Thank you, Madam Chair.
Thank you, committee members. I very much appreciate this opportunity to speak before you.
The brain is the most vital and complex organ of the human body. Brain disorders carry both economic and human costs that are greater than those for cancer and cardiovascular disease combined.
While some brain diseases respond to treatment, there are no cures at the present time. People with a brain disorder may live for a very long time, and with some conditions, they may slowly degenerate and lose function before dying.
When we link direct costs and costs associated with disability, we reach an economic burden that is in the order of $60 billion, and this is a conservative estimate, based on a 38% cost relative to the total cost of disease. Of course we've heard numbers about the growing Alzheimer's impact and related dementias, and of course the numbers are going to significantly escalate in the coming years.
For the past 10 years I have been the president of a neuroscience research funding organization that has brought science, business leadership, and academia together. During this period I worked closely with the Honourable Michael H. Wilson, who was our past chair and is now the honorary chair, and who has been a long-time advocate for the neurosciences. The current chair, Rupert Duchesne, is the CEO of Groupe Aeroplan Inc., but he started his career in neuropsychopharmacology. Both Michael and Rupert have been personally and directly touched by a brain disorder in their lives, so this is a very personal and meaningful mission for them.
The goal of NeuroScience Canada has been to maximize our current investment in research but also to make future investments more efficient and, most importantly, more focused on outcomes that will link directly to patients. NeuroScience Canada, with that in mind, provided the impetus and the rationale to form Neurological Health Charities Canada. That has been the grouping that has brought together the voluntary health organizations. It's significant to note that the U.S. has been quite envious of this accomplishment, because in fact to bring together all of these disease groupings around one common voice has been a significant challenge, and we are the first to have been able to accomplish this.
Over the past 10 years I have learned a great deal about both research funding and the science, and there are two themes that have emerged for me: our current state of funding, and where the science is going. For me, the main undercurrent of these two and how they're linked together is based on how we're funding and based on where the science is going; do we have an alignment, or do we need to fundamentally change the model upon which we are currently basing our decisions for funding science?
To look at the current status of funding, Canada has benefited because of government and private donors, who have put a significant amount into funding infrastructure and salaries to attract and retain our top faculty. This is seen through the Canada Foundation for Innovation, the Canada research chairs, Genome Canada, as well as private donors, such as what Dr. Song mentioned as being pivotal to his research.
Canada is a leader in the field of neuroscience, as all of my colleagues have mentioned. Many of the most important discoveries around the brain have been made by Canadian researchers or a Canadian lab. But we also excel at collaboration. We have a culture where we share knowledge and we share information. This is quite different from the way research is traditionally done in the U.S.; even though much better funded, it's a highly competitive and much more individualistic model. So we have something in Canada that is really quite special, and it's very appropriate for the brain, where there is a complexity that requires us to collaborate.
We also are known for our ability to maximize every dollar that we do provide to research. Although we hear that our funding is relatively low compared to the U.S., we are still able to achieve breakthroughs. So we should be very proud of the output of Canadians.
We have the capacity and the excellence. What's missing is the third leg of the stool, and that is the operating grants. Operating grants are what enable our researchers to run their labs and provide training environments to doctoral students and post-doctoral fellows. This is where we fall behind.
In 2009-10, the CIHR provided $179 million in operating grants across the neurosciences, and that includes mental health, addiction, and the sensory organs. The voluntary organizations, the ones grouped under Neurological Health Charities, combined were only able to disburse $20 million a year.
Now, that is a symbol of the public's response to the importance of funding brain research and their lack of understanding about the impact. The total is about $200 million.
That, when contrasted with the conservative $60 billion investment, we can see is really disproportionate.
Turning to the science now, 90% of what we know about the brain was discovered in the last 15 to 20 years. This was spurred by the 1990s, which were declared the Decade of the Brain, in which there was an explosion of brain research around the world. That led to basic discoveries about how the brain works. What we discovered was that we moved from looking at the parts of the brain to really understanding how the systems in the brain function and how the brain as a whole is one system.
We realize that there are three possible underlying causes to the range of brain disorders: cells die and particular types of cell groups or particular regions of the brain might result in a particular disorder; connections between cells don't function so they can't communicate with each other; or there are problems with the whole circuitry of the brain linked to a chemical or molecular imbalance, and this is the case for the vast majority of psychiatric conditions.
This also broke down these two silos of neurological and psychiatric conditions so that we have to stop thinking about the brain and the mind and start thinking about one mechanism in which there are linkages. We should also note there are many conditions, Alzheimer's being one key example, in which there are both neurological and psychiatric components, so we no longer have this barrier.
How have we been funding research? Traditionally we focused on individual grants to support researchers in specific disciplines or around specific diseases. This has produced important new knowledge about how the brain works, but recent experience indicates that we can actually fund in a way that will accelerate our ability to translate this knowledge into patients and treatment.
A series of pilot studies undertaken by NeuroScience Canada provided five grants that were multidisciplinary, multi-institutional, and focused on common mechanisms, and we saw dramatic results in terms of achieving breakthroughs. This program, which was called the brain repair program, was celebrated around the world by leading researchers. It partnered with the CIHR and worked with all of the communities, including the voluntary health organizations. We developed something that we feel is really very special, which led to our ability to more rapidly reach breakthroughs and to translate these into applications for how we are going to diagnose, treat, and cure brain disorders. So we see that there is a link between the funding and where the science is going.
What have I learned from all this, and what are my key conclusions? First of all, in order to maximize the return on our investments in infrastructure and salary, we need to do more on the operating grant side. We need to congratulate the government and private donors for building this infrastructure, which has given us the capacity, and now we need to make sure that these labs and these researchers are fully operating.
Second, we need to focus our research investment on the brain as one complex system and not just as a collection of diseases, and on investigating commonalities from which a single breakthrough has the potential for therapies and cures for multiple illnesses.
Dr. Song gave an excellent example of how an anti-epileptic drug was being used for Alzheimer's, so if that research had not been done in an area that one would think had no relation to Alzheimer's, we wouldn't have had what is a significant breakthrough. We have to stop thinking in terms of diseases and start looking overall at how we can have a multiple effect.
We need to better coordinate our existing efforts so that we can spur discovery and create resources that the whole field can share, through such things as creating technology platforms or bringing technology and people together so that we have something that everybody in the community can use and benefit from. We need to involve the public, patients, families, caregivers, and ultimately all Canadians who will be touched by brain disorder. Doing so will better link patients to outcomes and will also ensure that government investment is recognized and is used to stimulate private dollars, because we need to do more, as the general public, in terms of how much we are investing in research.
What does this mean finally? It means exciting the public around one unifying vision for the brain and engaging all of the key players: science, business and philanthropic leadership, and the voluntary sector. This is the thinking behind the national brain strategy that has been tabled to this committee.
We need to fund collaborative, multidisciplinary research with common themes that link the brain disorders to this big vision for the brain and reinforce the brain as one system. This does not mean that we stop funding the pipeline. The pipeline is important, and the individual grants are important, but we need to focus our efforts on the next big breakthroughs, and those are going to come about with these larger grants.
Finally, we need to create a public-private partnership to provide not just more government funding but strategic funding with a private component, a bottom-up consultative process, not a top-down one. This is the research pillar of the national brain strategy, and that was developed by the Canadian Association for Neuroscience working with the voluntary health organizations through Neurological Health Charities.
I believe the result will be a more efficient and effective use of public funding and a leverage effect that stimulates private investment in brain research. I believe the public will applaud a government partnership with the private sector for matched funding as a demonstration of their working closely with the voluntary sector organizations that represent patients, families, and caregivers; with the research community; and with business and philanthropic leaders.
We have a chance, right now, to do something spectacular for the brain. Canada has all the components needed: the way we do science, the way we collaborate, the infrastructure and salaries we've developed, and the model we have put in place.
Let's be a leader in this and let's do something really remarkable.
