Canada in a Flat World: A Health & Science Superpower

The following article written by Dr. Alan Bernstein, President of the Canadian Institutes of Health Research (CIHR), ran in the May 23, 2007 edition of the Globe and Mail. It is an abbreviated version of an address Dr. Bernstein gave to the Canadian Club of Toronto on March 26, 2007

The rise of India and China as economic powerhouses, the development of new global communication technologies, global warming, the emergence of new infectious pathogens like SARS, powerful new insights into the workings of the human body, are all creating tremendous challenges and opportunities for countries like Canada. In a flat world, no country is immune from these global tectonic shifts.

We are in a race without a finish line

The 20th century has been characterized by remarkable improvements in human health, virtually everywhere, except sub-Saharan Africa. Longevity in the West has increased by almost two years per decade for the past sixteen decades. New drugs and diagnostic technologies, fuelled by profound advances in the biological sciences, are increasingly based on a detailed molecular understanding of human biology and disease. We are reaching the stage where we can prevent or slow down the onset of some diseases before clinical symptoms are even apparent.

Information and communication technologies (ICTs) will also play a key role. As our population ages, and as we move increasingly from the acute diseases to the chronic conditions of aging (dementias, diabetes, arthritis, frailty), ICTs will link together our homes, our bodies, our clinics and our hospitals. Regenerative medicine, including nanotechnology, bioengineering and perhaps stem cells, will transform how we repair or replace defective or worn out body parts.

But, most profoundly, it will be the synergy that will come from combining this new science and new technology and a heightened sensitivity of our personal responsibility for our own bodies, that will transform human health and our health system.

This profound transformation of health care into a knowledge-based activity has huge economic implications. In our country, health care is a $140 billion industry. In the U.S., that number is $2 trillion. China currently spends $60 per person per year on health care. For Canada, that number is $4,600. So, as China's spending on health care goes from $60 to $600 million over the next decade, the health care industry in China will become a $800 billion industry.

Despite all our concerns about our own health system, Canada has arguably one of the best and well run health systems in the world. That know-how, that knowledge is as exportable and profitable as lumber or oil. Health care is Canada's largest knowledge industry, an industry that will experience phenomenal growth and export opportunities over the next twenty-five years. It is an example of the importance of knowledge and knowledge industries to Canada's future. And, it is a model for how we should structure our thinking about Science and Technology (S&T).

To start, we need to rethink our view of productivity and competitiveness. Productivity today is not about lowering the unit costs of manufacturing picture-tube TVs. Productivity today is about inventing flat screen technologies. Productivity today is not about lowering the unit production costs of bovine insulin. Productivity today is about invention of recombinant DNA technology to produce human insulin in bacteria.

Productivity today is not about improving the efficiency of our health system through training fewer doctors and nurses. Productivity today is about the invention and system-wide application of new ideas and new technologies that will speed up and improve health delivery.
The process of discovery is itself transforming the nature of competition. In a resource-based economy, scarcity drives up price. But in a knowledge economy, it is just the opposite. Software's value goes up the more it is shared. The first fax machine or phone was useless.

And there seems to be no end to new knowledge. Knowledge is not like oil or a piece of capital equipment. Knowledge is not used up, worn out or consumed. Quite the opposite - knowledge and new ideas are different: the more you use them, the more valuable they become.
The centrality of S&T to Canada's future raises other issues such as the need for partnerships and collaborations. In a knowledge economy, knowledge is the most precious commodity. Often, the ideas or intellectual property generated in one company or one university acquires value only when combined with the ideas from another company or university.

Companies, universities and countries must therefore strike strategic and dynamic collaborations in an attempt to create the synergies and complementarities that can only come by merging ideas, creating partnerships and building relationships.

Canada is well positioned to take leadership in this area. Science diplomacy, particularly health science diplomacy, will be a powerful way for Canada to reach out to the world. We place importance on good health and a public health system. I believe that those values, coupled with Canada's exceptionally strong health research enterprise and the universal nature of science that transcends language and culture, will make health science diplomacy as important a diplomatic tool in this century as Pearsonian diplomacy was for Canada in the last century.
For our cities to become a knowledge-based hub, proximity to market is no longer the issue. But, proximity to the world's best universities and to the best research talent is.

We are witnessing the 'death of distance'
The last point is obvious. A successful knowledge economy is built on a highly educated workforce and a society that understands what research is all about and engaged in the issues raised by science. Science is, quite simply, the best way humanity has come up with to solve important problems. Indeed, some of the greatest opportunities for economic progress will come from helping the world solve its biggest problems - in human health, in energy, the environment, in building sustainable cites. This is how, I believe, we will generate the new jobs, wealth for our country, and well-being for our citizens.

This is what science and innovation is all about - discovering and applying new scientific ideas, new knowledge to change the world.

Real, cutting-edge research is tough to do
But transforming science into new products and new policies is even tougher - it is a complex process that involves iterative interactions between the producers and users of new knowledge.
Canada is in a race without a finish line. It's a race to build a nation that provides rewarding careers for our children, that has a sustainable health system, a strong education system, and that is a paradigm for the planet. We're in a race to generate new ideas and to transform those ideas into economic advantage.

I believe Canada can win that race. But how on earth do you win a race without a finish line? First, you have to enter the race. And second, you have to enter it to win.