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The issues and problems of drug development and regulation are matters it which the physician and surgeon can identify on a broad personal basis. As a cardiac surgeon I know better than most the fundamental role which drug research and development has played in recent years in the control and relief of heart disease. As a clinical scientist and professor at the University of Ottawa Medical School I am cognizant of the need for biological research and for the continuous relationship with the international pharmaceutical industry to develop, test and market the results of that research. As an administrator, I have dealt with the maintenance of standards using limited resources. As a member of the Senate of Canada I am sensitive to the social and political pressures which governments face in providing their nations with the latest drug treatments while, at the same time, ensuring that such treatments are not only effective but safe. The public looks to governments and to regulators to ensure that our cures are not sometimes worse than the disease which they seek to treat. They demand the avoidance of another thalidomide disaster. In the present paper, I would like to discuss the future of academic medical science in Canada and why its preservation is essential. Recently an organization in Lausanne classified the 34 best industrialized countries for the World Economic Forum. Canada was classified first in 20 or so categories: one of these was the quality and accessibility of health care for employees and their families. But its principal weaknesses are also clearly emphasized. Its lack of qualified manpower across Canada put it in that respect in 14th place. In manpower motivation it is placed only 16th and in quality of manufactured products 13th. In long term, if nothing moves, Canada risks losing out because of weaknesses such as these.

The funding of quality in medicine: one country's challenge