2024-2025 Annual Report: Ontario Trials, Canadian Strength

Clinical trials are where science transforms to care, and Ontario has built the conditions for that connection to thrive. With world-class hospitals and research institutes, diverse communities, engaged patient partners, streamlined processes, and strong industry collaboration, Ontario is home to a thriving life sciences ecosystem that drives discovery, attracts investment, and advances healthcare.

Ontario’s clinical trials leadership has been shaped through years of collaboration among institutions, sponsors, patient organizations, and government—working together to create a stronger, more predictable environment for clinical research. The progress we’ve made here in Ontario contributes to Canada’s national role as a clinical trials leader. And that contribution is vital, because trials are not conducted in provincial silos, but across countries.

 As we grapple with geopolitical instability and rapid technological change, we recognize an opportunity to harness Ontario’s strengths and foster national collaboration. By working together within Ontario and across provincial borders, we can strengthen research and innovation, accelerate critically needed therapies and devices, and build a resilient, globally competitive clinical trials ecosystem that benefits patients and generates economic growth. 

The moment—and the challenge—before us

Ontario is well-positioned to contribute to a more connected, efficient and accessible clinical trials environment—one that supports research teams, sponsors, and patients alike. Patients need more equitable access to promising therapies, including in rare diseases, and clinical trials provide these opportunities. Institutions and Research Ethics Boards continue to balance capacity pressures with the need for rigorous and timely reviews and efficient, predictable start-up processes.

 Building on our strengths, we have an opportunity to align and evolve to establish modern clinical trials frameworks that enhances coordination and enable more seamless collaboration across Canada, while upholding the highest standards of quality and ethics.

CTO is helping to turn ambition into action, mobilizing solutions that strengthen Ontario’s infrastructure and advance national alignment and competitiveness.

Committed to moving forward—together

CTO’s QuickSTART Refresh, supported by a $5 million investment through Phase 2 of Ontario’s Life Sciences Strategy, is modernizing study start-up with practical tools aimed at achieving a 45-day activation target. A critical component is the Ontario Universal Agreement for Clinical Trials (UACT) which will reduce contracting delays and improve consistency for sponsors and sites across Ontario

Stream, Ontario’s single ethics-review platform, has successfully transformed multi-site trial review in the province, supporting over 175 sites and over 300 sponsors in 2024-2025. 

This year, Stream will begin supporting efficient ethics reviews on a national scale as part of CanReview, a pan-Canadian collaboration for multi-site clinical trials. CanReview represents a Canadian win, and CTO is proud to support efforts across provincial borders to strengthen clinical trials for all.

CTO continues to engage patients and members of the public to ensure policies, platforms and programs related to clinical trials are relevant and accessible. Our College of Lived Experience takes this one step further, collaborating directly with researchers and industry to provide input on clinical trials. We are grateful to CTO’s College members for the time they give to make our community stronger.

Looking ahead

Ontario contributes to Canada’s clinical trials strength—and in return, a stronger Canadian clinical trials ecosystem benefits Ontario. By accelerating trial activation, adopting shared standards, advancing national alignment and engaging patients every step of the way, we are creating a system where research moves faster, reaches more people, and delivers greater impact.

This progress would not be possible without the collaboration of hospitals and research institutes, universities and colleges, industry partners, contract research organizations, patient groups and health charities, policy makers, regulators and our supportive and committed partners in the Government of Ontario. We also thank the members of our visionary Board of Directors, who are always aiming five years ahead and challenging us to think bigger and do better. And we thank the members of CTO’s lean but mighty team, who connect our community and bring these ambitions to life. It’s by working together that we can ensure Ontario’s thriving life sciences ecosystem, in concert with Canada’s broader research community, will remain a driver of discovery, economic growth, and improved health for years to come.