*** Note: a correction was made to this article on 30 August, where noted***
Introduction by Croakey: Government Ministers made some big promises for the Medical Research Future Fund (MRFF) when it was announced as the centrepiece of the 2014-15 Federal Budget.
The then Treasurer, Joe Hockey, stated it was going to be “the biggest endowment fund of its kind in the world”.
Prime Minister Malcolm Turnbull, who inherited the MRFF from predecessor Tony Abbott, promised it would “find the cures of the future” and Federal Health Minister Peter Dutton claimed it would deliver “tens of thousands of South Australian jobs”.
However, from its inception the MRFF has also attracted some scepticism from leading scientists and researchers.
Professor Ian Frazer called for the scope of the fund to be broadened to include health economics and preventive and “translational” health, while Chief Scientist, Professor Ian Chubb and Sir Gustav Nossal expressed concern about the MRFF driving a wedge between medical research and other “enabling” areas of research, such as chemistry, biology and genetics.
Other health groups questioned whether the benefits of the fund would justify the offsetting cuts to existing programs, such as the National Preventive Health Agency and savings of over $500 million from Indigenous Affairs.
Two years ago, Associate Professor Lesley Russell raised serious doubts about whether the MRFF was living up to the promises made by government.
Building on this work, she has now undertaken a more comprehensive investigation, including examining the MRFF’s funding sources, expenditure patterns, governance processes and evaluation mechanisms.
This analysis reveals some serious inconsistencies in reported expenditure, an overall lack of transparency and accountability and significant gaps in the scope of research funded and the input from consumers and affected communities.
Below is the first of a two-part investigation, #MRFFtransparency. It covers funding sources, expenditure, reporting systems and priority setting. Part 2 will address what is needed to ensure that the MRFF delivers the best value and outcomes.
Russell raises a number of pointed questions for the Government and other stakeholders, which Croakey will seek to have answered. See the questions here, including this: Why has primary healthcare research not attracted more funding?
Lesley Russell writes:
The Medical Research Future Fund (MRFF) was announced in the 2014-15 Budget and established in August 2015. The fund reached the target of $20 billion in July 2020, and the returns on the investment of this capital are used to fund biomedical research.
In early 2019 I reviewed the MRFF funding decisions to determine if the fund was fulfilling its promised mission of “an unprecedented investment that will provide ongoing sustainable funding for ground breaking health and medical research”.
At that time the MRFF was not yet fully funded and my findings were critical of the fact that some of the funds were allocated outside of the priorities set by the Advisory Board, presumably on the basis of decisions made independently by the Minister for Health. I called for a dramatic increase in transparency around the management and distribution of these funds.
It seems timely to look again at these issues. This was reinforced by the findings of a paper published in the Medical Journal of Australia while I was in the midst of this work that was an stunning indictment of MRFF-funded research on COVID-19.
My analysis is done in two parts.
Part 1: How the MRFF is funded, how the research funds are distributed, the public reporting on this, and how the research initiatives that are funded align with the MRFF Strategy and Priorities.
Part 2: What else is needed for a national funding project of this size.
The MRFF is an ongoing research fund set up by the Australian Government in 2015, currently totalling over $20 billion. Medical research is funded from the net interest from the fund’s capital.
The 10-year investment plan for the MRFF (announced in the 2019 Federal Budget) provides the broad framework for the allocation of funding, and includes:
- four key themes for funding research: patients, researchers, research missions and research translation;
- 21 separate initiatives which are grouped under these themes, including:
- Eight research missions (larger programs of work)
- 13 research initiatives (smaller scale activities)
Within this broad framework, the Government is advised by the Australian Medical Research Advisory Board (AMRAB) on the allocation of MRFF funds.
This advice is provided primarily through the development of:
- the Australian Medical Research and Innovation Strategy (every 5 years); and
- the Australian Medical Research and Innovation Priorities (every 2 years).
AMRAB is also responsible for the 16 funding principles developed to guide the development of the strategy and priority documents and other MRFF activities.
The current 2020-2025 strategy has six strategic platforms and there are 12 priorities defined for 2020-222. The priorities must be consistent with the Strategy that is currently in force. As the current Strategy expires during the life of the 2020-22 priorities (in November 2021), these will need to be revisited in 2021.
The Minister for Health makes the final decision about the allocation of MRFF funds. While the MRFF legislation requires the Minister to take MRFF priorities into consideration when making funding decisions, s/he is not required to follow them directly or to address every priority.
The MRFF budget – income and expenses
- The goal of $20 billion in capital for the MRFF was reached in July 2020 (two years longer than the original commitment)
- The MRFF capital was obtained from funding originally allocated to programs in Health and Indigenous Affairs
- The impact of de-funding these health and Indigenous programs is not clear
- The returns on the investment of the MRFF capital have been considerably better than anticipated
- The MRFF has not met its goal of distributing $500 million annually by 2019-20 and it will not meet – by a considerable margin – the goal of distributing $1 billion in the year 2022-23
- Not all the revenue returned on investments is available for distribution for research – no explanation has been provided for this
- The figures provided in the MRFF 10-Year Investment Plan do not align with those in the Budget Papers
- The 2016-18 Report to Parliament contains funding inaccuracies and lacks explanations for major decisions taken and not taken.
There are three main sources of information about expenditure under the MRFF: the Federal Budget Papers; the MRFF 10 Year Investment Plan; and the quarterly portfolio updates.
Explainer – sources of funding data on the MRFF
Federal Budget Papers: includes actual revenue and expenditure for current and past years and projected expenditure for future years in the Budget horizon (usually five5 years).
MRFF 10 Year Investment Plan: outlines projected revenue and expenditure over 10 years.
Quarterly portfolio updates: reports on actual revenue from investments and funds available for disbursement, by quarter.
Federal Budget Papers
The data in Table 1 outline what the Federal Budget Papers, including the Finance Department Portfolio Budget Statements (Outcome 2), say about MRFF funds and their availability over the forward estimates.
Explainer – how to read the Budget tables
MRFF special account: This is the figure usually reported as MRFF expenditure – it is the sum of project payments + management fees
Opening balance: The amount of capital in the fund
Revenue: Income derived from the capital
Management fees: Funding to the Future Fund for management and administration
Transfers to special account for project payments: Funding distributed for research
The 2021-22 Budget Papers show a decrease in funds in the MRFF special account for 2021-22 of almost $200 million over that previously anticipated. This appears to be due to an expected decrease in revenue, perhaps because of the pandemic.
MRFF 10 Year Investment Plan
The Budget information about funds in the MRFF special account does not align well – especially in the out years – with the information provided in the MRFF 10-Year Investment Plan (Table 2).
The Investment Plan for the MRFF, released as part of the 2019-20 Budget, is a mere three pages and provides no information about how the funding figures were derived or who generated them. It is really more a promotional piece than an investment plan.
There is no explanation given for the differences in the amounts listed in these two documents; for example, in 2021-22 there is a discrepancy of $82.6M.
One possibility might be different assumptions about returns on investment: it appears that the Investment Plan assumes these will decline over the years 2021-22 to 2027-28 whereas the Budget Papers are more optimistic and assume they will reach a billion dollars in 2024-25.
What is the reason for the discrepancy in the MRFF funds between the 2019-20 Budget statement and the Investment Plan?
Quarterly portfolio updates are available for the MRFF. The target is a 2.7 percent annual return on investment; the average from inception has been 4.0 percent.
Neither the Budget Papers nor the Investment Plan show that the MRFF has met its goal of distributing $500 million annually by 2019-20 and it will not meet – by a considerable margin – the goal of distributing $1 billion in the year 2022-23.
One key factor contributing to this deficit is revealed by the Budget Papers: not all the revenue returned on investments is available for distribution for research.
For example, in 2024-25, when investments are predicted to deliver $1.067 billion, only $743.1 million is available for distribution. Over the years 2020-21 to 2024-25 this discrepancy amounts to $1.45 billion.
What happens to the MRFF revenue that is not being spent on research?
Where did the $20 billion capital come from?
There is one further funding mystery: the extent of the savings claimed from the 2014-15 Budget that have contributed to the capital of the MRFF.
The Government reported that the capital value of the MRFF reached the goal of $20 billion on 20 July 2020 with the transfer of $3.2 million credit from 2020-21 from what is described in the Budget Papers as “uncommitted funds from the Health and Hospitals Fund (HHF), plus further contributions consisting of amounts equivalent to the estimated value of health function savings published in the 2014-15 Budget adjusted for any subsequent associated government decisions.”.
However, the HHF was closed on 1 January 2015 and the remaining $1 billion in funds was transferred to the MRFF at that time so it is not clear why there was outstanding funding from the HHF being transferred in 2020-21.
Not all of the budget cuts proposed in 2014-15 were enacted, and my estimate is that maximum savings that could subsequently be achieved was of the order of $5.4 billion in 2019-20 (see Table 1 in my 2019 analysis).
Despite this, the Government has continued – unseen and unacknowledged – to generate more than $20 billion in savings from the Health and Indigenous Affairs portfolios (Table 3).
It is particularly galling to consider the impact this must have had on the Closing the Gaps efforts in recent years.
For me, this funding source increases the onus on the MRFF to show that it is funding needed research and undertaking appropriate translation efforts to improve the health of all Australians and particularly the lives of Aboriginal and Torres Strait Islander people.
Why were funds recorded as transferred from the HHF in 2020-21 when the fund closed down in 2015?
What areas in the health and Indigenous Affairs portfolios were the $20 billion in savings obtained from?
How funding decisions are made and priorities are set
1. Accountability and governance issues
The AMRAB meets at least three times a year, but Communiques are only available for two meetings, perhaps because these were attended by the Minister for Health.
The Report to Parliament states that the Department of Health utilises the Business Grants Hub within the Department of Industry, Innovation and Science, the Community Grants Hub managed by the Department of Social Services and the National Health and Medical Research Council (NHMRC) as grant administrators of MRFF initiatives.
There is no way to determine if these hubs and the NHMRC charge the MRFF for their administration roles in assessing, overseeing peer review, and decision-making about which grants are funded and then grant distribution and management. There are certainly costs and personnel involved in this grant administration.
2. Priority setting issues
It is striking that the 2020-22 Priorities (developed in late 2020) do not give a prominent status to research to better understand and treat the coronavirus pandemic and its consequences. COVID-19 is only mentioned in the context of global health.
It is equally striking that there is no place in the priorities for research on the impacts of climate change on health.
Why are communiques not available for all AMRAB meetings?
Does the MRFF pay the NHMRC, the Business Grants Hub and the Community Grants Hub for their role in administering the MRFF?
3. Evaluation and monitoring issues
There are two main documents which provide overview of the performance of the MRFF: the MRFF Monitoring, Evaluation and Learning Strategy and the two yearly reports to Parliament. These are discussed in more detail below.
The MRFF Monitoring, Evaluation and Learning Strategy
A MRFF Monitoring, Evaluation and Learning Strategy 2020–21 to 2023–24 was released in November 2020. That is very late in the game, with four years of funding decisions, some of these for millions of dollars, already made.
The strategy assesses the MRFF against the following five impact measures:
- Better patient outcomes.
- Beneficial change to health practices.
- Evidence of increased efficiency in the health system.
- The commercialisation of health research outcomes.
- Community support for the use of, and outcomes from, funding.
There are a number of problems with this strategy:
- These measures are very conceptual (even the document admits that!) and not easily measured.
- The document indicates that evaluations will be done via progress and final reports and evaluation reports from grantees. A footnote says, “The Department will engage with grant recipients to undertake retrospective evaluations”.
The strategy document also includes goals for each Mission and Initiative, but these are so general as to be meaningless. For example, the goal for the Cardiovascular Health Mission is “To make transformative improvements in heart health, vascular health and stroke for all Australians”.
How is the Department measuring the impact of MRFF grants?
How is the Department engaging with grant recipients to undertake retrospective evaluations?
Why isn’t evaluation an integral part of all funded research and translation and not an after-the-fact add-on?
Report to Parliament
The MRFF Act 2015 requires the Minister for Health to report to the Parliament every two years. The Morrison Government has been slow to do this: the 2016-18 report was not released until September 2019 and the 2018-20 report is yet to be released.
This report has some value but this is undermined by a number of errors and limitations, as follows:
- Total spending numbers provided (in Table 2 of the report) are wrong. The total 8-year proposed spend is given as $1,404.0 million but it is $1,095.1 million; the out-year total is given as $313.7 million but it is $122.5 million; the total spend (should be the sum of 8-year spend + out-years + $500 million from Genome Mission) is given as $1,217.6 million but is $1,717.6.
- There is an inconsistency in the total funding for all the initiatives funded from November 2016 to November 2018 (Appendices C and D) which is given as $213,856,845, considerably more than the funding for 2016-17 to 2018-19 provided in Table 2 ($186 million). This might be explained by the difference between the proposed and the actual budget for 2018-19 (the latter is given as $239.9 million in the 2019-20 Budget Papers).
- No information Is given about how or why major decisions were made, for example the decision to have a Genomics Health Futures Mission funded at $500 million.
- No explanation is provided for why this Priority did not proceed: “In partnership with the states and territories, determine the feasibility of establishing a national institute focused on health services, and public and preventive health research to facilitate evidence-based and cost-effective healthcare”.
Why did the priority relating to a national institute for health services, public and preventive health not proceed?
Why are the reports to Parliament so delayed?
What is the reason for the discrepancy in funding figures between the report to Parliament and the Budget Papers?
How research funded by the MRFF aligns with the Strategic Platforms and Priorities
- Information is available about most of the projects funded by the MRFF, with the exception of those projects funded via the Research Missions and MTPConnect
- The extent to which the initiatives funded align with the 2016-21 Strategy and the 2016-18, 2018-19 and 2020-22 Priorities is very subjective but clearly some Priorities are privileged over others
- Priorities and funding levels do not reflect the current Australian disease burden and health care needs
- Notable gaps are the minimal focus on dementia and the limited funding available for primary care and health systems research
- The current MRFF structure does not permit the timely development of priorities for and funding of coronavirus research
- There is nothing to drive collaborations across Research Missions to maximise the benefits of this innovative research
- The MRFF definition of consumer-driven research seems very narrow (funding provided to patient and disease groups) and does not appear to involve consumer consultation and co-design
- It is not possible to determine how successful efforts to date have been in building infrastructure and data coordination and management systems
- Without these, much of the research will not be properly captured and utilised.
Summary of funding allocations to date
Since its inception in 2015 to May 2021, the MRFF has funded 555 research grants totalling $1.51 billion.
The MRFF website provides information about all grant recipients – at the time of writing, this is current to May 11, 2021. Since then, Health Minister Greg Hunt made an announcement of additional grants totalling $180 million on 30 June 2021.
There is an MRFF collection page on the DoH website that contains the implementation plan snapshots for 2019–21 for the 20 missions and initiatives that are part of the MRFF 10-year plan. All these documents are dated November, 2019 and this page has not been updated since July 2020.
The information on these websites highlights the following:
- The focus of the research funded by the MRFF is very clinical and biomedical
- The titles of the projects funded reveal a huge bias towards cancer research
- Very few projects are focused on issues that pose an equivalent health burden to cancer, such as dementia and obesity.
- There is little research funded that addresses the drivers of health and wellbeing, including the social determinants of health, and health literacy and communications.
- There is little funding allocated to primary care and health systems research.
Many of these issues were raised in a paper published in the MJA in February 2021 which highlighted that MRFF funding targeted to disease-based research goes mostly to those conditions with a high death burden (for example, cancer) and largely ignores those with a high disability burden (for example, hearing).
Funding by category
It is difficult to track funding allocated to priority areas as some of the categorisations are quite idiosyncratic. For example, some priority areas, such as Indigenous Health show up across the spectrum of categories.
Issues arising from the tracking of spending against MRFF priorities are outlined below.
The 10-year plan outlines the funding for each of these by financial year to 2027-28 (in some cases the Morrison Government now inflates these totals by adding in funding for 2028-29).
Table 5 below is a collation of the spending to May 11, 2021 date (as outlined in list of grant recipients) against the project spend. It separately includes the funding announcements made by Minister Hunt in June.
Specific comments on individual missions follow below.
Brain Cancer Mission
Funding for the Brain Cancer Mission has been augmented by $66.35 million in philanthropic contributions and $9.35 million from other MRFF initiatives (probably Clinical Trials Activity) to a final 10-year total of $124.7 million
Cardiovascular Health Mission
- Around $10M less than projected has been allocated
- The Cardiovascular Health Mission Roadmap spells out the funding principles and priorities. This document makes specific mention of the need for culturally appropriate approaches and active partnerships with Aboriginal and Torres Strait Islander people to set priorities and for the co-design and implementation of research initiatives.
Dementia, Ageing and Aged Care Mission
- To date, only $27 million of the available $45 million has been allocated; this includes one major grant, for $10 million to the Clem Jones Centre for Ageing Dementia Research at the University of Queensland.
- A draft Roadmap was released in February 2020 but apparently has not been finalised.
- Despite the enormous and growing burden of dementia to the healthcare and aged care systems and society, and the appalling findings from the Royal Commission into Aged Care Quality and Safety in Aged Care (which found aged care research is not given sufficient priority or funding), the Dementia, Ageing and Aged Care Mission is clearly lacking the drive needed to improve and expand research in this area.
Why has the roadmap for the Dementia, Ageing and Aged Care Mission not been finalised?
What is the reason for the under-spend in the Dementia, Ageing and Aged Care Mission?
Genomics Health Futures Mission
- For some reason the list of many of the projects funded under this mission do not include the names of the Chief Investigator/s.
Why do many of the projects funded under the Genomics Health Futures Mission not include the names of the Chief Investigator/s?
Indigenous Health Research Mission
- The Indigenous Health Research Mission has a Roadmap and an Implementation Plan. One of the four priority areas is “Addressing the root causes of inequity” and this includes “strengthening culture as a determinant of health”.
- It is encouraging to see the extent of Indigenous expertise (the majority of members are Indigenous) on the Expert Advisory Panel. However, as far as I can tell, only one of the 10 projects initially funded has an Indigenous person as Chief Investigator.
- A significant amount of funds ($35 million) was allocated to the University of Western Australia for the development of a vaccine to prevent rheumatic fever. This funding ceases July 1, 2021. From 2021-22 through to 2028-29 the funding available for this Mission is $12.5 million / year. This seems paltry given the need, although there are some projects on Indigenous health issues funded under other MRFF initiatives.
How many of the projects funded by the Indigenous Health Research Mission have an Indigenous person as Chief Investigator?
Million Minds Mental Health Mission
- The Million Minds Mental Health Mission is the only Mission where funding given out exceeds that projected – likely this reflects the Government’s response to recent reports calling for greater investments in mental health and public concerns about this.
- The Advisory Panel has a carer advocate and a consumer advocate but is dominated by clinicians; there does not appear to be anyone with lived experience of mental health issues.
Does the Advisory Panel for the Million Minds Mental Health Mission include anyone with lived experience of mental health issues?
Stem Cell Therapies Mission
The following section highlights key points of interest relating to the 13 research initiatves.
Emerging Priorities and Consumer Driven Research
Included in this category are a number of grants to patient and disease organisations. The largest of these includes:
- $30 million to the Australian Parkinson’s Mission at the Garvan Institute.
- $25 million to the Juvenile Diabetes Research Foundation
- $10 million to the MS Research Flagship at the University of Tasmania
Two additional large grants are $54 million to the Zero Childhood Cancer Precision Medicine program at the University of New South Wales and $25 million to the National Drug Discovery Centre at the Walter and Eliza Hall Institute.
This category also includes $5 million for nine projects funded in 2020 to look at the impact of bushfires.
While most of the competitive projects are funded under the rubric “Accelerated Research”, the grants to patient and disease organisations are described as “Targeted – Patient Led”. It is impossible to know how recipients in this latter category are selected and their funding levels determined and the role that ministerial discretion plays in these decisions.
How are recipients of grants described as “Targeted – Patient Led” inthe “Emerging Priorities and Consumer Driven Research” category selected and their funding levels determined? What role did ministerial discretion play in these decisions?
Clinical Trials Activity
All of the projects funded are designated as competitive except for $5 million for Clinical Trials Registries made in 2017.
Every year since 2017 there have been grants made for clinical trials that are part of international studies, but other than that, since 2018 the focus has been totally on rare cancers.
The focus of research here is quite narrow with all the projects addressing aspects of anti-microbial resistance.
In 2017, $2 million was provided to the Coalition for Epidemic Preparedness Innovations (CEPI), for their National Security Against Pandemic Risk program. That is the only funded provided for this type of research, which in retrospect now appears so critical.
Frontier Health and Medical Research
This appears to be a “catch-all” category for projects that don’t fit elsewhere. It has only been funded in 2018 and 2021.
In 2017-18, projects in this category were funded as “Next Generation Clinical Researchers”; from 2019 on, the projects are under the category of “Investigator Grants”. Only researchers with medical qualifications are eligible for these research grants.
The extent to which the focus is on the next generation of researchers (i.e. early stage researchers) is unknown but does not appear to be obviously the case as judged by those listed as Chief Investigators on the grants.
How many of the Chief Investigators of projects funded under the “Next Generation Clinical Researchers” are early stage researchers?
Rapid Applied Research Translation
This encompasses 27 projects funded in 2017-18. All of these were classified as “Competitive – pre-qualified.
Primary Health Care Research
It is shocking that only 11 projects totally $13.85 million have been funded in this important area since the inception of the MRFF.
Essentially this funding replaces that once channelled through the Australian Primary Health Care Research Institute (APHCRI). APHCRI was last funded at $22 million for the years 2010-2014 – so there has been no increase in funding for primary care research since then.
Why has primary health care research not attracted more funding?
National Critical Research Infrastructure
This category includes 5 projects on the role of artificial intelligence (AI) in health and four projects around improving regional, rural and remote health.
These include funding of $72.2 million to the Queensland Department of Health for telehealth trials and $30.5 million to the NSW Ministry of Health for trialling access to innovative healthcare in regional, rural and remote areas.
Medical Research Commercialisation
Researcher Exchange and Development Within Industry
The single project funded in this category went to MTPConnect for the REDI Program. (More detail on MTP Connect follows in a section below).
Preventive and Public Health
This category covers a number of issues. These include:
- $10 million in 2017 to the Sax Institute for the work of the Australian Prevention Partnership Centre (most of the funding for the APPC comes from elsewhere).
- In 2018, 12 grants focussed on “Keeping Australians out of Hospital”, including targeted grants to Tasmania and the ACT.
- In 2019, 10 grants for “Targeted Health System and Community Organisation”.
- In 2020, 10 grants for “Maternal Health and the First 2000 Days”.
- In 2021, $47 million to MTPConnect for a Diabetes and Cardiovascular Accelerator initiative – this is described as a competitive grant.
Coronavirus Research Response
This funding, totalling $58.1 million, includes $3.0 million for a clinical study of hydroxychloroquine and some $9 million for vaccine research. It is notable that just three projects (totalling $600,000) are funded on communication strategies and there does not appear to be any funding to investigate long-COVID.
A recent perspectives paper that accompanied a critical study of Australia’s funding of coronavirus clinical trials, published in the MJA, makes several salient points that relate to MRFF funding of research in general and coronavirus pandemic research in particular:
- Australia does not have a nationally resourced and coordinated trials infrastructure for this work.
- The ability to conduct clinical studies was hampered because funding decisions were made late and there were few COVID-19 patients to enrol and to give meaningful results from clinical trials.
A response from the Department of Health, included in a newpaper article about this, stated that the Commonwealth Government has, to date, spent $374 million on COVID-19 treatment and vaccine research on nine possible candidates. (That figures must include sums spent elsewhere, presumably through the NHMRC.)
Who made the decision to make coronavirus research a priority and when was this decision made?
Why is there no research funded on long COVID?
What was the Government’s involvement in the decision to fund research on hydroxychloroquine?
MTPConnect is a not-for-profit organisation set up in 2015 as part of the Commonwealth Government’s Industry Growth Centres Initiative. It has received $146.3 million of MRFF funds – ten percent of all funds distributed to date. This includes the following:
- The BioMedical Translation Bridge Program ($22.3 million) has so far funded 20 projects, 15 going to industry and 5 to universities. The website provides only a little information on the topic of these projects and nothing about the funding or the anticipated outcomes.
- The BioMedTech Horizons Program ($45 million) is aimed at the medical device sector. It currently funds 41 projects with industry.
- The REDI Initiative ($32 million) aims to build the medical technology, biotechnology and pharmaceutical workforce. This work is based on a skills gap report (prepared by consultants). Contracts have been awarded for skills gap training and education programs and applications are currently open for up to 40 industry fellowships.
- The Targeted Translation Research Accelerator (TTRA) initiative for diabetes and cardiovascular disease states it will provide a “new integrate research program to improve the prevention, management and treatment” of these diseases. This will include new research centres for diabetes and cardiovascular disease and a research project funding program – which seems to run the risk of overlapping with the work of both the MRFF (specifically the Cardiovascular Health Mission) and the NHMRC.
MTPConnect funds are part of the Medical Research Commercialisation Initiative (MRCI) which is set to receive $311.3 million of MRFF funds over 10 years.
As this analysis was being prepared for publication there was a media report that the MRCF was committing $40 million over the next three years to the establishment of a dedicated biotechnology hub to focus on personal health and disease prevention.
This would appear to overlap with a number of other aspects of research and development and commercialisation being undertaken using MRFF funding. Research incubation hubs were a 2016-18 Priority but have not been listed as such since (see Table 6).
Addendum added on 30 August 2021:
I have been advised by Brandon Capital Partners (which operates the MRCF) that in the initial version of this article I had confused the MRCF and the MRCI. That has now been corrected (above).
Brandon Capital Partners confirmed that the MRCF has received $39.5 million from the “newly-announced” Early Stage Translation and Commercialisation Support (ESTAC) program, which is part of the Medical Research Commercialisation Initiative. I was also advised that, at the same time as the MRCF received this funding, MTPConnect and AndHealth each received $19.5 million.
The webpage for the MRCI (last updated 24 August, 2021) has a dot point about ESTAC (it “funds support for early stage Australian medical research and medical innovation projects with commercial potential”) but no further information is provided.
Health Minister Greg Hunt issued a media release about these new funding grants on 20 August 2021 (after this analysis was submitted for editing).
It is not clear how we will learn about the success or otherwise of all this funding and the administration costs taken by MTPConnect and its advisors and partners. If Australia is to be more successful in commercialising research discoveries, then these sorts of partnerships are essential. But when the expenditure of taxpayers’ dollars is involved, transparency is an imperative.
How will the performance of MTPConnect be measured?
How well were priorities met?
Table 6 is my effort to map the categories under which research is funded against the strategic platforms and previous and current priorities.
This is a fairly subjective task and so it is no surprise that the Report to Parliament on the 2016-18 Priorities does this differently.
Key points to note
Table 1 in the Report to Parliament indicates (via italics rather than words) that some areas were poorly addressed:
- National data management study – “Associated work occurred in the context of developing the data and analytics stream of the Genomics Health Futures Mission.”
- Drug effectiveness and repurposing – “Captured in part under the intent of the Australian Brain Cancer Mission, Genomics Health Futures Mission and Lifting Clinical Trial and Registry Capacity.”
- National infrastructure sharing scheme – “Potential reference to Government announcements around the National Research Infrastructure Roadmap and Lifting Clinical Trial and Registry Capacity.” Note that the National Research Infrastructure Roadmap is still in development. Funding of $5 million over four years was provided in 2017 to the Australian Clinical Trials Alliance to build the capacity of Clinical Trials Networks, but ongoing funding is needed.
The MRFF infrastructure and evaluation provision was “Addressed outside of the MRFF with the Government’s commitment of $20 million over four years to support AMRAB activities and program oversight.”
Behavioural economics is apparently covered by Preventive Health Research and public good demonstration trials by clinical trials on rare cancers, the Brain Cancer Mission and the Million Minds Mental Health Research Mission.
Nothing is said about the failure to address the National Institute of Research.
For the years 2018-20 and 2020-22, I can find nothing that obviously fits under comparative effectiveness research (perhaps clinical trials make the cut?).
It is interesting to note that although drug repurposing has been a priority since the inception of the MRFF, projects in this area were not funded until 2020.
Finally, the MRFF definition of consumer-driven research seems very narrow (funding provided to patient and disease groups) and does not appear to involve consumer consultation about priorities for research funding and co-design of research projects, nor consumers identifying priorities for research and for funding.
• PART 2 will address what is needed to deliver on the investment in the MRFF
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