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 million Victoria million Queensland - 4.5million South Australia 1.65 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 National State / Territory Committees State / Territory Committees State and Territory Cabinets State and Territory Cabinets State and Territory Health Departments State and Territory Health Departments Australian Government Crisis Committee Australian Government Crisis Committee National Security Council Prime Minister National Security Council Prime Minister Department of Health AustralianHealth Protection Committee AustralianHealth National Incident Room Australian Government Crisis Coordination Centre Emergency Management Australia Australian Government Crisis Coordination Centre Emergency Management Australia State and Territory Emergency Operations Centres State and Territory Emergency Operations Centres Australian Government Agencies 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 YearIssueGrants 2005 H5N1 Pandemic Influenza H1N1 Pandemic Influenza Hendra Virus8 Traditional Approach- Targeted and Urgent Calls for Research

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): 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 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

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