Public Research Funding in Health Emergencies – Australian Perspective and Strategies

Clive Morris

Head, Strategic Policy

National Health and Medical Research Council

Australia

1. The Australian Context

o Public Health Emergency Response Environment

2. Lessons from the past

o Research funding challenges

3. Future Strategies

o Nationally and internationally coordinated research

NSW - 7.2 million

Victoria - 5.4 million

Queensland - 4.5million

South Australia1.65 million

WA – 2.3million

Tasmania- 500,000

Northern Territory 230,000

ACT - 360,000

Australian Population Density 2010

Australian Federation – shared responsibilities

Australian Health Sector Emergency Response Landscape

State & Territory

• Emergency response

• Hospitals

• Emergency services

• Public health

• Environmental health services

Federal

• National coordination (policy & response)

• Funding

• Aged Care, Primary care

• Border control

• International engagement

Whole of Australian Government Response

5

National Crisis Committee

State / Territory Committees

State and Territory Cabinets

State and Territory Health Departments

Australian Government

Crisis Committee

National Security Council

Prime Minister

Department of Health

Australian Health

Protection Committee

National Incident Room

Australian Government Crisis Coordination Centre

Emergency Management Australia

State and TerritoryEmergency

Operations Centres

Australian Government Agencies

Disease Detection

• National Notifiable Disease Surveillance System

• National Focal Point

State and Territory Public Health System

WHO

International Health Regulations

Public Health Legislation

Australian Challenges in supporting research within health emergencies-

• No intramural research capacity

• Research not well integrated within the health system

• Medical research funding not well coordinated

Unique Australian Challenges

Responding to emerging disease threats

Year Issue Grants

2005 H5N1 Pandemic Influenza 33

2009 H1N1 Pandemic Influenza 41

2012 Hendra Virus 8

Traditional Approach-Targeted and Urgent Calls for Research

http://www.who.int/csr/sars/country/table2003_09_23/en/index.html

Summary of probable SARS cases 2002 - 2003

Total no. of cases

No. of deaths

Case Fatality Ratio (%)

No. of HCW infected

Australia 6 0 0 1 Canada 251 43 17 109 China 5327 349 7 1002 China Hong Kong

1755 299 17 386

Vietnam 63 5 8 36

Targeted Calls for Research approach-

• Time lag between the ‘threat’ and the research response.

– opportunities missed to undertake critical clinical and public health research that could have informed policy and saved lives.

– Delays in obtaining funding, then in getting ethics & regulatory approvals.

• Research not well aligned with policy and health system needs.

Lessons learnt

Australia New Zealand Intensive Care Society

Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med, November 2009; 361(20):1925-34.

International Severe Acute Respiratory Illness Consortium – global response to emerging infectious disease including pandemics

ANZICS Clinical Trials Group - Infectious Disease

Prof Steve Webb

Objective- Research Readiness

• Researchers, networks,

funding, and approvals in

place

• Capacity to respond at short

notice

• Closely linked to international

networks and initiatives.

FUTURE STRATEGIES

CONSIDERATIONS - 20131. Identify the need

• Participation in the work of the European Commission, leading to establishment of GloPID-R .

• Developing concept of a national research partnership.

2. Engagement and consultation with Government • Federal Department of Health. • Alignment with Australian Communicable Disease Control Framework.• Need for a ‘National Partnership’ recognised. • NHMRC and DoH now engaging states and territories.

3. Consult the research community• Consortium of Australian researchers and research networks developed a

business case and operational framework. • Peer Review indicated more work was required to define research

governance responsibilities to embed research in the health sector framework.

Future Strategies

Desired Outcomes:

• National partnership - research integrated with public health/emergency response.

• Incorporating research across clinical, laboratory and public health streams.

• Capacity to support research during infectious disease outbreaks.

• Research coordinated with international research efforts.

• Nationally agreed research priorities and protocols aligned with health system needs.

• Capacity to rapidly mobilise research during public health emergencies.

• Engagement with international networks such as GloPID-R.

Research Preparedness Strategy

THANK YOUFOR YOUR ATTENTION