What is the point of health and medical research?

Is it to keep researchers in jobs? To boost the economy and increase corporate profits? To add to the prestige and power of universities and associated research institutes? To add to the global store of knowledge? To respond to community needs and priorities? To improve the health of the community and the greater good? Or perhaps even to contribute to a fairer distribution of health?

The Government has released draft terms of reference for a review of health and medical research. It plans to announce who will conduct the review and the terms of reference by the end of this month, with the panel due to produce a final report by 31 August 2012.

It’s notable that the “context to the review” includes no mention of equity-related matters. Nor is there mention of broader issues which might affect the future context for research, eg the Gov 2.0 agenda, the digital revolution with its potential for greater community engagement, or such trifling public health matters as climate change.

The announcement describes the changing landscape for research thus:

  • The burden of disease in Australia has altered. Chronic diseases, including those associated with ageing, and mental health have replaced acute infectious diseases and acute vascular events as the leading causes of morbidity and mortality.
  • The mapping of the human genome and ICT revolution have both accelerated our acquisition of new knowledge while also increasing the resources required for that level of research.
  • The nature of research, whereby individuals and small groups could initiate and carry out meaningful research, has also changed and significantly larger infrastructure is now required. New and emerging technologies make it easier for larger groups to work together to achieve more meaningful outcomes.
  • There is a growing recognition of the importance of rapidly translating discoveries from basic research into treatment, and ensuring that those breakthroughs become clinical practice.
  • Australian’s health sector is undergoing significant reform and it is important that our research activities align with that process.

Meanwhile, these are the matters suggested for consideration in the review:

·  The need for Australia to build and retain internationally competitive capacity across the research spectrum, from discovery research through to translation.

·  Current expenditure on, and support for, health and medical research in Australia by governments, industry, non-government organisations and philanthropy; including relevant comparisons internationally.

·  Opportunities to leverage additional investment and support for health and medical research in Australia through private sector support and philanthropy, and opportunities for more efficient use and administration of existing expenditure; again, including relevant comparisons internationally.

·  The relationship between business and the research sector, including opportunities to improve Australia’s capacity to capitalise on its investment in health and medical research through commercialisation.

·  Likely future developments in health and medical research, both in Australia and internationally.

·  Strategies to ensure Australia has the research workforce capable of meeting future challenges and opportunities.

·  The Commonwealth’s principal approach to funding health and medical research through the NHMRC compared to relevant international jurisdictions, including governance and structural issues

·  Opportunities to improve collaboration in health and medical research and the translation of research outcomes into improved health policies and practices within and between Australia’s research and clinical sectors as well as other sectors relevant to public health; again including relevant comparisons internationally and opportunities for enhanced international collaboration.

·  Ways in which the broader health reform process can be leveraged to improve research and translation opportunities in preventative health and in the primary, aged and acute care sectors, including through expanded clinical networks, as well as ways in which research can contribute to the optimal implementation of these health reforms.

·  Ways in which health and medical research interacts, and should interact, with other Government health policies and programs; including health technology assessments and the pharmaceutical and medical services assessment process.

·  Ways in which the Commonwealth’s e-health reforms can be leveraged to improve research and translation opportunities, including through data linkage.

·  The degree of alignment between Australia’s health and medical research activities and the determinants of good health, the nation’s burden of disease profile and national health priorities.

·  Opportunities for Australia’s health and medical research activities to assist in combating some of the major barriers to improved health globally, especially in the developing world.

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If you’ve other thoughts for what the review might consider, now is the time to speak up – although the announcement doesn’t spell out the avenues for feedback, let alone how to suggest members for the review panel. Hopefully this is not symbolic.

As we speak, Iceland is crowd-sourcing its new constitution (this site links to a stack of news articles about the process).

What would we get, I wonder, if the review of health and medical research was opened up to the wider community through a Gov2.0-style process?

At least, no-one could accuse the review of being somewhat inward-looking and narrowly focused.