Bench-to-bedside research in Australian research institutes: a snapshot.

The Medical Journal of Australia ISSN: 0025-729X 1/15 December 2003 179 11/12 603-HIDDEN ©The Medical Journal of Australia 2003 www.mja.com.au The Research Enterprise DURING THE 20TH CENTURY Australians have benefited immensely from improvements in their general health and life expectancy. Our average life span has increased by 25 years, and even in the century’s dying decade we managed to gain another two years! As with many success stories, there have been numerous contributors, but there is no doubt that basic medical research has played a prominent part. Indeed, the interplay between basic research and advances in medicine is succinctly captured by the phrase “from bench to bedside” or by the term “translational highway” — an autobahn for taking basic research advances and transferring these into clinical practice. The powerhouses of basic research in Australia are our universities and research institutes. Their financial underpinnings are the competitive grants provided by both government and non-government organisations. In 2002, for example, the National Health and Medical Research Council’s expenditure on health research and development was $276 million. Of this, the universities received $190 million (69%) and the medical research institutes received $74 million (27%). Since 1995, the Christmas issue of the Journal has regularly featured Australian medical research institutes, beginning with portraits of the Walter and Eliza Hall Institute in Melbourne and the John Curtin Institute of Medical Research in Canberra, and featuring most recently the Menzies entre for Population Health Research in Hobart in 2001 (now the Menzies Research Institute). This year, we sought to explore a different avenue. In 1998, the the Minister for Health, Dr Michael Wooldridge, empowered a prominent committee chaired by Peter Wills, then Ch irman of the Garvan Institute of Medical Research, Sydney, to review health and medical research in Australia and report on strategies for these efforts in the first decade of the 21st century. In its final report, the committee identified a number of issues including: ■ the need to sustain and expand an effective health and medical research sector underpinned by innovative and high impact basic research; ■ a greater need for research that contributes directly to the health of the people and the healthcare system; and ■ the need for links between research and industry to capitalise on the potential commercialisation of research findings. In short, the report recommended an increased emphasis on “bench-to-bedside” research, focused on the health and economic wellbeing of the nation. To gain some perspective on the vitality of this research in Australian medical research institutes, we recently conducted a poll of institute directors (see Box). Their responses are given on the following pages. What inferences can we draw from this snapshot? Firstly, it is apparent that “bench-to-bedside” research is alive and well in Australian medical research institutes, and is wide-ranging in its scope. It includes public health advances relevant to South-East Asian and Australian Indigenous communities, clinical advances in areas such as assisted reproduction and cancer, and improved treatments for chronic disorders, such as diabetes or visual impairment in older people. Secondly, this research is achieved by teamwork between clinician–scientists and scientists working together in a collegial spirit. Thirdly, and most importantly, it takes time. Finally, it is apparent that our research institutes are increasingly forging closer links with industry. However, there is one overriding message — that success in basic research cannot be solely developed from imposed priorities and schemes. Research is driven by human imagination, inquisitiveness, insight and a generous sprinkling of serendipity. For, as observed by the Nobel laureate Albert Szent-Gyorgi, “. . . research means going out into the unknown with the hope of finding something new to bring home. If you know in advance what you are going to do or even to find there, then it is not research at all: then it is only a kind of honorable occupation.” In short, basic research has two defining features: uncertainty and surprise. As long as these twin principles are treasured in our medical research institutes, meaningful “bench-to-bedside” research will continue to advance the practice of medicine. Martin B Van Der Weyden