Budget Cuts for Eye Research

Australia’s medical research sector and the future health of Australians are under threat.

In the lead up to this month’s budget, the Australian government is reviewing its funding of the National Health and Medical Research Council (NHMRC), Australia’s peak body for supporting health and medical research.

Cuts to medical research funding could reach up to AUD$400 million over the next three years.

In 2008, the English Department of Heath commissioned The RAND Corporation to conduct a review of Health and Medical Research in the United States

Such significant cuts would have a devastating impact on an already stretched sector, disadvantage Australian researchers and diminish the translational benefits they deliver to the community.

Applying for research funding is already a highly competitive process and excellent, high-quality projects deserving of funding frequently miss out.

The NHMRC annual budget is about AUD$750 million. A cut of AUD$400 million over three years would be equivalent to around 18 per cent of the Council’s yearly budget.

The Council’s current budget allows them to fund just 23 per cent of all research projects seeking their support. With budget cuts, this rate would drop dramatically. As institutes compete for a smaller pool of money, trials will undoubtedly be shelved and laboratories will be threatened with closure.

Community Health Benefits

The most obvious argument for investing in medical research is the resulting translational benefits for the community. Anyone who has benefitted from a research breakthrough, whether it is a new treatment, an improved surgical procedure or drug delivery method, will attest to its value.

The last decade has produced numerous breakthroughs that have the potential to change the lives of millions: the Gardasil cervical cancer vaccine; development of an artificial pancreas for diabetes patients; Australia’s first successful artificial heart transplant to name a few.

Without funding, none of these breakthroughs would have occurred.

From the ophthalmic world, we’ve seen the development of a revolutionary new drug for wet age-related macular degeneration (AMD), the bionic eye, new corneal transplant surgical procedures and the use of retinal imaging to predict the onset of cardio-vascular disease.

All of these breakthroughs have achieved the core purpose of medical research – to improve patient outcomes.

Investment Makes ‘Cents’

Funding of Australian medical research is an investment resulting in immeasurable returns for the community, including improved health outcomes, reduced healthcare costs, and a boosted economy.

The cost of eye disease to Australia is a significant and growing problem. Renowned economic analysts, Access Economics (2010), estimate that the total economic cost of vision loss in Australia in 2009 was AUD$16.6 billion or AUD$28,905 per person with vision loss over the age of 40.

The direct costs of treating eye disease were estimated to be AUD$2.98 billion in 2009. The ageing population will see this figure increase rapidly over the next decade. By 2020, it’s estimated that allocated health expenditure will reach AUD$4.8 billion or AUD$5,950 per person with vision loss aged over 40.

Vision loss is one of the leading causes of disability in Australia. It has a significant impact on independence and quality of life. It increases the risk of morbidity, social isolation and depression and doubles the risk of death.

Its affect on an individual’s independence leads to a myriad of indirect costs including visual aids and equipment, carers, career opportunity costs and productivity losses. Together, the indirect costs of vision loss in 2009 were estimated to be AUD$4.2 billion.

Research The Solution

Access Economics (2005) has shown that for every AUD$1 invested in eye research, there’s an estimated AUD$5 return in patient benefit and savings in health service provision.

It’s clear that addressing preventable and treatable vision loss by investing in research is not only cost-effective, but cost saving over the longer term.

Access Economics (2004) found that expenditure on health research and vision disorders is below par – both relative to other diseases in Australia and in comparison to other national per capita expenditure, especially that of the United States.

In 2008, the English Department of Heath commissioned The RAND Corporation to conduct a review of Health and Medical Research in the United States.

The study found that the U.S.A is the world leader in health research in terms of total investment, as well as investment in proportion to overall health spending.

The U.S.A government’s commitment to research investment has propelled the country to become the world leader in medical research innovation.

Home to numerous world-class research institutions, the country is recognised as an international hub for research and development in pharmacology, biotechnology, and medical devices. In 2003, 70 per cent of the global drug development pipeline belonged to U.S.A-based companies. Furthermore, well-funded U.S.A universities and institutes continue to win most of the Nobel prizes in science.

For Australia to be internationally competitive in this sector, it is imperative that research institutes receive both financial and moral support from government.

Scientific Brain-drain

Funding cuts to the NHMRC will also impact on the sector’s ability to attract and keep talented researchers, promoting a brain-drain to overseas institutes.

Attracting world-class researchers is a difficult business and without funding, it’s impossible. If talented researchers can’t get their programs funded, they’ll simply go overseas.

There are many examples of unfunded research projects being taken abroad. A perfect example can be found in a Centre for Eye Research Australia (CERA) project involving the world-first trial of a novel laser therapy aimed at stopping the progression of Age-related Macular Degeneration (AMD).

If successful, the treatment will be a significant breakthrough that will benefit many millions of people in Australia and around the world.

The trial, a partnership between CERA and Ellex Medical Pty Ltd, involves an Australian designed novel laser device that delivers a controlled nanosecond dose of laser energy into the eye.

Preliminary results from a phase one trial are very promising and CERA researchers recently applied for an NHMRC project grant to carry out the first definitive multi-centre trial of this treatment.

Should the trial of this invention go unfunded, researchers are expected to take their project to an overseas institute – a move which would prove a significant loss to AMD patients and Australia’s research sector.

The Australian Government has traditionally been a passionate supporter of medical research. Their support has enabled many important breakthroughs and spawned a vibrant and successful sector of world-class standards. Any cuts, small or large, will be detrimental to the sector, the future health of Australians and our competitiveness on the world stage.

If you’re reading this column, then it’s likely you’re a supporter of eye research. If you feel strongly about this issue, I urge you to voice your opinion by writing a personalised letter to your local federal member of parliament in support of continued funding.

The Discoveries Need Dollars campaign urges the government to take a long-term view of the role of medical research in boosting the economy and improving Australians’ health by maintaining its investment in research.

Find out more by visiting www.discoveriesneeddollars.org.

Professor Jonathan Crowston is a clinician-scientist who specialises in glaucoma and is the Managing Director of the Centre for Eye Research. He completed his ophthalmology training at Moorfields Eye Hospital, London and subsequent Fellowships at Westmead Hospital, Sydney and the Hamilton Glaucoma Centre, University of California, San Diego. His research is focused on age-related neurodegeneration and neuroprotection of the optic nerve.

Lucentis to Slow Vision Loss

The drug Lucentis, trialled at CERA in 2006, has been shown to successfully slow and in some cases, stop, vision loss in patients with wet AMD. In Australia, one in seven people over the age of 50 are affected by the disease and the incidence increases with age. Of the two common forms of AMD, wet AMD is the more serious of the two and is often characterised by rapid vision loss. Sydney resident, Jane Borton, was diagnosed with wet AMD in 2001. Her outlook was bleak after she lost the central vision in her right eye. With the introduction of Lucentis however, Jane’s prognosis improved dramatically. Since 2007 she has been receiving regular injections of the drug. Jane said the availability of Lucentis had saved her vision and changed her life. “Before the injections, my vision was very poor and I was on the brink of losing the central vision in my left eye completely,” Jane said. “These days, my vision is good and I’m still in the work force which is very important to me. I still drive, even at night, and I’m about to take up tennis again after 10 years – life is very much worth living. My reading speed has slowed so I just allow a bit of extra time for it.” “I’m indebted to the researchers who developed and trialled the drug. Without them, my sight is likely to have deteriorated dramatically which would have had a serious impact on my independence and quality of life.” “Research is just so important – the more money that can be invested in research, the quicker we’ll find more treatments and cures for eye disease.”