The panel recommended that effective performance targets be identified but stated that, overall, III appeared to be on the right track and moving towards achieving its mandate and objectives. This provides a venue for distributing Institute publications and for interacting with the research community. In , III organized a workshop to determine the potential scope and mechanisms for implementing a KT strategy for the Institute.
The workshop report Footnote 1 charts a path for improving efforts in this important area. Given the existing well-established and well-funded infection and immunity community, an initial challenge for III was to identify gaps and opportunities where strategic initiatives would likely have a significant impact.
The Institute's first strategic plan, , was developed in collaboration with the research community, professional societies, non-profit agencies, patient groups and the Institute Advisory Board IAB. Consultations took place through numerous town hall meetings at Canadian academic centres, small working group sessions with key research leaders, thematic workshops and an e-mail survey of the III community at large.
In consultation with the IAB, III identified two broad strategic research themes with several related priorities grouped under each Table 1. A key overarching priority for III has always been training and capacity building. The first slate of priorities shows a good balance between the two components of the III mandate: The Institute has developed strategic initiatives to address all of these priority areas.
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Following a second round of consultations, the Institute's second strategic plan regrouped the original priorities to achieve greater focus:. From the outset, III was challenged with a series of emerging health threats including: The Institute has been proactive in responding rapidly to these threats through a variety of strategic initiatives.
Pandemic influenza preparedness became an Institute priority following the SARS outbreak in and the Influenza Research Priorities Task Group was assembled to identify strategic priorities. The Institute has identified strategic research priorities in both immunology and infectious diseases while retaining the flexibility to address emerging priorities precipitated by sudden health crises. Footnote 3 This plan sets out six priority research themes: The Institute's strategic initiatives have also built capacity in the other three research themes: Since , III has developed strategic initiatives focused on infectious diseases and immunology.
In many cases III has bridged the gap between these communities by actively promoting collaborations between immunologists and microbiologists in such areas as vaccines, microbial resistance and innate immunity.
The key initiatives described below were selected based on the availability of measurable outcomes and because they highlight III's success in recognizing and responding to emerging health threats, managing and coordinating large, politically charged, federal research agendas, and building capacity in important but underserved research areas. The formation, by III, of the member Canadian Research Coalition for Safe Food and Water in , heralded a new era of cooperation between federal departments, funding agencies and industry associations - something that would have been difficult to achieve prior to the creation of III.
The coalition identified national research priorities and developed a process for combining funds and resources to jointly address a shared health concern that crossed the mandate of many organizations. Footnote 5 The emergence of food safety issues such as bovine spongiform encephalopathy BSE and listeriosis-contaminated meat emphasizes the importance of a continued focus on this topic. III's leadership in the Safe Food and Water Initiative established a new era of collaboration between government departments and academia.
SARS was a new respiratory disease that emerged in China and spread rapidly around the world in By the end of the epidemic, people had died, including 43 in Canada. In response, III formed the Canadian SARS Research Consortium - a group of representatives from national and provincial governments, the private sector and health associations -to coordinate and support research on diagnostics, vaccine development, therapeutics, epidemiology, databases, public health and community impact.
This innovative, agenda-setting approach would have been nearly impossible before the creation of CIHR and was largely achieved by III's highly committed scientific director and dedicated staff. The Institute set an all-time record at CIHR by launching and reviewing a funding opportunity in 19 days without compromising peer review. This rapid response received national and international attention and was cited by the federal government as an example of excellence in Canadian innovation.
Footnote 6 Between April and April , III and partners launched four strategic initiatives to support research on the biology and epidemiology of SARS, the impacts of the outbreak on public health and health systems, and to develop a SARS sample bank and registry to support future research.
Footnote 7 In the words of one of the partners:. A task group was established which, in consultation with stakeholders, developed a new set of outbreak-specific research priorities: The research component of PPSRI, managed by III, has supported a broad range of funding opportunities to address these research priorities through operating grants, catalyst grants, team grants, applied public health chairs and meeting grants. When the H1N1 outbreak occurred in the spring of , this existing infrastructure and funding framework facilitated the rapid funding of catalyst grants targeting pandemic-specific topics.
Almost 25 years after the discovery of HIV, millions of people around the world, including thousands of Canadians, are newly infected with HIV each year. Without a cure, millions continue to suffer and die from AIDS. Targeted funding opportunities have been developed in the strategic areas of prevention, health systems and services, and resilience, vulnerability and determinants of health. As well, a merit review system has been created that rates proposals on their potential impact as well as scientific merit and engages knowledge users on the review panel.
These changes ensure that knowledge transfer and research uptake are central to the research process. In the words of one researcher:.
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As such, it is a model of research that ensures 'knowledge to action' strategies for change. Antibiotic resistance has been an Institute priority from the outset and III has launched several strategic initiatives since One focused on vulnerable populations such as the elderly and people living in northern Canadian communities. Another examined links between antibiotic use in agriculture and antibiotic resistance in humans. A third centred on infection control practices.
In , III launched its largest initiative in antibiotic resistance: The initiative focused on novel approaches such as immune system function and the potential to modulate antibacterial immune responses, the design of physical systems and biomaterials that can resist bacterial and biofilm growth, and innovative alternatives to antibiotics, such as phage and probiotics, that were not being funded in the CIHR open competition. The Institute's novel approach to antibiotic resistance attracted national and international partners, many of which were new to CIHR.
As a result, Dr. Many advances in knowledge have taken place in the infection and immunity field, especially from the strong community of researchers funded through the CIHR open competitions. A few key examples include:. Institute strategic initiatives are now also beginning to contribute new knowledge in the world literature, as described below. This same document describes a fold increase in Canadian publications related to pandemic influenza between and , which occurred largely as a result of publications on the SARS outbreak and the lessons learned.
In fact, the SARS Impact Assessment document reports the creation of new knowledge in outbreak control, treatment, health policy and antivirals resulting in more than publications and more than conference presentations, including a Paper of the Year award in for the description of a novel antiviral for SARS.
Footnote 6 As of May , 84 articles have been published as a result of funding from the pandemic preparedness initiative. It is expected that this number will grow over time.
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Specific examples of knowledge creation include:. Footnote 21 Another study, by Dr. Mohamed Karmali's team on verotoxin-producing E. Footnote 22 This finding will lead to improved diagnosis and management of this highly dangerous food- and waterborne pathogen. Outcomes from the pandemic preparedness initiative such as development of a recombinant live attenuated swine H1N1 influenza vaccine, Footnote 23 the identification of a compound that reduces viral production and protects cells from death due to Tamiflu-resistant influenza virus, Footnote 24 and the characterization of the transmission dynamics of the H1N1 virus Footnote 25 will all be important in the control of future influenza outbreaks.
Between and , the number of such publications per year doubled, accompanied by a steep increase in the Canadian share of world publications.
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Patricia Spittal and her team on the Cedar Project Partnership are uncovering the complex relationships between gender, sexual abuse, drug use and vulnerability to HIV and HCV in young Aboriginal people, which will be critically important for addressing epidemics in this population. Stephen Moses and colleagues demonstrated that male circumcision can significantly reduce the spread of HIV.
Eric Cohen is contributing significantly to the understanding of HIV pathogenesis and has uncovered the mechanism through which a specific HIV protein HIV-1 Vpu accessory affects Tetherin, a host restriction factor that potently blocks HIV-1 release and viral transmission. Canadian researchers are also contributing to world literature in the field of antibiotic resistance. Figure 3 shows that Canada ranks third for relative citations, suggesting that Canadian publications on antibiotic resistance and infection control are of high quality and have high impact.
The data also show that Canada ranks third for relative change in number of publications from , with a 4. The number of publications is represented by the size of the circles. A specialization index SI greater than 1. Databases searched may not cover all publications in this area and ARC data are incomplete for Countries were ranked based on total number of publications Specialization index and average of relative citations for top 10 countries publishing in antibiotic resistance and infection control, III anticipates that its recent initiatives on antibiotic resistance will result in an increased publication baseline as the community becomes more established and forges new international linkages through III's Canada-UK partnership on antibiotic resistance.
We would have had great difficulty in obtaining funds for this new research through regular funding channels because our proposed research was novel and not previously undertaken in my lab. Our RFA-funded project has already produced unexpected and very provocative results related to the effect of phages on the pathogenicity of Pseudomonas aeruginosa , and the potential use of phage-derived therapies against this important human pathogen.
These programs have supported graduate students, postdoctoral fellows and health care practitioners from a variety of fields and disciplines. Based on progress and end-of-grant reports, trainees from these programs have gone on to receive additional scholarships from federal and provincial agencies, and many are now academic researchers, postdoctoral fellows or tenure-track faculty. Others have chosen careers in industry, as clinical fellows or in science management.
The regular group activities made possible by this training program have tremendously enhanced the quality of the training we now offer our students and fellows. In addition, the Institute has hosted three young investigator meetings and funded Pilot Project Grants targeted to new investigators. Almost half of these grants have gone to young investigators, most of whom went on to receive multi-year operating grant funding. Capacity building has also been integral to many of III's strategic research initiatives with a focus on team building, as described below.
More than 80 trainees were supported by SARS funding and many national and international collaborations were created, including a research network established by Dr. Robert Anderson with hubs in Canada, Taiwan and Thailand for the study of emerging viral respiratory and hemorrhagic diseases. Phage therapy represents a potential adjunct or replacement for traditional antibiotics but, prior to the Novel Alternatives to Antibiotics Initiative, CIHR did not fund research in this area. One objective of this initiative was to engage decision makers in the research process.
As an example of success, a multidisciplinary team focused on safe drinking water and led by Dr. Isaac-Renton, overcame disciplinary and jurisdictional boundaries to focus on community health. The study engaged experts in each area along the source-to-tap continuum. As a result, provincial decision makers used research results to alert local residents of the need to get their well water tested regularly for E. In another example, Dr. Mazumder and his team persuaded farmers to reduce the time their cattle spent in rivers in order to reduce bacterial contamination of river water.
In one case, river contamination was reduced by building a bridge across the river which re-routed cattle away from the water. Researchers also distributed an information pamphlet prompting individual farmers to contact researchers. As a result, the farmers became full partners in the subsequent research projects. Successes such as these may not lead to publication in top-tier journals, but they demonstrate the added value of III's strategic initiatives, which have achieved outcomes that would not have been realized in open competition funding. Meanwhile, the results of this research have had almost immediate impacts on population health.
Information gained from a study of the long-term psychological consequences of the SARS outbreak has been widely communicated and incorporated into pandemic planning in Canada and Australia, and by the World Health Organization WHO. Many research contributions to decision making during the H1N1 pandemic originated from research begun during the SARS outbreak.
Examples include the evaluation of existing vaccination policies, patient prioritization strategies for treatment, and the strategic use of anti-virals by the Pandemic Influenza Outbreak Research Modeling Team, headed by Dr.
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