Maychai Brown

The Canadian Breast Cancer Research Alliance (CBCRA) was a voluntary association of eleven well-known foundations and government agencies that collaborated over a period of 17 years. Through their efforts 583 Canadian breast cancer research initiatives received over $197,000,000, enabling Canadian researchers to perform world-class breast cancer research. However, collaboration came to an end by mutual consent on March 31, 2010.

Jackie Holzman, who was the vice-chair at the time of its dissolution, recently said, “The CBCRA was an excellent model for allocating research dollars.” One may then ask, “Why did it come to an end?” The answer is open to conjecture. There are unsubstantiated rumours that some of the partners felt their respective organizations were not receiving adequate recognition. It may just be, however, that this was a case of an effective organization setting goals that were beyond its capabilities.      

In 2007 an external expert review panel challenged the CBCRA “to become more strategic and proactive in shaping the breast cancer research landscape.”

The CBCRA took the challenge seriously. The following year it invited 75 participants to take part in a National Summit to lay the foundation for the Alliance’s future. The participants agreed that changes were needed in the funding of Canadian breast cancer research. Several problems were identified:

• duplication of research was occurring;

• discoveries were not quickly translated into medical practice;

• new.research.did.not always.build.on.recent discoveries;

• too much funding went towards investigator-initiated research rather than targeted research.

The CBCRA then invited 16 scientific experts to form a working group to build on the findings of the National Summit by making an exhaustive examination of the state of breast cancer research with particular attention to research that would quickly impact medical practice.

The result was an impressive 80-page document, introduced in December 2009, which was titled, The National Breast Cancer Research Framework: A Roadmap for Research...(www.scribd.com/fullscreen/24289143). Co-chairs of the working group, Drs. Eva Grunfeld and Morag Park, heralded the document as “the first initiative of its kind for breast cancer research in the world.”

The National Framework laid out 17 high-impact areas for research, one third of which had no prior funding in Canada. Among the two areas it identified as most in need of funding were early detection and one that resonates with BCAM’s mission: “Etiology (Causes of cancer) – Understanding the interplay of multicausal factors: genetics and environment.”

The Framework closed with a section titled, “Call to Action,” which announced the commitment of the CBCRA Board to focus its next five years on championing the National Framework by actively maintaining the network of breast cancer research funders, brokering collaborations among them, and monitoring future research advancements in order to update research priorities.

During the four months following the publication of the Framework, something happened to change the minds of the partners. The CBCRA dropped a bombshell, issuing a statement on April 1, 2010, stating that the partners would not embark upon another five-year mandate (http://www.breast.cancer/ca/detail-en.htm). The former partners stated their intention to “fund breast cancer research through our own organizations and through new partnership opportunities,” and vowed to “focus our collective efforts on supporting, promoting and updating the National Breast Cancer Research Framework.” But no plan was announced about how the support, promotion, and updating would be carried out.

Former members are reluctant to say why they chose to disband. After three years of soul-searching, had organizational fatigue set in? Did the prospect of jointly funding a secretariat to facilitate the meetings, forums, and analyses called for in the “Call to Action” seem too costly for the member organizations? Or were the organizations simply eager to set out on their own after 17 years of working in tandem?

At the time of writing, almost two years after the CBCRA signaled its closure, there is, in fact, no functioning structure to take its place. With the original partners now acting independently, the collaboration outlined in the Framework has not happened.

However, some activity towards forming a new group is taking place. In the final months of the CBCRA wind-down, one of the partners, the Canadian Breast Cancer Foundation (CBCF), volunteered to serve as the host organization for a proposed new collaborative project of the Alliance partners. CBCF also volunteered to take on some of the work of “hosting” the National Breast Cancer Research Framework in the interim by maintaining the website (http://www.nationalframework.ca).

Brian Bobechko, the Senior Director for National Grants and Partnerships of CBCF (Ontario Region), has been in touch with the former partners of the CBCRA to lay the groundwork for a new entity to be called the Canadian Breast Cancer Research Collaborative. He explained that the delay in progress has been partially due to the steps required to wind-down the CBCRA.

One partner of the proposed Collaborative is the Canadian Cancer Society whose former vice president of research, Dr. Michael Wosnick, used the metaphor of “a marriage broker” to describe how the Collaborative will work. Rather than collecting a pool of money from all of its members, it will encourage like-minded funding groups to form partnerships to support scientific research germane to their individual missions. The Collaborative will take its lead from the research priorities as set out by the National Breast Cancer Research Framework, and at the same time, it will be tasked with continually evaluating and updating those priorities.

There is much to be worked out in establishing this new Collaborative. The long delay in regrouping raises several questions. Has the enthusiasm for the Framework’s vision waned? Will funders who have acted independently for two years find the new Collaborative sufficiently helpful to their goals to warrant investing in it?

Until the Collaborative becomes a reality, one hopes that funders are paying attention to the 17 research priorities identified by the Framework. There is some evidence this is taking place. The Canadian Breast Cancer Foundation has chosen to invest $5,000,000 in one of the Framework’s high priorities noted above – early detection. BCAM hopes that the Canadian funding community will come forward to support research into that other priority highlighted in the Framework: “Etiology (Causes of cancer) – Understanding the interplay of multicausal factors: genetics and environment.”

Those who care about breast cancer research hope that the Collaborative will eventually come together and will be at least as effective as the CBCRA. It remains to be seen whether the visionary Framework as described in 2009 will drive Canadian breast cancer research toward understanding and eradicating the disease.

Groups Affiliated with the CBCRA

Partners

Canadian Cancer Society

National Cancer Institute of Canada (NCIC)

Health Canada

Public Health Agency of Canada

Canadian Breast Cancer Foundation (Run for the Cure)

Avon Flame Foundation

Canadian Institutes of Health Research (CIHR)

Canadian Breast Cancer Network (CBCN)

Friends

Cure Foundation (Denim Day)

Breast Cancer Society of Canada

Cancer Research Society

 

(The Quebec Breast Cancer Foundation was not a participant of the CBCRA.)