Science and Policy in Health

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Science and Policy in Health: A
feedback loop process
February 2012
Pierre J Charest, Ph.D.
Acting Executive Vice President
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Canadian Federal S&T Structure
Industry Canada
PARLIAMENT
PRIME MINISTER
Minister of Finance
Minister of Industry
CABINET
Minister of State (S&T)
President of Treasury Board
Science, Technology &
Innovation Council
Research Funding
Granting Agencies:
• Natural Sciences & Engineering Research
Council (NSERC)
• Social Sciences & Humanities Research
Council (SSHRC)
• Canadian Institutes for Health Research
(CIHR)
Foundations:
• Canada Foundation for Innovation (CFI)
Research Funding
Research Performed in Labs
• National Research Council’s
Industrial Research Assistance
Program (IRAP)
• Canada Revenue Agency’s
Scientific Research &
Experimental Development
(SR&ED) Tax Credits
• National Research Council (NRC)
• Science-based Departments &
Agencies: Environment Canada,
Natural Resources Canada (NRCan),
Health Canada
• Genome Canada
Post-secondary research in
universities, colleges and
teaching hospitals
Industry
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NSERC’s Priorities:
Supporting Canada’s S&T Strategy
People
Total budget in 2011-12
$1.07B
30,000 students supported through
scholarships, fellowships and research
funding
Discovery
Support for the research of 12,000
university professors across Canada
Innovation
4,100 research projects involving more
than 1,900 Canadian companies
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Science Policy and Health
1. Accessing and generating the scientific
evidence necessary to support health policy
development and commitments and,
2. Anticipating and addressing impacts of
emerging science and technologies on health
policy, health care delivery and regulation
This presentation will focus on the second facet
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Scientific Risk Assessment Process
Trigger
Endpoint
Consider
Physical,
Biological
&
Chemical
Properties
Risk
Elements
-Exposure
-Fate
-Susceptibility
Broader decision making context –
Lines often blurred between assessing
and managing risk and benefit
Assess
Risks
(Benefits
if
applicable)
Manage
Risks
Decide,
Document
&
Act
Review
&
Adapt
-Hazard
Evidence Base: Access, Conduct, Assess and Share
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Risk Management in Public Policy
Broader Context:
Legal considerations
-Duty of care
-International obligations
Communication/
Consultation
Problem/
Problem/
Hazard Identification
Hazard
- scientific evidence
Identification
- scientific
evidence
assessment
Precautionary
Development of
Policy Options
-cost/benefit
- instrument
choice
Ongoing/Operational
Activities
-research
-surveillance
-policy revision
Decision
-political advice
and input
-Cabinet /Parliament
approval as required
Implementation
and Evaluation
- results of
effectiveness
Approach
Public context
-values &ethics
-policy priorities
-public view of
acceptable risk
Scientific evidence is one of many
considerations in public decision making
Adapted from Risk Management and Canadians
Report of the ADM Working Group on Risk
Management, (PCO), Annex A
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Public Policy Development Simplified
 Frame the problem (s) through analysis (e.g. scientific risk
assessment) and determine its urgency
 Engage responsibility centres and stakeholders
 Clarify roles and responsibilities
 Determine policy goals and commitments related to the issue
 Articulate options, their advantages and disadvantages
 Make evidence-based recommendations
 Instrument choice and target outcomes largely dictate next steps
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Current Issues
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Policy Complexity
Applications resulting from emerging science and technologies will
require government decision making to some degree
Consider:
- Policy implications
across lifecycle
- Multiple potential
sources of exposure
- Multiple pieces of
legislation and
regulatory triggers
1. Extraction
2. Research
3. Manufacturing
4. Market
5. Disposal
6. Transportation (and Storage)
Product lifecycle from “cradle to grave”:
-Known unknowns
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Emerging Technology Key Policy
Questions
 Is it sufficiently different (or complex, or of such a
magnitude) to warrant revising the approach to
coordination, governance and/or regulation?
 Will it promote health such that there is a role to
facilitate its uptake into a sustainable health care
system? Contribute to global health goals?
 Should health science and research priorities be
set for both internal and external research
activities in order to address present and future
knowledge needs?
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Common Policy Approach
Emerging science and technology health policy
development should address:
– Scientific evidence base and skills/capacity
– Legislation/regulation/policy impacts, including
ethical, legal and social perspectives
– Health system innovation and knowledge transfer
– Awareness (Internal and External)
Incremental, build evidence - Collaboration is
essential
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Policy implementation tools






No action
Public communication and awareness
Monetary incentives or disincentives
Acts and Regulations, enforcement
Voluntary Standards and guidelines
Programs
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Key Policy Challenges
How to best engage with scientists? How to reduce/address uncertainty?
- Access information across the evidence chain:
research, data sharing, knowledge
synthesis/translation, options, decisions
- Reporting schemes (mandatory/voluntary)
- Culture of safe, open dialogue on divergent
conclusions, judgements and assumptions, data
gaps, lack of validated methods, pressures
- Precaution on specific products
- Communicating openly in hierarchies
How to achieve regulatory
cooperation?
- Risk assessment methodologies
- Complex product classifications
- Right balance of pre &post market regulation
- Addressing ethical, legal and social issues
How to support consumer choice?
- Labelling?
- Overcoming trade/IP barriers – e.g. confidential - Accessible, balanced information
business information
- Targeted public engagement
- Efficiency in reviews
- Common language/nomenclature
- International and domestic standards
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A Stand-Alone Challenge
The data deluge
Businesses, governments and society are only 1200 exabytes of digital data will be
starting to tap its vast potential
generated this year – 1 exabyte equals 10
billion copies of The Economist
Feb 25th 2010 | The Economist
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Closing Remarks
 Science is global and crosses national borders
 Policy makers around the world face similar
challenges raised by emerging technologies
 Partnerships and collaborative models (domestic and
international) are essential for policy development
and implementation
 Adaptability and flexibility necessary
 Informed decisions require quality, impartial advice
based on best available evidence and rational
analysis
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