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Tight budgets complicate Canadian health research reforms
World Report
Tight budgets complicate Canadian health research reforms A major overhaul of the grant and peer review system at the Canadian Institutes of Health Research is underway. But will finances and objections from researchers hamper plans? Brian Owens reports.
www.thelancet.com Vol 385 June 13, 2015
Reforms underway But despite these cash infusions, budgets remain tight at a sensitive time for the CIHR, which is in the middle of a major restructuring of its investigator-initiated grants, peer review system, and the governance and funding of its 13 institutes. The aim is to decrease the administrative burden on researchers and encourage more interdisciplinary work. “Researchers are spending too much time writing
“The budget for individual research grants has not been cut, but has failed to keep pace with inflation over the past several years.” grants, they should be doing more research”, says Beaudet. So the agency’s investigator-initiated grants are being overhauled and split into two types. The Foundation Scheme will provide the strongest researchers with a single large grant over a longer time period—5–7 years—to free them from the need to continually reapply for new grants and, says Beaudet, allowing them to be more creative. The Project Scheme will provide more traditional short-term grants, with the budget split 50-50 between the two schemes. At the same time, the peer review system is being revised to make it more structured and less onerous on reviewers. Instead of groups of two to three reviewers meeting to discuss a batch of applications, five reviewers will initially evaluate proposals remotely, discussing them in an online bulletin board, before meeting to hash out any “grey zone” applications that received markedly different rankings between reviewers. Evaluations in the Foundation Scheme will focus heavily on the applicant’s personal qualities:
their capacity for leadership and impact on the research community, as well as a high-level review of their proposed research programme. For the Project Scheme, reviewers will use a highly structured evaluation to ensure comparable evaluations.
Research concerns But many of these changes do not sit well with the health research community, says Jim Woodgett, director of research at the LunenfeldTanenbaum Research Institute at Mount Sinai Hospital in Toronto. “There are major concerns at every level, especially among researchers”, he says. “I have yet to meet anybody who is not worried.” Woodgett says the way the transition to the Foundation Scheme has been implemented has left many researchers facing gaps in funding of several months, leading them to downsize their laboratories. “That will end some careers”, he says. It is also making it difficult to recruit new researchers from abroad. Woodgett says one new overseas recruit applied for the first round of the Foundation Scheme
CIHR
The Canadian Institutes of Health Research (CIHR) received some good news in the federal government’s pre-election budget this spring: a modest CAN$15 million increase in its $1 billion annual funding. But the extra cash comes with strings attached. The annual increases don’t begin until next year, and all of the new money is earmarked for specific programmes. $2 million is reserved for research on antimicrobial resistance, while the rest will go to the agency’s Strategy for PatientOriented Research (SPOR), which is focused on health-care efficiency and effectiveness. The budget for individual research grants has not been cut, but has failed to keep pace with inflation over the past several years. Alain Beaudet, president of the CIHR, says that although the government has specified how it wants the new money spent, it is not narrowly targeted. “[The SPOR] is a very broad topic, it’s a major initiative of CIHR that involves a number of partners with a very clear objective of entering impact into the health-care system”, he says. And Beaudet points out that the CIHR’s share of the $1·5 billion Canada First Research Excellence Fund, which aims to develop world-leading centres of excellence at Canadian universities, will amount to around $35–40 million this year. A large proportion of the Canada Foundation for Innovation’s (CFI) infrastructure funding will also go towards supporting biomedical research facilities, he adds. The CFI was given an extra $1·33 billion over 6 years in the budget, but the new money will not arrive until 2017. “If you add that to what was announced in the budget, we’re not in bad shape at all”, he says.
Alain Beaudet, president of the CIHR
2339
Andy Clark/Reuters/Corbis
World Report
Experts are worried about the effect of CIHR reforms on Indigenous health research
last September, before arriving at Lunenfeld-Tanenbaum in February. But the submission was rejected because he was required to be physically in the country at the time he applied—even though the funding would not start until July, 2015. He will apply again in the second round this autumn, but if he is successful will not receive any funding until summer 2016—18 months after he arrived in Canada. “This is not how to encourage the best young scientists”, says Woodgett. “It’s a terrible time to be recruiting.” Woodgett also says the way in which Foundation Scheme applications were evaluated was “caustic” to young researchers, who were evaluated on their leadership skills, evidence of trainee mentorship, and other qualities he says were “inappropriate” for early-career investigators. And Woodgett is not convinced the new peer review system will encourage creativity. “The more formulaic the science is, the more it will fit into the structured review. You have to think the way the application forces you to think—that’s not a good way to get creative science”, he says.
Indigenous health Changes to the agency’s institutes have also raised concerns. In an effort to break down silos and encourage more collaboration, CIHR will halve the research budgets of its 13 institutes 2340
and place half in a common pot. To access that money, the institutes will have to work together and with other partners, such as companies willing to cofund the work, to develop projects that span disciplinary boundaries. The institutes’ 13 individual scientific advisory boards are also being merged into fewer, larger boards that will advise multiple institutes. Those changes are particularly worrying for the Institute of Aboriginal Peoples’ Health (IAPH), says Frederic Wien, who studies Aboriginal health issues at Dalhousie University in Halifax. There is no guarantee that projects funded by the IAPH’s
“The revisions to the peer review system also meant that the specific review committee dedicated to Aboriginal research was disbanded...” contribution to the common pot will be relevant to Indigenous people, and the advisory boards may lack expertise in the unique ethical and community involvement standards of Aboriginal research. The need to find other funding partners is also “a very significant obstacle in our field”, he says. “Health Canada is generally not interested, the provinces say Aboriginal issues are a federal responsibility, and Aboriginal organisations don’t have much money.” The revisions to the peer review system also meant that the specific review committee dedicated to Aboriginal research was disbanded, and those proposals will now be evaluated alongside unrelated applications. “The way research is done with Aboriginal communities is very different”, says Wien. “In mainstream research, it is assumed knowledge resides with the researcher. But in Aboriginal research there is another stream of community-based knowledge that must be respected and integrated. We need reviewers who can assess those qualities.”
Beaudet says he hopes the common pot and broader advisory boards mean that Aboriginal research becomes more of a focus for the agency as a whole. Aboriginal health is one of four priorities in the CIHR’s new strategic plan, but many researchers tended to assume that the IAPH was solely responsible for looking after the issue. “Aboriginal issues were considered a silo, so they now can be more included”, he says. Wien says having Aboriginal health as a CIHR priority is important, and could be an advantage for research proposals on Indigenous health issues. But he is concerned that Aboriginal issues could be shoehorned into applications to help win the grant, by researchers without sufficient community involvement. And he says the proportion of the agency’s budget dedicated to the topic—a little more than 3%—is too low. “It should at least match the proportion of Aboriginal people in the population”, he says, which would put it at 4·6%. Over the past several months, leaders in the Aboriginal health research community have repeatedly written to the CIHR administration voicing their misgivings. But despite several encouraging meetings, Wien says there has been no concrete response on their specific concerns. Woodgett says that lack of real engagement from CIHR management has been typical throughout the modernisation process. “Alain Beaudet has been going out to universities, and holding town hall meetings, but it’s pretty much been all show and tell”, he says. “No one who has raised concerns feels they’re making much impact.” Overall, Woodgett is concerned that CIHR is trying to change too much, too quickly. And the lack of any extra money in the budget to help cover all of these reforms has left the agency in a tight spot. “They’re trying to change their underwear while wearing their suit”, he says. “There’s not a lot of room for manoeuvre.”
Brian Owens www.thelancet.com Vol 385 June 13, 2015
Tight budgets complicate Canadian health research reforms A major overhaul of the grant and peer review system at the Canadian Institutes of Health Research is underway. But will finances and objections from researchers hamper plans? Brian Owens reports.
www.thelancet.com Vol 385 June 13, 2015
Reforms underway But despite these cash infusions, budgets remain tight at a sensitive time for the CIHR, which is in the middle of a major restructuring of its investigator-initiated grants, peer review system, and the governance and funding of its 13 institutes. The aim is to decrease the administrative burden on researchers and encourage more interdisciplinary work. “Researchers are spending too much time writing
“The budget for individual research grants has not been cut, but has failed to keep pace with inflation over the past several years.” grants, they should be doing more research”, says Beaudet. So the agency’s investigator-initiated grants are being overhauled and split into two types. The Foundation Scheme will provide the strongest researchers with a single large grant over a longer time period—5–7 years—to free them from the need to continually reapply for new grants and, says Beaudet, allowing them to be more creative. The Project Scheme will provide more traditional short-term grants, with the budget split 50-50 between the two schemes. At the same time, the peer review system is being revised to make it more structured and less onerous on reviewers. Instead of groups of two to three reviewers meeting to discuss a batch of applications, five reviewers will initially evaluate proposals remotely, discussing them in an online bulletin board, before meeting to hash out any “grey zone” applications that received markedly different rankings between reviewers. Evaluations in the Foundation Scheme will focus heavily on the applicant’s personal qualities:
their capacity for leadership and impact on the research community, as well as a high-level review of their proposed research programme. For the Project Scheme, reviewers will use a highly structured evaluation to ensure comparable evaluations.
Research concerns But many of these changes do not sit well with the health research community, says Jim Woodgett, director of research at the LunenfeldTanenbaum Research Institute at Mount Sinai Hospital in Toronto. “There are major concerns at every level, especially among researchers”, he says. “I have yet to meet anybody who is not worried.” Woodgett says the way the transition to the Foundation Scheme has been implemented has left many researchers facing gaps in funding of several months, leading them to downsize their laboratories. “That will end some careers”, he says. It is also making it difficult to recruit new researchers from abroad. Woodgett says one new overseas recruit applied for the first round of the Foundation Scheme
CIHR
The Canadian Institutes of Health Research (CIHR) received some good news in the federal government’s pre-election budget this spring: a modest CAN$15 million increase in its $1 billion annual funding. But the extra cash comes with strings attached. The annual increases don’t begin until next year, and all of the new money is earmarked for specific programmes. $2 million is reserved for research on antimicrobial resistance, while the rest will go to the agency’s Strategy for PatientOriented Research (SPOR), which is focused on health-care efficiency and effectiveness. The budget for individual research grants has not been cut, but has failed to keep pace with inflation over the past several years. Alain Beaudet, president of the CIHR, says that although the government has specified how it wants the new money spent, it is not narrowly targeted. “[The SPOR] is a very broad topic, it’s a major initiative of CIHR that involves a number of partners with a very clear objective of entering impact into the health-care system”, he says. And Beaudet points out that the CIHR’s share of the $1·5 billion Canada First Research Excellence Fund, which aims to develop world-leading centres of excellence at Canadian universities, will amount to around $35–40 million this year. A large proportion of the Canada Foundation for Innovation’s (CFI) infrastructure funding will also go towards supporting biomedical research facilities, he adds. The CFI was given an extra $1·33 billion over 6 years in the budget, but the new money will not arrive until 2017. “If you add that to what was announced in the budget, we’re not in bad shape at all”, he says.
Alain Beaudet, president of the CIHR
2339
Andy Clark/Reuters/Corbis
World Report
Experts are worried about the effect of CIHR reforms on Indigenous health research
last September, before arriving at Lunenfeld-Tanenbaum in February. But the submission was rejected because he was required to be physically in the country at the time he applied—even though the funding would not start until July, 2015. He will apply again in the second round this autumn, but if he is successful will not receive any funding until summer 2016—18 months after he arrived in Canada. “This is not how to encourage the best young scientists”, says Woodgett. “It’s a terrible time to be recruiting.” Woodgett also says the way in which Foundation Scheme applications were evaluated was “caustic” to young researchers, who were evaluated on their leadership skills, evidence of trainee mentorship, and other qualities he says were “inappropriate” for early-career investigators. And Woodgett is not convinced the new peer review system will encourage creativity. “The more formulaic the science is, the more it will fit into the structured review. You have to think the way the application forces you to think—that’s not a good way to get creative science”, he says.
Indigenous health Changes to the agency’s institutes have also raised concerns. In an effort to break down silos and encourage more collaboration, CIHR will halve the research budgets of its 13 institutes 2340
and place half in a common pot. To access that money, the institutes will have to work together and with other partners, such as companies willing to cofund the work, to develop projects that span disciplinary boundaries. The institutes’ 13 individual scientific advisory boards are also being merged into fewer, larger boards that will advise multiple institutes. Those changes are particularly worrying for the Institute of Aboriginal Peoples’ Health (IAPH), says Frederic Wien, who studies Aboriginal health issues at Dalhousie University in Halifax. There is no guarantee that projects funded by the IAPH’s
“The revisions to the peer review system also meant that the specific review committee dedicated to Aboriginal research was disbanded...” contribution to the common pot will be relevant to Indigenous people, and the advisory boards may lack expertise in the unique ethical and community involvement standards of Aboriginal research. The need to find other funding partners is also “a very significant obstacle in our field”, he says. “Health Canada is generally not interested, the provinces say Aboriginal issues are a federal responsibility, and Aboriginal organisations don’t have much money.” The revisions to the peer review system also meant that the specific review committee dedicated to Aboriginal research was disbanded, and those proposals will now be evaluated alongside unrelated applications. “The way research is done with Aboriginal communities is very different”, says Wien. “In mainstream research, it is assumed knowledge resides with the researcher. But in Aboriginal research there is another stream of community-based knowledge that must be respected and integrated. We need reviewers who can assess those qualities.”
Beaudet says he hopes the common pot and broader advisory boards mean that Aboriginal research becomes more of a focus for the agency as a whole. Aboriginal health is one of four priorities in the CIHR’s new strategic plan, but many researchers tended to assume that the IAPH was solely responsible for looking after the issue. “Aboriginal issues were considered a silo, so they now can be more included”, he says. Wien says having Aboriginal health as a CIHR priority is important, and could be an advantage for research proposals on Indigenous health issues. But he is concerned that Aboriginal issues could be shoehorned into applications to help win the grant, by researchers without sufficient community involvement. And he says the proportion of the agency’s budget dedicated to the topic—a little more than 3%—is too low. “It should at least match the proportion of Aboriginal people in the population”, he says, which would put it at 4·6%. Over the past several months, leaders in the Aboriginal health research community have repeatedly written to the CIHR administration voicing their misgivings. But despite several encouraging meetings, Wien says there has been no concrete response on their specific concerns. Woodgett says that lack of real engagement from CIHR management has been typical throughout the modernisation process. “Alain Beaudet has been going out to universities, and holding town hall meetings, but it’s pretty much been all show and tell”, he says. “No one who has raised concerns feels they’re making much impact.” Overall, Woodgett is concerned that CIHR is trying to change too much, too quickly. And the lack of any extra money in the budget to help cover all of these reforms has left the agency in a tight spot. “They’re trying to change their underwear while wearing their suit”, he says. “There’s not a lot of room for manoeuvre.”
Brian Owens www.thelancet.com Vol 385 June 13, 2015