Australia’s draft National Science and Research Priorities

In reference to Priority 2: Supporting healthy and thriving communities.
We commend the recognition of the environmental and social factors as key determinants of health. However, to comprehensively support healthy and thriving communities there is a requirement for deeper engagement and coordination mechanisms with health service providers, clinicians, medical and health researchers and Government health departments in all jurisdictions to provide the multidisciplinary and multisector collaborations that will be necessary to meet this challenge, minimise duplication of efforts and clashing priorities, and to deliver greater impact. We would recommend the establishment of a cross government platform (Department of Health and Aged Care, Department of Education, and Department of Industry, Science and Resources) to coordinate delivery.

We would also like to emphasise the importance of the following major challenges that if addressed would dramatically increase the health and wellbeing of Australians:

• Prevention and early detection of cardiovascular risk factors (raised blood pressure, dyslipidemia) contributing to cardiovascular disease and stroke, the leading causes of death in Australia and globally. In 2021, there were over 42,000 deaths (25% of all deaths) and 600,000 hospitalisations attributable to cardiovascular disease (AIHW).

• Healthy aging. With the average life expectancy continuously increasing, industrialised countries are facing two challenges presented by the demographic shift: how to manage the extra costs associated with longer term care; and how to manage the prospect of possibly spending more years in declining health.
In Australia, it is predicted by 2066 that more than a fifth of the total population will be 65 years and above (AIHW). There is an urgent need to ensure that Australia is prepared for the looming demographic shift and acts now to put in place preventative measures and programs that will support healthy aging. We also need to better understand the mechanisms and biology of aging and interventions that will support independence and maintenance of quality of life. This will require an integrative preventive approach that tackles not only the social and environmental factors but also behaviour, genetics, and medical factors which are also key determinants of health.

Considerations could include:
The establishment of a First Nations Advisory Group within the governance framework to be advisors across all priorities identified. It would be important to establish this Advisory Group early on and ensure broad consultation and communication throughout the timeframe of all priorities/activities.

In reference to Priority 2: Supporting healthy and thriving communities:

• To further refine these research pathways, particularly in addressing immediate challenges, one effective approach is to focus on the reduction of chronic condition rates, such as cardiovascular disease (CVD) and stroke, as the leading causes of death in Australia. We support the use of technologies and techniques for an integrated preventive health system. However, we would like to stress the importance and need for early detection and screening of disease and risk factors at a population level, underpinned by evidence-based research and adoption of innovative discoveries such as imaging, biomarkers, precision medicine. It is notable that, among 3 things bullet-pointed as “Critical Research”, “Mechanisms of brain function and repair and how to address deterioration of brain function” is specifically listed as a stand-alone item. While we do not question the importance of mental health, this bullet point appears to be more calibrated toward avoiding cognitive decline with age. The justification for this as a stand-alone item for “Critical Research” is not at all clear and we would question the appropriateness of this when, particularly, CVD is the #1 cause of combined morbidity and mortality in Australia. We want to emphasise that chronic conditions like hypertension, cardiovascular disease (CVD), and stroke significantly contribute to cognitive decline and dementia. Additionally, it's important to acknowledge the reciprocal connection between CVD and mental health. Understanding and addressing this interplay is essential for comprehensive healthcare, highlighting the importance of taking a holistic approach that encompasses both physical and psychological well-being. Therefore, we recommend prioritising research in the area of whole-body system approaches to study the mechanisms of brain function deterioration.

• We also note that equitable access to care is a major priority for Health Departments across the country with a focus on providing access to best practice care and robust digital solutions and support for rural, regional and remote communities. There is an opportunity to leverage from their activities that could support immediate rollout.

• We wholeheartedly endorse the collection and careful curation of data to enhance overall well-being outcomes, ensuring that interventions are monitored and informed by data-driven insights. We would also suggest that such platforms are co-ordinated with AIHW and adhere to international data standards to ensure interoperability across all jurisdictions.

In reference to Priority 3: Enabling a productive and innovative economy.
• The medical technology sector in Australia is worth $6.1 billion and employs over 36,000 people. While the sector is growing, there are significant opportunities to accelerate this growth. It is estimated the medical technology industry has the potential to create an additional 28,000 jobs and $18 billion in gross domestic product (GDP) nationally by 2025. It would be important to include this sector in the critical areas of research and strengthen this industry in Australia.

The Australian Cardiovascular Alliance Ltd (ACvA) is a member-based organisation representing the interests of diverse members which spans individual researchers, research institutes, government agencies, peak bodies (advocacy groups/consumer groups), and industry members.

The vision of the ACvA is to deliver transformative change to cardiovascular research and health outcomes by building a thriving cardiovascular ecosystem serving health and the economy. This is done by bringing the cardiovascular research sector together to develop solutions to the most pressing areas of need and make a measurable difference to cardiovascular health for communities.

The ACvA has devised seven strategic flagships that provide a platform of strengths and capabilities in cardiovascular research and clinical care: 1) Implementation and Policy; 2) Clinical Trials; 3) Big Data; 4) Precision Medicine; 5) Drug Discovery; 6) Bioengineering, and 7) Disease Mechanisms. These strengths are applied to the cross-cutting clinical themes of coronary artery disease, heart failure, stroke, arrythmias, hypertension, and to improving the health of Aboriginal and Torres Strait Islander Peoples. Importantly they are also applied to priorities identified by senior government officials (health), and data and clinical experts through biannual Cardiovascular Health Leadership Research Forums (CV HLRFs) that provides a strategic government engagement platform between research and the health systems.

b. The National Collaborative Research Infrastructure Strategy (NCRIS) capabilities (funded by the Department of Education) will be invaluable in support of the National Science and Research Priorities. Specifically, to meet the objectives of Priority 2, there is a critical role for the NCRIS Health Group that provide national infrastructure and expertise in ‘omics technologies, health innovation and technologies, population health and data linkage as well as underlying data infrastructure provided through the Australian BioCommons and the Australian Research Data Commons.