March 1, 2023
Dear Prime Minister Trudeau and Deputy Prime Minister Freeland:
On behalf of HealthCareCAN’s Board of Directors and our members representing health research institutes, hospitals, and healthcare organizations across Canada, we are writing following several meetings with the federal government to express our serious concern about the state and direction of health research in Canada, which we view as an urgent priority that needs to be addressed.
The long-term impact for healthcare in Canada will be significant if the Government of Canada stays on its current course. We would like to provide our recommendations to you and your fellow Cabinet colleagues in the hope that you will recognize this as a clarion call to commit to increased, sustainable funding for health research in Budget 2023, which is paramount to safeguard the health of people across Canada and maintain Canada’s competitive and economic edge globally.
We fully acknowledge and appreciate your efforts to improve healthcare in Canada. Your government can be rightly proud of the healthcare agreement that it has reached with the provinces and territories. The improvements promised for integrated healthcare for Canadians, including the expansion of access to family health services, support for health workers, access to quality mental health and substance use services, and, notably, the modernization of the health system with health data and digital tools, is a signal achievement. We also recognize the funding constraints all governments must still contend with as we chart a path for the economy from recovery back to growth.
However, one foundational consideration has not received sufficient attention in the recent discussions around healthcare that is essential for the long-term sustainability of our current healthcare system: health research and innovation. We simply cannot transform healthcare delivery and improve outcomes without prioritizing this aspect of health policy in the budget discussion.
It is owing to fundamental science that we were able to respond so quickly to the health challenges COVID-19 presented for Canadians and the world. The rapid development of diagnostics, therapeutics — and vaccines themselves – could not have been possible without it.
Other governments facing similar budgetary pressures are acutely aware of the necessity of committing to long-term investment in research. The U.K. will increase total research and development funding from 1.7 per cent of its GDP in 2017 to 2.4 per cent by 2027. The U.S. recently announced a US$2.5 billion funding increase to the National Institutes of Health (NIH), an increase of 5.3 per cent, for a total budget of US$47.5 billion in 2023.
By way of contrast, consider that Canada’s current investment in research and development across all sectors remains at around 1.6 per cent of our GDP. More concerning, the Canadian Institutes of Health Research (CIHR) annual budget increased by just over 1 per cent in 2020-21 to approximately C$1.2 billion. We simply cannot attract strong research talent and foster a dynamic, innovative health research ecosystem in such a globally competitive environment, given these chronic challenges of underfunding.
We are encouraging you to take a bold, decisive path at this crucial juncture now that the agreement with the provinces and territories is freshly signed: doubling the budgets for the Tri-Council. Such a commitment would transform our research ecosystem to be competitive, innovative, and sustainable. With greater funding must come a greater focus on practical application in the health system, so we can make transformational improvements to the delivery of care.
The status quo, unfortunately, leaves Canada in a precarious position. Increasingly the best researchers will leave the country, and we will not be able to attract international talent to replace them. Canada’s health research ecosystem is a complex network of knowledge hubs between research hospitals, academic institutions, and the private sector sharing expertise that represent decades of experience. Without the ability to attract the brightest and the best to these institutions, our research ecosystem is becoming fragile, given how competitive the global market is for research breakthroughs. When researchers leave Canada, they take their innovations and discoveries with them, meaning Canadians lose out on the health and economic benefits of these innovations.
It we take the right course now, the long-term effects of these investments will be better health outcomes and – crucially – the reduction of overall costs to our health system over time. We will also be able to commercialize health innovations and treatments faster and more effectively, and that will make us far more competitive for global talent and investment. We will be able to say, with pride, that we are not only educating but also retaining the next generation of leading researchers and clinicians in our research hospitals and healthcare organizations.
We know that health research is just one of many issues that you, as decision makers, must weigh in the balance of priorities that require urgent consideration. And yet, if we are going to succeed in fixing healthcare, increasing investments in Canada’s health research ecosystem by doubling the budgets for the Tri-Council, and namely CIHR, is the single greatest contribution the federal government can make.
Should you or a member of your team be interested in discussing these matters further, please do not hesitate to contact me as we would be pleased to meet with you at your convenience.
Dr. Michael Gardam
Chair, HealthCareCAN Board of Directors and CEO, Health PEI
President and CEO, HealthCareCAN