Page created by Rhonda Miles
                    AND INNOVATION STRATEGY

Australian Medical Research and Innovation Strategy 2016 – 2021   1
Table of Contents
LETTER FROM THE CHAIR                                           ii
THE STRATEGY                                                    1
   Vision                                                       1
   Aim                                                          1
   Objectives                                                   1
   Strategic platforms                                          1
   Impact measurement                                           1
OPPORTUNITIES AND BENEFITS                                      2
THE FUND                                                        3
ALIGNMENT AND COMPLEMENTARITY                                   3
   National Health and Medical Research Council                 3
   Innovation and Science                                       4
   Other governments and non-government interests               4
   International alignment                                      5
CHALLENGES AND CULTURE                                          5
   The research pipeline                                        5
   Consumer engagement and collaboration                        6
   Transdisciplinary and industry cooperation                   6
   Research in practice                                         6
   Full cost of research                                        7
FIVE YEAR STRATEGIC PLATFORMS                                   7
   Strategic and international horizons                         7
   Data and infrastructure                                      7
   Health services and systems                                  8
   Capacity and collaboration                                   9
   Trials and translation                                       9
   Commercialisation                                            10
NEXT STEPS                                                      11

Australian Medical Research and Innovation Strategy 2016-2021   i
The Hon Sussan Ley MP
Minister for Health and Aged Care

Dear Minister,
The Australian health system must be innovative and ready to respond to future challenges,
including new health technologies, communicable diseases, and caring for an ageing
population with complex and chronic health problems. Research is the best way to prepare for
these challenges. Research can contribute to health system safety and quality, ensure
effectiveness of health interventions, and enable Australia to develop better methods of
preventing and treating disease.
Priority focussed research funded by the Medical Research Future Fund (MRFF) will
complement largely investigator initiated research funded by the National Health and Medical
Research Council (NHMRC). The MRFF will attract and retain excellent researchers, allow for
the discovery and commercialisation of new medicines and technologies, and enable
innovative treatments and cures. It will deliver improved health for all Australians, contribute to
a sustainable health system, and provide significant economic benefits.
I am pleased to present this document, the Australian Medical Research and Innovation
Strategy 2016-2021 (the Strategy) and the accompanying inaugural two yearly set of
Australian Medical Research and Innovation Priorities 2016-2018 (the Priorities), prepared by
the Australian Medical Research Advisory Board (Advisory Board) in accordance with the
Australian Medical Research Future Fund Act 2015.
The Advisory Board has proposed a number of strategic research platforms to ensure that the
Australian health system is ready for the future. This Strategy has been developed following
extensive national consultation with consumers, researchers, healthcare providers and
managers. The focus for this Strategy is on areas for investment that cut across the health
system, with investment opportunities relevant to all health issues.
The Strategy does not identify specific health issues as targets for investment. Rather, the
existing National Health Priority Areas 1 act as a reference. It is noted that over time and with
new data these priority areas may be subject to change. The National Indigenous Reform
Agreement (Closing the Gap)2 also provides important context for the delivery of the Strategy
and Priorities.
I would personally like to thank the members of the Advisory Board for their commitment.
Collectively, the Advisory Board would like to acknowledge the goodwill of the health and
research community and consumers for their engagement in the consultation. We also
acknowledge, with gratitude, the considerable support of Department of Health staff in the
preparation of this Strategy and the accompanying Priorities.
Yours sincerely,

Professor Ian Frazer AC
Chair, Australian Medical Research Advisory Board

  Australian Institute of Health and Wellbeing, National Health Priority Areas, [website], 2016,, (accessed 13 October 2016).
  Council of Australian Government, National Indigenous Reform Agreement (Closing the Gap), [website], -reform/national-
agreement_sept_12.pdf, (accessed 26 October 2016).
Australian Medical Research and Innovation Strategy 2016-2021                                            ii
THE STRATEGY                                               series of strategic platforms that, if funded,
The Medical Research Future Fund (MRFF)
                                                           have potential for greatest impact. These
is a $20 billion vehicle for investment in
                                                           platforms will serve as a framework for the
health and medical research. It represents
                                                           two-yearly identification of the Australian
the single largest boost to research funding in
                                                           Medical Research and Innovation Priorities
Australia’s history. The net earnings from the
                                                           (the Priorities), the first of which accompany
MRFF will serve as a permanent revenue
                                                           this Strategy.
stream, which when fully capitalised, is
expected to disburse around $1 billion                     In accordance with the Medical Research
annually, effectively doubling the Australian              Future Fund Act 2015 (the Act), the
Government’s direct investment in health and               Australian Government must take into
medical research and innovation.                           account the Priorities that are in force at the
                                                           time of making disbursements from the
This first five-year Australian Medical
                                                           MRFF. The Advisory Board has constructed
Research and Innovation Strategy 2016-2021
                                                           the Priorities as a document that should be
(the Strategy) prepared by the Australian
                                                           read and considered in conjunction with the
Medical Research Advisory Board (Advisory
                                                           Strategy as there is alignment with the
Board) sets out the vision, aims and
                                                           strategic platforms.
objectives for the MRFF. It identifies a

                                                         Position the research sector and health
Vision                                                    system to tackle future challenges
A health system fully informed by quality                Facilitate the commercialisation of great
health and medical research.                              Australian research
                                                         Demonstrate the value and impact of
Aim                                                       research investment

Through strategic investment, to transform              Strategic platforms
health and medical research and innovation
to improve lives, build the economy and                  Strategic and international horizons
contribute to health system sustainability.              Data and infrastructure
                                                         Health services and systems
Objectives                                               Capacity and collaboration
 Create health and economic benefits                    Trials and translation
  from research discoveries and                          Commercialisation
 Embed research evidence in healthcare                 Impact measurement
  policy and in practice improvement
 Drive collaboration and innovation                     Better patient outcomes
  across the research pipeline and                       Beneficial change to health practices
  healthcare system                                      Evidence of increased efficiency in the
 Strengthen transdisciplinary research                   health system
                                                         Commercialisation of health research
 Provide better access to research
 Maximise opportunities for research                    Community support for the use of and
  translation by engaging with consumers                  outcomes from funding

Australian Medical Research and Innovation Strategy 2016-2021                                            1
OPPORTUNITIES AND                                          The practical benefits of improved health
                                                           have been supported and enabled by
BENEFITS                                                   research, which has helped Australia become
Australian researchers have an excellent                   a leading economy of the 21 st century.
reputation and make a difference locally and               Between 1992-93 and 2004-05, the estimated
globally. Our researchers have developed                   expenditure on Australian research and
lifesaving discoveries, pioneered procedures,              development returned a net benefit of
and been awarded Nobel Prizes for their                    approximately $29.5 billion.4 For every dollar
extraordinary contributions to medicine. They              invested in Australian research and
continue to lead work in emerging fields of                development, an average of $2.17 in health
science, and champion the adoption of new                  benefits is returned. 5
                                                           An increase in wellbeing provides additional
Health and medical research spans a pipeline               benefits to the economy and to society. It:
from concept to laboratory through to                       enhances productivity gains by avoidance
translation, clinical application and                        of premature mortality and morbidity;
community benefit. This research answers
                                                            reduces care, carer and aids costs; and
questions about causes, prevention,
management and the impact of disease, and                   reduces loss associated with government
about how best practice healthcare and policy                transfers such as taxation revenue forgone
can be effectively implemented. It typically                 and welfare and disability payments.6
embraces a range of different disciplines,                 In 2014, the National Commission of Audit
occurs in universities and hospitals, medical              raised concerns about the future cost of
research institutes and companies, and in the              health, with expenditure on key health
community at large. It involves multiple                   programs projected to continue to grow faster
professions, public and private entities and               than Gross Domestic Product. Not all health
consumers.                                                 expenditure is equally cost-effective.7 Cutting
                                                           funding for health without transformational
Research is an essential part of the health
                                                           change can put health outcomes at risk.
system, sometimes visible to the larger
                                                           However, research accompanied by
community on the frontline of care, but often
                                                           concerted efforts to translate findings into
operating behind the scenes to make a
                                                           practice has the potential to reduce costs and
difference in the type, quality and
                                                           improve health outcomes.
effectiveness of the care delivered.
                                                           Strategic investment into health and medical
Health and medical research results in
                                                           research can serve to minimise the upward
healthier Australians and innovations that
                                                           pressure on costs associated with new
boost national wealth. It has a measureable
                                                           treatments, an ageing population and the
impact on health system sustainability,
productivity, and health outcomes. The 2013                4
Strategic Review of Health and Medical                       Lateral Economics, The Economic Value of
                                                           Australia's Investment in Health and Medical
Research3 outlined a vision of better health               Research: Reinforcing the Evidence for
through research and emphasised the                        Exceptional Returns, Port Melbourne, Research
importance of strong links between                         Australia, 2010.
biomedical, clinical, public health, and health              Access Economics, Exceptional Returns: The
                                                           Value of Investing in Health R&D in Australia II,
services research. The MRFF will build on                  Canberra, Australian Society for Medical
this vision.                                               Research, 2008.
                                                             Access Economics, Returns on NHMRC funded
                                                           Research and Development, Canberra, Australian
                                                           Society for Medical Research, 2011.
3                                                          7
 McKeon et al, Strategic Review of Health and                National Commission of Audit, The Report of the
Medical Research, Canberra, Department of                  National Commission of Audit - Volume 1,
Health and Ageing, 2013.                                   Canberra, Australian Government, 2014.
Australian Medical Research and Innovation Strategy 2016-2021                                            2
increasing burden and complexity of disease.               Agenda (NISA), and other interests including
This is where the MRFF can have an impact.                 state and territory governments and the
                                                           private and not-for-profit sectors.
The MRFF was established as an endowment                   National Health and Medical
fund to be preserved in perpetuity, to provide             Research Council
a secure additional revenue stream for health
and medical research and innovation. Under                 The NHMRC is Australia’s leading body for
the Act, the independent Advisory Board is                 supporting health and medical research and
responsible, following consultation, for                   has been operating since 1937. Australia’s
developing the Strategy, which spans five                  excellent research reputation has been
years, and a two yearly set of Priorities for              nurtured and built by NHMRC’s commitment
Government investment consideration.                       to sponsoring quality research administered
                                                           through nationally competitive grant
In accordance with the Act, once made, the                 programs.
Strategy and accompanying Priorities are
lodged with the Federal Register of                        Australia’s research system is mature enough
Legislative Instruments to enable the                      to run distinct and parallel funding streams,
documents to be tabled in Parliament. The                  like many other nations. The MRFF will
Health Minister is required under the                      neither replicate the role of, nor operate in
legislation to consider the Priorities when                competition with the NHMRC. Rather, it will
putting forward proposals to Government for                enable Government to provide targeted
MRFF funding distribution.                                 funding guided by the Advisory Board-
                                                           determined Strategy and Priorities.
The Act provides flexibility on how MRFF
funds can be distributed by Government. This               The relationship between the MRFF and
can occur via an approach to market, by an                 NHMRC will evolve through collaboration,
independent expert selection process, or by                facilitated by the welcome inclusion of the
direct funding to any eligible organisation.               NHMRC Chief Executive Officer on the
Alternatively, funds may flow through a                    Advisory Board.
corporate Commonwealth entity, or under an
                                                           There are opportunities for collaboration
agreement with states and territories.
                                                           between the MRFF and NHMRC, based on
Ultimately, decisions about disbursements
                                                           the flexibility permitted in the Act. The
are made by the Government.
                                                           Government can decide, with reference to the
The MRFF is managed by the Future Fund                     Strategy and the Priorities, to administer
Board of Guardians, which invests the assets               disbursements using the NHMRC’s peer
of the Fund. The Board of Guardians is                     review processes, or collaborate on joint
required to maintain the nominal value of the              targeted calls for research. The MRFF can
credits made to the MRFF in order to enable                also be used to top up one or more existing
a predictable and secure ongoing flow of                   NHMRC programs to maximise impact.
funding for health and medical research and
                                                           Both the NHMRC and the Advisory Board are
                                                           committed to working together to ensure
                                                           complementarity of funding is maintained
ALIGNMENT AND                                              through collaboration, governance, and
COMPLEMENTARITY                                            shared administration where appropriate.
It is critical that funding from the MRFF and
other sources is complementary to, and does                Innovation and Science
not duplicate, the work of the National Health
                                                           The NISA recognises that the next wave of
and Medical Research Council (NHMRC), the
                                                           economic prosperity for Australia depends on
emerging National Science and Innovation
Australian Medical Research and Innovation Strategy 2016-2021                                            3
building domestic science and innovation                   There are a broad range of Australian
capabilities. Governance of the NISA is                    Government activities that contribute to the
facilitated by Innovation and Science                      research infrastructure landscape in
Australia, an independent statutory board,                 Australia, including the NISA and the National
with responsibility for providing strategic                Collaborative Research Infrastructure
whole-of-government advice to the                          Strategy. This highlights the need for an
Government on all science, research and                    ongoing coordinated and integrated approach
innovation matters. Innovation and Science                 across Government, industry and health,
Australia complements the Commonwealth                     especially as research increasingly crosses
Science Council, which continues to advise                 disciplinary boundaries.
the Government on high level science
challenges facing Australia.                               The MRFF cannot operate in isolation from
                                                           broader research infrastructure
Innovation and Science Australia will develop              considerations under the Roadmap and
a whole-of-government 15-year plan for                     National Collaborative Research
innovation, science and research for                       Infrastructure Strategy, but it also cannot fund
Government consideration at the end of                     all needs. As the MRFF is still maturing, the
2017, and this will likely have relevance to               best immediate use of funds will be through
advancing health and medical research                      measures that harness existing infrastructure
capacity. It is important for the MRFF to be               and human capital.
connected with the NISA to ensure
complementarity of activities, and to                      Other governments and
maximise opportunities for health and
                                                           non-government interests
medical research advancement.
                                                           State and territory governments have a
A key initiative under the NISA is the                     strong history of funding research and, as
Biomedical Translation Fund. This fund seeks               health system managers, are critical to
to open up the research pipeline by investing              implementing on-the-ground projects. The
in the commercialisation of the outcomes of                MRFF has legislative flexibility to participate
health and medical research. The Biomedical                in unique co-funding opportunities in
Translation Fund operates as a for-profit                  collaboration with states and territories to
co-investment venture capital fund under                   maximise research translation. The MRFF
which licensed fund managers secure at least               could amplify investment by working closely
matched private capital to the Australian                  with all levels of government.
Government contribution of $250 million.
Together, the Biomedical Translation Fund                  High-end philanthropy is still relatively
and the MRFF provide a real opportunity to                 underdeveloped in Australia. This is in
address the twin ‘valleys of death’ commonly               contrast to the increasing global trend
referred to along the research pipeline where              exemplified by organisations such as the
the translation and commercialisation of                   Wellcome Trust in the United Kingdom and
research can be put in jeopardy.                           the Bill and Melinda Gates Foundation in the
                                                           United States. The Australian philanthropic
Research infrastructure is a crucial enabler of            sector is currently characterised by a large
research. Under NISA a new National                        number of small charitable organisations that
Research Infrastructure Roadmap (the                       mostly raise funds for disease-specific
Roadmap) is also being developed by                        research. The potential for co-investment by
Australia’s Chief Scientist, which will inform             the MRFF along shared national research
future consideration of national research                  agendas as articulated in the Priorities is
assets for public and private collaborative                significant.
benefit over the next decade. Infrastructure
for health and medical science is being                    Leading nations support research from
considered in the Roadmap.                                 multiple sources, including government,
Australian Medical Research and Innovation Strategy 2016-2021                                            4
industry and philanthropy. There is an                     population health science, and discusses
opportunity through the MRFF national                      specific research priorities and actions to
priority setting exercise to leverage                      foster population health improvement.
non-government funding to maximise
strategic investment. Once harnessed, these                The importance of engaging with consumers
co-funding relationships from domestic and                 is emphasised across all of these agendas.
international sources can address national
and regional health security and build health              CHALLENGES AND
system capacity in our region.                             CULTURE
                                                           Health and medicine is one of Australia’s
International alignment                                    strongest fields of research and Australia
Health and medical research is ultimately an               ranks highly against a range of international
international effort. Australia is a significant           benchmarks.11,12 There are, however, a
collaborator with researchers from other                   number of challenges facing the health and
countries, and it is important to look for                 medical research sector in Australia that need
strategic input and insight. Several recently              to be addressed to lift and accelerate the
published international research strategies                health and economic gains to be made from
complement the intention of this Strategy.                 research.

The Canadian Institutes of Health Research                 The research pipeline
five-year strategic plan (2014-15 to 2018-19)8
                                                           From the consultation process to develop this
discusses the importance of achieving a
broader disciplinary mix of researchers                    Strategy, the Advisory Board has identified
                                                           that the level of research and development
across the health fields, and embracing the
                                                           supporting the health system is insufficient
data revolution.
                                                           and the research pipeline itself needs to be
In the United Kingdom, the Academy of                      strengthened.
Medical Sciences’ recent publication
                                                           The pipeline is often characterised as having
Improving the health of the public by 2040 9
                                                           two ‘valleys of death’. Typically these occur at
calls for encouraged transdisciplinary
                                                           (1) the pre-clinical phase, where a lack of
research, to develop innovative and ethical
                                                           funding inhibits the progression of discoveries
means to utilise data, and unite public health,
                                                           to early proof-of-concept, and (2) the post
health and medical research and clinical
                                                           proof-of-concept commercialisation stage;
practice for the purpose of translation and
                                                           where funds are required for advanced
universal improvement.
                                                           pre-clinical work and early phase clinical
The US Academy of Medicine recently                        trials. It is important that the MRFF is used to
published Advancing the Science to Improve                 address not only these two valleys, but to
Population Health, 10 which explores the basic             reinforce the pipeline along its entire
and translational research needs for                       continuum. Discovery, development, and
                                                           commercialisation cannot occur without
8                                                          appropriate workforce capacity, effective
  Canadian Institutes of Health Research, Health
Research Roadmap II: Capturing Innovation to               implementation and a means to evaluate the
Produce Better Health and Health Care for
Canadians Strategic Plan 2014-15 – 2018-19,                   Butler ‘Impacts of Performance-based
Ottawa, 2015.                                              Research Funding Systems: A Review of the
  The Academy of Medical Sciences, Improving               Concerns and the Evidence’, Performance-based
the Health of the Public by 2040, London, 2016.            Funding for Public Research in Tertiary Education
   National Academies of Sciences, Engineering,            Institutions: Workshop Proceedings, Paris, OECD
and Medicine, Advancing the Science to Improve             Publishing, 2010.
Population Health: Proceedings of a Workshop,                 Australian Research Council, Excellence in
Washington, DC, National Academies Press,                  Research for Australia National Report 2012,
2016.                                                      Canberra, 2012.
Australian Medical Research and Innovation Strategy 2016-2021                                            5
impact this work has on quality of life for                Transdisciplinary and industry
consumers and patients.
The current level of expenditure on health
                                                           Collaborations between researchers, those
and medical research is disproportionately
                                                           involved in health service delivery (public and
small when compared to the size of the
                                                           private) and industry must improve. Cultural
sector. The MRFF has the potential to meet a
                                                           and institutional issues have historically
need for investment in proof-of-concept, pre-
                                                           constrained these connections and have
clinical, clinical and health services research,
                                                           limited the flexibility of career pathways for
to facilitate translation and the pathway to
                                                           researchers with an interest in applying or
market, and to build the capacity of the sector
                                                           commercialising their research. Many
to pursue these activities. Such investment
                                                           universities have commercialisation or
would help improve the reproducibility and
                                                           translation offices that help researchers bring
reliability, and therefore the impact, of
                                                           their discoveries to market and there are
biomedical and technological research. 13
                                                           noticeable improvements in this space.
                                                           However, university rankings and income
Consumer engagement and                                    remain largely driven by academic
collaboration                                              excellence, including indicators such as
                                                           publications and student intake. These can
There is a limited degree of consumer
                                                           discourage efforts in translation and
engagement and collaboration across the
research pipeline, which impacts on the
success of research outcome translation into               Industry experience, past success in solving
clinical practice. Consumers and their                     industry problems, and non-academic
families are the ultimate funders, users and               translation are not generally part of the
beneficiaries of health and medical research.              metrics of academic excellence. The 2015
Healthcare is a significant social, economic               Review of Research Policy and Funding
and political issue and there is evidence in               Arrangements16 has recommended a shift
Australia that consumers are willing and                   (consistent with the NISA) in policy settings
wanting to be more engaged. 14                             for higher education to maximise innovation
                                                           performance, including the provision of
Australians appreciate the connection
                                                           incentives to increase university (and other
between evidence-based healthcare and
                                                           research organisation) engagement and
health outcomes. However, often consumers
                                                           collaboration with business and other end
are not engaged early in research discovery
work, particularly in applied research. Co-
design and creation present an opportunity to
think about the end product or therapy and its
                                                           Research in practice
user, its degree of direct benefit and                     There are barriers and disincentives that
adoptability. In the future, consumers will                impede research within the healthcare sector
drive their own healthcare in partnership with             itself. Historically, teaching, training and
clinicians, and it is therefore important to start         research resources have been block funded,
working together earlier in the research                   with their utility neither measured nor fully
pipeline.15                                                appreciated. Research is frequently viewed
                                                           as an 'added cost' easily redirected towards
   Academy of Medical Sciences, Reproducibility
and Reliability of Biomedical Research: Improving
Research Practice, London, 2015.
   Research Australia, Australia Speaks! 2016
Opinion Poll, Darlinghurst, 2016.                           Watt et al, Report of the Review of Research
   Topol E., , The Patient Will See You Now, New           Policy and Funding Arrangements, Canberra,
York, Basic Books, 2015.                                   Australian Government, 2015.
Australian Medical Research and Innovation Strategy 2016-2021                                              6
urgent activity demands. 17 Often, ability and             FIVE YEAR STRATEGIC
reputation of an institution to undertake
world-class research depend on the                         PLATFORMS
administration appreciating the benefits for               The Advisory Board has consulted widely
patients, for staff recruitment and retention,             across the sector and broader community.
and for health outcomes more broadly.                      Feedback received has been used to develop
Similar experience is evident in the primary               six strategic platforms that underpin this
care sector, where private business models                 Strategy. The platforms recognise the
based on care transactions have limited                    challenges and cultural issues outlined, and
capacity to embed research in practice.                    the inherent need to maintain and support
These pressures must be addressed so that                  basic research into disease causation that
the potential for research translation is                  underpins all health research, translation and
realised.                                                  delivery.

                                                           The platforms capture and group together
Full cost of research                                      themes and provide a framework for the
The full cost of research includes indirect                Priorities to improve research capacity and
costs that cannot easily be attributed to a                capabilities in the research sector. Through
single research program or grant. These                    targeted funding from the MRFF, these
include the cost of research administration,               platforms will advance health and medical
research infrastructure, and research support              research and innovation over the next five
services. Approaches to equitably funding                  years and help Australia meet its future
these costs across the research sector and                 healthcare challenges.
by different funding agencies have met with
little success. Currently, direct research costs           Strategic and international
can be paid by one agency and the indirect
research costs by another, based on fragile
and administratively complex and expensive                 Health services in Australia can benefit from
arrangements.                                              strategic and focused international research
                                                           efforts, with funding models that are agile in
A whole-of-government approach is needed                   the face of disruptive health challenges and
to address the issue of research costing to                new technologies. The health problems of
ensure the research sector can continue to                 today and tomorrow are complex and will
thrive. MRFF funding cannot in isolation solve             require large scale, globally collaborative and
the conundrum that surrounds indirect costs                long-term research efforts.
and may with the injection of new funds
increase the need for a solution. The                      Many countries are currently investing heavily
Advisory Board, while advocating for a whole-              in international consortia to address a range
of-government and research sector agreed                   of research issues, including the impact of
solution, must therefore abstain from                      new technologies such as genomics,
implementing yet another funding model. In                 synthetic biology, epigenetics, microbiomics,
the short term MRFF program investment                     the challenge of antimicrobial resistance and
should adhere to existing costing                          the emergence of new pathogenic viruses.
approaches. Collaboration between
                                                           Australia stands to benefit from being a
Government and funded bodies to identify an
                                                           leader rather than a follower in international
equitable solution should be prioritised.
                                                           collaborative research. The MRFF should
                                                           provide support for Australian consortia to
                                                           participate in and lead international research
                                                           projects focusing on major global health
 McKeon et al, Strategic Review of Health and
                                                           challenges and threats, and these should be
Medical Research, Canberra, Department of
Health and Ageing, 2013.                                   complementary to the international
Australian Medical Research and Innovation Strategy 2016-2021                                          7
collaborative research activities of the                   Maintaining internationally competitive
NHMRC. MRFF funding can enable Australia                   technology and supporting talent to operate it
to reap local, regional and global economic                is demanding because equipment costs
benefits and further raise Australia’s                     continue to increase, while their length of
reputation as a health research powerhouse                 time as ‘state of the art’ items contracts. The
that ‘punches above its weight’.                           MRFF, noting the National Research
                                                           Infrastructure Roadmap, must help build
Data and infrastructure                                    research infrastructure capacity, specifically
                                                           as it relates to health and medicine. This can
Emerging fields such as bioinformatics,                    be best realised by sharing new and existing
computational biology, metagenomics,
                                                           infrastructure, and by enhancing user
artificial intelligence and new diagnostics
depend on data assets. An integrated
national health data framework that supports
healthcare delivery, service improvement and
                                                           Health services and systems
best practice adoption is essential, and the               Much of the health and medical research
MRFF should fund research that enables the                 conducted in Australia is product and drug
planning and implementation of this initiative.            focussed, and research on health
                                                           interventions is dominated by the acute care
National datasets currently have limited utility           experience. The MRFF can play a significant
without linkage with clinical software and the             role in bolstering Australia’s capacity in health
use of common data dictionaries. MRFF                      services and systems research. For example,
funding can facilitate research on the                     MRFF investment activities can work with the
interoperability of existing and future datasets           Medicare Benefits Schedule Review
for basic science and health services                      Taskforce and new policy and program
research.                                                  agendas, such as the Australian
Providing access to health data facilitates                Government’s Health Care Homes trial.
evidence-based care and drives efficient use               Health services and systems research seeks
of resources. This applies to clinician-                   more affordable models of healthcare and
captured data, surveillance information,                   innovative evidence-based approaches to
clinical quality registries, biobanks, and the             treatment, prevention, diagnosis and the
wealth of data related to the new ‘omics’                  management of disease. It combines clinical,
technologies. These datasets and the means                 public and population health disciplines with
to analyse them will be the basis of the future            economics, and behavioural and
health system architecture and will drive new              implementation science. This form of
advances in healthcare.                                    research is often embedded in healthcare
The collection, curation, linkage and                      delivery to maximise translation by engaging
application of health data across the health               actual clinicians.
system must be nurtured, and where possible                The efficiency and cost-effectiveness of many
integrated with the digital health agenda via              routinely used health interventions are not
My Health Record. Custodianship and                        known and/or not proven. Healthcare
governance should be clear, systems must be                professionals continue to undertake activities
interoperable, privacy must be protected, and              that are suspected to be of little benefit in
data assets must be made appropriately                     place of, or alongside, proven effective
available to drive research, industry and                  interventions. Research delivering new
service delivery.                                          methods that avoid wasteful interventions,
Physical infrastructure requirements for                   adopt best practice and foster information
health and medical research are another key                exchange will allow clinicians to benchmark
part of any capacity building exercise.                    with peers and lead to continuous quality
Australian Medical Research and Innovation Strategy 2016-2021                                            8
Equally important is an appreciation of the                collaboration on a national scale by investing
impact of location (urban, regional and                    in multi-disciplinary, institute and sector
remote), culture, and socio-economics on                   teams. The funding itself can be collaborative
healthcare access and outcomes. Close                      by leveraging co-investment from other
collaboration is also required with Aboriginal             governments, private and philanthropic
and Torres Strait Islander Australian health               interests.
stakeholders, including the community
controlled sector, to ensure Indigenous                    Through collaboration, researchers can be
Australians are engaged in research process                encouraged to adopt entrepreneurial
and design, and that research is utilised to               approaches, test implementation science
Close the Gap.                                             applications, and look for opportunities to
                                                           traverse academic, health service and
Adequate numbers of healthcare                             industry work.19
professionals with training in clinical research
are critical to ensuring meaningful service                Trials and translation
and system performance and the MRFF can
                                                           Clinical trials guide the development of new
make a significant contribution in building this
                                                           drugs and devices, new models of care, and
                                                           improved clinical practice. Australia has an
                                                           excellent reputation for delivering clinical
Capacity and collaboration                                 trials, and significant efforts have been made
The MRFF can encourage increased                           by all levels of government to streamline
interchange between academia, service                      ethics and governance arrangements. This
delivery and industry with research practice               work needs to continue, to lift Australia’s
and solutions in mind.                                     reputation as a preferred location for clinical
Health and medical research depends largely
on workforce talent. Research training should              The MRFF has an important role to play in
be integral to the education of all health                 facilitating non-commercial clinical trials of
service providers, and be one of the key                   potential significance. MRFF support of
performance indicators for the health services             clinical trial networking infrastructure can also
and their senior management. Insufficient                  serve to enhance the efficient conduct of
attention to developing the skills of our                  multicentre trials, with both public and
scientists and healthcare professionals will               commercial impact.
sell Australia short in the health and medical
research arena.                                            Clinical trial networks are groups of active
                                                           clinician researchers who come together to
Researchers in more diverse, yet relevant                  design research questions and implement
disciplines (e.g., social sciences, behavioural            multi-site and multi-sector trials that solve
sciences, economics, chemistry, engineering,               real time practice problems. Networks are not
and mathematics) equally need to be offered                confined geographically, and work
opportunities to participate in health sciences            horizontally across the care continuum,
research to harness innovation.                            providing on-site training and mentoring,
                                                           multi-site recruitment and collective peer-
Collaboration across research disciplines with             support. The researchers that perform clinical
the intent of innovation and productivity is               trials and the networks themselves must
crucial – the same is true between sectors. 18             incorporate all relevant professions, including
The MRFF can work to enhance research                      general medical, nursing, and allied health.
                                                           There are a number of clinical trial networks
  Bell et al, The Role of Science, Research and
Technology in Lifting Australia’s Productivity,              The Academy of Medical Sciences, Improving
Australian Council of Learned Academies,                   Recognition of Team Science Contributions in
Melbourne, 2014.                                           Biomedical Research Careers, London, 2016.
Australian Medical Research and Innovation Strategy 2016-2021                                            9
across Australia and some have international               research workforce. Under ordinary
connections. The MRFF is in a unique                       circumstances the MRFF should not replace
position to galvanise the potential of these               industry and venture capital funding, but
networks.                                                  there is capacity for the MRFF to support the
                                                           progression of some projects to a stage more
The main way that health research is                       attractive for private sector investment, as per
measured as having impact is by research                   the MRFF aligned Biomedical Translation
findings being translated into both clinical               Fund. Translational research with limited
practice and behavioural change. Recent                    potential for profit – but with significant public
accreditation of Advanced Health Research                  benefit – should also be considered for MRFF
and Translation Centres (AHRTCs) by the                    support.
NHMRC has identified world-class clinical
facilities ready to embrace and facilitate                 Aside from the challenge of attracting venture
translation. AHRTCs are leading centres of                 capital, many researchers lack awareness of
collaboration with a focus on practical                    entrepreneurial options and/or confidence in
translation, education and training, and                   their own abilities. Commercially-focused
outstanding healthcare. They foster research               research is sometimes viewed as
across boundaries between general and                      incompatible with unrestricted sharing of
hospital practice, geographical regions, and               research results. Researchers largely remain
health service disciplines. The NHMRC is                   focussed on academic metrics rather than
looking to accredit further AHRTCs and                     application. Although barriers are more
potentially broaden the scope into regional                perceived than real, researchers may not
areas.                                                     pursue commercialisation because they
                                                           regard other aspects of research activity as
The MRFF is well placed to support these                   more important. Often, commercial efforts
AHRTCs to conduct targeted collaborative                   reduce the time available for researchers to
and transformative research. Cooperation                   pursue activities necessary to maintain their
between the MRFF as funder and the                         current academic employment. A cultural and
NHMRC as accreditor is an excellent                        systems change is required.
demonstration of complementary practice,
and shared purpose.                                        To overcome barriers to research
                                                           commercialisation, the MRFF can support the
Commercialisation                                          creation and brokering of linkages between
                                                           researchers and industry that are
The MRFF cannot overlook the
                                                           transdisciplinary in nature. A two-way
commercialisation end of the research                      exchange of knowledge and expertise in
pipeline, where discoveries become every
                                                           research, and its translation into clinical
day realities. Through commercialisation,
                                                           practice is needed. This would result in
consumers are given access to innovations.                 researchers increasingly looking to industry
Despite occasional commercial success
                                                           as a pathway for career advancement. There
stories, Australia has a relatively
                                                           is also a need to better encourage adoption
underdeveloped culture for biomedical and                  of the requirements for successful
biotechnology commercialisation, resulting in
                                                           commercialisation in both the academic and
limited knowledge and skills among the
                                                           business environment.
broader research community.

Challenges to the commercialisation of
research discoveries in Australia include lack
of funding for proof-of-concept and early
stage clinical research, which discourages
start-up companies and provides infertile
ground for would-be entrepreneurs within the

Australian Medical Research and Innovation Strategy 2016-2021                                             10
MEASUREMENT,                                               NEXT STEPS
MONITORING AND                                             Through this Strategy the Advisory Board is
                                                           confident that the purpose and scope of the
EVALUATION                                                 MRFF encompasses support for not only
For the MRFF to be successful it requires an               laboratory based and pre-clinical research,
architecture that can support both the                     but also clinical and applied research in
Advisory Board and Government into the                     hospitals, primary care and other health
future. The following tasks will be first year             settings. This direction affords unprecedented
priorities for the MRFF Advisory Board:                    opportunities to address existing and
 determine ways to effectively engage                     emerging national health priorities.
  consumers and define priorities;
                                                           This Strategy and the related Priorities serve
 determine a durable methodology for                      as a guide for the Australian Government to
  future MRFF priority setting; and                        ensure that funding from the MRFF has a
 establish a measurement framework to                     strong evidence base. Program level
  support ongoing monitoring of return on                  disbursement decisions will be made through
  investment.                                              Government Budget processes and will be
MRFF investments will occur within a                       reported in Budget papers. The decisions on
complex landscape of modern health and                     funding will be accountable to Parliament in
medical research, where the pace of change                 biennial reports from the Health Minister,
and interactions among stakeholders make it                which must describe how financial assistance
critical to measure the return on investment.              provided for health and medical research and
                                                           innovation is consistent with the Strategy and
The Advisory Board has proposed the                        Priorities; and how the spending profile for
following initial key indicators for the MRFF:             the MRFF complements and builds on
 better patient outcomes;                                 existing Australian Government funding.
 beneficial change to health practices;                   The MRFF represents a significant
 evidence of increased efficiency in the                  opportunity for Australia to improve the
  health system;                                           effectiveness, efficiency, quality and safety of
 commercialisation of health research                     clinical service delivery to yield substantial
  outcomes; and                                            benefits for consumers, the community and
                                                           the health system - one from which future
 community support for the use of and
                                                           generations will benefit.
  outcome from funding.
A more comprehensive evaluation framework
and defined measurement methodology will
be critical to determine the difference the
MRFF has made. Such a framework will need
to be practical, durable and sensitive enough
to capture social and economic benefits as
well as health outcomes. Many of these
impacts will not be immediately evident as
MRFF investments will span the medium- to
long-term, with far-reaching and diffused
direct and indirect effects. Further
consultation with stakeholders will inform this
framework and other foundational
architecture for the MRFF.

Australian Medical Research and Innovation Strategy 2016-2021                                           11
Australian Medical Research and Innovation Strategy 2016-2021   12
You can also read