This year I’ve attended meetings at Parliament House discussing with various MPs the Draft National Preventive Health Strategy. The draft strategy included some important potential reforms, including the establishment of a target of 5% of health spending being committed to public and preventive health; the need for the establishment of a mechanism to draw upon evidence to drive the allocation of such resources should we reach this target; and the principle of ensuring industries with fundamental conflicts of interest (think the alcohol industry, for example) do not have a major influence on preventive health related policy.
An important part of the discussion was around the research effort needed to lead future policy and resource allocation in public and preventive health.
By way of illustration, the AIHW has published a report on expenditure on the management of neoplasms. The report suggests that in 2015–16, health system expenditure on cancer and other neoplasms was estimated to be $10.1 billion, comprising $9.7 billion on diagnosing and treating cancer and $409 million on the three national population cancer screening programs—bowel, breast and cervical. Further, a cost to the health budget of $2.7 billion was attributed to cancer risk factors, such as high sun exposure, tobacco use and overweight and obesity. This makes up 42% of expenditure on the cancers known to be affected by these risk factors.
Research to tackle the behavioural and environmental causes of cancer are unlikely to be led by basic science in the lab, although there are still many discoveries that may help tackle these challenges.
Much like Australia’s successful response to the COVID19 pandemic, the type of research that will have enormous impact in this area will be, and has been, population health research. This focuses on human behaviour, systems, policies and processes that drive what we as humans do. Mathematic modelling of how different levels of restrictions would influence infection rates, what communications would best influence high levels of community adherence to restrictions, what processes were most effective for contact tracing, and timely analysis of infection trends across settings all helped Australia to ‘destroy the curve’, to paraphrase Michael Ryan, Executive Director of the WHO Health Emergencies Programme.
Population health research must guide advice to governments and politicians. Happily, Australia has proven to be successful and effective in this field in the last 15 months. This type of research is essential to the successful rollout of the various COVID19 vaccines.
The Australian Society for Medical Research (ASMR) has an important role to bring together and create a voice for Australia’s health and medical researchers. It is essential that the wide diversity of people who have dedicated their life’s work to improving health be recognised and embraced. The basic, bench and clinical scientists in the lab and the hospitals are fundamentally important to tackling the current and future health challenges for Australia and the world, and are rightly proud of the successes they have had.
Population health researchers are similarly proud and successful. They are an essential part of the research community, integral to the efforts of the ASMR. Expanding opportunities to foster cooperation and collaboration between the basic, clinical and population health research communities under the banner of ASMR will benefit all involved. But perhaps more importantly, the knowledge advances achieved by this collaborative research will benefit the Australian community (who after all provide the funds!) and beyond to the international community as well.
Terry Slevin is the CEO of the Public Health Association of Australia, and is also Adjunct Professor in the School of Psychology at Curtin University and Adjunct Professor in the College of Health and Medicine at the Australian National University.