RESEARCH Kirby turns 30 The Kirby Institute’s achievements are cause for celebration as UNSW’s world-leading infectious disease research centre marks its 30th anniversary, writes Melinda Ham.

ward and soon we just manageable disease, and has couldn’t keep up. There was a “We’ve been part been since 1996 after the THE HISTORY lot of fear of the unknown.” of a miracle of development of effective In one early response, antiretroviral therapy. Cooper and some colleagues modern medicine,” “We’ve been part of a cientia Professor David met key Sydney gay miracle of modern medicine,” Cooper, now the Kirby organisations and set up a says Professor Sean Emery, Institute’s Director, study to enrol these men with AIDS: Epidemiology and head of the Kirby Institute’s was a specialist at St HIV/AIDS and follow them Clinical Research, established Therapeutic and Vaccine SVincent’s Hospital when the over time. This became SAPS, at UNSW in 1986, which Research Program. HIV/AIDS pandemic loomed the Sydney AIDS Prospective became the Kirby Institute for “Previously HIV was a fatal menacingly back in the early Study, one of the most infection and immunity in infection and now we have 1980s. More and more people influential early studies society in 2011 to better reflect individuals diagnosed and kept coming to the hospital defining the natural history its research focus. This name going on to near live normal with symptoms of HIV. and immune response to HIV. honours Michael Kirby, lives – albeit taking a cocktail “This was a completely Cooper was foundation ’s longest serving of drugs every day.” devastating time,” he says. Director of the National judge, a passionate advocate When Emery joined the “We started off with a couple Health and Medical Research for health and human rights. Institute in 1993, most of beds in our immunology Council’s Special Unit in HIV is now a chronic research focused on the

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them available to the vast remote Aboriginal majority of the 230,000 communities. Australians living with the “This means clinics can get disease. quick results - most often on “The Kirby Institute has the same day -and provide been an international leader in immediate treatment right evaluating new hepatitis C away instead of waiting treatments among people who weeks,” Kaldor says. inject drugs,” Dore says, “Sometimes people with an adding that global infection had left the pharmaceutical company community by the time the development programs Professor Sean Emery results came back.” exclude people with ongoing drug use, and many settings deny access to highly curative included the status of REGIONAL ENGAGEMENT treatments for these people. Australia’s first people. “Thus our clinical trials But it was not until 2007 With more than 200 embraced HIV treatment, and trying to find out if partial continue to build the evidence that the Institute established researchers in 13 research are now assisting cutting traditionally done in of effectiveness in the most the Aboriginal and Torres program areas, the Institute’s where people living with HIV PNG is also protective, and if marginalised populations Strait Health Program, with primary functions are to co- need more options for so why.” with hepatitis C,” he says. the explicit mission of closing ordinate national surveillance accessing testing and Reflecting on the Kirby The huge challenge now is the gap between Indigenous programs, population health treatment. We are using Institute’s 30-year history, to move towards the and non-Indigenous people, and epidemiological research, observational research and Cooper says it’s been a elimination of hepatitis C as a focusing on sexual health and and conduct clinical research interventional research to find fascinating journey. “It’s major global health problem, blood-borne viruses. and trials. out what works in improving unusual in a medical career to Dore adds. “This will require The Program led It was a natural access,” Kaldor says. see the evolution of a disease continued efforts in research, Australia’s first national survey progression for the Institute to The Institute also has had a from its beginnings - to a public health policy into the sexual health and set up research collaborations strong collaborative research disease that emerged as a development and advocacy relationships of young with countries in the Asia- program in PNG particularly global health catastrophe - to for access for therapy for all.” Aboriginal and Torres Strait Pacific, including , in recent years. The program this point now, where medical To this end, the Institute Islander people (GOANNA), Cambodia, Indonesia and research is bringing it under also has a multi-disciplinary and also the STRIVE study, , to work control,” he says. “These treatments stemming the rate of EXPANDING ITS SCOPE Viral Hepatitis Epidemiology working with remote with local researchers It’s unusual in a “I feel valued to be transmission – individuals and and Prevention Program, Aboriginal community clinics responding to epidemics in medical career to involved in this work and to are good for the populations benefit.” In the mid-1990s the headed by Professor Lisa to support them to improve the their own countries. These are have been able to make a individual but also Today, the Institute’s Institute’s academics also Maher. It conducts public uptake of testing and treatment often concentrated in see the evolution difference for so many people.” researchers are also involved became involved in projects health research focused on of STIs among adolescents and vulnerable populations such as of a disease from extraordinarily as the international co- assessing the transmission people who inject drugs, young adults. men who have sex with men, The Kirby Institute would like effective at ordinating centre for HIV rates and impact of sexually recognising this is a diverse “Our research showed that people who inject drugs, sex its beginnings – to to thank the following clinical trials in more than 300 transmitted infections (STIs) population both within testing in the clinics improved workers and transgender … where medical individuals and organisations stemming the rate sites in 30 countries. Other and hepatitis C on the general Australia and the Asia-Pacific 30 to 40 per cent,” says Scientia people. for their generous support: of transmission” projects include trialling population. region. Professor John Kaldor, who The Institute’s researchers research is preventative treatment The Viral Hepatitis has a long involvement with have assisted in a wide range bringing it under Government regimens on sexually-active Clinical Research Program the Institute’s Aboriginal of projects including gay men, and also the many was formed in 2003 and now INDIGENOUS AUSTRALIANS health research. “That was a therapeutic trials, public health control.” The Atlantic Philanthropies efficacy of experimental strands of the START focuses on three main areas; good start but it still needs to surveillance systems and Estate of the late Peter Ikin antiviral medications. But as (Strategic Timing of clinical research through From the early 1990s, be much higher; we want to training for research in these Berg Family Foundation the drug regimens evolved and AntiRetroviral Treatment) national and international trial researchers at the Institute really help services to find countries. has collected the first The Glendonbrook Foundation became more effective, the project, including liver networks, molecular virology became involved in Indigenous ways to improve uptake. We “We worked closely with comprehensive information on Jillian Segal, John Roth and focus switched to more fibrosis, pulmonary and research and epidemiological health by ensuring the also discovered that these the Cambodia Ministry of a number of key STIs. the Roth Charitable strategic questions that neurology sub studies. research using data linkage collection of national HIV data remote services need ongoing Health when it really Researchers are also involved Foundation determined how the drugs studies and mathematical support to ensure sexual health in evaluating the same point- Geoffrey Alder could be used more effectively; modelling. stays on the agenda.” of-care technology used in Estate of the late Lynn Joseph should they be taken every day Professor Greg Dore heads Another project currently Indigenous research to test or episodically and how and the program, which implemented in remote pregnant women for curable To find out more about the when should they be started? particularly focuses on people communities is TTANGO STIs that could adversely work of the Kirby Institute, or “By effectively treating who inject drugs - the key (Treat Test And Go), a world impact their babies’ birth how you can support their infected individuals population affected by the first trial. Using point-of-care health. endeavour to lead the transmission to uninfected hepatitis C virus. technology initially created to Another unique program is research effort against blood- individual is reduced,” Emery The Federal government test for tuberculosis, looking at penal cutting borne viruses and related says. “There is a remarkable has committed $1 billion over researchers are working with practices widely practiced in infections in Australia and our intersection; that these the next five years to subsidise health services to implement PNG. “Studies in Africa have region, please contact the treatments are good for the new treatments for hepatitis C and evaluate point-of-care tests definitely shown that male UNSW Foundation on individual but also which have a cure rate of 95 for chlamydia and gonorrhoea circumcision protects against +61 2 9385 3202 or extraordinarily effective at Scientia Professor David Cooper per cent, potentially making Professor Greg Dore across a number of clinics in Scientia Professor John Kaldor HIV,” says Kaldor. “We are [email protected]

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