More than 50 regionally based Australian universities and health agencies have joined forces to demand greater involvement in medical research, saying that the needs of the bush are being neglected by a city-centric funding regime preoccupied with biomedical cures.
The Spinifex Network – named after Australia’s ubiquitous dune grass – wants more research funding directed towards the health needs of rural, regional and remote Australia. And it wants more rural representation on the panels that influence funding.
Regional people comprise about 29 per cent of Australia’s population and suffer disproportionately from chronic conditions and risk factors ranging from obesity and occupational accidents to asthma, arthritis and alcoholism. Yet a 2018 study found that just 1 to 2 per cent of grant funding from the National Health and Medical Research Council had gone to projects catering to the bush.
And of 79 advisory group members so far appointed to advise government on the “missions” of the A$20 billion (£10.2 billion) Medical Research Future Fund (MRFF), all but four are based in capital cities and just one lives in rural Australia.
Non-metropolitan Australians barely number among the panels’ researcher, clinician, policymaker or even consumer representatives. “Even if you could argue that more of the good researchers are in the cities, there’s absolutely no reason why you wouldn’t have rural consumer voices,” said Spinifex co-convener Christine Jorm, a professor in the University of Newcastle’s School of Medicine and Public Health.
She said regional Australians had 30 per cent more “burden of disease” than their city counterparts, with mental health problems exacerbated by drought and bushfire. “Solutions to help the mental health of farmers are not going to be built in big city research institutes,” she said.
Former Victoria University pro vice-chancellor Warren Payne added that “fly-in fly-out” researchers were not the answer. “You’ve got to embed it in those communities,” said Professor Payne, who now heads the Western Alliance academic health science centre in regional Victoria. “Research to make a real difference, given the health inequalities, has to be based in those centres.”
Policymakers often lament the difficulty of attracting doctors to the bush. Professor Payne said that having more regional research would help.
Professor Jorm said the bush was a no-go zone for medical graduates with laboratory aspirations. “At the moment, if they’re even thinking about a research career, they can’t have one in the country,” she said.
She said governments spent “a fortune” on rurally based medical schools, hoping graduates would remain in the regions. “To really benefit from those investments, we have to provide real careers,” she said.
Professor Jorm said the alliance wanted at least 20 per cent of medical and health research funding dedicated to rural health, but even half of that would be an improvement. She said applied clinical research played second fiddle to basic research in funding decisions, even though it often produced more benefits.
She cited Alzheimer’s disease as an example. “If just 5 per cent of what we’ve spent on trying to understand the pathophysiology of the disease [had gone to] helping families with relatives with Alzheimer’s – the care side of things – we’d be so much better off,” she said.
Professor Jorm criticised the “military language” of the biomedical world, saying stated aims to “conquer” disease were rarely realised. “Most of the time we don’t conquer or win. But it means we’ve got no resources left to care.”
