Redesigning Canada’s health policy to spur innovation
An opinion editorial article by Dr. Richard Gold
Published December 22 2025 in The Hill Times
E. Richard Gold is a distinguished James McGill professor at McGill University’s faculty of law, faculty of medicines and health sciences, and the Bieler School of the Environment. He is the chief policy and partnerships officer at Conscience, an independent organization building open science drug discovery where other methods are not getting results, and a former lawyer advising technology firms.
The next health crisis is coming, and Canada is unprepared. COVID-19 cost this country’s economy $469-billion and nearly 61,000 Canadian lives. In reaction, Ottawa invested $2.5 billion in life sciences, building capacity, but not enough to protect Canadians when the next, inevitable, health crisis arises.
As we wrap 2025 and move towards a new year, it has become clear that Canada needs to decide whether it will lead in global health preparedness, or fall further behind.
Beyond COVID-19, antimicrobial resistance (AMR) alone could shrink our cumulative GDP by $388-billion, and cause an additional 140,000 domestic and five million global deaths by 2050. Current investments in solutions, both at home and globally, remain inadequate. Canada committed $28-millionfor AMR research from 2023 to 2027, while, according to the Global AMR R&D hub, total global investments amounted to only US$2-billion in 2021. Meanwhile, pharmaceutical firms are exiting the field and the small biotechs that continue to work on AMR are operating on the brink of bankruptcy.
Beyond these health crises is the fact that 95 per cent of rare diseases still lack any drug. According to the Canadian Organization for Rare Disorders, there are approximately three million Canadians living with such a disease, leaving approximately 2.85 million Canadians without a treatment.
This country’s research and development policies rely on markets to spur companies to address health needs. Yet, markets react to acute crises, not prevent them. For slow-burning threats such as AMR and climate change, Canadians risk becoming the proverbial frogs in the heated water, headed toward tragedy unless action is taken. The solution is not to abandon markets, but to redesign them. After all, it will be firms—not governments or universities—that bring new products forward. But the market needs to be moulded and cajoled into action. What Canada needs to do, therefore, is to shape the incentives that spur private sector investment. This involves a critical assessment of existing incentives.
Beyond research grants, subsidies, and procurement, governments use legislative (like patents and copyrights) and regulatory exclusivities (such as data protection) to encourage private investment in health research. While this allows firms to charge higher prices and recoup R&D costs by excluding competitors, it comes at a cost. Patents offer firms the broadest protection, yet can impose the greatest burden on innovation, creating barriers to collaboration and encouraging secrecy as companies continually seek additional patents. This trade-off may be justified when the social payoff is high, but not in other cases.
Patents can sometimes hinder research rather than help. In areas with small or weak markets, such as AMR or rare diseases, firms may not invest because exclusivity offers limited reward, and patents slow research and block collaboration. For some, scientifically complex diseases for which no treatment is yet available, such as Parkinson’s disease and most dementias, teams and sharing are needed to tackle the complexity. As a result, firms such as Biogen are moving away from such neurodegenerative diseases.
If Canada is to address AMR, rare diseases, and complex diseases, we need to encourage firms and their higher education partners to explore exclusivities that genuinely drive innovation. When patents create an unbalanced system of protection, regulatory exclusivities, which safeguard a company’s data from being copied by competitors while still allowing scientific collaboration, offer a better alternative. These protections enable firms to attract investment without imposing the innovation costs associated with patents. To make this approach even more appealing, Canada could extend protection by four years for firms that forgo patents and commit to broad data and material sharing.
This country cannot act alone. With just 2.1 per cent of the global biopharmaceutical market, we must partner with like-minded countries to align incentives and fund consortia committed to open, collaborative R&D protected by regulatory exclusivities. Organizations such as Conscience, which are advancing open, collaborative models of drug discovery, show how this can be done.
Canada has the tools to lead, but only if it dares to redesign the rules that shape innovation itself. Next year can be the turning point; 2026 can be the year Canada chooses to reshape its innovation system rather than wait for the next crisis to force its hand.