ARCHIVED - Canadian Institutes of Health Research - Report

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Minister's Message

I am pleased to present the 2010-2011 Departmental Performance Report (DPR) for the Canadian Institutes of Health Research (CIHR).

The Government of Canada continues to implement its multi-year Science and Technology Strategy that seeks to promote a better quality of life for Canadians through science and technology, while creating jobs and economic growth. CIHR has been a significant contributor to this strategy through its support of health research excellence and innovation.

CIHR celebrated its tenth anniversary last year, a key milestone in the delivery of its mandate. In its tenth year, the organization moved swiftly to implement its second strategic plan, Health Research Roadmap: Creating innovative research for better health and health care. As part of Roadmap, CIHR launched a process to attain greater focus and impact from its strategic investments. The launch of CIHR's Signature Initiatives will help CIHR strategically allocate its resources to make the strongest possible impact on health and health care.

With the release of its first three-year Roadmap implementation plan and progress report in 2010-2011, CIHR continued to demonstrate its commitment to Roadmap's four strategic directions: Investing in world-class research excellence; Addressing health and health system research priorities; Accelerating the capture of health and economic benefits of health research; and, Achieving organizational excellence, fostering ethics and demonstrating impact. The annual publications of the Roadmap implementation plan and progress report reports on CIHR's progress made towards implementing its Strategic Plan, and effectively measure the success of current and future Roadmap initiatives.

During 2010-11, CIHR launched the Banting Postdoctoral Fellowships, a new prestigious postdoctoral fellowship program, in collaboration with the Natural Sciences and Engineering Research Council of Canada (NSERC) and the Social Sciences and Humanities Research Council (SSHRC) - to attract and retain outstanding health researchers. This new flagship program will help brand Canada as a destination of choice for outstanding postgraduate research trainees.

CIHR has taken a leadership role in working closely with its partners, including provincial and territorial governments, the Multiple Sclerosis Society of Canada, and numerous medical associations and societies, to advance safe, evidence-based research on multiple sclerosis (MS). CIHR has taken an active role in gathering experts who are reviewing the existing research evidence, and will reach conclusions regarding: (1) a common standard for reliably diagnosing the proposed Chronic Cerebrospinal Venous Insufficiency condition using imaging or other techniques; and (2) a potential association between impaired cerebral venous drainage and MS. CIHR has also provided valuable support to health professional associations to ensure that physicians and health care providers have the necessary information to support MS patients and their families.

In 2010-11, CIHR completed its second International Review. The review was conducted by an independent, international blue-ribbon panel of experts to draw conclusions on the performance of CIHR as a whole, as well as the performance of its Institutes. CIHR's commitment to openness and transparency in measuring and accounting on its performance publicly demonstrates CIHR's strong desire to achieve organizational excellence.

I want to congratulate CIHR on another year of significant accomplishments. Its current strategic directions and ongoing partnerships will continue to support excellence among Canada's best and brightest health researchers for the benefit of Canadians, now and in the future.

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Section I: Departmental Overview

Raison d’être

CIHR is the Government of Canada's health research funding agency. It was created in June 2000 by the CIHR Act (Bill C-13) with a mandate "to excel, according to internationally accepted standards of scientific excellence, 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".

Responsibilities

CIHR's mandate seeks to transform health research in Canada by:

• Funding investigator-initiated research, in addition to research on targeted priority areas;
• Building research capacity in under-developed areas and training the next generation of health researchers; and,
• Focusing on knowledge translation that facilitates the application of the results of research and its transformation into new policies, practices, procedures, products and services.

CIHR integrates research through a unique interdisciplinary structure made up of 13 "virtual" institutes. These institutes are not "bricks-and-mortar" buildings, but communities of experts.  In its topic area, each of CIHR's 13 Institutes supports a broad spectrum of research: biomedical, clinical, health services and systems; and, social, cultural, environmental and population health. Institutes form national research networks linking researchers, funders and knowledge users across Canada to work on priority areas. This innovative structure has been hailed as a global best practice and supports a solution-focused, multidisciplinary and collaborative approach to health research.

CIHR is governed by a Governing Council of 16 members. The President of CIHR serves as its Chair, with the Deputy Minister of Health an ex-officio and non-voting member. CIHR reports to Parliament through the Minister of Health and plays a key role in the Health Portfolio, the focal point for the Government of Canada's health-related activities. As Canada's health research funding agency, CIHR makes an essential contribution to the Minister of Health's overall responsibilities by funding the research and knowledge translation needed to inform the evolution of Canadian health policy and regulation; and, by taking an advisory role on research and innovation issues.  This is achieved through an extensive and growing set of linkages with Health Canada and the Public Health Agency of Canada, providing decision-makers with access to high quality and timely health research knowledge.

CIHR also works closely with the Natural Sciences and Engineering Research Council (NSERC) and the Social Sciences and Humanities Research Council (SSHRC). The three Councils collectively manage several flagship programs for the Government of Canada, including the Networks of Centres of Excellence Program, the Canada Graduate Scholarships Program, the Vanier Graduate Scholarship Program, the Canada Research Chairs Program, and the new Banting Postdoctoral Fellowships Program.

In 2010-11, CIHR continued to support the Government of Canada's Science & Technology Strategy. CIHR's focus on excellence and innovation helps ensure that its investments are aligned to the Strategy's key theme of mobilizing S&T to Canada's advantage.

Strategic Outcome and Program Activity Architecture (PAA)

The figure below illustrates CIHR's Program Activity Architecture (PAA) for the 2010-11 fiscal year, which was approved by Treasury Board in May 2009. The PAA consists of one Strategic Outcome and five Program Activities that support the Strategic Outcome. The performance information presented in Section II is organized according to this PAA structure.

View a textual description of the above figure

* Note: In June 2009, the Randomized Control Trials Program was integrated into the Open Research Grant Program.

To accomplish its mandate, CIHR provides a range of programs and activities that are designed to improve the health of Canadians and to deliver more effective health care services to Canadians. CIHR's Strategic Outcome positions Canada as a world leader in the creation and use of health knowledge for the betterment of both Canadians and the international community. This Strategic Outcome is achieved through the following Program Activities:

• 1.1 Health Knowledge: Creating health knowledge which leads to the development of new and better ways to improve health and health outcomes, and to prevent, diagnose and treat disease;
• 1.2 Health Researchers: Ensuring Canada has top quality health researchers who can conduct health research;
• 1.3 Health Research Commercialization: Commercializing research discoveries into effective health products and services;
• 1.4 Advances in Health and Health Services: Advancing the delivery of health services that Canadians need through new and/or improved practices, policies and programs;
• 1.5 Internal Services: Activities and resources that support the needs of CIHR's programs as well as its other corporate obligations.

PAA Crosswalk

The new PAA better aligns CIHR's Management, Resources and Results Structure (MRRS) with the mandate and vision of CIHR; enables CIHR to collect financial and non-financial information, results and other key data on program activities to support informed decision making; and, ensures CIHR is able to provide improved public performance reporting.

The table below provides a cross-walk between the new 2010-11 PAA and the 2009-10 version at the Program Activity level.

PAA Crosswalk – Program Activity Level Integration of 2009-10 Program Activities into 2010-11 Program Activities
2010-2011 Program Activity	2009-2010 Program Activity
1. No Sub-Activities related to this Program Activity
PA 1.1 Health Knowledge	PA 1.1 Open Research
	PA 2.2 Research Resources and Collaborations
	PA 2.4 Ethical, Legal and Social Issues 1
PA 1.2 Health Researchers	PA 2.1 Researchers and Trainees
PA 1.3 Health Research Commercialization	PA 3.2 Commercialization of Health Research
PA 1.4 Health and Health Services Advances	PA 1.2 Strategic Priority Research
	PA 2.3 National and International Partnerships
	PA 3.1 Knowledge Translation of Health Research

The table below provides a cross-walk between the new 2010-11 PAA and the 2009-10 version at the Sub-Activity level.

PAA Crosswalk at the Sub-Activity Level Integration of 2009-10 Program Activities into 2010-11 Program Activities
2010-2011 Sub-Activity	2009-2010 Program Activity/Sub-Activity
2. No Sub-Activities related to this Program Activity
SA 1.1.1 Open Research Grant Program	SA 1.1.1 Open Operating Grant Program
	PA 2.2 Research Resources and Collaborations 2
	PA 2.4 Ethical, Legal and Social Issues 2
SA 1.1.2 Randomized Control Trials (RCT) Program	SA 1.1.2 Randomized Control Trials (RCT) Program
SA 1.2.1 Salary Support Programs	SA 2.1.1 Salary Support Programs
	SA 2.1.3 Canada Research Chairs
SA 1.2.2 Training Support Programs	SA 1.1.3 Team Grant Program
	SA 2.1.2 Training Support Programs
	SA 2.1.4 Canada Graduate Scholarship Program
SA 1.3.1 Research Commercialization Programs	PA 3.2 Commercialization of Health Research 2
SA 1.3.2 Networks of Centres of Excellence NCE) Programs	SA 3.1.2 Networks of Centres of Excellence (NCE) Program
SA 1.4.2 Knowledge Translation Programs	SA 2.3.2 Partnership Programs
	SA 3.1.1 Knowledge Translation Program

Organizational Priorities

In 2009, CIHR launched its new five-year strategic plan, Health Research Roadmap, which provided a sound foundation and framework for the effective management of key health-related strategic priorities and decisions. A three-year implementation plan and progress report has been developed for the strategic plan. It is published and refreshed annually.

Priority Status Legend

Priority	Type 3	Strategic Outcome(s) and/or Program Activity(ies)
3. Type is defined as follows: Previously committed to—committed to in the first or second fiscal year before the subject year of the report; Ongoing—committed to at least three fiscal years before the subject year of the report; and New—newly committed to in the reporting year of the DPR.
Invest in World-Class Research Excellence	Ongoing	1.1 Health Knowledge 1.2 Health Researchers
Status
Met All Launched the new Banting Postdoctoral Fellowship Award Program. Completed an environmental scan of peer review best practices from national and international funding agencies; and, initiated the design of training and evaluation strategies. Completed an assessment of current funding mechanisms and developed an initial draft of program objectives for enhanced Open programs. Supported 45 new joint health research projects between Canada and China's National Natural Science Foundation of China. Promoted partnerships between Canadian HIV researchers and their counterparts in low- and middle-income countries through the new Canadian HIV Vaccine Initiative.

Priority	Type 4	Strategic Outcome(s) and/or Program Activity(ies)
4. Type is defined as follows: Previously committed to—committed to in the first or second fiscal year before the subject year of the report; Ongoing—committed to at least three fiscal years before the subject year of the report; and New—newly committed to in the reporting year of the DPR.
Address Health and Health System Research Priorities	Ongoing	1.4 Health and Health Services Advances
Status
Met All Approved five new pan-CIHR signature initiatives: Evidence-Informed Healthcare Renewal; the Canadian Epigenetics, Environment and Health Research Consortium; Community-Based Primary Health Care; Personalized Medicine; and, Inflammation in Chronic Disease. Completed the Strategy for Patient-Oriented Research. Funded a major pan-Canadian study on patient safety in home care with the Canadian Patient Safety Institute. Organized the first forum on Research Methodologies in Real World Drug Safety and Comparative Effectiveness to discuss challenges and best practices in post-market drug safety and effectiveness research. Joined the International Collaborative Research Strategy for Alzheimer's Disease.

Priority	Type 5	Strategic Outcome(s) and/or Program Activity(ies)
5. Type is defined as follows: Previously committed to—committed to in the first or second fiscal year before the subject year of the report; Ongoing—committed to at least three fiscal years before the subject year of the report; and New—newly committed to in the reporting year of the DPR.
Accelerate the Capture of Health and Economic Benefits of Health Research	Ongoing	1.3 Health Research Commercialization 1.4 Health and Health Services Advances
Status
Met All Held five successful Best Brains Exchanges (BBE) with federal and provincial decision-makers on: Primary Care, Patient and Family-Centered Care, Health Research in the Arctic, Social determinants of health and obesity in First Nations Communities; and, integrated care systems for Mental Health and Addiction illnesses. Approved a new joint science-policy internship program with Health Canada to foster positive exchanges between health researchers and policy-makers. Renewed a critical partnership between CIHR and Rx&D (Canada's Research-Based Pharmaceutical Companies). Increased investments in interdisciplinary collaborative research projects from $6.9M to $10.2M through the Collaborative Health Research Projects Program, a CIHR-NSERC partnership. Partnered with Cochrane France and the province of Quebec to support the translation of systematic review abstracts and increase access to health research results.

Priority	Type 6	Strategic Outcome(s) and/or Program Activity(ies)
6. Type is defined as follows: Previously committed to—committed to in the first or second fiscal year before the subject year of the report; Ongoing—committed to at least three fiscal years before the subject year of the report; and New—newly committed to in the reporting year of the DPR.
Achieve Organizational Excellence, Foster Ethics and Demonstrate Impact	Ongoing	1.5 Internal Services
Status
Met All Launched the Health Research Roadmap three-year rolling implementation plan and progress report. Named one of the National Capital Region's Top 25 Employers. Participated in a second International Review. Developed best practices for ethical health research involving children and adolescents. Launched the Research Reporting System to provide systematic, high-quality reporting of the results of funded research and provide evidence on the effectiveness of CIHR funding programs.

Risk Analysis

CIHR has adopted a proactive approach to identify, assess and mitigate risks under the terms of the Risk Management Framework approved by Governing Council in November 2009. The Risk Management governance structure contained in the Framework clearly defines the roles and responsibilities of Risk Owners, CIHR management, Chief Risk Officer, Governing Council, and Audit Committee.  The Framework also includes CIHR's Risk Management Policy, and describes the process that has been established to develop and refresh the Corporate Risk Profile (CRP).

The implementation of CIHR's five-year strategic plan, Health Research Roadmap, continued to be the most significant risk that was actively managed by CIHR. Specifically, the risk is that CIHR will be unable to fully deliver on the strategic directions as outlined in Roadmap's defined timeframe. This includes the risk that both internal and external stakeholders do not understand, or support, the proposed changes to operational requirements and competing priorities, which may prevent resources from contributing Roadmap's implementation. To address this particular risk, CIHR:

• Created a three-year rolling plan for the Health Research Roadmap implementation, which includes an assessment of all key internal and external stakeholder consultations, communication activities, and a risk assessment.
• Implemented a formal governance structure for the Roadmap implementation, which includes an executive Task Force, dedicated Design Team, and Implementation Network comprised of senior staff and subject matter experts.
• Completed an external stakeholder analysis, and developed a stakeholder engagement and communication plan.

While progress has been made on the approved mitigation strategies, the risk level associated with the successful implementation of Roadmap remains high. The objective of CIHR management is to reduce the level of risk in the future through the implementation of Roadmap's directed stakeholder communication and engagement plan; and, active monitoring of the plan's progress.

Summary of Performance

2010-11 Financial Resources ($ millions)

Planned Spending	Total Authorities	Actual Spending
980.8	1,029.9	1,026.9

Total Authorities:

CIHR's total Parliamentary authorities increased to $1,029.9M in 2010-11, an increase of $49.1M compared to its planned spending. The increase in Parliamentary authorities was the result of an increase to CIHR's base budget of $16M announced in Budget 2010, as well as the launch of new programs such as the Medical Isotopes Initiative ($4.9M), the Canada Excellence Research Chairs program ($4.6M) and the Banting Postdoctoral Fellowships program ($1.6M). CIHR also received additional Parliamentary authorities during the 2010-11 fiscal year (via the Supplementary estimates) to fund the third round of grants for the Centres of Excellence for Commercialization and Research (CECR) Program ($9.7M), a $3M transfer from the Public Health Agency of Canada to fund breast cancer research; and, additional transfers from other Federal government departments totalling $3.6M to fund strategic investments in areas including chronic disease, population health intervention and autism research. CIHR also received an additional $5.7M in operating authorities via the 2010-11 Supplementary Estimates, including a $2.2M carry forward 2009-10 unspent authorities, as well as $3.5M through technical adjustments to cover higher employee salaries and related benefits.

Actual Spending:

In 2010-11, CIHR's expenditures totalled $1,026.9M, which was $3.0M less than its total available Parliamentary authorities. CIHR lapsed $2.4M of its Grants Vote during 2010-11 fiscal year and $0.6M from its Operating expenditure Vote. CIHR is not able to carry forward any of its unspent authorities to the 2011-12 fiscal year.

Approximately $1.5M of CIHR's Grants Vote lapse occurred with respect to listed grant programs where CIHR did not receive enough eligible applications to fully disburse available authorities. CIHR is unable to reallocate unused authorities from listed grant programs to other initiatives. Parliament was dissolved in late March, 2011, which resulted in Supplementary Estimates C not being approved. As such, CIHR lapsed an additional $0.7M of its Grants Vote due to the inability to transfer authorities to another federal department as planned. Other immaterial lapses of grant funds totalled $0.2M.

2010-11 Human Resources (FTEs)

Planned	Actual	Difference
430	432	(2)

No material variance was noted between planned and actual FTEs in 2010-11.

Note: CIHR uses a peer review process to identify exemplary projects and individuals that merit funding. In 2010-11, over 2,900 peer reviewers provided their time, without remuneration, and served on 249 peer review committees to review nearly 18,000 applications. Without the voluntary support from this community of experts, CIHR would not have the necessary financial and human resources to review and fund the same amount of quality health research.

Strategic Outcome 1: A world-class health research enterprise that creates, disseminates and applies new knowledge across all areas of health research

Performance Indicators	Targets
1. Canadian ranking in health research intensity compared to international levels.	Maintain or increase international ranking.
2. Canadian number and share of world health research papers.	Maintain or increase share.
3. Number of citations of Canadian health research papers compared to international levels.	Maintain or increase international ranking.
4. Researchers per thousand workforce compared to international levels.	Maintain or increase international ranking.
5. Changes in health practices, programs or policies informed by CIHR-funded research.	Evidence that the work of CIHR funded researchers resulted in long-term impacts.
6. Diversity of research supported (by theme and Institute)	Maintain diversity of funding and increase funding in priority areas.
2010-11 Performance Summary
Health research intensity is measured by the overall relative expenditure on health-related research and development. According to a report published by the Organization for Economic Co-operation and Development (OECD) in 2010, Canada increased its international ranking from the top four to the top two out of 16 OECD countries in "health-related research and development in government budgets as a percentage of the Gross Domestic Product (GDP)" [Annex A]. Canada's number and share of world health research papers showcases both Canada's contributions to advancing and disseminating health knowledge; and, the productivity of its health research community. According to reports published in 2010, the number of Canadian publications in Medical Sciences per million dollars of Gross Domestic Expenditure on Research and Development (GERD) has been trending positively from 2001 through 2008. In 2008, Canada tied with the U.K. for first place at 1.14 publications per million GERD [Annex B]. Additionally, Canada's world share of medical publications remained stable at nearly 5% from 2009 to 2010 [Annex C]. An internationally recognized, standardized measure for citations used to determine the impact and quality of Canada's published health results is the Average of Relative Citations (ARC). The ARC value for publications is based on the number of citations received by a paper in a 3-year period following its publication. Canada's ARC value for publications in medical research was 1.42 in 2010, with Canada ranking 9th place worldwide, an increase from its ARC value of 1.37 and 11th place ranking in 2009 [Annex D]. The Average of Relative Impact Factor (ARIF) is a measure of the scientific impact of the journals in which a paper is published. The impact factor of the journals is a reflection of the quality and value of the papers published in those journals. The ARIF for Canadian publications was 1.20 in 2010, which remains the same compared to 2009. The 2010 ARIF score puts Canada in 8th place worldwide, compared to 7th place in 2009 [Annex E]. To maintain comparability between Canada's performance and that of other countries, the number of researchers and the annual growth rate of the number of researchers by country are reported, instead of the number of researchers per thousand workforce. A report published by the OECD in 2010 showed that the growth rates of the number of researchers and the number of Research and Development (R&D) personnel in Canada are comparable to those of other countries in the OECD. The compound annual growth rate of the number of researchers for Canada between 1998 and 2008 is at 4.6%, and for the number of R&D personnel, at 5% [Annex F]. This growth rate of 4.6% in the number of researchers in Canada is reported to be in step with half of the OECD countries, where the growth rate is over 4.5%. According to a report published by the United Nations Education, Scientific and Cultural Organization (UNESCO) in 2010, the number of Canadian researchers in 2006 was recorded at 139,011 [Annex F]. This puts Canada among the top 10 countries in terms of the number of researchers hosted. CIHR continues to support an increasing number of health researchers and trainees, thus steadily contributing to building Canada's health research capacity. Since inception, the number of CIHR-supported health researchers and trainees has grown from approximately 6,000 in 2000-01 to over 14,000 in 2010-11 [Annex G]. Reports from the Institutes and other sources show that CIHR-funded research has had a positive impact on creation and implementation of new health practices, programs and policies. For example: In 2010, the Canadian Medical Association Journal (CMAJ) recognized a new model of care for hip and knee replacements by Dr. Cyril Frank, Dr. Deborah Marshall, Dr. Peter Faris and Christopher Smith of the Alberta Bone and Joint Health Institute as one of the six top achievements in Canadian health research. Their CIHR-funded work led to the international adoption of clinical outcome measures in osteoarthritis pain and fatigue, and significant reductions in wait time for hip and knee surgeries. CIHR-funded researcher Dr. Lisa Dolovich has provided reliable research evidence showing that pharmacists can play an important role in helping seniors manage their multiple prescriptions and avoid common problems, such as adverse drug reactions. Her research demonstrated that having pharmacists in family physicians' offices helped optimize medication regimes and improved monitoring of medications. As a result, the Ontario Ministry of Health now funds full-time pharmacist positions for family health primary care teams. As of 2009, there are about 90 Ministry of Health-funded pharmacists in these positions. Dr. Janice Eng developed Fitness and Mobility Exercise (FAME), a special fitness program for stroke survivors that includes stretches, weight-bearing exercises, walking and quick-reflex exercises.  With CIHR funding, she tested FAME and found that patients who participated in the program were about 30% faster than when they started, they gained muscle strength, and they maintained their bone density. FAME is currently operating in at least 50 sites in seven countries, including the United States and Canada, where it is up and running in several cities, including Vancouver and Toronto. In 2010-11, CIHR continued to fund all areas of health research by primary themes, and Institute-specific research area [Annex H]. The total expenditure on grants and awards increased by 4% from $929 million in 2009-10 to almost $967 million in 2010-11.

CIHR's successes at the Strategic Outcome-level are supported by expenditures at the Program Activity (PA) level.

The following table is a breakdown of CIHR's planned
and actual spending by PA for 2010-11.
(in millions of dollars)

Program Activity	2009-10 Actual Spending	2010-11				Alignment to Government of Canada Outcomes
		Main Estimates	Planned Spending	Total Authorities	Actual Spending
1.1 Health Knowledge	453.2	449.5	449.5	458.0	468.5	Healthy Canadians
1.2 Health Researchers	194.7	201.6	201.6	208.3	195.7	Healthy Canadians
1.3 Health Research Commercialization	47.4	46.2	46.2	55.9	53.1	Healthy Canadians
1.4 Health and Health Services Advances	256.9	257.8	257.8	279.3	275.4	Healthy Canadians
1.5 Internal Services	31.5	25.7	25.7	28.4	34.2
Total	983.7	980.8	980.8	1,029.9	1,026.9

Expenditure Profile

Canada's Economic Action Plan (CEAP)

The Government of Canada's 2009 Budget, Canada's Economic Action Plan, provided CIHR with $35 million over three fiscal years to temporarily expand the Canada Graduate Scholarships (CGS) program. The CGS program supports Canada's top graduate students to help ensure a reliable supply of highly skilled personnel to meet the needs of Canada's knowledge economy. The CEAP provided CIHR with $14 million in additional funding in 2010-11 to fund additional Doctoral scholarships (valued at $70,000 each) and Master's scholarships (valued at $17,500 each) under program activity 1.2, Health Researchers.

Departmental Spending Trend

($ millions)

View a textual description of the above figure

Estimates by Vote

For information on our organizational votes and/or statutory expenditures, please see the 2010-11 Public Accounts of Canada (Volume II) publication. An electronic version of the Public Accounts is available.

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