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Public health brigade urged to stand up and be counted

After keeping us waiting for some time, the NHMRC has finally delivered a swag of reviews and reports for public comment, including the much-anticipated Nutbeam Review of Public Health Research Funding (which has been the subject of some interest previously at Crikey and Croakey).

The NHMRC is seeking comment on its strategic plan,  and has also released a review conducted in October 2007 and chaired by Professor Alan Bernstein, the then President of the Canadian Institutes of Health Research, as well as a review conducted in January 2008 and chaired by Dr Elias Zerhouni, Director of the United States National Institutes of Health (both available here).

In the article below, Professor Glenn Salkeld, head of the School of Public Health at the University of Sydney, gives an overview of the Nutbeam review and urges colleagues to “get active”:

“We should all get behind the recommendations of Nutbeam Report of the Review of Public Health Research Funding in Australia. If I had to pick one sentence that captures the spirit of the report it is this:

“High quality public health research that leads to improved health outcomes is most likely to emerge from a thriving public health research community conducting a combination of investigator driven and strategic research.”

This report is all about what it will take to truly deliver the promise that public health research will improve population health. Yes, it will take additional investment by NHMRC in public health research but the message here is not simply to ‘splash the cash’. Rather, a far more strategic and crafted approach to how the investment is made and how it links to policy and practice is required.

The Report contains 14 recommendations that call on NHMRC to take a greater role in leadership in public health research and in improving the processes and coordination of research, policy and practice in Australia.

The report delivers the recommendations in 3 sections: strategic leadership and co-ordination (aligning to the Government’s preventative health strategy), changes to funding strategies and mechanisms and improvement’s to NHMRC application and assessment processes.

The sentiments behind the recommendations are forward thinking and collaborative. Strategic thinking, priority driven research, innovation, flexibility and responsiveness, transparency, infrastructure and workforce capacity building are needed.

The Report calls for NHMRC to move beyond descriptive research and fund more intervention research.

There is a separate and comprehensive set of recommendations relating to Indigenous Public Health Research. Again the call is to move beyond further descriptive studies and focus on intervention research and on rigorous evaluation of interventions in priority research areas.

The deployment of these ideas and improvements will take strong leadership and political commitment by NHMRC. We are not off to a good start.

Recommendation 3 calls on DoHA to further develop the Public Health Education and Research Program (PHERP) to support national Centres of Excellence in key public health priority areas. So what does DoHA do? Abolish PHERP.

PHERP has delivered generalist public health education to the masses but we need to move on and develop specialist training and workforce capacity building.

As the Nutbeam Report observes, we have spread our public health research talent too thin in the application of PHERP funds. What we need is a smaller number of world-class groupings in Australia.

The recent call for NHMRC Centres of Research Excellence in Public Health and Health Services Research are an important step towards that objective.

Imagine what could be achieved if that was matched with a DoHA initiative to fund a national Public Health Office Training Program that took our best and brightest MPH graduates and delivered specialty training ‘in the field’.

While we’re at it, what are we doing to support the next generation of health policy makers?

Then there is the all important track record in public health research funding. In the last decade the NHMRC research funding pie has grown substantially yet the success rate for Public Health for project grants, research fellowship and program grants has been poor. There is a dearth of NHMRC Senior Research Fellows in Public Health.

Many countries have faced the same problems, how to build public health workforce capacity, focus on strategic research (whilst maintaining important investigator driven research) and how best to transfer results into policy and practice. Canada leads the way with the establishment of a Public Health Research Canada Strategic Plan which includes start-up funding grants, rapid response intervention program, infrastructure grants and support for 14 Chairs at mid-career (Associate Professor) level. All great ideas – good enough to borrow for ourselves.

For a relatively modest investment in money, infrastructure and improved processes NHMRC has an opportunity reap great rewards from their investment in Public Health.

We have a unique opportunity with the Government’s commitment to preventative health to do just that. Write to Warwick Anderson, the CEO of NHRMC, and tell him you back the Nutbeam Report recommendations. The sooner the better.”

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