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Canada Biomedical Research Fund and Biosciences Research Infrastructure Fund

In alignment with Canada's Biomanufacturing and Life Sciences Strategy , the Canada Biomedical Research Fund and the Biosciences Research Infrastructure Fund will help ensure Canada is prepared for future pandemics by increasing domestic capacity through investments and partnerships across the academic, public, private and non-profit sectors to produce life-saving vaccines and therapeutics.

Competitions

Stage 1: research hubs selection.

  Competition closed

Application process

Learn about the Stage 1 application process

Selection criteria

Learn about Stage 1 selection criteria, including details about the scientific and technical and the strategic review processes

Ratings matrices

Learn more about the ratings matrices used in the Stage 1 competition

Competition results

Selected research hubs from the Stage 1 competition

Scientific and Technical Review Committee

Learn about the Scientific and Technical Review Committee members for the Stage 1 competition

Strategic Review Committee

Learn about the Strategic Review Committee members for the Stage 1 competition

Stage 2: Applications for research, talent development and infrastructure projects aligned with research projects

Learn about the Stage 2 application process

Learn about Stage 2 selection criteria, including details about the scientific and technical and the strategic review processes

Learn more about the ratings matrices used in the Stage 2 competition

Notices of intent

(Excel document, 157 Kb) List of Notices of intent for Stage 2

Guidelines for Scientific and Technical Review

(PDF document, 697 Kb) Learn about the Scientific and Technical review guidelines for the Stage 2 competition

Guidelines for the Strategic Review

Guidelines for members of the Strategic Review Committee assessing Stage 2 applications

Selected projects from the Stage 2 competition

Learn about the Strategic Review Committee members for the Stage 2 competition

Scientific and Technical Review Committees

Learn about the Scientific and Technical Review Committee members for the Stage 2 competition

Related information

The integrated canada biomedical research fund and biosciences research infrastructure fund (cbrf-brif) public communications guidelines for institutions.

• Canada Biomedical Research Fund email: [email protected]
• Biosciences Research Infrastructure Fund email: [email protected]
• Help—Convergence Portal: [email protected] Tel.: 613-995-4273

On social media

Tri-Agency Institutional Programs Secretariat

•       @TIPS_SPIIE
•       TIPS-SPIIE

Canada Foundation for Innovation

•       @innovationca
•       canada-foundation-for-innovation
•       CFIFCI
• Government of Canada funds new projects to further grow the domestic biomanufacturing and life sciences sector May 6, 2024
• Planned outage for data centre move April 25, 2024
• Statement from Minister Champagne, Minister Holland and Minister LeBlanc on new measures to protect Canadian research January 16, 2024
• Government of Canada establishes new research hubs to accelerate Canada’s vaccine and therapeutics production March 2, 2023

From: Social Sciences and Humanities Research Council

Quick reads on Canadian topics

Home › Economics and finance › Federal Funding for Health Research in Canada

Federal Funding for Health Research in Canada

By loprespub on November 22, 2021

Disponible en français.

Sources of Health Research Funding in Canada

Health research refers broadly to all research related to health, health systems or health care delivery. Sources of funding for health research include the federal government, provincial/territorial governments, higher education institutions such as universities, industry, including stakeholder businesses, and non-governmental organizations such as health charities. This HillNote provides an overview of federal sources of funding for health research in Canada.

Sources of Federal Funding in Canada for Health Research

Federal granting bodies.

The Canadian Institutes of Health Research (CIHR) is the primary source of federal funding for health research. CIHR provides funding for biomedical, clinical, health system services and population health research. Figure 1 outlines CIHR funding by primary research theme from 1999–2000 to 2020–2021.

Figure 1 – Canadian Institutes of Health Research Funding by Primary Research Theme, 1999–2000 to 2020–2021 ($ millions)

CIHR, through its 13 virtual institutes , has discretion over funding for research projects, which consist of investigator-initiated research and priority-driven research identified by the federal government. The organization also provides funding for graduate students and postdoctoral fellows . Figure 2 shows CIHR funding for health research by funding type between 1999–2000 and 2020–2021.

Figure 2 – Canadian Institutes of Health Research Funding, by Funding Type, 1999–2000 to 2020–2021 ($ millions)

CIHR’s budget increased significantly in 2020–2021 following the increased need for priority-driven research related to the COVID-19 pandemic. CIHR has funded more than 400 COVID-19-related research projects totalling $250 million since March 2020 to develop diagnostics, treatments, public health measures and communication strategies. Specific areas of investment include Indigenous communities’ experience with COVID-19; mental health and substance use during the pandemic; safety in long-term care homes; and prescribing and dispensing guidelines for opioids.

Some of the CIHR budget includes funding envelopes established by the federal government and provided to CIHR for tri-agency programs and for Government of Canada priorities over which CIHR has very limited discretion in allocating.

In February 2021, CIHR released its strategic plan for 2021–2031 . The organization’s focus over that period will be on developing a more inclusive vision for health research in five priority areas:

• advancing research excellence in all its diversity;
• strengthening Canadian health research capacity;
• accelerating the self-determination of Indigenous peoples in health research;
• pursuing health equity through research; and
• integrating evidence in health decisions.

While CIHR is the largest contributor to federal health research funding, there are other federal granting agencies and foundations that also contribute. The tri-agency funding programs include programs run collaboratively by CIHR, the Natural Sciences and Engineering Research Council of Canada, and the Social Sciences and Humanities Research Council. All three granting agencies focus entirely on funding extramural research (research conducted outside of the agency) defined by their legislated mandates. Two of the largest of these tri-agency programs are the Canada Research Chairs Program and the New Frontiers in Research Fund. A new tri-agency program, the Canada Biomedical Research Fund, is to be launched in 2022–2023 with a budget of $250 million over four years. It will fund high-risk applied research, training and talent development in support of domestic biomanufacturing capacity.

Other Departments and Agencies

The National Research Council Canada (NRC) conducts intramural (research conducted in-house) research within 14 research centres and also participates in some collaborative projects. Several of their research programs relate to health and are primarily carried out at two of its research centres: the Human Health Therapeutics Research Centre (which includes several facilities) and the Medical Devices Research Centre. The NRC also provides small grants for extramural, technology-driven research by small- and medium-sized businesses through its Industrial Research Assistance Program.

The Public Health Agency of Canada’s (PHAC) National Microbiology Laboratory (NML) investigates existing and emerging infectious diseases. NML researches the characteristics of pathogens, including how they are transmitted and ways to detect infection (i.e., diagnostics), and develops treatments and vaccines. PHAC and Health Canada are also involved in intramural research, extramural research in collaboration with external researchers, research conducted by unaffiliated researchers using Health Canada or PHAC premises, and external research that has been contracted out.

The Strategic Innovation Fund (SIF), administered by Innovation, Science and Economic Development Canada, was announced in Budget 2017 to simplify and consolidate existing innovative technology programs. The SIF supports large-scale, transformative and collaborative projects, which include the category of health and biosciences.

Not-for-Profit Corporations

Genome Canada was established in 2000 to fund genomics-related research. The organization co-funds large-scale applied, leading-edge technology and translation research projects through six regional genome centres across the country, with additional funds coming from provincial governments and other stakeholders. Genome Canada provides funding for genomics-related health research and research in the agriculture and agri-food, forestry, fisheries and aquaculture, environment, energy and mining sectors.

The Canada Foundation for Innovation (CFI), created in 1997, funds research infrastructure such as the laboratories, equipment, buildings and databases required to conduct research. Similar to Genome Canada’s funding, CFI funding is not limited to health and includes a broad range of applications. Budget 2021 announced a new investment of $500 million over four years, beginning in 2021–2022, for CFI to launch the Biosciences Research Infrastructure Fund (BRIF). The BRIF will provide funding in support of post-secondary and research hospital bioscience infrastructure needs.

A Comparison of Spending on Health Research in Canada and Selected Countries

Statistics Canada provides total federal spending on science and technology by socio-economic objectives, one of which is health (see Figure 3). While this data collection does not include health research beyond science and technology, for example health policy research, it does capture most health-related research and development spending.

Figure 3 – Federal Spending on Health-Related Research and Development, 2015–2016 to 2019–2020 ($ millions)

The World Health Organization’s Global Observatory on Health R&D analyzes international data collected by the Organisation for Economic Co-operation and Development and the United Nations Educational, Scientific and Cultural Organization to identify health research and development priorities based on public health needs. Figure 4 reveals the amount of annual biomedical research grants provided by the principal public funders of health research in selected jurisdictions. Even after accounting for population differences among countries and regions, the United States (U.S.) is the largest public funder of health research globally. The data also suggest that Canada, in comparison to other countries and regions and taking into account population size, is a major public funder of health research.

Figure 4 – Annual Grants for Biomedical Research by Funder in Selected Jurisdictions, 2018 (US$ millions)

International Collaboration on Health Research

The World RePORT is “an interactive, open-access database and mapping of global research investments from some of the world’s largest biomedical funding organizations” housed at the U.S. National Institutes of Health. A review of the database reveals that many investments involve global collaborations. For example, in 2019, CIHR funded projects involving partnerships across all continents. The proportion of CIHR grants (both in number and funding) with international linkages has been increasing since the organization’s creation in 2000 and now makes up almost 15% of the total number of grants. CIHR explains that international collaboration promotes access for Canadians researchers to international expertise, technologies and facilities, while global health research focuses on topics such as the health implications of globalization, health equity of marginalized populations, neglected conditions affecting disadvantaged populations and transnational health risks and opportunities.

Additional Resources

Canadian Association for Neuroscience, Science Funding in Canada – Statistics , 2020.

Canadian Institutes of Health Research, CIHR COVID-19 Investments: By the Numbers .

Government of Canada, Canada’s Biomanufacturing and Life Sciences Strategy .

Author: Sonya Norris, Library of Parliament

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Categories: Economics and finance , Health and safety , Science and technology

Tags: funding , health care , health research

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Science funding in Canada – Statistics

(Last updated – October 2023)

Fundamental research funding in Canada is viewed in a positive light by Canadians, who understand its importance for their health and well-being, and by the current government.  However, despite the re-investments in the Canadian funding agencies announced in 2018, research funding in Canada remains low when compared to that of other countries.

CIHR statistics

Compiled by the Canadian Association for Neuroscience from data available on the CIHR website.

Project grants granted by the Canadian Institutes of Health Research are the core funding mechanism for biomedical research in Canada.  Unfortunately, success rates in recent competition have been dwindling (Figure 1).  The success rates for funding applications at CIHR has steadily declined since 2005, from a 31% success rate to a success rate below 15% in 2018 (less than one in six successful applications). Current success rate levels are too low to maintain a diverse and flourishing research environment, as many excellent research programs go unfunded due to lack of available funds. Success rates under 20% means that researchers spend countless hours writing grant applications, while their chance of being successful are too low to be sustainable. In addition, it should be noted that the current funding level is only achieved by making drastic cuts to the budgets of all project grants (often >25%), which further highlights the lack of sufficient funding for this competition.

CIHR Grant application success rates 2000-2021

Data source available here (xls format)

CIHR budget 2000-2023

Year 2020-2021 included Statutory Authorities $203.6M time-limited funding for COVID-19 research (Pursuant to the Public Health Events of National Concern Payments Act). As this funding is a one-time addition to the CIHR budget not dedicated to the regular programs, it is indicated as extra data points (in yellow and orange in the graph)

https://can-acn.org/docs/cihr_nserc_statistics_2000-2023.xlsx

Comparison with the NIH budget

The NIH’s 2020-2021 budget was $41.5 billion USD (approx. $55.7 billion CAD), compared to CIHR’s $1.44 billion CAD (which includes one-time investments in COVID-19 research). This represents a 39-fold difference in funding support for CIHR , which contrasts with the nine-fold difference in population between the United States and Canada.

View data sources

NSERC Statistics

Nserc budget 2007-2023.

SSHRC statistics

Sshrc budget 2006-2021.

Data points 2006 to 2019-2020 are actual spending, as reported in the SSHRC annual reports.

Four data points are reported for 2020-21 – the bottom two represent planned spending, while the upper two data points represent actual spending, and includes significant time-limited funding for COVID-19 research (Pursuant to the Public Health Events of National Concern Payments Act)

Student stipends

More support is required to maintain Canada’s attractiveness for the next generation of researchers. Trainees that successfully compete for Canada Graduate Scholarships (Master’s program; CGS-M), receive an $17.5K CAD per year award, an amount that has not kept up with inflation and is stagnant since 2003. This is below the low-income level cut-off of $22k CAD for a person living alone in a major Canadian city. The NSERC website states that “ This support allows these scholars to fully concentrate on their studies in their chosen fields ”. This is no longer accurate, and disheartening for students, who must now face rising housing costs and inflation rates. Academia is viewed as an uphill battle, with no clear indication that the situation will improve, which is a daunting prospect for trainees.

Paying students a living wage is the base for equity, diversity and inclusion, and absolutely required if we are to attract the brightest minds from diverse backgrounds and not only those who are independently wealthy.

Update – August 2022: the Support our Science Campaign website: https://www.supportourscience.ca/ presents more data on funding of trainees by NSERC.

The Fundamental Science Review Report (2017)

The Advisory Panel on Federal Support for Fundamental Science was appointed in June 2016. Their mandate entailed a review of the federal system of supports for research conducted by scientists and scholars employed outside of federal, provincial, or territorial government departments and agencies. The Fundamental Science Review, also known as the Naylor Report, made important recommendations to improve the Canadian Research Ecosystem.

The Panel’s single most important recommendation (R6.1) is that the federal government should rapidly increase its investment in independent investigator-led research to redress the imbalance caused by differential investments favouring priority-driven targeted research over the past decade.  (Investing in Canada’s future – Strengthening the Foundations of Canadian Research: Canada’s fundamental Science Review, page xviii http://www.sciencereview.ca/eic/site/059.nsf/vwapj/ScienceReview_April2017-rv.pdf/$file/ScienceReview_April2017-rv.pdf )

In response to the publication of the Fundamental Science Review, the Federal budget of 2018 announced a historic investment in science. However, examination of the recommendations of the Naylor report and the investments announced in 2018 shows that full implementation of the recommendations of the Naylor report has not been achieved.

The Fundamental science review report proposed investments in Investigator-led direct project funding over 4 years of $1215 Millions, while $689 Millions were included in the same four year period in budget 2018, or 56.7%.

Source: Report of the Fundamental Science Review, p. 154 http://www.sciencereview.ca/eic/site/059.nsf/vwapj/ScienceReview_April2017-rv.pdf/$file/ScienceReview_April2017-rv.pdf

and Budget 2018 Chapter 2 p. 122—Progress millions of dollars – Investing in Canadian Scientists and Researchers: Granting Councils (https://www.budget.gc.ca/2018/docs/plan/toc-tdm-en.html)

Data from the World Bank

Oecd statistics.

The Organisation for Economic Co-operation and Development (OECD) is an international organisation that works to build better policies for better lives. The OECD collects data and publishes statistics on a wide range of range of social, economic and environmental challenges. Here we present a collection of graphics on science performance, science funding and the number of researchers in Canada. Canada is compared to the other countries of the G7.

Gross domestic spending on Research and Development

The following figure shows that Canada is the only country in the G7 in which Gross domestic spending on R&D has been going down since 2001.

Canada is now second to last in the G7 in this metric.

Direct link:  https://data.oecd.org/chart/6atc

Researchers

The following figure shows that the number of researchers per 1000 employed as compared to the average number for OECD countries

Youth science performance

Research-driven innovation is one of the pillars of today’s knowledge-based economy. The Canadian Association for Neuroscience is committed to advocating for increases in the total budget of the three main granting councils of Canada, CIHR, NSERC and SSHRC.

Read our submission to pre-budget consultations

The House of Commons Standing Committee on Finance invited Canadians to participate in its annual pre-budget consultations process. The committee will table a report on these consultations in the House of Commons with recommendations to be considered by the Deputy Prime Minister and Minister of Finance in the development of the 2025 federal budget.

Read CAN’s submission to these consultations here:

The Canadian Association for Neuroscience applauds new investments in science and research announced in budget 2024

The Canadian Association for Neuroscience applauds new investments in science and research announced in budget 2024 by the Honourable Chrystia Freeland, Minister of Finances of Canada. These announcements demonstrate that scientific research has real-world benefits to people across Canada, to Canada’s economy, and to Canada’s future prosperity. We specifically applaud the following measures:

Increased funding for graduate student scholarships and post-doctoral fellowships

(more…)

Research is the key to better brain health

One in two people will suffer from a mental illness across their lifetime. It is estimated that 1.7 million Canadians will suffer from dementia, such as Alzheimer’s disease, by the year 2030. The burden of brain disorders and diseases has substantially increased over the last 25 years with the aging of the population and the negative impact of the pandemic. This is having a detrimental impact on the economy, healthcare systems, and Canadian livelihood. Neurodegenerative diseases are the leading cause of disability and the second leading cause of death worldwide , and mental health disorders are the leading cause of days off work.

Canada is fortunate to have a rich and diverse community of brain scientists who tackle this challenge from many different angles. In addition to neurologists and brain surgeons, who treat patients directly, we must remember that the development of innovative treatment avenues relies on new basic research. (more…)

Invitation to write to the Minister of Finances

We invite you to write to the Minister of Finances, the Honourable Chrystia Freeland, to remind her and her team of the importance of investing in scientific research as they work on the 2024 Canadian budget.

CAN has drafted a sample letter, you can dowload here: CAN letter to Freeland (more…)

Urgent appeal to recapitalize the Canada Brain Research Fund

We invite you to read a letter calling for urgent recapitalization of the Canada Brain Research Fund we recently sent to

The Honourable Ya’ara Saks , Minister of Mental Health and Addictions of Canada The Honourable Mark Holland , Minister of Health of Canada The Honourable Chrystia Freeland , Minister of Finances of Canada The Right Honourable Justin Trudeau , Prime Minister of Canada

Read the letter here: CAN-Brain-Canada-support-letter-2024

Read CAN’s submission to the 2024 Pre-budget consultations

Investing in science will create new jobs and build a greener, more competitive, more innovative, more inclusive, and more resilient canada..

Read our main recommendations here:

2023 CAN Parliament Hill Day

CAN held its second in-person Parliament Hill Day in Otttawa on November 7, 2023. This presented an exceptional opportunity for a team of CAN advocates to meet face-to-face or virtually with members of Parliament, Senators, Parliamentary staff members and important senior civil servants to advocate for a increased support for the major federal funding agencies in Canada (Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council of Canada (NSERC), Social Sciences and Humanities Research Council (SSHRC) and graduate student and postdoctoral fellowships and for making research on Brain and Mental Health a national priority. (more…)

ThinkSci Outreach Program wins a CAN Advocacy Award

The Canadian Association for Neuroscience is proud to announce its support of the ThinkSci Outreach Program with a 2023 CAN Advocacy and Outreach award.

The “ThinkSci Outreach Program” is a workshop-based initiative organized and led by undergraduate and graduate students, with the goal of immersing high school seniors and 1st year CÉGEP students into the world of neurophysiology. Its long term goal is to reach local, regional and national underrepresented student communities in Canada. (more…)

Investing in science will benefit all Canadians.

CAN is sharing with you the brief we have submitted to the House of Commons Finance (FINA), which is currently holding its consultations in advance of federal budget 2024. – our three recommendations are

The Canadian Association for Neuroscience recommends the following: Recommendation 1: That the government double the budgets of the three main federal funding agencies : Canadian Institutes of Health Research (CIHR), the Natural Sciences and Engineering Research Council (NSERC) and the Social Sciences and Humanities Research Council (SSHRC) for the benefit of all Canadians. This recommendation aims to bring Canadian investment in scientific research to a level commensurate to that of other G7 countries. Recommendation 2: That the government of Canada double support for graduate students and postdoctoral fellows by increasing both the value and number of fellowships awarded in the next budget. In conjunction with Recommendation 1, this recommendation will ensure our next generation of scientists have the means to participate fully in Canada’s knowledge economy. Recommendation 3: That the government of Canada make research on the Brain and Mental Health a national priority by investing in research to understand the brain through well-established and trusted organizations in the field.

Read our full submission for the FINA pre-budget submission here: (more…)

Brief submitted to study on Government of Canada’s Graduate Scholarship and Post-Doctoral Fellowship Programs

Read the brief submitted by the Canadian Association for Neuroscience to the House of Commons Standing Committee on Science and Research study on “ Government of Canada’s Graduate Scholarship and Post-Doctoral Fellowship Programs ”.

Canada needs to stop the brain drain

Get in touch if you have any questions or comments:

[email protected]

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Prime Minister of Canada Justin Trudeau

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• Prime Minister announces new support for COVID-19 medical research and vaccine development

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New information on COVID-19 emerges every day. Researchers and scientists in Canada and around the world are working hard to better understand the virus, and its impacts on people and communities. By keeping pace with this information, we can better protect the health of Canadians and set our country on the path to recovery.

The Prime Minister, Justin Trudeau, today announced more than $1 billion in support of a national medical research strategy to fight COVID-19 that includes vaccine development, the production of treatments, and tracking of the virus. This new funding builds on the $275 million investment for coronavirus research and medical countermeasures announced in March.

The Government of Canada will invest in new medical countermeasures to better understand COVID-19, and develop the infrastructure needed to fight the virus here in Canada. This includes:

• The establishment of the COVID-19 Immunity Task Force that will operate under the direction of a leadership group, which will include Dr. David Naylor, Dr. Catherine Hankins, Dr. Tim Evans, Dr. Theresa Tam, and Dr. Mona Nemer. The task force will establish priorities and oversee the coordination of a series of country-wide blood test surveys that will tell us how widely the virus has spread in Canada and provide reliable estimates of potential immunity and vulnerabilities in Canadian populations.
• $40 million for the Canadian COVID-19 Genomics Network (CanCOGeN), led by Genome Canada, to coordinate a COVID-19 viral and host genome sequencing effort across Canada. This research will help track the virus, its different strains, and how it makes people sick in different ways, providing valuable information to public health authorities and decision-makers as they put in place measures to control the pandemic. The results of this work will be available to researchers globally to support additional research, including Canadian vaccine development efforts.
• $23 million for the Vaccine and Infectious Disease Organization-International Vaccine Centre (VIDO-InterVac) to accelerate development of a vaccine against COVID-19. This funding will support pre-clinical testing and clinical trials of a potential COVID-19 vaccine, essential steps to ensuring that vaccines are effective and safe for human use.
• $29 million for the National Research Council of Canada to begin the second phase of critical upgrades to its Human Health Therapeutics facility in Montréal. Building on ongoing work to ready the facility for the production of vaccines for clinical trials, this funding will support operations to maintain the facility, as well as provide infrastructure to prepare vials for individual doses as soon as a vaccine becomes available.
• $600 million, through the Strategic Innovation Fund, over two years to support COVID-19 vaccine and therapy clinical trials led by the private sector, and Canadian biomanufacturing opportunities.
• $10 million for a Canadian data monitoring initiative so we can coordinate and share pandemic-related data across the country to enhance Canada’s response to COVID-19.
• $10.3 million over two years, and $5 million ongoing, to support the Canadian Immunization Research Network in conducting vaccine-related research and clinical trials, and to enhance Canada’s capacity to monitor vaccine safety and effectiveness.
• $114.9 million through the Canadian Institutes of Health Research for research projects that will accelerate the development, testing, and implementation of medical and social countermeasures to mitigate the rapid spread of COVID-19, as well as its social and health impacts.

Separately, the Government of Canada is providing over $675,000 through the Stem Cell Network to support two new research projects and one clinical trial. The clinical trial will evaluate the safety of a potential cell therapy to reduce the impacts and severity of acute respiratory distress associated with COVID-19, and the two projects will generate critical information about how cells in the airway and brain are affected by the virus.

By supporting COVID-19 research, the critical work being done by our country’s scientists, and vaccination efforts, we will be able to better protect the health and safety of Canadians and vulnerable populations around the world.

“Since the beginning of the COVID-19 pandemic, we have been working closely with Canada’s health experts and researchers, who are some of the most skilled and brightest in the world. We are making sure that Canada remains at the forefront of scientific research to help us make smart and effective decisions on the path to recovery.”   The Rt. Hon. Justin Trudeau, Prime Minister of Canada

“The investment Canada is making now in research will result in our country being better equipped to plan for the coming months. Some of the best health experts and health researchers in Canada will help us implement the right next public health measures to respond to COVID-19. They will also help us put in place strategies to support essential workers – based on evidence and on what we know about who has been exposed – and plan for the use of a vaccine.” The Hon. Patty Hajdu, Minister of Health

“We know that science is fundamental to beating COVID-19 and Canada is benefiting from the impressive and innovative power of Canadian researchers in our coordinated national approach to fight COVID-19. Together, we are rapidly scaling up our research capacity to harness genomic sequencing data to inform public health interventions and to advance a vaccine against COVID-19 to protect Canadians and end the crisis.” The Hon. Navdeep Bains, Minister of Innovation, Science and Industry

Quick Facts

• The COVID-19 Immunity Task Force will operate under the direction of a leadership group with a mandate to establish priorities and oversee the coordination of a series of serological surveys. An external, dedicated secretariat will help maximize the efficiency of the task force’s work, and ensure rapid reporting of results to governments and Canadians. The Government of Canada has worked with provinces and territories on the creation of this task force.
• The task force will provide data to decision-makers, including disaggregated data that will help us understand the impact of COVID-19 on vulnerable populations, while also leveraging new and existing lab capacity for research. The better we understand the virus, its spread, and its unique impact on different groups, the better we can fight it, and eventually defeat it.
• A serological test is a blood test. This test detects the presence of virus-specific antibodies in blood samples so that previous exposure to the COVID-19 virus can be detected. 
• Dr. David Naylor, co-chair, who is well known for his scientific leadership and influence in advancing healthcare innovation. From establishing successful institutions that fill gaps in evidence to his role as President of the University of Toronto, Dr. Naylor is a thought leader who continues to seek better outcomes for the health of Canadians;
• Dr. Catherine Hankins, co-chair, a Professor of Public and Population Health at McGill University. Dr. Hankins’ leadership role in developing good participatory practice guidelines for trials for HIV and emerging pathogens has influenced research design and conduct to ensure research benefits communities. Her leadership role as Chief Scientific Advisor to UNAIDS brings international public health experience in knowledge translation and networks to the task force
• Dr. Tim Evans, the Director of the School of Population and Global Health at McGill University. Dr. Evans will be the executive director of the task force and external secretariat. He brings strong international health experience through his former positions as Assistant Director General of the World Health Organization and Senior Director at the World Bank. His experience leading complex initiatives provides a foundation for his role as the task force lead.  
• Dr. Theresa Tam, Canada’s Chief Public Health Officer. In addition to being the federal government’s lead health professional, Dr. Tam is a physician with expertise in immunization, infectious disease, emergency preparedness and global health security. She brings a wealth of leadership experience in Canada's response to public health emergencies including severe acute respiratory syndrome (SARS), pandemic influenza H1N1 and Ebola.
• Dr. Mona Nemer, the Chief Science Advisor to Canada’s Prime Minister, Minister of Science, and Cabinet. In her current role, Dr. Nemer regularly provides advice on issues related to science and government policies that support it. Before becoming the Chief Science Advisor, she was Professor and Vice-President of Research at the University of Ottawa and Director of the school’s Molecular Genetics and Cardiac Regeneration Laboratory.
• The members of the leadership group will be appointed in the coming days and will be include leading scientists in the fields of virology, immunology, public health, and health care.
• On March 11, 2020, the Government of Canada announced a $1 billion package to help Canadians cope with the COVID-19 outbreak , which included $275 million for coronavirus research and medical countermeasures, and $50 million to ensure adequate supplies of personal protective equipment. This was in addition to the investment of $27 million to fund coronavirus research announced on March 6, 2020.
• $12 million for VIDO-InterVac to develop a vaccine manufacturing facility to meet the good manufacturing practice (GMP) standards necessary for human vaccines. This complemented an $11 million investment by the Canada Foundation for Innovation to support VIDO-InterVac’s ongoing operating costs through to March 2023.
• $15 million for the National Research Council of Canada to upgrade its Human Health Therapeutics facility for GMP compliance to develop, test, and scale up promising vaccine candidates to be ready for industrial production.
• On April 2, 2020, Genome Canada launched additional rapid response funding for COVID-19 research in the six regional Genome Centres across the country. That $1.5 million in funding aims to leverage other funding and support genomics-informed solutions to COVID-19 at local, provincial and national levels through collaborations between academia, industry, not-for-profit and public sectors.

Associated Links

• Coronavirus disease (COVID-19)
• Canada’s COVID-19 Economic Response Plan
• Canada’s plan to mobilize science to fight COVID-19
• Prime Minister announces new partnerships with Canadian industries to fight COVID-19
• Prime Minister announces Canada’s Plan to Mobilize Industry to fight COVID-19

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MRF 2024 Grants Competition

The MRF Board is pleased to announce our 2024 Grants Competition , featuring a total of up to 6 internal awards (4 Research Development Grants, 1 Idiopathic Pulmonary Fibrosis Grant and 1 Cox Award), as described below. The application deadline for the competition will be:  October 17th, 2024 .

The 2024 MRF Research Grants competition will include the following awards: Research Development Grants

• Up to 4 Research Development Grants will be awarded.
• Each grant will be for a total amount of up to $20,000.
• All applications to this competition will also be considered for the Cox Award (see below).

Idiopathic Pulmonary Fibrosis Grant

• A total of 1 Idiopathic Pulmonary Fibrosis Grant will be awarded.
• This grant will be for a total amount of up to $20,000.
• All applications will also be considered for the Research Development Grants and Cox Award.

The Cox Award

• In addition to the 4 Research Development Grants and Idiopathic Pulmonary Fibrosis Grant described above, the competition will also include a Cox Award that will be awarded to the top-ranked application in the competition.  
• The Cox Award will be distinguished by raising the total amount of the grant to $30,000.  
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2020 Ovarian Cancer Research Grant  Competition The MUN Faculty of Medicine and MRF are pleased to announce that the 2020 Ovarian Cancer Reserach Grant was awarded to Dr. Jules Dore, Division of BioMedical Sciences, MUN Faculty of Medicine, for his research project entitled: "Defining the roles of Engrailed 2 in growth and metastasis of ovarian cancer". This grant was sponsored by Belles with Balls NL . Their mission is to raise funds to support Ovarian Cancer Research and Education in Newfoundland and Labrador.   

For additional information on this grant competition, please contact the  RGS Research Manager . ========================================================================

2019 Epilespy-NL Grant Competition The MUN Faculty of Medicine and MRF are pleased to announce that the 2019 Epilepsy-NL Grant was awarded to Dr. Curtis French, Discipline of Genetics, MUN Faculty of Medicine, for his research project entitled: "Effectiveness of Cannabis extracts at reducing seizure rate in a zebrafish model of epilepsy".

This grant was sponsored by Epilepsy Newfoundland and Labrador. Bridging the gap between the medical and social realities of living with epilepsy, Epilepsy Newfoundland and Labrador offers a wide range of programs and services.  For additional information on this grant competition, please contact the  RGS Research Manager .

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• Published: December 1998

The Medical Research Council of Canada: Integrating research to Canada's health care system

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Nature Medicine volume  4 ,  pages 1353–1355 ( 1998 ) Cite this article

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The Medical Research Council (MRC) of Canada funds health research in Canadian universities, research institutes and teaching hospitals. In this commentary, the MRC's president, Henry G. Friesen, discusses its history, structure, achievements and future goals.

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Friesen, H. The Medical Research Council of Canada: Integrating research to Canada's health care system. Nat Med 4 , 1353–1355 (1998). https://doi.org/10.1038/3936

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• Hexoskin Announces $4.2M Additional Funding Round and Acceleration of Clinical AI Development Platform

August 27, 2024

Montreal, Canada - August 27, 2024 : Hexoskin, a Montreal-based digital health and AI company developing medical-grade wearables and algorithms for health monitoring and diagnostics, is very excited to announce today an additional USD $4.2M capital raise to invest in growth, digital biomarkers research, and new AI-based digital diagnostics solutions. Investors include AQC Capital and Anges Quebec (Canada), BDC Capital (Canada), ballas invest (Europe), Deep Divers Ltd (UK), and 19 other US and Canadian private investors.

Pierre-Alexandre Fournier, Hexoskin’s CEO, commented: “ Hexoskin’s team has over 15 years of experience in clinical AI development and high-resolution wearable sensors. Our investors understand how our digital platform is uniquely positioned to develop a range of diagnostic tests and digital solutions that can address the needs of large populations in disease areas with large unmet needs, such as cardiac, respiratory and rare diseases .”

Hexoskin's current wearable sensing products (Hexoskin & Astroskin) serve the clinical research, defense, and aerospace markets. Its customers, including CSA, NASA, DOD, Yale Health, Boston Children's Hospital, and hundreds of research teams across the world, have published over 250 scientific papers with Hexoskin data. Hexoskin smart shirts are also used in pharma clinical trials, and its technology has been part of the International Space Station since 2019 to support clinical trials in space.

" We are excited to team up with Hexoskin and its investors to enable its next phase of development globally " said Laurent van Lerberghe, Co-Founder of ballas invest and former Chief Strategy Officer at Sanofi. " We have been impressed by the wealth of expertise accumulated by Hexoskin with trillions of data points, more than a hundred clinical trials, and over 250 peer-reviewed publications. Through novel higher resolution digital measures and digital biomarkers in clinical and real-world settings, Hexoskin is unlocking the possibilities of early disease detection, high quality monitoring, hence improving treatment decisions and patients’ quality of life ".

Hexoskin’s software and wearable sensor products are used by clinical research teams around the world to collect digital endpoints in patient populations for a wide range of health conditions: cardiac (arrhythmias, heart rate variability), respiratory ( CODP, asthma ), cancer, neuro (dementia, epilepsy ), rare diseases and pediatric research (Rett syndrome, ME/CFS , Long Covid). 

" This additional equity funding allows us to better serve the scientific and medical communities ," added Fournier. " Patients, healthcare providers, and researchers are looking for products that are accurate, validated in diverse populations, and easy to use to collect clinical data in real-world settings. Hexoskin’s solutions accomplish these goals, offering high-quality and reliable tools to improve patient outcomes through research and clinical care . Expanding our investor base from Canada to US and Europe is a clear marker of our global potential. "

About Hexoskin

Hexoskin (Carré Technologies Inc.) is a pioneer in continuous, passive remote health monitoring driven by AI. Hexoskin's platform and technology are used by hundreds of institutional partners for research purposes, in studies examining breathing disorders, cardiac and pulmonary diseases, rare diseases, stress, sleep, epilepsy, and other conditions. If you're interested in investing in Hexoskin please consult our investor relations section .

An End-to-End Solution for Clinical Research

Launched in 2023, the company’s new clinical development software platform, Hexoskin OneView , allows research teams to follow cohorts of participants as the complete clinical protocols, monitoring compliance and data quality. The platform is used today to collect data for new clinical AI algorithms for diagnostics and quality of life assessments. The data captured include heart rhythms and ECG, breathing patterns, PPG/SpO2, blood pressure, temperature, activity, and patient-reported outcomes with standardized questionnaires or symptoms reporting.

From Space Medicine to Ivy League Research

Hexoskin's current wearable products (Hexoskin and Astroskin) serve the clinical research, defense, and aerospace markets. Its customers, including NASA, DOD, Yale Health, Boston Children's Hospital, Columbia University, and hundreds of researchers and hospitals, have published over 250 scientific papers with Hexoskin data. Hexoskin smart shirts are used in pharmaceutical clinical trials, and its technology has been part of the International Space Station since 2018.

Mayo Clinic Accelerator Program

Hexoskin has been selected by Mayo Clinic in 2019 for their MedTech accelerator program and is currently implementing remote patient monitoring programs in cardiology and pulmonology with health systems in the US and Canada.

Hexoskin’s Unique Database

Over the past 10 years, Hexoskin has built the largest ambulatory cardio-respiratory database in the world. The database includes hundreds of millions of breathing patterns and billions of cardiac rhythm patterns, in addition to sleep data and annotations specific to many other health conditions, developed with hospitals and research partners in the US, Canada and Europe. The company leverages its proprietary database to develop new AI-based digital diagnostic solutions.

Pediatric Research

Hexoskin is one of few companies that have made available wearable sensing solutions for pediatric research . The Hexoskin Junior biometric shirt is used by research groups to study sleep patterns, respiratory health, and rare diseases in children 3 to 17 years old.

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Government of Canada invests in community projects to reduce health inequities

From: Public Health Agency of Canada

Backgrounder

The Intersectoral Action Fund (ISAF) is the first Public Health Agency of Canada (PHAC) program explicitly dedicated to support collective action across sectors on the social determinants of health to reduce health inequities. This grant program seeks to strengthen capacity and build knowledge and tools to enable partners to work together across sectors to advance action on the social determinants of health. The program prioritizes funding upstream projects, or projects that are addressing the root causes of ill health and health inequities.

August 2024

Following the 2021 ISAF Call for Proposals, 27 projects were funded in communities across Canada in 2021-2022 and 2022-2023. A renewal of ISAF through Budget 2023 enabled the program to fund an additional 16 projects from the 2021 solicitation, representing over $3.2 million in funding.

Funded projects address a wide variety of social determinants of health impacting communities across Canada, including homelessness, pay inequities, racism, and also prioritized projects led-by and serving equity deserving populations, including Indigenous, Black, and other racialized communities, 2SLGBTQIA+ communities, women, and older persons.

The 16 additional projects that received funding are:

Lead organization:  Canadian Centre for Housing Rights Project name:  Advancing the right to housing for individuals released from health-care facilities Location : Toronto, Ontario Funding: $248,950 Description: This project aims to address the pressing issue of homelessness risk associated with individuals staying in and being discharged from health-care institutions in Canada. This will be done through investigating the scope of the present issue, its impact on different equity-seeking groups (including seniors and people with addictions and mental health challenges, who it is suspected may be most impacted) and by formulating effective strategies to support individuals whose housing is at risk during extended healthcare stays or upon discharge into precarious housing situations or homelessness.

Lead organization:  Canadian Mental Health Association, Metropolitan Toronto Branch Project name:  Toronto supportive housing growth plan: Advancing intersectoral action on harm reduction and anti-racism Location : Toronto, Ontario Funding: $195,148 Description: This project will drive progress in the implementation of two priorities of the Toronto Supportive Housing Growth Plan: harm reduction and anti-racism. It will strengthen and formalize partnerships between municipal partners, community organizations, housing providers and health providers to co-design improvements to advance health equity by:

• enhancing access to harm reduction services in housing settings and streamlining the integration of leadership from organizations that are led by and serve racialized communities and people with lived experienced.
• expanding the capacity of multiple sectors to establish and grow a network of community partners to address urgent needs of people experiencing homelessness in the City of Toronto.

Lead organization:  Centre for Innovation and Research in Aging Inc. Project name:  Development, implementation, and evaluation of a bilingual rights-based data repository: An educational intervention to improve knowledge about the human rights of older adults Location : Fredericton, New Brunswick Funding: $249,622 Description: This project seeks to develop an interactive web-based tool offering up-to-date, de-identified, and customizable data on Older Persons Human Rights. The project aims to develop, implement and evaluate a web-based Older Person's Human Rights Indicator Framework (OPRIF) data repository in both of Canada's official languages and to establish the feasibility and acceptability of an online framework. This will be based on the Child Rights Indicators Framework (CRIF), which was implemented a few years ago as a static online report. The two web-based CRIF and OPRIF data repositories will support the Government of New Brunswick, and other provinces, to uphold the human rights of children and older persons, respectively, in their development, implementation, and evaluation of policies, programs, and practices.

Lead organization:  Community-Based Research Centre Society Project name:  Establishing the Canadian coalition to abolish conversion therapy Location : Burnaby, British Columbia Funding: $250,000 Description: The Canadian Coalition to Abolish Conversion Therapy will connect 2SLGBTQIA+ community organizations (including those serving Indigenous people, Black and People of Colour and newcomers), with academics, researchers, legal experts, survivors, and key stakeholders from mental health organizations and affirming faith organizations.Collaborative knowledge sharing and coalition development are necessary to support broader prevention efforts. By working together, they aim strengthen equality for 2SLGBTQIA+ people; and help people who have been exposed, or may be at risk of exposure, to conversion practices, centre themselves.

Lead organization:  Council of Agencies Serving South Asians Project name:  Racialized health initiative: Addressing health disparities in racialized communities in Ontario Location : Toronto, Ontario Funding: $248,282 Description: This project seeks to create system-level changes in health care in Ontario by addressing health disparities in racialized communities. The project seeks to further develop work by the Racialized Health Working Group to develop population specific health and wellbeing strategies, create community awareness for the need for disaggregated race-based data collection, and gain community input on strategies and data standards.  

Lead organization:  Déclic, Initiatives pour la formation et l'emploi des jeunes Project name:  Développement d’un protocole d’intervention intersectoriel au soutien de la transition à la vie adulte des ex-placés de la protection de la jeunesse Location : Montreal, Quebec Funding: $239,865 Description: This project seeks to develop an intersectoral action protocol for former children and youth in care of Quebec's Director of Youth Protection. This vulnerable population faces major challenges in terms of health, education and social and professional integration. This protocol will focus on the social determinants of health and wellbeing and facilitate collaboration between players who traditionally operate independently (in "silos").

Lead organization:  HIV Legal Network Project name:  It’s not so “simple”: Assessing the impact of the simple drug possession and trafficking offences on health equity Location : Toronto, Ontario Funding: $92,671 Description: This project seeks to gather information through a comprehensive review of literature and primary interviews on the distinction made between drug possession for personal use versus for the purpose of trafficking. Additionally, it explores how people acquire, keep, carry, and consume criminalized substances for personal use. The project will also look at the immediate and longer-term impacts of the prohibition of simple drug possession and trafficking on the health and well-being of people who use drugs. The findings will assist policymakers to make more informed decisions that improve the justice system’s response to personal drug use and trafficking, with potential beneficial outcomes that include reduced harms to the health and wellbeing of people who use drugs.  

Lead organization:  Mino Care Project name:  Black Canadian perinatal health network: A Canadian African, Caribbean, and Black (ACB) reproductive and perinatal health research and policy initiative Location : Toronto, Ontario Funding: $195,147 Description: This project proposes a national study and policy initiative that addresses the Black maternal health experience that Black birthing persons have had over the past decade in Canada through a survey and focus groups. This knowledge will then be used to begin policy-based initiatives that will encourage the Canadian government to acknowledge the Black maternal health experience and make care more equitable, culturally safe and reduce morbidities and mortalities.

Lead organization: National Collaborating Centre of Determinants of Health (via St. Francis Xavier University) Project name:  Becoming an intersectoral network-of-networks: Leveraging the Health Promotion Canada platform to create an intersectoral and interdisciplinary space for promoting collaborative action on the social determinants of health and wellbeing Location : Antigonish, Nova Scotia Funding: $171,088 Description: This project seeks to support an intersectoral network-of-networks, through a virtual space uniquely designed to undertake collaborative action on the social determinants of health at the national level. This does not currently exist in Canada and has been identified as a need by health promotion and public health practitioners, including both the National Collaborating Centre of Determinants of Health and Health Promotion Canada.

Lead organization:  New Brunswick Coalition for Pay Equity Inc. Project name:  Building Indigenous partnerships for pay equity Location : Moncton, New Brunswick Funding: $168,913 Description: This project will partner with the New Brunswick Committee for the Advancement of Aboriginal Women (CAAW) to build capacity to advance intersectoral action on New Brunswick Indigenous women’s income and pay equity in New Brunswick First Nations communities, in collaboration with First Nation communities and Indigenous organizations.  The New Brunswick Coalition for Pay Equity and CAAW will identify and meet key Indigenous organizations, share their knowledge of pay equity and invite them to propose representatives to join an advisory committee to co-develop research and make recommendations on pay equity in the context of NB First Nations communities.

Lead organization:  Sexual Assault Services of Saskatchewan (SASS) Inc. Project name:  Building an intersectoral primary prevention workforce to advance gender transformative approaches to sexual violence prevention in Saskatchewan Location : Regina, Saskatchewan Funding: $249,465 Description: This project seeks to build capacity for a diverse team of policy and practise stakeholders who are committed to intersectoral action in leading and testing new primary prevention efforts to end sexual violence. In partnership with Shift: The Project to End Domestic Violence at the University of Calgary, SASS will develop an understanding of root causes and drivers of sexual violence for Saskatchewan’s unique context; identify the multi-sectoral policy structures that inform strategic priority setting in Saskatchewan; and develop internal processes and tools to support intersectoral action on sexual violence prevention.

Lead organization:  Smart Prosperity Institute (via University of Ottawa) Project name: Strengthening the core: Increasing social license for healthy infill development in London, Ontario Location : Ottawa, Ontario Funding: $174,384 Description: This project seeks to identify and co-develop policy solutions, with the London community, to encourage greater social license for building “healthy infill” housing in urban cores that improves community health outcomes, quality of life, and housing affordability.

Lead organization:  Sport Tourism Canada Project name:  Project SEEIM: Sports Socio-Environmental-Economic Impact Model Location : Kingston, Ontario Funding: $242,100 Description: This project seeks to build a free and universally accessible online tool that will function as an accountability system for sport activity planning. It will allow for an accurate assessment of not only financial impacts but also indirect and induced social, economic, health and environmental impacts, separately and collectively. This will allow for the calculation of the total impacts associated with the activity, which will inform decision-making.

Lead organization:  The Alberta First Nations Information Governance Centre Project name:  Building capacity across health and education boundaries for action on social determinants of health and wellbeing in First Nations communities Location : Tsuu T’ina First Nation, Alberta Funding: $209,904 Description: This project seeks to determine cross-cutting issues in health and education with the greatest potential to address overall wellness in Alberta First Nations communities. By engaging sectors and experts of First Nations health and education, the project intends to gather and synthesize information, both through an examination of research literature and engagement of program staff, as well as community members/Elders, on cross-cutting issues that may then be used as a ‘source of truth’ in the development of a set of ‘Consensus Statements’.

Lead organization:  Women's College Hospital Project name:  Scaling up equity-mobilizing partnerships in community (EMPaCT) to facilitate intersectoral action on the social determinants of health Location : Toronto, Ontario Funding: $192,596 Description: This project seeks to directly scale the adoption of EMPaCT, an award-winning, scalable model of diverse citizen engagement, at Trillium Health Partners (THP) to foster transformative partnerships capable of co-creating knowledge and policy solutions to advance health equity in Mississauga. Specifically, the project will co-design, co-initiate and co-develop a jurisdictionally-based EMPaCT at THP. This will directly generate transferable knowledge about how EMPaCT can be implemented across organizations and communities, break down institutional silos, and build capacity to mobilize knowledge between jurisdictions for greater collective impact through advocacy and upstream policy influence.  

Lead organization:  York Region Food Network Project name:  Social procurement collaborative for York region Location : Aurora, Ontario Funding: $109,571 Description: This project seeks to develop the necessary infrastructure for social procurement to flourish in York Region, by improving access to fair employment and decent work. This will be done by connecting the dots between the policy (regional) and practice of social procurement on the ground by curating the tools, processes and relationships to make these opportunities accessible to communities.

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Inhaled Insulin Helps Patients Overcome Fear of Needles

Akshay B. Jain, MD; James W. Kim, MBBCh, PgDip, MScCH

Authors and Disclosures

Disclosure: Akshay B. Jain, MD, has disclosed the following relevant financial relationships:   Serve(d) as a speaker or a member of a speakers bureau for: Abbott; Acerus; AstraZeneca; Amgen; Bausch Healthcare; Bayer; Boehringer Ingelheim; Care to Know; CCRN; Connected in Motion; CPD Network; Dexcom; Diabetes Canda; Eli Lilly; GSK; HLS Therapeutics; Janssen; Master Clinician Alliance; MDBriefcase; Merck; Medtronic; Moderna; Novartis; Novo Nordisk; Partners in Progressive Medical Education; Pfizer; Sanofi Aventis; Timed Right; WebMD   Received research grants/research support from: Abbott; Amgen; Novo Nordisk   Received consulting fees from: Abbott; Acerus; AstraZeneca; Amgen; Bausch Healthcare; Bayer; Boehringer Ingelheim; Dexcom; Eli Lilly; Gilead Sciences; GSK; HLS Therapeutics; Insulet; Janssen; Medtronic; Novo Nordisk; Partners in Progressive Medical Education; PocketPills; Roche; Sanofi Aventis; Takeda

Disclosure: James W. Kim, MBBCh, PgDip, MScCH, has disclosed the following relevant financial relationships:   Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Abbott; AbbVie; AstraZeneca; Bayer; Boehringer Ingelheim; Eisai; Embecta; Eli Lilly; GSK; Janssen; Novo Nordisk; Miravo; Teva; Takeda; Sanofi  Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; AstraZeneca; Boehringer Ingelheim; Eisai; Embecta; Eli Lilly; GSK; Janssen; Novo Nordisk; Miravo; Pfizer Takeda; Sanofi; Otsuka   Received research grant from: Novo Nordisk   Received income in an amount equal to or greater than $250 from: AbbVie; AstraZeneca; Boehringer Ingelheim; Eisai; Embecta; Eli Lilly; GSK; Janssen; Novo Nordisk; Miravo; Linpharma; Pfizer Takeda; Sanofi; Otsuka   Serve(d) as Co-director: Partners in Progressive Medical Education

This transcript has been edited for clarity. 

Akshay B. Jain, MD: Welcome back to Medscape, from ADA 2024. I'm Dr Akshay Jain, an endocrinologist from Vancouver, and I'm joined by Dr James Kim, a primary care physician from Calgary, Canada. 

Both Dr Kim and I attended ADA 2024. We went over all our learnings and decided that there was a whole heap of clinical pearls that we learned from the conference. We thought it would be awesome if we could share our learnings with all of you, both from a primary care lens and from an endocrinology perspective.

One study Dr Kim and I learned about, and we think has some definite nuances in management of people living with diabetes, regards inhaled insulin . When we have patients in our clinic who have perhaps failed multiple oral agents or have very high blood sugars, we obviously want to consider starting them on insulin for type 2 diabetes .

Sometimes there is a significant barrier, which is related to the needles. There's an actual term for this: trypanophobia — a fear of needles. For the longest time, people have not wanted to take insulin or injectables because there's only one way of administering it, which is subcutaneous.

Enter now inhaled insulin. We saw studies at the ADA 2024 conference that looked at a new inhaled insulin called Afrezza . Afrezza essentially is a short-acting insulin, so it's kind of like a prandial insulin derivative, where it can be inhaled by an individual and it will work for mealtime control of blood sugars.

Dr Kim, in your practice, how often do you see people not wanting to take shots, and has this been a big barrier for you in starting insulin? 

James W. Kim, MBBCh, PgDip, MScCH: Thank you for having me. To answer your question, absolutely I encounter this on a weekly basis — and I'm not even an endocrinologist. I just have an interest in diabetes. There are a number of patients that I think will benefit massively with insulin but they're needle-phobic. You taught me that word, but I can never pronounce it, so my apologies for not remembering that phobia . I'm just going to call it needle phobia because I'm a simple-minded person.

The needle phobia is massive. I think there's a definite fear of the needle, but there's also a fear of failure. As soon as an injection is mentioned, many patients feel they failed miserably. There's an emotional roller coaster that happens.

I'm sure, Dr Jain, you have seen many patients, especially from Asia, who would say, "Oh, my auntie got on insulin and 3 months later, she got a kidney transplant." "My uncle started on insulin and he unfortunately passed away a couple of months later." Unfortunately, they're blaming many of those things on insulin.

I also have a number of patients who said they were on insulin before many years ago, and they experienced some severe hypoglycemic events, and they don't want to get on the insulin ever again. This is unfortunate because you know that if those patients, those aunties and uncles, were on insulin long before, maybe we could have saved their legs and kidneys, and potentially death.

Now we have advanced so much with insulin that hypoglycemia does occur, but much less than before. We still have many barriers when it comes to insulin initiations. Therefore, having this idea of inhaled insulin is fantastic, and I think we can get many more patients on insulin — the medication they actually need.

Jain: Absolutely. From the studies on inhaled insulin at ADA 2024, the key thing I found very interesting, regarding the pharmacokinetics of the insulin, was that it's working very quickly. It starts working within minutes of administering it.

Additionally, it lasts in the body only for a shorter duration of time compared with other injectable short-acting insulins, so it lasts in the body. The active insulin time is roughly about 2 hours or so, based on the studies, which in my mind opens up a whole world of possibilities because it means that people can take another correctional insulin if the blood sugars are still high after taking their first inhaled dose. You can take another dose subsequently without worrying about stacking of insulin. 

Many of us are familiar with this term, which is if you take two shots of short-acting insulin too close to each other, the insulin doses might add up and there can be a big drop in the blood sugars; it's called stacking of insulin. This can be potentially avoided. 

Similarly, if you take your dinnertime inhaled insulin and the sugars are still high around bedtime, you could take a smaller dose of the inhaled insulin and not worry about middle-of-the-night hypoglycemia because the effect of the insulin would be only for a little while.

That's one key learning that I found very helpful. The other important thing that I found was that this is not for everyone, so there are some restrictions. Essentially, the contraindication is that people who have asthma or COPD cannot be prescribed an inhaled insulin.

What are your thoughts, Dr Kim, based on this for your practice in primary care? 

Kim: It is very fascinating, for sure. I cannot wait to get hold of this insulin. I can already think of some patients who may benefit. You've mentioned the asthma and COPD patients, and that makes more sense because there is an actual airway problem.

I also wonder what will happen to patients who have restrictive airway disease, where asthma and COPD fall under obstructive airway disease. What if they have obesity , where it's really pressing into the diaphragm, and where they may not be able to take the deep breath in? How will they react?

What about someone who's got a cold, someone who has postnasal drip, or someone who tends to cough frequently? What about egg allergies? There are many question marks around this insulin before initiating these medications. There is excitement, but there are also many questions at the same time.

Jain: I think these are very important, practical considerations that we'll uncover as we start using more of this in clinical practice. The other important thing to note is that the presenters told us it's important to monitor pulmonary function tests. It's important to get a baseline pulmonary function test, and then we have to do another one in 6 months, followed by annually thereafter.

If, at any point of time, the FEV 1 drops by 20% or more, then that would be an indication for discontinuation of the inhaled insulin. The pulmonary function test does not need to be one of those fancier ones. The study group would just do office spirometries. I'm wondering, Dr Kim, in primary care, do you think this could potentially be a rate-limiting factor?

Kim: In Alberta, where I reside, no. Spirometry is very easily accessible in the province. For example, in Calgary alone, we have a population of about 1.3 million people. We have over 13 or 15 companies that can do this spirometry. We can get these things done literally within a week or two.

However, I am aware that in other provinces in Canada, it can definitely be a huge rate-limiting factor. Not everyone has the office-based spirometry, and definitely not within the primary care office. It has to be referred out to these private companies, most likely, and some of the rural areas will have to rely on the provincial hospitals, where the access can be even more challenging. 

On the day of the actual spirometry, if the person has a cough or is not feeling well, it's going to be a problem because you don't want the spirometry to be infected with a whole bunch of viruses. You'll have to cancel that and it can be a bit of an issue.

Jain: Many of our viewers are from the United States and other parts of the world, and spirometry is quite easily accessible in most places. As an endocrinologist, I must confess that it's been a long time since I've even ordered a spirometry or any clinical form of pulmonary function test. Once I start using the inhaled insulin, I'll need to start brushing up on my pulmonary function test knowledge. 

I think these are exciting times. At least we've got something to offer to people who would have otherwise not taken any insulin at all. There's certainly that hope that now there's a different way to administer this, and hopefully it can only get better from here on.

Thanks for joining us again, Dr Kim. This is Dr Akshay Jain with Medscape, from ADA 2024. Don't forget to check out our other videos on Medscape for more coverage of the conference.

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