Expert Review Team Report for Institute of Infection and Immunity

Submitted by: Professor Deborah Smith
Chair, Expert Review Team
February 2011

Table of contents


Report Headlines

Overall impression of the Canadian research landscape in this area:

III has been transformative in a number of areas:

III pillars 3 and 4 have generated positive and productive outcomes:

III has achieved its mandate in part:

Overall impression:

To note: The Expert Review Teams (ERT) for the 2011 CIHR International Review were asked to provide an objective assessment of the effectiveness by which the institutes are fulfilling their mandate. The ERT for III found this to be a challenging brief, given the relative brevity of and lack of depth in the Internal Assessment Report, together with the limited supplementary information provided in advance (lists of grants and key publications with appropriate attributions) that were not transparently linked to III output. We advocate generation of standard metrics that would allow robust assessment of III's contribution to advancing knowledge, building capacity and achieving impact within their target areas of activity. Our face-to-face discussions on the day of the review were open, interactive and informative, allowing us to gain considerable insight into the operations and achievements of the III under its Scientific Director.

Section 1 – Institute mandate

Created in 2000 as one of the 13 institutes of the Canadian Institutes of Health Research (CIHR), the Institute of Infection and Immunity has a mandate to support research to enhance immune-mediated health and to reduce the burden of infectious disease, immune-mediated disease and allergy through prevention strategies, screening, diagnosis, treatment, support systems and palliation. The III mandate transcends disciplines and encompasses all four health research themes: biomedical; clinical; health systems and services; and social, cultural and environmental factors that affect the health of populations. III's mission is to establish national leadership, priorities and programs to reduce the global burden of infection and immune-based diseases.

CIHR Institute of Infection and Immunity – Internal Assessment for 2011 International Review, pg 1

Section 2 - Status of this area of research in Canada

Infection and immunity research in Canada covers a range of activities that span from the highest internationally-ranked science to areas of national priority, incorporating the four prioritised themes (or pillars): biomedical, clinical, health systems and health services, health of populations, societal and cultural dimensions. The III operates within this arena, drawing extensive additional strategic funding (HIV/AIDS, Pandemic Preparedness etc) on top of its core budget, with III-affiliated researchers also securing extensive funds from the Open Operating Grant Program.

The HIV/AIDS Research Initiative has a large budget ($22.5M/year but leveraging substantial additional support externally e.g. Bill and Melinda Gates Foundation funding) and its own governance. It funds in all 4 pillars with substantial research at the leading edge internationally. Highlights include the identification of a T cell–specific HIV reservoir critical in viral persistence (pillar 1), the launch of a Canadian HIV Vaccine initiative and a Canadian HIV Trials Network (pillar 2) and the development of dual streams of community-based research (CBR) in the general and aboriginal populations, perhaps most notably studying the relationship between housing status, housing stability, health outcomes for people living with AIDS (pillars 3 and 4).

High profile public health threats such as SARS and H1N1 have increased the visibility and public awareness of III. For SARS, the leadership and rapid response of the III teams was universally admired, with subsequent establishment of the Canadian Rapid Research Response Team, a framework for rapid vaccine clinical trials, and the development of new guidelines and practices for international roll-out.

Other areas of III strength include developing activity in antibiotic resistance, including partnership working internally and externally (with the UK Medical Research Council joint funding initiative), as evidenced by increased publications/citations. Newer initiatives include world-leading microbiome studies and vaccine research while the immunity balance will be maintained and strengthened by new research planned in the areas of transplantation and inflammation.

Overall impression of the Canadian research landscape in this area

Section 3 - Transformative Impacts of the Institute

Overall impression – to what extent has this Institute been transformative?

III has been transformative in a number of areas:

Section 4 - Outcomes

Overall impression – to what extent has this Institute been successful in achieving outcomes?

Section 5 - Achieving the Institute mandate

Overall, the III is respectful of and responsive to its mandate. It supports research across the breadth of infection and immunity and determines strategic priorities through broad discussion and consolidation across its full range of stakeholders. The Scientific Director is the ultimate arbitrator of funding decisions, backed by the Institute Advisory Board and external review. It is unclear as to the relative contributions of each of these or whether decisions can be appealed. Are views of other stakeholders equally valued?

The III works across all four health research pillars and is highly effective in this activity in some areas; in others, there is less obvious synergy between pillars 1 and 2 and pillars 3 and 4. This is a challenge to be addressed.

Other limitations:

Overall impression – to what extent has this Institute achieved its mandate?

Section 6 - ERT Observations & Recommendations

Overall impression of the performance of this Institute


Appendix 1 - Expert Review Team

Chair - Professor Deborah Smith
Professor of Molecular Parasitology
Centre for Immunology and Infection, University of York
Chair, MRC Infections and Immunity Research Board, UK

Expert Reviewer – Professor Hidde Ploegh
Professor, MIT Department of Biology
Whitehead Institute for Biomedical Research
Cambridge, MA USA

International Review Panel – Professor Rudi Balling
Director - Luxembourg Centre for Systems Biomedicine
University of Luxembourg

Appendix 2 - Key Informants

Session 1 – Review of Institute

  1. Dr. Marc Ouellette, III Scientific Director
  2. Dr. Chris Power, Chair – Institute Advisory Board
    Professor, Departments of Medicine and Medical Microbiology & Immunology
    University of Alberta
  3. Dr. Katherine Siminovitch
    Head, Division of Genomic Medicine
    Toronto General Research Institute
    Senior Investigator, Samuel Lunenfeld Research Institute
    Mount Sinai Hospital
  4. Dr. Martin Schechter
    Professor, School of Population and Public Health
    University of British Colombia

Session 2 – Consultation with researchers

  1. Dr. Keith Fowke
    Associate Professor, Department of Medical Microbiology
    University of Manitoba
  2. Dr. Sean B. Rourke
    Assistant Professor, Department of Psychiatry
    University of Toronto
    Scientific and Executive Director
    Ontario HIV Treatment Network
  3. Dr. Michel Bergeron
    Director, Division of Microbiology and Le Centre de Recherche en Infectiologie
    Université Laval

Session 3 – Roundtable with stakeholders

  1. Dr. Mike Mulvey
    Chief, Antimicrobial Resistance and Nosocomial Infections
    National Microbiology Laboratory
    Public Health Agency of Canada
  2. Dr. Chris Archibald
    Director, Surveillance and Risk Assessment Division
    Public Health Agency of Canada
  3. Dr. Arlene King
    Chief Medical Officer of Health
    Ontario Ministry of Health and Long Term Care
  4. Dr. Neil Cashman
    Scientific Director
    PrioNet Canada
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