Generating IP: Keep the Bright Lights of Medical Research On During COVID-19!
April 13, 2020
By Noel Courage
Hospitals across Canada are warning the federal government about the rapid shuttering of clinical trials and highly skilled job losses. HeathCareCAN, the national organization of hospitals, raised this issue in a direct letter to the Prime Minister and top federal Minsters at the end of March. Tonda MacCharles has now reported in the Toronto Star that other hospitals have also signed onto another letter directly appealing to the Prime Minster and his team. This is a side effect of COVID-19 causing suspension or cancellation of hospital research and clinical trials that do not involve COVID-19. The funding for hospital research provided by pharmaceutical and medical device companies and charities has dropped off. The federal government wage subsidy is not applicable to publicly funded institutions. There is not enough cash coming in to pay staff. The same issue is expected to occur with industry and charitable foundation-funded research in universities1.
Canada cannot let these bright lights go dark. Federal and provincial governments should find funding. Research should still continue into everything else that is endangering Canadians, even if less urgent (i.e. don’t taking funding or resources away from COVID-19). Once highly skilled research jobs are cut, talent will start to migrate away and be difficult to reassemble. Research skill-sets are necessary for Canada to be successful in the innovation economy in future. R&D also helps build intellectual property (“IP”) assets.
The federal government should step in and temporarily plug this gap in funding in order to continue:
- vitally important non-COVID-19 medical research and clinical trials, in order to get important new medical knowledge, and to get drugs and devices approved;
- highly skilled jobs in research and clinical trials (research management and administration, hands-on research, regulatory, stats, etc.); and
- student positions, to provide hands-on training of graduate students and post-doctoral fellows.
In many cases, hospital research institutes have enforceable contracts with industry study sponsors. Hospitals can lean on sponsors to continue their commitments, but this can only be done to the extent reasonably possible under the contracts. Perhaps some payback of the government could be possible in future, if and when clinical trials are able to resume, and the outside funding comes back onstream.
Why is research funding hospital research so important? Canada has a long history of remarkable medical innovation, much of it tied to our hospitals. Here are a few examples that we can find just by looking at a single hospital’s accomplishments, Toronto’s UHN (formerly Toronto General Hospital).
Drs. Frederick Banting and Charles Best, who developed insulin as the treatment for diabetes, both had academic and hospital ties. It was in 1920 that Banting first thought of using the insulin extract to treat Type 1 diabetes patients. To this point, Type 1 diabetes had been an incurable, fatal disease. The first large scale clinical trials were run at the Toronto General Hospital, starting in 1922. This research had such a significant impact that it was recognized by a Nobel Prize only a year later, in 1923.
This insulin research work also shows two other important aspects:
- The need for long term (patient) support of medical research. Insulin went from idea to clinical trial in about two years. The current, modern drug R&D timelines are far longer for new compounds these days. The longer research time is due to more sophisticated research techniques, and increased regulatory requirements to show drug safety and efficacy. Shuttering research therefore means long term job losses and disruption of multi-year work.
- The importance of industry in getting clinical research to market is shown by the Eli Lilly pharmaceutical company helping improve protein insulin yield and scale up production from lab scale to market scale. Industry and charitable foundations will try to step back in to support their respective research obligations once trials are resumed and they are financially able to meet obligations.
Dr. William Bigelow of the University of Toronto Banting Institute and Toronto General Hospital, was a pioneer of open heart surgery in the 1940’s and 1950’s. He co-developed the first electronic pacemaker.
Modern Day Medicine
The leading edge research continues at UHN. As a very recent example, UHN has set up a new cell therapy program at its Princess Margaret Cancer Centre, developing new immunotherapy treatments for cancer patients (e.g. CAR T-cell therapy). Sarah Coyle, the Project Manager for the Cell Therapy Program, says on behalf of UHN, “It’s the definition of personalized medicine.” UHN lists many other current research successes on its website, including spin-off companies such as AvroBio and Northern Biologics, which are partly rooted at UHN.
Thornhill Medical, which is playing a key role in producing ventilators for COVID-19, also has roots in UHN and the University of Toronto. Thornhill Medical was founded by Dr. Joe Fisher and Dr. Ludwik Fedorko in 2004 long before COVID-19 was an issue. Thornhill Medical shows the importance of supporting a broad range of research, since you never know where it will be applied later. UHN also seeks out and adopts new therapies from other institutions, such as Dr. Tulin Cil traveling to Europe to learn how to perform robotic-assisted surgery so that she could bring it back to Canada.
All these lines of research produce new medical knowledge, treatments, jobs for skilled workers and create new IP. There are many other R&D innovations in progress at hospitals and academic institutions across Canada, and federal and provincial governments must step up and support it.
1 There is recent precedent for extending government grant funding, though this is not a replacement for industry and charitable foundation funding. The Canadian grant agency, NSERC, recently announced that its Discovery Grant recipients can elect to receive a one year extension with funds at their current funding level. No word yet on other types of NSERC research grant or grants for graduate students and post-doctoral students.
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