Hon. Assoc Prof Leanne Coombe and Dr Saman Khalatbari-Soltani
We have all heard the old saying – prevention is better than cure.
As Australia’s health system struggles with the growing burden of preventable disease, Government investment in public health research to discover new ways to stem the growing tide of illness is essential.
But unfortunately, our new analysis published in the Australian and New Zealand Journal of Public Health this week shows that when it comes to Government research funding, public health is taking a backseat to clinical interventions, like looking for new cures and treatments.
For those working in the public health sector, the outcomes of our analysis of public health and prevention research funding via the Government’s Medical Research Future Fund (MRFF) won’t come as a surprise.
While there are six MRFF Initiatives that clearly relate to public health and a specific “Preventive and Public Health Research Initiative”, researchers working in our sector have long felt in the dark about how much genuine public health research is being funded through the scheme.
What is particularly disheartening is our finding that even when MRFF funding is issued under a “preventative and public health” banner, half of the time the research is not genuinely public health focused.
Defining public health research
To undertake our analysis, the first thing we had to do was develop a definition of public health research.
Using an expert panel, and agreed public health definitions, we developed a public health research checklist that would be used to assess MRFF projects and judge whether they were genuinely public health related.
In general, we were looking at things like “Does this research project aim to keep people healthy or stop them from getting sick?” “Does it aim to improve health at a population, rather than at an individual level?” “Does it look at the causes and fixes of health inequities within particular communities or subgroups?”
We then examined research projects funded through six key MRFF Initiatives to uncover what type of research was being conducted, how much funding they were receiving, and whether they fit the definition of public health.
For those projects that focused on prevention, we also looked at what sort of prevention was being researched. Was it early prevention (stopping disease before it starts), detecting illness early, or slowing down how fast it progressed?
What we found
One of the most ironic and concerning findings related to funding granted through the MRFF’s specific “Preventive and Public Health Research Initiative”. This Initiative is meant to focus on public health, and over $238.8m in funding has been distributed under this banner since 2018.
Counterintuitively, less than half of the research projects funded under this Initiative were public health focused. This translates to less than 40c in every $1 spent going to public health and prevention.
On a wider scale, within the six MRFF public health-related Initiatives we analysed, we found that only 57 percent of the 249 projects and around half of the funding granted was for genuine public health research.
We also found that there was little focus on early prevention to stop people from getting sick in the first place – with many research projects relating instead to early detection or slowing disease progression.
What now?
We want to be clear – our research doesn’t show that the MRFF is wasting money. We suspect that many of the projects funded through the MRFF Initiatives we analysed, while not fitting the definition of public health, are still important (who doesn’t want a new cancer cure or treatment?)
We also acknowledge we may not have captured all Government public health research funding by limiting our scope to six MRFF Initiatives.
But what our research does show is that Government public health research funding is not transparent or clear – and it should be. Likewise, when Government research funding is allocated under a public health and prevention banner, it should genuinely reflect a public health approach.
It is crucial to prioritise public health projects that target the root causes of ill health and health inequities, such as our living conditions, our work, and our social supports, to enhance the health and wellbeing of all Australians.
That’s why we need the MRFF to adopt a better, clearer definition of public health research so that funding can be allocated appropriately.
Similarly, we need to see a proper Government commitment and investment in public health and prevention. To date, the National Preventive Health Strategy has yet to receive any real funding for implementation.
In Australia today, there are unfair and avoidable differences in health between different population groups, and this is one of our biggest public health challenges. At the same time, the numbers of Australians living with chronic diseases is exploding, while the cost of treatments and cures is skyrocketing.
We will be paying for the lack of investment in prevention for years to come.
It’s clear that the Australian health system is struggling and will continue to do so unless our governments act now.
We must stop parking the ambulance at the bottom of the cliff, and make sure we are properly and transparently funding public health research that will stop people falling from a great height.
Read the full paper, “Public health and prevention research within the Medical Research Future Fund,” by Benedicta Natalia Latif, Leanne Coombe, Tim Driscoll, Anita van Zwieten, Catherine Sherrington, and Saman Khalatbari-Soltani.
Hon. Assoc Prof Leanne Coombe is Policy and Advocacy Manager at PHAA. Dr Saman Khalatbari-Soltani is Senior Lecturer in Population Health at the University of Sydney.
Image: Canva
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