Stop calling for more funding and use what you've got better

Next month the Department of Innovation, Industry, Science and Research will release the results of its Strategic Roadmap for Australian Research Infrastructure.

This document will articulate Australia's national research infrastructure priority areas. This is an important step in managing the distribution of the finite pool of resources available for medical and health research and will, it is hoped, ensure new approaches, strategies and technologies are given scope to develop, securing the best possible health outcomes for Australia.

It is not just governments who should be considering their strategic directions. It is critical that Australian researchers position their organisations to make the greatest possible impact with the limited funds available.

At the Australasian Gastro-Intestinal Trials Group we have devised an innovative approach to identifying potential improvements in bowel cancer research.

We will be holding a consensus meeting on 23 August which will bring together cancer survivors, health care providers, funders and researchers to identify the areas of bowel cancer research that are in need of attention. Identifying gaps in bowel cancer clinical trials will help define and prioritise future research into improving patient care and outcomes.

Cancer survival rates in Australia are currently among the best in the world.

This is due to many factors, amongst which are well-trained clinicians who practice evidence-based medicine. In doing so, they themselves have a focus on research with the current emphasis on translational trials. These trials translate laboratory research into clinical practice.

The goal of co-operative clinical trials groups is to conduct clinical trials to improve the treatments on offer to Australian patients by driving innovation into cures and disease management strategies.

The focus of our work is on finding better cancer treatments, prevention and early detection, as well as studying quality of life and rehabilitation issues.

Co-operative clinical trials groups are comprised of doctors, nurses, researchers and patients who volunteer their time and expertise to test the latest innovative treatments with patients in hospitals and medical centres across the country.

These organisations are funded indirectly by the federal government, industry and the community and must compete with other health and medical research organisations for the finite pool of funds available.

The benefit of carrying out clinical research in Australian hospitals is that it gives Australian doctors a direct involvement in the latest research and treatment techniques, providing better outcomes for Australian patients.

Indeed the very process of planning and conducting trials of novel therapies forces clinicians to standardise current treatment strategies based on the best available evidence, thereby improving care even before the results of the trial are known. But recently, external factors such as the high Australian dollar and more attractive investment climate in Asia, has diverted funding into other markets.

As a result, we risk losing our status and expertise as growing numbers of trials move to Asia. With their large populations and increasing subsidies for clinical trials, South Korea and Taiwan are already formidable competitors in the region.

In order to ensure that medical research capabilities continue to flourish it is critical that Australia focuses on further research investment in clinical and translational research. It is this cutting edge research which will be of most benefit to health outcomes for Australians and bolster our international position in the long-term.

An example of this is playing out around Australian cancer centres. The Australasian Gastro-Intestinal Trials Group is currently investigating a new approach which will change the way we treat pancreatic cancer.

Trials conducted to date have shown that cancers are radically different between people and respond differently to treatment. This research revolutionises the conventional approach of focussing on the affected organ. Personalised treatments focus on the development of biomarkers to help researchers and clinicians select the optimal treatment for each individual patient by investigating the molecular markers in each person's tumour.

This will hopefully minimise the number of cancer patients who undergo ineffective treatment and also provide significant cost savings on expensive and unnecessary treatments. This is where the future of cancer research and its treatment lies.

Since trials first began in 1991, in collaboration with the National Health and Medical Research Council (NHMRC) Clinical Trials Centre, the AGITG has improved cancer outcomes through a range of clinical trials.

These include using oral chemotherapy as a less invasive alternative to intravenous therapies, pre-operative chemo radiation for locally advanced oesophageal cancer, as well as improving quality of life for cancer patients by identifying when to introduce palliative chemotherapy and achieving fewer side effects by using a combination of chemotherapies. These and trials like them have helped develop and maintain a world-class standard of treatment in Australia.

It is a fact of life that budgets are finite. Let us therefore play to our strengths as a small yet dynamic nation by ensuring we foster innovative clinical research in order to continue to provide the best possible health care to all Australians.