Keynote address at Research Australia Health and Medical Research Awards

I start by acknowledging the Gadigal of the Eora Nation as the traditional custodians of the land on which we gather. I pay my respects to their Elders past and present and extend that respect to other Aboriginal and Torres Strait Islanders who are present here today.

Fellow Research Australia Board Directors and Board Alumni here tonight: Senator Kim Carr, Hon Pru Goward, Tania Mihailuk, Yasmin Catley MP, Dr Alan Finkel, Chris Chapman , Nadia Levin, Research Australia members and supporters

This Research Australia event is a wonderful celebration of research – and of those who support it.

I’m interested in the work of RA in multiple capacities – as a Board member, as VC of UNSW, as Chair of the Group of Eight, as Chair of SPHERE, which I will talk about later and, most importantly, as a doctor and health researcher.

I am grateful for this platform to speak with such a distinguished audience, on a few topics I feel are important.

There are few more noble endeavours than that which we celebrate tonight.

Quite simply, research changes and saves lives.

With the pace of change in the world today, the complexity of global grand challenges and the tight budgetary environment, the best friend of the researcher is collaboration – the first point I’d like to speak on.

Throughout my career, I have seen collaboration work to powerful effect.
Key to the success of any collaborative initiative is unity of purpose and generosity of partnership.

They are certainly a driving force behind, SPHERE, the Sydney Partnership for Health, Education, Research and Enterprise – which I have the privilege of Chairing.

SPHERE brings together 14 leading organisations hospitals, LHDs universities, MRIs to deliver a step-change in the translation of excellence in research and education, into outstanding healthcare in our region.

SPHERE is one of seven nationally-accredited Advanced Health Research and Translation Centres, which now have MRFF support and are the critical nidus of Academic Health Science Partnerships developments in Australia.

Academic Health Science Partnerships have been successfully adding value and transforming the way healthcare and research is delivered in the US and Europe for decades – bringing together hospitals, universities, institutes, primary care, public health and, at their best, industry.

I had the privilege of helping establish UCL Partners in London and of leading the Manchester Academic Health Science Centre.

I saw both drive partnership and innovation beyond all expectations – the work with stroke being a good example.

The work in stroke started with research showing that rapid thrombolysis could reduce handicap and death after stroke – a clinical community recognising a massive evidence-practice gap, and health service management recognising the potential economic and community benefit from adoption and scale-up of thrombolysis.

Implementation, however, required enormous change to bring all the disparate components together – education of GPs and the public, rapid ambulance responses, and transfer to specialist imaging and treatment centres rather than the nearest hospital.

These major reforms meant challenging change for clinicians and health service managers – giving patient care priority, ahead of the needs of individual organisations, departments, services or health professionals. But it has resulted in best practice and it saves lives.

I witnessed this in action when my father-in-law in the UK had a massive stroke.

He was quickly taken by NHS ambulance and then helicopter from Kent to a specialist centre in London and within 45 minutes had a CT scan and thrombolytic therapy.

Amazingly, within 24 hours, he was sitting up in bed watching his beloved West Ham United on tv. From my perspective, the only way it could have been a better outcome was if he had woken up an Arsenal supporter.

There is a caveat to that story. The stroke was a result of him waiting more than six months for elective treatment of atrial fibrillation – a desperate failing by the NHS – and he waited another six months after his stroke to be fitted with a pacemaker.

We have seen similar progress in stroke care re-organisation in NSW, pioneered initially in the Hunter Valley and then adopted in Sydney, after sweeping reforms to align the ambulance service, hospitals and clinicians.

It is saving the state tens of millions of dollars and, more importantly, saving lives.

We are now entering an even more exciting era of mobile stroke units – ambulances carrying lightweight portable CT scanners and staff delivering thrombolysis in the field.

A partnership is now in development between the two Sydney AHRTCs, NSW Health and NSW Ambulance to pilot a mobile stroke unit in Sydney in 2019, emulating successful adoption in Melbourne this year.

It is my hope that the clear benefits of partnership through AHSPs will help overcome the protectionism and self-interest we too often see preventing true evidence-based care in the best interest of patients.

AHSPs can help overcome issues of evidence based clinical care delivery but they are much more than that. They are also a great vehicle for top quality translational research, as has been recognised by funding through the Medical Research Futures Fund MRFF.

The Medical Research Future Fund is a wonderful initiative which I believe will be transformational for translational and applied medical research in Australia. I welcome the 12 newly announced MRFF national priorities for 2018-2020 – which include Antimicrobial Resistance, Ageing and Aged Care, Aboriginal and Torres Strait Islander and Global Health and Health Security and public health and funding for clinical research training.

I have advocated to Minister Hunt that a part of that funding should be used along the lines of the successful UK Biomedical Research Funding Model – a tested mechanism for driving translation and training the next generation of clinical scientists.

The first Biomedical Research Centres were established in 2007. They bring together big groups of outstanding clinicians and academics in hospitals and university partnerships to focus on major translational research issues. The awards to each centre are substantial for 5 years and importantly the topics, disciplines and focus of research are not defined by the funder the NIHR. The funding is awarded on the basis of external, international peer review to groupings able to demonstrate excellence in delivery of translational research in areas they define.

Having that substantial level of sustained funding to bring together outstanding talent across leading hospitals and universities has created an environment where scientific endeavour thrives, where the foremost talent wants to work, where world class outputs are produced, clinical trials can succeed and industry is attracted – not surprisingly it has contributed to the UK’s international competitiveness in health research

I strongly advocate that approach being used for part of the Australian Medical Research Future Fund and I hope that Research Australia will support it too.

Which brings me to my next topic – the great work by independent third parties, like Research Australia, in keeping health and medical research on the national agenda.

It reinforces a point I made when I addressed the National Press Club this past August.

We need Australians to care about research the way those of us in this room do.

Not just about the economic return on research funding – which we know, for Go8 universities alone, is some 10-fold annually returning $25b from the $2b pa in public research funding we receive – but about the social impact.

Advances such as solar energy cells, the Gardasil vaccine, effective care for HIV or diverse areas of current research such as: producing 3D replacement skin, automating Australia’s mining industry and helping farmers with water usage, all have the potential for powerful, high-impact outcomes which can’t always be measured in dollars.

Research Australia, under the guidance of Chris and Nadia, has been a persuasive advocate for health research, delivering on its mantra to engage, connect and influence.

The impact of Research Australia is well illustrated by two key achievements.

The first is the Frontiers program which Nadia mentioned earlier.
An innovative way to apply translation to market thinking – in terms of the funding of research – into ‘treatments of the future’ like epigenetics and immunotherapies.

Research Australia and its stakeholders are to be applauded for the effort and persistence in getting this across the line with the MRFF.

The second achievement is Research Australia’s ability to bring together the disparate parts of the health and medical research sector to unite on a common platform.

Research Australia is working to successfully position HMR as a key economic driver for Australia and to speak with the collective voice that is so necessary if we are to influence Government policy and funding decisions.

I congratulate Chris and Nadia on their leadership.

A topical point that I cannot avoid mentioning before I finish is the imperative of protecting the integrity of our peer review grant award system.

Although government input in determining high-level research priorities is a good thing, I strongly support the Haldane principle that specific research funding awards should be independent of political influence.

I know this has been a concern with the structure of the MRFF Act. The Office of Health and Medical Research has indicated that ‘Captain’s picks’ will be limited to about 10%, with the remaining funds competitively awarded.

In my opinion, even if a Minister identifies a legitimate disease area or challenge for funding, the funds will be best used if they are awarded by transparent peer review.

I’m sure you shared the outrage of my university colleagues, at the recent revelation that the former Minister for Education secretly vetoed 11 ARC research projects which had been highly ranked in robust and very competitive peer review, only to then defend the decision by claiming taxpayers would not think the projects were worthy of funding, based on one of the titles.

The current Minister of Education has assured us of transparency in exercising his discretion but has proposed adding a ‘national interest’ test to the application process.

In my view the national interest is best served by having robust peer review.

But, if we are going to have to accommodate a ministerial second guess, perhaps we should have some fun with it and turn it into a national ‘quiz’ – something akin to charades.

Of course, this game could get tricky when trying to act out such outstanding research in the humanities as this important grant award:

An information theoretic clustering approach for unveiling authorship affinities in Shakespearean era plays and poems.

On a serious note we are yet to have a conversation about this new idea of a ‘national interest’ test for research grants and Minister Tehan’s recent op-ed in The Australian didn’t shed much light.

While applicants already do have to explain the broader social benefit of their research, the fundamental problem remains that we so often do not know where research will lead.

Take for example Alexander Fleming’s discovery of penicillin. The man often described as a ‘careless lab technician’, accidentally contaminated a staphylococcus culture plate before heading off on a two-week vacation and came back to find the ‘accident’ had prevented the growth of staph.

‘One sometimes finds what one is not looking for’ Fleming said.

“When I woke up just after dawn on Sept. 28, 1928, I certainly didn’t plan to revolutionize all medicine by discovering the world’s first antibiotic, or bacteria killer……but I guess that was exactly what I did.”

Or Australia’s own Nobel Laureates, Barry Marshall and Robyn Warren, who had a similar story with their helicobacter discovery.

All their cultures were negative when thrown out after the standard 48hrs. But another careless lab technician – the unsung heroes of discovery research, it seems – left one going over the weekend and became the unwitting catalyst of a revolutionary understanding of stomach ulcers.

Under a national interest test, one can’t help but wonder: would Fleming’s or Marshall and Warren’s work have been funded?

Enough of that. Tonight, we celebrate research.

We celebrate the very best of research discovery conducted for pure intellectual curiosity, translational and applied – all important for our future wellbeing and prosperity.

My thanks to Research Australia for the great work you do on the behalf of all those who care about health and medical research.

To all the nominees, I offer my heartiest congratulations.

Enjoy the rest of the evening.

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