In the 2021 budget, $15.2 billion was earmarked for infrastructure over the next decade. In the first of a new series, we ask eminent Australians what they’d do with $15 billion to splash on making the country better.
It’s not easy giving Professor Ian Gust $15.2 billion of infrastructure budget to spend, even in his imagination. He wants every cent of it in the hands of others, spent combating climate change.
Gust is not only the inaugural director of the Macfarlane Burnet Centre (now the Burnet Institute) but also the research director at CSL for 17 years, and advisor to the World Health organisation, the World Bank and the Gates Foundation. As a decades long medical researcher specialising in viruses and vaccines, you’d imagine health would be top of mind. Instead it’s a topic that he insists is related.
“Virologists can also be ecologists,” he explains. “They understand evolution, and so on, and I think that unless there is concerted global action, that the human race is a very strong candidate for extinction.
“Climate change really is an existential threat, it’s not just words. Although I’m not an expert on the best ways to deal with it, the absolutely number one priority for major investment, from my perspective, is to address climate change and to speed the transition from our dependence on fossil fuels.”
Pressed on his own area of expertise, in science and medical research, Gust wants investment and better governance in our research institutions.
“My first order would be to very critically and independently review the outcomes of the Medical Research Future Fund,” he says. “That is an enormous investment, which if handled properly could be transforming for health and medical research, and for commercialisation of health and medical research in this country.”
The Medical Research Future Fund (MRFF) was established in 2015 by then prime minister Tony Abbott. It’s a $20 billion long-term investment delivering research funding predominantly to universities; it covers everything from rare cancers to male infertility. The sums granted each year from the fund’s net interest are vast and varied.
Several organisations help manage the MRFF, including a Board of Guardians, who look after the money, and the Australian Medical Research Advisory Board, which sets funding priorities. Ultimately, it’s the minister for health who decides which projects are supported.
Gust explains: “The original intention of it was for it to be used to invest in strategic opportunities for the country. For example, to enable new world-class technologies to thrive in the country, for investments to be made in activities which might result in new product development and so forth. And it was a terrific, terrific initiative.
“The problem, at least from my perspective, is that like so many of these initiatives, it’s not being administered arm’s length from government, and so it gets entangled in the government of the day’s priorities and becomes a little bit of a slush fund for favourite projects or projects that can’t be funded elsewhere – the health minister or the prime minister of the day’s interests.
“It also, to some extent, suffers from the fact that the academics who are likely to be the major beneficiaries of the fund have a disproportionate influence in the distribution of the fund.”
He cites as a better administration model research institutions overseas that have more independent and innovative governance, a mix of high-flying academics – independent from the local academic community – and successful venture capitalists who understand the pharmaceutical/biotech medical research industry.
“People who’ve got product development expertise so that they understand what it actually takes to develop a product and whether a particular idea is a sound one or not. Sometimes they’ll have an economist, or a health economist as well. But it’s a somewhat different shape. And they certainly don’t have people who are there for their political connections or their political influence.”
Given free rein, Gust would prioritise funding a handful of areas in which Australia already has a competitive advantage and build on them.
“You can’t predict what the local academic community is likely to produce over the next five or 10 years. I would have a significant pool of money in an entity like the Medical Research Future Fund, managed somewhat differently, and I would spread it over a range of endeavours.
“For a long time, we’ve been world class in immunology and infectious diseases. We’ve been world class in neurosciences. We are probably world class, I think, in the area of cancer. And probably diabetes and hypertension as well. Those would be half a dozen – I’m sure that there are others as well – but those are half a dozen that I would give special attention to.
“I’d set aside a certain amount of money to enable the rapid testing of exciting new ideas to see whether they were likely to fly. And I would provide significant support to help start-up companies, not only financially, but provide them with the infrastructure around them, and the mentoring and skills that gives them the best chance of being successful.”
Could this model of governance have led to a different outcome for the University of Queensland’s MRFF-funded COVID-19 vaccine trial, which employed novel molecular clamp technology and was abandoned after trial participants returned false positive HIV tests?
Gust believes the outcome was a combination of inexperience and “a little bit of bad luck”.
“I think that academic scientists, when they’re doing their research, aren’t accustomed to thinking through all of the production and regulatory issues that might be involved as a consequence of certain decisions that they make early on in their research,” he says. “I think that had they had access to people with real industry experience, they would not have chosen to use any component of HIV in their construct, just on the off chance that it might stimulate a reaction, which meant that they couldn’t continue with the production of it.”
Gust says that the pandemic has demonstrated “yet again” Australia’s need for a single national body like the Centres for Disease Control (CDC) in the United States.
“In Australia, for historical reasons, we’ve never had one and we’ve patched together all sorts of ad hoc solutions to problems. If [the pandemic] doesn’t cause the politicians to rethink the need for a national centre for disease control, or centres for disease control…
“It wouldn’t all have to be in a single place – I don’t know what will. This is something that the government has been sympathetic to, or various governments have been sympathetic to, over recent years, but the idea has floundered over location, and state jealousies, fights over territory.
“I think it’s timely to really think about having a National Centre for Disease Control funded properly, responsible to but at arm’s length from government, to provide the ongoing surveillance, the policy advice, and all of the monitoring that goes with it, and the associated research, like the CDC was. But the critical thing would be not only to make it independent but to make sure that the leadership of it was not politically determined as it is in the United States.”
Gust gives Australia’s response to the Covid-19 pandemic a mixed report; he’s a little more concerned about the current outbreak in Melbourne, where there is evidence of community transmission. While our ability to contain the spread of the virus is excellent, he is scathing on the vaccine rollout.
“I’ve been constantly amazed at how a country with so many natural advantages as we have, and a glut of vaccine, could be so slow at getting it out to people. And to arrange such a cumbersome system, or at least initially such a cumbersome system. It seems to be picking up ahead of speed now, but it’s been nothing short of disastrous.”
Ian Gust is a virologist and medical researcher. He’s best known for his work to create drugs and vaccines to combat viral diseases, including developing vaccines against the Hepatitis A virus, and as the Australian Government’s lead medical and scientific advisor on AIDS (1989–92).
Sally Warhaft is a Melbourne broadcaster, anthropologist and writer.