2015-4-16-2

gaetanburgio

2015-4-16-2

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Transcript

Station: ABC Date: 15/04/2015

Program: NATIONAL PRESS CLUB ADDRESS Time: 12:32 PM

Compere: LAURIE WILSON Summary ID: M00061350047

Item:

PRESS CLUB ADDRESS WITH PROFESSOR WARWICK ANDERSON AM,

CHIEF EXECUTIVE OFFICER, NHMRC.

INTERVIEWEES: PROFESSOR WARWICK ANDERSON AM, CHIEF

EXECUTIVE OFFICER, NHMRC.

Audience: Male 16+ Female 16+ All people

9000 6000 15000

VOICEOVER:

Today at the National Press Club, the Chief Executive of

the National Health and Medical Research Council,

Warwick Anderson. The Council is Australia's leading

director of health and medical research. Professor

Anderson is about to leave, and reflects on projects

funded and knowledge gained in today's National Press

Club Address.

[Bell rings].

LAURIE WILSON:

Ladies and gentlemen, welcome to the National Press

Club for today's National Australia Bank Address. It is

indeed a great pleasure for me personally to be able to

welcome our guest today. I first met Professor Warwick

Anderson when he arrived in Canberra a little over nine

years ago, a little under nine years ago, around a

decade ago anyway, to take up position as the newlyappointed

Chief Executive of the National Health and

Medical Research Council, the principal funding body

for medical research in this country.


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In fact he's no longer the Chief Executive of the

NHMRC. As you just heard, he in fact, finished his

position … I think it was the end of last month as I

recall, and later this year in July will move onto an

interesting new position of Secretary-General of the

Human Frontier Science Program in Strasbourg.

To reflect on his time within NHMRC and to give us his

thoughts of how he believes we can and should be

making better use of medical research in this country,

and hopefully - he might not talk about it in his

address, but I think we can ask him - a little bit about

his new role, too. Would you please welcome,

Professor Warwick Anderson.

[Applause].

WARWICK ANDERSON:

Well, thank you Laurie and Ken, and it's a great

opportunity to talk a little bit about why medical

research is so important, and how we can make a bit

more of it, I think. So thanks for joining me today.

And as Laurie pointed out, I have been head of the

National Health and Medical Research Council, here on

called NHMRC, for going on a decade. That's actually

four governments, six ministers, funding increase from

$440 million to $860 million, and of course tens and

tens of thousands of applications for funding. And to

my amazement, when I finished two weeks ago I was

the longest serving head of any government medical

research funding body internationally. So they're my

credentials, Laurie.


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I really want to make just two points today. The first is

that we can get more benefits from medical research

than perhaps you know, and we can get them faster

and better. And the subtheme today is that we, you

the taxpayer, you the public, need always to be vigilant

against vested interests in health, and in health and

medical research.

Now I'm sure you all know that Australians

overwhelmingly support government funding of

medical research. I believe that people do support it so

strongly because it brings hope; it brings hope for new

treatments and cures for diseases that we all suffer

from. I'm going to talk a little bit later about how we

can increase the value of the investment in medical

research, and I'm going to stir the pot a bit.

But first I want to remind you of how we've all

benefited from health and medical research in

Australia - Australian health and medical research.

Maybe you're one of the one in five Australians who

suffers from high blood pressure. It was Australian

researchers who first showed that even if your blood

pressure is only a little higher than normal, drug

treatment will substantially reduce your risk of stroke

and heart attack. Or maybe you've had an ulcer or

gastritis. Thanks to the wonderful piece of scientific

lateral thinking by an excellent, modest pathologist at

Royal Perth Hospital, Robin Warren, and the larger

than life young doctor Barry Marshall, who I think has

been presenting here at the Press Club. Of course you

can be cured by a short course of antibiotics, rather

than many months, perhaps years, of a drug treatment.


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Women can be protected against most cervical cancers

after Ian Frazer's remarkable piece of really excellent

science that led to Gardasil, the vaccine, brought to

market by- or developed by the Australian biotech

company, CSL.

Now, you baby boomers in the room - and that

includes you, Chief Scientist - now you're in your 50s,

or is it 60s, you might be sleeping better because Colin

Sullivan at Sydney University worked out years ago that

a mask that produced a little pressure on your airways

during sleep overcame annoying and, in fact, deadly

sleep apnoea, which also led to a successful

commercial company ResMed. I hope that you or your

loved one hasn't needed a bone marrow transplant for

leukaemia. But if you have, the life-long work of Don

Metcalf at Walter and Eliza Hall in Melbourne on

colony stimulating factors may have saved your life.

And thanks to research, in fact seven out of 10

childhood cancers can now be cured.

I could go on, and you probably don't want me to, but I

want to now move onto the great economic benefits

that health and medical research bring too. And this is

often overlooked, but it's really very substantial. Well,

first, studies commissioned by the Australian Society of

Medical Research show that expenditure on medical

research has an economic return of at least three-fold

to the economy through health improvements.

Medicines Australia say that around $600 million flows

into the Australian economy each year to conduct

clinical trials. Medicinal and pharmaceutical exports

have been worth about $4 billion a year over recent


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years, and that's more value than wine exports. The

gross in fact- in fact, the gross of the biotech, life

sciences, and pharmaceutical and devices industry, is a

story that we don't celebrate enough in this country.

For example, investment in biotech and the life

sciences through the stock exchange now runs about

$50 billion a year, and this index has easily

outperformed the All Ordinaries Index over the last

decade and a half. I hope your superannuation fund

has some of those companies. And we have two big -

biggish - biotech companies, Cochlear and CSL, that

already do manufacturing in this country, and have

marvellous factories in Sydney and in Melbourne, and

employ thousands of Australians in interesting,

worthwhile jobs of the 21st century.

Of course having successful innovative industries that

rely on brands, knowledge, and research is absolutely

essential to our nation's future. And I just want to leave

you with this thought from the US Government. The US

Government says that they invested about $3.8 billion

in research about the Human Genome Project over 15

years, $3.8 billion; but they've also calculated that for

every one of those dollars, $178 has been returned to

the US economy. So by any measure, supporting

medical research is an investment with an excellent

return.

But that brings me to my second main point: there's so

much more that can be done to increase the value of

health and medical research. And I think I should

apologise at this point; I said there were two points in

the beginning, well there's actually several sub-points


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to this one, so I'm sorry if I've misled you. The first of

these sub-points is that we could make savings to the

public and private purse if we could use research

better. Let me give you a couple of examples to

describe that. If you've got cracked bones in the

vertebrae, the bones in your back, they're painful and

they cause other problems. And so, sensibly, some

surgeons realised, or reasoned, that stabilising these

cracks with a medical cement should help patients. But

Dr Rachelle Buchbinder of the Cabrini Hospital in

Melbourne, with colleagues at Monash and Melbourne

University, did a marvellous, brave, piece of research

funded by the NHMRC that showed that, in fact, it

didn't work. Patients recover just as quickly with the

same amount of pain whether or not this procedure

was done to them or not. And so as a result, no longer

does the taxpayer or the patient need to pay for what

turns out to be an ineffective procedure.

A second example, it's from one of the groups I most

admire in Australian health and medical research is a

big group of intensive care clinical researchers. They do

really important and really difficult clinical trials. What

they showed a few years ago was that in intensive care

wards the use of simple, cheap saline solution - that's

just salt in water - gave just as good results for patients

as the much more expensive alternative of using a

solution made up from albumin derived from human

blood. Access Economics estimated that if this finding

were implemented it would save expenditure of

around $700 million to $800 million a year. That's

roughly the same amount of funding NHMRC has for

research, by the way.


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Well, of course the challenge goes well beyond

individual pieces of research. To derive evidence-based

policy and practice in health is really a very big

challenge for governments and for administrators.

There are thousands of new findings coming out of

research every day around the world. Thousands. So

how is an administrator or practitioner able to keep up,

make sense, adjust his practice, as this evidence

accumulates? Well, although it's the 21st century,

turning research into guidelines for policymakers or

practitioners is currently done in very ad hoc and

piecemeal fashion. Of the more than 1000 clinical

guidelines in Australia, only a minority have been

developed with any rigour based on the evidence, and

too many are clearly affected by vested interests. This

is an area that really calls for new approaches. We

need a 21st century way of reading these vast amount

of research findings, and providing it in reliable and

easily digestible forms. And we can't afford to leave

that to commercial interests.

Another way to more quickly and effectively gain

patient benefit from research is to better connect the

leaders who administer the health system and leaders

in medical research. Health care is, or can be seen to

be, a very large industry. In fact, it costs us all about

$140 billion a year, that's Commonwealth and state

expenditure and out of our own pocket. And like any

other industry then, it needs research and

development to progress. In most industries research

and development are integral parts of the industry

itself, but in health, here and most other countries, we

do something quite different, we separate research

from the delivery of health care. We fund health


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research, mainly through the higher education system,

and we fund healthcare through a wide range of

policies and mechanisms that change quite frequently,

but certainly without any clear stream of funding of

research in hospitals or in primary care.

Now NHMRC is by far the largest funder of medical

research in Australia, about 850 million a year, that's a

lot of money. But to put it in perspective, that's a little

less than $40 a year per Australian. So $40 a year,

that's about one coffee per month, one main course at

a Canberra restaurant each year, half a tank of petrol in

your SUV, or, for some of this audience, two KFC family

burger boxes. It's less than 1.5 per cent of

Commonwealth Government expenditure on health,

and about 0.6 per cent of total health expenditure,

public and private. Now NHMRC does fund some

research in the health system, about a quarter of a

billion dollars a year in clinical research, there are

fellowships for people who do both research and look

after patients, and we do offer shared grants to bodies

that are working in health care, State and Territory

bodies, the national prescribing service, beyondblue,

Red Cross, and about 200 other organisations.

But a deeper engagement between research and

health care is definitely needed, and that's why I

believe the recent NHMRC initiative can be

transformational. This as an initiative we call Advanced

Health Research and Translation Centres, they have

leaders in research, and leaders in health

administration working together collaboratively. I think

they're a very important step along the way to bringing


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research and health care more strongly together, and

encouraging the leaders in both sectors to work more

effectively together. Somewhat to our surprise, I think,

we have had very enthusiastic support from state and

local health leaders for this initiative, and I think we all

feel can help us feel what a previous review of health

called an agile and self-improving system. So we have a

deputy secretary of health in the audience, so over to

you sir to help with this concept, over to Almac, and to

state and territory enthusiasts for this concept. Let's

see if we can bed cooperation and leadership in the

system to provide benefits for both the taxpayer and

for patients in our system.

So now I'd like to turn to research itself, how I think it

will need to change, and how self-interest could derail

the changes that are needed. First, let's stop wasting

half the best talent in the country. Women are 60 per

cent of applicants for NHMRC's Early Career

Fellowship, but fewer than 20 per cent- less than 20

per cent of applicants for our most senior fellowship,

the Senior Principal Research Fellowship at professorial

level. And looking at research leaders, less than 10 per

cent of Medical Research Institute directors are

women, and of the Group of Eight deans of medicine,

only one is a woman. NHMRC recently surveyed all

institutions funded by it to analyse their policies on

retaining and promoting women in medical research,

and the results of that survey were frankly

disappointing. We felt that only two of the 70

institutions that sent us policies had policies that were

comprehensive and were practical. So I recently

amended NHMRC's policy here to require institution to

have proper policies about retention and promotion of


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women in medical research, and to have those in place

by the end of this year.

Next I want to issue a challenge to leaders in the

medical research sector itself. I've spoken many times

about my concern that the Australian medical research

sector is too fragmented with too many, too small

institutes. Cracking the hard questions in health now

requires teams, requires access to a wide range of

equipment, a wide range of facilities, a wide range of

disciplines and know-how. And modern scientific

equipment is expensive. It makes no sense to duplicate

or under-utilise expensive equipment. The trend, too,

is strongly towards international cooperation in order

to tackle the big health issues. And that's why I made

sure that the NHMRC joined a range of top-shelf

international research consortia and collaborations,

such as the International Cancer Genome Consortium,

about 30 countries tackling the basic thing that goes

wrong in the 50 most common cancers, and also the

Global Alliance for Chronic Disease Research with most

of the big medical research funding bodies around the

world.

Australia is just 3 per cent of the world's medical

research effort. We must band together better to

compete with the much bigger international players.

Whether these players are the established one, like

Harvard and its teaching hospitals, or the massive new

Crick institute, that joins together medical research

from the three big London-based universities, or,

increasingly, with China, South Korea, Singapore, and

others in our region. Australia currently has more than


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50 independent medical research institutes. Yet twothirds

of NHMRC research is conducted at just seven

universities, and if we add the six largest Medical

Research Institutes, that's another 17 per cent. So the

remaining 20 per cent or so is a spread around more

than three dozen other independent Medical Research

Institutes, and more than 30 universities. No doubt it's

satisfying to be king of a small castle, but is it really

serving Australia's medical research effort as best we

can do?

I'm thinking I'm up to about point 2.4, a couple to go.

Next, a few words on peer review. Now for those

outside science, peer review is probably something you

don't want to know too much about and it probably

seems a little mysterious, but really it's pretty simple.

It's about getting the best possible experts, judging the

science of other scientists, and doing it fairly and

without bias. Now, with the falling NHMRC success

rate, some critics have been suggesting that peer

review is just too much hard work and perhaps a

lottery would be better. Mind you this is a suggestion

from economists, so take that any way you want. Of

course, the true remedy for falling success rates is

more money for the NHMRC, to fund more excellent

grants. So there is always less money available than

there are good ideas, ideas that, if funding weren't

limited, would be highly worth funding. Last year, less

than 15 per cent of applications to NHMRC were able

to be funded; it'll be lower than 15 per cent this year.

There's no doubt that applying for, and peer review of,

grants does involve lots of hard work.


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My own view is that scientists wanting public money

generally understand that they do need to argue their

case to other experts of the value of the idea and their

ability to deliver. It's certainly hard work, too, for peer

reviewers who have to read, understand, and check

the claims of their fellow scientists applying for

funding. So it's the role of research funding bodies -

NHMRC, the Australian Research Council - to make

sure that peer review is as high quality as possible, so

that taxpayers' funds are used just to fund the best

possible research. We also, of course, do need to make

it as efficient as possible so as not to needlessly waste

researchers' time. I think there are three big challenges

to peer review right now. The first comes from the

political world. For example, in the US the National

Science Council's peer review is under attack from

Congress.

The second attack comes from within, from a small

section of the medical research sector itself. This group

belongs to what I've called the father knows best

school of research funding. Using the argument that

applying for grants and peer review wastes time, this

father knows best school urges that NHMRC simply

stop all this peer reviewing and just give them the

money, because they are wiser. In short, it's a return to

the old days when NHMRC gave institute directors a

large amount of funding and then he - they were all

hes - was then left how to decide how to spend it. It's a

bit of a hankering for the past. Most researchers do

support peer review and participate willingly,

especially here in Australia. Of course, most

researchers don't necessarily agree with the outcomes

of peer review if their own grant is not funded.


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The third challenge to peer review comes from vested

interests, who actually want to bypass bodies like the

NHMRC and the ARC altogether and go directly to

governments for funding. In recent years we've seen

election promises to direct funding specifically to

prostate cancer research, Type 1 Diabetes research,

and tropical health research, and for many, many new

laboratory buildings. I'm not saying that these aren't

good causes. I'm not saying that, diabetes, prostate

cancer, and new labs are not worthwhile, research into

those is not worthwhile, but without peer review of

the merits relative to other calls on funding the

taxpayer can't be sure that they get the best value for

money. I think it will be especially important to be

vigilant as the Medical Research Future Fund is rolled

out. Decisions must be made through peer review, and

so it's reassuring to hear the Prime Minister say that,

and I quote: the vast majority of disbursements from

the fund will be in the hands of the National Health and

Medical Research Council. But I can tell you that vested

interests are already circling like sharks.

My second-to-last point relates to early career

researchers. Let's do train lots of PhDs in this country,

but train them for many careers, not just for full-time

research. A full-time life-long career in research can

only ever be available to a proportion of the hundreds

of biomedical and life science PhDs that we produce

each year, and right now we face quite a difficult

situation. We have over an overabundance, in one

sense, of bright, emerging biomedical researchers who

wish to have a career in full-time research; many, many

more than the number of full-time fellowships that are

available. As a country, we need to find ways by which


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this group of highly talented, highly trained people can

benefit Australia in other ways, as well. I can

completely understand why so many great young

Australians want a career in medical research; it's

deeply, deeply satisfying to work on a project that's

both challenging mentally and has the prospect of

being of benefit to human kind. But as the Chief

Scientist has pointed out, we could do with many more

research-trained people in the private sector too,

where we compare unfavourably with our advanced

country competitors.

We also need more researchers working in government

and the public service, in non-government

organisations, in the community sector, and in

teaching. We also need research institutions to better

help emerging researchers understand and train for

this wider range of possible careers. And we also need

them to provide more security of employment for

those who do want to shoot for a full-time research

career. Making post-docs totally dependent on gaining

a NHMRC fellowship is a very poor employment policy,

and very unfair.

My final point then is that we need to move away from

magic. I've talked a lot about using science and the

outcomes of research more vigorously in health care,

so it's distressing when unscrupulous people exploit

the sick for their own personal gain selling products

that have no help at all of helping the patient. I guess

it's one thing when people sell magic therapies to the

worried well - that's mostly just a waste of money or

expensive urine. Perhaps a little placebo effect, as well.


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But it's an entirely different matter when people who

are ill with a treatable illness are pushed therapies that

don't work and, in fact, are often implausible, pushed

by practitioners who we must assume either believe in

magic or perhaps are just dishonest. Ill health has

attracted charlatans since time immemorial. Snake oil

merchants wanting to take your money by promising

false hope. It's false, because it doesn't offer hope if it's

ineffective. Maybe this sort of behaviour was

understandable before science began to come up with

real, effective treatments and cures, but this is no

longer justified. Science and medical research have the

means to test everything for their effectiveness above

a placebo effect.

As others have said, it makes no sense to classify things

as either conventional medicine or complementary and

alternative medicines. They're really just medicines

that work, shown by vigorous scientific peer-reviewed

research, and medicines that don't work, also shown

by vigorous scientific peer review. So it's fairly

astounding to me that 19th century quackery lingers

into the 21st century. Did I say lingers? I think should

have said roars into the 21st century. I personally can

see no excuse for practitioners urging people who are

ill with diseases that are entirely treatable, and even

curable by what its critics call conventional medicine,

for those to be substituted by other treatments with an

ineffective product. This is especially unethical when

the practitioner personally benefits, say, by selling a

line of herbal extracts, or miracle foods, or even an app

or a cookbook. We tend to metaphorically shrug our

shoulders when we hear about these cases, but we

should not. We should take the same serious


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approaches to so-called alternative medicines as we

take to those produced by the pharmaceutical

industry.

So, to finish, are we getting good value for money from

medical research? Yes, absolutely. Are we getting the

best value we could? Probably no. There's still too big a

gap between what happens in the health system and

what should happen if we could better implement the

findings from research. And I hope I've outlined a few

ways in which this could happen. And finally, always be

wary of vested interests in health and in research. We

all have vested interests, whether it's the

pharmaceutical industry, the wellness industry, lobby

groups of all time, professional organisations, and

certainly research. Health is big, health's a big business.

Restraining the cost growth, the growth in cost, and

providing better treatments and cures definitely needs

a healthy national health and medical research effort,

and one that's certainly worth more than a monthly

cup of coffee.

Thank you very much.

[Applause]

LAURIE WILSON:

Warwick Anderson, thank you very much for your

comments. Let me get the ball rolling with our first

media question today before I go to the floor. You

made the point that you'd endured, in this job, for

somewhat longer than your predecessors or other

research institutes, I think you were suggesting. That

would suggest a certain degree of political adeptness.


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Now, without wishing to, necessarily invite you to give

advice to your successor, I'm just wondering, how have

you found - you navigated the pathway through

numerous governments in fact. I mentioned the

number earlier. You know, what was the key to that?

How have you dealt with that and found it?

WARWICK ANDERSON:

Well, Laurie of course tempted(*) to say outstanding

personal characteristics, but that would be a lie.

[Laughter]

Look first of all, it's extraordinary the support there is

in the community for medical research and that's

reflected in the support that both sides of government

provide. So I think one of the achievements I am quite

proud of is helping the Rudd and Gillard Governments

stick to the promise of increased funding made by the

Howard Government and that did require working

quietly as opposed to yelling loudly in public. Look it's

the greatest job in the country - I said that to the Prime

Minister once, I'm not sure he believed me, but -

because you do get to run a system that supports all

sorts of wonderful people doing their absolute best

with not much salary income on behalf of their fellow

human beings. Nine years though I think has worn me

out and what I'm really pleased about is that my

successor is Professor Anne Kelso - is an absolutely

wonderful human being and wise and canny and I can't

think of a better successor.

LAURIE WILSON:

Going to the floor now. Question from Dan Harrison.


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QUESTION:

G’day Professor Anderson. Dan Harrison from The Age

and The Sydney Morning Herald. Thank you very much

for your speech. You spoke a lot about vested interests

and you said at one point that vested interests are

circling like sharks and I think you were talking about

the Medical Research Future Fund. What's your

greatest fear for the Medical Research Future Fund and

what must be done to prevent that coming to pass?

WARWICK ANDERSON:

Well, I think it was the Prime Minister, the Treasurer

and the then health minister who said that the

NHMRC’d be responsible for decisions about how – you

know, about what it would be spent on, so I think the

sector has to be vigilant to keep those promises. The

then minister for health Peter Dutton told the council

of the NHMRC that his inbox was filled with great ideas

about how to spend the Medical Research Future Fund

within about 30 seconds of it being announced so –

and, of course, when you are a health minister - it's a

hard job being a health minister because you have

people with very good causes in your ear all the time.

Who wouldn't want to cure Type 1 Diabetes, who

wouldn't want to cure breast cancer? So I can

completely understand how the politicians get lobbied

for good causes, but every time you spend a dollar on X

you don't spend it on Y and I suppose my main point is

that only other peers can decide whether Y is a better

use of taxpayers' money than X. So, I'm sure Minister

Ley has the same issue of people offering her good

advice on how to spend the Medical Research Future

Fund all the time. I think the researchers out there and

in the audience today have to make sure that they just

keep an eye on this and so that the public benefit from


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this big investment and the public will benefit best if

the dispersement is through peer review.

LAURIE WILSON:

Now to Simon Grose.

QUESTION:

Simon Grose from Canberra IQ. Warwick, I’d like to go

to the last point in your speech, you talked about –

well, you basically expressed your frustration with 19th

century quackery having - still having a strong presence

in the 21st century. In your time in the NHMRC I think

we've lost ground when it comes to fluoride, we've lost

ground when it comes to vaccination, complementary

medicine has basically lost ground [laughs]. But you

said we shouldn't shrug our shoulders, we should - you

more or less said we should do something about this

which starts to - that raises the idea of more assertive

regulation, pre-emptive regulation, legal intervention.

So do you have any ideas there as to how, rather than

shrug our shoulders, if you want to do something, what

would we do?

WARWICK ANDERSON:

Yeah. I'm a little frightened somebody will say more

red tape, but look, I just don't see why somebody

who's not a pharmaceutical industry or biotech

industry or a devices industry can say this will do you

health benefit, this will cure you or this will look after

your current health problem when industry has to run

a regulatory process that means that they have to

prove that what they're doing is effective. Now they

don't always get that right and we know there's been

many scandals out of the pharmaceutical industry of

hiding results and so on, but I don't think that excuses

the unregulated industry from that. So if I were God


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what I would do is say look if you want to say

something is healthy - has a health benefit you've got

to provide some evidence about it, and really what

we've done is grandfathered ancient remedies from

the 19th century into our current process.

If you're in complementary medicines some of which

probably work, some of them which do work, but you

do not have to go through the same TGA process as the

pharmaceutical industry does. I can't see the

justification for that. What annoys me, as you probably

heard even more, is when individual practitioners talk

individual patients, or people suffering from a treatable

disease to have something that is not effective and I'm

sure many people in this room will have experienced

that. I personally have of a 30-something-year-old son

of some friends of mine who had a treatable cancer,

was persuaded by an alternative therapist to not take

that but to take what she was offering and died in

three months for something that he could still be alive

on. So it just seemed to me unfair and unreasonable

that sort of evidence-based approach can go on in

2015.

LAURIE WILSON:

Well, just to follow up, particularly on the inoculation,

the vaccination issue, I mean that does seem to be -

obviously the Government's trying to wage a battle on

that front, but we've seen major outbreaks particularly

of measles, for instance, around the world, in France

where you’re going, I think a couple of years ago, in the

US and we’ve seen obviously problems in this country

and now, of course, there’s talk about children who

aren't vaccinated they won’t be – they'll be – stop


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them going to school or, you know, whatever. But, I’m

just wondering, what are your thoughts on how you

counter the opposition to vaccination?

WARWICK ANDERSON:

Yes. Probably two things, and the Council of the

NHMRC had a presentation by a researcher from the

University of Sydney whose name I have forgotten, but

who is acknowledged as the world expert in this sort of

area and I've heard her on the radio as part of this

current government initiative and she advises the

Gates Foundation who are, of course, rolling out

vaccination into developing countries in a major way.

There's no magic wand. I think you have to, of course,

talk about why it's effective but that doesn't get to the

people who say well, that's all very well, but not my

child. And, distressingly, that seems to be most

common in the rich and well-educated so that the

electorate of Wentworth, famously, has a lower

vaccination rate than Western Sydney electorates.

I can only put that down to a kind of sense of

entitlement that people have sometimes. That's all

very well, but I'm important I don't need my kid to do

this risk. There's just such a low risk being vaccinated.

It's not zero, but it's so low, but there's a very high risk

of ill health having measles. Trust me, I had measles as

an 18-year-old. It was bloody awful, excuse me, it was

terrible. I think it must be, Laurie and I can't really

explain it, but I think it must be a combination of a

sense of entitlement by some and you know, perhaps

just a drift unless we keep reminding people that their

children and other's children are protected against

really awful diseases by vaccination.


Page: 22

LAURIE WILSON:

Question now from Rashida Yosufzai.

QUESTION: Professor, hi. Rashida Yosufzai from Australian

Associated Press. You mentioned in your speech that

the process for grants will become more competitive

this year. There are some concerns that some scientists

may be gaming the system in order to, you know, be

successful in that round. Do you hold any concerns that

the council may be funding - inadvertently funding

unworthy projects as a result of this?

WARWICK ANDERSON:

So, no, to the last bit, but I'll explain why. Well look,

I suppose from time immemorial scientists have tried

to work out how to, if you like to call it, game the

system but how to get an application in that gives them

every best chance of being funded. But what I did

when I went to the NHMRC is do a whole pile of things

that I think made it clear that we got the best research,

the highest quality and we did it fairly. For example we

separated out who may - the experts who were on the

panel, from the experts who selected the experts from

around Australia and around the world to look at it. We

appointed independent chairs who are briefed within

an inch of their lives about what we value and what we

don't value in a research grant.

We are very clear on exactly what gets you a grant. It's

a scientific merit, if it's basic science it's how innovative

it is, if it's applied, it's how significant it could be, and

then how well is this team set up to answer that

question? Now you've got to game all those three

things and we have community observers in the room

in every panel room, a community observer looking at


Page: 23

the way that works and I acknowledge Elizabeth Grant

who's one of the community observers who's in the

room here today and there are many others from

around Australia.

So - and also we have observers from the research

community, young emerging researchers who we bring

into the room and they sit there and they also examine

it. Finally, it's a secret ballot from the 12 or 13 people

in the room, all of whom are looking at those three

criteria voting secretly on three, pulling it together. So

yip, I guess people try and do the best they can. Look,

the only other thing I would say is the rumours that

some scientists believe are what happens in peer

review bear little resemblance to what happens.

Laurie, one of the experiences over the last nine years

a number of people have come and said to me well, of

course we know that this happens and so we're going

to do that and I look at them and say what planet are

you on, it's not like that. So, it’s an important issue you

raise, I don't mean to dismiss it. Funding bodies like us

and the ARC always have to be vigilant against it, but I

think we've got a very good system, a system actually

that is well admired by other medical research funding

bodies around the world.

LAURIE WILSON:

Roger Hausmann.

QUESTION:

Roger Hausmann for Inside Canberra. Now you

mentioned complementary medicines and you're

heading to Strausberg so no doubt you'll be mixing

some [indistinct] syrup with red wine and calling it a

cardinal. However, coming back to the present and,


Page: 24

you know, the suggestion that in the past budget we

had $6 billion allocated for medical research

specifically, can you tell us how much of that money

has actually hit the labs or is going to hit the Labs by

having projects approved and what is the spread of

these projects across different groups of medical

research? Obviously as our society is changing our

medical needs are changing, too.

WARWICK ANDERSON:

It's a very good point and it's part of the reason why

we have involved community members and consumers

on all NHMRC committees and, in fact, have a specialist

committee advising us generally about community

issues. Look, the question around spread research is a

really interesting one. As the NHMRC funding has

increased the split between what we used to call basic

and used to call applied - although nothing falls that

neatly, is still roughly the same, 50/50, but what has

been growing have been from small bases - but what

have been growing is some of the research I talked

about, that research closer to the patient's bed side,

research closer to policy-maker. If you're talking about

the geographic spread, I'm afraid Victoria still does way

better than everybody else, about 45 per cent of

funding goes to Victoria. It's all on merit, it's all

competitive and Melbourne and Monash University

nearly always come one and two in total funding.

One of the things I think that I've really noticed or two

associated things, one is almost none of our grants go

to a single researcher anymore. They're all teams. It's a

public health research grant, there are more than five

investigators as the research team. If it's a centre of


Page: 25

research excellent there usually 10 cooperating

researchers there. And then the second thing is, and

it's something that the Aidan Byrne of the ARC and I

have talked about a lot, is the merging of disciplines.

You know, to answer difficult questions in medical

research these days you need engineers, you need

social scientists, you need ICT experts, you need data

experts and so the old idea of separate disciplines has

really basically gone. People work across disciplines,

they put together teams to attack(*) research.

LAURIE WILSON:

Can I just follow up, I’m not too sure what the current

situation is, but certainly in the past it's been suggested

that we're not doing enough in the area of research

into Alzheimer's. Now that may have changed I don't

know, but I'm just wondering what is the current state

of play - and we're all getting older it's obviously a

critical problem for a community to deal with.

WARWICK ANDERSON:

So I could be gratuitous, Laurie, and say that issue

about vested interest...

[Laughter]

Well, the Commonwealth Government in the last

Federal Budget actually gave NHMRC $200 million, a

single initiative on dementia research. Some of that is

in cooperation with the Australian Research Council

which is very welcome and Professor John McCallum

who's in the audience is leading that from the

NHMRC's point of view. It raises an interesting

question, I mean what we've tried to do with that $200

million is two things, bind together all the bits and


Page: 26

pieces of dementia research in Australia to one bigger,

combined strategic effort and also to identify, what is it

in Australia we can do that isn't being done by the

other 97 per cent of research around the world? And

what the team at the NHMRC has done is made

contact with the big efforts out of the G7, out of the EU

and out of the US to try and say how can we work

together in a better way?

So I think the $200 million - well, $200 million will be

well spent and we are hoping at the NHMRC that it can

be a step towards this more national collaborative

research around binding things together and having a

national strategy in an important area like dementia.

LAURIE WILSON:

Okay, move on now. A question now from Steve Lewis.

QUESTION:

Professor Anderson, Steve Lewis, I’m a director of the

National Press Club. A question about one of the most

pressing issues Australia faces, energy supply and

security. Why is the NHMRC continuing to straddle the

fence when it comes to wind farms? You've come out

with a report which basically said there were no major

health concerns and yet your funding, I think, another

$500,000 in research into that issue. Why don't you

just give the green light to that particular issue? And

while we're on security, I'd like to ask your view, if I

might, about nuclear energy. You're aware that

Premier Mike Rann has established a royal commission

into that issue. Obviously, in the past there have been

a lot of concerns about health impacts. Do you think

Australia is ready for nuclear energy as we go forward

and as we face pressing energy concerns?


Page: 27

WARWICK ANDERSON:

Thanks Steve. Wind farms...

[Laughter]

…quite sure why wind farms have followed me around

this job but there you go. With respect Mr Lewis, what

you’ve said is not right. That’s not what we’ve found,

we found there was hardly any good evidence that –

the evidence was certainly not pointing towards

obvious physical effects of the wind farm but the best

evidence was that there was annoyance and sleep

deprivation and so on and the evidence for that was

stronger than the direct physical effect. So given this

was brought up by the State Governments to the

NHMRC Council and given we're about to have the

third Senate Select Committee on this area, it seemed

– it is an issue of some, some, community concern. I

have to say I've been a bit surprised by some in the

public health research area, people who support

alternative energies because I would've thought if you

wanted more wind farms and more low-pollution

forms of energy, you'd want to really stamp out the

possibility that there are health effects of them and if

there are, you want to know what they are, so you

could plan around them.

And if you look at what we called for, one side was, you

know, within a kilometre of other health effects. The

other side was what are the social and cultural issues

that are raising these annoyance, sleep deprivation and

so on? That may not be physical at all, that may be

anti-advocates - there might be a whole pile of things

who are leading this to and, of course, there are some


Page: 28

researchers who've done it. So, I'm not the slightest bit

apologetic of what we've done there and I think it’ll it’s

like a lot of new technology. There are concerns that

people have to start off, which with good research can

go away or in fact be shown to be a concern. I think I

want to thank you for the question on nuclear energy. I

would think that the health profession will always be

concerned about the potential health effects of

radiation and nuclear industry.

So I was asked this recently by a politician, and I said

that whenever we're talking about the technology,

whenever we're talking about the economic benefit, it

has to have a complete community view there at the

beginning about the concern about the health effects.

These are real health effects. These aren't potential like

wind farms. These are real. And so you will have to -

the industry, the politicians, the Royal Commission will

have to address these [audio skip] and openly [audio

skip] versus the benefits.

LAURIE WILSON:

Ken Randall.

QUESTION:

Professor, Ken Randall from ISentia. You mentioned

the Research Future Fund a number of times. There's

been some very big figures put around it but not much

specifics about what it does to the future of the

research sector in Australia. What's your view? How is

it going to change the picture that you've painted

today?

WARWICK ANDERSON:

Thanks, Ken. It's a very insightful question in a way,

because the sector faces - and I have to say, I have


Page: 29

spoken to Government about this, but the sector faces,

sort of, two things here. One is flat NHMRC funding

and falling success rates, I've already said be well less

than 15 per cent this year for project fronts on one side

and then the other side the potential of something

building up. Now we don't know aat this stage how

much it will build up to because of - well, you all know

why.

So we're not sure the size of that. My concern is that if

we - if the research community - if the community - if

the political world focus on the research Future Fund

and forget the Medical Research Endowment account

which the NHMRC has for funding research we could

really distort the research effort here. You know, we

fund research into all those major health issues that

the country faces - cancer's number one, but

everything that people suffer from out there. We fund

that. And so we've got to be careful that any new

amount of funding doesn't distort things so that we're

not addressing the major health issues. And that's why

I am a little concerned about vested interests trying to

assert their importance by saying, well, you know, we

should spend all the Medical Research Future Fund on

this or that or on us, a section only of the whole sector.

LAURIE WILSON:

[Inaudible]

QUESTION:

Greetings, hello and thank you. I must fess up, I guess

in the interests of transparency, I'm also President of

the Climate and Health Alliance. My question – and

sorry to do this, takes you back to the wind farms and


Page: 30

again I need to fess up we’ve actually got - we're

preparing a grant for one of those questions.

WARWICK ANDERSON:

Excellent transparency, Liz, yes.

[Laughter]

QUESTION:

I hope this doesn't scupper my question.

WARWICK ANDERSON:

[Laughs]

QUESTION:

The bottom line, of course, is that the burden of

disease is minimal when you consider the comparison

to fossil fuels. You know, with the extraction,

transportation, burning, and so there's widespread

concern around the community and of course the

research community in terms of the fact there's

potential for NHMRC to sort of have suffered some

political interference in terms of the relative

proportion that you're actually giving this issue as

compared to something that's a very big health issue

that we're facing. If you care to comment now that

you've retired, gone.

[Laughter]

WARWICK ANDERSON:

I can say without a shadow of a doubt there's been

no political interest and there's none at all. And this, I

remind you, was raised by Chief Health Officers who

comprise the Council of the National Health and

Medical Research Council. They're the people who

brought it to the NHMRC. These are people in each


Page: 31

state and territory responsible for the health in the

states and territories and it started in 2009 or

something like that. And a couple of those in particular

were really quite worried. You know, they said look,

this isn't the usual group of people who are worried

about things and the environments, it’s(*) a completely

different group, maybe there's something real out

there. Well, I just wasn't willing to ignore that – it’s my

council. And so that got us onto this track that's now

led to a call for research.

I will point out that it's - it's $2.5 million over five years

so that's about $2 million in 4 billion. So you know, it's

not a huge diversion and who knows? I don’t - I'm sure

you're a great researcher, if you got a grant, maybe you

would discover something more general about the

importance of planning for an industry in an area that

hasn't had an industry before, which is mainly what it is

in wind farms. That if you want to look after the

psychological and physical health of a community when

you're introducing a new industry, then maybe you

should go about it this way rather than the others.

There are wind farms that have been built with the

consent of the community, which I'm told there are

few complaints about. But that doesn't mean, I think,

you can dismiss the complaints of the many, many

people who approach these state and territory chief

medical officers.

So - I must say, this does sound like senate estimates,

so you know, I love senate estimates of course, servant

of democracy that I am. But I think for the last seven or

eight, I've only been asked about wind farms. I haven't


Page: 32

been asked about cancer research. I haven't been

asked about research to better support community

health in Aboriginal communities. I haven't been asked

about mental health and suicide. I've been asked about

wind farms. It's really extraordinary.

LAURIE WILSON:

Well, before we conclude…

[Applause]

…I’m going to ask you a final question about the future

and about this new role, the Human Frontier Science

Program. It's not - it doesn't have large funding but I

understand that it does in fact have some pretty heavy

hitters in terms of the connections for instance with

Nobel Prize winners and the like. So, what are the

challenges there for you?

WARWICK ANDERSON:

They're pretty tough the challenges actually, Laurie, I

have to live in France.

[Laughter]

LAURIE WILSON:

Yes, I’m told [indistinct].

WARWICK ANDERSON:

Well, the real challenge actually, of course, is to keep

17 countries, including our own, contributing to this

funding. So that’s the real challenge. But like

everything else, the challenge is peer review. Getting

the best possible people you can to make the best

possible decisions. Now, the success rate for the

Human Frontier Science Program research grants is 2.5


Page: 33

per cent. So it’s a pretty tough contest. But does it does

attract the really outstanding researchers around the

world and people can apply from anywhere around the

world. And Australia does very well in this, by the way.

And yes, it’s got a wonderful track record. It’s been

running for 26, 27 years. It was started by the Japanese

Government, who are still very generous supporters of

it. About 16 other countries do too. And the majority of

which now are in Asia and Pacific although it’s the EU

and America and Canada. But so far, 19 Nobel Prize

winners have had a Human Frontier Science grant. So

what’s the challenge? To get that up to 25, I guess.

Thank you.

LAURIE WILSON:

Thank you very much. We’ll conclude on that note.

[Applause]

LAURIE WILSON:

Mr Warwick Anderson, thank you very much for your

time again today. It’s been a pleasure, and

congratulations on the success of your period with the

NHMRC, and as we remarked earlier, the longevity of

navigating that pathway through various Governments.

And congratulations on the new job as well. It’s my

pleasure to be able to renew your membership to the

National Press Club. I guess you won’t have a chance to

use that too much once you leave for France, but this

does in fact get you into many numerous Press Clubs

and foreign correspondents’ clubs around the world.

So we’ll check out which ones are close to Strasbourg

for you. Not sure there’s one there, but there’ll be one

certainly in the broader region. And also a copy of

Stand and Deliver, the book written by Steve Lewis,


Page: 34

about the 50 years’ history of the Press Club, which

contains some of the most significant speeches,

including a number in the medical research area, a

number of – our own Nobel Prize winners. So thank

you very much.

[Applause]

* * END * *

TRANSCRIPT PRODUCED BY ISENTIA

www.isentia.com


Page: 35

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