IA Strategic Plan 2007-2012: The Future is AGING
Table of Contents
About the Institute of Aging
Message from the Scientific Director
I. Canada: The Future is AGING
II. Looking Back: The First Five Years
III. Looking Forward: The Next Five Years
IV. The Future is AGING: Our Strategic Plan to 2012
The Canadian Institutes of Health Research is Canada's major federal funding agency for health research. Its objective is to excel in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products, and a stronger Canadian health care system.
In July 2000, the Canadian Institutes of Health Research (CIHR) established 13 Institutes - each one responsible for identifying priorities in its area of health research, for creating new knowledge, and for translating that knowledge into more effective services and better health for Canadians.
All Institutes actively support both discipline-based and interdisciplinary health research across the areas of: biomedical research, clinical research, research related to health systems and services, and research on the health of populations. The Institutes are expected to work together to forge a health research agenda that crosses disciplines, sectors and regions, and meets the health needs of Canadians. They are also expected to examine social, ethical and legal issues related to health research.
Each Institute is responsible for developing - through consultation with researchers, health and other service providers, policy makers and Canadians who will benefit from its research - a strategic plan to guide its activities. These plans set out how each Institute will contribute to achieving CIHR's five strategic goals:
- Creation and synthesis of outstanding research
- Building a community of outstanding researchers in innovative environments
- Translating health research into action
- Developing and nurturing effective partnerships and public engagement
- Promoting and facilitating organizational excellence in all institute activities.
Advancing knowledge in the field of aging.
Improving quality of life and health of older Canadians.
By 2015, for the first time in its history, Canada will have more older people, age 65 and over, than young people under age 15. Our population is aging and, when the first baby boomers reach age 65 in 2011, that trend will accelerate. The greying of our society will have a profound impact on individuals, communities, and social and health services. Aging will be one of the most significant social forces shaping our society over the next 20 to 30 years.
CIHR established the Institute of Aging "to support research, to promote healthy aging and to address causes, prevention, screening, diagnosis, treatment, support systems, and palliation for a wide range of conditions associated with aging." Unlike many other CIHR Institutes, which are focused on particular diseases, the Institute of Aging's mandate is the aging person in an aging society, and the effects of different diseases and conditions on aging. Its goal is to improve the quality of life and health of older Canadians by understanding and addressing or preventing the consequences of a wide range of factors associated with aging.
Under the leadership of Anne Martin-Matthews, Scientific Director, the Institute is based at the University of British Columbia. Its work is guided by an Advisory Board made up of experts in research on aging and health, as well as key members of the voluntary sector.
Developing the Strategic Plan
The Institute of Aging's first strategic plan, It's Time for Research on Aging!, was issued in 2002 by the Institute's founding Scientific Director, Réjean Hébert. That plan, which was developed through extensive consultation with stakeholders across Canada, set out the actions that the new Institute should take to become the leader in health research on aging in Canada. It also identified five strategic priorities for research in aging:
- healthy and successful aging
- biological mechanisms of aging
- cognitive impairment in aging
- aging and maintenance of functional autonomy
- health services relating to older people.
The Future is AGING is the Institute's second strategic plan. To develop this plan, the Institute's Advisory Board engaged in a strategic planning process that involved: reviewing the Institute's progress over its first five years; assessing how aging research in Canada had advanced; identifying emerging opportunities; appraising the nation's capacity to conduct research on aging, and examining the current environment and issues facing older Canadians. It also reviewed feedback from the research community received through CIHR's mid-term and five-year reviews, along with input from the Institute's regional workshops held with seniors across Canada. Based on these analyses, the Advisory Board developed a plan that sets the course for the Institute of Aging over the next five years.
Leading a young organization that has the potential to make a difference in so many lives is a deeply satisfying experience. The Institute's broad focus on the aging person in an aging society makes this task both exciting and challenging.
During our early mandate, we concentrated primarily on establishing the Institute and laying the foundation for our future success. It is with pride that I reflect on all the Institute has accomplished. First and foremost, we have built a Canadian research community in aging. The strong partnerships and working relationships we've developed with researchers, seniors, service providers, policy makers and other CIHR Institutes are essential to achieving our goal of improving the quality of life and health of older Canadians. We were the driving force behind the Canadian Longitudinal Study on Aging (CLSA), a significant undertaking that will provide a national platform for research on aging and fundamentally change the research environment for years to come. We were the first to develop the concept of New Emerging Teams: providing grants that encourage researchers to work together to answer complex questions related to aging. We made the strategic decision to devote substantial resources to the research priority deemed most pressing and devastating for aging Canadians: cognitive impairment. We also successfully maintained service and programs throughout the period 2003-2004, when the Institute moved from the Université de Sherbrooke to the University of British Columbia, in association with my appointment as Scientific Director.
Over our first five years, we have achieved many of our early objectives. The Institute of Aging is now a more confident, informed and strategic organization. Our new plan retains the goals from our initial plan that are still relevant - but focuses on strategic activities essential to the next stage in the Institute's development.
Over the next five years, we will continue to build and support a strong community of researchers in aging - finding new ways to encourage researchers to turn their attention to aging, and supporting those already doing excellent work in this field. To reap the full benefits of the Canadian Longitudinal Study on Aging, we will help scholars develop the capacity to use this unique research platform. We will also continue to attract people with a wide range of expertise, to serve on our Advisory Board and enrich our work.
While we will continue to support research in all of our five priority areas, we will invest significant resources in one priority that determines quality of life for so many older Canadians: mobility. We will also use the information gathered through ongoing consultations with our stakeholders to identify and start shaping our next strategic initiative.
During the next five years we will begin to see the results of our initial research investments. As reports are published and findings announced, the Institute of Aging is committed to evaluating the impact and effectiveness of our funded research. For example, by monitoring our research investments in cognitive impairment, we will learn whether the funding tools and strategies we have used, have had the desired impact, are sustainable, and can be adapted to other priorities.
An additional challenge will be knowledge translation - enabling researchers, policy makers and service providers to build working relationships and develop the skills needed to move new health knowledge into action for the benefit of older Canadians.
We recognize that the research we support has implications for other CIHR Institutes and external partners; and in turn, the research they support informs our agenda. Over the next five years, it will be largely through collaborative actions that we will move towards enhancing the health and lives of older Canadians.
Given the imperative of an aging population, our work is more important and timely than ever. To help aging Canadians thrive, we must sustain the excitement and energy of a young organization, while wisely using the experience, skills and resources we have developed, to provide leadership in research in aging.
Our thanks to the members of the Institute Advisory Board (IAB), and in particular to Dorothy Pringle (IAB Past Chair) for her invaluable guidance, to Carole Estabrooks for her contributions on knowledge translation, and to Howard Bergman (IAB Chair) and Jane Rylett (IAB Vice-Chair) for their expert review of this document.
Institute of Aging
The Institute of Aging will champion health research on aging in Canada, and create innovative opportunities for research and researchers. All researchers working in the field of aging will want to be affiliated with the Institute. Policy makers will look to the Institute for information and advice, and use the knowledge we generate to develop more effective policies and services. Our work will enhance the health and lives of older Canadians.
The Institute of Aging will use the following values to guide its work:
Excellence. All activities funded by the Institute will be high quality, and meet or exceed international standards of excellence in research.
Population needs based. The Institute's priorities will be based on the health needs of older Canadians.
Risk taking, creativity, innovation. Creating new knowledge that will change health and health services will require innovation and risk taking. The Institute of Aging will provide opportunities for researchers to take risks and pursue creative new ideas.
Integration, partnerships. The Institute for Aging will pursue partnerships that cross disciplines, sectors and regions of the country, and lead to new knowledge.
Transparency, accountability. The Institute of Aging will communicate openly with all stakeholders and clients. All its decision-making processes will be transparent and accountable.
As the baby boomers age, Canada's senior population is growing. By 2021, 6.7 million Canadians will be over age 65. By 2031, about one of every four Canadians will be 65 years or older. By 2056, one out of every 10 Canadians will be over 80 years of age.
July 1, 1966 and 2006
Source: Statistics Canada
Canadians have one of the highest life expectancies in the world. On average, a 65 year-old man in Canada can expect to live another 17.4 years and a 65 year-old woman an additional 20.8 years. Most older Canadians will now live about 13 of those years after age 65 in good health. Over the past few years, Canada has seen a drop in hospitalizations for hip fractures, improvements in functional health (e.g., sight, hearing, speech, mobility, dexterity, cognitive abilities) - particularly in older men, and an increase in the number of seniors who have never smoked. Older Canadians also perceive themselves as being quite healthy - physically and mentally.
Life expectancy at birth continues to increase
Despite these positive health trends, seniors in Canada still face many complex health challenges associated with aging, and their quality of life tends to decrease with age. For example, the prevalence of chronic diseases is increasing: in 2005, 91% of seniors reported one or more chronic conditions (up from 87% in 2001).
Because of an increase in health problems as they age, seniors are more limited in their activities than younger Canadians: 7% need help with activities of daily living, such as bathing, dressing, eating and moving from room to room, and 24% need help with instrumental activities of daily living, such as preparing meals and doing housework. Disability rates increase with age: 32% of seniors have disabilities that affect their mobility, 29% have disabilities that affect their agility, and 25% have disabilities that cause them pain. Older Canadians are also at higher risk of injuries and falls that will limit their mobility and independence.
About 16% of Canadians over 65 will experience some cognitive impairment, such as memory loss, and another 8% will be diagnosed with a degenerative brain disease, such as Alzheimer's Disease or another dementia. The risk of cognitive impairment increases with age. Over the age of 85, 1 of every 3 Canadians has Alzheimer's disease or a related condition. In 2006 alone, there were approximately 97,000 new cases of dementia. The most recent estimates indicate Alzheimer's Disease and other dementias cost the Canadian health system $5.5 billion annually or $15 million a day. These costs do not include the social costs to families and caregivers, or the personal cost to individuals with dementia.
If the Institute on Aging is to achieve its goal of improving the quality of life and health of older Canadians by understanding and addressing, or preventing the consequences of a wide range of diseases and conditions associated with aging, it must address the impact that both mobility problems and cognitive impairment have on seniors, as well as on society at large.
During the first five years, the Institute of Aging launched a number of innovative strategies designed to establish the Institute and advance research on aging in Canada.
Building a Community of Researchers on Aging
Excellence in research depends on the right people with the right knowledge and skills, and with sufficient resources to sustain their efforts. The field of aging has traditionally attracted relatively few scientific investigators and health care specialists. Unlike some other CIHR Institutes, which had well-established research communities - specialists, researchers and agencies with a particular health focus - the Institute on Aging needed to build its own community. We did this by bringing the comparatively small group of Canadian researchers in aging together, many of them for the first time; providing age-focused research funding; and encouraging others to work in this important field.
The Institute worked with CIHR to develop two new peer review committees focused on aging research. This created an environment that encouraged more investigators to target their research on aging.
To ensure that Canada has the capacity to do the research in aging that is critical to its future, the Institute also invested in salary support for researchers and emerging scholars.
Creating Cross Cutting Multidisciplinary Teams
Aging is a complex process. Effective research on aging requires people with a broad scope of knowledge and skills. In addition to more traditional strategies to support researchers, the Institute on Aging was the first to introduce the innovative New Emerging Teams (NETs) grants. These grants provided the incentive for researchers to look beyond their specialty or institution, connect with other researchers in related fields, and develop new multidisciplinary teams. The grants were available only to groups of researchers who had not collaborated in the past. The goal was to advance the field by creating new ways of looking at problems, new synergies, and teams with the skills to do the cross cutting research required to answer the complex questions facing an aging society. This strategy has since been adopted by other CIHR Institutes.
The Institute also funded four Strategic Training in Health Research Programs, designed to build Canadian capacity in research on aging. These programs applied the same multidisciplinary team focus to graduate research training.
Creating a Partnership on Cognitive Impairment in Aging
At any given time, there may be dozens of researchers and organizations with different skills and resources looking at different aspects of the same problem. Usually they work in isolation or in small partnerships among two or three organizations. Often they compete for the same funding. The Institute of Aging believes there is a better way. If research is going to transform practice and solve large problems, it must be guided by the collective wisdom of the research community. To address the urgent needs of Canadians who are cognitively impaired and their families, the Institute brought together all the major Canadian organizations with expertise in this field - such as the Alzheimer Society of Canada, the Consortium of Canadian Centres for Clinical Cognitive Research, Neuroscience Canada, provincial agencies, non-governmental organizations, and pharmaceutical companies - and created a partnership.
The Cognitive Impairment in Aging Partnership is a collaboration among more than 15 voluntary, public and private sector organizations. Members meet biennially to discuss their common challenges and findings. Members actively support research aimed at improving prevention, diagnosis, treatment, and rehabilitation for older people with cognitive impairment.
The partners have pooled knowledge and resources to develop grant programs that support young scientists and new emerging teams investigating the biological mechanisms and treatment of Alzheimer's Disease, vascular health as it relates to dementia, caregiving, and brain repair. As part of the Partnership, more than 40 projects and studies have been funded, and almost $16 million invested in the past four years. The Institute will track the impact of this investment over the coming years.
Developing the Canadian Longitudinal Study on Aging (CLSA)
Just as the field of aging had only a small and diffuse research community, it had little comprehensive data on aging Canadians that could be used to track and understand their changing health needs. To fill this gap, the Institute developed the vision for the Canadian Longitudinal Study on Aging, an ambitious long-term national study that has the potential to transform research on aging in Canada and beyond our borders. The study, which will follow a very large cohort of Canadians as they age, will provide a rich database that will support a range of national research studies on the impact of aging and the factors associated with aging well. The CLSA will be launched in 2008 under the leadership of three co-principal investigators and more than 200 researchers across the country.
Over the past five years, the Institute of Aging has devoted significant resources to developing the CLSA. This exciting initiative has captured the imagination of other Institutes and the CIHR Governing Council, who, seeing the potential for the research platform of the CLSA to help answer important questions, have contributed funds to its development.
Engaging our Community
The Institute of Aging is one of the few CIHR Institutes with a constituency that represents a significant and increasing proportion of the population. Older Canadians have an enormous stake in health research related to old age and the aging process. Since 2004, the Institute has hosted one national and five regional consultations involving seniors, people who provide services or programs for seniors, policy makers, and researchers in aging. The Regional Seniors' Workshops on Research were designed to help seniors become familiar with the research on aging in Canada, and to involve seniors and service providers in identifying research priorities. These priorities along with others identified through more theme-based consultations will guide the Institute's operational planning over the next five years.
The Importance of Research on the Experience of Aging
- Most older Canadians perceive themselves to be in good health.
- The prevalence of many chronic diseases increases with age leading to frailty and lower quality of life.
- Many of the health-related challenges associated with aging can be prevented or delayed.
- Loss of independence becomes more likely with multiple chronic conditions.
- Research can help us understand the processes of aging and improve quality of life in old age.
The five priorities identified by the Institute in 2001 are still highly relevant.
Over the next five years, the Institute of Aging will continue to support research on:
- Healthy and successful aging
- The biological mechanisms of aging
- Cognitive impairment in aging
- Aging and maintenance of functional autonomy
- Health services and policy relating to older people.
At the same time, the Institute will focus its attention on the following five key initiatives.
1. Mobility in Aging
The Institute of Aging has identified mobility in aging as a strategic focus. Mobility is key to independence and aging well. Many chronic conditions associated with aging affect mobility and functional autonomy. The challenge for health researchers will be to develop a clear understanding of the factors that limit mobility in older adults and find solutions that address both human and environmental causes of mobility problems. Using a variety of innovative strategies, the Institute is actively promoting research on mobility in aging.
2. Cognitive Impairment
Cognitive impairment remains one of the main health risks for older Canadians. It continues to rob too many Canadians of quality of life as they age. The Institute will work with its partners to sustain excellence in research and knowledge translation in this field. The Cognitive Impairment in Aging Partnership is now firmly established. In addition to the current grant programs, partners are developing plans to support a five-year Research to Action Program in Dementia (RAPID), which will be launched in 2007 and will facilitate and accelerate the translation of knowledge to the user community. The Institute will continue to support and participate in the Partnership, and encourage collaborative research that will benefit older people with dementia and their families.
3. Research Capacity
Despite the progress that the Institute of Aging has made in drawing researchers to this field, there is still a gap between the number of urgent questions about aging and the people with the knowledge and skills to find the answers. The Institute is committed to creating opportunities for emerging scholars in aging, supporting researchers in aging throughout their careers, and encouraging investigators in other disciplines to apply their research skills to issues of aging and health.
4. Knowledge Translation
Our investment in research must make a difference in the lives of older Canadians. For that to happen, research must be developed in alliance with those who need the new knowledge. Research findings must be shared and used to shape services, programs, products, and policies. They must be put in the hands of those who can assess their relevance and, when appropriate, use them to promote healthy aging.
With the guidance of the CIHR Vice President Knowledge Translation and Canada's leading knowledge translation scientists and practitioners, the Institute will work with our investigators to ensure they are creating new knowledge that is both useful and used. We will also facilitate interaction among researchers, seniors, service providers and policy makers to develop the partnerships needed to mobilize knowledge.
5. New Alliances
During its first five years, the Institute focused on building partnerships among researchers and organizations in Canada. It is now time to forge alliances with nations and regions that are similarly addressing issues of population aging. This will allow Canadian research centres and laboratories to benefit from and contribute to international work in aging, compare research results and apply them as appropriate in Canada.
It is also time to engage sectors that typically have not been involved with research on aging, such as engineering, urban development, transportation, and housing. Through partnerships with a broader range of researchers, professions, businesses, and policy makers, we can ensure health research on aging captures the complex issues facing older Canadians.
More and more Canadians are living longer. The challenge is to help Canadians and our society age well. Over the next five years, the Institute of Aging will pursue a range of activities designed to achieve the following goals and objectives, and contribute to CIHR's strategic outcomes.
Here is our plan to 2012.
Goal 1. Outstanding Research
Objective 1.1: Support high quality, relevant research in the five priority areas
Over the last five years, the Institute of Aging has created the foundation for excellence in research in aging. Over the next five years, we will build on that foundation. We will continue to support initiatives that address our five priorities: healthy and successful aging, biological mechanisms of aging, cognitive impairment in aging, aging and maintenance of functional autonomy, and health services and policy relating to older people. We must learn more about the factors that affect aging, and use that knowledge to enhance health.
The Institute of Aging will continue to identify and support relevant and outstanding research on aging. We will ensure that the health needs and priorities of older Canadians drive all our research activities.
- Work with stakeholders to identify key emerging questions, topics and themes in each of the five priority areas
- Promote relevant research in each priority area
- Support innovative investigator-driven research ideas that will contribute to knowledge about health and aging
- Strengthen aging-focused peer review panels, ensuring they have the skills to select excellent, relevant, ground-breaking research.
Objective 1.2: Create a culture of interdisciplinary research in aging
Aging is a multidimensional process and should be studied from different perspectives. Interdisciplinary, collaborative research will bring new insight to issues of health and aging.
- Create opportunities for researchers, trainees, partners and stakeholders to interact, share knowledge, develop mutual understanding and collaborate on research in priority areas
- Work closely with partners, other CIHR Institutes and other research funders to identify how their work connects to research in aging, and explore opportunities to jointly support interdisciplinary, relevant research.
Objective 1.3: Provide national leadership on ethics in research on aging
Researchers doing work in aging face a number of ethical challenges, including the capacity of some older people to give informed consent and the responsibility of the researcher to disclose information about life-threatening conditions or abuse gathered during a study. Their work must be guided by ethical principles of human research. The Institute on Aging is already providing leadership within CIHR on ethical issues and, in collaboration with the CIHR Ethics Branch, will promote both ethics in research and research on ethics.
- Take a lead role in building awareness among researchers and other stakeholders, of ethical issues in research on aging
- Fund programs of research that extend knowledge of ethical issues in aging research, and their management.
Goal 2. Outstanding Researchers in Innovative Environments
Objective 2.1: Develop a vibrant, innovative community of researchers in aging
High quality, relevant research knowledge is produced by outstanding individual or teams of researchers, working in innovative environments. The Institute of Aging is committed to attracting new researchers to the field and to keeping highly skilled mid-career and senior researchers engaged in research on aging. We will help investigators develop the skills needed to compete and succeed in the new health research environment.
- Attract emerging scholars to research in aging, enrich their training and support their work in this field
- Support, encourage and motivate researchers who are actively working in the field of aging
- Actively recruit researchers working in related areas who may not associate themselves with research in aging
- Create opportunities for current researchers as well as emerging scholars to develop or enhance their capacity to: work as part of an interdisciplinary team, involve stakeholders in developing and conducting research studies, and translate knowledge into action
- Create opportunities for researchers with diverse interests to collaborate on research in the priority areas
- Work with researchers to improve the success of proposals for research on aging.
Goal 3. Translating Health Research into Action
Objective 3.1: Shape products, practices, programs and policies
The goal of our research investment is to enhance the health and well-being of older Canadians. To achieve this, new knowledge must not only be communicated in relevant ways to its various audiences - whether these be other researchers, decision-makers, clinicians, or the public - it must be translated into effective products, practices, programs and policies. It is therefore necessary that the end users participate in the various stages of the research process.
- Recognize and showcase successful knowledge translation in aging research
- When appropriate, incorporate meaningful knowledge translation within Institute sponsored activities
- Develop knowledge translation capacity and skills in high priority research areas and especially among IA sponsored research and training teams
- Create opportunities among investigators from different areas of the scientific community to share knowledge in aging research
- Develop partnerships with other Institutes and research agencies to influence policy and practice.
Goal 4. Effective Partnerships and Public Engagement
Partnerships will lead to more comprehensive research, more expertise focused on aging, more collaboration, and better use of resources. They will also help the Institute translate health research into action.
Objective 4.1: Engage the public - particularly older Canadians - in research on aging
Older Canadians should play a key role in helping to identify priorities for research that will improve their lives. People who provide services for older adults and researchers should also play a central role in identifying the need for new knowledge. The Institute of Aging will continue to consult with our constituents and other stakeholders on emerging research priorities.
- Continue to hold consultations and involve Canadians in priority-setting activities
- Identify other mechanisms to engage the public in ongoing dialogue and research activities
- Promote the need for and benefits of research in aging.
Objective 4.2: Establish partnerships with other research funders
By working with other research funders, we can leverage research investments, be more strategic in our research funding, avoid duplication, and promote a culture of collaborative, interdisciplinary research. These benefits will speed the development of knowledge essential to improving the health of older Canadians.
- Develop and nurture links with other research funders
- Leverage resources and jointly fund research on aging.
Objective 4.3: Nurture strategic partnerships among stakeholders
Traditional stakeholders such as researchers, practitioners, aging and elderly clients of health services, program developers, policy makers and provincial organizations can be powerful partners in advancing research on aging, especially in response to emerging needs. Non-traditional partners, such as city planners, the insurance industry, financial services, building developers, and ministries of housing and transportation, will also be important in guiding relevant research that ultimately supports healthy aging.
- Work with traditional and non-traditional partners to use research findings to develop strategic programs and initiatives.
- Identify and develop opportunities for partners to share knowledge and understand their different perspectives and approaches to health issues in aging.
Objective 4.4: Seek out international partnerships that add to our knowledge and create opportunities for Canadian researchers
Other nations are addressing the challenges of their aging populations by supporting strategic research in this field. The Institute of Aging has an opportunity to develop collaborative international relationships that can enhance knowledge development and translation. It also has an opportunity to ensure other countries can benefit from our outstanding research and researchers, and that Canadian investigators contribute to important international research initiatives in aging.
- Promote research collaborations and exchanges between Canadian and foreign researchers in aging to address the five priority areas
- Identify opportunities to promote the Institute of Aging and Canadian health research on aging, internationally.
Goal 5. Organizational Excellence
In our role as Canada's leader in research on aging, we must ensure the quality of our planning and our operations. Our staff must be skilled, and our systems efficient.
Objective 5.1: Champion research on aging in Canada
Our ultimate commitment is to aging and older Canadians; to help identify their needs and develop responsive research initiatives. Underlying this is our responsibility to people who provide services, develop products, and create policies towards improving the health and quality of life of older adults. The Institute of Aging plays a vital role as a conduit, linking the research community with those who need to know.
- Work with researchers, service providers, policy makers and seniors to identify effective and efficient ways to advance health research on aging in Canada
- Establish the Institute as a key source for information on research on aging
- Use resources strategically, focusing where the needs are greatest
- Build the national community of stakeholders in health research on aging
- Develop and promote a culture of innovation and risk-taking that will advance the field.
Objective 5.2: Develop a highly efficient responsive organization
As an organization, we must be able to respond to new knowledge and changing needs. We must have the capacity to monitor trends and assess the impact of our efforts on the health and well-being of older Canadians.
- Maintain an effective, expert Institute Advisory Board
- Recruit, retain and support excellent staff
- Nurture productive relationships within CIHR and other key organizations
- Be accountable for the successful implementation of the strategic plan
- Evaluate the effectiveness of all our programs and initiatives and make adjustments as required.
- Date modified: