Australia to become leader in understanding infectious disease

Anastasia Tsirtsakis

13/11/2020 4:52:09 PM

It is hoped a new institute for infectious disease will improve capacity to respond to pandemics, but experts say GPs must be involved.

Professor Brendan Crabb
Burnet Institute Director and CEO Professor Brendan Crabb says the role of general practice is sure to be part of the institute’s focus.

Melbourne is set to become home to the largest centre of biomedical expertise in the Indo-Pacific region.
Plans for the Australian Institute for Infectious Diseases and Global Health, announced on Friday by Victorian Premier Daniel Andrews, will bring together academics, clinicians, industry and government agencies in a bid to accelerate research into identifying and responding to infectious diseases in the region.
‘We’ve only got through this pandemic by backing our scientists and researchers,’ Premier Andrews said.
‘Victoria leads the world in medical research and is the natural home for an infectious diseases institute to protect our state and our nation against future pandemics.’
The Burnet Institute will be relocated next to the new $550 million hub in Parkville that will be physically connected to the Doherty Institute, a venture of the University of Melbourne and Royal Melbourne Hospital.
Other key partners include the Eliza Hall Institute for Medical Research, the Murdoch Children’s Research Institute, and biotech company CSL, which is manufacturing two coronavirus vaccines for domestic distribution.
Burnet Institute Director and CEO Professor Brendan Crabb told newsGP the concept pre-dates COVID, and has been on his radar for at least a decade.
‘COVID’s given that impetus to bring it to life, but it was very easy for us to bring together because our conversations and how we might do this are really quite mature already,’ he said.
‘There’s already a very strong collaboration between all those groups and others. So what it really means is upping the ante on what’s happening already.’
The Victorian Government has committed $155 million to the initiative. The Burnet Institute and other partners will contribute a further $150 million, while the remaining funds will be sought from the Federal Government.
The facility will be designed to deliver everything researchers need to detect, analyse, manage and treat infectious diseases, featuring next-generation laboratories and high-containment facilities to ensure international best practice for specimen storage in large-scale clinical trials.
A cross-disciplinary Centre for Infectious Diseases Modelling will allow the development of more sophisticated models to predict disease patterns, while a new facility at the Royal Melbourne Hospital will facilitate early-stage clinical trials to quickly develop vaccines and treatments.

The vision will also see healthcare workers training to respond to outbreaks at a new education and simulation facility.
‘Australia has done incredibly well in responding to the pandemic, but there are some things that we could have done better, or that we really struggled to do at all,’ Professor Crabb said.
‘Some of those are limited laboratory capacity to do the necessary work under the restrictive conditions that you need to work with pandemic viruses.
‘But also other capacity to screen our own drugs has been hard here, and to progress vaccines to the point that we would have liked to has been difficult.
‘So it will mean a lot for future pandemics.’
Meanwhile, the institute will also have merit for HIV, tuberculosis, malaria, emerging antimicrobial resistance, and hepatitis viruses.
The concept for a centralised pandemic response was proposed earlier this year by the late RACGP President Dr Harry Nespolon.
‘Australia needs a national plan for dealing with potential pandemics like this virus. This isn’t the first and won’t be the last,’ he told newsGP in February.
‘Let’s use what this virus has shown us to be well prepared into the future. GP involvement in planning and early access to resourcing must be a given in the future.’
Professor Mark Morgan, Chair of the RACGP Expert Committee – Quality Care (REC– QC), welcomed the news but also supported Dr Nespolon’s assessment, stating that the inclusion of GPs and primary care researchers will be essential.
‘This is exciting news because it brings together centres of research to create a hub of expertise,’ he told newsGP.
‘I very much hope that some of the excellent primary care GP researchers will be brought into the fold – they’d have a lot to add.  
‘GPs are central to the rapid identification of new constellations of symptoms, and of course, GPs have their own questions, which are not necessarily about the design of the new treatment but the non-pharmaceutical questions.
‘What really works in infection control? We’ve seen people working from very old pieces of research and a bunch of assumptions.’
Dr Glynn Kelly, Chair of the RACGP Specific Interests Disaster Management network, agrees. He told newsGP that without a seat the table, the true value of general practice in pandemic preparedness and response is unlikely to be realised.
‘I’m very encouraged by the fact that there seems to be a focus on future infectious diseases and how they may impact,’ Dr Kelly said.
‘What it comes up with has got to be really included into a national pandemic plan that’s actually exercised regularly and involves health departments, hospitals and general practice.
‘They don’t realise the competence of GPs [and] they don’t realise the extent of the practice workforce in Australia.
‘If institutes don’t know what is available, they won’t know how to appropriately involve it.’
While the hub is a Victorian-led initiative, Professor Crabb says both national and international collaboration with existing networks going forward will be key to its success.
The finer details of the institute are set to become clearer over the next six months as partner institutions work to develop a business plan and Professor Crabb says the role of general practice is sure to be part of the focus.
‘We’ve learned a lot during the pandemic about effectively involving community health in the broader sense of the word, and I’m including GPs in that,’ he said. ‘From my perspective, we haven’t done brilliantly in that respect.
‘I run a public health institute and work internationally on all sorts of infectious diseases and problems, and the secret to the response is when they’re community focused and even led, whatever the circumstance you’re in.
‘It’s something we’ve all learned along the way. So let’s see if that stands the test of time.  
‘How can we engage our wider GP and community health service networks, right from day one, as key people in the response? That will be an absolutely major focus of the wash up of COVID-19 effort in Australia, but also of this new initiative.’
In doing so, Professor Morgan hopes that the institution will engage with organisations such as the RACGP.
‘Because there is a risk that when people think about research, they think about creating the next antiviral drug or the next antibiotic class,’ he said.  
‘Although those things are important, they’re only a part of the story.’
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