Evidence-based decision-making, the process of using the best available evidence to guide health policy and practice, is increasingly under threat. Around the world, its foundations are weakening in the face of political rhetoric, fiscal restraint, and the unchecked spread of misinformation. Canada should take note. Cuts to research funding and pressures on public systems are undermining universities and health institutions, weakening our ability to generate and apply knowledge that improves care, guides decision-makers, and strengthens public health.

This is not just an academic problem. During economic crisis, when research funding and programs become targets for financial austerity, the consequences are felt across health systems, public policy, and everyday lives. Federal budget cuts, workforce restructuring and policies that limit universities' ability to attract and retain talent are destabilizing the infrastructure necessary for research innovation and impact. In Canada, three federal research councils have been asked to cut their budgets by 15% - a move that has left scientists ‘alarmed’ and concerned this will ‘hollow out’ Canada's long-term research competitiveness. This fiscal restraint is rippling through many government-funded sectors and industries with increasing visibility in healthcare. In British Columbia, health authorities are cutting jobs in response to ‘mandated’ budget reductions intended to prioritize frontline care. While commendable, these cuts often overlook genuine opportunities for cost savings—such as non-evidence-based programs launched without clear justification or continued funding of ineffective initiatives that fail to deliver improved patient outcomes and experiences.

The result? A system that undermines the very people and structures we rely on to strengthen and inform public policies and public health interventions. Good research and innovation require time and sustained investment before benefits can be seen. But scientific evidence and innovation are meaningless if they never reach the people who need them. Sharing, translating, and promoting the uptake of research across audiences and settings – the core aims of knowledge mobilization, knowledge translation, and implementation science - are essential to bridging this gap, yet they are often overlooked. These tools, which deeply value community and person-centered engagement, also ensure that research does not remain trapped within academia but reaches the clinics, hospitals, and communities where it can transform lives and inform policies and practices.

The gap between research and practice is well documented. On average, it takes nearly two decades before evidence that could improve outcomes is integrated into clinical practice. And even then, adoption does not necessarily translate into meaningful or measurable impact. For example, health and social care professionals rely on many forms of research to guide care and treatment decisions, but scientific evidence alone is rarely sufficient to guide change. For example, 30% of clinical practices are delivered inappropriately (e.g., overused or underused) in Canadian healthcare, reinforcing the gap between what we know and what gets applied in practice.

Adopting and implementing evidence in health and social care settings is complex. Decisions about what works and for whom must also be interpreted in the context of local resources, frontline realities, and policy priorities. This requires expertise in implementation science – researchers, patient-partners, and clinicians who understand how to adapt evidence-based interventions to diverse healthcare settings and patient populations. Understanding and evaluating the barrier and facilitators to integration are critical. Without consistent investment in the expertise required to translate evidence into practice, public health suffers. As some have rightly argued, “we don’t have a healthcare crisis in Canada; we have an implementation crisis.”

What can we do to ensure that knowledge is effectively translated into practice?

First, we must recognize implementation science as a core component of evidence-based decision making. This means dedicated and protected funding streams at the federal and provincial level for researchers who study how to move research into health and social settings. Second, we need collaboration between health systems, academic institutions, and governments - creating pathways for continuous feedback between those generating evidence and those applying it in practice or policy. Third, we must invest in training the next generation of research scientists onhow-to-do implementation science. Such individuals don't just apply research—they generate new evidence about what works in real-world contexts, studying how interventions perform across diverse settings and populations. Finally, we need accountability across organizations to close the ‘knowing-doing’ gap. Success should be measured by the full research to practice cycle—dissemination of evidence, implementation to diverse settings, and evaluation of real-world effectiveness—not just the production of new knowledge. Without these commitments, even the best evidence will remain underutilized while the health and social care sector struggles with preventable inefficiencies and inequities.

At a time where the public is looking for answers and demanding more of public institutions, the scientific community is calling for investment in implementation science training and integration to inform evidence-based decision-making which ultimately serves to improve health and social care systems towards enhanced health outcomes.

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