Medical Research
The discovery of INSULIN in 1922 by Frederick BANTING, J.J.R. MACLEOD, Charles BEST and James COLLIP stands as the most celebrated event in Canadian medical research history. Its discovery led to the establishment of the SANOFI PASTEUR laboratories (formerly Connaught Laboratories) and the Banting Institute at the University of Toronto.
Since that time, research in Canada has been conducted into areas such as molecular biology, neuroscience, immunology, nutrition and metabolism, biochemistry, reproductive biology, CANCER, behavioural sciences, genetics, cardiology, developmental biology, DENTISTRY, microbiology, pharmacology, OCCUPATIONAL DISEASE, health-care organization, environmental health hazards, and the biology and health of human populations.
Canadian investigators, many of whom are world leaders in their areas, are examining the function and diseases of particular organs and systems such as the skin (dermatology), the blood system (hematology), the kidney (nephrology), the eye (ophthalmology), the ear, nose and throat (otolaryngology), the stomach and intestines (gastroenterology), the endocrine glands (endocrinology), the respiratory system (respirology) and connective tissue disorders.
Current Canadian medical research is addressing a number of key health concerns that range from vaccination to surviving cancer. Microbiologists are developing a new meningitis vaccine through innovative genetic research on mouse animal models that could improve the efficacy of vaccination. Because meningitis symptoms progress rapidly a key issue around vaccination is development of a vaccine that can stop the virus before it infects the patient. Oncologists examine the consequences of surviving cancer treatment on patients. Due to the effects of chemotherapy some people are at greater risk of developing other severe health problems such as heart disease, and tailoring survival strategies by following young cancer patients over the long term will help to improve their chances for a healthy life. Sleep researchers are investigating the connection between a sedentary lifestyle, fluid retention and the development of obstructive sleep apnea. The severity of apnea appears related to the amount of daily sedentary activity a patient engages in, such as sitting. This research could lead to addressing the cause of apnea through a healthier lifestyle, instead of merely treating the symptoms.
The range of accomplishments is impressive. Research in cardiovascular surgery alone has contributed significantly to the overall treatment of blood vessel and HEART DISEASE. Canadians have been responsible for major developments in heart pacemakers, heart-lung machines to oxygenate blood and correct heart defects, and the first coronary care units. Hans SELYE was a world-renowned expert in understanding STRESS, its effects and its management.
International diabetes research was significantly advanced by a group of researchers at the University of Alberta. Led by Dr. James Shapiro, the team developed an innovative technique to transplant pancreatic islet cells into people whose own islet cells had been destroyed by type 1 DIABETES. The technique, called the Edmonton Protocol, has been available for more than 10 years and has treated more than 100 people. The research allowed the patients to live without requiring daily supplemental insulin and significantly advanced the medical knowledge about diabetes and the ultimate potential of genetic research.
In the neurosciences Canadians have made major contributions to the knowledge of the central nervous system and its related diseases. The Montreal Neurological Institute (established in 1934) is an important centre for such research. Its founder, Wilder PENFIELD, not only pioneered the technique of brain-mapping, which is conducive to the better understanding of localized functions of the brain, but also built the MNI into an internationally known training centre.
Research at the MNI has led to improved surgical and nursing techniques for the management of spinal lesions, to the development of electroencephalography (EEG) to treat conditions such as epilepsy, and to a deeper understanding of cognitive and other behavioural changes associated with brain lesions. Noninvasive imaging techniques, such as computerized axial tomography (CAT) and positron emission tomography (PET), in conjunction with a new understanding of neurotransmitters, help researchers understand the way the various parts of the brain and nervous system grow, develop, take on specific tasks, and repair and replenish themselves.
At the University of Western Ontario, Charles Drake has achieved international recognition for developing new techniques for the improved repair and treatment of potentially fatal aneurysms - weakening or ruptures of brain arteries, notably the basilar artery.
The federal government, provincial governments, voluntary agencies and private foundations, industry, business and foreign sources all contribute to the support of biomedical research in Canada, including equipment, operating costs, research training and technical assistance.
Wilfred Gordon Bigelow, scientist
Bigelow pioneered the use of hypothermia to slow tissue metabolism and thus protect the heart and brain from damage during heart surgery. Painting by Irma Coucill (courtesy Museum of Cardiovascular Surgery, Toronto General Hospital, and the artist).
Hans Seyle, scientist
Selye's theories on stress inspired a new approach to medicine (courtesy Library and Archives Canada/PA-11671).
Federal Funding Agencies
The CANADIAN INSTITUTES OF HEALTH RESEARCH (CIHR) is the major federal agency responsible for funding health research in Canada. Established by Act of Parliament in April 2000, it consists of 13 institutes that provide partners in the research process. The CIHR was designed to have a comprehensive mandate and the research partners include the funding agencies, researchers and the research institutes. Each health institute has a broad and inclusive focus and sets priorities for research in each topic area. The institutes are led by an advisory board and scientific director as well as the CIHR governing council. The areas covered by the institutes include: Aboriginal people's health, AGING, cancer, circulatory and respiratory health, GENETICS, health services and policy research, infection, musculoskeletal health, diabetes and PUBLIC HEALTH.
The CIHR was developed out of the Medical Research Council of Canada, part of the NATIONAL RESEARCH COUNCIL. The Medical Research Council began as the Associate Committee of Medical Research in 1936, becoming the NRC Division of Medical Research in 1956 and then an autonomous body of NRC in 1960.
The CIHR funds health research and research training in universities, health-care institutions and research institutes. It provides support, on the basis of scientific excellence as determined by national peer review, for research and for training of health-science researchers in the health-science faculties. These include the departments and laboratories of the 17 medical schools, 10 dental schools and 10 pharmacy schools and their affiliated HOSPITALS and institutes across the country.
Health research at CIHR is divided into 4 broad categories: bio-medical; clinical; health services; and social, cultural, environmental and population health research. The CIHR is also responsible for ensuring that the knowledge generated out of health research is translated into findings that reach decision makers, and therefore help to ensure that medical research ultimately works to benefit the health of Canadians.
The CIHR is also mandated to provide researchers with opportunities to participate in international medical research. It cooperates with the CANADIAN INTERNATIONAL DEVELOPMENT AGENCY (CIDA), the International Development Research Centre and HEALTH CANADA in research to improve people's health in Canada and the world.
Research into cancer is led by the Institute of Cancer Research, with the Canadian Strategy for Cancer Control (CSCC) responsible for coordinating all cancer research in the country. The CSCC was created in 1999 and involved the establishment of a research alliance from the groups that were formerly in charge of cancer research - the National Cancer Institute of Canada, the Canadian Association of Provincial Cancer Agencies and Health Canada.
The former major Canadian health research initiatives have largely been maintained and expanded on by the CIHR. Canadian research in genetics is now undertaken by the Institute of Genetics encompassing the work of the former Canadian Genome Analysis and Technology program, which was Canada's participation in the international Human Genome Project. CIHR has research initiatives focused on hepatitis C, HIV/AIDS, antimicrobial resistance, and pandemic H1N1 influenza, among others.
Provincial Funding Agencies
Provincial agencies in Alberta, BC, Manitoba, Ontario, Québec and Saskatchewan contribute to medical research and training through such organizations as the Alberta Heritage Foundation for Medical Research and le Fonds de la recherche en santé du Québec.
Voluntary Funding Agencies
Voluntary agencies, which are generally "disease-specific," also play a major role in medical research. The National Cancer Institute of Canada and the Canadian Cancer Society integrated in 2009 and created the Canadian Cancer Society Research Institute (CCSRI). The CCSRI ensures that cancer research donations fund the most promising Canadian cancer research.
Research costs such as salary support and capital expenses to construct laboratories and animal-care facilities are generally paid by the institutions where the research is conducted. The institutions receive funds for this purpose through provincial governments and private donations.
Structure of Medical Research
Medical research is highly decentralized in universities and teaching hospitals and their affiliated institutions throughout the provinces. Canada is one of a small minority of countries without significant government laboratories devoted to biomedical research. While this decentralization links research with professional training and health-care delivery, it makes it difficult to define or maintain a national focus for concerted programs, especially as health care and education are provincial responsibilities. However, in 1982 federal and provincial representatives identified several health areas of national concern (cancer, accidents, arthritis and joint disorders, cardiovascular and cerebrovascular diseases, maternal and infant health problems, MENTAL HEALTH and respiratory diseases).
In 1983, the federal Cabinet approved a framework for medical research that emphasizes the provision of high-quality training; a balance between basic and applied research, and a balance across regions and disciplines (with special attention to areas of national health concern); and the utilization of new knowledge for improved health care. In 1986 the Medical Research Council of Canada (MRC) adopted an additional objective, to enhance the interaction between researchers in the health sciences and industry by implementing joint university-industry programs. The MRC also placed renewed emphasis on women's health issues and on the inclusion of greater numbers of females in clinical trials, since women traditionally were excluded from clinical trials due to concern over possible effects on monthly hormone cycles and pregnancy.
When the umbrella under which Canadian research is conducted became the CIHR in 2000, the health research mandate was altered to reflect current needs. The research agenda included health services research along with other under-developed areas like population health. In addition, more research has been funded on targeted areas of priority such as diabetes, obesity, aging and infectious diseases. The mandate also expanded to include knowledge translation, whereby the research results can be transformed into policies, practices, services and procedures.
The institutes that comprise the CIHR help determine which medical research studies are conducted in Canada. The institutes fund the Canadian research projects deemed to provide the most benefit to the health of Canadians; the funded topics are myriad.
Issues in Medical Research
Medical research critics claim that advances in medical research have led to little improvement in health status. Some blame this on inadequate communication among workers in the health sector and recommend an increase in the number of clinicians conducting research to improve the introduction of new knowledge into health care and to increase treatment-oriented research. Others charge that the conservative nature of the peer review system precludes progress of innovative science, and they advocate the participation of a greater variety of health professionals in medical research, eg, nurses and pharmacists, who have received less support in Canada than basic and clinical researchers. Canadian researchers and research institutions have worked to improve communication procedures between health-care professionals, and to be more inclusive of the various health professionals in medical research. This has led to a highly diverse group of people working in the field, and is more reflective of the changes in modern Canadian society.
There is also ongoing debate about the appropriate balance between curiosity-driven and targeted research, and between research that is oriented towards costly, technologically sophisticated medical treatments and more broadly based epidemiological and environmental medicine.
Ethics remains a vital issue in health research (see MEDICAL ETHICS; BIOETHICS). The establishment of the CIHR altered the ethical framework for health research in Canada. The MRC helped establish guidelines for the safe and ethical conduct of human experimentation, research with animals and the use of hazardous and infectious agents. However, the guidelines were not law and there was a need to formally address ethics.
The CIHR is mandated by Parliament to adhere to the highest international ethical standards, to apply ethical principles to health research, and to monitor and evaluate ethical issues. Ethics is a shared responsibility among various groups that extend across all levels of the CIHR. The standing committee on ethics identifies emerging ethical issues, while the ethics office develops and implements ethics in research policies. Each institute advisory board has an ethics designate, and the peer review committees that help to determine project funding include a focus on ethics. There is additional support for ethical issues related to research integrity and stem cell research. In addition, the 3 federal research agencies, CIHR, the National Science and Engineering Research Council and the Social Sciences and Humanities Research Council, jointly created the Interagency Advisory Panel on Research Ethics to promote ethical research involving humans in 2001.
International aspects of research are becoming more critical with the increase both in health problems (such as AIDS and pandemic influenza) that face many nations and in multinational studies to examine such problems. New developments, such as cloning and gene identification, present a host of ethical issues. The implications for the misuse of some technologies create what some might view as obstacles to research. The potential uses of cloning have caused the governments of many countries, including Canada, to work toward legislation that will restrict its application. Genetic research, in particular, presents several ethical dilemmas. The ability to identify genomes raises the issues of privacy, confidentiality and autonomy and raises some serious questions for future medical research. Does anyone have the right to genetic information about another individual? Will there be a distinction made between genetic technology for therapeutic purposes and using it to enhance an individual's characteristics? Will such technology change the way we view ourselves and how we define normal/abnormal?
See also HUMAN GENOME PROJECT.
Future of Medical Research
The health-care system in Canada is changing. Developments such as the increased recognition of the contribution of environmental and behavioural factors to mental and physical health, the growing focus on cost containment and the allocation of scarce resources, the significant rise in the number of women in medicine and research, the increased need for chronic-disease care in an aging population, the trend towards home care and away from hospital care, and the increase in hospital-based research institutes have all influenced the nature and extent of medical research.
Many of the discoveries of medical research, such as those that have recently offered new abilities to manipulate genes, to perform in vitro fertilization and embryo experimentation, to transplant organs and to screen for genetic problems, will continue to require excellent research by scientists. However, the growing social and ethical issues raised by such research will necessitate closer co-operation between scientists and the Canadian public. Scientists can help the public understand the implications of new knowledge, and the public needs to exercise its responsibility in guiding the extent, conduct and application of medical research in Canada.
The increase in privatized health-care services across the country will likely influence future medical research. Provincial and federal governments will be challenged in the future to balance the research needs of Canadians against the research wants of corporate profit-based medical care.
Author JUDITH MILLER AND NEIL R. MORRIS Revised: PATRICIA BAILEY
Suggested Reading
Donald Jack, Rogues, Rebels and Geniuses (1981); S.E.D. Shortt, ed, Medicine in Canadian Society (1981); Alison Li, J.B. Collip and the Development of Medical Research in Canada (2003).
Links to Other Sites
NeuroScience Canada
The website for NeuroScience Canada highlights Canadian achievements in neuroscience research and offers an overview of the human nervous system and neurological disorders.
Health Canada
The website for Health Canada. This section contains an overview of Health Canada and provides you points of entry to many Health Canada-specific related topics.
The Troubled Healer
An article about the history of Connaught Laboratories and its founder John Gerald FitzGerald, and the evolution of Canada's public health care system. From the UofT Magazine.
Heart and Stroke Foundation
The Heart and Stroke Foundation is a national voluntary non-profit organization whose mission is to improve the health of Canadians by preventing and reducing disability and death from heart disease and stroke through research, health promotion and advocacy.
Rick Hansen Foundation
The website for the Rick Hansen Foundation. Features an overview of research into spinal cord injury, an illustrated profile of Rick Hansen, and much more.
Genome Canada
Learn about the science and applications of human genome research in this Genome Canada website.
Scientific American
The latest news and in-depth reports about current issues in science from the "Scientific American" website.
Epilepsy Canada
An extensive information source about epilepsy for patients and care givers.
Juvenile Diabetes Research Foundation Canada
An authoritative information source about Type I and Type II diabetes. Check out the excellent dietary tips and other recommendations for a healthy lifestyle. Also features a history of diabetes research and a summary of the latest research initiatives.
Dr. Brett Finlay
A profile of acclaimed Canadian scientist Dr. Brett Finlay. From the Michael Smith Laboratories at UBC.
Canadian Medical Association
The official website of the Canadian Medical Association. An extensive source of information about hundreds of health issues.
Héma-Québec
Learn about compatibilities of various human blood types and other blood facts at the Héma-Québec website.
The Canadian Medical Hall of Fame
The Canadian Medical Hall of Fame website profiles past and present leaders of Canada’s medical community.
Food Safety Network
An extensive online information source about food safety for the general public. From the Food Safety Network (FSN) at the University of Guelph.
First pacemaker implanted in human
Watch a CBC interview with Dr. John A. Hopps, the Canadian electrical engineer who invented the heart pacemaker.
Canadians for Health Research
The website for Canadians for Health Research provides the latest news and information about programs that promote science and health research initiatives in Canada.
Centre-INRS-Institut Armand-Frappier
The website for the INRS-Institut Armand-Frappier research centre, a leading-edge health-related research organization in Québec. Check out “Research Areas” for an overview of the Centre’s multidisciplinary programs and facilities, profiles of key personnel, and opportunities for graduate study. See also the “Canadian Irradiation Centre” and the link to colourful online exhibits at the “Armand-Frappier Museum.”
Tuberculosis: 2. History of the disease in Canada
A history of the incidence and treatment of tuberculosis in Canada. From the Canadian Medical Association Journal. A PDF file.
BC Cancer Agency
This extensive BC Cancer Agency website is an authoritative information source about current research and public health issues concerning all forms of cancer.
Nature
Worldwide coverage of the latest science news from the highly acclaimed science journal "Nature."
Brass Instrument Psychology at the University of Toronto
View an interesting collection of antique brass instruments used in experimental psychology at this University of Toronto website.
University of Toronto Museum of Scientific Instruments
Check out the collection of antique medical and scientific instruments at this University of Toronto website.
InnnovationCanada.ca
Catch up on the latest developments in Canadian scientific research at the InnnovationCanada.ca website.
Canadian Science Policy Centre
The latest news and information about Canada's science sector.
Canadian Bioethics Society
The website for the Canadian Bioethics Society, an organization concerned with ethical issues relating to human life and health, biology, and the environment. Click on "Bioethics Community" to access their blog and other online resources.
Muscular Dystrophy Canada
An excellent resource about Muscular Dystrophy for patients, care givers and the general public. Features news about current research programs and activities of MDC chapters across Canada.
Canadian Journal of Rural Medicine
The official journal of the Society of Rural Physicians of Canada. Provides full text academic articles about rural health issues.
Centre for Rural and Northern Health Research
A great resource for academic information about rural health issues in Canada. From Laurentian University.
Sanofi Pasteur
The website for Sanofi Pasteur, the vaccines division of sanofi-aventis Group. In the upper menu, click on "Sanofi Pasteur in Canada" for a brief history of Connaught Laboratories and a profile of founder Dr. John G. FitzGerald.
Public Health Agency of Canada
Check this site for the latest news about current health issues. Covers chronic disease prevention, public health emergencies, infectious disease outbreaks, and other topics related to health hazards.
Stem Cell Network
This extensive site offers technical and non-technical articles about stem cell research. Covers breakthroughs, potential benefits, and related ethical issues. From Canada’s Stem Cell Network.
Canadian Stem Cell Foundation
Explore this Webby award-winning site that focuses on the nature of stem cells and how communities can connect with the latest stem cell research initiatives.
Glossary: Biotechnology
This glossary was developed to help you understand the terms used in the field of biotechnology. From the website for Health Canada.
Open Medicine
Open Medicine is a peer-reviewed, independent, open-access general medical journal. The Journal examines issues relevant to health and clinical medicine both in Canada and internationally.
Canadian Bulletin of Medical History
Search for full text articles on a variety of medical topics at the website for the Canadian Bulletin of Medical History. Published by Wilfrid Laurier University Press.
R. Samuel McLaughlin Centre for Population Health Risk Assessment
The website for the R. Samuel McLaughlin Centre for Population Health Risk Assessment, a national centre of excellence in population health risk studies at the University of Ottawa.
Canadian Society of Intestinal Research
CSIR is dedicated to funding education and research regarding gastrointestinal diseases and disorders. Their website provides information on a wide range of diseases, related treatment options, research programs, support groups, and much more.
Canadian Society of Immunology
The Canadian Society of Immunology (CSI) is an organization that fosters and supports Immunology research throughout Canada
Internation Centre for Infectious Diseases
The website for ICID, an organization committed to innovative research and development programs related to biosafety and biosecurity.
Glossary: Reproductive and Genetic Technologies
A bilingual glossary of some common terms related to reproductive and genetic technologies. From the Canadian Nurses Association. A PDF document.
Regulating Assisted Human Reproduction
UBC professor and reproductive health consultant Judith Daniluk talks about choices and dilemmas in regard to assisted human reproduction. A University of British Columbia website.
Canadian Journal of Pathology
Read full text articles from the "Canadian Journal of Pathology." From the website for the Canadian Association of Pathologists.
Canadian Society for Brain, Behaviour and Cognitive Science
The website for an oganization devoted to advancing Canadian research in experimental psychology and behavioural neuroscience. Clicked on "Meetings" and then "Archives" to view abstracts from sessions at previous meetings.
Changes proposed for Alberta's research and innovation system
A news release regarding proposed changes to Alberta’s research and innovation organizations. From the Government of Alberta.
Canadian Institutes of Health Research
The website for the Canadian Institutes of Health Research, the Government of Canada's agency responsible for funding health research in Canada. Check out "Outcomes and Impacts" for "Milestones in Canadian Health Research" and notes about more recent Canadian research initiatives.
Let's Talk Science
Let's Talk Science offers interactive learning programs and resources for teachers and their students.
Dr. Michael Smith
A profile of Dr. Michael Smith, from the website for the Michael Smith Foundation for Health Research.
Creation of genes in lab raises hopes, concerns
A brief news story that addresses ethical concerns related to the development of the first cell that contains only synthetic genetic material. From the SFGATE.com website.
The Cochrane Collaboration
The website for the Cochrane Collaboration. Patients and other healthcare consumers can assess the potential risks and benefits of their treatment.
Association of Faculties of Medicine of Canada
The website for the Association of Faculties of Medicine of Canada, a good information source for students interested in pursuing medical studies. Provides links to websites of medical faculties, details about admission requirements, online publications about medical education and research, awards for innovative teaching initiatives, and more.
A medical family, elegantly dissected
A review of the book "What Disturbs Our Blood," chronicles a famous family's troubled history within the context of the development of modern medicine in Canada. Written by James Fitzgerald, grandson of Dr. John G. FitzGerald, founder of Connaught Antitoxin Laboratories. From the National Post.
The Discovery and Early Development of Insulin
An outstanding online exhibit about Canada’s leading role in the discovery and development of insulin as a treatment for diabetes. This digitalized collection of original archival material features laboratory notebooks and charts, correspondence, published papers, photographs, awards, scrapbooks and much more. From the website for the University of Toronto Libraries.
Shawnadithit grew anxious waiting for her uncle, Longnon, to return to camp at the junction of Badger Brook and the Exploits River, deep in the wilds of Newfoundland...
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