Addressing the Gaps: Focused Research Investments

Stephanie Reid 0:08
Welcome back to the Beyond Research Podcast. In today’s episode, we continue our thought-provoking conversation with Stefan Leslie and Dr. Melissa Flagg. If you missed that episode, you might want to listen to it first. It set the context for today’s discussion on a new initiative in Nova Scotia: Focused Research Investments. Today, listen as we discuss the challenges and opportunities inherent in reshaping the research landscape, with a particular emphasis on salient, collaborative research, community engagement, and the pursuit of impactful solutions for society – solutions that address immediate problems, but also have applicability in other ways in areas. We hope you enjoy the conclusion of this insightful discussion.

Stefan, do you want to just take a moment to tell us a little bit about the initiative? What are Focused Research Investments? And how will they address some of the gaps and opportunities that we talked about in the last episode?

Stefan Leslie 1:11
At its core Focused Research Investments, we will select two or three of these strong problems, but where that’s matched by capacity, where you can define that outcome that you’re looking to pursue, and then develop a sustained attention to those sets of issues with significant funding now, let’s just pause for a moment here, because Melissa didn’t ever actually say it, but I think you oversaw a budget of $12 billion at the Department of Defense, which is, did I get that right? 12 billion?

Melissa Flagg 1:44
What I actually over saw was more like $6 billion.

Stephanie Reid 1:48
Oh, is that all?

Stefan Leslie 1:50
Yeah, just 6 billion. So, I’ll get the numbers slightly off, but I’d say that’s about a quarter to a fifth of the entire Canadian investment in R&D. By that I mean government, industry, academic. So, let’s just better scale. But in the Nova Scotia context, when I talk about a lot of money, I mean, somewhere between $5 and $20 million over five to seven years, and for us that is sustained and significant investment on a set of issues that will result in an improvement to society. So, the key thing in looking for what we want to support is we really want to identify where those outcomes will really matter, and part of the reason why I was drawing out this issue, how you define those outcomes, is that we actually want to find a blend between those sorts of issues that are going to provide really helpful, useful, applicable information in support of an immediate issue, but also have a broader application. So, the example you used was, I think, 1000 people don’t have lead in their water, that’s a very discreet concrete thing. Well, in doing that, in pursuing that very worthwhile objective of providing safe drinking water to 1000 people who didn’t have that security before. To me, the worthwhile, broader objective or outcome that you want to pursue is, what have you learned in working through those sets of issues that could not just influence or affect the safety of drinking water for 1000 other people or a million other people, but what might that teach you about, I don’t know, climate adaptation, or the provision of better primary education? Seemingly unrelated matters, but nevertheless, the outcome that you’re seeking, is connecting a research community to a set of people and perhaps one of those outcomes is actually finding a way to engage fruitfully between those two groups.

Melissa Flagg 3:59
I think this is such an interesting, it’s such an interesting effort, right? And I actually love that you’re doing it with what we would call a constrained budget in the U.S. I understand it’s a lot of money. But the community is very discreet, right? I mean, you’re focused on Nova Scotia, and the opportunities here are so interesting, right? Like, I don’t know what the answer will be. But I think what you’ll find is that sometimes there are these problems that seem quite small, but if you solve that one problem, it cascades into the community being more stabilized and more able to help itself in other ways, right? And so I think the first question is really beginning to understand the value of that problem, either in the local ecosystem, or in the larger ecosystem, as you describe. What does it mean in your ability to apply that to other communities, or what does it mean for a larger problem of climate or something like that, right? So, whatever the context is that you’re defining the value of that problem, whether it’s the local community, whether it’s scalability, whether it’s its role in this larger problem set, understanding the position, like where in the map of that problem space, does that problem sit? And how critical is it? And how tied to other parts of the problem is it, that really matters when you choose that problem, right? Some problems are more peripheral, and some really have innate networked value in other ways. So, I think that’s one thing where social science could be so interesting and important in this. And honestly, I mean, I immediately thought, like, I’d love to just see if I could, like for, like, basically just cost try to help someone map themselves in the science landscape to see, like, how connected is this problem you’re solving to all of these other problems? And who could we give you access to? And who could we draw on? Right, etcetera. I mean, I think there’s some really interesting ways you can map these problems spaces both qualitatively and quantitatively. And for me, that’s the first step. That’s also such an interesting way to get to know your stakeholders, right? But again, this is very high touch, it really means you have to value that qualitative part of the research. And you have to view choosing the problem almost as it’s part of the experiment, right?

Stefan Leslie 6:42
So, you know, as we’ve been working to develop this model internally over the past several months, the question keeps coming up. How is this actually going to work? Like, how do you select the problem? How do you find people who are driven to be social actors who are, have the talent but also the interest and the drive to keep at this, who are willing to hold themselves to account for delivering to a group of people that is different from what the usual scientific system demands of them? And so, you told a story earlier, and I’ll tell one now, because it’s based on a research, actually a couple of research projects, that we’ve already funded, which in some respects models several of the elements that you’ve talked about here, both in just your most recent answer, but also before, and that is a series of projects that we had around in a long term care facility and preventing the residents from respiratory illness. Of course, it was brought on by SARS-CoV-2, COVID-19. But long term care facilities are also subject to significant RSV influenza, and such a high proportion of the residents, talking about constraints, can’t follow public health measures, because they’re suffering from forms of dementia, which means distancing, hand washing, mask wearing, is not possible, or it is extremely difficult or uneven. And so, the actual intervention was testing, does this particular thing work? Is it effective? And I think the standard research project probably would go that far, right? Like you have a population, you want to prevent the transmission of respiratory illness from one to another, from the infectious to the potentially infected. But what was interesting about this project, or these couple of projects is it also looked at what are residents, family, the staff, personal care workers, what are they interested in? What are they willing to do? What are they concerned about, about the introduction of new technology? Is this potential solution, even if it does work, is it cost effective? Is there any way we could possibly afford to deliver that solution, even if it did work? And given the structure of the long term care facilities, we’re not going to be rebuilding these things overnight, is it actually feasible from an engineering perspective? Can you actually introduce it and so even though on its surface, this project was all about, it’s kind of, very kind of medical orientation. It was, in fact, a social science component as well. So you talk high touch points. There are all kinds of constant touch points because you’re dealing with residents and out of that project has come all sorts of innovation around how do you actually detect in that population when you see an erosion of their health, because they can’t necessarily say I’ve got a headache today, or my arm’s feeling numb or whatever symptoms you may be interested in, they are unable to communicate in that way. And so it’s also elicited a whole bunch of work around how do you actually determine whether someone is likely to be getting sick or not, and then divert them into the kind of stream of care to ensure that you’ve got proper testing. And so when I think about what Focused Research Investments could do, it would be taking that kind of thought model, not necessarily that subject matter, but that idea of framing the outcome of how do you protect a population that is vulnerable. And in a society, I don’t know what the numbers would be for Nova Scotia, but a report came out just this morning, that the percentage of the population or the number of population that is going to be living with dementia in 2050, will three times what it is now. So that emits all, or sort of suggests all sorts of questions about how are you going to deliver public transit? How are you going to deliver health care, of course. What is housing going to have to look like? How is technology going to interact with your life? There’s all sorts of potential research-based, outcomes-focused questions that could come out of that very issue around increasing dementia, vulnerable population, how society’s going to operate. And so you can start to see that, within that very broad area of health care and increasing dementia, that you can begin to take these issues and make them meaningful for the research community. And then perhaps make them as excited about those who will benefit from the solutions or the information, because you are working on something that is going to be meaningful, and that you are working with the residents and the management of these facilities, and the nurses and, the families and caregivers.

Melissa Flagg 11:49
I mean, I think it’s such an incredible example. Right? And I think there are a few things that come to mind, one being, I think this is exactly what students are actually looking for. So the first thing I’d be doing is going to every college, university, community college, high school, right, and talking to kids about, like, if you want to stay in Nova Scotia, and you really care about these communities, like there are opportunities for you to do work like this, right? Science isn’t just sitting in a lab, hiding from the world, right? It can also be this very engaged solution-focused endeavor, right? I think that’s one thing. I get asked a lot when I go to universities, by students, like I want to do something with impact. I don’t want to just be cloistered away, right? So, I think that’s like one aspect of this is really exciting. I think the other aspect that comes to my mind that I think is interesting, as you’re developing these types of, because you have developed a context right, within which 1000 research problems could be developed, which actually, I think is a great FRI, right, it gives people a lot of choice and a lot of space, but it also it gives them a wrapper within which they have to be responsible and responsive to, right? So, I love that. I think one aspect of this also is that you almost innately or almost like inferred a value system, which was quantity of life is more important than quality of life. And this is, I mean, I don’t think you, I probably, I’m over, I’m exaggerating. But I hear this a lot with public health, which is I can keep them safe by putting them in a room by themselves for two years. And what I will tell you is that my mother died at the beginning of COVID, and I was home with her on hospice because she would have either been alone in a hospital or I’d take her home. So, I moved back to Missouri, where I’m from originally, and stayed with my mother and took her home on hospice until she died. And I was talking to one of my father’s, my father had died two years before, one of my father’s friends came over, he was distraught because we couldn’t have a funeral and all this stuff, right? And he said, I’m going to meet you in the backyard and you’re meeting me and there’s no arguing about it. And I’m like, okay, whatever I’m not gonna argue with, like some people I will argue with, I’m not arguing with him, and I’m sad and whatever. So we’re sitting in my parents backyard. And I’m like, what are you doing and you know, this is dangerous for you. And he said, I’m 75 and this is my life expectancy and I’ve had this amazing life, and Washington wants me, and this is his words, right? I mean, it is Missouri, so we’re a little crazy out here. Washington wants me to not see my grandchildren for the next two years. I don’t want to die not having seen my grandchildren’s first steps. I don’t want to die not having said goodbye to you. That’s not the life I want to live. So if you want to, if you want me to engage in desiring safety, you need to meet me halfway here, you need to meet me where I am, where my values sit for my health, and where that intersects with the values that I hold for everyone else’s. And I thought that was so powerful. And again, I think it’s where you have such opportunity with FRI where you really want to hear from the caregivers and from the communities and from people themselves who may be in early stages of dementia, but still are clear right now. What do you want your future to look like? God, wouldn’t that be an amazing opportunity to sit with people in the early stages of dementia, and ask them to help you define what that future looks like for them. And how empowering for those people who can’t do anything about their situation, to have this opportunity to be helpful, not only to themselves, but to the people coming behind them. Like I just think it’s such an interesting opportunity. So I guess one is really back on that problem definition space where scientists don’t spend any time, honestly, I mean, I shouldn’t say that, they spend less time because they have to spend time on this is the project I want you to fund which is going to necessarily be very tight and focused and small. But you have this opportunity to define the wrapper, which allows a value system and other social questions to be explored. And within those social questions, say I have two or three values that emerge that are in conflict with one another. And then I’ve funded a whole bunch of individual research projects, now I can bounce those up against those values, which values are dominating? Which values are not being supported? Which outcomes are being pushed by the technology, but are not being prioritized by the people? I think it’s such an interesting structural opportunity between these two things. I also would just say one last thing along these lines, which is you get to the point of choosing the problem and funding the projects, but that’s where it tends to get lost as well, at least in the U.S. system, I think is you’re funded, and you do your science, how is all of that brought back together with people outside of your own consortia, right? How was that brought together in the end? Maybe every two years, you’re having a big workshop in Nova Scotia where anyone in the community can come and engage. And you have some panels where people are talking about this is what we’ve learned and this is how it matches what we heard from you. This is how it’s playing out in your community. These are the specific topics we’re tackling and where they sit in this bigger context. So even though they seem disconnected from you, because they’re long term, this is why they matter. And continually contextualizing that for the communities over time. And you have a real opportunity for that. Especially because Nova Scotia is such a, it’s such a well-defined community with a limited population where you can really do this, I think.

Stefan Leslie 18:22
Yeah, I mean, there’s a million here, same size of Rhode Island, at least by population, so you can wrap your arms around it, in some respects, but what’s really important, I think, in selecting FRI and seeing how they continue is making sure that that concept of the intended beneficiaries or the intended users are embedded from the get go and are used or are engaged at the appropriate times throughout the cycle. So sure, these may last five to seven years, and then you really want to see these, you want to solve for five to seven, but you want to endure over the long run like we want to see this as the vehicle or a vehicle, a really important vehicle to creating the capacity to do more and even better work. And we want to use this as a vehicle to allow for those researchers for whom this is the model that they want to work towards. In fact, maybe this is the model they’ve been looking for and didn’t quite know how to phrase it. We want to make sure they know this is the home for them, right? And that there’s going to be more work that they can do after the timeframe and maybe others want to come and join them. That would be that would be just great. But nevertheless, within that timeframe that you actually have these series of projects that are working. You want to make sure the user or the beneficiary or the community however you want to define it is participating at the right time. That doesn’t mean they’re necessarily doing alongside in the lab coat with all the others enduring the research project, right, like let’s be sensible here. But at the same time, that may be heavy engagement at the problem definition, probably pretty heavy engagement in the choices that you have to go through to prioritize those problems and actually establish the kind of baseline set of projects that you’re going to work on or the components you’re going to work on. And then reasonable touch points throughout, right? And so, inevitably, every research project that we have ever been involved in, it has to make choices, there’s the ideal that is established at day one, and then reality sets in and you learn something, and you should decide that you need to move in a different direction or a piece of equipment isn’t available, or there’s a better piece of equipment you can use, and you have to make choices. So I think that the right balance here is where and when and how those particular, I’m going to use very strong, insert quotes, “non scientific components” of the system are integrated. And that if we, if we have confidence that we’ve defined those outcomes well, and that we have confidence that the process or the system that we have set up, is robust and accountable, and that people are in agreement for what they are there to achieve, then us as the funder, because ultimately, we’re dealing with public money, right? Like, as you said, you are taking funds from people who worked hard. And we are telling them, we have a good use for this. And we are, please trust us that it is good that if we are going to be in that kind of position, than we have to be able to account for it. But if we have really strong agreement on outcome and that the system is right, then we can give that research group significant discretion on how best to get there. And that’s how you then align it with this concept, which is really important of kind of research freedom or academic freedom, whatever it is, because what you’re doing is saying, we’ve given you the framework, we have helped with a problem definition. And now we really, in fact, we desperately need your creativity and your enthusiasm and your passion and your drive to say, these are all the tools that I have been given and I have earned over the course of my life to get to this point, I can tell you, this is how I will devote them in service of achieving that end, right? And then as the funder, we can say, okay, so you need to fund, you need to spend this much in year one and this much in year five, well, that can change over time, or you need these people and that equipment and that space and this capital expenditure and that operating cost this branch, well, that’s going to change too. But if we’ve already agreed to those other elements, then those kinds of choices can go back to where they need to be, which is invested in the researchers themselves to be able to make those calls.

Stephanie Reid 22:49
And I think this is a great minute, sorry to interrupt, Melissa, but just to talk about those critical components of FRI. I know we’ve been talking around it a bit. It is a shift from more traditional funding opportunities, it’s going to be a shift for the community to grasp. So, what are those key ingredients that make this initiative so different from other funding opportunities currently available?

Stefan Leslie 23:14
Right, well, I’ll maybe I’ll just go through because I think there’s probably four main things, you could probably break, you could group them into three or break them into five. But nevertheless, I think the first and foremost is this focus on outcomes. If this conversation over the past however long we’ve been going at it reveals anything, it’s clearly this idea that society is singing here, right? Like they’re singing and they’re calling the tune. And so, we need to find a way to identify those right sets of problems that lend themselves to be able to define them as a set of outcomes. So, I would say that would be the first area. The second is, even though the issue may be important, and you can define the define the outcome that you’re looking to pursue. They do have to be the salient issues, right? So, it’s not just that we know what the outcome is, and so yes, a certain form of cancer is present here, it is a significant burden on healthcare and it really reduces quality of life, but is the set of questions that are going to be pursued through the FRI going to be on point for actually resolving those. So that’s that drawing the connection between the research activities that are proposed under this FRI and their devotion to those outcomes? I think the third is there has to be a really strong research component to it. You know, there are a lot of challenges that we have in society that may be informed by research, but research isn’t the limiting nutrient in that ecosystem, right? It’s a matter of priority or it’s a matter of funding, or it’s a matter of policy development, or there’s a set of trade offs, which are actually reasonably well informed, but we haven’t actually brought ourselves to the point where we’ve been able to make them, and so we need to find FRI and really kind of push them to identify those sets of challenges, that research and the supply of that, you know, what’s the endpoint of those discovery process? How is that going to fit into the framework and actually push things along? And then finally, I think it’s not just that research in the abstract is useful, but the type of research that’s needed, is going to benefit from coordination and integration. You know, there’s lots of research challenges where you don’t want to manage it. I mean, you don’t want to have an external person, like some knob like me come in and tell you how to use your funds or what questions you want to pursue, because, you know, they’re discovering fundamental things about what makes the world go and that is not somewhere where coordination is going to help. And so what we actually do need to find is, is not find the way for a system which generally doesn’t intrude on those questions, and find a way to do it, but shift the nature of the system that we’ve created to say, where are those areas where we not just think that coordination is helpful, but we want to create a structure where, in the particular case that we were just talking about, those who are supply chain experts, social psychologists, immunologists, economists, and various others are truly working together and are willing to spend the time to inform their colleagues about what they need to know, but equally, are willing to absorb the lessons from their colleagues. So, we need teachers, we need people who want to teach and people who want to learn, almost in equal measure.

Melissa Flagg 26:53
Yeah, I feel like this is, it’s so interesting, right? It’s not rocket science. But we literally don’t do it. You know, I’m fascinated by this, because what you’re describing is really just like, we have a problem, we have a whole bunch of research that exists, we could probably build on it, but it’s going to require us to get together a bunch of people outside of their specialties, they’re going to have to change slightly what they would do, based on the constraints of the problem and input from their colleagues. So they’re going to have to be open minded, as you said, learning, right? And they’re actually going to have to teach other people the outcomes of the work that they do, so that it can be built on by others and integrated by others, right? And we have devalued teaching, honestly, in the system, and we’ve lifted up independence so much. And I’m a huge believer in academic independence and research freedom. In DOD, I think we take to heart that, give us your problem, don’t tell us how to solve it, we will necessarily have a broader range of ideas on the art of the possible than you the consumer. However, I need to know what that final solution set kinda has to look like, and then I can make my choices, right? But this idea that we’re going to actually ask people to edit their ideas, to amend their actions based on taking in information from other people. And then being responsible for providing your outcomes to others, is just something that somehow got devalued in the lifting up of freedom and independence. And I actually think this is, it’s so simple to say it, but it is so hard to do it because again, it’s high touch, you’re going to have to bring these people together, there are going to be fights and arguments and you want those, right, you want good intellectual debate. So you’re going to have to create environments where that respectful intellectual debate occurs. And I think that that’s really possible with the way that you’re going about this. And I want to help just because I think you’re giving us an example that needs to exist in North America.

Stefan Leslie 29:28
I think it’s first important to say that we are not trying to overturn the entirety of how research happens. You know, there is a lot of really important work that goes on out there and that we support, right, and that needs to continue because that is what provides the workforce, the equipment, the ideas. There’s all sorts of stuff that needs to keep happening. And so I think it’s important first of all to say that what we want to do is create the environment or a structure that appeals to a different set of problems for which this kind of model is the most suitable, or to kind of go back to what you’re saying, at the very beginning, Melissa, is that the efficiency is actually tuned to what you want to see at the end. Not the efficiency defined in a different context. But you actually want an efficient way to get there. So this is the right time to do this because I don’t see the challenges in the world getting any smaller. I don’t see the research community comprehensively addressing all of it. And so therefore, it behooves us to seek out new ways to try different things. And if not now, then when? And as an organization, we’re in a bit of a Goldilocks kind of zone, because we’ve been around for four or five years and so we have, you know, a functioning governance structure, we have sufficient funding, at least for the time being, we have the ability to manage projects, we’ve got people on board, so we have some of those key ingredients, but I think at sort of four or five years, the inevitable kind of calcification that happens in any organization that establishes a set of expectations haven’t yet set in. And so we are able, at this stage in our existence to say, what is our core mandate, like, what were we really put here to do? Why did someone think that’s a good idea to fund to set up and fund and we thought, okay, so we do lots of other things which need to continue, but this is the time to say, let’s look at this problem from a different way. Let’s fund it with a chance of success. Let’s treat it like not an experiment in something that’s cavalier, but something that, you know, you’re going to have to stay nimble and adaptive, and so that you can set things up and say, we know, we’re not necessarily going to get it all right. We want to get it mostly right. And we want to set in place a culture internally and externally, that acknowledges that we’re going to need to make mid-course corrections, because what we have that will stay solid is that pursuit of the ultimate destination. And so, if we maintain our focus as an organization, and then pass that on to the individual FRIs, that what really matters is the achievement of that outcome. And so, we are now at the position where I think we can stand up and say, this is worth trying. And so we’re going to have a good solid crack at it. We need lots of people who believe in this as a model. So not just in Nova Scotia, but others who have thought about these challenges elsewhere, but also a research community that is willing to take up the challenge, right? Like, this is not something where we can say we’re most interested in issue X, and so we’re going to do it in issue X. You need to find the match between the problem and the people, right? You need to find the right set of issues, the right kind of community that is interested and willing to participate, and a research community that is ready to rise to that challenge, and having done this also for just long enough, in this particular kind of organization, I’m confident that there are researchers out there who look at this and say, I bet if I had the security of kind of a research focus over that five to seven years, I can do great stuff. Those are the people we want to find and those are the people that we’re hoping to draw out by making this offer.

Melissa Flagg 33:45
This is such an incredible opportunity for young people in Nova Scotia to bet on themselves, right? To bet on their communities. To invest their time, their energy, their intellectual kind of capability in an experiment that’s really all about their future, right? And honestly, to draw people into Nova Scotia, who really are seeking that kind of, a place that bets on itself, right? I mean, what you’re really doing is saying, we’re making a bet, on Nova Scotia. We’re going to draw on our own people and we’re going to take responsibility for our own problems, and we’re really going to commit to making this a place that people want to be and live and thrive 20 years from now, 50 years from now, 100 years from now. And I just think that there are so few opportunities like this, and there are so few people in the scientific community that are allowing you to do something that connects you to your community that grounds you that allows you to be a part of something that you can see, and feel, and hear, and understand all the time, not just a theoretical concept of future value. That I think it’s such an incredible opportunity, and it’s rare. And that I think you’re gonna find a lot of people who really are hungry for that.

Stephanie Reid 35:21
I agree. Anything you would add to that Stefan?

Stefan Leslie 35:23
I’m going to put that on a card and stick it to the wall.

Stephanie Reid 35:27
That’s what I was thinking.

Stefan Leslie 35:28
The only thing I think I can add to this is, there is always going to be a debate of how much money should go into the research system, you know, are we investing enough as an, either gross amount, or as a percentage of your GDP? Those sorts of questions I’ll always endure and that’s a tough one to answer from inside the research community because our perspective is, by definition, coloured by what we see as the opportunity, and it’s very hard for us to balance off, well, where else might those funds best go? So, if we can provide input to that question, but can’t resolve it, what we can resolve, and what we actually have the responsibility to resolve, is how can we best make use of the resources we do have? Whether they’re small or big, whether they’re growing or shrinking, how do we best mobilize those resources, that is in keeping with the spirit in which they were given? And the only reason that the public provides those funds through the taxation system, through the government appropriation process is because they believe that an investment at that level is going to help society. It is going to make the environment better, it’s going to keep them healthier, it’s going to grow the economy, whatever it might be, it is positioning them to solve the problems in the future just as much as it is to fix things now or to pursue opportunities now. And so, we have to respect, deeply respect, the privilege that that brings to us.

Stephanie Reid 37:07
Focused Research Investments will tackle the salient issues of our time using a mission-oriented approach while providing the funding and resources required to meet specific societal outcomes. For more information or to apply, visit http://www.researchns.ca/fri. Thank you for listening, and we’ll see you next time.