Global Health 3.0: CIHR’s Framework for Action on Global Health Research 2021-2026

At the Canadian Institutes of Health Research (CIHR), we know that research has the power to change lives. As Canada’s health research investment agency, we collaborate with partners and researchers to support the discoveries and innovations that improve our health and strengthen our health care system.

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Contents

• Message from CIHR’s President and Scientific Lead for Global Health
• Introduction
• Global Health Research at CIHR
• Impact
• Case Study: Spotlight on Child Health
• Alignment
• Case Study: Spotlight on the United Nations Research Roadmap for the COVID-19 Recovery
• Capacity
• Case Study: Spotlight on Capacity Building
• Contact us

Message from CIHR’s President and Scientific Lead for Global Health

We are very pleased to introduce Global Health 3.0: CIHR’s Framework for Action on Global Health Research, 2021-2026. This Framework is the result of extensive consultation and engagement. We would like to thank the hundreds of researchers, trainees, community leaders, and policymakers who informed the development of this framework and whose continued engagement will ensure its success.

At the Canadian Institutes of Health Research (CIHR), we have always invested in global health. In the Act of Parliament that created the agency in 2000, CIHR was asked to invest in research that would improve the health of people in Canada and around the world. Perhaps 20 years ago the people of Canada and people in the rest of the world were thought to be two separate populations. Events over the last few years, most notably the COVID-19 pandemic, have made it clear to all that our lives are intrinsically and inseparably linked together like never before.

The health threats that we face are increasingly transnational in nature. Environmental disasters know no borders and, as the spread of SARS-CoV-2 reminded us, viruses do not carry passports. Such transnational threats require collective global effort, which means that individual countries like Canada cannot afford to work in isolation. At the same time, we are also increasingly sharing a common vision for the future. The United Nations Sustainable Development Goals are a leading example of driving forward with a shared agenda, which Canada and 192 other countries have committed to achieve by 2030.

Recognizing that the world is changing and, in accordance with its legislated mandate to improve people’s health in Canada and around the world, CIHR has updated its approach to supporting global health research efforts. In the CIHR Strategic Plan 2021-2031: A Vision for a Healthier Future progress on global health research is identified as one of three strategies the organization will undertake to support its Priority D commitment to “Pursue Health Equity through Research.” The publication of this Framework for Action fulfills the related Action Plan for Year 1 commitment to “launch and promote CIHR’s global health research framework.” Together, the CIHR Strategic Plan and this Framework for Action outline directions and actions that seek to ensure a robust and responsive global health research environment; to enable the generation and translation of knowledge so that Canadians and people around the world experience tangible benefits; and to maximize global health equity for all.

Equity is at the centre of our Framework because we believe it is the single most powerful concept for accelerating health improvement around the world. We believe that equity is Canada’s global health opportunity to lead the world, address historical wrongs, and achieve transformative impacts for everyone’s benefit. Everything that CIHR initiates as a result of this Framework will have equity at its core.

This new Framework also recognizes that, given the agency’s comparatively modest resources, CIHR must invest strategically and focus on a few key areas that leverage our country’s strengths and align with Canada’s domestic and international priorities, in order to achieve the greatest impact on health and well-being around the world.

We see this Framework as a valuable contribution to CIHR’s strategic direction and one that positions us for leadership in this field, which is a core part of our mission and intimately tied to our Act. Ultimately, this Framework encourages Canada’s global health researchers to continue to work in concert with their colleagues in every country of the world to achieve the greatest health impacts and equity for all.

Michael J. Strong
MD FRCPC FAAN FCAHS
President

Steven J. Hoffman
JD PhD LLD
Scientific Lead for Global Health

Introduction

As the COVID-19 pandemic has reinforced, the health and well-being of Canadians is intertwined and dependent on the well-being of people everywhere. That is why CIHR has invested in global health research since its inception and why the CIHR Strategic Plan 2021-2031 identifies global health research as a core component of its commitment to pursue health equity through research.

Global Health 3.0: CIHR’s Framework for Action on Global Health Research 2021-2026 is the agency’s commitment to leveraging the power of research to accelerate global health equity for all. The Framework recognizes that CIHR must work globally because today’s most pressing health problems – and many of the most effective strategies to prevent, contain, and address them – are global.

The world shares both common challenges and shared aspirations. As the United Nations (UN) Sustainable Development Goals (SDGs) articulate, transnational threats to health, peace, and prosperity require a collective mobilization of global intellect, ambition, and action.

Approaches to health around the world have not always been rooted in global solidarity, equity, and shared responsibility. Tropical medicine – what some might call “Global Health 1.0” – developed in response to new diseases and harsh conditions experienced by new colonies and focused mainly on epidemic control and the protection of colonial representatives and labour forces.

The international health paradigm that emerged in the 20th century alongside new international organizations including the World Health Organization (WHO) – “Global Health 2.0” – essentially divided our planet into two worlds and focused on how people in high-income countries like Canada can help those in low- and middle-income countries. With this updated Framework for Action on Global Health Research, CIHR articulates and firmly positions itself in a new era – what we are calling “Global Health 3.0” – where health is understood to be an outcome of globally shared risks and responsibilities that require collective action to achieve good health for all.

This Framework is designed to empower the Canadian global health research community to participate in a truly global research enterprise aimed at understanding and acting on health risks, determinants, responsibilities, and solutions that transcend national boundaries.

The research and solutions sparked by the actions outlined in this Framework will prioritize authentic partnerships, reciprocal learning, and transnational cooperation, while focusing on achieving health equity for marginalized populations everywhere.

Global health has come to encompass more complex interactions between individuals, environments, and societies and Canada has an opportunity to learn from scholars, communities, and citizens around the world. With this Framework, CIHR hopes to prioritize the tools, resources, and ethical guidance needed for our research community to make the greatest possible impact. Our new approach also recognizes that, given CIHR’s comparatively modest resources, Canada must focus on areas that leverage our strengths and align with our domestic and international priorities, in order to achieve the greatest impact on health and equity around the world, including in Canada.

CIHR’s Commitment to Global Health

Global Health Research at CIHR

As Canada’s health research funding agency, CIHR supports over 14,000 health researchers and trainees in universities, hospitals, and other research institutions across the country. Since the creation of the agency in 2000, CIHR has supported global health research through the strategic efforts of its Institutes as well as through its open suite of investigator-driven programs.

Global health research focuses in particular on the health of people living in low- and middle-income countries (LMICs) and also on understanding systematic factors that shape health and are inherently global. CIHR considers global health research to include the following areas:

• Globalization

  Explaining patterns of health, health equity and well-being within a global context or as shaped by global economic, social, cultural, environmental or political factors.

• Health Equity

  Improving the health of populations facing conditions of marginalization such as people living in poverty in LMICs and Indigenous Peoples in multiple international settings.

• Neglected Conditions

  Tackling the circumstances, conditions and diseases that disproportionately affect disadvantaged populations who are excluded from markets and society, including biomedical research on these diseases and conditions.

• Transnational Risks

  Addressing health threats, opportunities, determinants or solutions that transcend political boundaries.

Investments in Global Health Research

From 2000 to 2019, CIHR invested almost $460 million in global health research.

This investment has supported 1,167 principal investigators through 1,937 grants.

CIHR's Framework for Action on Global Health Research

It is apparent that today, more than ever before, the health of Canadians is deeply intertwined with the health of people around the world. Responding to this accelerating interdependence and the new global development agenda laid out in the SDGs, CIHR initiated the development of this new Framework for Action on Global Health Research in November 2017. A renewed Framework was needed to clearly reflect CIHR’s approach to global health and Canada’s strategic potential as a leader in global health. Specifically, CIHR aimed to develop a framework that: 1) builds on existing Canadian global health research strengths; 2) aligns with existing domestic and international priorities; and 3) focuses narrowly where Canada’s impact and added value can be the greatest.

This Framework was developed through an extensive consultation process co-led by CIHR and the International Development Research Centre (IDRC), and with the support of the Canadian Coalition for Global Health Research (CCGHR). The aim of these consultations was to better understand the challenges, opportunities, and Canada’s existing strengths in global health research, in order to update our strategic priorities accordingly. Throughout the one-year consultation period, we engaged with key partners across the Government of Canada, numerous Canadian NGOs working in the global health space, and global health researchers from across the country. Altogether, we had the opportunity to hear from over 400 researchers and stakeholders, which we believe represents the most extensive consultation processes ever conducted by a national government to define its global health research priorities.

This Framework, resulting from the consultation process, will guide CIHR’s strategic investments and activities in global health research from 2021–2026. It will encourage the agency to leverage the range of its resources and domestic and international relationships to make meaningful and lasting impacts – with regard to both generating new knowledge and to equitably mobilizing this knowledge for improved health and well-being.

Our Approach

Equity is the overriding theme of this Framework, guiding its purpose, objectives, and intended outcomes. Our hope is that this Framework not only promotes Canadian global health research excellence, but also tangibly contributes to improving the lives of hard-to-reach communities and populations facing conditions of marginalization, whether in low- or high-income countries, and whether in Canada or abroad. Global health research can achieve outsized health gains for people who are too often forgotten or unheard. Our efforts will particularly prioritize the health of girls and women, children and their families, Indigenous Peoples, racialized persons, and the world’s poor.

At CIHR, global health is one of the few topics that equally spans the mandates of all CIHR Institutes and includes researchers and approaches from all four health research pillars (i.e., biomedical, clinical, health systems, and population health). Because of the expansive scope of global health, it is essential that we leverage expertise and resources from across the agency. Honouring our shared responsibility for good health for all will also require CIHR to be continually conscious of the intersecting root causes of inequities, including settler colonialism, racism, classism and ableism and to consider how it can support partners to ensure that the benefits of research are shared by all involved. This Framework outlines our first steps in an ongoing process to identify how CIHR can champion global health research processes, relationships, and projects that challenge inequity and contribute to shared good health.

With that in mind, CIHR’s Framework for Action on Global Health Research was developed to build Canadian research capacity to achieve big IMPACT, foster ALIGNMENT, and strengthen CAPACITY in global health. For impact, our attention will be focused narrowly on three key areas of opportunity that emerged from the national consultation process, where Canada is poised to make the greatest transformative impacts. For alignment, we will proactively create synergies in global health research and policy efforts among Canadian and international stakeholders, particularly by supporting the use of research evidence in global policymaking processes. For capacity, we will support global health research through improved internal processes aimed at enhancing Canada’s global health research environment.

CIHR's Framework for Action on Global Health Research
Global Health Equity

Impact

Goal: Promote transformative im pact in three key areas of global health research

Over the next five years, CIHR will focus its strategic global health commitments on:

1. prevention of non-communicable diseases
2. sex, gender, and health
3. health emergencies

Building on feedback received through discussions with the research community and stakeholders, CIHR has identified three impact areas with great potential for Canadian researchers to make a difference. These are areas where Canada is positioned to capitalize on existing research strengths and leadership and build on federal and international partnerships to spur cutting-edge research and deliver impact.

Impact Area 1: Prevention of Non-communicable Diseases

Advancing the science of prevention to reduce the global burden and inequities of NCDs

What we know

Non-communicable diseases (NCDs) have been steadily increasing and now account for 41 million deaths per year.^{Footnote 1} NCDs affect people of all ages, ethnicities, races, genders, and socioeconomic status, in all regions of the world. However, like most health conditions, NCDs disproportionally affect those who are socially and/or economically marginalized, including Indigenous communities and people living in low- and middle-income countries (LMICs).

Canada is well-positioned to lead in advancing the science of prevention in the global NCD agenda. Alongside research expertise, Canada has already taken a leading role in developing and implementing policies designed to prevent NCDs – including smoking restrictions, alcohol taxes, healthy eating guidance, and incentives for physical activity. Given the uneven distribution of NCDs and the burden of NCDs in low-income countries and under-resourced communities, pursuing this impact area is an important step towards reducing global health inequities.

What we need

There is tremendous potential to change the course of NCDs globally with the right commitments, evidence, and action. In addition to the existing research and policy efforts related to the treatment and care of NCDs, Canada and the world need a significant and sustained focus on NCD prevention. Canada has an opportunity to reduce the burden of NCDs by building on expertise in implementation science and supporting and strengthening research that aims to understand and address the root economic, cultural, environmental, social, legal, and commercial determinants driving NCDs.

Our strategy

CIHR will champion global NCD prevention efforts by supporting research, building capacity, and facilitating the uptake of prevention solutions that improve health equity. In addition to continuing existing funding commitments, CIHR will work with partners to identify additional resources to amply efforts to identify and address the upstream drivers of NCDs.

Key actions

• Amplify leadership and investment in the Global Alliance for Chronic Diseases (GACD)

  Building on past successes with GACD, CIHR will work in partnership with international funders and LMIC research communities to promote and support research and knowledge mobilization on the prevention of NCDs. CIHR will play a key role in the implementation of the organization’s strategic plan and aim to participate in the annual funding calls on NCD prevention in adolescents, young adults and other vulnerable stages across the life course (2021); interventions in urban environments to reduce NCD risk (2022); and integrated management of multimorbidity (2023).

• Build on CIHR’s leadership of the Healthy Life Trajectories Initiative (HeLTI)

  Launched in 2015, HeLTI builds on Canadian expertise to develop a unique set of harmonized, linked international intervention cohorts to understand how environmental factors interact with genes during the earliest years of life to affect our health throughout the lifecycle and across generations. Together with the WHO, teams from China, India, South Africa, and Canada are building a platform that is generating new avenues for prevention research to inform national and international policymaking. Renewal of this collaboration will solidify Canada as a leader in the application of the “developmental origins of health and disease” concept for preventing NCDs.

Impact Area 2: Sex, Gender and Health

Building on the consideration of sex and gender variables towards gender-transformative approaches

What we know

Sex and gender are important variables when it comes to our health, influencing everything from our cells to our societies. More specifically, sex and gender influence our risk of developing certain diseases, our symptoms and the severity of the illness, how well we respond to interventions, how often we seek health care, how the health care system treats us, and what opportunities society offers. For example, too often, women, girls, and transgender people have limited access to health care resources and assets, experience higher rates of sexual- and gender-based violence, and face discriminatory laws and policies that limit their freedom over their bodies and reproductive choices. Similarly, gender norms cast men and boys into roles in ways that shape their interactions with the health care system and can negatively impact their mental and physical well-being and lifespan.

Canada is a leader in the science of sex and gender. Having established a strong cadre of health researchers in this field, Canada is positioned to lead global efforts to further understand the impacts that sex and gender have on health and to develop strategies to reduce the resultant health inequities at home and abroad. Canada has also been a global leader on harnessing gender-transformative approaches, not only through research but also at the policy level through the Government of Canada’s Feminist International Assistance Policy (FIAP). Supported by Global Affairs Canada (GAC), this policy seeks to ensure that by 2021–22, no less than 95% of Canada’s bilateral development assistance initiatives will target or integrate gender equality and the empowerment of women and girls.^{Footnote 2}

What we need

To advance global health equity, we must amplify the integration of sex and gender into global health research and policy. We must also build on the existing foundation of sex- and gender-based analysis by examining how gender-transformative approaches – which actively examine, question, and change the root causes of gender inequity – can improve the way we undertake research, design policies, and deliver health care and social services.

Our strategy

CIHR will take a leadership role in championing, testing, and scaling-up research approaches that challenge harmful sex and gender norms, promote gender equality, and foster health equity for all genders.

Key actions

• Collaborate across government to advance research on sex and gender in global health

  CIHR will collaborate with other parts of the federal government and interested stakeholders to develop strategic approaches to address gendered health inequities.

• Lead the global conversation on the importance of sex- and gender-based analysis and gender-transformative approaches in global health research

  Across its multilateral engagements and at global health fora, CIHR will champion the incorporation of sex- and gender-based analysis and gender-transformative approaches throughout global health research. Building on existing sex- and gender-based analysis tools and expertise, CIHR will take a leadership role in promoting global health research processes and approaches that promote gender equality.

Gender-Responsive Assessment Scale^{Footnote *}

There is a continuum of approaches to research and action on gender and health that range from those that exploit and perpetuate gender inequity, those that accommodate gender inequities but do not address them, and those that address the causes of gender-based health inequities by aiming to transform gender norms, systems and relations. CIHR's Framework for Action on Global Health Research encourages gender transformative approaches whenever possible.

Impact Area 3: Health Emergencies

Leading the global science of health emergency response

What we know

Shocks like infectious disease outbreaks, humanitarian crises, and environmental disasters challenge and stress health systems and communities worldwide. They create conditions that facilitate the spread of disease, increase physiological, psychological, and social stress, and limit access to routine and preventative healthcare and the necessities of life including clean water, food, sanitation, and shelter. The impacts of health emergencies are experienced disproportionately by individuals, communities, and countries experiencing poverty and marginalization. Drawing on expertise and capacity across research institutions, civil society, and government sectors, Canada has repeatedly taken a leadership role in rapidly mobilizing research responses during global health emergencies. By undertaking research in preparation for (and during) health emergencies, Canada has earned a reputation as an international leader in humanitarian response and in reaching out to the most vulnerable populations.

What we need

The health emergencies of the 21st century require strengthened preparedness and new, more nimble research response mechanisms. CIHR will fund research that provides an evidence base for how to build resilient health and social systems and how best to respond before, during, and in the aftermath of crises. Better science on preparing for and responding to health emergencies can ensure that health inequities are reduced during emergencies, rather than exacerbated by them.

Our strategy

CIHR will leverage Canada’s research strengths, established partnerships, and experience in emergency response leadership in order to support rapid research on global health emergency response and engage in knowledge mobilization activities to support evidence-informed policies and practices to emerging crises.

Key actions

• Build Canadian expertise in preparedness and response research

  CIHR can play an important national and international leadership and coordination role in times of health emergencies. In keeping with the CIHR Strategic Plan 2021-2031 commitment to enhance rapid response capacity, CIHR will work with partners to enable rapid and evidence-informed responses to emerging health threats and explore the creation of a Centre for Research on Pandemic Preparedness and Health Emergencies.

• Improve responsiveness of health emergency research funding

  To capitalize on the value of rapid research opportunities and to enable research that can guide improvements in global health emergency responses, CIHR will work with partners to develop and implement a mechanism to release funds more quickly from its Emerging Health Threats Research Fund during emergency situations.

• Enable research partnerships for improved global health emergency response

  CIHR will work with national and international partners, including civil society organizations, to enable research partnerships, strengthen cross-pillar and inter-sectoral ties, support the development of authentic global partnerships, and facilitate the integration of research and tacit knowledge.

Case Study: Spotlight on Child Health

Canadian global health research excellence should tangibly contribute to improving the lives of populations facing conditions of marginalization – communities that are too often left behind, forgotten, and unheard. One such group is children.

Children and their families are disproportionately affected by poverty, conflict, and health emergencies, and the unique biological and psychosocial needs of parents, newborns, infants, and children are oftentimes overlooked or excluded from health research and from the development and roll-out of health interventions. While significant improvements have been made in reducing child deaths since 1990, more than 15,000 children under the age of five still die every day, most due to conditions that could be prevented by simple, affordable interventions.^{Footnote 3} Research across all three Impact areas identified in this Framework can improve the health and well-being of children and families around the world.

Impact Area 1: Prevention of Non-communicable Diseases

Although most NCD-related mortality occurs in adulthood, the impacts of NCDs such as respiratory diseases, diabetes, mental illness, and childhood cancer can begin early in life, with the resulting morbidity causing long-term disability and premature death. The impacts are greater in resource-poor settings where environmental exposures can be higher and there is limited access to treatment, as well as in response to global trends such as rapid urbanization. Prevention of NCDs needs to start in the earliest years of life, as exposure to environmental risk factors such as pollution, alcohol, tobacco and toxic stress interacts with genes during fetal development, infancy and childhood, profoundly impacting the development of NCDs into adulthood and across generations. As such, it is imperative that research on the prevention of NCDs addresses the needs of children and their families.

Impact Area 2: Sex, Gender and Health

From even before conception, the survival and health of infants, children, and adolescents is shaped by gender inequities. Beliefs about the role and value of women and men impact a range of maternal and child health outcomes including access to sexual, reproductive, prenatal and neonatal care, distribution of food within a household, and experiences of violence. Internationally, gender transformative approaches to the health of women and families demonstrate that involving men as active participants in addressing gender inequality improves the health and well-being for everyone.^{Footnote 4} Research to further understand how gender, kinship structures, and family-focused policies impact child development and health is a key part of an equity focused research agenda.

Impact Area 3: Health Emergencies

The social disruption, human displacement, and stress on health care systems resulting from health emergencies disproportionately affect women, infants, and children. In addition to increased exposure to infectious disease, environmental and humanitarian crises put children and their families at heightened risk of malnutrition, sepsis, trauma, violence and maternal and neonatal complications. Women and children are up to 14 times more likely to die than men in disaster circumstances.^{Footnote 5} The science of preparing for, responding to, and recovering from health emergencies must address the unique needs of children and their families.

Research on the health and well-being of children and their families is an example of how the activities and opportunities outlined in CIHR’s Framework for Action on Global Health Research can improve the lives of populations facing conditions of marginalization. Addressing the unique needs of various populations will make important contributions to achieving a number of SDGs related to children and their families, including the reduction of newborn and under-five mortality in every country.

Alignment

Goal: Strengthen the alignment of global health research and policy across Canadian and international partners

What we know

Canada’s position as a middle power in international affairs and its influence in global health is strengthened by its significant multilateral engagement (e.g., G7, G20, WHO, APEC, OAS, Commonwealth, la Francophonie) and leadership in large international research initiatives (e.g., GACD, GloPID-R, EU Joint Programming Initiatives, Human Frontier Science Program). These partnerships amplify Canada’s influence and strengthen the alignment of Canada’s global health policies and investments with global development priorities. Additionally, engagement in international fora exposes Canadian scientists and decision-makers to innovative solutions being developed around the world.

That being said, there remains too much fragmentation across global health institutions, policies, and priorities, both domestically and internationally. This fragmentation limits Canadian researchers’ ability to make substantial and strategic contributions towards global health and well-being. As an example, the funding landscape for global health research in Canada includes a number of actors that successfully work together on ad hoc projects and initiatives, but rarely align their long-term strategic efforts. Similarly, while most organizations strive to develop programs and policies based on solid research evidence, there remain significant gaps in the uptake of such evidence at local, national, and international levels.

There is an opportunity with the global commitment to the SDGs and a just recovery from COVID-19 to focus on collective goals (rather than individual objectives), and to collaborate with domestic and international partners to make measurable and lasting progress towards health equity.

What we need

The SDGs call for all countries to work together in a global partnership to eradicate poverty in all its forms, protect the planet, and improve health. These commitments apply to health research as much as any other sector and challenge us to be more coordinated and deliberate about our collaborations. Meeting the SDGs and embracing a Global Health 3.0 approach to improve health for the least well-off everywhere will require us to work with partners around the world to drive mutual benefits from global research and innovation. For Canadian global health research, we need a more organized and well-connected ecosystem that facilitates our responsiveness to the evolving needs and opportunities of the 21st century and prepares us to translate global lessons to the Canadian context.

Our strategy

Acting on the CIHR Strategic Plan 2021-2031 commitment to enhance national and international collaborations, CIHR is committed fostering a more coherent and connected global health research ecosystem. To accomplish this second goal, CIHR will convene key domestic partners and establish mechanisms to improve coherence of Canadian global health research activities; promote and support evidence-informed decision-making in global health; and cultivate international strategic alliances and collaborations.

Objective 1 – Coherence in Research

Addressing the shared risks and responsibilities that shape global health requires inter-sectoral and inter-jurisdictional action. Through greater alignment, we can better link Canada’s research, policy, and programmatic contributions to global health needs; build larger and more strategic research programs; and ensure that there are no critical gaps in the funding landscape for Canadian researchers and their partners.

Key actions

• Establish mechanisms to enhance engagement and alignment among federal government partners involved in global health

  Improving alignment requires creating structured opportunities for increased interactions between Canadian actors in global health. To strengthen coordination and improve regular and strategic engagement with GAC, IDRC, Health Canada and the Public Health Agency of Canada (PHAC), CIHR has spearheaded the creation of an Interdepartmental Steering Committee on Global Health. A newly established Scientific Advisory Committee on Global Health includes a range of global health researchers who provide federal government departments with evidence-informed advice on pressing global health challenges. These and other mechanisms involving sectors such as civil society organizations will aim to improve harmonization among global health researchers, policymakers and implementers and ensure that those with the greatest need benefit the most from research activities.

• Collaborate with Canadian partners to develop and support global health research activities

  Successes such as the Innovating for Maternal and Child Health in Africa Initiative, jointly funded by CIHR, GAC, and IDRC, as well as important partnerships with Grand Challenges Canada, have demonstrated that the collaboration of Canadian partners provides benefits for researchers, communities, and policymakers alike. CIHR will build on this experience and work with Canadian partners to build complementary activities related to the three impact areas identified under Goal 1. CIHR commits to engaging diverse Canadian stakeholders, including civil society organizations such as the Canadian Coalition for Global Health Research and the Canadian Partnership for Women and Children’s Health, in the development of its global health activities and working with stakeholders to address shared priorities.

• Develop a comprehensive CIHR-IDRC partnership with a set of complementary activities and efforts

  CIHR will work with IDRC to develop a comprehensive partnership that is anchored in the concepts of Global Health 3.0 and leverages the unique and complementary mandates of the two organizations. The partnership will improve communication between the organizations, allow for synergistic approaches to shared research and policy priorities, and strengthen ties for collaboration in specific research areas.

Objective 2 – Evidence-informed Decision-making

Part of CIHR’s mandate is to advance knowledge mobilization in order to improve health and strengthen health systems. Canada has an opportunity to strengthen the alignment of global health research with the needs of health professionals, program leaders, policymakers, and populations facing conditions of marginalization to ensure that research evidence is available to those who can act upon it. Robust knowledge mobilization mechanisms will also generate opportunities to leverage international evidence to improve health equity in Canada.

Key actions

• CIHR will work with Canadian and international partners to foster collaboration between researchers and policymakers and the communities they serve

  Through mechanisms such as Best Brains Exchanges and engagement at relevant policy discussions, CIHR will champion the role of science in global health policymaking and work with partners to bring researchers and decision-makers together around key issues in global health.

• CIHR will champion implementation science in global health

  CIHR will promote, invest, and build capacity in implementation science through its global health research activities and encourage other research funders to do the same. Implementation science is the science of ensuring that people and communities get the right resources, programs, and treatments, in the right away, at the right time. Central to implementation science is the study of scaling up proven interventions in different economic, social, political, and clinical contexts, to understand whether those interventions are still effective, for whom they are effective, and why.

• CIHR will contribute scientific and research policy expertise to guide international policies related to global health

  CIHR is committed to harnessing Canada’s scientific expertise and its own experience with funding research to play a meaningful role in the efforts of multilateral organizations tasked with addressing global health issues. We will prioritize policy discussions at the World Health Organization (including the International Agency for Research on Cancer), G7, and G20, and around issues linked to the three impact areas identified under Goal 1.

Objective 3 – International Collaborations

CIHR is working to strengthen partnerships and alignment internationally so that Canada's efforts are part of a truly global research enterprise. In 2020, CIHR led the development of the United Nations Research Roadmap for the COVID-19 Recovery and is committed to mobilizing the global research community in support of SDGs and a more equitable, resilient and sustainable future.

Key actions

• CIHR will continue to provide leadership in international research funders consortia

  Numerous international partnerships, such as the Global Research Collaboration for Infectious Disease Preparedness (GloPID-R) and ESSENCE on Health Research, are focused on coordinating research investments, harmonizing and sharing data, and developing collective capacity building activities. These strategic alliances provide opportunities for Canada to take on meaningful leadership roles, contribute and build Canadian expertise, and promote best practices among funders of global health research for greater collective impact.

• Champion greater LMIC and Indigenous Peoples participation in international research consortia

  In alignment with our commitment to equity, CIHR will advocate for greater participation of LMIC and Indigenous researchers and representatives in international research initiatives. This increased participation will ensure that a greater diversity of expertise and experience is guiding global health research initiatives and that the world can benefit from wider breadth of knowledge, approaches, and practices.

• CIHR will develop funding partnerships with international organizations to advance global health research and ethics

  To enable Canadian researchers to collaborate with colleagues and stakeholders around the world on global health issues, CIHR will strengthen existing multilateral collaborations and support the participation of Canadian researchers in global health research partnerships.

Case Study: Spotlight on the United Nations Research Roadmap for the COVID-19 Recovery

CIHR’s leadership in developing and mobilizing implementation of the UN Research Roadmap embodies its commitment to leveraging the power of research to accelerate global health equity for all.

In June 2020, the United Nations (UN) Deputy Secretary-General Amina J Mohammed invited Dr. Steven J. Hoffman, CIHR’s Scientific Lead for Global Health, to lead a 10-week participatory process among researchers, research funders, government policymakers, civil society leaders and UN officials from around the world to identify research priorities for a better socio-economic recovery from COVID-19 and continued progress towards the Sustainable Development Goals (SDGs). This initiative aimed to ensure that the COVID-19 recovery could be informed by the best available research and that early lessons from the response could inform later recovery decisions. To deliver, CIHR commissioned five rapid scoping reviews, convened five steering groups involving 38 research funding agencies, and coordinated a series of formal and informal consultations. More than 270 individuals and organizations participated.

The resulting UN Research Roadmap for the COVID-19 Recovery was released in November 2020. The Roadmap outlines 25 research priorities, all focused on how COVID-19 socio-economic recovery efforts can be purposefully designed to stimulate equity, resilience, sustainability and progress towards the SDGs. The Roadmap also provides an overview of five key science strategies and actions that must be taken to implement them. After its publication, CIHR worked with the UN and other partners to mobilize new partnerships and strategic funding opportunities focused on the Roadmap’s priorities. For example, on January 29, 2021, CIHR and the UN Office for Partnerships co-hosted an open dialogue between the UN Deputy Secretary-General and the heads of international research funding agencies on how science can support development in the context of COVID-19.

CIHR’s Framework for Action, in action

Supporting the development of the UN Research Roadmap for the COVID-19 Recovery is a clear demonstration of CIHR’s commitments to Impact, Alignment and Capacity.

Impact

The UN Research Roadmap not only represents a clear contribution to advancing the science of global health emergency response, it also highlights the points of intersection among the three impact areas identified in this Framework for Action. For example, a clear theme of the UN Research Roadmap is the importance of ensuring intersectional research focused on health and gender equity and the importance of building resilient systems that continue to support chronic disease prevention even during acute crises.

Alignment

The UN Research Roadmap is a demonstration of CIHR’s intention to help bring coherence to national and international global health research investments. The development of the Roadmap benefited from support and engagement from across the Government of Canada and the rapid but wide-reaching process to develop the Roadmap included leaders from all continents and income economies. Particular attention was paid to including implementers and voices from marginalized communities to ensure the research agenda reflected the needs of communities and decision-makers from around the world.

Capacity

The UN Research Roadmap showcases how CIHR can work together to mobilize Canadian health research expertise in service of global health equity. Led by CIHR’s Institute of Population & Public Health, this initiative was supported by CIHR’s Strategic Partnerships & International Relations and Communications teams. The effort further benefitted from rapid mobilization of scholars and alumni of CIHR’s Health Systems Impact Fellowship program led by CIHR’s Institute of Health Services & Policy Research with nine other CIHR Institutes.

Capacity

Goal: Grow global health research capacity and excellence using CIHR’s full range of levers

What we know

Canadian global health researchers and trainees have been successful in CIHR funding competitions through programs that support all fields of health research, as well as through strategic initiatives launched by CIHR’s Institutes. However, we also heard from Canadian global health researchers that they experience unique barriers to securing funding, such as an inconsistent awareness among peer reviewers that global health research falls squarely within CIHR’s mandate and – as with other fields of health research – that there are challenging periods of transition from trainee to independent investigator and again at the midcareer stage. Global health research also requires unique skills, cultural competencies, and approaches to ensure that research is conducted in an ethical and equitable manner. Yet these best practices in ethical global health research are inconsistently applied across the research community.

There is an opportunity to continue building on the significant contributions of Canadian global health researchers, to foster research and ethics excellence, and to ensure that the research funding system in Canada is attuned to the unique nature of global health research – including to what “research excellence” means in this context.

What we need

It is essential for Canada’s research funding ecosystem to value and support a broad range of global health research and talent so that Canadian researchers can contribute to the global health challenges of today and respond to evolving and emerging issues. Global health research excellence will require CIHR to not only foster research talent but also build systems that reward authentic relationships and value collaborative interdisciplinary research. It is also necessary to promote the reach and impact of global health in order to ensure that it remains a highly attractive and viable field of research for new investigators to pursue in Canada.

Our strategy

CIHR’s commitment to support scientifically and ethically sound research that prioritizes authentic partnerships is at the heart of this Framework’s focus on capacity. In this regard, CIHR recognizes the need to ensure that Canadian researchers and trainees have training, support, and opportunities to conduct excellent global health research; support the integration of excellent global health research and opportunities across all CIHR Institutes and pillars; and unify internal CIHR efforts to make Canadian global health research more visible.

Overall, CIHR is committed to using its full range of levers to champion global health research excellence and improve health for all.

Objective 1 – Increase Capacity

CIHR will leverage existing resources and talent to ensure that global health researchers and trainees are fully supported in their efforts to address health challenges and responsibilities, and will ensure the full consideration of equity, inclusion, diversity, and authentic partnerships in all funded research.

CCGHR Principles for Global Health Research^{Footnote **}

Key actions

• Formally adopt the Canadian Coalition for Global Health Research (CCGHR) Principles for Global Health Research and support their use in global health research

  The CCGHR Principles provide an equity-centered framework and invite researchers to question their assumptions and roles in the global health research process. To foster a culture of excellence, CIHR formally adopts the CCGHR Principles framework as a best practice in conducting global health research and will implement mechanisms to ensure that they are followed by researchers where relevant and appropriate.

• Support Canadian researchers to develop authentic partnerships

  Authentic partnerships require the intentions and actions of global health researchers to be aligned around equitable relationships, processes, and outcomes. Building these types of partnerships requires open dialogue with local partners about the ethical considerations and impacts of research. CIHR will enable Canadian global health researchers, especially early career investigators, to develop and implement authentic partnerships through the creation and maintenance of trust-based relationships with partners.

• Ensure that global health research is recognized across CIHR’s open and strategic funding competitions

  Adopting a truly global approach to health is fundamental to CIHR’s Framework for Action on Global Health Research. We will work to ensure that funding opportunities and peer review processes for investigator-driven and strategic grant programs fully recognize the scope of global health and its relevance and importance to CIHR’s legislated mandate.

• Create a path and provide resources to increase capacity in key areas of Canadian global health research

  We will leverage CIHR’s strategic action plans for training and early career investigators to ensure that these plans consider and benefit Canada’s global health research community. We will additionally undertake targeted efforts to support emerging global health research leaders in the three impact areas identified under Goal 1.

Objective 2 – Integrate Global Health Research Across CIHR

The breadth of the SDGs and extent of global health disparities create an opportunity and need for all CIHR Institutes and initiatives to make important, strategic contributions to global health research. While a number of CIHR Institutes and initiatives are already making substantial contributions to global health, CIHR will encourage and support the engagement of all Institutes and branches in global health research.

Key actions

• Support all CIHR Institutes and branches to engage in global health research

  CIHR Institutes and branches will be supported in identifying strategies to support global health research opportunities. Resources will be available for Institutes and branches to identify and develop global health research funding opportunities and incorporate a global health and equity lens throughout their initiatives and activities.

• CIHR Institutes will support global health research in their activities and incorporate global health into their Institute strategic plans

  In order to maximize collective impact, all Institutes will contribute to global health research in important ways that are relevant to their mandate areas and strategic plans. Engagement by all Institutes in global health research will leverage their expertise, capabilities, and networks, and will strengthen the breadth and depth of the Canadian global health research community.

Objective 3 – Enhance Communication

Strengthening capacity includes recognizing the plethora of excellent global health research projects being conducted by researchers based in Canada and the positive impacts they are achieving on the health and well-being of people everywhere. CIHR is committed to enhancing communication efforts in order to showcase the importance of global health research at CIHR, celebrate the impact of Canadian global health researchers, and inspire the next generation.

Key actions

• Leverage CIHR’s communication resources to promote the field of global health research

  CIHR has a variety of tools and mechanisms to communicate with our stakeholders and the Canadian public. These resources will be leveraged to enhance regular communications on global health research and publicly recognize the impacts of our funded researchers and their partners.

• Develop an annual CIHR update on global health research

  To showcase the contributions and impact of Canadian global health researchers, an annual update on global health research will be produced and shared with the research community, partners, and the public. The update will demonstrate the breadth of funding and activities supported through CIHR’s open programs and across all Institutes’ initiatives, with a special focus on the Framework goals. The update will be guided by a performance measurement plan and enable the tracking of progress against this Framework.

Case Study: Spotlight on Capacity Building

CIHR is committed to training the next generation of health researchers and ensuring that the Canadian health research community has the skills r equired to be national and international leaders.

In line with this commitment and CIHR’s strategies on training and early career investigators, this Framework includes a number of actions and opportunities designed to strengthen Canadian capacity for global health research.

Global health research is unique in a number of ways from other areas of science. In order for global health research to have an impact, researchers must not only have strong research skills, but also be talented relationship-builders, authentic partners, and have access to decision-making fora that are receptive and empowered to understand and act on research evidence. CIHR’s Framework for Action on Global Health Research recognizes and celebrates these unique features and aims to support researchers to develop and hone all of the required skills for excellence in global health research and knowledge mobilization. This will be done through actions as describe d in this Framework.

• Embedding capacity-building objectives and resources into all global health research funding opportunities
• Developing cross-government structures to facilitate strong connections between researchers a nd poli cymakers and facilitate evidence-informed decision-making
• Contributing to the development and implementation of tools to build capacity for implementation science in glo bal health
• Providing support for the development of authentic research partnerships
• Formally adopting and supporting the uptake of the CCGHR’s Principles for Global Health Research, which espouse a powerful ethical and equity-centered approach to research
• Hosting Best Brains Exchanges to enhance the capacity for dialogue and shared learning among global health researchers and policymakers
• Developing capacity-strengthening opportunities related to new areas of research such as rapid responses during health emergencies

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Date modified:

2021-05-31