Cyril B. Frank, M.D., FRCSC
Scientific Director, The Institute of Musculoskeletal Health & Arthritis
Canadian Institutes of Health Research (CIHR)
Calgary, AB

Since my last report to readers of the COA Bulletin, I am pleased to say that the Institute of Musculoskeletal Health and Arthritis (IMHA) has made considerable progress.  

Institute Advisory Board Members - Institute of Musculoskeletal Health and Arthritis Left to Right Top *Marie-Eve Hudon, Carol Richards, Ilona Skerjanc, Jane Aubin, Denis Morrice, Robin Poole, Joan McGowan, Elizabeth Badley, John Dossetor, Henri Menard, Jim Lund, *Mary Ann Linseman Left to Right Bottom Melody Denecky, Loretta Wong, Flora Dell, Doris Ward, Juliette Cooper, Cy Frank, Helene Plante, Ed Biden, *Elizabeth Robson *CIHR Staff

To achieve that mandate, 13 "virtual" institutes were created each with an independent focus but a common goal, to bring together representatives of the research community, provincial government agencies, international research organizations, health professions, policy-makers, industry, patients and partners. Their goal? - To shape a national health research agenda, and to help CIHR become the best health research agency in the world.

The Institute of Musculoskeletal Health and Arthritis (IMHA) is one of the 13 institutes working to help CIHR achieve its goal. Unlike most Institutes, IMHA is comprised of six equally important focus areas - Arthritis, Bone, Skin, Muscle, Rehabilitation and Oral Health. Our vision is to eradicate pain, suffering and disability and to enhance the quality of life for people affected by arthritis, musculoskeletal, dental and skin conditions.

Over the next two decades, the prevalence of many chronic diseases and conditions is going to increase, consuming a far greater proportion of Canada's health care resources. Chronic pain, loss of mobility and function, and loss of independence are common outcomes of a host of musculoskeletal and connective tissue conditions from arthritis, systemic rheumatic diseases, osteoporosis and metabolic bone disorders to periodontal disease, fractures and soft-tissue injuries. We know that the incidence of IMHA-related conditions is increasing, and that governments and taxpayers are beginning to realize the impact of these kinds of diseases on their health agendas, systems, services and budgets.

In furthering the interests of all of our foci, our Advisory Board has been working on a road map for the future - a Strategic Plan that will help us develop a national health research strategy on a national and international level. As we move from establishing our roles to the more complex task of developing and implementing our Plan, we are clearly breaking new ground. In so doing, however, we hope to create the kind of Plan that will serve as a framework and an important meeting ground for those interested in our core focus areas.

One of the ways we are working to establish this meeting ground is by creating a database that will include all IMHA researchers, as well as stakeholders and constituents who wish to identify with our Institute. We hope that this database will not only provide us with valuable information on our key stakeholders, but will also serve as an important communications tool establishing an ongoing flow of information between IMHA and its key audiences. In the near future, we will be posting both our Strategic Plan and our database on our web site. We hope that you will take a minute to visit us at www.cihr.ca to review each of these documents and provide your input.

As we put the final touches on both our Strategic Plan and our database, you will be encouraged to know that we haven't lost our momentum. For CIHR and IMHA, capacity building continues to be a primary concern. In Canada alone, we anticipate that 100,000 new researchers and scientists will be required by 2010. The future of our health care system demands that we build and strengthen this next generation of health researchers.

To this end, in July 2001, we launched the Strategic Training Programme to support the development of innovative, effective and competitive research training programmes - IMHA is currently contributing to ten of these training centres across the country. We recently announced the results of that competition and would like to take this opportunity to congratulate two of our successful applicants in the field of musculoskeletal research - Dr. Ron Zernicke, Calgary and Dr. Hubert Labelle, Montreal.

As you know, musculoskeletal conditions are complex diseases influenced by genetics, gender, environment, occupation and lifestyle. Yet, throughout Canada and around the world, there is a dire shortage of highly qualified clinician-scientists. Dr. Zernicke's integrated research and training efforts will seek to establish a premier graduate education and research programme for clinician scientists focusing on primary and secondary osteoarthritis.

Mobility and postural problems such as arthritis, limb and spinal deformities, and neuro-muscular problems have a significant impact on the quality of life of a large proportion of Canadians. The objective of the Dr. Labelle's "mentor" programme is to nurture the next generation of researchers in the musculoskeletal field by creating a unique research- training environment. In addition to their standard curriculum, students at the MSc, PhD or post-doctoral levels in the health and engineering sciences will be exposed to an enriched training centre around five key areas: 1) multidisciplinarity, 2) team work, 3) new technologies, 4) scientific objectivity and 5) ethical rules.

Going forward, IMHA plans to launch a variety of Requests For Applications (RFAs) designed to foster research in our six foci areas. At our recent Advisory Board Meeting in March, we identified four broad research areas that will provide the focal point for IMHA-related research in 2002. These priority areas include:

- Injury, Immunity, Inflammation, Repair and Tissue Engineering;
- Pain, Disability and Rehabilitation;
- Mobility, Fitness and Exercise; and
- Biomaterials and Devices.

Researchers interested in the above priority areas can look forward to the launch of the "New Discoveries" programme in May 2002. A tool that will encourage innovative, high risk/high yield health research, New Discoveries acknowledges that speculative research can have a tremendous impact on each field of health research. It is hoped that these high-risk initiatives will eventually lead to the development of new research directions that can be submitted to CIHR's regular operating grants competition.

In addition to New Discoveries, IMHA plans to launch investigator-initiated operating grants and post-doctoral fellowships for health professionals, as well as funding for two additional strategic training programmes somewhere in Canada. To find out more about these programmes, we again invite you to keep an eye on our web site.

In just two short weeks from the time of writing, IMHA, The Arthritis Society (TAS) and the Canadian Arthritis Network will join together to launch the Osteoarthritis Consensus Conference 2002. From April 20 - 21, this one of a kind conference will unite leading arthritis groups and consumers to explore the latest advances in osteoarthritis (OA), and to create an integrated strategy for treating and curing one of the greatest health challenges of the 21^st century.

Osteoarthritis (OA), as you well know, is the most crippling disease of aging populations and the biggest musculoskeletal problem we face in the Western Hemisphere. Today, about four million Canadians suffer from OA. That's approximately one in every six people. And, with 9.8 million baby boomers expected to turn 50 in the next decade, the incidence is just going to increase. In Canada, the direct and indirect cost of the management of arthritis - much of it OA - is in the neighborhood of $23 billion.

This exciting conference will bring national and international researchers together to unveil the latest understanding about the disease's progression, its health and economic impacts, and new methods for its diagnosis and treatment. Although the OA Conference is yet to be launched, I can tell you that it has already been a success. To date, IMHA, TAS and CAN are working to form a partnership devoted to establishing a national arthritis strategy for Canadians. We have also begun discussions with our counterparts and colleagues in the United States to find common ground in our research efforts. As time goes by, I am confident that there will be even more exciting news coming out of this conference. In the meantime, although the conference may be over by the time you read this, you are invited to find out more by visiting www.oaconference.ca

In closing, I would like to take this opportunity to thank the numerous leaders in the orthopaedic health research community who have provided valuable input along the way. These are exciting times for IMHA and the orthopaedic health research community. We hope that you will not only continue to keep abreast of our progress, but will join us in shaping the future.