A Health Check on Medical Research Funding
Strengthening the connection, understanding and quality of engagement between the philanthropic sector and the for-purpose organisations that deliver programs and change on the ground is central to our work at GoodWolf.
Therefore, staying abreast of the swings and roundabouts of this ever-changing space is a core part of our work, and building connections and relationships across the sector is what we do best.
In the following article, we’re pleased to share some findings from our most recent inquiry….
The Health and Medical Research sector is one of the largest recipients of philanthropic giving in Australia. GoodWolf recently set out on a ‘listening tour’ with a selection of 10 CEOs from foundations granting into this sector to explore their evolving practice model for supporting this critical field, and to understand how they are adapting to its opportunities and challenges.
We invited our colleague Prof. Alice Pébay AM to sit alongside GoodWolf in these discussions. Alice’s scientific career and success was transformed through philanthropic support, and we also wanted to ensure we had ‘the scientist’ represented in the discussion to better examine the issues from both sides. Read more about Alice on her LinkedIn page.
Our findings were alarming, if not unexpected: everyone we spoke to agreed that the overall funding model for research is broken and has been for a while.
Last month’s Economist article, for example, asserts dated funding models and a daunting amount of bureaucracy are driving a fizzling out of the dynamism of scientific research. It cites a 2014 study in Australia that estimated researchers spent a combined 614 years applying for grants from a single funding body (NHMRC) in 2014 alone. This figure is probably closer to 1,000 years now in 2023…The article also estimates that around 40% of a top scientists’ time is spent on things other than research, and mostly in trying to identify ways to fund it.
Philanthropic investment in health and medical research is, after all, a big bet. The odds of a pay-off are long, as is the timeframe of 15+ years before any public health benefit is typically realised. If at all. The complexity of the science and the dependency on key individuals ups the ante, and donors or funders often need to find a bridge to a better understanding of the science and scientists they are investing in, and the bet they are taking. But when these bets pay off, the impact can be life-changing, and transform the quality and longevity of life prospects for beneficiary groups or whole communities.
Given the sector’s fundamental importance to our overall quality (and longevity) of life and the liberties we have come to enjoy, it is surprising to note that government funding of Health and Medical Research in Australia has been on a steady decline in real terms for over 10 years. This is at a time when the overall funding models for universities, where over 70% of health and medical research takes place, are up in the air following the loss of international students whose fees have cross-funded research activities, and leaving medical research institutes at universities scrambling to foot the bill of research infrastructure, overheads and administration amounting to $1.5 for every $1 research funding.
This funding malaise and the changing success factors for research creates a dilemma for philanthropy in locating its optimum role and place in the funding mix and translation pathway. The sheer quantum of ‘fundable but unfunded’ research arising from historically low success rates, for example, has seen an initiative introduced by NHMRC to bring in philanthropy to address this gap: https://www.nhmrc.gov.au/about-us/resources/philanthropic-engagement
But philanthropy doesn’t always want to play second fiddle to the Government’s agenda. It sometimes harbours ambitions to play a more catalytic role, and often in a bespoke area of research set down by its founders. The recent announcement of the $100m gift by the Snow Medical Foundation to advance Australia’s position in immunology research in partnership with the Walter & Eliza Hall Institute is great illustration of such vision at work.
Of course, there’s no blanket solution to perfectly realign funding models and research needs. Rather funders are working away at the expanding patchwork quilt of ideas and experiments on how to better leverage relationships and networks, and to centre the needs of the ultimate beneficiaries.
1.‘How are we quantifying or comparing the relative need for the science, to direct our focus?’
For philanthropies that have tighter objects or purposes defined, this was an easier question to answer. For those that don’t, some skipped directly to the next question to look for world-leading science, irrespective of the cause, or linking their arguments to a national health priority.
Some, understandably, wonder about the ‘orphan diseases’ or some of the unmet need around the popular disease areas and finding projects or opportunities that were more proportionate to their funding capacity.
2.‘Is the science (scientist) not just good, but world class?’
This is ultimately what a funder is looking for, and it is critical to leverage scientifically sophisticated individuals that have a global perspective on the quality of the science, who are impartial, and who can help identify the most promising talent.
Most Foundations have a Scientific Advisory Committee to help navigate the complexity of the science, and to opine on the decision, but need to check on its diversity – including on gender, race, seniority and experience mix of such panels – for them to be more fit-for-purpose.
3.‘Is the scientist a strong leader, and do they have the right wrap-around support?’
Interestingly, nearly all the Foundations we spoke with are largely investing in the human capital and capacity support for scientific excellence, where promising talent is given a ‘leg up’ with multi-year funding packages. This seems to be a sweet spot for the sector in terms of the return potential.
Most Foundations have programs to invest in mid-career scientists that can also lead discovery teams to truly scale their work in a short period of time. Qualities in addition to being a good scientist are critical to success, as well as:
Equipment and overheads commitments are often built into packages to support mid-career fellowships
Some Foundations build-in leadership development support and coaching into their support, as these are essential skills to maximise the potential of a research team
4.‘Does the scientist have the right networks and relationships to improve the probability of success?’
Health and medical research, like any discipline, relies on collaborations and relationships across disciplines to optimise the translation and potential of the science.
Qualifying the networks and relationships of the scientists is an important part of credentialising a candidate for support, and investing in this aspect through their grantee relationship, e.g.:
Providing support for conferences and travel
Providing a network for mentoring and for extra research activities? (Snow Foundation does this with its annual retreat)
5.‘What are the innovations pathways, and how can we anticipate these to improve the translation potential?’
Anecdotally, around 90% of primary research is not translated further beyond the laboratory. Organisations like Covidence are creating better linkages and pathways to the global body of scientific evidence to be more easily searched and accessed. AI is going to play a significant role in all of this too. But the funding pathways ahead don’t have to be solely about grants, as the opportunity for funders and donors to invest behind some of the promising research. Impact Investing by Foundations is also a relatively new area, such as the example of the MedTech actuator funded by Menzies Foundation and Mind Ventures, newly formed venture fund, seeded and managed by the Black Dog Institute, Australia's leading mental health research institute.
6.‘How do we ensure the voice and needs of the end-beneficiaries, or patient, are incorporated in the experimental design?’
‘Look out, not in!’ shared the Chair of one of the Foundations, a scientist herself who saw a tendency for researchers to sometimes take a narrow or siloed view of their work, with a focus on publication and citations. We can’t forget the ultimate mission of the research – to positively impact the health and wellbeing outcomes of individuals, families, communities, society.
Finding a way to better represent the interests of the community in the purpose, design and implementation of the research is a critical element of better outcomes. The growing importance of consumer-directed medical research is starting to feature more prominently. In some instances, Foundations include a patient and consumer perspective in the selection process (for example, the Macular Disease Foundation Australia explained how they employ this process to great effect in their grant reviews assessment).
7.‘Do scientists understand the potential that philanthropy can play in their work?’
Finally, we have been presuming here an adequate knowledge and appreciation for the role philanthropy can play in accelerating and catalysing outcomes for researchers. In fact, there appears to be only a cursory understanding of research scientists of the area of philanthropy, some limited relationships that are often fiercely protected, and sometimes there is even an outright pejorative view (e.g. that philanthropy can be counterproductive, or not worth the effort).
Better relationships could be fostered by a better appreciation of the potential role philanthropy can play, and this could be fostered by universities through education and networking sessions.
Networks are often too domestic in focus, where the true potential for funding world-leading science lies in the deeper pool of philanthropic capital that lies abroad. Advancement strategies need to develop a strong international focus.
If you are interested in following up on this discussion about trends and developments in Health and Medical Research funding, please contact simon@goodwolf.com.au