ARCHIVED - RPP 2006-2007
Canadian Institutes of Health Research

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Section I - Overview

Minister's Message

It is my pleasure to present to my parliamentary colleagues, and all Canadians, the Canadian Institutes of Health Research's (CIHR) Report on Plans and Priorities for the fiscal year 2006-2007. As an important member of the Government of Canada's Health Portfolio, CIHR supports more than 10,000 health researchers and trainees in universities, teaching hospitals and other health organizations and research centres across Canada.

CIHR plays a critical role in providing health and economic benefits for Canadians. As a strategic funder of health research, CIHR is building on the foundation of research excellence through research investments focused on activities that are helping the Government of Canada to address important priorities such as the development of a cancer strategy, pandemic preparedness and a healthy environment. As well, in partnership with the Provincial/Territorial Deputy Ministers of Health, CIHR funded research related to establishing evidence-based benchmarks for medically acceptable Wait Times. This research was essential in assisting them in meeting provincial commitments outlined in the Ten-Year Plan to Strengthen Health Care. CIHR continues to work with the Provinces and Territories to develop additional benchmarks in the areas of cardiac procedures, diagnostic imaging, and cancer.

The ability to build meaningful partnerships, the ability to help shape and articulate and mobilize world-class research activities and the capacity to help transform this research into action are all qualities that have helped distinguish CIHR in its first five years of its existence and will continue to play an important role as the organization continues to evolve. The Government of Canada relies on these qualities as it strives to serve the health needs of Canadians in a way that is both accountable and grounded in evidence.

CIHR has a clearly articulated plan for achieving its objectives - advancing health knowledge through research, developing and sustaining Canada's health researchers and catalyzing health innovation for the benefit of the healthcare system and the economy. CIHR has greatly expanded the scope of health research conducted in Canada, building the expertise needed to address important and pressing issues across the full spectrum of health research. This expanded vision has likewise increased the opportunity for health research to inform policy development across a wide area of government priorities.

CIHR's Report on Plans and Priorities presents a detailed picture of results-based planning and budgeting for the year ahead and beyond. In the coming fiscal year, CIHR will continue to focus on these objectives which, in turn, will help the Government of Canada meet its broader objectives.

Tony Clement
Minister of Health and
Minister for the Federal Economic Development Initiative for Northern Ontario

President's Message

Since its creation in 2000 as a federal agency within the Health Portfolio, CIHR has moved carefully and deliberately from its origins as a largely reactive biomedical granting council to an outcomes-driven, excellence-based strategic research organization.

Today, CIHR has 13 health research Institutes, each led by an internationally recognized Scientific Director. Over 225 Institute advisory board members provide advice and support to their respective Institutes, linking individual Institutes to CIHR overall, to the wider health research and research user communities, to the public and other stakeholders. CIHR has a strategic plan, Blueprint, which is the culmination of broad national consultations with health researchers and other stakeholders. Each Institute also has a strategic plan from which national research agendas on everything from obesity, aboriginal peoples' health, and regenerative medicine, have been implemented.

Beyond our development as an organization, CIHR has had profound impact on the Canadian health research landscape. Numerically, more health researchers are being funded at higher levels of funding than ever before, allowing Canadian investigators to remain internationally competitive. Fundamentally, a transformation has occurred in the way health research is conducted in Canada.

CIHR-funded researchers are now working in all health-related disciplines, from the biosciences, to engineering and bioinformatics, to the humanities and social sciences. CIHR also directs approximately 30% of its funds into strategic initiatives that respond to important scientific opportunities and/or to health challenges of priority to Canadians. These initiatives are led by CIHR's 13 Institutes, which have built research communities, bringing together funders, researchers and research users, including policy-makers and practitioners, to work in collaboration to set strategic priorities for research and to ensure that Canadians realize the value of research through results that are applied as quickly and effectively as possible.

Knowledge translation activities - moving research from the lab or research office into clinical practice, policy, or the private sector - that were essentially non existent, now account for over $20 million annually. Targeted programs have been developed to fill key gaps in this pipeline from academia to the health system, population or marketplace

CIHR is not working in isolation, having developed important new partnerships in Canada - with federal departments, provincial health research agencies, provincial and territorial ministries of health, industry, trade unions and health charities - and internationally. Since 2000, these partnerships have contributed close to $500 million in support of common national priorities in health research.

The impact of all of these investments and new programs are becoming clear. In objective international analyses of research activities around the world, the Canadian health research community ranks at or near the top and it is clear that health research is perceived internationally as one of Canada's key strengths in research. And CIHR is producing research outcomes that matter to Canadians, in areas like improving access to quality care, developing new health policies, and supporting the development of new treatments, therapeutics and spin-off companies.

In short, a great deal has been accomplished since 2000. Without question, there is more to do and in many ways, CIHR is about to enter the most interesting part of its development. As noted on the pages ahead, CIHR is ready to move forward with strategic new investments that will continue to improve the health of Canadians, strengthen our health care system and support a more productive and knowledge-based economy.

Dr. Alan Bernstein, O.C., FRSC
President, Canadian Institutes of Health Research

Management Representation Statement

I submit for tabling in Parliament, the 2006-2007 Report on Plans and Priorities (RPP) for the Canadian Institutes of Health Research.

This document has been prepared based on the reporting principles contained in Guide for the Preparation of Part III of the 2006-2007 Estimates: Reports on Plans and Priorities and Departmental Performance Reports:

• It adheres to the specific reporting requirements outlined in the TBS guidance;
• It is based on the department's approved Program Activity Architecture structure as reflected in its Management Resources and Results Structure (MRRS);
• It presents consistent, comprehensive, balanced and accurate information;
• It provides a basis of accountability for the results achieved with the resources and authorities entrusted to it; and
• It reports finances based on approved planned spending numbers from the Treasury Board Secretariat in the RPP.

Dr. Alan Bernstein, O.C., FRSC
President, Canadian Institutes of Health Research

Summary Information

Raison d'être The mandate of CIHR is 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 (Bill C-13, April 13, 2000). To accomplish this, CIHR provides a range of programs and activities that are designed to support outstanding research - both investigator-driven and strategic, to build health research capacity, and to promote knowledge translation in accordance with CIHR's mandate and strategic directions. CIHR funds more than 10,000 health researchers and trainees in universities, teaching hospitals and other health organizations and research centres across the country who conduct research in the following areas: biomedical; clinical; health systems and services; and the health of populations, societal and cultural dimensions of health and environmental influences on health. Together, these activities will position Canada as a world leader in the creation and use of health knowledge for the betterment of Canadians and people everywhere. In support of these programs and activities, Federal Budget 2006 announced a $17M increase to CIHR’s annual budget and an additional $2.5M in 2006-2007 for Avian and Pandemic Influenza Preparedness. A further $11M increase in 2006-2007 has been allotted for a post-market study of treatments for Fabry disease and Hurler-Schie disease.

Financial Resources: (in millions)

2006-2007	2007-2008	2008-2009
$862.8	$871.5	$878.7

Human Resources:¹

2006-2007	2007-2008	2008-2009
390	390	390

Departmental Priorities:

Priority	Type	Programs	Planned Spending (in millions)
			2006-2007	2007-2008	2008-2009
Strategic Outcome: Outstanding Research
Strategic Priority #1: Research Advance health knowledge, through excellent and ethical research, across disciplines, sectors, and geography.	Ongoing	1.1. Fund Health Research	$469.4	$472.9	$480.1
Strategic Outcome: Outstanding Researchers in Innovative Environments
Strategic Priority #2: Researchers Develop and sustain Canada's health researchers in vibrant, innovative and stable research environments.	Ongoing	2.1. Fund Health Researchers and Trainees 2.2. Fund research resources, collaboration and other grants to strengthen the health research community 2.3. Develop and support a strong health research community through national and international alliances and priority setting 2.4. Inform research, clinical practice and public policy on ethical, legal and social issues (ELSI) related to health and health research	$325.4	$330.5	$330.5
Strategic Outcome: Transforming Health Research into Action
Strategic Priority #3: Knowledge Translation Catalyze health innovation in order to strengthen health and the health care system and contribute to the growth of Canada's economy.	Ongoing	3.1. Support activities on knowledge translation, exchange, use and strategies to strengthen the health system 3.2. Support national efforts to capture the economic value for Canada of health research advances made at Canadian institutions	$68.0	$68.1	$68.1

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¹ All references to human resources are for Full Time Equivalents (FTEs), unless otherwise noted.

Management Priorities
In December 2005, CIHR's senior management cadre, including representatives from the 13 Institutes, developed three-year operational priorities (2006-2007 to 2008-2009) to guide business planning across the organization. These priorities and the related key activities will be reviewed annually:

• Continue transformation and improvement of CIHR's programs and peer review system;
• Improve CIHR's service delivery and streamline processes;
• Strengthen accountability and reporting;
• Promote and integrate knowledge translation into CIHR's culture;
• Foster a motivated, committed and productive workforce; and
• Manage organizational change.

CIHR Plans and Priorities

1. Approach to Health Research

CIHR is the Government of Canada's agency for health research. CIHR's vision is to position Canada as a world leader in the creation and use of new knowledge through health research that benefits the health of Canadians and the global community.

A Problem-Based Multidisciplinary Approach

Through its 13 Institutes, CIHR is creating new opportunities for Canadian health researchers to produce results that matter to Canadians and the rest of the world. CIHR uses a problem-based, multidisciplinary and collaborative approach to health research. The majority of its funded research is investigator-driven, while funding is also directed towards specific strategic initiatives that respond to health challenges that are of high priority to Canadians.

CIHR's approach is enabled by its structure - unique in the world - that brings together researchers from across disciplinary and geographic boundaries through its 13 Institutes. Each Institute addresses a health research theme that is of importance to Canadians.

In total, CIHR funds more than 10,000 health researchers and trainees in universities, teaching hospitals and other health organizations and research centres across the country. It supports health research that meets the highest international standards of excellence and ethics in the following areas: biomedical; clinical; health systems and services; and the health of populations, societal and cultural dimensions of health and environmental influences on health.

CIHR Institutes

Aboriginal Peoples’ Health
Aging
Cancer Research
Circulatory and Respiratory Health
Gender and Health
Genetics
Health Services and Policy Research
Human Development, Child and Youth Health
Infection and Immunity
Musculoskeletal Health and Arthritis
Neurosciences, Mental Health and Addiction
Nutrition, Metabolism and Diabetes
Population and Public Health

2. CIHR's Core Business

CIHR activities include the funding, coordination and promotion of health research through open competitions, strategic initiatives, and knowledge translation. CIHR also participates with other federal agencies in a number of programs, including the Networks of Centres of Excellence program, Canada Research Chairs, and Canada Graduate Scholarships.

CIHR invests a significant portion of its budget on research grants and personnel support awards in "open" competitions, enabling individual researchers or groups of investigators to identify research areas that they consider to be of importance. The remainder of the CIHR budget is invested in "strategic" research, that is, research on specific topics identified by CIHR's Institutes following broad consultation.

CIHR provides a range of career and training programs to support health researchers across all disciplines, building capacity in those areas where needs are identified. It develops and supports innovative training programs that promote a multidisciplinary approach to understanding health and disease. CIHR also contributes to improved research ethics policies and practices in Canada.

During its first six years, CIHR has established many new initiatives, almost all in partnership with others, to realize the potential of research to improve the health of Canadians, strengthen Canada's health care system, and contribute to our knowledge-based economy. They include:

• programs to assist researchers in translating their discoveries to applications in the marketplace, and to engage communities across Canada in health research;
• strategic initiatives that address emerging health threats and other important issues of concern to Canadians; and
• innovative training initiatives that will support the next generation of health researchers and provide them with the training they need in a collaborative, interdisciplinary research environment.

Knowledge Translation
A key part of CIHR's mandate, knowledge translation (KT) is about turning the knowledge gained through health research into improved health for Canadians, more effective services and products, and a strengthened health system. This includes supporting initiatives, like the Partnerships for Health System Improvement program - an initiative that produces high quality evidence that will inform priority areas in the health care system. It also includes funding research into how best to promote knowledge translation.

Commercialization
Health-related companies, including biotech companies, are responsible for more than $20 billion in revenues each year. CIHR has developed a coherent suite of programs to help move research discoveries from the academic setting to the marketplace. CIHR's new Commercialization and Innovation Strategy builds on work done to date, and fills gaps identified in moving discovery to the marketplace.

World Class Research Through CIHR's Peer Review Process
Applications for support from CIHR undergo rigorous peer review on a competitive basis by committees of experts in the field. These experts examine proposals with respect to their significance in advancing knowledge and promoting the health of Canadians. They also assess them on the basis of innovation and feasibility of technical approach. The qualifications and track record of the researchers and the availability of the resources and expertise necessary for the proposed studies are also examined. Through a process of consensus, the committee arrives at a numerical rating for each proposal. As a result, only those that meet internationally accepted standards of excellence are funded.

There are now more than 100 CIHR peer review committees and the peer review process involves over 2,300 volunteer expert reviewers each year, from Canada and abroad. The committees make recommendations on the merits of applications to CIHR's Governing Council, which then decides which applications will be funded within the available budget.

3. Supporting and Aligning to Government of Canada Strategic Outcomes

CIHR's programs contributes to a number of Government of Canada outcomes reported in Canada's Performance 2005, the federal government's report to Canadians on national performance. CIHR directly contributes to Canadian progress, as shown in the table below.

CIHR Strategic Outcome	CIHR Program Activity	Alignment to Government of Canada Strategic Outcomes (Theme: Outcome)
1. Outstanding Research	1.1. Fund health research	Economic: An innovative and knowledge based economy Social: Healthy Canadians With Access to Quality Health Care
2. Outstanding Researchers in Innovative Environments	2.1. Fund health researchers and trainees	Economic: An innovative and knowledge based economy Social: Healthy Canadians With Access to Quality Health Care
	2.2. Fund Research resources, collaboration and other grants to strengthen the health research community
	2.3. Develop and support strong health research community through national and international alliances and priority-setting
	2.4. Inform research, clinical practice and public policy on ethical, legal and social issues related to health and health research
3. Transforming Health Research into Action	3.1. Support activities on knowledge translation, exchange, use and strategies to strengthen the health system	Social: Healthy Canadians With Access to Quality Health Care
	3.2. Support national efforts to capture the economic value for Canada of health research advances made at Canadian institutions	Economic: An innovative and knowledge based economy

CIHR also contributes indirectly to several other Government of Canada outcomes, including; Clean and Healthy Environment, Safe and Secure Communities, and A Secure World through Multilateral Cooperation.

4. CIHR's Partnerships - The Key to Success

The CIHR Act requires CIHR to engage voluntary organizations, the private sector, the public sector and others, in or outside Canada, with complementary research interests; to pursue opportunities and provide support for the participation of Canadian scientists in international collaboration and partnerships in health research; and to consult, collaborate and form partnerships with the provinces and with persons and organizations in or outside Canada that have an interest in issues pertaining to health or health research. CIHR's Institutes are the primary focus for development of partnerships relevant to their mandates.

In 2005-2006, CIHR had approximately 160 established partnerships, with many more being negotiated. These partnerships represented a realized financial contribution of more than $104 million², a 19% increase over the level of the previous year. The value of partnerships, however, extends beyond that of a financial transaction. Non-financial contributions can include access to professional networks, areas of expertise, shared tools and documentation, and in-kind resources. Whatever the contribution, CIHR partnerships are true collaborations - driven by shared goals and a desire to improve health and quality of life.

CIHR engages partners along the entire spectrum of health research, from the setting of research priorities, through the funding of the actual research, and eventually to translating the resulting knowledge into practice. Partnerships are developed primarily by Institutes to address the research they have identified, in collaboration with their partners, but can also involve CIHR-wide programs, such as those involving industry. Through strategic partnerships, CIHR is leveraging support for government priority areas.

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² As of March 7, 2006.

Partnership Example - Partnering to Battle Canada's Growing Obesity Problem The Institute of Nutrition, Metabolism and Diabetes (INMD) has chosen a single research priority: obesity. Unravelling the mystery of obesity isn't a job for just one researcher, so the Target Obesity initiative is supporting the training of 14 new obesity researchers, each bringing a different perspective to bear on the issue. The Heart and Stroke Foundation, the Canadian Diabetes Association and five other CIHR Institutes are partners in the initiative, which is devoting $1.4 million over five years, commencing 2004-05, to supporting trainees investigating such areas as chemicals in the brain that regulate food intake and body weight gain, childhood predictors of adult obesity among Aboriginal youth, and the genes involved in obesity. INMD also has launched "Canada on the Move", a national initiative, with partners such as Kellogg Canada, that asks Canadians to "donate their steps to research". By recording the number of steps they take each day on the website, Canadians will help researchers determine what motivates Canadians to be active and design programs to increase activity and reduce obesity. In addition, INMD is also developing a new partnership, with the Centre de prévention de l'obésité de la Fondation Lucie et André Chagnon, focusing on childhood obesity.

Partnership Example - Partnering with Decision Makers to Establish Wait Times for Medical Treatments and Screening Services In the 2004 Ten-Year Plan to Strengthen Health Care, the federal and provincial governments agreed to establish maximum acceptable waiting times for cancer care, heart surgery, diagnostic imaging, joint replacement surgery, and sight restoration by December 2005. In partnership with the Provincial/Territorial Deputy Ministers of Health, CIHR recently funded research to assist them in meeting provincial commitments related to establishing evidence-based benchmarks for medically acceptable Wait Times. Eight national research teams, funded by the provinces, territories and CIHR, recently delivered their second report synthesizing the world's best research evidence related to a number of key priority areas including hip replacement and sight restoration. On December 12, provinces and territories announced common wait time benchmarks for medical treatments and screening services. This research will help inform the development of evidence-based benchmarks and identify key gaps where further research is needed in order to establish new benchmarks or to modify existing benchmarks as new evidence emerges. The third research report, due April 30, 2006, will provide gap analysis and identification of priority areas and questions for future research.

Examples of Current CIHR Partners: Working Together for the Health of Canadians ³

Federal Departments/Agencies	Provincial Departments/Agencies
Agriculture and Agri-Food Canada Canada Foundation for Innovation Canadian Blood Services Canadian Food Inspection Agency Canadian Health Services Research Foundation Canadian Institute for Health Information Canadian International Development Agency Department of National Defence Environment Canada Genome Canada Health Canada International Development Research Centre National Research Council National Secretariat on Homelessness Natural Sciences and Engineering Council Public Health Agency of Canada Social Sciences and Humanities Research Council Statistics Canada	Alberta Heritage Foundation for Medical Research Fonds de la recherche en santé du Québec Government of Saskatchewan (Innovation and Science Fund) Manitoba Health Medical Research Fund of New Brunswick Michael Smith Foundation for Health Research (BC) Ministère de la santé et des services sociaux du Québec Newfoundland and Labrador Centre for Applied Health Research Nova Scotia Health Research Foundation Ontario Innovation Trust Ontario Ministry of Health and Long-Term Care Ontario Research & Development Challenge Fund PEI, through the Regional Partnerships Program Provincial/Territorial Deputy Ministers of Health
Voluntary Organizations	Industry
ALS Society of Canada Alzheimer Society of Canada The Arthritis Society Canadian Allergy, Asthma & Immunology Foundation Canadian Association of Gastroenterology Canadian Association of Medical Oncologists Canadian Breast Cancer Research Alliance Canadian Cancer Society Canadian Chiropractic Research Foundation Canadian Diabetes Association Canadian Digestive Health Foundation Canadian Fanconi Anemia Research Fund Canadian Hypertension Society Canadian Institute for Relief of Pain and Disability Canadian Lung Association Canadian Medical Association CNIB E.A. Baker Foundation Epilepsy Canada Health Charities Coalition of Canada Fragile X Research Foundation of Canada Heart and Stroke Foundation of Canada Juvenile Diabetes Research Foundation The Kidney Foundation of Canada Muscular Dystrophy Canada NeuroScience Canada Ontario Neurotrauma Foundation	Canada's research-based pharmaceutical companies (Rx&D) Canadian biotechnology companies National agri-food organizations
	International
	Australia Research Council Bill and Melinda Gates Foundation (U.S.) Centre National de la Recherche Scientifique (France) CNPq (Brazil) CONICET (Argentina) Human Frontier Science Program (France) Indian Council for Medical Research Institut National de la Santé et de la Recherche Médicale (France) International Agency for Research on Cancer (France) Japan Society for the Promotion of Science Max Planck Institute (Germany) Medical Research Council (U.K.) National Institute of Health of Mexico National Institutes of Health (U.S.) National Natural Science Foundation of China The National Research Council (Italy) New Zealand Health Research Council Veterans Administration (U.S.) Wellcome Trust (U.K.)

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³ This list is representative of CIHR partners. CIHR values all its partners; however, space limitations prevent the listing of all partner organizations.

CIHR has also established various funding programs to facilitate partnership activities with international partners including:

• Canada, through CIHR, was the only country that was a funding partner in the Gates Grand Challenges for Global Health initiative. Three of the 43 teams funded are based in Canada. CIHR is providing $5.6M over 5 years towards these projects;
• Various CIHR Institutes have been active in establishing collaborations with counterpart organizations in China (neuroscience, maternal and child health, cardiovascular disease, genetics, diabetes and obesity, and infection and immunity), Japan (neuroscience, maternal child and youth health, aging), Germany and Italy (genomics), Mexico (tuberculosis, influenza), Australia and New Zealand (Aboriginal peoples' health), the U.S. (mental health, heart/lung/blood), and India (chronic and life-style diseases);
• CIHR has been the lead, along with Health Canada, the International Development Research Centre, and the Canadian International Development Agency, in developing the Global Health Research Initiative, a novel initiative to increase Canada's involvement in addressing the health research needs in the developing world;
• CIHR participates in seven international scientific exchange programs, which are intended to foster collaboration between independent investigators in Canada and those from Argentina, Brazil, China, France, Italy and Japan;
• CIHR contributes to the 31-nation Human Frontiers Science Program (HSFP), both in terms of funding and the participation of CIHR's VP Research as VP of the HFSP organization;
• CIHR is a major contributor to Heads of International Research Organizations (HIRO), the informal group of equivalent health research funding agencies in countries including the U.S. (NIH), U.K. (MRC), France (INSERM), Germany (Max Planck), China (Chinese Academy of Sciences), and Australia (NHMRC); and
• CIHR contributes to the International Agency for Research against Cancer (IARC), both in terms of funds and the participation of the Scientific Director of CIHR's Institute of Cancer Research.

5. Moving Forward: Blueprint for Health Research and Innovation

In January 2004, CIHR launched its first strategic plan: Investing in Canada's Future: CIHR's Blueprint for Health Research and Innovation. The foundation of Blueprint was the extensive work of CIHR's 13 Institutes in developing their individual strategic plans, and included wide-ranging consultations with a variety of stakeholders to identify research needs and priorities and to contribute to the development of Canada's first national health research agenda. In addition, CIHR conducted national consultations to gain input from health researchers and other stakeholders (federal and provincial governments, health charities, industry, and others) across the country.

Blueprint builds on CIHR's early years, charting a path for the next phase of growth and setting out its future direction. The plan sets out five key areas where CIHR will focus over the period 2003-2004 to 2007-2008:

1. strengthen Canada's health research communities;
2. address emerging health challenges and develop national research platforms and initiatives;
3. develop and support a balanced research agenda that includes research on disease mechanisms, disease prevention and cure, and health promotion;
4. harness research to improve the health status of vulnerable populations; and
5. support health innovations that contribute to a more productive health system and prosperous economy.

Through the implementation of Blueprint, Canada will be a leader in the international health research community, carrying out research that is strategic, responsive, and relevant. Benefits to Canadians will include better health, a stronger and sustainable health care system, and a knowledge-based economy.

6. Exceptional Value for Canadians

CIHR is creating new opportunities for Canadian researchers to be internationally competitive at home in Canada. Today, more researchers are being funded with higher levels of funding in more disciplines and more institutions than ever before. For example, since its inception in 2000, CIHR has been able to:

• increase the number of CIHR-funded researchers from approximately 5,600 to more than 10,000 in 2005-2006;
• increase average annual open competition operating grants for researchers from $92,000 to over $111,000 in 2005-2006;
• create innovative new programs to encourage and catalyze the commercialization of research; and
• support the work of the Provincial/Territorial Deputy Ministers of Health through the funding of research to assist them in meeting provincial commitments outlined in the Ten-Year Plan to Strengthen Health Care related to establishing evidence-based benchmarks for medically acceptable Wait Times.

As part of its commitment to accountability and transparency in delivering results to Canadians, CIHR's Governing Council has commissioned its first External Review of CIHR and its 13 Institutes. An international panel has been appointed to evaluate the organization's progress towards meeting its mandate. The results of this review will be made public in mid 2006.

7. Managing Risks and Challenges

CIHR is continuously assessing opportunities, challenges and risks at three levels: strategic, programmatic and administrative. Each of the thirteen Institutes has an Advisory Board that provides a wide variety of perspectives on health and health research issues. The Advisory Boards aim to identify those threats to the health of Canadians, or opportunities for rapid advances in health knowledge, that require strategic research initiatives. At the programmatic level, CIHR develops research funding mechanisms and review systems that take into account the opportunities and risks associated with different types of research. It aims to support not only established projects with high likelihood of success but also highly innovative projects for which the outcome is less certain. Administrative opportunities and threats are regularly assessed and responses approved by management committees.

Research takes time and a sustained investment, and as a result, a large portion of CIHR's budget is committed to grants and awards that extend over three to five years. A significant amount of the money CIHR has to invest in new research each year stems from the redistribution of funds from research projects that have come to an end. This provides a challenge for CIHR to manage research funding strategically since decisions must be made based of funds available in any fiscal year rather than funds required to deliver on specific research initiatives.

Another major challenge facing CIHR is the increased application pressure from the research community, driven not only by CIHR's broadened research community, but also by the other investments in health research made by the federal and provincial governments and other funders. During the time that CIHR's budget has more than doubled, the success rates in major competitions have gone down. It is important to note that the growth in applications has not been accompanied by deterioration in quality. In fact, the number of applications that are assessed by peer review as deserving funding has increased from about 200 per competition to over 600, and therefore the funding cutoffs now routinely exclude many research applications rated "excellent". Going forward, it will be important to ensure a stable source of funds to keep pace with this increasing research capacity and ensure Canada does not begin to lose many of its outstanding investigators.

In addition, specific risks and challenges related to each Strategic Outcome have been identified in Section II of this report.

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