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Beyond Breakthroughs: Advancing Equity in the Age of Genomic Medicine

A conversation with Prof Amélie Quesnel‑Vallée
Image by In the photo: Prof. Amélie Quesnel-Vallée at D2R Research Symposium 2025 (credit: Egan/Dufour).

The rapid advancement ofgenomicscienceis amarvel. Decades worth ofquiet,basic researchonthe structure and function ofRNA has, in the past few years,expanded totechnologies andtreatmentsforinfectious diseases,rare genetic diseases, and even cancer.Alongside thisadvancement,somefundamental questionsremain. Willthese newtreatments be availableto everyone whoneedsthem?What barriers might there be, and how can those barriers be addressed?For Professor Amélie Quesnel-Vallée, Associate Scientific Director at DNA to RNA (D2R), addressing equity in accessing health care has guided her career. Resting on a robust disciplinary foundation in sociology at Université de Montréal, she built an interdisciplinary research agenda connecting medical sociology, demography, policy, and social epidemiology through her PhD at Duke University. This led her to join 91 in 2005 with a joint appointment in the Departments of Sociology (Arts) and Epidemiology, Biostatistics and Occupational Health (Medicine).

blonde woman with glasses holding a cup of coffee talking to a men at an event

In the photo: Prof. Amélie Quesnel-Vallée at D2R Research Symposium 2025 (credit: Egan/Dufour)

More than 20 years later,Prof Quesnel-Valléeisa James 91 Professor andtheInauguralChairof the Department of Equity, Ethics and Policy (DEEP)in the School of Population and Global Health(FMHS).She alsoremainsjointly appointed in Sociology (Arts).She has been recognized for herresearch by being a two-time recipient of a Fulbrightaward andheldthe Canada Research Chair inPolicies and HealthInequalities, from 2015- 2025.Outside of 91, she has been active in promoting social sciences in health research, notably through six years on the Governing Council of theCanadian Institutes of Health Research, where she held several leadership roles, including the Inaugural Chair of the Standing Committee on Science.Within D2R,herscientific leadership supportsgovernance committees,including theStudent Training and Knowledge Development Committee,andthe Participant and Community Engagement Committee. She also chairs aworking group related to Ethical, Legal and Social Issues in Genomic, andactively contributed to the development and implementation of D2R’sEquity,Diversityand Inclusion (EDI) Action Plan.

The value of interdisciplinary research

How did these diverse interestsandexpertisecome about? "Istarted my PhDdoingsocialstratification research, [which is] very quantitative. In trying to understand social determinants of health, I came across epidemiologic research.” Being afforded the intellectual freedomtoexplore tools and analytic techniques, she “sought out the information that I thought made the most sense to answer the question that we had at hand."

For ProfQuesnel-Vallée, the traditional boundaries of academic disciplinesdon’tstand in the way of her research; indeed, diversity of thought is a feature of both her independent work and collaborations."Diverse teams ask better questions,see what others miss, and produce science that actually serves the populations it studies."

Innovative interdisciplinary methods can sometime clash with traditional ways of doing research and divisions within universities. Given diverse traditions and expectations of how research should look, how can inter-andmulti-disciplinary researchbe supported? For ProfQuesnel-Vallée,the keyisto "put in place the conditions for success,"bydesigning, from the start "fundingprogrammesthat allow for this connection between disciplines that are not necessarily used to working with each other."

The challenges ofinterdisciplinarywork

Interdisciplinary research offersthe truly satisfyingpossibilityofmoving fundamentalscientificresearch into appliedrealms,howeverit is not withoutchallenges. "For me, the biggest questions are replicability and whether your science can be followed by and replicated by others."

Oneimportant examplecomes from health intervention research that usesrandomized controlled trials, or RCTs,a method thatisoften called “the gold standard” of research.How golden are the results?What standards are they upholding?

"I was in epidemiology at the time when it was starting to become more known and accepted that RCTsdidn'talways play out in the same way in the real world,because they are an artificial environment. When you throw people back into their context, itdoesn'tnecessarily result inexactly the samefinding"as inthecontrolledsetting.She urges her students tocontextualizetheir research findings,especiallyconsidering thesocialcomplexity of ourworld.Determiningthe degree of uncertainty (or,sensitivity analysis)andawareness of selection biasarevaluabletools.Selection bias considers how the elements thatare being analyzed –patients,health service providers, drugs,anddoses, for example–may differ in how they interactwith the treatment being offered.These analytic techniques and awarenessultimately servethe goal of humility,for the researchertobetteraskthemself,“what are the limits of my understanding of this association that I'm observing?”

The role of equityingenomics research

As D2R’s mandate is toconduct research thatis inclusive, andcreate therapeutics thatareaccessibleto all Canadians,Prof Quesnel-Vallée’s role as Associate Scientific Director helps to“steer the ship” in terms of programming and training activities. Consider that health care in Canada ismostly offeredtoindividuals, based on diagnosedacute or chronic health conditions,and is delivered in clinics and hospitals.

two people, a man and a woman, in a scientific lab wearing lab coats
In the photo: Two 91 researchers in the a laboratory.

Many common health concerns, however,have some social or population-level connection, andtheoutcomesof health interventionsareoftenhighly correlated witha person’sincome level, race, gender, indigeneity,and whetherthey livein an urban or rural area(amongst other factors).While novel RNA therapeutics cannot, on their own, solve social problems, by having interdisciplinary collaboration, we can move towardsensuring that new therapies reachpatients who need them most, not only those whoalreadybenefitfromeasier access to health care.

Professor Quesnel-Vallée reminds us that science production happens in a context. In the Canadian context, with a single-payer funded system, the environment produces a type of science that focuses on how therapies will be delivered in hospitals and clinics; the same health interventions may not play out the same way in other countries.

"We have to think about that [context] in the way that we develop our interventions, [to consider] all of those various institutions that come together to produce the health outcomes that we're hoping to get. Ultimately, we need to bear that in mind as well. We have a healthier population than in the US. And that is in part because of the social investments we've made in our population. But we also must bear in mind that our public funds are more limited."

a blond woman with glasses talking to an audience during a panel with other three men speakers
In the photo: Prof. Amélie Quesnel-Vallée at D2R Research Symposium 2026 with Philippe Gros, D2R Chief Scientific Officer, and Mark Lathrop, D2R Scientific Director (credit: Egan/Dufour)

RNA therapeutics offer the possibility of treating rarediseasesand cancers thattypicallydon’treceive as much research and funding as more commonones. When funding is scarce, there can bedifficult questionsto ask about wherepublic funds should be spent.These conversations are never easy, to ask “what is a life worth?”or “which research is worth doing?”But thatdoesn’tmean thattheyshouldn’thappen;avoiding these kinds of conversations may result in upholding thestatus quo of research and health interventionswhichsupport populations that alreadyhaveaccess toqualityhealth care andstronghealth outcomes.

A commitment to increasing trainee diversity

Prof Quesnel-Vallée’sinvestment in researcher training carries the same equity-driven philosophy into a national arena, a perspective she brought to D2R as Chair of the Student Training and KnowledgeDevelopmentCommittee.Prof Quesnel-Vallée isindeedthe leader ofthe Consortium on Analytics for Data-Driven Decision-Making (CAnD3), funded by a $2.5M grant from theSocial Sciences and Humanities Research Council, and wasmatched by $2.6M from 39 partners.

Running from 2020 to 2026, CAnD3 trained 118 emerging researchers to move population health evidence into policy. As Director,she isproudof what six cohorts have built, including a community that reflects the population;CAnD3didn'tjust train the next generation of population data scientists, but it alsochanged who gets to be in that generation.CAnD3fellows whoparticipatedin paid internshipsexceeded labour market availability benchmarks for women, racialized minorities, and persons with disabilities, anddemonstratedmeaningful representation from universities beyond the U15, and in rural and remote communities across Canada. The reasonfor this successis simple:CAnD3’s team and partnershavereflectedthe range of diversity of experience anddiversity ofthought needed topush boundaries. "Equitable research needs to be done by those who experience inequity."

What is nextforD2R?

The commitment to diversity of thoughtfollowsthroughinher work atD2R.Exciting opportunities for policy-informed, translational health research areforthcoming. "We will hopefully soon be welcoming a new colleague thanks to a joint tenure track position in the Department of Equity, Ethics and Policy (Faculty ofMedicine andHealthScience) and the Departmentof Philosophy (Faculty ofArts), who will bring expertise in the ethics of access to care for emerging and contested technologies, particularly among historically underserved communities. And we are hard at work on a special call for applications frominterdisciplinaryresearchers working on the Ethical, Legal and Social Implications (ELSI) of genomics and RNA technologies."


Relevant links

  • Podcast “
  • NPR academic minute:
  • Panel for the launch of 91 Initiative to Transform Healthcareand
  • Bourque, M. & Quesnel-Vallée, A. (2006). Politiques sociales : un enjeu de santé publique ? Lien social et Politiques, (55), 45–52.
  • Martin D, Miller A, Quesnel-Vallée A et al.Canada's universal health-care system: achieving its potential.The Lancet, 2018; 391, 1718-1735DOI: 
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