Introduction by Croakey: The Trump Administration is continuing its assault on science and health, firing four senior leaders of the National Institutes of Health, following last week’s announcement by Robert F Kennedy Jr that the US Department of Health and Human Services would reduce its workforce by 20,000 employees.
This includes downsizing critical agencies including the Center for Disease Prevention and Control, Food and Drug Administration, and Centers for Medicare and Medicaid Services, according to CBS News. The changes will have significant implications for health and scientific research.
Below, Adjunct Associate Professor Dr Lesley Russell says that Australia’s Medical Research Future Fund has struggled to deliver, and that bipartisan support is required to see Australian research flourish. Her article was first published at the Conversation.
Lesley Russell writes:
Australian researchers are reeling from the international reach of the Trump administration’s ideological war on science and research, which threatens local research projects that receive funding from the United States National Institutes of Health.
In this context, some may have found a grain of comfort in Opposition Leader Peter Dutton’s budget reply speech with his commitment of continued support for the Medical Research Future Fund.
The fund provides a concrete opportunity to supplant those US funds without further cost to the federal budget.
But to date the Medical Research Future Fund has struggled to deliver on the promises made at its inception in 2015 that, a decade on, are still so needed.
What is the Medical Research Future Fund?
This research fund was the sweetener in the Abbott Government’s 2014–2015 budget, which slashed spending in health and Indigenous Affairs.
Virtually all the savings were invested in the new research fund, with the target of reaching $A20 billion at maturity (this happened in 2020) and then distributing $1 billion each year.
The funds are allocated in accordance with the Medical Research Future Fund’s funding principles. They are based on Australia’s medical and research innovation strategy (revised every five years) and priorities (which should be revised every two years, but have not been updated since 2022). These are set by an independent medical research advisory board.
However, it is the federal government, via the Minister for Health and Aged Care, who develops the ten-year investment plan and has the final say in how funds are used.
How is the money being used?
The current ten-year plan (for the decade to 2033–2034) has four themes: patients, researchers, research missions and research translation. There are 22 initiatives under these themes across a wide range of basic and clinical research areas, population health initiatives and commercialisation endeavours.
The Future Fund Management Agency is in charge of investing the funds which, by September 2024, had now grown to $23.85 billion.
But although the returns on investment have always been above the annual set targets, the returns to research have fallen well short.
This is because in 2021 the Morrison Government – with Labor support – enacted legislation to cap the fund’s expenditure at $650 million a year.
Since 2015, the fund’s investments have earned $6.435 billion. Yet only $3.15 billion has gone out to fund research (data as of September 2024).
This year, the Future Fund Board of Guardians has set the “maximum annual distribution amount” at $1.053 billion.
The cap on yearly spending means $403 million that could boost research funding remains locked up in an oversubscribed investment portfolio.
That pot of unallocated research funds will continue to grow unless there are legislative changes to lift the cap.
A tough climate for research
It’s not an exaggeration to say these are tough times for Australian researchers. Australian investment in research and development, as a proportion of GDP, has been falling steadily behind the OECD average.
Funding awarded by the National Health and Medical Research Council (the other main source of government funding for biomedical research) has almost flat-lined over the past decade, at an average of $887 million a year.
Success rates for researchers securing National Health and Medical Research Council and Medical Research Future Fund grants are at historic lows. The adverse impact on research and researchers is recognised on the National Health and Medical Research Council website.
The COVID pandemic, the growing obesity epidemic, the burgeoning mental health crisis, health threats of climate change, the disappointing failures of Closing the Gap initiatives, and growing health inequalities – all point to the need to spend more on research and to do this smarter.
The Medical Research Future Fund could and should do much more to fulfil its aim “to transform health and medical research and innovation to improve lives, build the economy and contribute to health system sustainability”.
So, is it working?
Over the years, there has been a range of criticisms of the fund’s processes. These prevent it from realising its mission and include:
- funds have been allocated outside the established priorities
- reporting on the fund’s activities and outcomes is not timely and lacks transparency and accountability (note the required report to parliament for 2022–2024 is not yet available)
- there is no collaboration across research missions and with the various agencies of the federal government, particularly the the National Health and Medical Research Council
- not enough has been done to ensure consumers and patients are actively consulted and involved
- funding is focused on disease groups with high rates of premature deaths at the expense of those that cause disabilities.
What’s being done to fix the issues?
Some of these issues are being addressed.
In particular, efforts are underway to reform the governance and administration of the Medical Research Future Fund and the National Health and Medical Research Council’s Medical Research endowment account.
This is to ensure the community obtains the greatest benefits from these investments in health and medical research. However, the timetable is regrettably slow – this work began in May 2023.
The hard reality is that boosting Australia’s biomedical research capabilities and capacities requires bipartisan political commitment, which has been scarce in recent times.
The last two budgets from the Albanese Government offered little for research, aside from the existing commitments to the fund.
To date, all we have from Dutton is a single statement highlighting his role in establishing the fund and his ongoing commitment to it.
It’s time to boost Australia’s reputation as a country that nurtures and promotes research excellence. This would be both an investment in Australians’ health and wellbeing and Australia’s economy and a counter to Trump’s denigration of biomedical science.
Dr Lesley Russell is Adjunct Associate Professor at the Leeder Centre for Health Policy, Economics and Data, University of Sydney, a member and contributing editor of Croakey Health Media, and author of The Health Wrap.
See Croakey’s archive of articles on health research.
