HEAL Committee Meeting

STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Monday, December 6, 1999

• 1536

[English]

The Chair (Mr. Lynn Myers (Waterloo—Wellington, Lib.)): Ladies and gentlemen, I call this meeting of the health committee to order.

We're dealing with Bill C-13, as you know, with respect to the establishment of the Canadian Institutes of Health Research, but I first have a couple of announcements.

To start, Minister Allan Rock will be here Wednesday at 3.30 p.m. to testify with respect to Bill C-13.

I also want to indicate that in light of the ability to get witnesses onto the committee roster and move accordingly, it looks as though we'll begin clause-by-clause hearings on Bill C-13 beginning Wednesday at 4.15 p.m. We haven't scheduled Thursday. I'm hoping we won't have to, and that we'll in fact be done on Wednesday and have it reported back to the House.

I would remind all members—and the clerk of course will do this in addition to my doing it here today—that if you have amendments to the bill we need to know those as soon as possible. We need to know whether they're amendments you're proposing at the committee stage or whether they're amendments you're proposing at the report stage. So we need to know those as soon as possible.

I also want to note for the record that today is December 6. Accordingly, the minister associated with health has the supplementary estimates relating to health. That has now been deemed to be reported.

That having been said, we want to move on to our witnesses with respect to Bill C-13.

Do you have a question, Monsieur Ménard?

[Translation]

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): The amendments we wish to introduce in the House at report stage do not necessarily have to be introduced in committee. Now we are just talking about amendments to be introduced in committee. We both understand how these work. All amendments may not be ready on Wednesday; there are only two law clerks drafting amendments, and they are completely overloaded. Some of the amendments opposition parties wish to table may be available only at report stage.

The Chairman: I understand.

[English]

That's why I made the distinction that some amendments can come here to committee. For those that aren't ready or that you want to have at report stage, however, you can proceed accordingly.

Let's move on to our first witness, Hassan Yussuff, executive vice-president of the Canadian Labour Congress.

We have on your behalf an opening statement that's in English only. We'll have that translated, of course, and with the committee's indulgence we'll proceed accordingly.

If you would, Mr. Yussuff.

Mr. Hassan Yussuff (Executive Vice-President, Canadian Labour Congress): On behalf of the Canadian Labour Congress, I want to thank the committee for the opportunity to present today. Accompanying me is my colleague, Dave Bennett, director of health, safety, and the environment department at the congress.

The Canadian Labour Congress represents 2.3 million members in both in public and private sectors across Canada. Occupational health is a major issue for our members. It is an issue that invariably ranks close to the top of union members' concerns, second only to job security but above wages and benefits.

We're also citizens for whom social, cultural, and environmental determinants of health are of prime concern, especially when we realize that our members tend to live in areas and regions in which social and environmental impacts on health are the most severe. This often means that workers are subjected to a double dose of social and environmental factors of ill health—for example, pollutants; a concentrated exposure to chronic health hazards at work; and a lower but continuous exposure in the community.

• 1540

For these reasons we welcome the bill to establish the CIHR. The government is to be commended for its initiative, for the speed with which it is addressing an important social issue, and for the size of the financial resources it has so far committed to the institutes. But so fast and so effectively has the government proceeded that we fear the prime decision-makers—namely, parliamentarians—have been left out of the picture.

For instance, though it is the governing council that is to be responsible for establishing the institutes and their policies, much of the work is already far advanced through the activities of the interim governing council and the task force. It is unlikely that the governing council could make radical changes in the direction of the CIHR already being planned. In its present state, the bill allows no role whatsoever for Parliament, even initially, to establish any direction that may differ from what is currently envisaged.

A small but important example is in the fact that the government wishes council members to be appointed, but council members, by qualification, background, or experience, need to make strong policy decisions without incurring the displeasure of the authority that appoints them.

More broadly, Parliament cannot make its views felt on the weight and emphasis that is to be given to the concept and general policy thrusts the institutes are to undertake. It is appreciated that the direction of the institutes needs to be flexible, but the fact is, there is no central focus given to the environmental determinants of health, no priority given to research on the prevention of ill health, and no mention at all of the importance of research into the causation of ill health.

This is a weakness even from the government's own point of view. We should bear in mind the official policy of the government in Pollution Prevention: a Federal Strategy for Action, 1995, and the fact that the current revision of the Canadian Environmental Protection Act, or CEPA 1999, is subtitled “An Act respecting pollution prevention and the protection of the environment and human health in order to contribute to sustainable development”. In CEPA 1999, pollution prevention is to be a national goal and the priority approach to environmental health hazards.

At best, these concepts amount to one cluster among many, competing with several others for research support. For instance, social, cultural, and environmental influences on health are recognized while improvements to prevention strategies are mentioned in passing.

The reasons for downplaying prevention are linked, we believe, to the commercialization of research. There is far less of an industry arising out of the preventive disciplines than there is out of disciplines informing control and remediation of environmental hazards and the treatment of sick people. Preventive disciplines, however, are the key to radical reduction of ill health and chronic disease.

Paragraph 4(i) lays down an objective of CIHR to facilitate the commercialization of health research. This is both vague and dangerous, because it suggests that research itself is to be privatized. It would be far better for public policy to state that a leading aim of the CIHR is to facilitate the uptake of research, by both public and private bodies equally, for the public good, i.e., public health. This is the mandate of, for instance, the Health Evidence Application and Linkage Network, HEALNet, one of the most successful networks in the centres of excellence program.

Nevertheless, it needs to be stated that applied research and applications of research are not the only source of pressure to produce high-quality research. There will always be a crucial need to develop research agendas without the exclusive pressure of immediate application.

In order to shift the balance towards prevention and causation in the general area of environmental health, the CLC and others have called specifically for a Canadian institute for occupational and environmental health research under CIHR, the work environment being one important subset of the general environment. We would like to explain the reason for this in what follows, and to justify the recommendations for changes to the bill made in the executive summary at the conclusion.

The environmental determinants of health are central. If we take just one health determinant—namely, cancer—it is clear that the general majority of cancers are in some way environmental as opposed to the role played by viruses and heredity. For instance, the World Health Organization estimates that at least 80% of cancers are environmentally related. The number of cancers due to the work environment is variously estimated as being between 4% and 40% of the total. Even if we took a lower figure of 10%, this would far exceed the number of deaths due to occupational injury, up to 1,000 a year, and it would far exceed the number of deaths on Canadian roads.

• 1545

Environmental health is a perennial issue. Not only are environment determinants of health essential; they are also perennial, not liable to decline in the lifetime of the CIHR bill. It is true that specific issues come and go. For instance, research on the genetic screening of workers has given way to research on the relevance and predictive value of medical tests and examinations.

Research on the physical causes of injury has largely given way to research on ergonomics, musculoskeletal injury, and the stresses of work. The health physics of ionizing and electromagnetic radiation are now disciplines in their own right. General toxicological studies of industrial chemicals are becoming more refined—for example, low-dose testing of potential endocrine disrupters and genetically engineered foods. In the area of population health, there is an emerging need for studies on the impact of poverty and unemployment on individual and community health.

The issues change because socio-economic conditions change, these conditions being one of the determinants of lifestyle. But the chief factor is changing technology. Technological change occurs without enough research on the health effects of the changes implemented. The links between technology assessment and health impacts go largely unexplored, thus putting an undue research burden on established technologies.

With regard to causation and the primacy of prevention, without legislative direction there is no indication that the institutes planned to date by the interim governing council will give a central focus to the prevention of ill health and the avoidance of disease. In turn, prevention strategies are impossible without research into the causation of ill health, since we cannot estimate causes without knowing what they are.

Canada lags behind other countries in the creation of environmental health institutes. Countries such as Sweden and Finland, with much smaller populations, have occupational health research institutes. Canada has none, leaving that function to provinces such as Ontario and Quebec. Brazil has a large and influential occupation health institute. The U.S. has institutes for both occupational and environmental health that undertake exhaustive research and make policy recommendations to the government.

For instance, the National Institute for Occupational Safety and Health, or NIOSH, recently recommended a tenfold reduction in the exposure limit for metalworking fluids from the common standard of 5 mg/m³ to 0.5 mg/m³. If NIOSH's documentation were taken seriously and implemented in Canada, it would protect the health of literally hundreds of thousands of workers who are exposed to the hazards of metalworking fluids.

It is clear that environmental health research is needed in Canada and that we have the potential to undertake such research, provided there is proper focus and support. Leaving aside the scientists who are employed by private industry, roughly 130 academic scientists are engaged in occupational health research and injury prevention; 200 are in environmental health; and 250 are in the related fields of nutrition and food safety, drug safety, and infectious or communicable diseases. About 100 epidemiologists study both occupational and environmental factors, to which should be added about 450 academic researchers in allied fields such as demography, human development, health economics, health policy, health promotion, and health-related social sciences. Further, well over 2,000 scientists are employed by governments across Canada, with a constant interchange with academia. They need both training and the results of research conducted in universities in order to make informed public policy.

• 1550

Without a focus and equitable funding, you will lose such research to other areas. Researchers also need to respond to public pressure from the constituencies, which are the ultimate benefactors of the research. We have appended to this submission a list of organizations that support the CLC in the calling for an institute on occupational and environmental health. Without such pressure, CIHR cannot encourage innovation in the areas and methods of health research.

For instance, whole new preventive disciplines are growing up among the occupational health practitioners that provide a rather different perspective from those based on epidemiology and risk assessment. Unless the practice is informed by research on the methodology and efficiency of prevention, it stands little chance of being recognized as legitimate in policy-making, both on the part of business and among government regulators.

Our executive summary shows changes that are needed in the CIHR bill. In clause 4, change the phrase “societal and cultural dimensions of health and environmental influences on health” to “with a central, institutional focus on the social, cultural and environmental determinants of health and the preventive strategies which are derived from them, to the point of creating a specific Institute for Occupational and Environmental Health”.

In paragraph 4(e)... an identical change to the one in subparagraph 4(e)(ii).

In paragraph 4(i), delete the phrase “facilitating the commercialization of health research” and add the phrase “facilitating the utilization and uptake of research by both public and private bodies in Canada, for the public good”. So paragraph 4(i) reads:

encouraging innovation, facilitating the utilization and uptake of research by both public and private bodies in Canada, for the public good, and promoting economic development through health research in Canada.

In subclause 7(3), change the appointments of members of the governing council to hold office “during pleasure” to “on good behaviour”.

Acknowledgement of some of the statistics used in the submission are derived from the work of Dr. Cameron Mustard, scientific director of the Institute for Work and Health, and Dr. Patricia Baird, distinguished professor at the University of British Columbia. The CLC alone is responsible for their accuracy.

On behalf of the Canadian Labour Congress, we submit this brief.

The Chair: Thank you very much, Mr. Yussuff.

We'll move on now to the other presenters, and then I'm sure there will be questions later on.

Dr. Peter Vaughan is the secretary general and chief executive officer for the Canadian Medical Association. Dr. Vaughan, please.

Dr. Peter Vaughan (Secretary General and Chief Executive Officer, Canadian Medical Association): Thank you, Mr. Chairman. As secretary general and CEO of the Canadian Medical Association, I am here today representing our members, more than 46,000 physicians from across Canada. The association has a twofold mission, namely to provide leadership for physicians and to promote the highest standard of health and health care for Canadians. A vibrant national research endeavour is fundamental to both parts of our mission. I am pleased to have this opportunity to speak in support of the establishment of the Canadian Institutes of Health Research.

For the past several years, the CMA has been advocating for an increased federal commitment to health research. Our recent submission to the Standing Committee on Finance recommended that the federal government continue to increase funding for health research on a long-term, sustainable basis.

We have pointed out that according to the Organisation for Economic Co-operation and Development, Canada spends only one-third as much per capita on health research as do other G-7 countries such as France, the United Kingdom, and the United States. The enactment of CIHR should redress this imbalance to a significant degree over the course of the next several years, provided that funding continues to increase.

I would like to focus my comments on Bill C-13 at four specific areas: the transfer of research results from the laboratory bench to the bedside; the need to focus on health outcomes; the need for capacity-building; and the need for balance.

First, I would underscore the overall objective of CIHR to excel in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products, and a strengthened Canadian health care system. During the past decade there has been an increased focus on the continuum of health research, beginning with basic bed science and extending through clinical trials, meta-analysis, population-based studies, and the development of tools such as clinical practice guidelines. There is still a clear need for more work in these areas.

• 1555

We believe that one way to promote the continuum of bench to bedside will be to ensure that the perspective of the actively practising clinician is represented on the governing council of CIHR.

Moreover, we would urge that the perspectives of clinicians both from the academic health science centres and from the community be represented on the advisory board to each health research institute that is established under CIHR.

CMA believes that the ultimate goal of the Canadian health care system is to improve health status and health outcomes for Canadians not only in terms of survival and longevity but also with respect to quality of life. If health research is to promote this goal, a focus on health outcomes must permeate throughout CIHR and the institutes. In order to promote this, the CMA would recommend the establishment of an office of clinical excellence within CIHR, with a mandate to make recommendations on protocols that specifically address health outcomes.

One area where this needs to be addressed, in particular, is the field of health services research, which is restricted either to short timeframes that limit the ability to observe health outcomes, or to the use of administrative data that more typically measure outputs than outcomes. Indeed, a good first step in this area would be to develop consensus around measures of health status and health outcomes that can be used in a wide range of clinical and population studies.

A related function of this office could be that of a national clearing house with respect to the activities and products of many health service research organizations that have been established at the provincial level since the 1980s. Such an office could be operated in a cost-effective manner through the formation of innovative partnerships within Canada and internationally.

Speaking as secretary general and chief executive officer of the CMA, I say that research is an important component of the professional lives of many physicians. We recognize that today's research is tomorrow's quality care.

According to the results of our national 1999 physician resource questionnaire, almost three out of ten physicians report spending at least one hour per week on health research. That's 29%. If we look more closely at these figures, just over four out of ten specialists, that's 43%, report spending at least one hour per week on research, compared to slightly fewer than two out of ten general practitioners and family practitioners, or 18%.

I think this difference clearly points to the need to foster the development of capacity for community-based research. I would also urge CIHR to work with national certifying bodies, the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada, to explore ways of leveraging their existing programs, such as the two-year clinical investigator program of the Royal College and the sentinel-based national research system of the College of Family Physicians of Canada.

It is our belief that the CIHR can play a key role in reversing the brain drain that has taken place over the past decade with the loss of many of our excellent clinician scientists. I would urge that CIHR develop a two-pronged strategy that would in the first instance encourage researchers to remain in Canada, and in the second encourage some of our expatriate researchers to return to Canada. Retaining and repatriating our health researchers will improve Canadians' access to quality health care within our national medicare program.

Mr. Chairman, I would like to offer three comments with respect to the need for balance. The first lies in the distinction between the first two guiding principles of the CIHR. These guiding principles call for national research priorities on one hand, while recognizing the important role of investigator-initiated research on the other. The establishment of health research institutes will provide a link and a balance between health priorities and health research.

The second need for balance lies between the biomedical and social sciences. While the CMA has continually emphasized the important contribution that the health care system and medical care make to improving the health of Canadians, we recognize the need to work with others to improve the health of the population by addressing the determinants of health, including social, lifestyle and physical environmental factors. The need for this balance is underscored by the persistent social inequalities in health in Canada and other industrialized countries that cut across all disease categories.

• 1600

Thirdly, we need to balance between building on our strengths in health research and identifying and filling in the gaps.

Finally, Mr. Chairman, I would commend the CIHR for the strong ethics mandate it has been developing, as this will be an increasingly challenging era in the future.

Thank you very much.

The Chair: Thank you very much, Dr. Vaughan.

We'll now move on to Dr. Bartha Knoppers, professor at the University of Montreal.

[Translation]

Dr. Bartha Knoppers (Professor, Université de Montréal; Chairperson, Interim Governing Council Subcommittee on Ethics, Canadian Institutes of Health Research): Thank you, Mr. Chairman.

As do all members of the Interim Governing Council Subcommittee on Ethics, who worked on this report before you, I personally believe that we are at a historic moment, a time when we can incorporate ethics into Canadian law. Bill C-13 is living proof of your effort to give ethics a fundamental role in health research.

To illustrate that fundamental role, I would like to describe the variety of sources from which ethics standards are drawn, then talk about the development of ethical norms and how institutes plan to show respect for and achieve human dignity both within ethical norms and within the structures of these institutes.

With respect to the diversity of ethical sources, you have already heard witnesses before you describing the variety of disciplines that contribute to ethics. There are many schools of thought, many different ideas, and many different disciplines.

The field of ethics represents a form of questioning, and is perforce a multidisciplinary exercise. There are also bioethical centres across Canada, all recognized for their expertise. I can name a few. One such centre in Toronto is studying issues relating to euthanasia. One in Dalhousie is looking at aging-related issues, McGill is dealing with AIDS, the Université de Montréal with genome genetics, and the Alberta centre with ethical liability. This means that, today, Canada can already draw on a wealth of thought and research in the field of ethics.

There are also some existing structures, such as the National Council on Ethics in Human Research, the Canadian Council on Animal Care, and the Canadian Biotechnology Advisory Institute. These structures already promote and protect people and animals.

[English]

I would now like to talk about the development of ethics norms. Ethics norms fulfil three functions. The first is a proactive function, a prospective function. This means that the Canadian institutes have to hold to the highest standards of ethics. They also fulfil a function of reflection. Not only do they have to be proactive, but they also have to support independent scholarship through research activities that allow Canadian researchers to reflect not only on the issues at hand but also on the issues that are coming. They have to be effective, and to be effective we have to build capacity in ethics here in the country.

We have over 300 ethics committees dealing with human research subjects. We have over 224 ethics committees concerned with animal welfare. We do not have the sufficient training nor a locus of research activity that allows young Canadian scholars to focus in and prepare themselves for this mandate.

Most importantly, I would like to turn to the third part of my presentation, having looked at the diversity of ethics norms, having looked at the functions or development of ethics norms: how will the institutes respect and, if you like, réaliser, realize human dignity through their activities?

• 1605

The first is through the principle of stewardship. Stewardship will be reflected in the structures of the institutes. The subcommittee of the interim governing council suggested three possible structures to fulfil the stewardship mandate. The first is to collaborate and to cooperate with the bodies that are already present in Canada, as I mentioned earlier. The second is to create within the institutes a policies and procedures committee. Obviously the institutes are responsible to the Canadian public, are accountable to the Canadian public, for the procedures to be followed by researchers receiving money from the institutes. To that end, the policies and procedures committee would be setting down the standards and ethics norms for issues such as integrity, conflict of interest, or commercialization of research.

The subcommittee also recommended that a separate committee be created, a consultative advisory committee, to deal with future issues. This would be more of an arm's-length, independent committee reflecting various schools of thought across Canada, working together with other agencies and looking at the larger ethical issues—both those that are here now and those that are coming in the future, such as cloning, duties to future generations, germ line therapy, and so on. The committee would not wait for science to come with a given fact, with a given event, and then always be in reaction.

The subcommittee also recommended that the governance of the ethics aspects of the institutes be not only central in terms of policy and procedures, but also be throughout the institutes, whether they be virtual or real. In other word, ethics would be an integral part of every institute as well. We recommended certain structures for ensuring that ethics were central to every institute.

We also recommended that there be created an ethics office. There is nowhere in Canada that you can go now unless you're going to a particular professional body, or unless you're concerned with animals or you're concerned with humans. There's nowhere that the Canadian public can go to a kind of clearing house, if you like, a source of information when the issues come up and they want to know more and they want to talk about the ethical issues.

Finally, there is no doubt that there has to be a leadership role of ethics within the institutes, but also of the institutes themselves internationally. Canada, as you know, does not have an ethics committee or an ethics body like most other countries have. Our visibility internationally is only ensured by the individual scholars who are interested in the subject and have managed to bring the Canadian perspective to bear on international issues. This is very important. We have no way of having a Canadian presence on the international scene.

At this point in time, it's very important not only that Bill C-13 be adopted, but that the central focus given to ethics in this bill be realized. Canadians are often looked at by Europeans and by Americans as being a sort of carrefour, a crossroads, if you like, of European and American cultures. This makes us particularly well suited to take a leadership role internationally and to assume our international responsibilities.

[Translation]

Briefly, then, the document you have before you is the report of the Interim Governing Council Subcommittee on Ethics. As I said, this is a historical moment. We can make a more consistent ongoing and fundamental contribution to ethics in research, and particularly to ethics in the everyday lives of researchers.

I believe that ethics should inspire young people and guide researchers, and I also believe that these institutes can become models for other countries throughout the world. Thank you.

[English]

The Chair: Thank you for those comments, Dr. Knoppers. We appreciate them much.

We'll now go to questions.

[Translation]

Mr. Ménard.

Mr. Réal Ménard: Mr. Chairman, this reminds me of the good old days between 1993 and 1997 when the Bloc Québécois was the Official Opposition. Times have obviously changed, but I am nonetheless very pleased to have this opportunity to ask the very first questions.

Mr. Bernard Patry (Pierrefonds—Dollard, Lib.): I don't understand what you mean.

• 1610

Mr. Réal Ménard: What I mean is that generally I am the second to ask questions, but today I can be the first.

Mr. Bernard Patry: You have always been first where health is concerned.

Mr. Réal Ménard: I have four questions, Mr. Chairman.

First of all, I would like Dr. Knoppers to tell us how the recommendations of the ethics subcommittee will help us approach the issue differently from, say, the Medical Research Council of Canada.

My second question is this: two witnesses said that, from a strictly ethical standpoint, representatives of pharmaceutical companies should not sit on the interim governing council, which will become a permanent council. When you talk about ethical considerations, do you mean considerations like these? I would like your views on this.

My next question is for Mr. Vaughan. I would like more information on the office of clinical excellence that he mentioned. I'm a little afraid that we will have too many structures, and I would like to understand how that office would fit in with the committees already planned. As far as I'm concerned, the most important aspect of this project is that the institutes be autonomous. How do you see the institutes' autonomy with respect to the governing council? This will be an important factor as we consider this bill.

My last question is to the Canadian Labour Congress. Obviously, we appreciate the fact that their concerns focus on workers, since that is what the CLC is there for. Would they like the interim governing council, which is to become permanent, to designate a separate institute on environmental health? Would you like us to recommend that in our report?

The Chairman: Thank you, Mr. Ménard.

Doctor Knoppers, please.

Dr. Bartha Knoppers: First of all, with respect to the transition between the MRC and the institutes, I should point out that the bill and all subcommittee reports focus on the institutes' mission to exceed strictly biomedical standards. That is a first. No other country is making so much effort to integrate social sciences and humanities into research. Canada is making a strong, ongoing effort.

Bill C-13 reflects that integration of principles and concerns that go beyond the strictly biomedical plane. This is evident not only in the wording of the bill itself, but also in all the documents that have been published since the bill was first introduced.

Mr. Réal Ménard: I was not thinking about the transition as such. Let us say that you have a research protocol before you: how will your procedure differ from the MRC's procedure in making absolutely sure that the research conducted in all the institutes—we do not of course yet know what they are—will incorporate the ethics which are your fundamental concern?

Dr. Bartha Knoppers: The assessment of research protocols from an ethical standpoint is still within the purview of universities. Standards have been established for all three councils, of course including the Social Sciences and Humanities Research Council. Independent researchers and groups of researchers seeking funding from an institute will have to comply with or meet a number of criteria. These criteria could include the four themes described in the bill. But I very much hope this will not be somehow artificial. I hope that forcing people to work together will lead to genuine integration, rather than a forced marriage, as it were.

Mr. Réal Ménard: You mean working together without wanting to.

Dr. Bartha Knoppers: Without wanting to, or even just pretending to.

You also mentioned the concern about having representatives of private sector pharmaceutical or biotechnology companies on the boards of individual institutes or on the national governing council.

• 1615

That is of course a concern, particularly in bioethics. But let's remember that over 60% of research is subsidized by the private sector. Unlike many of my colleagues, I deplore the fact that we have not focussed some of our awareness-raising efforts in ethics on the private sector. I consider that a serious problem. By having people from the private sector sit at the same table with bioethics experts, sociologists, researchers and other stakeholders, we help pharmaceutical companies become more aware of ethics and also promote closer links between ethics in the public sector and ethics in the private sector, if they exist.

Mr. Réal Ménard: I'd like to give you an example: take the Canadian HIV Trials Network. You talked about McGill, which is obviously a centre of expertise. At present, the Canadian government is funding the infrastructure for the Canadian HIV Trials Network, but pharmaceutical companies decide the kind of research that will be carried out.

I'm not criticizing these companies. There is a kind of research that pharmaceutical companies tend not to focus on. For example, AIDS activists tell us that very little research has been done on medication dosages.

How can we ensure that all sectors of research are covered by the biomedical centres we establish? Would having a given pharmaceutical company present... Well, we can simply say that the whole system will basically function as a collective. The PMC—the Pharmaceutical Manufacturers of Canada, an association that has now changed its name to R_x&D—could be represented, but would you agree that having an individual representative of any pharmaceutical company, be it a patent or generic company, could lead to a conflict of ethics?

Dr. Bartha Knoppers: No, in my opinion, it would lead to the opposite. I would see it as an opportunity to bring together those two separate worlds for the first time. They really are two separate worlds, but the private sector is nonetheless becoming increasingly important in research. Most research programs now require partners. Researchers are forced to find partners, and then condemned for working with industry. I find that strange. It is not their fault. There is simply not enough public money to fund research.

Since the private sector is providing more and more funding for research, this is the time to incorporate them into a model that is respectful of values and protects the public, rather than doing the opposite and saying that we want their money but we don't want to dirty our hands by sitting at the same table with them. We have to respect the role that the private sector plays, but also require it to comply with ethical standards already established in the public sector. And the only way to do this is to work with them.

Your third question...

[English]

The Chair: Thank you very much.

Did you want to go on to the third, Dr. Vaughan?

Dr. Peter Vaughan: Thank you, Mr. Chair.

The office of clinical excellence is really a cross-organizational office in that the institutes are very much independent. The office of clinical excellence would be the type of office that would cross all of those various institutes to ensure that the knowledge transfer that we talk about takes place.

Let me make that clear. There's a lot of talk about taking scientific ideas from bench to bedside. The question is how to do that. The role of the clinician-scientist has eroded in this country over the past several decades, but it is crucial in being able to bring that research to the bedside, where it's implemented. That's implementation. The office crosses all the institutes and would ensure that there are mechanisms in place to allow for that knowledge transfer.

[Translation]

Mr. Réal Ménard: But how can those things be reconciled? If I understand correctly...

[English]

The Chair: Mr. Ménard, sorry, but you're extending the questions and we're almost at ten minutes just for you. I think we're going to have the final question answered, and then we'll move on.

Mr. Bennett.

Mr. Dave Bennett (National Director, Workplace Health, Safety and Environment, Canadian Labour Congress): Thank you, Mr. Chair. We would like to respond to two of the issues raised by Mr. Ménard.

The first is over the autonomy of the institutes, and I think there are four factors here that will ensure that the institutes are autonomous. The first is that the governing structure of the institutes should be such that the institutes have their own built-in guarantees of autonomy. We believe it is up to this committee to ensure that the language of the bill is in fact expressed in such a way that the autonomy of the institutes is guaranteed.

• 1620

The second factor is a balance of interests on the governing council, and again this committee may decide that it wants to lay down some rules over the composition of the governing council that are more specific than the rules that are in the current bill. We've already indicated to Minister Rock that we do want to see labour interests represented on the governing council.

The third factor is transparency. It's not at all clear from the bill that the requirements of transparency are sufficient to show that the institutes will have the autonomy that members of this committee clearly desire.

And the fourth question is accountability. In our view, there has to be somewhere in the bill some discussion of how accountability is going to take place between the specific research institutes and the governing council that is clearly responsible for them.

I should say that in HEALNet, which is one of the most successful centres of excellence the government has set up, the scientific review committee is now composed entirely of scientists and is at arm's length from the governing body of HEALNet. In our view, it is virtually impossible in this case that you would get the undue influence of any one constituency over the work of the institutes—and in this case the undue influence includes influence from labour. From our point of view, obviously we want to see labour interests reflected in the research, but if there's going to be impartiality, it's quite clear that every constituency has to be excluded from the review process. This is what occurs in HEALNet, and perhaps this committee should decide that it wants to lay down rules of accountability in the bill that's before us right now.

The Chair: Thank you very much, Mr. Bennett.

Mr. Dave Bennett: Secondly, do we want a specific institute? May I reply to that?

The Chair: Yes, very quickly, but please also state your title for the record.

Mr. Dave Bennett: Yes, my name is Dave Bennett, and I'm national director of health, safety and the environment for the Canadian Labour Congress.

In response to the question about whether we're asking for a separate institute for occupational and environmental health, yes, we are. Also, in the executive summary appended to our presentation—the committee will get that quite shortly—we've set down a number of proposed changes to the bill that we hope the committee will adopt when it puts forth its report to Parliament.

The Chair: Thank you very much for that clarification.

[Translation]

Mr. Patry, you have the floor.

Mr. Bernard Patry: Thank you, Mr. Chairman, and thank you to our witnesses. I must say that I'm extremely satisfied with the presentations you have made today. My first question is for Mr. Vaughan.

In the same vein as Mr. Ménard, I would like to ask you about the office of clinical excellence within CIHR. That office would be responsible for recommending protocols to specifically address health outcomes.

I don't feel that what you say is very clear, in that your statements are made purely from the standpoint of social sciences and the humanities; you are talking about basic and clinical research. I would like more details on this, if you don't mind.

Secondly, you said a great deal about biomedical and social sciences, social factors, lifestyle and factors relating to the physical environment, something I am very interested in. You said there was a need for balance, yet made no specific recommendations. I would like to know how that need for balance would be reflected in the bill before us today.

Doctor Knoppers, this is the first time I have seen such an elaborate report on ethics, and I would like to congratulate you as chairperson of the subcommittee. In part III.C, you deal with advice and reflection on the ethical, socio-cultural, legal and policy dimensions of health research and health systems. You said that we needed a national forum.

The subcommittee sees three options. First of all, you suggest creating a fully independent advisory committee, but since that may take time—you know how much time things can take here in Parliament—you would create such an advisory committee within CIHR.

• 1625

How would you see that advisory committee on ethics, which could affect all the sciences and all the institutes?

[English]

The Chair: In response to Monsieur Patry, Dr. Vaughan.

Dr. Peter Vaughan: Thank you, Mr. Chairman.

The first question relates to the office of clinical excellence and outcomes research. We need to take the information that we derive from research and speak specifically not just with regard to the output that various research bodies do; we need to think about what the outcomes of this research are going to mean to the health of Canadians.

Now, the kinds of indicators that are used currently are felt by many people in the research world, and I think in the health services world generally, to be not as good as what we need to develop in order to understand what we are getting for our money, so to speak, and what it means to Canadians. We need to develop those kinds of indicators that can more clearly define what it is health outcome means as a result-oriented approach. That's the first thing.

That cuts across various components of the research field, so it's not just what those outcomes mean in terms of biomedical research but what it would mean in terms of social science research, and I think we need to get much more rigorous in our understanding of what it means to determine results from the social sciences research. So allowing us to think about what the outcomes are for Canadians helps us to focus our research to include, across the spectrum of the institutes, outcomes for Canadians and what it means for their health.

That's the first part of your question.

Mr. Bernard Patry: Yes.

Dr. Peter Vaughan: The second part refers to how we achieve a balance of interests. Well, that is the work of this committee, with all due respect, Mr. Chair, and we would be supportive of all of the interests that you have to balance.

The Chair: So whatever we do, you'll like.

Dr. Peter Vaughan: I have no doubt that you will make the best decisions possible.

The Chair: Thank you very much.

Dr. Knoppers, please.

[Translation]

Dr. Bartha Knoppers: I will answer your question on one of the three structures to be established within CIHR. The office will be the infrastructure used to disseminate information. The committee on ethics policy and procedure will establish standards for researchers and the internal operations of the institutes to ensure that the standards governing researchers are harmonized, if not uniform.

Canada desperately needs an independent committee that reflects on macro-issues, rather than simply respond to events. Through these institutes, perhaps we may begin to fill that need. The committee would be within the Health Department, since the institutes would be subsidized by the Health Department. It would be reasonably independent and multidisciplinary, so that it could pave the way for reflection upon themes of importance in the future. The committee on ethics would be rather like our own committee on policy and procedures. Canada does not have a central body dealing with such issues. So through these bills and CIHR, we may see our first Canadian Advisory Committee on Ethics.

[English]

The Chair: Thank you very much.

Mr. Patry.

[Translation]

Mr. Bernard Patry: Paul Lucas, a representative of Glaxo Wellcome Inc., a pharmaceutical company, sat on the Interim Governing Council Subcommittee on Ethics. Do you see an ethical problem with having a representative of a patent drug company sitting on a standing committee, as opposed to on an interim committee, or on some boards of directors? Could there be a conflict of interests?

Dr. Bartha Knoppers: I will give you the same answer I gave before.

Mr. Bernard Patry: Yes.

Dr. Bartha Knoppers: There are two schools of thought. Many people in ethics are strongly opposed to having any representatives of drug companies on the governing council. In fact, that is the majority view.

• 1630

Personally—and this is my personal and probably minority view—I think that the time has come to integrate the private sector into the governance of research. By private sector I mean drug companies, people who invest venture capital, and so forth. Since the private sector now subsidizes most of the research carried out, it must be included in research governing bodies in order to raise its awareness of ethical norms and bring it into the ethical responsibility culture as we know it in the public sector. That means transparency, accountability, and all the rest.

The Chairman: Thank you.

[English]

Ms. Wasylycia-Leis, please.

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): Thank you, Mr. Chairperson.

I'd also like to thank all the presenters for this afternoon's appearance. I have three questions—one, I think, for each our presenters.

The first is to Mr. Yussuff and Mr. Bennett regarding the major focus in their paper on whether or not this bill truly lives up to its billing to create a transformative approach to health care research in this country today. It has been billed as a way in which to start shifting the agenda so that we consider economic, environmental, social, and cultural determinants both in our research agenda and in enhancing our health care strategies.

What you seem to be saying is that the bill as it's written doesn't seem to do that. I'd like to pursue that a bit further. Obviously in this process we aren't going to accomplish the agreement from the government about which institutes will be established. What else can we do in terms of this bill to ensure that there is a real focus on, as you said in your paper, prevention and causation, and that we truly live up to that aspect of the bill?

The second question ties into that, and it goes to Dr. Vaughan. It is a question we raised earlier, and that is, if we're transforming our research agenda to look at these fundamental determinants of ill health, how can we measure progress? How do we ensure that the results of that research get transformed into action?

We've talked in the past about the need for both political will and a fundamental shift in public policy. You suggest an office of clinical excellence. When we've raised this in the past, it has been suggested that there will be a regular reporting through the CIHR to Parliament, and that this is one way we can keep track of things and ensure that we hold people to account. I'm wondering if that's enough. How we can advance the idea of this office?

The third question has to do with the whole area of ethics. Many people have raised concerns with us about whether or not the same group of people, the group of people responsible for the research, can also be in charge of the ethics. They wondered if in fact we should be looking at a separation of the two functions and having, as I understand it—I could be wrong—what is the case now in the United States, with the separation of an ethics committee from the NIH and a direct reporting to government. My question is, would it not be in our best interest to avoid any perceived or real conflict of interest and separate that function from the governing council per se?

The Chair: Thank you very much.

Let's begin with either Mr. Yussuff or Mr. Bennett, please.

Mr. Dave Bennett: Thank you, Mr. Chair.

I think Ms. Wasylycia-Leis' diagnosis of the problem with the bill is quite right. If you look at the intentions as expressed in the bill, they are in some cases there—they're at least mentioned—but they're not amplified. Furthermore, there's no indication in the bill that these aims and intentions will be achieved. There's no mechanism set down whereby parliamentarians can ensure that the intentions they've endorsed actually are translated into practice.

For example, innovation is quite rightly mentioned in the bill, but one of the key factors in innovation is to ensure that the public demand for research is properly reflected in the work the institutes undertake. There's no indication in the bill that this is going to happen. Public pressure is surely just as much as a motive as scientific curiosity, and it's even more of a motive than business pressure in producing the sort of research that's going to meet public demand.

• 1635

So we'd like to suggest that the committee should look at the idea of some way of relating the quest for innovation with the mechanisms that are going to be used to ensure that innovation does in fact take place.

If you look at prevention, the reason we are wanting to see an explicit emphasis on the prevention of chronic disease is that if you look at the spectrum of research that's undertaken, there's a quite clear bias towards research on cures for disease, on treatment of disease, and on the dynamics of disease, rather than on prevention itself. It needs the contribution of Parliament and parliamentarians to point out that you must have a balance between prevention and remedial action.

The bill has to express that balance. Unless that's done, we're going to see a continuation of a very traditional pattern of bias towards treatment and remediation—a bias, by the way, that is expressed in the work of the various associations that are there, quite rightly, to promote public health. There are, for example, the institutes for cancer in North America; their work is very strongly biased towards prevention and treatment. Even where there is a claim that they address prevention, when you actually look at it, the prevention is in fact very much in terms of what's called “secondary prevention”, i.e., arresting the progress of disease, which is certainly not primary prevention and is not the sort of prevention we're talking about when we say we need preventive disciplines to be addressed.

In our suggestions for legislative change, we've suggested the phrase “a central institutional focus” on prevention and causation. If the committee would want to go even further and specifically recommend an institute for occupational and environmental health with a mandate on prevention and causation, that would be even more helpful.

Finally, if we look at the language of the bill in terms of the determinants of health, the causation that's linked with prevention, first of all, it isn't there. The word “determinants” is never used. You have the word “influence” used, and you have the word “factors” used, but it's almost as if the drafters of the bill had a fear of actually committing public policy to prevention and causation.

By the way, if you look at the French version of the bill, it's even weaker than the English one. There is a huge discrepancy between what the English version of the bill says and what the French version of the bill says. Neither of them, in any event, use this word “determination”, which relates to causation.

So there are many ways in which the bill could be improved, and we would like to see those improvements incorporated into the report to Parliament.

The Chair: Thank you very much.

Dr. Vaughan, please.

Dr. Peter Vaughan: Thank you, Mr. Chair.

The issue of determining how you measure the outcomes of determinants of health is a crucially important one. It's important to recognize that if we are going to know exactly the value of the research that we are doing for Canadians and what it means for Canadians, we need to have some commitment to look not just at the throughput of what we do, but at what it means where the rubber hits the road. Talking about the social determinants, while important, also makes us focus our attention on the need to look at the outcome for those dollars spent for Canadians, for the value of that research, which is clearly important.

The second component is how you move this forward. I think that's what we're trying to do here today by talking to you about this and by creating awareness of the importance of knowledge transfer.

We have to once again reiterate that this is a very serious deficit we have currently. Because of the lack of current federal financing for health research over a number of decades, where the rubber hits the road—in the trenches, in the clinical laboratories, where hospitals and laboratories intersect—we have lost a tremendous capacity: those people who have been doing that research and transferring that knowledge to the bedside have left the country.

• 1640

This is a crucial point to make. We need to build that capacity. And the only way to do that is, first of all, to recognize that we've lost a tremendous resource in this country and that we need to focus our attention to rebuild it. This office of clinical excellence recognizes that need, that knowledge transfer component, and brings it into the institutes, across the institutes, so we can transfer that important knowledge that's gained in all of the institutes to the bedside, to the population, to the clinic, wherever it may be.

The Chair: Thank you very much, Dr. Vaughan.

Dr. Knoppers, please.

Dr. Bartha Knoppers: Yes, to answer your question, you're describing what happened in the United States, when the Office for Protection from Research Risks was moved recently out of the NIH. In our discussions, we were very well aware of not falling into the same trap of both writing the rules and then judging conformity with the rules.

Currently, all research protocols on an individual level go through the tri-council filter, through the university ethics committees. Tomorrow you'll be hearing from a group called NCEHR, the National Council on Ethics in Human Research. They are created by three councils to set the standards for research ethics boards, and evaluate how the boards are doing and what problems research ethics boards across Canada are having, similar to the Canadian Council on Animal Care. Those bodies, then, will be the initial, if you like, filters for conformity to ethics standards of research within CIHR or anywhere else.

Our proposal for the creation of a policies and procedures committee within CIHR would be to set the internal requirements for all institutes and all applicants for institute funding that would allow the institutes to add another level of accountability on questions such as integrity, conflicts of interest, and commercialization. So we would only be building on the tri-council document and not in any way doing the judging function that NCEHR and the universities already have. The other function, the think-tank, the free-standing, independent advisory committee, would be, in a way, moving their whole research and ethics agenda forward for Canada. So those firewalls have been built in.

The Chair: Thank you very much, Dr. Knoppers.

I wanted to ask a quick question on ethics. I think it's paragraph 5(d) that talks about monitoring, analysing, and evaluating ethics. I wondered if you, in your opinion, thought that the legislation gave enough emphasis on ethics in this case.

Dr. Bartha Knoppers: Perhaps you have more of a historical memory of previous health legislation, but to me, the number of times ethics comes up is quite remarkable. I think I've counted four so far—once in the preamble and three times in the substantive body of the text.

Now, it is generic. Paragraph 5(d) does not describe the instruments. It will be left to the CIHR themselves to set the standards for monitoring, analysing, and evaluating. We had an advisory group with us in our ethics subcommittee in the preparation of our report that represented the interests and the role of NCEHR, the CCAC, and so on. It will not be a solely CIHR function, because these bodies already exist. So you want to collaborate and cooperate, rather than duplicate. There is, however, a responsibility for CIHR to keep its own house in order. And in that sense, for internal standards, it must also develop its own polices and procedures.

The Chair: Thank you.

Dr. Vaughan, you spoke about the need for balance between the biomedical and the social sciences in CIHR. I wondered if you thought that should extend in a proportional representation way to the bodies—the interim council and the committees and such—and whether or not, with respect to funding, it also should be proportional representation.

Dr. Peter Vaughan: Mr. Chair, that's a very good question in terms of the how. We feel that the balance, however it is achieved, would be crucial in terms of the quality of people who are on the governing council, and not so much the hats they wear. I think where you're coming from should not be the reason you're appointed to the governing council. From my perspective, it should be the quality of the individuals who are there.

• 1645

So I think it is possible to achieve a balance, with an appropriate search for pre-eminent Canadians who can bring a balanced perspective within their own minds and hearts to that table, rather than simply defining constituencies and having everyone at the table. I think we need to move beyond that. As we talk about developing a knowledge-based organization like this, it should be the quality of the intellect that people bring to the table.

The Chair: Can I also push you a little bit on when you spoke about keeping Canadian scientists here? We're going to hear, in a moment, from some of those people who have actually come back. Would you give advice to us that we should be actively recruiting Canadians who've left to come back to Canada?

Dr. Peter Vaughan: Mr. Chair, as a Canadian who's come back—and who was brought back with great enthusiasm—I can certainly speak to that point. And I'm glad to be here. I think it's important that we sell ourselves, and I think that's one thing we can learn from other jurisdictions that have gone out and harvested Canadians, because in some ways we are easy pickings. I think we need to learn from those behaviours, to go out and start to harvest back the Canadian minds that are already out there, and demonstrate, in this type of initiative, that we are serious about knowledge growth and innovation in this country.

I think it deserves serious time, effort, and commitment to go out and bring people back. We have to demonstrate that there is something to come back to and that it is worth coming back. I believe it is. I believe this bill's a good start. We need to continue the funding for that.

The Chair: Thank you.

Finally, to Mr. Yussuff or Mr. Bennett, when the interim governing council had its consultations, were you involved in those consultations and are you aware of other unions who were as well?

Mr. Dave Bennett: Yes, we were certainly well aware that they were going on, and we've had discussions with the acting manager of the institutes. But three times we have requested Minister Rock to involve the Canadian Labour Congress on the interim governing council and the task force, and three times there's been no reply.

The Chair: Thank you very much.

We're under a bit of time constraint here; we have another panel of witnesses. So I would like to thank each and every one of you very much for your participation today. It's very insightful and very useful for all of us. We'll suspend these hearings for about five minutes, and we'll make the change at that time. Thank you very much.

• 1647

• 1653

The Chair: Ladies and gentlemen, we want to move on with our next panel with respect to Bill C-13, and I offer my apologies to each and every one of you. I know you're very busy people, but we were running a little bit late in terms of time from the previous panel.

We have Dr. Ron Worton here. He is, of course, the CEO and scientific director for the Ottawa Hospital Research Institute.

Dr. Worton, you'll recall that a number of us went on a tour there, I think it was a week ago Thursday. We met on site, and it was very well received in terms of what you told us at that time. We're also certainly looking forward to what you can tell us here today by way of testimony as well.

I'm going to let you introduce the people you've brought with you, if you would, Dr. Worton, and I'm sure you have some opening comments. Why don't we proceed on that basis, and we'll have questions from the committee once you've done that.

Dr. Ron Worton (Chief Executive Officer and Scientific Director, Ottawa Hospital Research Institute, University of Ottawa): Thank you for the invitation and the opportunity to present today.

As part of my opening comments, I certainly will introduce the four young scientists who are with me. I'd like them to take a few minutes each to tell you their story.

These are four people who have recently worked outside of Canada. In fact one of them is an American who was recruited to Canada. I think it's important for them to tell you their story so that you get first-hand some feeling for what this legislation means to them, for what it means to their future, because they're the future of Canada. I represent the past and the present in Canadian science, but they represent our future.

We really want to talk about Bill C-13 as a whole. We're not here to take issue with any particular clauses or statements with Bill C-13. I think our message is a very positive one.

• 1655

We think this legislation is perhaps the most important legislation in the health and health care fields that's come along probably since the creation of the Medical Research Council of Canada back in 1960. We want to emphasize this point: the importance of this legislation as it stands as a whole, how it is going to help Canadian science, how it's going to help Canadian scientists, and how it will help to allow us to recruit and retain scientists in Canada—and not just Canadian scientists, but scientists from other parts of the world who may choose to work here.

All five of us will be directly and pretty dramatically affected by this legislation and by the creation of the CIHR. All five of us are also career scientists. I emphasize that because there are many people who do science but who do many other things as well. Many university professors who are doing a lot of teaching also carry research programs, and very important ones. All of us are involved in a research institute setting, where research is really our primary involvement. We do teach, to be sure. We teach graduate courses and so on, but our careers are really in research. Therefore, we are very dramatically impacted by this legislation.

So the topic, if you want us to summarize it in a nutshell, is the brain gain. We're talking about recruiting and retaining Canadian scientists.

Let me introduce Dr. Andrew Badley. He'll tell you more about himself in a minute, but Andrew is a clinician, an expert in infectious disease, and a research scientist in the Ottawa Hospital. He's also an assistant professor at the University of Ottawa and has done part of his training in the U.S., as he will tell you in a few moments.

Also here is Dr. Valerie Wallace, who is a PhD research scientist who was recruited to our Ottawa Hospital Research Institute fairly recently. She is also an assistant professor at the University of Ottawa.

Thirdly, Dr. David Picketts is a research scientist—we're all from the Ottawa Hospital Research Institute, in essence—and he is a full-time scientist in the institute and an assistant professor at the University of Ottawa.

Finally, Dr. David Park is a neuroscientist who came to Canada about a year ago from the United States. He's an American citizen who has chosen to work in Canada.

I should tell you that recruiting U.S. scientists to Canada is important for us. It is important that we bring in other people and other kinds of expertise. It's not always easy to do that, so David will tell you his story as well. David is in the Neuroscience Research Institute, which is part of our hospital structure, and he is also an assistant professor in the university.

On the reason we're here, I think you know a little bit about us already. There was a very nice article written in the Ottawa Citizen back in June, talking about the opportunities that were presented by creating a new research institute in the Ottawa Hospital, and how that has allowed us to bring people from outside the country.

The institute that was created in 1996 at the Ottawa Hospital... I should say, by the way, that there are two research institutes affiliated with the Ottawa Hospital. One is the Loeb Institute for Medical Research, which is on the Civic campus of the hospital. The other one, the one we're here to talk about today and the one we're representing, is the Ottawa Hospital Research Institute, which is on the General campus, together with the medical school.

The institute that we created just three years ago—and I was recruited here to create that institute—has a major focus on the molecular determinants of disease. What has become clear over the last decade or more, over the last fifteen years or so, is that opportunities now exist for characterizing diseases; characterizing all forms of illness at the molecular level; and learning what happens at the molecular level, inside cells, and causes disease. That leads us to prevention, to treatments, and to management. We therefore created an institute that really has a focus on the molecular genetics of disease, as a lot of the molecular components of disease are dictated by our genes.

• 1700

The molecular genetics of disease is one aspect. As part of that, we have a major research focus on HIV and AIDS because of the importance of that problem in the world at large, and Andrew is going to talk a little bit about his HIV work.

A third major area is molecular neuroscience—the molecules that determine how the brain develops, how it is maintained, and what happens at the molecular level when neurodegeneration takes place. Both David Picketts and David Park are going to talk about that a little.

Valerie Wallace is in our eye institute, and she will tell you a little bit about her research on the eye.

Our recruiting efforts over the last three years have to some extent focused on Canadian scientists, but our ads have gone out broadly. We've been able to recruit twelve scientists into our institute over the last three years. Of those twelve, several were Canadians who were in training positions outside the country and have come back. Four of those are with us today. Then, as I said, David Park represents a brain gain from the U.S.

I want to say for a moment how important it is that our scientists from Canada, our young Canadian scientists, do train on the outside. I did that myself. I went to Yale when I was a research fellow, after I completed a PhD here. I am one of those who is quite insistent that our young scientists, particularly when they complete a PhD degree and before they settle into a research career, really should go outside of the country. It's not that we can't train good people here, but they get a different perspective from outside the country. The choice of labs to work in is broader.

Having people go to the United States or Britain or France or other countries serves us well in the long run if we bring them back. If we don't bring them back, it's our loss. If we send them out to train elsewhere and they stay there, that doesn't help us one bit. But if we can have them train outside the country and they then come back, they bring new knowledge, new ways of doing things, and an expanded vision of their own research programs that is important for the country.

Amongst the scientists who are with us today, all were recruited from outside the country. All have benefited from the CFI new opportunities program. You're all familiar with CFI, and your creation a couple of years ago of the Canada Foundation for Innovation. Part of the Canada Foundation for Innovation money for infrastructure went into a program called the new opportunities program. That was really for young people who were starting up their labs within the first few years of their training, and who could therefore benefit. All four of them have benefited from CFI funding as they've come back into Canada. If you like, they could easily expand on that a little.

All of them have very good grant support for a young group of investigators, and all of them have the talent, the energy, and the enthusiasm to become internationally renowned scientists. All of them, however, need the kind of support that the CIHR will give if they're going to succeed, and if they're going to succeed at the level of becoming internationally renowned scientists. As I've said, all have the capability of doing that, but that's virtually impossible with relatively low levels of funding.

I think the CIHR are key to their success. Some of the elements of the CIHR are key to their success, such as the peer review system, for example. All of them, I know, will compete very well in the peer review system to obtain the kinds of grants they will need to make them internationally competitive.

Just before asking them to tell their stories, let me tell you a little bit of my story. I trained at the University of Manitoba for a master's degree and a bachelor's degree. I then went to the University of Toronto for a PhD—and that was many years ago, I might add. I then went to Yale. I spent three years at Yale during the height of the Vietnam War—which was another enlightening experience—as a post-doctoral fellow, and then came back to the Hospital for Sick Children.

I spent 25 years at the Hospital for Sick Children. During that time I moved from being a junior scientist to a scientist to a senior scientist, and I went through the ranks in the university up to professor. In the last 11 years that I was there, I headed the department of genetics in the hospital, and just at the beginning of that time period it was my lab that discovered a gene that causes one of the forms of muscular dystrophy. As a result of that, we not only discovered the cause of muscular dystrophy, but we also developed the first diagnostic test for that disease, the first carrier test to detect the defective gene in mothers who carry the gene and pass it on to their sons. We developed the first prenatal diagnosis for that disease, which is now done around the world routinely.

• 1705

I'm telling you this for a reason, because I want you to realize that there are many, many places in Canada where excellence prevails and where we do have worldwide reputations.

Following the discovery of the muscular dystrophy gene, the team of Dr. Lap-Chee Tsui, who is right across the hall from me, discovered the cystic fibrosis gene. Shortly after that, the lab next door discovered the Fanconi's anemia gene, and the lab around the corner discovered the Wilson's disease gene.

We were all on the same floor in the same place, and it became probably the most exciting and the most world-recognized genetics department in the world. We would have visitors come in from Japan or Europe who would say “My God, I know all of you by reputation, but I didn't know you were all on the same floor in the same hospital.”

That's because we had good funding from Canada. Those were the good days. We had good funding from the Medical Research Council, from health charities, and from other sources. So good science can be done in Canada, and we have the people to do the good science, but they need support.

In my own case, that research recognition came in the form of membership in the Royal Society of Canada, a Gairdner Foundation international award, and the Order of Canada. Of the small group of people that I just described on one floor at Sick Kids, four of them in fact wear the Order of Canada pin.

I've held a number of influential positions, as chair of the genome analysis program, the forerunner to Genome Canada, which I'm sure you're also going to be debating in the legislature before too long. I've been a vice-president of the International Human Genome Organization, and a vice-chair of the board of the Muscular Dystrophy Association. Next year I'll be president of the American Society of Human Genetics, which represents geneticists throughout North America and in fact has many European members, with a total of 5,000 membership.

Lastly, I just wanted to mention that I am on the interim governing council—perhaps you may know that—and in that capacity I would be happy to at least try to answer any questions that have come up over the last few days, if you think I can be of help.

My research support has come from the Medical Research Council almost continuously since 1978, as well as from other agencies.

So that just gives you an idea of where I come from. Since 1996 I've been here at the Ottawa Hospital, and my job really has changed from doing research to building research enterprise, recruiting young people and supporting them.

So I will introduce first Andrew Badley, who will give you a profile about himself, his own research expertise, what brought him back to Canada, and what the CIHR means to him.

The Chair: Thank you very much, Dr. Worton. That was a very impressive presentation, and we appreciate your opening comments and the fact that you're with us today.

Dr. Badley, please.

Dr. Andrew Badley (Clinician and Research Scientist, Ottawa Hospital Research Institute, University of Ottawa): Thank you for the opportunity to speak to you today.

I'll just give you a brief summary of my background. I did my undergraduate medical school training in Dalhousie in Nova Scotia. At the end of my internship year I looked for a fellowship program and was recruited to go to the Mayo Clinic in Minnesota, in the United States.

I spent seven years there doing internal medicine, infectious disease, and immunology training. During my time there, I happened to be situated with the right group of individuals who were able to do some research into novel mechanisms by which HIV potentially destroys the immune system. It's somewhat surprising to learn that although HIV has been an epidemic for about 15 years now, the underlying reason that HIV and HIV infection causes the immune system to malfunction is still somewhat unknown.

In my time at Mayo, we were lucky enough to collaborate with a variety of investigators who had unique opportunities. We were able to describe for the first time one mechanism by which HIV can destroy the immune system. There are several others that are currently receiving interest worldwide. Because of that, I've been fortunate to have a number of recognition awards, including awards internationally and within Canada and the United States.

• 1710

Around that time I started to look for my first academic job. As a young investigator looking for the first full-time academic job, what I was interested in was an opportunity to sink or swim so that, at the end of my two- or three-year first posting, if I failed, I couldn't say it was because I didn't have the opportunities. I wanted true opportunity to do what I could do.

When I looked at the job prospects available, there were a number of job prospects in the States and a few in Canada. My perception was that the opportunities in Canada were not as good as the opportunities in the United States, and primarily that was because of funding. So for that reason I actually did not wish to come back to Canada and I explored opportunities of extending my educational visa so that I could stay in the United States.

That didn't work, and so I started to look for opportunities in Canada. Within Canada, truly, in my opinion, the best opportunity was in Ottawa due to the multidisciplinary nature of the research that's going on in Canada, particularly in Ottawa, and the collaborative environment between social sciences and epidemiology and pharmacology and basic science.

So I came to Canada, and I was fortunate in my first couple of years to receive funding from Canadian sources and international sources, and my success is due in no small part to the fact that I'm in the right field. HIV is a very topical field. Funding in HIV is probably easier than virtually any other field of research right now. So I've been very fortunate to get excellent research funding, but that opportunity is not available to all other fields of research.

So if I had one message to bring to the committee today, I would say that is to increase the level of funding to all fields of research so that those opportunities are available for all fields of investigation.

To me, the importance of CIHR would be primarily that if CIHR were instituted, there would be more opportunities for funding, and potentially and very excitingly, the opportunities for funding would be of longer duration. That's a real benefit to somebody in my position. If you're spending most of your time writing grants and trying to get them renewed, you have that much less time to do research. So the opportunity for more funding, more dollars, and the longer duration of funding is what's most exciting to me in the CIHR proposal.

The Chair: Thank you very much, Dr. Badley.

We'll move on to Dr. Wallace.

Dr. Valerie Wallace (Research Scientist, Ottawa Hospital Research Institute, University of Ottawa): I'd like to thank the committee for this opportunity to speak with you today.

I have a very different story. I did my bachelor of science degree at the University of Ottawa and I went to Toronto for seven years to do a PhD in immunology in Dr. Tak Wah Mak's lab, where I worked on a number of aspects of immune system development.

After completing my PhD, I decided to switch fields entirely and work on neural development. To do that, I felt at the time the best training opportunity for me would be in the U.K. with actually an expatriate Canadian. So I studied at University College, London for four years and became a neural developmental biologist with a primary interest in retinal and optic nerve development.

Right now my major interest in optic nerve and retina development is in the signalling molecules that control the development of those processes. Although I work on very early development in rodent model systems, some of that work may eventually be very important in trying to understand how to restore vision, which is a very important area to be thinking about because of the changing demographics in Canada and the increase in eye disease, retinal degeneration, and in optic nerve development in terms of looking at ways of treating multiple sclerosis.

So while I was training, I was fortunate enough to receive support from the Canadian government. I had a Medical Research Council post-doctoral fellowship while I was away in London. Unfortunately, that wasn't actually enough money to live on in London, and I was fortunate enough to get an international fellowship from the human frontiers in science program.

I've been back in Canada for a year and a half, and one can ask the question, why did I want to come back to Canada? I came back to Canada because I wanted to live in Canada. I did not come back to Canada for the science because of the funding situation. In fact I was usually discouraged by my colleagues to come back to Canada and I explored opportunities abroad, but the desire to live in Canada prevailed.

• 1715

Certainly this opportunity to work at the Ottawa Hospital Research Institute was a very exciting opportunity for me. It was one of the best opportunities at the time in Canada and it certainly gave me enough support to get my lab going.

Since arriving in Canada, I've been fortunate enough to get some very good funding. I have funding from the National Cancer Institute, the Terry Fox New Investigator Award, from the E.A. Baker Foundation for the Prevention of Blindness. So my lab is getting started and we're moving along.

There are a few things I'd like to say today about why this bill is important to someone like me.

First of all, to do internationally competitive research you need a lot of money. If you compare the level of funding that I have compared to what an American would have in terms of start-up and running costs, it's a lot less. So there's no way I can compete on that level.

Secondly, the grants are usually for three years. That means you're trying to renew your grant in two and a half years' time. Research takes time. Most of what you do doesn't work. You need to have the time to explore and do things properly and get somewhere.

Three-year grants create a lot of problems. Also, because we don't get enough money to do what we need to do from our first grant, you will notice most of us have multiple funding sources. So we're spending most of our time writing grants and not training the people in our lab to do experiments and not doing our experiments ourselves.

Finally, I am ambitious. I'd like to do well in my career and I'd like to stay in Canada. If the funding situation isn't appreciably better, then I don't know if people like me will stay in Canada. We may look for opportunities elsewhere.

Thank you.

The Chair: Thank you very much, Dr. Wallace.

We'll move on. Dr. Picketts, please.

Dr. David Picketts (Research Scientist, Ottawa Hospital Research Institute, University of Ottawa): I too would like to express my gratitude and appreciation for being invited here to talk to you today. I'll also follow the same format and give you an introduction about myself and the reason I'm here today.

I'm a molecular geneticist, trained initially at Queen's University with a BSc in Biochemistry. Following that, I went to McMaster University in Hamilton for an MSc and then returned to Queen's University for a PhD.

I also looked at the opportunity of where to do a post-doctoral fellowship. I agree with Dr. Worton that it's important that people go abroad to see what it's like to do research in other countries. I also chose the U.K. and travelled to the Institute of Molecular Medicine, which is affiliated with the University of Oxford in Oxford.

I stayed there for four years. While I was there, we cloned a gene that, when it's mutated, gives rise to several forms of mental retardation. At that time it was touted as one of the most significant advances in mental handicap research since the identification of the fragile X gene.

There was ample opportunity to remain in the U.K. and begin my own research group there. Mainly for personal reasons... I think a lot of Canadians who were born and raised here ultimately want to return to Canada, and that's my situation. I had a strong desire to return to Canada to do research here. I began looking for opportunities where I would be successful at that.

The Ottawa Hospital provided that opportunity. There's a generous start-up package that is very competitive amongst other institutions that I looked at. So it was quite an easy decision to come back. I also heard a lot of optimism from other scientists, colleagues, and friends who were in Canada that the funding situation was going to improve. I was fortunate enough to get a Medical Research Council operating grant in the lean years in 1996.

I'm about to renew this grant this year, in March. I too would just like to point out the importance of CIHR in this respect.

• 1720

With that grant, I was able to fund one research technician and provide supplies for that person and me to do the research. To be internationally competitive, I think, you need three or more people on a project to really drive the science forward and make a significant contribution. That's one of the reasons I'm in favour of CIHR: the increased grant support, which will allow for more than one employee on a project and increase the international competitiveness.

There's another way to look at that. Since we've cloned this gene involved in one form of mental retardation, we've identified eleven other genes that represent strong candidate genes. We're only able to pursue one of those eleven genes to pursue that interest, to try to determine its role in mental handicap. I think that with increased funding and being able to apply more than one individual per project, we can hopefully move the science a little faster.

The Chair: Thank you very much, Dr. Picketts.

Dr. Park, please.

Dr. David Park (Neuroscience Research Institute, Ottawa Hospital; Faculty of Medicine, University of Ottawa): Thank you very much.

I did all my training in the United States. I was recruited to the Neuroscience Research Institute about a year and a half ago from the United States. I did so less because of the research that was being done in Canada in general, but more specifically because of my excellent colleagues at the NRI.

My area of research is in neurodegeneration and stroke, which is one of the key reasons I came to Canada: there were some opportunities here, specifically with some of my colleagues, which I could not have easily obtained in the United States.

In truth, like Dr. Wallace, I was strongly warned against coming to Canada, both by U.S. researchers and, surprisingly, by established Canadian researchers as well. They characterized Canadian research as having excellence, but warned that this excellence existed in spite of the current funding climate, and that is something a new researcher doesn't necessarily want to hear.

So I came to Canada with a little bit of trepidation. Having been here for a year and a half, I do find some sense of optimism, and that mainly comes from the initiative of the CIHR. The ways in which the CIHR would help me personally as a Canadian researcher are very similar to what my colleagues have said previously. I'd just like to add that it's also, for me, a very likely prerequisite for continuing to stay in Canada for the long term.

The Chair: Thank you very much, Dr. Park.

We'll lead off now with questions, beginning with Monsieur Ménard.

[Translation]

Mr. Réal Ménard: I appreciate the fact that you focussed on research concerns that help us understand your expectations. When you are outside the field, you tend to see researchers as eccentric, cerebral creatures locked in their ivory towers with no connection to the world around them. You have perhaps given us a more realistic image.

I have four or five questions. The first is to Dr. Worton, who is on the interim governing council. I will come back to it in a moment.

My second question is on AIDS, an issue I am very interested in. We try to understand why people leave Canada. Grant money is of course always an issue. Don't project leaders ever get funding that extends over more than three years? I thought that the interim governing council would be approving strategic plans for each institute, but that those plans would be annual. How would that make it possible to commit longer-term funding, given the way the institutes would operate?

• 1725

Secondly, on the issue of AIDS, how can we explain the success that a private laboratory like BioChem Pharma is having? Would researchers there have had the same success within research institutes, or in a public-sector laboratory? How can you explain their success?

Obviously, some people say that a full research cycle—from the moment you first isolate a given molecule to the moment you come up with a patent drug—can easily cost $500, $600 or even $700 million. I would like to hear Dr. Badley's view on this.

Now for my last question. If I understand correctly, the institutes will not be focussing on equipment acquisition. They won't be aiming for the latest laboratory equipment, but rather on concrete measures that will foster research and the ability for researchers to network. What is more important for a researcher? Funding for his laboratory, or equipment? How important do you consider equipment? I understood it was very important as well, but is not a prime focus of these institutes.

My last question is to Dr. Worton, whom we lost a few moments ago. You are on the interim governing council. What will happen if a given institute's strategic plan fails to get internal approval and goes back to the board? How will decisions on AIDS research be taken? Some people want a separate institute for AIDS research, while others, like Dr. Sékaly, say that there should be an institute on virology and immunology. How do you feel such decisions should be made?

The Chairman: Thank you, Mr. Ménard.

[English]

Dr. Badley, would you lead off, please?

Dr. Andrew Badley: Certainly. Regarding the first question concerning how there are perhaps more opportunities for longer-term funding outside of Canada than in Canada, currently in Canada there are relatively few mechanisms in place for pharmaceutical-government collaboration in terms of long-term drug trials.

A large number of the advances we've made in HIV—and in fact in other diseases—are related to the science that can be attached to drug therapy trials. As mentioned, in Canada these are not very well funded. Outside of Canada, they are.

There are two main agencies in the United States that fund these. First, there are NIH-sponsored studies. There is currently one that's been initiated by Dr. Tony Fauci, the director of the institute, on a therapy of IL-2 or interleukin-2. This trial has 10 years of funding, so it has government funding to treat patients for 10 years and follow them over that 10-year period. It's the follow-up that is essential in order to get novel insights into how you're making a difference in disease course. It would not be possible to do that kind of study here.

The other source of funding for that in the United States is another institute called the AIDS Clinical Trial Group—ACTG. They also have mechanisms in place through government funding—although it's a different pathway—for studies of up to five years. Currently in Canada that is not an opportunity. Currently the funding in Canada for HIV-based research is through MRC-related trials of a maximum of three years.

I think the longer duration is essential, especially when you're trying to make an impact into disease progression. Frequently we won't know whether or not we've made an impact for several years, so three years is not—

[Translation]

Mr. Réal Ménard: So through the institutes researchers will be able to get funding for periods of more than three years, even though their strategic plans...

[English]

Dr. Andrew Badley: Yes.

[Translation]

Mr. Réal Ménard: ...will have to be prepared annually? How will the institutes allow researchers to get five-year funding, for example?

[English]

The Chair: Dr. Worton.

Dr. Ron Worton: Having been on the interim governing council, I think perhaps I can best answer that. Yes, we do plan that the institutes will submit annual plans and that those plans will be approved on an annual basis.

However, those annual plans can commit funding for the long term, so that if there's an institute related to infectious diseases and one year it suddenly realizes that we have a major health problem with hepatitis C, as we recognized a few years ago, a plan can be instituted in that year, with some long-term goals to enhance the research in that area and to develop specific approaches to deal with the problem.

• 1730

So the annual budget that will be developed by any given institute does not imply that it makes only short-term commitments. Part of its annual planning will be to put into place long-term commitments.

The other aspect is that a substantial proportion of the funding that comes to any given institute and is directed through an institute will come from researchers who put in grants to do research in their area of research, which will be judged excellent by the peer review system. Simply because there will be more money available to CIHR than there was to MRC, it will be possible to make longer-term commitments.

From everything I've heard in our discussions at the interim governing council, we would anticipate that the CIHR governing council will want to institute a program of longer-term funding so that some of the initial grants, which are given for only two years now, will be for three. The renewal of those grants, instead of being for three years, will likely be for five years. That's going to free people up from this necessity to write two or three grants a year.

When I was writing a lot of grants a few years ago when my program was at its peak, I had grants from four different agencies. Some of them were shorter-term and some of them were longer-term. If I wrote a really good grant that would have some assurance of being funded, I would put three months of effort into that. If I have to write four grants a year and each one gets three months of my time, you can see how much time I'm spending in the lab doing the work. Longer grants are enormously helpful in allowing scientists to get on with the job of doing science.

The Chair: Thank you very much. While you're at it, Dr. Worton, did you want to respond to Monsieur Ménard's last question?

Dr. Ron Worton: The last question was how will the CIHR determine the slate of institutes? If we're going to have 15 institutes, what will they be? Will one be for cancer? Will one be for heart? Will one be for aging? Will one be for social determinants of health? Or will one be for the problems of health in the workplace, as we heard from somebody in the last hour?

We've wrestled with that question for close to a year now, for nine months. I think the process we're just putting into place is the best one, that is, we're going into a very broad consultation. Up until now, the interim governing council has chosen not to be fully consultative, because we had to define what an institute would look like and how the whole thing would function. We spent the first three months getting draft legislation in place, of which about 85% to 90% has been preserved in the current legislation that you see before you in Bill C-13.

What we have done—and it started last week—is that a broad call went out to all of the universities across the country, to all of the major health charities, to the health charity organizations as a group, and to all of the other major stakeholders. What we said to them is that by January 14 we'd like to hear from them, that we'd like to know what they think the slate of institutes should be.

That's a very different question from the one we were posing before. Before, we allowed and encouraged people to submit a plan for their favourite institute, and we've had 160 or so submissions for those. But that results in a very biased kind of request. Everybody wants their favourite institute. The people in infectious disease want an institute for infectious diseases, but the people who work on AIDS want their own institute as well as one for infectious diseases, even though AIDS is an infectious disease.

We will get a much better kind of consultation by asking for the full slate. All of the organizations across this country—all of the universities, for example—are gearing up to spend the next six weeks, with a break at Christmas and New Year's, to put their heads together, to bring together their senior researchers and some of their junior researchers in all aspects of health research, including biomedical, clinical research, social sciences and so on, to try to determine, if they had to choose 12 or 15 institutes, what they would be.

• 1735

In that process, we are hoping the answers that come back will be varied but that certain aspects will be pretty constant. We think certain institutes will come back in all those recommendations, over and over again, and make it easier to choose those. However, we're certainly not viewing this as a popularity contest for institutes, but rather what makes sense, what will capture the best interests of the country, what will allow us to cover the full spectrum of health research that needs to be captured, and what will provide a home for all the researchers in the country so that nobody is left without an institute to call home. So that's the process.

The Chair: There was a question about equipment. Did somebody want to respond to that?

Dr. Wallace, please.

Dr. Valerie Wallace: I think the question is how we distinguish between funding for equipment versus funding for running a lab. Am I correct?

[Translation]

Mr. Réal Ménard: Will you be able to get equipment? How important will it be to your work? We get the impression that institutes will make it much easier for researchers to get funding, but will not do anything to modernize research laboratories.

[English]

Dr. Valerie Wallace: I can answer part of that, but I think I'll have to turn it over to Dr. Worton afterwards.

Usually in funding an operating grant, investigators can request equipment they deem necessary to accomplish the goals and objectives of their grant, and that has been difficult in, for instance, MRC funding for established investigators. It's very difficult to actually get equipment money. Maybe once there are more dollars in the system it will be easier to get new equipment on operating grants. I hope that will happen. Whether there's a mechanism in the CIHR to replace or to rejuvenate equipment in its institutes, I don't know.

Dr. Worton.

The Chair: Dr. Worton, quickly, please. I want to get to Mr. Jackson.

Dr. Ron Worton: Sure.

First of all, the CFI, the Canada Foundation for Innovation, has been enormously helpful in putting equipment into our institutes, but still the onus has fallen on me, for example, to get money from the hospital, from the research institute, from our foundation, through private funds, to purchase a lot of the equipment just because there hasn't been enough money available from government agencies. That's fair, but the CFI has been enormously helpful in that regard.

As Dr. Wallace said, individual scientists can ask for pieces of equipment as part of their operating grant, but there you're usually talking about equipment that's valued at less than $25,000, certainly less than $50,000. If you need a piece of equipment that costs $300,000, there's no way you're going to get that on a regular grant. That has to come through some special mechanism.

The Chair: Very good. Thank you very much.

Mr. Jackson, you've been very patient.

Mr. Ovid L. Jackson (Bruce—Grey, Lib.): Thank you very much, Mr. Chairman.

I'd like to welcome our guests here and thank them for coming.

I'm going to pursue the question on the prospects, as to how we develop our talents and keep them here.

Dr. Worton, you obviously believe in the family trait that if you love your children, you have to let them go and hopefully they will come back.

I'm not going to let you off the hook as somebody from the past and the present, because thanks to you and Dr. Friesen and people like that, I think you've had the vision, and as you sort of fade into the sunset, I'm sure your experience and expertise is going to be very important, not only to us a country but to these scholars as well.

I'd like to hear from you all. Dr. Worton, I'm sure you're still going to be interested in these things for quite a while, and you're going to have some kind of transition where you're going to pass on some of your old foxy skills to these people as you fade into the sunset and look after your grandchildren. But we've heard already that a lot of money is important and that your field of research was important, that where you wanted to go was important. What are other indexes?

There has always been a generation gap between the young and the old, and I think part of what's happening—and sometimes we don't pay attention to it—is that young scientists, for instance, marry other scientists, or scientists want to have families, and what happens in the case where both of them have a career? We have a lot of new age guys who probably would stay home and look after the kids. Some people believe just the woman can look after the child, but that's not necessarily the case.

• 1740

So I want to know what some of the top conditions are that would keep you here and what's important to you, starting with you, Dr. Worton.

Mr. Réal Ménard: Well, are you single?

Dr. Ron Worton: Scientists are no different from anybody else in society. They do want to have full and balanced lives. They do want to have families and children. Most scientists in fact do have families.

I think some of the challenges to scientists are perhaps greater than to those in some other professions, although I dare say that politics is one of those other professions where the challenges are great. You have to live apart from your families for long periods of time, and so on.

Scientists spend long hours in the labs. There are many jokes I could tell you about the hours that scientists spend in the labs. Long hours are a necessary part of being a scientist, a successful scientist. That's no different from a young entrepreneur who starts up his or her own business and has to work hard at it for the first many years. We do try to provide adequate benefits, benefit packages, maternity benefits, and that sort of thing, just like any other business.

Another ingredient that's important for success in science is critical mass. It used to be, many years ago, that a scientist could survive on his or her own and do good work without hardly ever talking to anybody. Those days are pretty much past. Most of our scientists now survive in an atmosphere where we have larger critical masses. Many scientists are working on the same floor or in the same department on similar kinds of research, because ideas then flow. It's not just the ideas between Dr. Wallace and Dr. Picketts, whose labs are across the hall from one another, but it's Dr. Wallace's students and research fellows talking to Dr. Picketts' students and research fellows. That's where the ideas come from. So critical mass is extremely important.

The last point I'll make is that one of the things you've heard today is about money, but it's not just money. If we are going to be competitive with our colleagues in the United States, Great Britain, Japan, and other places, we can't run a lab with one research technician doing experiments during the day and maybe the researchers themselves coming in and doing some experiments during the day while trying to write a grant the rest of the time. That's not competitive science.

When I was at my peak of activity at the Hospital for Sick Children, during the days when we discovered the cause of muscular dystrophy, I had 14 people working in my lab. To sustain 14 people, I needed to have research funding in the neighbourhood of $600,000 a year that came from four difference sources. Most of my grants were over $100,000. The average MRC grant recently has been down around $70,000. Now it's creeping back up towards $100,000.

So if we don't have labs with six, eight, ten, twelve or fourteen people in them, we're not competitive. That's what we're talking about to be highly successful.

The Chair: Thank you very much, Dr. Worton.

Mr. Szabo, please.

Mr. Ovid Jackson: No, I have not finished.

The Chair: I'm sorry, Mr. Jackson.

Mr. Ovid Jackson: I want each of them to tell me what's important to them, what brings them back.

The Chair: Okay, Mr. Jackson.

Mr. Ovid Jackson: They could be quick about it.

The Chair: Who wants to lead? Dr. Badley.

Dr. Andrew Badley: In my view, there are two kinds of research. There's high-risk, highly exciting research, and there's low-risk, less exciting research. In the academic environment today, it's very tempting to do the low-risk, less exciting kind of research, because that's what's going to get results, that's what going to get published, and what's published ultimately determines whether or not you get research awards. In an atmosphere where there is less competition for research dollars and higher availability of funding, I could foresee that the environment would change such that it would fund more of the high-risk and potentially more highly exciting forms of research. To me, that is what would distinguish between a good scientist and a great scientist, somebody who has the funding and resources to go for those more high-risk but higher-yield questions.

The Chair: Thank you.

Dr. Wallace.

Dr. Valerie Wallace: Along the same lines as Dr. Badley, I want the security of knowing I don't have to keep going back every two and a half years for more money and that I have time to go and do some of those high-risk projects. Things may not pan out, but if they do, the payoff is big. But I want to have the freedom and the security to know I can do that.

• 1745

At almost the same level of importance is critical mass. I want to be surrounded by people who are smarter than me, people I can learn from. That can only enhance my research program and enhance the experience of my trainees.

The Chair: Dr. Picketts.

Dr. David Picketts: I think critical mass is very important. If you have two or three people on a project, you can discuss the project amongst yourselves and come up with imaginative ideas and additional ideas that you may not think of by yourself. So that would be one thing.

As well, I would love not to be financially restricted to do a particular experiment that I think is important and that I think can give me the answer directly. Right now, that is somewhat of a concern.

The Chair: Dr. Park.

Dr. David Park: My reasons would be the same as theirs.

I just want to point out that when I first came here, I was very surprised at the size of the awards usually given out to beginning scientists. When you factor in the sticker shock of the exchange rate with the U.S.—and scientists here frequently buy a lot of things from the U.S. that can't be bought in Canada—the buying power of what we get from these MRC awards go down dramatically with the exchange.

I don't want to make it sound as though it all comes down to money, but that's so much an integral part of trying to establish a vibrant and competitive lab.

The Chair: Thank you very much.

Mr. Jackson, are you satisfied?

Mr. Ovid Jackson: I just want to add one thing.

An hon. member: You shouldn't have asked him.

Mr. Ovid Jackson: They always talk about money, and I always go back to the fact that if you do design some intellectual property that somehow becomes commercialized, it should be placed back into that institute to make that pot grow rather than just getting the money from the government. The government does have limited resources. If you want that critical mass, part of what the institute has to do is increase that critical mass exponentially, if it can, with some of the intellectual property.

The Chair: We're going to take that as an observation and good advice. Thank you.

Mr. Szabo.

Mr. Paul Szabo (Mississauga South, Lib.): Thank you, Mr. Chairman.

Dr. Friesen has been before our finance committee on a number of occasions and has defended the research community in terms of its seeking out quality research environments that will challenge our people as far as possible. He has done just a terrific job.

As you know, the research funding went down, was cut along with a whole bunch of other things. It came back a little bit. You could see the movement start to happen in terms of migration numbers. Hopefully this next wave, as it were, is going to happen again.

However, it seems to me a little bit idealistic to think that Canada could be a high-quality research environment in all of the different disciplines, at all times, and be competitive. In fact it would seem to me that for any eminently qualified person, such as any of you, the opportunity to do international work has to be almost a prerequisite for your longer-term career prospects.

Are we trying to be too many things to too many people or should we just understand that people do have to be mobile in this profession, and that international exposure, with the networking it brings, with the knowledge it brings that might not be available to Canada when you happen to be passing through that part of your career, is just part of the culture of doing excellence in research?

The Chair: Who wants to tackle that one?

Go ahead, Dr. Park.

Dr. David Park: Are we putting too many demands on the system right now in terms of what we want to accomplish? One answer, from my perspective, is that the boundaries we put on scientific investigation are somewhat artificial. Things we learn in one field can and do have significant impact on other fields.

• 1750

To say that we want to focus solely on AIDS research, or make it a primary focus on AIDS research, really minimizes what we can learn from other fields. I think you have to take, from my perspective, a more broad-based approach to building up science in Canada, not be so focused as to miss great things that you could discover in other fields.

Mr. Paul Szabo: Okay. I have a last question, Mr. Chairman.

In all the comments that you've made, not one of you talked about Canada's income tax system. There was an editorial in the Toronto Star on Sunday talking about Nortel, which has been quite critical of Canada's tax system in terms of brain drain or job drain, whatever you want to call it. But the editorial pointed out that the starting salary for engineers for Nortel who work in the U.S. is $53,000 U.S. In Canada, it's $49,000 Canadian, which is really the difference between getting $85,000 and $50,000 in Canada. It is a very substantial differential. And a lot of the discussion had to do with the breadth of opportunity as well as the high demand in the U.S. vis-à-vis Canada.

There are deadlines. It doesn't matter. The price of failure is much greater than the price of paying premium salaries. Are there those kinds of aspects in terms of the opportunities that might be available abroad, whether it be the U.S. or elsewhere, in the sense that any price will do because we need this work done? Is there a sense of urgency, that we are being so aggressively competed against for the people who basically get their fundamental training within Canada?

The Chair: Dr. Badley.

Dr. Andrew Badley: I guess there are two parts to that question, as I see it. First of all is the issue of salaries, and being a physician, the differential in salary that I could expect between Canada and the States is substantial. Certainly I've had offers of double or more salary in the States.

The second part to the question is responsibilities. If anything, I perceive that the responsibilities I have being a researcher in Canada are greater. Part of the reason for that is the relatively few numbers of HIV-based researchers in Canada. So rather than being responsible for one small aspect of a research question, you have much broader responsibilities. I think that's a price you must pay if you want to live in Canada—and there are a lot of attractive parts to living in Canada.

I said in my introduction I didn't want to come to Canada. The reason for that was solely my perception of research funding. There are a lot of reasons I do want to live in Canada, and that's a price I am personally willing to pay in order to achieve that.

The Chair: Thank you very much.

Several of you mentioned that you receive funding from multiple sources, and I wondered if that's typical of other countries. I also wondered whether or not you thought that would change under the CIHR or whether it would continue.

Dr. Badley.

Dr. Andrew Badley: I very much hope we don't have to seek multiple sources of funding, but in the current research environment we do have to. The average grant award from MRC, as Dr. Worton mentioned, is under $100,000. It costs me about $300,000 to run my lab as it is right now, so I need multiple grants. I'd love it to be the case with the new CIHR that one grant will do. But to be honest, I'm not sure that'll happen for a while.

The Chair: Dr. Worton, can you shed light on this?

Dr. Ron Worton: Yes. I think it's unlikely that Dr. Badley will get a single grant in excess of $300,000 a year from CIHR in the near future. But I think what will make the difference is that as the CIHR grants inch their way upward, it might be possible to operate with a major grant and some less important or minor grants, where the major one is for larger amounts of money and for the longer term. It provides your stability and so on. Then you can live with this idea of multiple grants.

• 1755

In answer to your question of other countries, yes, other countries do rely to some extent on multiple grants. In the U.S., it's much more common to have two grants from the National Institutes of Health than it is in Canada to have two grants from the MRC. People used to have two grants from the MRC; I had two grants at one point. But that luxury disappeared probably in the early 1990s. I don't know anybody who, for the last many years, has had more than one grant.

The Chair: On grants and such, is it fair to say that there's a different process and requirement for start-up grants as opposed to continuing grants? Is that a fair comment?

Dr. Ron Worton: No, I think the requirements for a first grant from MRC, or in the future from CIHR, are pretty much the same as the requirements to get a grant renewed. It used to be—many years ago, in the mid-1980s, when I actually chaired one of the MRC review committees—that new grants were treated a bit differently. We were more willing to give people the benefit of the doubt, more willing to be lenient on some points and say, they don't have preliminary data, but for goodness' sake, they're just starting in the system, so how could they possibly have preliminary data? That doesn't exist any more. Now we demand preliminary data, even from young people who are just getting started. So that puts the onus on my institution to give them start-up money so they can get their preliminary data, so they can get their first MRC grant.

The Chair: Thank you very much. That was my next question, actually, and you answered it.

Dr. Worton, finally, do you think we should attract Canadians back to Canada—actively recruit?

Dr. Ron Worton: Obviously, yes. I think there are a fair number of Canadians out there. Of the nine PhDs I have trained, either as graduate students or as research fellows, only three, I believe, are currently working in Canada. Now, a couple of the others were from Italy and went back to Italy, so that's quite natural. But three of my Canadian graduate students are now working in the U.S.

I think those who have been in the U.S. for 10 or 12 years and are comfortably set wherever they are, and are well-funded and doing well, we're unlikely to recruit back, unless we have a special opportunity to do that. I think the ones we have to focus on are the young ones who are in training today, who have perhaps done a PhD in Canada and are doing post-doctoral training in the U.S., Great Britain, or elsewhere, or those who are doing PhDs outside of the country. We should be keeping in touch with them, informing them of what's going on, and at the earliest opportunity we should be bringing them back to this country.

The Chair: Thank you very much.

Thank you to all of you for your time today. It was most enlightening, most useful, for us as a committee. We appreciate your testimony. Thanks very much.

This meeting is adjourned.