1 Science and Policy in Health: A feedback loop process February 2012 Pierre J Charest, Ph.D. Acting Executive Vice President 2 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 3 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 4 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 5 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 6 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 7 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 8 Current Issues 9 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 10 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? 11 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 12 Policy implementation tools No action Public communication and awareness Monetary incentives or disincentives Acts and Regulations, enforcement Voluntary Standards and guidelines Programs 13 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 14 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 15 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 16