. What was sorely missing was a credible and resiliant plan that built structures that take time to test and to get right. Surely we have learned from that painful lesson? If so, let’s demonstrate that realization by reexamining what CIHR should be doing going forth.
In other words, what is the role of CIHR in helping to, for example:
- navigate Canada out of the current crisis;
- step up vigilance of emerging pandemic threats;
- open up opportunities for new discoveries about life and threats to it;
- mitigate health effects of climate change;
- invent new healthcare practises that take advantage of the frantic needs of having to adapt to restricted hospitals and clinics;
- address the rising burdens of health due to delayed treatment;
- drill through the incompatible data lakes that obfuscate effective clinical trials;
- discover and validate new anti-microbials to replenish an empty cupboard;
- develop new health surveillance strategies and modelling;
- provide a modern educational path for the next generation of health researchers
Partial answers to these questions (and many others) might be buried in the Strategic Plan but even if so this is an opportunity for CIHR to redefine its relevance to government and Canadians. The danger in not doing so is to reinforce the idea of ivory tower research that carries on in an alternative world, largely ignoring the people who fund it. This perception would be incredibly dangerous but also deserved if the Plan is “business as usual”. In the outside world, nothing could be further from the truth.
You might think it premature to call for such a document. We are, after all, not even halfway through the current pandemic. But history has shown, repeatedly, that we soon forget and revert to old habits even if they are demonstrably out of touch. Now is exactly the time to rethink and reimagine. Previously reasonable base assumptions on which the strategic plan was based will dissolve. Moreover, tolerance for substantive change during an emergency is higher. Government funding will tighten (after an infrastructure frenzy to erect mandatory monuments to economic misery), deficits will be employed as weapons for austerity measures. Science will need to re-make its case alongside a field of other priorities. Why not regroup for this and be armed with answers about relevance accompanied by a blueprint for better preparation?
So, a plea. Please park the “before-Covid” plan and map a new journey, a Marshall Plan for Canadian Health Research. It’s far better we do this ourselves than having alternatives foisted upon us.
