33rd Institute Advisory Board Meeting – Institute of Infection and Immunity

Minutes

Present:	L. Barreto, E. Brown, R. Duncan, A. Fernandes, M. Grant, R. Hogg, A. Jevnikar, C. Kaposy, V. Loo, C. Power, B. Ward, G. Wu
Staff:	J. Bray, S. Desnoyers, J. Gunning, D. Hartell, M. Ouellette, M. Perrault, J. Raven
Regrets:	P. Ernst, M. Karmali, J. Stankova
Guests:	From the Public Health Agency of Canada: R. Englehardt, C. Holden, H. Njoo, F. Plummer, M. Raizenne, S. Read, J. Spika, G. Tipples, L. Vardy

Agenda and Minutes

The agenda for the meeting was accepted with the following modifications: the presentation on the Canada-UK Partnership on Antibiotic Resistance was replaced with a presentation on the Human Microbiome Initiative, and the start time of the meeting on May 26th was changed from 9:00 a.m. to 8:30 a.m. to allow sufficient time to discuss the transplantation initiative.

Motion to approve the minutes from the January 2011 meeting (G. Wu/ A. Jevnikar).

Scientific Director’s Report

M. Ouellette gave an overview of his activities as Scientific Director in the past 4 months. In early February, he attended the transplantation workshop in Montréal run by III. Sixty people attended this very useful meeting, and a report on the needs of the community is in preparation. The first review of III as part of the International Review process also occurred in February, and the Institute was well reviewed overall. The panel suggested that the III advisory board should have more international representation, and should have more partnerships with industry. The Institute also held a joint meeting with Canadian Blood Services to discuss their potential collaboration in the transplantation initiative, as solid organs are included in their mandate. At the Canadian Society for Transplantation meeting at Mt. Tremblant in March, the new initiative was well received, and the community provided valuable feedback to III. Canada will lead the International Human Microbiome Consortium conference in Paris next year, and the co-chairs will be M. Ouellette and Bhagirath Singh. While in Vancouver, Marc also visited the B.C. Centre for Excellence in HIV/AIDS at St. Paul’s Hospital, and attended the Immunomodulation of Cancer consensus conference led by ICR. During a scientific mission to China sponsored by the Canadian International Development Agency (CIDA), Marc and other Canadian scientists visited vaccine research and production facilities in Shenzhen and Taizou. In April, at the Canadian Society for Immunology (CSI) meeting, some members of the community expressed concerns regarding the success rate of IAB members for strategic initiatives. Our analysis shows that IAB members do not have any advantage over other members of the community. These numbers will be provided to the CSI board if requested. At the first annual PHAC-CIHR Influenza Research Network (PCIRN) meeting, the key advances made by the network in the field of influenza vaccination were presented. The network investigators also discussed potential ways to fund PCIRN beyond 2012, including expanding its mandate from influenza to immunization in general. The meeting of Scientific Leadership, including the heads of several Rx&D companies in Canada was also held in April. They have been visiting numerous universities discussing their priorities (which include inflammation), but some IAB members are concerned that the Canadian delegation cannot make decisions without the approval of U.S. or European branches of their respective companies. B. Ward has attended meetings with these companies in the past, in which researchers are “matched” with companies that have similar interests, to discuss moving novel compounds forward into clinical discovery. Running clinical trials in Canada is becoming increasingly difficult, since it is very expensive, and the quality of data coming from other countries is rapidly rising. Discussions on the next phases of the Canadian HIV Vaccine Initiative (CHVI) were also held in April. The new funds for CHVI will be used for basic research with a focus on why vaccines have failed thus far. In May, III participated in the Personalized Medicine workshop, led by ICR. This is a Roadmap Signature Initiative, and III may contribute to it if we have funds available when it rolls out. At the III co-led Inflammation in Chronic Disease consensus conference, 160 participants contributed to the development of the next steps for the initiative. It is important for III to participate in this initiative, since most topics included will be related to immunity on some level.

Budget

D. Hartell presented the updated Institute Strategic Initiatives budget. The Institute contributed $400,000 a year for 3 years to the Network Catalyst Grant competition in October 2011, and the recipients have been selected but will not be notified until June 30th. III will invest in the October 2011 Network Catalyst competition in the amount of $200,000 per year. The Institute also invested $450,000 over 3 years in the NSERC Collaborative Health Research Program. 2 grants will be funded at $75,000 per year, and will be relevant to one of the following areas: transplantation, antibiotic resistance and alternatives to antimicrobials, inflammation, the microbiome, and auto-immunity. III has no unallocated funds for 2011-12, $1 million for 2012-13, and $3 million for 2013-14. Unallocated funds will likely be split between III’s Transplantation Initiative, the Inflammation, Personalized Medicine and Primary Health Care Roadmap Signature Initiatives, and our emerging threats initiative.

Current Business

New Investigator Forum

S. Desnoyers gave an update on the planning of the New Investigator Forum. From the list of nominees provided by university department chairs, III received 52 applications, and an additional 59 applications from the open call. The organizing committee is responsible for the selection of the final delegates, and this selection will be based on eligibility, application date, research theme, geographical location and gender. This is the first time any application selection was necessary, as the response rate was higher than anticipated. The final list will be available in June. For future meetings, III might want to consider inviting volunteer health organizations (VHOs), and asking them to nominate their top-ranked fellows to attend the meeting. The board did not recommend any changes to the meeting program. The grant writing sessions will be chaired by the chairs of various peer-review committees, and the speaker at the funding portfolio session will be Louise Laperierre from Université Laval, who will be joined by Ian Graham from CIHR to discuss funding tools outside of the operating grant program. The goal is to find the right balance between the number of speakers needed to cover the relevant material, and the maximum amount of space available for the investigators.

Microbiome

J. Bray summarized the recent activities of the Microbiome Initiative. III brought the funded teams together for a workshop in Vancouver this spring. The teams seemed enthusiastic about attending the meeting, but hesitant about taking a more defined network further unless the funding and infrastructure is provided by CIHR. When it comes to organizing additional workshops for these investigators, there are several obstacles, including a reluctance to share data and information with each other. Several teams are already planning to meet using an MPD award from CIHR, so additional collaborations may result even if no concrete Canadian Microbiome Network is formed. Canada might be a little late to the microbiome community, but we can build on the work done in other countries. A Café Scientifique was held jointly with INMD in Toronto on the microbiome. The attendees were primarily students, with a handful of public participants. The Journalism Workshop, also on the microbiome, was a big success with the media and investigators engaging in the presentations and discussions. The investigators did an excellent job of bringing the subject matter down to the lay level, and some extra collaborations may have formed between researchers in attendance. Certain events on Parliament Hill, such as the “Bacon and Eggheads” program that engages MPs and scientists on a particular topic, could be useful for promoting the microbiome if we can find the right speakers.

HIV/AIDS

J. Gunning highlighted the recent activities of the HIV/AIDS Research Initiative. An additional $1.2 million was invested in the initiative due to funding from partners such as the Public Health Agency of Canada (PHAC), the Institute of Gender and Health (IGH), the CIHR Ethics branch, and Health Canada First Nations and Inuit Health Branch (FNIHB). PHAC contributed $800,000 for the co-morbidities catalyst grants, Ethics contributed to the MPD awards, and FNIHB supported travel grants for Aboriginals and researchers to discuss HIV. Through 2016, HIV/AIDS will receive revenue from CIDA for the Canadian HIV Vaccine Initiative (CHVI), new PHAC funds, CHVI renewal funding, and the annual Federal HIV Initiative budget. There are currently some unallocated funds, but many Institutes are launching funding opportunities that are relevant to the HIV mandate and therefore the initiative will contribute to quality research projects. There is some flexibility moving forward with the biomedical/clinical stream, and the CIHR HIV/AIDS Research Advisory Council (CHARAC) has held discussions on how best to use these funds.

An update was also given on the Community-Based Research (CBR) program, which engages community members throughout the entire research process. There are 2 funding streams for CBR: general and Aboriginal-specific, with a total of $2.7 million per year in available funding. CBR has 3 phases: phase 1 involves the transfer of the program to CIHR; phase 2 is the CBR program evaluation response; and the 3rd phase involves funding tool consultation. CHARAC recommended a review of the CBR funding tools and the CBR Facilitator program in particular. The board and the research community have mixed feelings about whether or not this is a good investment, as the quality of the facilitators tends to vary, and very little capacity is being built up in this area. The evaluation of the program must be streamlined.

The co-morbidity initiative has significantly progressed since the last IAB meeting, and is currently in phase 5 – the development of a major funding opportunity. The scope of the FO has been narrowed down to 2 areas: HIV and Aging; and HIV, Mental Health and Neurological Conditions. CIHR will be investing approximately $13 million over the next 7 years in this initiative through 2 rounds of funding opportunities, using multiple funding tools. The plan is to align the co-morbidity initiative with the Community-Based Primary Health Care (CBPHC) Roadmap Signature Initiative. The team grants tool in particular will be linked to CBPHC for vulnerable populations and chronic disease prevention and management.

There will be increased investments in HIV vaccine research through the renewed CHVI program, in the amount of $35 million over 5 years. An advisory board to guide CHVI has been established, and contains several representatives from III. Once this board has met, the launch of RFAs can begin. There are many upcoming activities for CHVI in 2011, including the advisory board meeting and the Global HIV Vaccine Enterprise Meeting in June, the CHVI Advisory Board Symposium in the summer, and the launch of FOs in the fall.

The HIV/AIDS initiative underwent the mid-term evaluation of the 2008-2013 strategic plan, which has resulted in the development of 2 new strategic directions: the eradication (either functional or actual) of HIV; and a renewal of the Canadian HIV Trials Network (CTN). A focus on Interventions for the Prevention and Care of HIV, and capacity building for the support of clinical scientists were also identified as priorities.

Transplantation Initiative

J. Bray presented the Transplantation Initiative in development by III. The main health issue behind this initiative is the fact that transplantation remains the preferred treatment method for end-stage organ failure, which kills over 100,000 Canadians annually. However, there is a severe shortage of donations, leading to high numbers on waiting lists and the death of patients before they receive a transplant. The relatively low donation rate in Canada also has a significant economic impact, as the annual cost of treating Canadians suffering from organ failure is $40 billion. The need for organs is predicted to increase by 152% in the next 20 years, which will significantly increase costs. The primary challenge for combating organ failure is the low donation rate, but other issues such as rejection, premature organ failure and the significant morbidity and mortality associated with immune-suppressive medications. The wide range of challenges in this area translates to a large number of research opportunities. An expert working group was convened, comprised of Dana Devine (Canadian Blood Services), Amit Garg (London Health Science Centre), Marie-Josée Hébert (CHUM Hôpital Notre Dame), Anthony Jevnikar (London Health Science Centre), Kirk Schultz (BC Children’s Hospital), and Lori West (University of Alberta). The III staff, in consultation with this working group, organized a workshop in early February 2011 to bring the wider transplantation research community together. The goals of the workshop were to identify current challenges and opportunities, propose recommendations on the scope and focus of a new SI aimed at improving the clinical outcomes of transplantation, and identify opportunities to leverage existing programs and resources. The discussions centred predominantly on solid organs, however included several discussions about bone marrow transplants which helped to identify several potential opportunities for collaboration between the disciplines. Participating CIHR Institutes included the Institute of Circulatory and Respiratory Health (ICRH), the Institute of Health Services and Policy Research (IHSPR), the Institute of Musculoskeletal Health and Arthritis (IMHA), the Institute of Nutrition, Metabolism and Diabetes (INMD), and the CIHR Ethics Office. External organizations attending the meeting included Canadian Blood Services (CBS), Québec Transplant, Cystic Fibrosis Canada, the Kidney Foundation of Canada, and the Canadian Lung Association. A report summarizing the discussions and highlights of the meeting has been prepared and is in translation. Key recommendations include: promote collaboration between the solid organ and hematopoietic stem cell research communities; create clinically transformative networks; seek ways to collaborate with external organization to address donor issues; improve the clinical translation of existing science to improve the quality and safety of grafts, extend long-term survival, and reduce the need for immuno-suppressive drugs; and provide support for further small, focused workshops and/or development grants to enable the community organize for future funding opportunities.

There is the potential for a link between the Transplantation Initiative and several of the Roadmap Signature Initiatives, particularly the Inflammation in Chronic Disease Initiative (ICDI), and the Strategy on Patient-Oriented Research (SPOR). When the SPOR network is launched, the SD of the Institute of Circulatory and Respiratory Health (ICRH), Jean Rouleau, is very enthusiastic about linking it to the transplantation initiative. ICRH has $300,000 annually that they are willing to contribute, and our hope is that Canadian Blood Services (CBS) will do the same. The other option is to launch a level 2 initiative on transplantation, which may prevent it from becoming “lost” within the broad scope of another topic. As III has $1.5 million/year earmarked for Transplantation, partnerships with ICRH and CBS would allow us to launch a good-sized level 2 initiative. ICDI and transplantation could link via projects seeking to: understand the mechanisms underlying transplant inflammation and premature organ failure, identify novel common markers of immune activation and inflammation; identify potential new therapeutic targets and treatments; and develop new imaging strategies to monitor and measure the progression of inflammation and organ injury. A transplantation network supported by III, ICRH and CBS might include tissue and biomarker repositories, clinical and research databases and/or registries that align with CBS and Canadian Society for Transplantation (CST) clinical trials, and a strong training and mentoring program. This approach has the added advantage of launching according to a III timeline, as neither SPOR nor ICDI will be ready for funding until FY 2013-14 at the earliest, and III has funds in FY 2012-13 earmarked for this project. A level 2 initiative would also give III considerable flexibility in terms of the type of funding tool used. If we wanted to fund teams, which would be the traditional tool used for an initiative like this, we could support 3 teams at $500,000 per year, or 5 teams at $300,000 per year. III would then try to bring the teams together for a networking event once they are funded. The alternative approach would be to create a transplantation program. Programs must have multiple fundable components, each of which is reviewed for scientific merit and the value it brings to the program. The program system is generally successful in inducing teams to perform, as the success of the program as a whole is dependent on the success of individual teams. This approach would likely require an application development workshop for interested parties.

If III intends to launch the initiative in the fall of 2011, a decision needs to be made soon. Whichever approach is chosen must involve both clinicians and basic scientists. The most established Canadian community under the transplantation umbrella at the moment is the bone marrow transplant group, although they have problems with sustained funding. CBS and the Transplant Society are the biggest groups working on solid organs, but certain activities (such as the CBS registry) are just starting up. As the community as a whole is quite fractured, the network or program could help them decide which clinical trials are worth following through on, and recommending patients for. The eventual goal of this would be to build a network like the Canadian HIV Trials Network (CTN). This would be different from a network grant, but a single network based at a university or research institution would give us the ability to leverage funds from the institution itself. The program model is more cohesive and comprehensive, as well as being more prescriptive. This would allow CIHR to ensure that all of the important questions are answered.

Inflammation in Chronic Disease Initiative

S. Desnoyers provided an update on the Inflammation in Chronic Disease Initiative (ICDI). A consensus conference was held in Toronto from May 17-18. This meeting had approximately 150 participants, including representatives from Alberta Innovates – Health Solutions, Allergen NCE, Canadian Arthritis Network NCE, Canadian Association for Dental Research, Canadian Association of Gastroenterology, Canadian Breast Cancer Foundation, Canadian Cystic Fibrosis Foundation, Canadian Dental Association, Canadian Dermatology Foundation, Canadian Diabetes Association, Canadian Skin Patient Alliance, CIHR Partnerships, Crohn’s & Colitis Foundation of Canada, Kidney Foundation of Canada, Lupus Canada, Michael Smith Foundation for Health Research, Muscular Dystrophy Canada, National Institutes of Health – Health, Lung and Blood Institute, SalWe (Finland), Tekes (Finnish Funding Agency for Technology and Innovation), the Arthritis Society, and the Lung Association/Canadian Thoracic Society. The conference contained 4 main sessions: mechanisms underlying tissue inflammation across chronic diseases; identification and validation of markers, therapeutic targets and imaging strategies; strategies for translation; and recommendations. The conference attendees provided a lot of feedback to the steering committee, including the need for a long-term initiative that: brings people and themes together; applies a prevention paradigm as well as a diagnosis/intervention strategy; includes an inventory of existing platforms and cohorts; enhances multi-sectorial partnerships; and breaks down disease and discipline silos.

The next steps for the initiative are to prepare the workshop report, revise the business plan for approval at CIHR, launch initial MPD and catalyst grant funding opportunities, and identify areas of overlap/collaboration between ICDI and the planned Transplantation initiative. There is $1 million in funding available in FY 2011-12, $1.25 million in 2012-13, and $3.05 million in both 2013-14 and 2014-15. There are several possible launch scenarios, depending on which funding tools and approach are deemed the most appropriate. Scenario #1: Catalyst Grant (launch August 2011) followed by Team Grant (launch April 2012). Scenario #2: MPD Planning Grant (launch August 2011) followed by Team Grant (launch April 2012). Scenario #3: Team Grant only (launch September 2011). The community has indicated that they are not interested in catalyst grants (or other short-term funding mechanisms), which should be taken into consideration when the approach is decided.

New Business

Presentations from the Local Community

Three members of the Winnipeg research community presented their CIHR-supported work to the IAB.
Keith Fowke – Summary of HIV Research Activities in the Winnipeg Region
Xi Yang – Appreciation and concerns: A presentation to the CIHR-III Advisory Board
Kevin Coombs – Global Screens Identify Host Genes that Protect Against Influenza Virus

Joint Meeting with PHAC

III hosted a joint meeting with representatives from the Public Health Agency of Canada’s (PHAC) Infectious Disease Prevention and Control (IDPC) branch, to discuss common areas of interest and potential areas for future collaborations or initiatives. Past and ongoing collaborations between CIHR and PHAC include the HIV/AIDS Research Initiative, the Hepatitis C Research Initiative, and the Pandemic Preparedness Strategic Research Initiative. Although PHAC is not a partner on the recent Canada-UK Partnership on Antibiotic Resistance, the topic is a high priority for both agencies. R. Englehardt from PHAC outlined the current strategic directions of the IDPC, while M. Ouellette summarized the priorities for CIHR-III. The two agencies then explored potential areas for future collaboration.

Concept of Excellence

M. Ouellette led a discussion on the concept of excellence with the IAB members. This is related to the CIHR Health Research Roadmap, and also the reform of the peer review system and the open suite of programs. The ultimate goal is to design a core suite of programs that: capture excellence across all pillars; capture innovative/breakthrough research; improve the sustainability of long-term research enterprise; and integrate new talent. Globally, research funding currently falls into one of two categories: programmatic, which supports a broad program of research over a number of years; and project funding, which supports a defined project described specifically in the application. CIHR investments are currently divided 30% into strategic programs, and 70% in open competitions. The reform will focus on how best to spend the open funding dollars.

Several scenarios have been proposed, although no decision has been made. A programmatic funding mechanism would have the application and reviews focusing on a track record of “excellence”. This presents the problem of defining what evidence from the track record of a researcher is valued by CIHR as a predictor of future successes, as this will be key to ensuring that this scheme is designed to support excellence across the spectrum of health research. The other option of a project-based funding mechanism would have an application and review process focusing on the quality of the idea, and its potential for impact if executed as described in the application. This is difficult for other reasons, as CIHR would be required to design a program that applies appropriate criteria to judge quality, in circumstances where evaluation criteria differ based on the type of idea. CIHR has requested IAB input on 2 key questions: what are the current criteria and evidence-base for defining excellence of a researcher in each of the four pillars; and what are the criteria and evidence-base for defining the quality of an idea?

The board feels that the review panels for mid-career investigators focus too much on the project, and a programmatic approach might benefit this group. A separate pot of money would be allocated for new investigators, to ensure that they are competing against their peers. If both program and project approaches are ultimately used, investigators should be prevented from receiving funding from both. The worry with the programmatic approach is that it might be seen to perpetuate the dominance of a small number of senior scientists that train “lieutenants” to follow in their scientific footsteps. The track record of researchers should be taken into account, as it does mean something. For example, a researcher proposing a new idea, who has not yet published in a reputable journal may have a lesser chance of success than someone who has. NSERC has recently abandoned their “lifetime” funding approach, after finding that they were not getting value for money. The concept of excellence itself will vary from pillar to pillar, but this does not necessitate separate evaluation criteria. The criteria could simply be expanded to include other factors such as policy and position papers, the relationship with the community, the overall impact of the research, and the development of new programs. The public is less concerned with the mechanism of funding than the results. A strong research program should include a training component, and credit should be given for training all highly-qualified personnel, not just those who choose to pursue careers in academia. This could result in researchers being more nimble and pursuing riskier projects, rather than being tied to the success of a single project.  Investigators pursuing research in emerging fields might have less success in the programmatic model, so this should be taken into consideration. Above all, we must ensure that we don’t create a system perceived to favour the “top tier”, or give the impression that the most successful are revamping the system to favour themselves. We also need to make sure that any reformed system does not result in regional favouritism. In order for this to work well, the parameters defining excellence must be clearly delineated. This would also help develop agreement from one peer review committee to another, and result in less fluctuation in grant rankings.

Overall, this program is good in that it indicates commitment to developing stable evaluation criteria for excellent projects. It may also reduce the redundancy of the projects funded, and save both investigators and reviewers time.

The possibility of rewarding service on grant review panels was also discussed. The reward should not be too big, but should be concrete enough that people are competing for the privilege of being on committees, rather than being guilted into serving. A section on the Common C.V. that rewards this and similar “public service” activities is one option. It should not be so big that individuals are dissuaded from serving as reviewers for volunteer health organizations (VHOs).

Future IAB Meetings

The board discussed the number of meetings to be held by III each year. We currently have 3 meetings annually, but other Institutes have only 2. At present, our meeting agendas are very full and we are often pressed for time to accomplish everything. If III does move to 2 meetings per year, the individual meetings may need to be longer. With the upcoming program reforms, CIHR may frequently seek input from IABs. III will continue with 3 meetings for now, and re-evaluate this approach as necessary.

Outgoing IAB Members

Several IAB members ended their terms at the Winnipeg meeting, including Michael Grant (2007-2011), Vivian Loo (2008-2011), Luis Barreto (2004-2011), and chair Christopher Power (2006-2011). M. Ouellette thanked all of the outgoing members for sharing their time and expertise with CIHR and III.

Meeting Adjourned: 12:25 p.m.