
                   CRITICAL RESEARCH ON THE CRITICAL LIST

                              By SHARON KIRKEY
                               Ottawa Citizen

     OTTAWA - They stood in the glare of media lights, two nervous but
     exhilarated Canadian scientists who had just cracked one of the
     greatest medical mysteries of the 20th century.

     Two years ago, Lap-Chee Tsui and Jack Riordan of Toronto's Hospital
     for Sick Children announced to the world that they had discovered
     the gene responsible for cystic fibrosis.

     It was a spectacular victory for medical science, but can it happen
     in Canada again?

        See <22health> for a discussion of medical milestones

     Canadian researchers are as bright and talented as any in the
     world, but unless the country's chronic underfunding of medical
     research is reversed, scientists predict scenes such as the above
     will become increasingly rare.

     The number of demoralized and dejected researchers working in
     Canadian universities swelled to one of the highest levels in years
     after the Medical Research Council - the federal conduit for
     research grants - was forced to deny funding to more than 900
     medical scientists during the latest round of grants competitions
     in March.

     ``It was very disheartening,'' MRC president Dr. Pierre Bois said.

     The MRC rejected more than half of the best new research proposals
     submitted this year. Operating grant renewals sunk to an all-time
     low as funding was cut for more than 40 per cent of the country's
     senior scientists.

     Council official Dr. Lewis Slotin said both the number and quality
     of grant applications was exceptionally high, and that about 75 per
     cent of the proposals would have been supported if more funds were
     available.

     Slotin predicts things will only get worse. The MRC and two other
     federal funding agencies have been slapped with a three-per-cent
     annual limit on program-spending increases for the next five years.

     ``It means we're going to have to fund fewer and fewer projects, or
     spread the money out thinner.''

     For decades scientists have been protesting the sad state of
     funding for medical research in this country. The budgets of
     federal granting agencies have barely kept pace with inflation over
     recent years, and in some cases have been slashed dramatically.

     Universities are so strapped for cash that the infrastructure
     needed to support research is crumbling. Fewer and fewer medical
     school graduates are even considering research as a possible career
     choice, and every year Canada loses top scientists to other
     countries.

     We have a responsibility to contribute to the world's understanding
     of diseases and how to prevent and cure them, yet observers warn
     we're running the risk of becoming totally dependent on the
     expertise and knowledge of other countries.

     ``How are we going to have a community that's not only going to do
     original work, but have a scientific basis to interpret data that
     comes from other countries?'' said Pat Guyda, director of Montreal-
     based Canadians for Health Research.

     Others say what money is now spent on medical research - by Ottawa,
     the provinces, non-profit organizations and industry - is
     disjointed and unco-ordinated, resulting in outdated, overcrowded
     labs in some regions and sophisticated but near empty ones in
     others.

     There's growing criticism that there are major discrepancies
     between the burden of ill health imposed by certain diseases and
     the proportion of health research dollars spent on them.

     And there's widespread concern that the high payoff areas in terms
     of public benefit - preventive medicine, hospital management and
     public education - are losing out to more glamorous fields, like
     heart and cancer research.

     Still, few disagree that medical research is gasping for breath in
     this country, and that significantly more money is needed if Canada
     is to keep up in medicine with the rest of the world.

     But how much money should we be spending? Who should get it? And
     who should decide what our research priorities are?

     The Mulroney government swept to power in 1984 promising to double
     Canada's investment in research and development by boosting
     spending to 2.5 per cent of Gross National Product.

     That target is as far off today at it was then.

     Spending for research and development has steadily declined from
     1.43 per cent of GNP in 1986 to 1.3 per cent today - about half of
     what is spent in Japan and the United States. Among the 23
     countries of the Organization for Economic Co-operation, we're 17th
     and falling.

     ``We're not even on the map,'' said Dr. Theo Kruck of the
     University of Toronto's centre for neurodegenerative diseases.
     Kruck has spent years studying the link between aluminum and
     Alzheimer's.

     In December, a House of Commons committee on industry, science and
     technology called on the government to boost research spending to
     1.9 per cent of GNP by 2000, and 2.5 per cent by 2005.

     The committee also recommended the government double the budgets of
     the three granting councils - the Natural Sciences and Engineering
     Research Council, the MRC and the Social Sciences and Humanities
     Research Council. Together, the three groups will fund some $734
     million worth of research this year, supporting about 25,000
     scientists.

     Many of the proposals echo recommendations already made by the
     prime minister's hand-picked National Advisory Board on Science and
     Technology, which haven't been adopted.

     ``Year after year there's a tremendous struggle to extract from the
     treasury of this rich country even enough money to allow research
     laboratories to keep up with the cost of inflation,'' said Dr.
     David Levine, a University of Ottawa scientist who is
     internationally recognized for his research into kidney function.

     Slotin said it would take a doubling or tripling of the MRC's
     current $216- million budget for the council to fund as many
     applicants as it did even three years ago.

     Another federal funding agency for biomedical research is the
     National Health Research and Development Program, which finances
     vital research into public health issues, health-delivery systems
     and the cost-effectiveness of medical technology.

     Last summer, the federal government quietly lopped $3.95 million
     from the program's 1990-1991 budget, a reduction of more than 12
     per cent. Observers criticized the move as yet another example of
     how government seems more concerned with curing sickness than
     spending money to reduce costs in the future.

     The mother lode for federal biomedical research funding is the MRC.
     Established by Parliament in 1969, the council supports 45.5 per
     cent of university-based research. This year it is supporting about
     2,300 researchers.

     Its funds are nearly always for basic science projects, filling a
     gap in research often left by charitable or non-profit foundations
     interested in promoting research into specific diseases.

     The council wields awesome power. Notes one long-time observer,
     failing to get an MRC grant ``is like being rejected by the gods.''

     Each year, about 3,000 researchers apply to the MRC for money to
     finance their research or training. Another 3,000 scientists, the
     cream of of their profession, form 36 different peer review
     committees that pick apart, dissect and brutally critique every
     applicant's credentials and proposals.

     So who wins?

     Levine, who has served on the council's peer-review juries, said
     the successful MRC applicant usually fits this profile: someone who
     is extremely well-trained - preferably at the best laboratories -
     and has a proven track record.

     Critics say that mould is a recipe for mediocrity. Although 67 of
     216 new investigators who applied for funding in 1990 were
     successful, Kruck says the ``crazy, innovative'' scientists who may
     yield brilliant results are too often snubbed in favor of those
     ``who've followed the trodden path.''

     The typical council grant is about $75,000. For many researchers,
     that's less than half enough to get a basic science laboratory up
     and running. And costs of scientific and professional equipment can
     rise as much as 12 per cent in two years.

     That means they have to get additional grants elsewhere, usually
     from organizations such as the National Cancer Institute of Canada,
     the Canadian Cancer Society, Heart and Stroke Foundation, or
     Arthritis Society.

     Non-profit agencies support about 23 per cent of university-based
     health science research in Canada and in many cases are the major
     sources of funding for their specific disease. The cancer society
     raised almost $40 million in 1989-90.

     Another 18.5 per cent of health science research in Canada is
     supported by provincial dollars. Alberta leads the pack through the
     Alberta Heritage Foundation for Medical Research, which has about
     $50 million to spend annually.

     But most provinces, except Quebec, pale miserably in comparison and
     observers fear troubled provincial budgets will mean only more cuts
     ahead.

     Canada's brand-name pharmaecutical industry is the only quarter
     where universities are finding substantially more research dollars.

     A controversial drug patent law passed in 1987 extended greater
     patent protection to the industry, which is dominated by foreign-
     owned multi-national drug companies, on condition it stop spending
     so much of its research money abroad.

     Since the law was passed, R and D spending by drug companies has
     climbed from 4.9 per cent of annual sales in 1987 to 10 per cent of
     sales in 1990.

     As the soaring investment fosters stronger links between university
     and industry, some groups worry about the conflict of interest that
     can result when university professors are dependent on industry for
     their research.

     There's also concern that too much of the corporate funded effort
     is applied to specific products rather than to basic, discovery
     research.

     But Dr. Guy Beauchemin, head of MRC's university-industry program
     and past president of the Pharmaceutical Manufacturers'
     Association, said closer links with industry are essential in the
     increasingly competitive fight against disease.

     ``Our budget won't increase any faster than three per cent for the
     next three years, so there's a great desire on the universities'
     part to get at money from industry.''

     ``There's always a concern . . . that industry could steer
     research. But there's no indication that that's happening,''
     Beauchemin said.
