Burnet Institute
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ANALYSIS Actioning health research Professor Brendan Crabb Director and CEO, Burnet Institute The Burnet Institute aims to achieve improved healthcare outcomes for the poor and vulnerable both in Australia and around the world. Positioned at the interface between research and public health, Professor Brendan Crabb, provides a glimpse into Burnet’s work towards identifying tools and methods to enhance national scale interventions 110 INTERNATIONAL INNOVATION ANALYSIS What drew you to the fi eld of healthcare? How did you become linked to the deployment of interventions to reduce the impact involved with the Burnet Institute? of major diseases or health problems in the developing world. The research performed in this Centre is directly related to improving the I trained as an infectious diseases scientist and early in my research ways in which these interventions are implemented. career, largely by accident rather than design, found myself working on malaria. Through my work on the disease, I came to understand that the Burnet’s approach to research is unique – interweaving solutions to many health problems in the developing world, and indeed laboratory-based medical research with fi eld-based public in our own marginalised communities, involved both sophisticated health programmes. Why is this strategy so advantageous? science and what can best be described as a humanitarian response. For example, I quickly learnt that malaria is a devastating disease of Complex health problems, especially today’s major infectious poverty, therefore solutions require interventions that address people’s diseases, such as HIV, tuberculosis (TB) and malaria, require solutions basic needs in health and nutrition, in the same way that highly across the discovery, treatment and public health spectrum. In technical therapies and prevention methods are needed. each case a combination of new scientifi c understanding and better methods of implementation is required. Burnet’s strategy is to be Can you briefl y outline the work undertaken at the three centres involved across this spectrum to address these and other health of excellence encompassed in the Burnet Institute? problems, as this approach allows for a comprehensive response where areas of research inform one another. The Centre for Biomedical Research is lab-focused. It seeks to understand the basic biology of the organisms that cause What is the current landscape of infectious disease in disease, with a view to identifying points of vulnerability which Australia? Why is understanding immune response to disease can be exploited for the development of vaccines. This Centre is so important? also involved in early stage commercialisation to progress these discoveries towards products for clinical care. The Centre for Infectious diseases in Australia are less important compared with Population Health works with communities and is particularly their impact on the developing world and are a lower priority concerned with the science of disease transmission and issues, than they once were in this country. This largely has to do with including behavioural factors, which promote or prevent the implementation of effective vaccines and antibiotics to treat transmission. The Centre for International Health is more closely some of our previously common bacterial infections. However, Healthcare hexagon The six key themes at the heart of Burnet’s healthcare research Alcohol, other drugs and harm reduction Maternal and child health The focus on risky behaviours associated with Working with communities, Burnet is improving drug and alcohol misuse aims at developing access to healthcare services such as family community-level education and preventive public planning, postnatal and newborn care, vaccinations, health programmes management of childhood illnesses and nutrition Immunity, vaccines and immunisation Sexual and reproductive health Developing vaccines to stop major infectious An important global issue, sexually transmitted diseases such as HIV, infl uenza and malaria requires infections (STIs), including HIV, impact on the health an understanding of the way in which the immune of all communities and are often related to alcohol system functions in health and disease and drug misuse behaviours Infectious diseases Young people’s health Burnet has expertise in specifi c infectious diseases The Institute’s research focuses on the health issues of global health signifi cance – HIV, malaria, arising from the risky behaviour of some young tuberculosis, hepatitis viruses, infl uenza and people, such as alcohol and drug use, as well as STIs emerging infectious diseases and mental disorders WWW.RESEARCHMEDIA.EU 111 ANALYSIS their newborns in Zimbabwe, Myanmar, Lao People’s Democratic Challenges to research Republic and PNG. With regard to vaccinations, we have helped the PNG Government monitor the performance of its immunisation programme; researched the best model of measles Professor Crabb pinpoints three of the most prevalent (helping to control measles in PNG with zero deaths over the past obstacles faced by public health researchers and 10 years); and carried out immunisation coverage surveys both in practitioners striving to improve community-level public PNG and Fiji. Burnet staff also donate time to the World Health health programmes Organization (WHO) headquarters, acting as key advisors in FUNDING: Attracting suffi cient funding to undertake quality immunisation and reproductive health. research that informs public health policy and practice. Funding is often inadequate or provided for insuffi cient By what means does Burnet foster the advancement of periods of time to properly answer complex questions knowledge and the development of healthcare tools? RESEARCH TRANSLATION: Ensuring research results Burnet publishes its science in peer-reviewed literature and are translated into action. There is very little funding for communicates with the public in many ways: online, in print and implementation research and quality evaluation of public health in person. It advocates to all stakeholders, but particularly to programmes, and appropriate involvement of the affected governments that fund much of our work. We develop healthcare communities to ensure the policy/programme has real impact tools using traditional commercialisation pathways, often in- house, at an early stage and then with commercial partners as the IMPLEMENTATION: On occasion, even when there is a technologies develop. strong research evidence base and examples of both national and international programmatic success, a policy may not What do you consider to be the Institute’s greatest be implemented for politically-driven reasons (eg. needle contribution to the fi eld of medicine? syringe programmes in prisons, alcohol distribution venues in disadvantaged suburbs) or because of perceived large short- Our development of a low-cost, point-of-care diagnostic term costs despite evidence of long-term cost-effectiveness test for CD4 T cells. This test, VISITECT® CD4, paves the way for drug therapy to become a reality for one-third to half of the global 35 million people currently infected with HIV. It is widely recognised internationally as a discovery of profound infectious diseases, and respiratory infections in particular, remain international signifi cance. signifi cant in Australia affecting otherwise healthy people; while a whole myriad of infections impinge upon less healthy persons (eg. diabetic or hospitalised individuals). Infl uenza, for example, remains a major threat in Australia as this disease alone is responsible Preventing risky behaviour for thousands of deaths every year. As for the immune response, solutions to infectious diseases, both within the country and The most prevalent risk factors associated with internationally, are likely to require a better understanding of its alcohol, drugs and harmful behaviour in Australia: contribution to disease and immunity. This knowledge can lead to interventions such as vaccines or immunotherapies to control these • Prison or contact with the • Mental health issues remaining infections. criminal justice system • Peer and family history Could you elucidate some of the steps taken by the Institute • Youth • Low economic status to develop best practices for the management of childhood diseases, newborn care and vaccinations? How can the importance of preventive action be emphasised? For more than 15 years, the Institute has been a key technical advisor to large-scale aid projects working with governments in our • Targeted media • Effective research region to improve health services for children – notably in Papua New Guinea (PNG), China (nationally and in the Tibet Autonomous • Focused interventions • Research translation Region of China) and Indonesia. In our role as an NGO, we have • Reduced stigma • Policy making grassroots development projects that work with local partners to improve access to pregnancy and postnatal care for women and www.burnet.edu.au 112 INTERNATIONAL INNOVATION.