Funder Focus: Dr. Roch Bernier and the Fondation Lucie et André Chagnon
March 7, 2005
By Nicole Zummach
This month in our Funder Focus we feature the Fondation Lucie et
André Chagnon, which became active in 2000 with an intent
to carry out long-term projects focused on reducing poverty and preventing
disease. CharityVillage spoke with executive director Dr. Roch Bernier
about the foundation's efforts to tackle the root causes of disease
and poverty, its unique approach to funding, and the importance of innovation
as a vital component of the foundation's work.
CharityVillage: The foundation has been active for less than
five years, yet it holds the distinction of being the largest foundation
in Canada. Do you feel you have a responsibility to set an example for
other funders?
Roch Bernier: Well, before becoming an example for others we
have to learn from others. We have been able to contact many foundations
since we were established and we learn a bit at every meeting we have
with them. This foundation will be inspired by many of them, but most
recently we consider ourselves as part of a centre for effective philanthropy.
So, in a sense we will distinguish ourselves from the more traditional
foundations, in that we want to target our gifts and be able to sustain,
for a long time, meaningful programs that will address some of the basic
issues in society. At this point in time we have two major focus areas:
prevention in health, and prevention of poverty. They are two very important
challenges for society overall.
CV: One of your mandates is to tackle the root causes of poverty
and disease. What have you discovered about these root causes since
being in operation?
RB: With poverty today in 2005, the gap between rich and poor
is larger than ever, and it seems to be growing, particularly if you
look at the younger population. This is very disturbing and alarming.
This is one of the major preoccupations of Mr. Chagnon. He wants, in
the long run, to be able to close that gap. In order to close that gap
you have to work with the poorest people to give them more opportunity
to grow, develop, and mainly to educate themselves. We won't be able
to achieve this through investments by the foundation alone, but with
a lot of cooperation on the part of the community and people at the
community level. This will be a very significant and distinct contribution
in the next 10 to 15 years, I hope.
For prevention in health, it is easy to see that at this time the provinces
devote more than half of their budgets to health. And by health, I mainly
mean a lot of curative issues. The prevention section is less than two
or three percent of the overall health budget. If we don't see a major
reversal of this trend we won't even be able to correctly manage health
and disease, and it will absorb more and more of the overall budget
of society. This trend needs to be reversed significantly. So, we will
support a lot of initiatives in order that we can do better in the prevention
aspect of health. This will address not just the health system itself,
but also every citizen of this country. If we address this issue correctly,
we could do something more for his/her health and exercise and nutrition.
Then we will be able to prevent many serious diseases, including cancer.
This is another long-term target that the foundation is working on.
CV: I think most people would agree with you that prevention
is the key to better health. Why do you think governments aren't really
focusing on this aspect of healthcare?
RB: Well, first let me tell you that the sharing of correct information
- what we call evidence-based information - is not as great as it might
initially seem. A lot of people don't know that if they paid proper
attention to nutrition and exercise they could prevent about half of
the cancer out there today. And this is very scientific, not just an
opinion. It has been well documented and proven. But the problem with
prevention, aside from not having a lot of money or government attention
- except words - is that in order to be successful, it has to be applied
over many years and there has to be a change in behaviour. Changing
the behaviour of the individual, and collectively changing our behaviour
is a large challenge for most people. It requires individual modification,
but also changing the environment, changing the industry, changing regulations.
The best example of this is the tobacco industry and smoking, and what
we are doing to try to get rid of this problem. It's been going on for
years and success is coming slowly, but it's still a major cause of
health problems today. It's not even as simple as this, if you think
about nutrition and food. It's much more complex than tobacco, and you
could say the same for exercise and living a physically active life.
From the foundation's point of view, a major problem is that it affects
young people and at a younger age than before. So we will have a lot
of trouble if we don't do anything about this very important issue.
CV: Do you see any evidence that the governments are starting to
recognize prevention as a key aspect of healthcare?
RB: We're seeing a lot of discussion, mainly in Quebec at the
provincial level, about what we have to do in health. They have said
that the number one target should be prevention, so it's a good sign
that a lot more people are conscious these days that we have to act
on this issue. I know, also, that at the federal level they are looking
at a pan-Canadian strategy to improve health and promotion of health.
I think we are in the right position for at least the debate to happen.
But from the foundation's point of view, it's not the debate that is
important, it's that we be able to take action - especially with young
people - and be able to demonstrate that prevention will absolutely
work, as the scientists say it should. So the challenge is there.
CV: Innovation is an important component of the foundation's
work. What are some of the innovative projects you are supporting right
now?
RB: The most innovative initiative right now is related to what
we call the integrated approach to prevention - teaching health professionals
about the use of prevention. We have been able to put in place a chair
in preventative medicine and alternative medicine at Laval University.
It was the first time that kind of chair was put in place. We did this
two years ago and it has already paid a lot of dividends. There have
been a lot of courses and lectures and significant learning by the medical
students and nurses about alternative medicine, what works and what
still needs research. Other faculties and medical schools in Canada
are looking at a way to follow the same path as Laval. This is something
that the foundation is proud of.
CV: Do you think innovation is something that more funders
need to embrace in their work? Is there a lack of innovation among Canadian
funders?
RB: The world of funders is very peculiar and particular. A lot
of private funders choose very special topics or give to very particular
causes. Innovation is not necessarily something the funder is looking
for. But I will say that in the last five years there has been a trend
toward more effective giving and setting programs and projects with
real targets and closer follow-up by funders. I would say that more
than half of foundations that were created in the past five years are
part of this 'effective philanthropy' movement.
CV: One of your goals is to be a catalyst rather than an
operator. What does this mean for the foundation and how are you acting
as a catalyst?
RB: Our largest program right now is Québec Enfants, whose
main goal is to contribute to a successful start at school for all children,
but first and foremost, for those from underprivileged areas. Though
still in the early stage of development, Québec Enfants is a
separate corporation with its own board of governance, its own officers,
and its own program director. They operate with their own mission and
vision. We supported them initially with the conception of the program
but now they are on their own. That is what we mean by catalyst. We
help and we give some money initially to set up the program, but after
that the program runs on its own. We still support them and follow them
closely, but we are a certain distance from them so that they are fully
autonomous in their functions and decision-making. That could become
our trademark - setting up well-based organizations that from the start
take responsibility for what they have to accomplish.
CV: Currently, you are not accepting proposals for funding.
What is your approach to grantmaking right now?
RB: At the present time, we have one major program - Québec
Enfants - which also receives funding from the Quebec government. We
are embarking on the last year of this four-year co-funded program.
Aside from that, we have three demonstration projects that are also
co-funded with the government. We have thirty community projects that
are going on right now, which must be evaluated before we fund any additional
ones. One of these demonstration projects is called Autonomie Jeune
Famille, which targets young families - single-parent families, for
example - and gives them support so that the children will receive the
same opportunities as other children. Another project will mobilize
the people of Quebec City with an aim to address obesity.
Next year we will be able to open up again to receive applications.
Our investment in the projects I mentioned was about $17 million in
2004 and it will be close to $25 million by the end of 2005. So that
gives you a sense of our growth. Initially, in the first year, we gave
less than $1 million. In the second year it was $4 million, then $8
million in the third year, and last year it was $17 million. By 2010,
we should be at about $60 million by ourselves, plus $30 million with
partners.
CV: Do you plan to eventually fund outside the province of
Quebec?
RB: We have said that until 2007 it will mainly be communities
in Quebec, but we will probably go outside of Quebec after that. That's
for action at the community level. For research and the medical schools
we could do things outside Quebec.
CV: What does the foundation hope to achieve in the next few
years? Where do you see things heading?
RB: I will be very impressed if we can be successful in implementing
Québec Enfants in every school. If we could have [less fortunate]
children succeed as positively as others who are more fortunate it would
be a great, great achievement for this foundation. For the prevention
in health, I think that if we are able to triple the percentage that
the government gives to that aspect of care it would be a great achievement
from the foundation's point of view. Maybe I'm an optimist, but if we
could triple it in a ten-year span, that would be something. It has
to start somewhere. Ultimately, the foundation does not want to influence
people with its money, but to work together against poverty and to be
able to choose prevention as the main focus of healthcare. Together
we can make a difference.
Dr. Roch Bernier M.D. has been executive director of the Fondation
Lucie et André Chagnon since it became active in 2000. A member
of the Collège des médecins du Québec [Quebec college
of physicians] since 1973, Dr. Bernier has had a very successful career
teaching family medicine at the Université de Sherbrooke, where
he became a tenured professor in 1988. For more information about the
Fondation Lucie et André Chagnon, visit www.fondationchagnon.org.
