The situation in Canada over the past decade has dramatically improved with the establishment of the Canadian Institutes of Health Research
) as Canada’s primary health research funding agency, along with several other relevant federal entities for direct and indirect health research support and substantially elevated levels of funding since 2000. The Canadian system of health research funding relies primarily on investigator-driven proposals and projects (i.e. is subject to extrinsic or strategic direction only to a limited degree and reflects the capacities, interests and priorities of its active researchers). The amount of research funds available, capacity development efforts and publications output in the field of addiction research have substantially increased since 2000. The area of illicit drugs is handicapped by the fact that within
the CIHR system22, the topic of ”addiction” is subsumed within the Institute of Neuroscience, Mental Health and Addictions
), where it plays a somewhat subordinated role and is limited in terms of strategic development or support opportunities. Traditionally, the bulk of research funding for substance use research – as is the case for health research funded by CIHR overall – has been committed to the areas of bio-behavioural (“basic”) science research. However, in recent years, the relative amount of funding devoted to other areas (e.g. social science/population health) of research has grown. Overall, the addiction research landscape inCanada is limited in the coordination of content between different funding levels and institutions and somewhat fragmented in its activities. The principal objectives of CIHR were to facilitate scientific excellence in health research and capacity development and to provide a substantially higher and sustained funding level. It also aimed to create a support framework of health research reaching beyond the boundaries of mainly biomedical research, partly in recognition of the importance of the social determinants of health and population health principles in the health status of Canadians, as well as incorporating clinical and health systems research as key domains.
In 1992 the US Alcohol, Drug Abuse and Mental Health Administration
) was reorganised to separate the services supported operations from those that represented research. The newly created service organization became the Substance Abuse and Mental Health Services Administration (SAMHSA)23. The research organizations, the National Institute on Drug Abuse (NIDA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the National Institute of Mental Health (NIMH) were moved under the large umbrella of the National Institutes of Health (NIH). Although NIDA always had both an intramural and an extramural research programme, by joining the NIH it was able to draw on a more extensive granting experience and support. Although there is no single body that builds the nation’s infrastructure to conduct and fund drug abuse research, NIDA remains the most influential in the
drugs field. Every five years NIDA in partnership with a large number of constituent groups develops a strategic plan for the next half decade. At the late 1990s, the then Director of NIDA supported the development of a five-year plan (NIDA, 2004)24, the new strategic plan is in draft
form awaiting comments. The centres that are funded by NIDA are university-based and conduct multidisciplinary research in key areas such as prevention, treatment, epidemiology, and neuroscience and are formally structured for training both within the centre through post-doctoral work and through course offerings such as summer institutes, seminars, or workshop series. The USA has a more centralised institutional approach to funding and has the highest level of spending and a broad range of topics. However international commentators have noted that there is a poor level of translation of research to policy and practice and a marked shortfall in the joining up of research to the translation from bench to clinical setting.
Research funding budgets
drug research. The Commonwealth government provides annual core funds to both centres, which amounted to a total of AUS $3,357,000 (approx. 2,014,200 €) in 2006. The estimate of the illicit drug research costs in Australia for the year 2006 is AUS $16.8 million (10.1 million €). This represents a per capita spending of $0.81 cents (0.49 €) per annum perAustralian. Relative to overall Australian investment in health research it is a very small amount. The NHMRC annual fund is $539 million (323 million €), of which $9.9 million (6 million €) is invested in illicit drugs research (1.8% of the total competitive health research investment).
The CIHR is the centrepiece of the domestic public funding for health – and thus illicit drug use related research in Canada. CIHR
has seen a substantial increase in its budget between its creation in 2000 and its most recent budget (2008), although budget increases have levelled off since 2005, partly determined by a new government in office since 2006. Overall, these developments have led to an unprecedented net increase in research operations and capacity development funding for health and addictions research in Canada since 2000. In the mid- to the late 1990s, the state of funding for health research in Canada had been deteriorating considerably. The key health research funding agency at the time, the federal Medical Research Council (MRC), had to take substantial budget reductions in the wake of general public expenditure cuts. The MRC’s budget was reduced by 13% from 1994 to 1998 alone, to a total funding amount of CAN $237.5 million (168.6 million €) in 1998. This funding amount was recognized as being considerably lower than funding amounts devoted to health research in e.g. Australia or the United Kingdom, and massively lowers than that available in the USA (Single et al., 2000). At the time substantially more health research funding came to the support of Canadian health researchers from US sources than the total funding amount available domestically. Furthermore, the MRC’s funding support was largely devoted to biomedical research as its ”principal forte” (MRC, 1997), and rarely funded research outside of this realm. Federal politicians increasingly recognized this situation as untenable, especially when the federal government managed to balance its annual budget at the turn of the century and had the fiscal opportunity for additional public spending. In this context, the federal government created the CIHR in June 2000 as a pivotally important event in the evolution and state of health research funding in present and future Canada.
The White House Office for National Drug Control Policy (ONDCP) estimated that the range of funding for treatment and prevention research in the field of illicit drugs increased from $702.4 million (583.0 million €) to $1,024 million (850.0 million €) between Fiscal Year (FY) 2000 and 2007 (ONDCP, 2008)25. The funding levels for the same period of time provided by NIDA (that include research management and support) range from $690 million (573 million €) in FY 2000 to $1,000 million (830 million €) (in FY 2007 (NIDA, 2004; 2008). Information was available on NIDA’s website for the distribution of research funding by category of research for FY 2007. According to this, clinical neuroscience research received $429.1 million (356.2 million €), epidemiology, services (treatment) and prevention, $249.6 million (207.0 million €), pharmacotherapies and medical consequences, $116.6 million (96.8 million €), clinical trials, $54.9 million (45.6 million €) and intramural research, $81.8 million (67.9 million €). Research management and support received $55.8 million (46.3 million €) for salaries and processing of research and research applications (NIDA, 2008). Altogether, these amounts sum up to $987.8 million (819.9 million €), representing a per capita spending of approximately $3.3 (2.7 €) per annum per inhabitant.