Christina Weise, Executive Director, Manitoba Health Research Council
30 years since its inception, MHRC’s demonstrable progress has proved beyond doubt the value of securing provincial funding and tailoring health sciences research to the needs of the local population
How would you sum up MHRC’s overarching mission? From what context was it established?
The mandate of the Manitoba Health Research Council is ‘to promote and assist basic, clinical and applied research in the health sciences in Manitoba and advise the Minister on health research related manners’.
In early 1980, Drs Arnold Naimark, Henry Friesen and Lyonel Israels met with the Provincial Minister of Health to express concern that the absence of provincial funding threatened the support and recruitment of young investigators to Manitoba and the retention of established scientists. Quebec, Ontario, Saskatchewan and Alberta all had established provincial funding to support health research, thus placing Manitoba in a comparably less competitive and disadvantaged position.
A positive response was received in late November 1980 when the Minster provided CAD $300,000 of unexpended residual funds within the health budget to Council. The Act legislating for the establishment of the Manitoba Health Research Council was passed on 30 June, 1982. 2012 marks the 30th anniversary of the official establishment of MHRC.
What has your personal experience of longstanding interest in health outcomes brought to bear on your role at MHRC?
Actually, my longstanding interest has been in research funding, having started my career in research administration when the federal and provincial governments in Canada were increasing their support for and interest in research. Over the years I have been able to see and really appreciate the diversity of research undertaken in Manitoba; its impact and benefits. It is the researchers’ curiosity and drive to make people healthier which has motivated me to ensure that MHRC is doing its best to support the research community in Manitoba.
Could you outline the unique geographical characteristics of the province, and how the population is dispersed? Are there any socioeconomic factors specific to Manitoba that influence health and health research in the region?
Manitoba is the easternmost of the three prairie Canadian provinces, located in the longitudinal centre of Canada. The northern 60 per cent of the province is on the Canadian Shield. The northernmost regions of Manitoba lie in permafrost (permanently frozen subsoil), and a section of tundra border Hudson Bay. Manitoba is the sixth largest Canadian province.
In 2011, the population of Manitoba was 1,208,268 of which 62.4 per cent of people live in Winnipeg, the province’s capital. In the 2006 Census, 15.5 per cent of Manitobans identified as Aboriginal.
According to the 2009 RHA Indicators Atlas, the health of most Manitobans continues to improve. Life expectancy increased and premature mortality rates are down. However, the health of people living in the lowest income areas (residents of the core area of Winnipeg and northern Manitoba) did not improve and may be getting worse. First Nations, Métis and Inuit peoples, the fastest growing demographic in the province, suffer from more illness and, as a result, often have shortened life expectancies.
Additionally, the Canadian Diabetes Association reported that 94,000 people in Manitoba have been diagnosed with Type 1 or Type 2 diabetes in 2010 – representing approximately 7.6 per cent of the population. This number is expected to increase by 45,000 over the next decade to 139,000 or 10.1 per cent of the population of Manitoba.
All of these factors, and many others, do influence the health research undertaken in Manitoba. For example, a new research group has established, placing a more focused emphasis on diabetes, the disease mechanisms, and its treatment and prevention. A cohort of third generation teenagers and young adults with Type 2 diabetes is the focus of their work.
After a period of stagnation in funding levels, the Government of Manitoba requested that MHRC lead in the development of a provincial strategy for health research. Where would you place the region now in terms of competiveness and effectiveness?
In terms of funding, we are on a par with Saskatchewan and Nova Scotia. With the increased funding we received in 2008, we created the Manitoba Research Chairs programme, which supports new-mid career investigators with $100,000 per year over five years, and has been effective in retaining researchers in Manitoba.
We have also started programmes which build capacity for health services research in the province. Health system innovation is critical to meeting the demands for high quality yet lower-cost healthcare services. Our funding provides support to key projects which seek to improve the health system by testing out novel ideas and seeking the input of policy makers at the front end to build interest in and support for knowledge translation down the road.
Could you provide brief examples of health research projects that have benefited from funding from MHRC?
• Five years of MHRC-funded research on human thyroid carcinoma has led to the establishment of a thyroid cancer cell bank resource at the Faculty of Medicine, University of Manitoba and the establishment of a surgery-anatomy translational team in thyroid research. Thyroid cancer is the most common tumour of endocrine organs
• Another project aims to understand the factors related to mental health and treatment needs of Canadian soldiers and the causes of suicide in First Nations communities. One outcome of the research with First Nations communities was the pilot of a suicide prevention and community building programme, which is expected to contribute directly in reducing the incidence of suicide
• An Establishment Grant in 2008 supported a research project on ‘Optimization and Development of Novel Antimicrobial Strategies for Therapy of Septic Shock’. Septic shock is the mechanism by which overwhelming infection of any sort (pneumonia, post-surgical complication, anthrax and other biowarfare-associated infection) can cause death, and it accounts for as many deaths as heart attacks and many more than breast cancer or AIDS. The research has led to the development of international policies and guidelines that promote the delivery of antibiotics faster. Locally, there has been a marked improvement in survival of septic shock, saving probably about 150 lives per year
In the context of today’s ageing population, many commentators have emphasised the cyclical nature of economic prosperity and improved societal health. What is your perspective on the health = wealth issue?
The link between people’s income and health is demonstrated around the world and in the province, the Manitoba Centre for Health Policy has looked at this issue closely in their recent report ‘Health Inequities in Manitoba: is the Socioeconomic Gap Widening or Narrowing over time?’
The study is an important one and provides some insights for policy changes to help close the health gaps. Its real benefit is in providing a clear picture of the health inequities in Manitoba and helping to promote the use of an ‘equity lens’ during the policy-making and implementation process.
How crucial a role has collaboration, and particularly partnerships with Canadian national research bodies, played in the success of MHRC programmes?
Collaboration is a core tenet of MHRC’s strategy and influences all of our activities. One of the partnership activities of which we are most proud is our Coordinated Trainee Competition. In 2007 we worked with local partners to establish a common framework for the awards given to local Masters, PhD and Postdoctoral Fellowship trainees. MHRC undertakes the peer review and ranking for all of our partner organisations and we work together to fund (in partnership or on our own) as many trainees as possible. We started out with five partners consisting of the local hospital-based charities and now have 10 partners which also include different faculties within our research intensive institutions and national charities.
At a national level, we participate in the National Alliance of Provincial Health Research Organization (NAPHRO) which is an alliance of provincial health research funding agencies created in 2003 to promote increased dialogue, linkages and partnership activities. We also participate in the Forum of Health Research Funders which includes the federal grant agencies such as the Canadian Institutes of Health Research and Genome Canada, the provincial agencies and a number of health charities. Through these discussions, MHRC works as part of the health research system in Canada to coordinate our collective activities and resulted in the following: the redevelopment of the Canadian Common CV; the development of the Canadian Health Researcher Directory; and a combined effort to assess return on our investments.
How does MHRC ensure that innovation and creativity is at the forefront of health research in the province?
We are a relatively small community in Manitoba, and our peer-review committees represent the diversity of expertise within it. I believe that because all the grants are reviewed by peers of different backgrounds and knowledge, there is an openness to innovation and creativity in our programmes. Additionally, our operating grants programmes are targeted at new investigators. This focus allows MHRC to see the new ideas first and support them at the early stages. This is important to building capacity in the province.
By what measures do you quantify your success? What would you say have been MHRC’s highlights to date?
To date, here are some of our highlights:
• MHRC has helped launch/establish the careers and research programmes of funded researchers
• MHRC is acknowledged by the research community as an important source of funding
• MHRC has more than doubled the number of funded applications from 39 in 2005 to 91 in 2011
• 109 supported researchers from 2000 to 2010 leveraged around $94 million CIHR grants and had 1,340 papers in peer-reviewed journals in the same time frame
• The work of several supported researchers have had an impact on clinical practice and policy
• MHRC supported the growth of health research in the province evident in the: 2.7 per cent annual growth of publications in peer-reviewed journals in past two and a half decades; funding leveraged from CIHR in 2010 reached $20 million, up from $8.6 million in 1990; 5.9 per cent annual growth of graduated students in the life sciences, and becoming a leader in health research as tracked
What are your hopes for the future of MHRC and Canadian health research in general?
I hope that MHRC continues to expand its ability to help the research community in Manitoba flourish by supporting the establishment and growth of multidisciplinary and translational research teams and by the development of patient-orientated and clinical research platforms. It is also important for us to work closely with the health system in Manitoba to assist with the ongoing evidence-based health system transformation.
I hope that Canadian health researchers continue to make cutting-edge and transformational discoveries which make our population, and that of the world, healthier. To that end, it is important for the health research funders in Canada: federal and provincial granting agencies; health charities; post-secondary institutions; and the health system to collaborate even more to ensure that the enterprise is best supporting the creation and translation of new knowledge.
Sustaining our current and building new collaborations and partnerships will be critical to this endeavour, both in Manitoba and throughout Canada.