A recent Healthy Debate article sounded an important alarm about the state of Canada’s clinical trials competitiveness and highlighted key barriers holding us back in the global race for industry investment.
Having worked for decades to strengthen Canada’s life sciences and innovation sector, we are deeply troubled by the data shared in that article signaling a decline in industry investment in clinical trials in Canada. But we are equally encouraged by the progress now underway, and by what it tells us about Canada’s ability to compete. Competitiveness has become something of a watchword in Canada’s life sciences sector and clinical trials are now recognized as playing a key role in securing a healthy future for Canadian patients and our economy. It is also becoming increasingly clear that Canada needs to do more to ensure a strong clinical trials environment, including securing investments and increasing efficiencies to make Canada more attractive. Importantly, with respect to the latter, we are beginning to see impact.
Across the country, research institutions, industry, patients, researchers, governments and clinical trials organizations are working to address fragmentation and delays that have held Canada back.
In Ontario, a new accelerated pathway called QuickSTART brings contracting, budgets and research ethics review together within a coordinated 45-day clinical trial start-up timeline. Pilot studies all completed the pathway in under 40 days, with multiple studies completing within 25 days. In more than one case, Canada was the first country to activate a global trial.
The Universal Agreement for Clinical Trials (UACT) is reducing contracting timelines from months to days. Now in use by nearly 30 organizations, the UACT has been central to Ontario’s QuickSTART success, with agreements completed more than 10 times faster than those negotiated without it. These results show that when institutions and industry agree on a common process, Canada can move at globally competitive speeds and get trials to patients more quickly.
In Quebec, the FAST TRACK evaluation service has demonstrated ability to accelerate clinical trial start-up within eight weeks. Alberta is also carving a path forward with Alberta FAST, which targets a 45- to 60-day activation timeline.
The movement toward collaboration and efficiency is taking hold nationally, too. The Accelerating Clinical Trials Consortium (ACT) has been a lynchpin in this effort, connecting hundreds of researchers, research networks, clinical trials units, hospitals, patient partners, biotechnology, government and experts spanning ethics, contracts, regulation, patient engagement, Indigenous self-determination, education and more.
CanReview, funded through ACT following a national competition, is implementing a coordinated single research ethics review system that works across the country while respecting jurisdictional differences, with more than 30 sites and research ethics boards participating in four provinces to date. Clinical trials with sites in multiple provinces and territories can receive one efficient, high-quality ethics review rather than requiring individual ethics reviews at every site across the country. Not only will this improve activation timelines, but it will also enable more cross-Canada research, bringing trials to more patients in areas where access has been limited or non-existent. CanReview targets a 28-day timeline for ethics reviews, aligned with top-tier countries including the U.K.
The race for global clinical trials is real, and so is our progress. These examples, and many others, show that Canada is making deliberate changes to address long-standing barriers. We are speeding up processes, reducing duplication, building alignment and creating new ways to work together across organizations and jurisdictions.
Is it enough? Not yet. We must build on our momentum and lean into the partnerships that make it possible.
Competitiveness is a shared responsibility. Governments and policy makers must create conditions for research to thrive. Institutions must challenge established ways of working. Researchers, patients and others must help design a clinical trials system that works for the people it is intended to serve. And industry must continue to be a partner in building it.
Canada’s clinical trials ambition goes beyond winning a global race, towards a future where more Canadians can participate in cutting-edge trials and benefit from a thriving life sciences sector that secures the future of care. That is a future worth investing in, and one that requires a shared, long-term commitment to patients and the future of health in Canada.
We have momentum behind us. Now is the time to collaborate, build on the progress we’ve made, commit to investments and solutions that will enable us to do better and keep patients at the centre of our decisions.
Together, we can build a clinical trials ecosystem that supports a healthy, prosperous and more resilient future for Canadians.
