Canada is Losing its Best Minds and Our Patients are Paying the Price

Dr. Sheila Singh
By: Sofia Robinson, Research Assistant and Pam Damoff, CEO The Pearson Centre

Dr. Sheila Singh has spent her career trying to cure brain cancer. A professor at McMaster University, Canada’s leading university in healthcare and medicine, and serving Director of several cancer research groups, Dr. Singh is exactly the kind of scientist Canada should be fighting to keep. A recent CTV article highlights just one of her lab’s accomplishments: Brain cancer breakthrough at McMaster University.

But Dr. Singh is planning to leave Canada, and not for warmer weather, but for the chance to actually save lives. This should be alarming for Canadians because Singh’s plans are just one example of a much deeper problem that the Canadian healthcare space is facing: risk aversion.

The specific issue Dr. Singh is facing is one that is rarely discussed in Canadian political circles. In the United Kingdom and many other nations including the United States, when a patient has exhausted all approved treatments available, that patient can access drugs in late-stage research and trial phases. It is not a guarantee of a cure, but rather a last chance that patients may opt-in to taking. In the US, this system is formalized under the “Right to Try” law. In Canada, however, that legal entitlement does not exist. “Currently, Canadians don’t have the right to use drugs that Health Canada has not approved. This means that even the seriously and terminally ill whose lives could be saved by using new, experimental drugs may have to wait for them to be approved for public use.” Canada does have a “Special Access Program” through which practitioners can submit a form to request access to experimental drugs. However, this is by no means a guarantee, and manufacturers are permitted to refuse the request. It also doesn’t address the issues researchers like Dr. Singh are facing here in Canada.

The justifications for these limitations are not without merit. Safety and liability issues, as well as upholding the integrity of the clinical trial process are all important considerations. However, in practice, this risk management ethic has fostered a pattern of avoidance, which has negative consequences for patients, the Canadians we are supposed to be protecting.

Besides the obvious consequences for patients who are not able to receive potentially lifesaving treatments, this risk aversion also means Canadian researchers struggle to translate their research into drugs. They can research, develop promising ideas, and trial new drugs, but then cannot give patients the chance to try them. For many, like Singh, this translation from laboratory to real life is the reason they pursued healthcare research to begin with. As a consequence, Canadian researchers look abroad to countries that allow compassionate access. Canada has the high caliber research institutions, resources, and educational systems in place to produce world class innovation and medical breakthroughs, but not the policies to allow them to happen in practice.

This risk aversion is not confined to drug approval alone. Another problem which is just as damaging is that we are also poor at commercializing our own science. Getting a promising discovery into a phase 0 or first-in-human trial requires expertise, dedicated infrastructure, and a willingness to take calculated risks in early stage ideas. All three of these are in short supply in Canada. We talk about “translation” and “precision oncology” as though we are leaders in these fields, but the reality is that we commit few dedicated resources or shared infrastructure to the scientists working to make them real. As Dr. Singh points out, too often we are not setting the pace, but following it, as our American, European, and Chinese counterparts commercialize their science.

There is another dimension to Canada losing our most talented minds. We are spending significant sums of money recruiting American researchers to cross the border and set up their labs and research here. This is not an inherently bad idea, because international talent and knowledge is a valuable investment. However, it is a curious choice when we are also fostering a research system that pushes our own researchers away. We are spending our money on recruiting in, rather than retaining the researchers we have already trained. If Canada is serious about becoming stronger, more independent, and less reliant on our neighbours, we need to be focusing on retaining Canadian researchers like Dr. Singh.

This issue is part of a broader conversation about what place Canada is going to have in the world in the coming years, especially in light of shifting geopolitics. Many Canadians are worried about the seeming erosion of our middle power status, and about how many young Canadians seem to be moving abroad to build their careers. Canadians are right to be proud of a healthcare system built on the principle that access should not depend on one’s ability to pay. However, we cannot allow this to prevent us from being bold. A healthcare system that prevents a terminal patient from trying an experimental therapy is not protecting that patient, and a research environment that drives its best scientists away is not protecting the integrity of science. It is protecting administrators and the liability of institutions, at the expense of people.

Dr. Sheila Singh should not have to move to the United Kingdom to do her life’s work. Canada built the conditions to produce world-class scientists like Dr. Singh. It just hasn’t figured out that the job doesn’t end there.

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