University Health Network is a Toronto-based academic health system and research hospital network, consistently ranked among the world’s leading hospitals. It combines advanced patient care with large-scale research, with strengths in transplantation, cancer, cardiac care and neuroscience.
What led you into healthcare, and who has had the greatest influence on your journey?
Like many young people, I stumbled into fortuitous opportunities more than planned. I stumbled into McMaster, which was reforming medical education and saying, “You don’t need a traditional route. It’s about learning how to learn, tackling big social problems, and creating a different kind of healthcare provider.” I also met remarkable mentors — world-class scientists, educators and clinicians — and most of the good fortune I’ve had comes from the people I’ve worked with and for.
John Bienenstock was the grandfather of inflammation and the mast cell. Fraser Mustard was an early voice on childhood development and the lifelong impact of weak maternal support. Raelene Rathbone showed me that big ideas aren’t enough — you have to put wheels under them and get them implemented. That’s defined my approach: success is turning big concepts into implementable, at-scale initiatives.
Canada produces world-class science but struggles to capture the economic upside. What needs to change?
Our science is second to none, but our commercialization is woefully lacking. The challenge is not generating great ideas; it’s implementation and having the infrastructure and tax structures that say Canada is the place to do this. The first time insulin was ever used was here at UHN at the Toronto General Hospital, yet today, none of the $45–$50 billion of profit from insulin comes to Canada. I don’t want to see another insulin story where our science doesn’t benefit our country long term and benefit the world.
Science creates jobs across construction, manufacturing, scientific and distribution roles. COVID showed what it’s like not to have control of your supply chain. Canada is waking up and saying we need supply chains as much as innovation. My friends on Bay Street say, “Money goes where it’s most welcome.” We need to make investing in the translation of science into commercial products something welcome in Canada.
If you could design a national playbook for Canada’s life sciences sector, what would you change first?
Canada’s strength is Canada’s weakness: good enough is good enough, but we must live in a world of great. We are too timid about excellence, often regressing to the mean and spreading the peanut butter evenly across institutions. That is not how you win, and it is not what China, India, the United States or advanced Scandinavian economies are doing.
If I were advising the prime minister, I would pair a world-class sector leader with the most senior public official. The official’s job is to move government out of the way, and the leader’s job is to work with global peers to define an implementation plan. Where the best operator is matched with a government official focused on removing impediments, you can unlock real magic.
You’ve highlighted AI as a major opportunity in healthcare. What excites you most, and what could hold Canada back?
The cell phone is the most powerful medical tool in the world. Canada has a strong history in AI and telephony — the “Godfather of AI” Geoffrey Hinton is across the street, and the Vector Institute is around the corner. We have an unbelievable concentration of leading minds, but we are falling behind on computing power, financial investment and infrastructure compared with China and the United States.
Every patient could have a form of primary care using their mobile phone, even when the world does not have enough access. Every patient can have a better experience with an agent coordinating their care. We can build a clinical trial in cancer in 10% of the time and hopefully 10% of the cost compared with two years ago. The opportunities are boundless, but we must not become too regulated or fearful. Canada has not clearly said it wants to lead in this space.
How should the country navigate capturing more of the value from major medical innovations?
Thanks to endocrinologist Daniel Drucker, we receive some annual royalties from Ozempic, but where is the real money? It is in Norway, so much so that Norway’s GDP needs to be calculated with Ozempic excluded because it is so profoundly shaping it. I look at Norway and its sovereign fund as a government that made difficult strategic choices about long-term wealth creation and protection.
Those are brave, bold choices Canada has to make if we do not want to fall back to complete dependence on foreign economies. Canada and the United States will always be cousins, but should we decrease our reliance? Of course, maybe from 75% to 50%, but not to zero. What we do not want is to be at the mercy of any other economy, in good times or bad. Making Canada the friendliest place for investment and for money to nest is something we can leverage.
Cuts and uncertainty in U.S. research funding created a window to attract global scientific talent. How did UHN leverage this moment?
We go hunting every day for the brightest in clinical medicine and science around the world. Suddenly, we were getting calls: “Do you have anything? My grants are drying up. My graduate students don’t have operating funds.” This opportunity fell into our lap.
We said Canada needs a bolder ambition and to recruit 1,000 of the very best scientists with industry links or potential. We raised a record $30 million in the first week with fewer than 30 phone calls. Over 800 scientists put up their hands and said, “I want to come.” But it is not just getting people here; it is keeping them. Scientists go where the money is.
UHN is known as “Canada’s hospital” with a history of medical firsts. Which areas of excellence stand out today, and what breakthroughs are coming next?
UHN’s Ajmera Transplant Centre had the first lung transplant and first double-lung transplant. If you get your lung transplanted in Toronto, you will have among the best outcomes in the world. The next opportunity is getting beyond rejection drugs — growing your own lung or heart on your own scaffold with your own cells, or knocking out rejection cells.
We will cure diabetes. From insulin, the next step is islet-cell transplantation and mechanisms for turning down the inflammatory response. One of UHN’s most important commitments is basic science — it is half a hospital and half a university. With the University of Toronto, you can throw a stone and hit a world expert within 100 yards, and geography matters when work is transdisciplinary.
Beyond research, what are examples of commercial or practical innovation coming out of UHN?
One of the top reasons people are admitted to emergency rooms in G15 countries is congestive heart failure or chronic obstructive pulmonary disease. With Medly, developed by Heather Ross at UHN’s Peter Munk Cardiac Centre, a patient uses a blood pressure cuff and scale daily, and the data downloads electronically. We have seen patients with 14, 15 or 17 exacerbations a year go to zero.
Every exacerbation further damages the heart, so the clinical and economic implications are enormous. This standard of care can be offered anywhere using existing technology. At UHN’s Princess Margaret Cancer Centre, we are also looking at liquid biopsy — a blood test that identifies cancers — but we need ethics and economics in the discussion. We already spend 40 cents of every tax dollar in Ontario on healthcare, and there is a limit where ROI takes away from other health-producing sectors like education.
There is a growing debate about Canada’s economic trajectory and its ability to convert strengths into sustained performance. What is the path forward?
A few changes could significantly improve performance. My biggest frustration is that we have the right ingredients but lack discipline and alignment. If this is a call to alignment and tough choices, that matters. You cannot build a house by putting the roof on first — you start with the foundation.
Canadians have to be more realistic about the order in which we build a stronger nation and economy. Support political decision-makers, but insist they work with implementation experts and hold both accountable. Demand a blueprint with outputs, timelines and investments. At the moment, success for scientists who discover something highly commercializable means leaving the country. That has to end — we need to be the place to come, not the place to leave.
