Editorials
Health services administration
Volume 194 - Issue 9

Cuts to the NHMRC budget will undermine the health of all Australians — today and in the future

Authors:  Garry L R Jennings, Stephen MacMahon and Geoffrey A Donnan

Med J Aust 2011; 194 (9): 436-437. || doi: 10.5694/j.1326-5377.2011.tb03052.x
Published online: 2 May 2011
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Our health and medical research sector is under threat and needs the support of the clinical community

Until quite recently, it was believed that peptic ulcers were caused by stress and lifestyle and that the most effective treatment was a bland diet and rest. However, in 1982, two Australian medical researchers (Barry J Marshall and J Robin Warren) discovered the bacterium Helicobacter pylori and demonstrated its role in gastritis and peptic ulcer disease.1 Thanks to this discovery, millions of people worldwide are now cured of peptic ulcer with a short regimen of antibiotics and acid secretion inhibitors.

This is just one of hundreds of examples of effective translation of Australian health and medical research into clinical practice and, importantly, better outcomes for patients.

Over the past 50 years, health and medical research has saved the Australian health care system trillions of dollars and delivered better quality of life for all Australians. It is estimated that between 1960 and 1999, medical research was responsible for a longevity gain of 8 years worth $2.9 trillion and gains in quality of life worth $2.5 trillion in avoided health expenses.2

Regrettably, these hard-won advances now stand to be undermined by potential cuts to National Health and Medical Research Council (NHMRC) funding in the May federal Budget. Over the past decade, the nation’s research community has achieved a level of critical mass, thanks to the vision and leadership of successive governments. But the sector was coming off a very low base and, compared with overseas competitors, Australian Government funding for research as a proportion of gross domestic product still remains low, at only 0.11%–0.12%.3

Over the same period, demand for medical research and the knowledge to cope with emerging disease patterns has grown with the inexorable rise in chronic disease, an ageing population and the impact of globalisation on health epidemics. In order to manage these new health challenges with the financial resources available, we will inevitably see more and more health care delivery taking place in the community and away from acute settings. In preparation for this seismic change, we need research breakthroughs and long-term, evidence-based solutions.

A cut to the annual $775 million NHMRC budget will not just affect Australians today but will compromise the health outcomes of our children, grandchildren and great-grandchildren. Health and medical research is an essential component of the current health reform agenda and plays a vital role in providing better outcomes for a self-improving health system.

A large proportion of Australian health and medical research is now focused on translational outcomes, such as disease prevention, improved clinical care, and new diagnostics, therapies and vaccines, which have a demonstrated capacity to reduce the nation’s health budget and deliver better patient care. Indeed, without such research, the impact of health reform on patient-relevant outcomes such as death and disability will remain substantially uncertain.

Another illustrative example of Australia’s contribution to global health gains is the development by Professor Ian Frazer and colleagues, in collaboration with CSL Biotherapies, of the quadrivalent human papillomavirus vaccine (Gardasil; Merck Sharp & Dohme) for cervical cancer prevention. According to an Access Economics report, the vaccine is expected to prevent around 70% of cervical cancers and result in significant economic returns in averted health care costs in Australia.4

As well as making significant contributions to global health, it is crucial that we maintain a strong Australian health and medical research sector in order to identify solutions for unique local health problems. Last year, researchers at The George Institute launched a major international trial of a very low-cost, once-a-day “polypill” for the prevention of cardiovascular disease. This treatment is particularly promising for Australia’s Indigenous communities, for whom cardiovascular disease is the leading cause of death and disability. Compared with other Australians, Indigenous Australians suffer heart attacks at three times the rate, at an average of 10–15 years younger, and have 3–4 times higher rates of diabetes.5 We are unlikely to “close the gap” in Indigenous health by reading reports of research conducted in the United States or Europe.

Moreover, cuts to research funding will seriously impair Australia’s ability to respond effectively to health crises, through delays in access to the latest and most effective vaccines and treatments. This applies equally to mobilising a rapid and successful response to acute emergencies such as severe acute respiratory syndrome, pandemic (H1N1) 2009 influenza or, in the context of the recent floods, outbreaks of Ross River fever.

For all these reasons, a cut to the NHMRC budget will increase health care costs in the long term and harm the Australian economy, through the failure to use the capacity of existing and new state-of-the-art facilities, a downturn in productivity and lost intellectual property as we are forced to “buy back” health innovations from international pharmaceutical and device companies.

There is also the very likely spectre of our brightest scientists and clinicians leaving Australia for rapidly growing biomedical research hubs in Asia and beyond, as well as a loss of future capacity through the failure to train an adequate research workforce. Interestingly, in the United Kingdom, medical research has been protected, despite wide and deep cuts in other public sectors, and in the US, biomedical research has been identified as a priority for government support by President Obama. India, China and Singapore are also making unprecedented investments in medical research and associated intellectual and capital infrastructure.

Proposed funding cuts will place emerging Australian medical researchers in a particularly vulnerable position, given that their training extends over a 10–15-year period. The effects of reducing training places, even in the short term, through a reduction in any of the funding programs will be felt for more than a decade.

It would only take a small cut to the NHMRC budget to have a serious impact on medical research outputs, denying Australians access to the best available preventive therapies, diagnostics and treatments, today and in the future. For this reason, the medical research sector has been forced to take its fight public in a bid to safeguard leading research programs that are a lifeline for children and adults suffering from heart disease, cancer, genetic diseases and many other forms of serious illness.

The support of Australia’s clinical community will be crucial to ensuring that our research sector continues to deliver translational benefits to Australians. There are a number of ways clinicians can provide this support. Writing letters to and raising the issue with members of parliament and the Prime Minister is critical to maintaining the profile of this issue. Research Australia has developed an online petition to the federal government (http://researchaustralia.org/personal-stories/petition-to-federal-government.html), and concerned clinicians can vote for community advocacy organisation GetUp! to take on the campaign (http://suggest.getup.org.au/forums/60819-campaign-ideas/topics/61385-i-suggest-a-campaign-about-/filter/top). More information is available at the Discoveries Need Dollars website (http://www.discoveriesneeddollars.org).

Authors

  • Garry L R Jennings MD, FRACP1
  • Stephen MacMahon DSc, PhD2
  • Geoffrey A Donnan MD, FRACP3
  • 1. Baker IDI Heart and Diabetes Institute, Melbourne, VIC.
  • 2. The George Institute for Global Health, Sydney, NSW.
  • 3. Florey Neuroscience Institutes, Melbourne, VIC.

Correspondence: garry.jennings@bakeridi.edu.au

Competing interests

The George Institute has received grant funding from Dr Reddy’s Laboratories, manufacturer of the polypill currently being trialled, and grant funding and travel assistance for meetings from Servier International.

References

Provenance: Commissioned; not externally peer reviewed

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