Feds developing unprecedented long-term research and pandemic preparedness strategy

The federal government is creating a first-of-its-kind long-term research and pandemic preparedness strategy that will include a new Centre for Pandemic Preparedness and Health Emergencies Research.

Ottawa has provided nearly $1 million to the Canadian Institutes of Health Research (CIHR) to take the scientific lead on developing the long-term strategy, including initial planning for the new centre, CIHR president Dr. Michael Strong told Research Money. “Across the board, everyone agrees that we need to be looking at a long-term strategy.”

“Looking back to SARS and counting the number of these (infectious disease outbreaks), whether it be Ebola, Zika virus, MERS (Middle East Respiratory Syndrome) and now COVID-19, this is no longer abnormal,” Strong said. “This is going to be steady state going forward. We’re going to have to be prepared for these.”

The long-term strategy will cut across federal agencies, encompass social, economic, public health and fundamental science aspects, and require long-term funding, he said. “It will need to be incredibly adaptable because we don’t know what each of these (outbreaks) is going to look like.”

No decision has been made on a timeline for implementing the strategy or when the new centre will start operations. However, Strong said CIHR will convene all the federal agencies and other important groups needed for the discussion, and he hopes to see some “reasonable parameters” by this fall for moving forward.

Several researchers told Research Money that investigations into SARS and MERS, along with funding for that science, dwindled after the outbreaks subsided.

COVID-19 is the third coronavirus outbreak in 17 years, yet there’s still no effective drug treatment for such pathogens, said Dr. (PhD) Matthias Gotte, professor of medical microbiology and immunology at the University of Alberta. Candidate anti-viral drugs were being investigated for SARS, but without sustained funding they didn’t advance to clinical trials, he said. “This is extremely unfortunate, because we need right now a treatment that would help us against the broad spectrum of different coronaviruses. That would help us right now in this crisis.”

Dr. (PhD) Pierre Talbot, director of the Laboratory of Neuroimmunovirology at the Université du Québec’s National Institute of Scientific Research, said: “Research on coronavirus should be ongoing, not just as a rapid response, but as relevant research.”

“We need to be in the game today, but we have to have a vision that we need a consistent research response for years to come on COVID-19,” agreed Dr. David Kelvin, professor of medicine at Dalhousie University. “Not only that, but on a larger strategy we need to make sure that we have an infectious disease research team engaged all year round. We need a standing army.”

Investment in public health has declined

Canada’s overall response to COVID-19 is significantly improved compared with the response 17 years ago to the SARS-1 coronavirus, said Dr. David Butler-Jones, who served as Canada’s first chief public health officer and deputy minister of the then-newly created Public Health Agency of Canada (PHAC). Along with the rapid provision of federal research funding, “the level of communications, transparency, sharing of information, best practices – all those things are much better than they were with SARS-1,” he told Research Money.

However, the COVID-19 response hasn’t been as effective as it could have been because government investments in public health have declined over the last eight years, Butler-Jones said. Some jurisdictions have divided public health programs and expertise among different departments, reducing their ability to coordinate planning and responsiveness, he added. “So there’s less capacity in the system than there was in 2012.”

The federal government created PHAC in 2004 after SARS, in response to recommendations in the report by the National Advisory Committee on SARS and Public Health, chaired by Dr. David Naylor, now professor of medicine and president emeritus at the University of Toronto. The report recommended that Ottawa provide funding of $300 million a year to provinces and territories to strengthen their public health programming, plus $100 million annually to support their capacity for infectious disease surveillance and outbreak management.

But governments at all levels currently spend only about 2% of their total health care funding on public health, notedDr. Paul Gully, public health consultant and adjunct professor of medicine at the University of British Columbia.

As a result, he said, there have been only “incremental” improvements since SARS in the ability to collect, analyze and share public health data across Canada’s health sector. “There needs to be a long-term investment in local public health to enable adequate surveillance and investigation in any outbreak,” Gully said.

“Our challenge in Canada is the federal government has not historically made public health a priority,” said Dr. Allan Ronald, senior advisor to the Winnipeg-based International Centre for Infectious Diseases and distinguished professor emeritus of medical microbiology at the University of Manitoba. Canada needs national standards for the collection of health care data and for long-term care facilities, along with more epidemiologists trained to analyze data and investigate disease outbreaks, Ronald said. “We’ve failed to create a national infrastructure that we need for detecting people with dangerous pathogens.”

Sharing health data remains a problem

Canada’s auditor general, in three separate reports to Parliament in the last couple of decades, pointed out the “inconsistent quality of national infectious disease surveillance information.” The AG’s 2008 report concluded that “PHAC has not made satisfactory progress on (previous recommendations) related to strategic direction, data quality, results measurement and information sharing.”

That situation hasn’t changed, according to Dr. (PhD) Amir Attran, professor of law, epidemiology and public health at the University of Ottawa. He told CBC Radio’s April 26 Sunday Edition that Canada is one of the worst among developed nations in sharing health data. Provinces are under no obligation to share data among themselves or with the federal government, even during a pandemic, Attran said. Ottawa should pass a law or emergency order obliging provinces to share data on each case of COVID they know about, he argued.

As part of its COVID-19 response, the federal government has established a five-member Task Force on Data Analytics, chaired by Dr. David Buckeridge, professor of epidemiology and  biostatistics at McGill University, that will examine data-sharing networks, including what data should be captured and how they can be gathered and accessed.

Given the problems that still exist, Canada has responded well to COVID-19, Gully said. “But we have to do a lot better if we really want to be able to respond adequately in the future.”

Paul Hodgson, associate director of business development at VIDO-InterVac (Vaccine and Infectious Disease Organization – International Vaccine Centre) at the University of Saskatchewan, predicts it will be a challenge, as people’s memory of COVID-19 starts to wane amid limited government budgets, to continue funding long-term research on coronaviruses and other future pandemics. Yet as someone once said, Hodgson added: “If you think research is expensive, you should try disease.”

Added CIHR’s Strong: “There has been a ton of work done over the course of years that talked about what we need to be prepared for. Part of our work is going to be ensuring that we coalesce all of that into a single process moving forward.”

With files from Mark Mann

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