Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
Australian Science and Technology Council Act - Australian Science and Technology Council - Reports - Medical research in Australia, dated 30 November 1981- Part 2-Appendices


Download PDF Download PDF

The Parliament of the Commonwealth of Australia

AUSTRALIAN SCIENCE AND TECHNOLOGY COUNCIL

Medical Research in Australia

Part 2 (Appendices)

November 1981

Presented by Mr Speaker 10 March 1982 Ordered to be printed 25 March 1982

Parliamentary Paper No. 67/1982

Medical Research in Australia A re p o rt to th e Prime Minister by th e Australian Science and Technology council (ASTEC)

Part 2 (Appendices) November 1981

MEDICAL RESEARCH IN AUSTRALIA

A REPORT TO THE PRIME MINISTER

BY THE

AUSTRALIAN SCIENCE AND TECHNOLOGY COUNCIL

(ASTEC)

Part 2 (Appendices)

NOVEMBER 1981

Australian Government Publishing Service Canberra 1981

© Commonwealth of Australia 1981

ISBN 0 642 07081 4 (Part 1)

ISBN 0 642 07082 2 (Part 2)

ISBN 0 642 07083 0 (Set of two Parts)

Printed by C. J. T hompson, Commonwealth Government Printer

MEMBERS OF ASTEC

Professor Sir Geoffrey Badger, AO, FTS, FAA (Chairman)

Professor J.H. Carver (Deputy Chairman) Director, Research School of Physical Sciences, Australian National University

Mr D.S. Adam General Manager Corporate Affairs, The Broken Hill Proprietary Company Limited

Professor B.D.O. Anderson, FAA Professor of Electrical Engineering, The University of Newcastle

Sir Samuel Burston, OBE Grazier

Mr J.N. Davenport, AO, DSO, DFC & Bar, GM, Managing Director, Monier Limited

Dr L.W. Davies, AO, FTS, FAA Chief Scientist, Amalgamated Wireless (Australasia) Ltd and Professor of Electrical Engineering, The University of New South Wales

Professor B.E. Hobbs Professor of Geology, Department of Earth Sciences, Monash University

Dr P.S. Lang, OBE Grazier

Mr K.H. McLeod Federal Secretary, Australian Insurance Employees Union

Professor Sir Gustav Nossal, CBE, FTS, FAA Director, The Walter and Eliza Hall Institute of Medical Research

Mr L.G. Peres Reader in Political Science, The University of Melbourne

Professor M.G. Porter, FASSA Director, Centre of Policy Studies, Faculty of Economics and Politics, Monash University

Mr J.G. Wilson, CBE Chairman, Australian Paper Manufacturers Limited

iii

CONTENTS

Part 1

1. SUMMARY AND RECOMMENDATIONS 1

Rationale for Medical Research and Development 1

in Australia Co-ordination of Effort and Efficient Use of Funds 2

Concentration of Research Effort 4

The Need for Additional Funds 5

Arrangements for Review of Medical R&D in 6

Commonwealth Government Laboratories

2. INTRODUCTION 8

Medical R&D in Australia 8

3. MEDICAL SCHOOLS 14

The Medical Schools in State Universities 14

The John Curtin School of Medical Research 18

Expenditure on Research in the Medical Schools 20

4. INDEPENDENT AND HOSPITAL RESEARCH 23

INSTITUTES

5. GOVERNMENT HEALTH LABORATORIES 30

Commonwealth Institute of Health 30

Institute of Child Health 31

National Acoustics Laboratories 31

Ultrasonics Institute 32

Australian Radiation Laboratory 32

National Biological Standards Laboratory 32

and Australian Dental Standards Laboratory Health Services Research and Development 34

Commonwealth Serum Laboratories 34

Other Commonwealth Government Organisations 35

6. THE NATIONAL HEALTH AND MEDICAL 35

RESEARCH COUNCIL NH&MRC Support for medical research 39

Level of NH&MRC funding 42

7. DISCUSSION 46

The University Sector 46

Independent and Hospital Research Institutes 48

Government Health Laboratories 50

National Health and Medical Research Council 53

(NH&MRC)

iv

3. CONCLUSIONS 55

Rationale for Medical R&D in Australia 56

Co-ordination of Effort and Efficient Use of Funds 60

A Medical Research Council 61

Concentration of Research Effort 67

The Need for Additional Funds 71

Arrangements for Review of Medical R&D in 72

Commonwealth Government Laboratories

REFERENCES 76

WORKING PARTY ACTIVITIES 78

Part 2

APPENDIX A INSTITUTES AND LABORATORIES OF THE 80

COMMONWEALTH DEPARTMENT OF HEALTH

Introduction 80

Commonwealth Institute of Health 81

Institute of Child Health 83

National Acoustic Laboratories 84

Ultrasonics Institute 86

Australian Radiation Laboratory 87

National Biological Standards Laboratory and 89

Australian Dental Standards Laboratory 89

APPENDIX B COMMONWEALTH SERUM LABORATORIES 91

APPENDIX C MEDICAL RESEARCH IN OTHER 96

COMMONWEALTH GOVERNMENT ORGANISATIONS

Introduction 96

Research Establishment, Australian 97

Atomic Energy Commission CSIRO Division of Human Nutrition 97

CSIRO Molecular and Cellular Biology Unit 98

CSIRO Division of Protein Chemistry 99

Department of Defence, Malaria Research Unit 100 Department of Science and Technology, 101

Antarctic Division Department of Veterans' Affairs 101

v

APPENDIX D INDEPENDENT AND HOSPITAL RESEARCH 103 INSTITUTES

Introduction 103

The Walter and Eliza Hall Institute of 103

Medical Research The Howard Florey Institute of Experimental 107

Physiology and Medicine The Baker Medical Research Institute 110

Queensland Institute of Medical Research 113

The Institute of Medical and Veterinary Science 117 Kanematsu Memorial Institute, Sydney Hospital 120 Garvan Institute of Medical Research 123

Medical Research Centre, Prince Henry's Hospital 126 Rolling Institute of Medical Research, 128

Royal North Shore Hospital Sydney The Cancer Institute, Peter MacCallum Hospital 130 Children's Medical Research Foundation, Sydney 131 Royal Children's Hospital Research Foundation 133

Melbourne St Vincent's School of Medical Research, Melbourne 137 Mount Royal National Research Institute of 139

Gerontology and Geriatric Medicine The Queen Victoria Research Foundation, Adelaide 141 Ludwig Institute for Cancer Research : Sydney 142 Cancer Therapy Branch; and Melbourne Tumour

Biology Branch National Vision Research Institute of Australia 145 Institute of Drug Technology 147

New South Wales Institute of Psychiatry 148

vi

APPENDIX A

INSTITUTES AND LABORATORIES OF THE COMMONWEALTH DEPARTMENT OF HEALTH

INTRODUCTION

A.l The Commonwealth Department of Health, established in 1921, im­ plements government policies and administers Commonwealth legislation in health and related fields. In addition to its responsibility for administering funds

allocated on the advice of the National Health and Medical Research Council (NH&MRC), the Department also makes a substantial, direct contribution to health R&D through its own research organisations. These organisations, which are discussed in greater detail below, are:

Commonwealth Institute of Health Institute of Child Health National Acoustic Laboratories Ultrasonics Institute

Australian Radiation Laboratory National Biological Standards Laboratory Australian Dental Standards Laboratory

A.2 Since the disbandment of the Hospitals and Health Services Commission in 1978, the Department has taken over responsibility for grants for health services R&D. This research is concerned with the planning, implementation, evaluation, administration and financing of health services. The program provides grants for applied research rather than basic clinical research, and does not normally support research into the causes and cures of illness; it is aimed at improving the

effectiveness and efficiency of Australian health services. Health services may include prevention of illness, health education, health promotion and rehabilitation, as well as treatm ent. Because the grants are concerned with applied health research, it is usual for applications to be developed in close conjunction with

those agencies actually providing the services. An indication is expected of how the results of the research will benefit the delivery of health care in Australia.

A.3 There are two types of study funded under the program. The first is

Health Services Research where some aspect of existing health services delivery is investigated. Evaluation studies, cost-effectiveness and cost-benefit studies, utilisation studies and studies of needs for services all come under this general heading. The second type of project is the Health Services Development Project.

These are usually small-scale demonstration projects where a new form of health care delivery is being tested. In some circumstances, a research grant may pay for a small number of clinical staff to enable the demonstration to be mounted, but the evaluation component of the project remains paramount.

A.4 In awarding grants, preference is given to studies which have general applicability beyond the specific services being investigated. Grants may be awarded to State health authorities, health institutions, educational institutions, private companies, or individuals. Projects may be approved in principle for one

80

or more years but funding is approved year by year. Grant applications are assessed both within the Department and by outside referees. Where possible, referees' assessments are forwarded to the applicant for comment prior to a decision being made. Applications are then considered by the Research and Development Grants Advisory Committee, who make recommendations regarding the grant applications.

A.5 In 1980-81, 42 research studies of the efficiency and effectiveness of health care systems were supported through the Health Services Planning and Research Program at a cost of $0.62million. During the same period 28

development projects aimed at testing and implementing improved health services were funded from the Health Program Grants at a cost of $0.86million.

A.6 The Department also provides grants in support of health R&D through its Health Facilities Branch, Public Health Division, Therapeutics Division, and Quarantine Branch. Total expenditure on health R&D undertaken within the Department was $7.6million in 1980-81; the amount provided for R&D, excluding the funds allocated on the advice of the NH&MRC and including those provided for health services R&D and to the Commonwealth Serum Laboratories, was

$11.9million.

COMMONWEALTH INSTITUTE OF HEALTH

A.7 The Commonwealth Institute of Health, officially opened in 1980, was formerly the School of Public Health and Tropical Medicine which had been established in 1930 by the Commonwealth Department of Health, in association with the University of Sydney, and incorporated the staff and facilities of the then Australian Institute of Tropical Medicine which had been established in 1913 in Townsville.

A.8 The original School arose from the need for education and training in public health and preventive medicine. It was decided to provide courses not only for medical officers but also for Civil Service Officers appointed to Common­ wealth dependencies, factory and health inspectors, and medical students. The School became the main centre in Australia for research on tropical medicine.

A.9 Much of the early research carried out by the School consisted of field work associated with particular diseases or conditions, or entomological or parasitological surveys for similar reasons. In the postwar period, all the original departments of the School were expanded and an equal number of new ones created, giving an increasingly wide coverage of health-related problems. In addition, the teaching load was extended and new courses in preventive and social

medicine were introduced.

Major R&D Programs

A.10 The Institute is now divided into six sections which carry out both

training and research. The Epidemiology and Biostatistics Section, created in 1979, has three major research programs. The National Perinatal Statistics Unit, which is part of the Faculty of Medicine of the University of Sydney, is located within the Institute and works closely with the Section in analysing perinatal data, with

81

particular attention being given to high risk groups. The second program is a study in conjunction with the World Health Organisation on steroidal contraceptives and their possible neoplastic effects. More recently, the Section is studying the possible effects of exposure to herbicides by Australian Armed Forces who served

in Vietnam.

A.11 The Human Nutrition Section is integrated with the Human Nutrition Unit in the University's Biochemistry Department. Recent research activities include: a nutritional survey of the people in the highlands in Papua New Guinea; vitamin C and vitamin A studies; surveys on the incidence of thiamin deficiency;

and dietary studies, including nutrition in Aborigines.

A. 12 The Occupational and Environmental Health Section is divided into three sub-sections. In Occupational Health, the major research efforts are directed towards studies that identify and define occupational factors in hyper­ tensions, and the health problems associated with the use of asbestos. Aspects of adaptation to climates is the major concern of the Environmental Health sub­

section. It is preparing for the International Biomedical Expedition to the Antarctic (IBEA) project in which it will collaborate in a series of laboratory experiments and field studies. Experiments, on behalf of the Australian Army, to develop methods of rapid acclimatisation of large numbers of people to heat are

also being undertaken.

A.13 The Preventive and Social Medicine Section has investigated the role and functions of voluntary consumer organisations in health care, and has conducted trials evaluating the effectiveness of the anti-smoking education program. Other research has involved an analysis of neural tube defects and their possible linkage with herbicides. This is part of a larger study on aspects of birth deformities.

A. 14 The Public Health Biology Section has three major areas of work. In biochemistry, studies on the effects of stress on dyslexoid and normal student groups, using biochemical parameters, are being undertaken. The Cell Biology Unit is participating in an international study of short-term tests for carcinogenicity.

The major research activity of the Microbiology Unit is concerned with the properties of Vibrio cholerae-like organisms isolated from river water, and drawing comparisons with similar organisms isolated from human outbreaks.

A.15 The Tropical Medicine Section carries out research in tropical medicine, medical entomology and parasitology. The major efforts are directed to the epidemiology of malaria, the documentation of information on mosquitoes and their pathogens, and investigations on the relationship between Australian freshwater molluscs and the hosts of human schistosomes. The latter study is supported by the NH&MRC.

Staff

A.16 The total staff of the Commonwealth Institute of Health, in 1981, is 123 of whom 49 percent are professionally-qualified research staff, 21 percent technical staff, and 30 percent support staff.

82

Expenditure of Funds

A.17 Expenditure for 1980-81 is shown in Table A .l. In addition, funds have been allocated to the Institute for a special epidemiological study into the effect of herbicides and other chemicals on Vietnam veterans, and for the establishment of a station in Torres Strait to monitor malaria and other insect-borne diseases.

Approximately $l.lm illion of the 1980-81 expenditure, equivalent to 35 percent, was directed to R&D. A similar amount was expended on teaching activities.

TABLE A.l

EXPENDITURE BY THE COMMONWEALTH INSTITUTE OF HEALTH

Expenditure 1980-81 Percentage of $ million total

Salaries 2.441 78

Plant & Equipment 0.186 6

Administrative 0.500 16

TOTAL 3.127 100

INSTITUTE OF CHILD HEALTH

A.18 In 1948 the Commonwealth Government approved arrangements for the establishment of an Institute of Child Health at the School of Public Health and Tropical Medicine of the University of Sydney, and for the creation of a Chair of Child Health within the University. By arrangement with the Royal Alexandra Hospital for Children, a clinical unit was located within the Hospital consisting of a laboratory and facilities for the treatm ent of child disorders for both in-patients and out-patients. The purpose was to promote the development of disciplines related to child health by providing facilities for the teaching of courses in paediatrics and for clinical investigations and research into childhood diseases and psychiatric problems. Later, the Institute moved to a building situated in the grounds of the Hospital.

A.19 Twenty years later, by which time all medical schools in Australia had a department of child health, the Commonwealth Government decided that the objective of its initiative at the University of Sydney had been achieved, and that it should not continue to support the Institute as a branch of the Commonwealth Department of Health. The present arrangements will cease on 31 December 1981. It is proposed that the teaching responsibilities of the Institute will be taken over by the University of Sydney, and that four members of the Research Unit of the Institute will be supported in the interim by the NH&MRC pending absorption of

the Unit within the adjacent Children's Medical Research Foundation.

83

Major R&D Programs

A.20 A major part of the Institute's research activities has been a long-term survey of rheumatic fever, chorea and rheumatic heart disease in children, with the aim of determining the effectiveness of penicillin in preventing rheumatic recurrence and ultimate heart damage. The original patients in this program are now adult, but their cardiac status is still being monitored. The Institute has begun a study of children with juvenile rheumatoid arthritis; the rheumatoid clinic

continues to provide consultation to paediatricians and to general practitioners. The other main area of research concerns purine and folate metabolism in transformed human leucocytes. It is hoped that this study, supported largely by

the NH&MRC, will lead to better understanding of the function and control of these pathways and thus of the biochemistry of the immune response.

Staff and Expenditure

A.21 The Director of the Institute is also the Professor of Child Health at

the University of Sydney. The Institute is currently staffed at the senior levels by two Associate Professors and several medical research officers, and the total staff is 20. Operational expenditure for 1979-80 was estimated to be $0.63million of which $0.55million was provided direct by the Commonwealth Government; the

remainder was provided in the form of grants from the NH&MRC and other bodies. Research expenditure was estimated to be approximately $0.25million excluding general maintenance and administrative expenditure.

NATIONAL ACOUSTIC LABORATORIES

A.22 The National Acoustic Laboratories grew from the Acoustic Testing Laboratory, which was established in 1943 by the National Health and Medical Research Council to examine problems associated with the noise levels experienced by servicemen on active duty. The organisation's name was changed to the

Acoustic Research Laboratory in 1944, and in 1947 it became a branch of the Commonwealth Department of Health and was renamed the Commonwealth Acoustic Laboratories. The Laboratories' main task was still to investigate the effects of noise on people; but, in addition to services for ex-servicemen suffering

from the effects of noise experienced during the war, it began to provide

audiological services and research in response to reports on the problems of deaf children. The Laboratories' services gradually increased to include the provision of hearing aids, and there was a considerable expansion in 1968 when pensioners and their dependents became eligible for the service. In 1973 the organisation became the National Acoustic Laboratories (NAL).

A.23 The NAL operates from a central administration and laboratory building in Sydney and from 27 Hearing Centres; other country areas are visited by staff at regular intervals. The clinical side of the Laboratories' audiological services program is carried out through the Hearing Centres and involves audiological assessment to evaluate and define hearing capacity, and the improvement of that capacity by fitting appropriate hearing aids and by other rehabilitation measures. This program is provided free of charge to those under 21, to persons referred by the Department of Veterans Affairs, to aged and other pensioners, and to armed

forces personnel.

84

A.24 In 1949 the Commonwealth Acoustic Laboratories designed and pro­ duced its first hearing aid, destined to become the forerunner of the Calaid devices upon which the Laboratories' audiological services are based. This involvement in manufacture was initiated because of the need to provide a standard range, encourage local production, reduce import costs and overcome problems associated with the supply of maintenance parts for commercial hearing aids then available. The first Calaids were designed for efficiency in function, ease of service and

maximum local involvement in production. Infrequent model changes, and the large numbers required, led to reduced prices. Today, the NAL continues to seek improvements to the Calaids through research, and a range of aids is available to suit individual requirements. The aids are designed by the NAL and are assembled by private contractors from Australian-made and imported components. The NAL retains responsibility for the testing, fitting and maintenance of these devices. These arrangements are likely to change as a result of the 1981 Review of

Commonwealth Functions, which recommended a greater role for private industry in the manufacture of the aids.

Major R&D Programs

A.25 The Laboratories' audiological services program provides the main impetus for its research activities; but research is also undertaken in relation to NAL's consultative services in noise and acoustic problems which are used by Commonwealth departments, especially Defence. As part of these consultative services, NAL has carried out surveys of armed forces personnel for hearing capacity, and has developed equipment for measuring noise impulses produced during the use of explosives and armaments. It has been involved in monitoring traffic noise, and has developed techniques to test devices designed to protect hearing.

A.26 The NAL is organised into five main sections, four of which include research in their functions. The Audiology Research Section carries out research into the mechanisms of hearing, the causes of hearing disorders and methods of rehabilitation of the deaf. The Audiology and Psychology Services Section, which oversee the clinical activities of the Hearing Centres, has responsibility for training audiology and audiometry staff and for the development, testing and standardisation of procedures, techniques and equipment used in the Centres. This includes procedures for evaluating hearing disorders and for monitoring the effectiveness of post-aid-fitting and special rehabilitation programs. The En­ gineering Services Section develops a range of hearing aids to suit the individual needs of patients, as well as calibration techniques and standards, and designs and tests hearing centres and equipment. The Noise Section is involved in the

measurement, analysis and reduction of noise, and in the evaluation of equipment used to protect hearing or for communication in situations of high noise level. It also develops and evaluates equipment used to generate noise for testing purposes, and carries out basic investigations in sound propagation. Other groups in this Section are studying the effects of noise on people, the detection and recognition of sound, the measurement of its subjective qualities, and the effects of noise on

the community with special reference to airfields and firing ranges.

85

Staff and Expenditure

A.27 In 1981 the NAL Central Laboratories had a total staff of 117, of whom approximately 27 were engaged in research and its support. Expenditure on R&D in 1980-81 was $0.75million.

ULTRASONICS INSTITUTE

A.28 In 1959 an Ultrasonics Research Section was established within the then Commonwealth Acoustic Laboratories to undertake research in the use of ultrasound in medicine, and to begin joint research programs with other

organisations for the clinical evaluation of the new techniques being developed. Considerable progress had been made by 1974, and the value of the new ultrasound techniques was such that the Section was reorganised in 1975 to form the

Ultrasonics Institute. The functions of the Institute are to undertake research and to provide advisory services in the use of ultrasonic irradiation for the diagnosis and treatm ent of disease. Close co-operation is maintained with the National Acoustic Laboratories, the two groups being housed in the same building.

Major R&D Programs

A.29 Research at the Institute is centred on the development of instrument­ ation and techniques for the application of ultrasonic waves in medical diagnosis. The Institute maintains an expertise in electronics, ultrasonics, transducer

technology and signal processing and imaging theory, as well as in the clinical applications of ultrasound. The researchers from the Institute engage in clinical research and instrumentation development by close co-operation with a number of clinicians.

A.30 The Institute has active clinical evaluation projects with the Royal Hospital for Women, the Royal Prince Alfred Hospital, the Royal North Shore Hospital and the Prince Henry Hospital. It also works in co-operation with the Royal Alexandra Hospital for Children and the Prince of Wales Hospital. Medical

specialists visit the Institute regularly on a consultant basis.

A.31 Members of the Institute have played an important part in developing the medical use of ultrasound both in Australia and overseas. For example, in 1969 the Institute introduced the 'grey-scale' method of display of ultrasonic images

which is now accepted as the general clinical technique throughout the world. Much of the Institute's recent work has been concerned with development of the U.I. Octoson, an automatic, general purpose, water-coupled echoscope, and with increasing its range of diagnostic abilities by using additional equipment, for

example, to allow quantitative measurements of blood flow.

A.32 The Institute has patents on 17 inventions, and another four with patent applications pending. The total number of patents at present held by the Institute is 67. Developments which are commercially viable are made the subject of licensing agreements with Australian companies for manufacture and marketing

throughout the world. At present there are three such licensing agreements covering the U.I. Octoson, a pulsed Doppler blood-flow system, and linear array technology. The latter two agreements are relatively recent with no sales as yet,

86

but 100 Octoson units have been sold, most of which have been exported. The agreement has produced $0.8million in royalty income to Consolidated Revenue over the last three years, $7million in export earnings, and employment for over 200 people in manufacturing and selling the equipment.

Staff and Expenditure

A.33 The Institute has 22 approved staff positions, including nine professional and 12 technical positions; there were 20 staff in 1981. Expenditure in 1980-81 was $0.73million provided from the Commonwealth Department of Health budget appropriations. Although the prime aim of the Institute is R&D, there is a

significant science and technology component which varies from year to year. In 1980-81 about half of the Institute's expenditure was related to R&D.

AUSTRALIAN RADIATION LABORATORY

A.34 The Australian Radiation Laboratory originated in 1926 when the Federal Health Council, later to become the National Health and Medical Research Council, established a national 'radium bank' with an initial purchase of 10 grams of radium at a cost of one hundred thousand pounds. To ensure that the radium was properly stored, maintained and distributed to hospitals for the treatm ent of cancer patients, the Commonwealth Government entered into an agreement with the University of Melbourne to establish a small section to undertake these functions within the University's Department of Natural Philosophy. A more formal agreement with the University was made in 1929, and the Commonwealth Radium Laboratory, as it was then called, was given responsibility for the safe and equitable use of the radium. It also provided a radon service and gave advice on radium and radon dosimetry and on precautions to be taken in their use of radium.

A.35 In 1935 the Commonwealth Department of Health extended the

Laboratory's functions to include establishment of a primary standard for measuring x rays and to provide advice on the dosimetry of x-ray therapy. As the work and staff of the Laboratory increased, new accommodation became necessary, and in 1938 a specially designed building was erected within the grounds of the University. The following year the Laboratory pioneered the development in Australia of miniature radiography of the chest, and this led to programs for the detection of tuberculosis.

A.36 In 1946 the Laboratory assumed responsibilities for the procurement and distribution of all radioisotopes used in Australia in medicine, industry and research, and the first radiopharmaceuticals were imported in that year. Between

1961 and 1978 these responsibilities were transferred to the Australian Atomic Energy Commission and to commercial suppliers; but the Laboratory maintains a quality assessment program for the performance of radioactive materials and for the chemical and radiological purity of radiopharmaceuticals.

A.37 In 1956, the Laboratory became involved in the monitoring of

radioactivity in the Australian environment, including that arising as fallout from the testing of nuclear devices in the atmosphere, and this activity continues. Since 1965 it has provided and maintained national standards for the precise measure­ ment of x rays, gamma-rays and radioactive materials. These functions were later expanded to include microwave, laser and ultraviolet radiations.

87

A.38 In 1973 the Laboratory's name was changed to the Australian Radiation Laboratory. Its functions, which had been consolidated in 1972, were modified to their present form in 1976. As a health laboratory it is concerned with the public and occupational health implications of radiation, and much of its work is directed

towards improving the understanding and practice of radiation protection in Australia. The various sections of the Laboratory, previously scattered over several separate locations, were brought together in 1979 in a new building at Yallambie, north-east of Melbourne.

Major R&D Programs

A.39 The Laboratory's research programs are determined primarily on their relevance to its public health functions. Some research is carried out by the Code and Monitoring Section, but the main programs are undertaken by the Health and

Safety and the Standards and Compliance Sections. Staff from each section may be brought together to work on a particular project, so that there is no clear division of interests.

A.40 Several of the Laboratory's current research programs are concerned with the mining and milling of uranium ores in Australia. They include field studies of radiation, radon and radon-daughter levels encountered at uranium mines and the influence of ore grade, mine configuration and climatic conditions; the development of a personal dosimetry badge able to withstand the severe conditions

of the mining environment; and the theoretical modelling of the lung to estimate the hazard from inhalation of radioactive material. The Laboratory is also developing facilities to simulate typical uranium-mine atmospheres so that monitoring and protective equipment can be evaluated in the laboratory before its

introduction into the field. It recently adapted the code of practice on radiation production in the mining and milling of radioactive ores for regulatory use under the Environment Protection (Nuclear Codes) Act of 1978, and is continuing field studies and public health assessment of residual radiation levels at nuclear weapon

test sites.

A.41 The other main branch of the Laboratory's research is concerned with the measurement and public health aspects of radiations. There is a continuing program for the improvement of methods of measuring radiation exposure, absorbed dose and radioactivity, and for the development of standards for laser,

ultraviolet and microwave radiation. The Laboratory is participating in a national survey of per capita radiation doses arising from the use of radiation in medicine and dentistry, and is undertaking theoretical and experimental studies of dose distributions resulting from diagnostic and therapeutic use of x rays. Other work is concerned with the attenuation of x rays in special shielding materials, with

improved methods of forming diagnostic images in nuclear medicine, and with development of a whole body monitor to measure total radioactivity of individuals.

A.42 The Laboratory also conducts research related to the purity and

effectiveness of radiochemicals. This includes the development of methods for testing the purity and stability of radiopharmaceuticals, studies of the preparation, chemical properties, structure and stability of radiolabelled materials used in nuclear medicine, and evaluation through field surveys of radioimmunoassay services provided by pathology laboratories.

88

Staff and Expenditure

A.43 The total staff of the Australian Radiation Laboratory in 1980-81 was 111, comprising 42 percent professionally-qualified, 37 percent technical, and 21 percent administrative staff. The total expenditure for 1980-81 was $2.75million. Approximately two-thirds of the manpower and budget is devoted to research and

development, and R&D expenditure amounted to $2.02million.

NATIONAL BIOLOGICAL STANDARDS LABORATORY (NBSL)

A.44 The National Biological Standards Laboratory was established in 1958. It has now become a major source of the scientific expertise needed to ensure that the therapeutic goods available in Australia are safe and of good quality.

A.45 The Laboratory's main functions are to assist in the formulation of

therapeutic goods regulatory policy and the evaluation of the chemistry, micro­ biology, quality control and labelling of therapeutic goods, and to carry out the research necessary to develop new or improved standards and test goods for compliance with standards. Officers of the NBSL also inspect manufacturing premises and provide scientific advice to government bodies and industry.

Australian Dental Standards Laboratory (ADSL)

A.46 The ADSL was incorporated within the Commonwealth Department of Health in 1952 and for many years was under the control of the Medical Services Division of the Department. However, because of the similarity of functions with the NBSL, control was transferred in January 1979 to the Director of NBSL.

A.47 The ADSL is responsible for standards in relation to dental materials and implements. It also undertakes research and development on surgical implants, the wear of polymeric restorative materials and the adhesion to teeth and creep of impression materials.

Staff

A.48 The National Biological Standards Laboratory (incorporating the Dental Standards Laboratory) has a staff establishment of 235 with 16 positions in the ADSL. Staff numbers at the end of March 1981 were 195. It has been estimated on the basis of man-years that 96 scientists and technicians carry out scientific research and development activities.

Expenditure

A.49 Total expenditure of the National Biological Standards Laboratory in 1980-81 is estimated to be $4.29milIion of which an estimated $2.08million, or 48 percent, will be spent on research and development. A more detailed exposition of expenditure in 1979-80 and estimated expenditure in 1980-81 is provided in Table A.2.

89

TABLE A.2

EXPENDITURE OF THE NATIONAL BIOLOGICAL STANDARDS LABORATORY (INCLUDING THE AUSTRALIAN DENTAL STANDARDS LABORATORY)

Expenditure 1979-80 Expenditure 1980-81

Total Estimated R&D Total Estimated R&D

$ million $million $million $million

Wages and Salaries 3.02 1.48 3.11 1.53

Vehicles, Plant, Machines, Equipment 0.17 0.06 0.23 0.06

Land, Buildings - - 0.17 0.11

Other current expenditure 0.67 0.33 0.78 0.39

TOTAL 3.87 1.87 4.29 2.08

90

APPENDIX B

COMMONWEALTH SERUM LABORATORIES

B.l The Commonwealth Serum Laboratories (CSL) were established by the Commonwealth Government in 1916 to provide essential sera, vaccines and other biological m aterial to meet the needs of the nation. Initially incorporated in the Quarantine Section of the Trade and Customs Department, the Laboratories came under the control of the newly formed Commonwealth Department of Health in

1921.

B.2 CSL first began production at the Melbourne Hospital in a part of the Walter and Eliza Hall of Medical Research. Initial production included diptheria and tetanus antitoxins and vaccines against various human diseases. In the

succeeding fifty years, there were strong pressures on CSL to expand its

production and range of products. In 1918, the Laboratories began preparing products for veterinary use. In the period between the wars, influenza vaccine, insulin, human blood products and snake anti-venom were developed and produced on a large scale. During the Second World War, emphasis was placed on the production of vaccines (particularly against tetanus), pencillin, and the preparation of human serum as a blood transfusion substitute. In the post-war period, CSL was heavily involved in the preparation of vaccines for the mass immunisation of children, an activity which led to the virtual elimination of diseases such as polio, tuberculosis and diptheria.

B.3 In 1961, the Commonwealth Serum Laboratories Act established the CSL as a statutory authority responsible to the Minister for Health. The first major licensing agreement also came into effect thus granting the right of CSL to manufacture and market the newly developed semi-synthetic antibiotics. Two years later, branches for sales and distribution of CSL products were established in all States. Since this time, CSL has expanded its export market, and has considerably improved its infrastructure with the completion of quality control, virus production, maximum security and veterinary vaccine laboratories.

B.4 During the 1970s, the CSL, in common with many pharmaceutical

manufacturers throughout the world, experienced the declining profitability of biological products as costs increased rapidly. The public service-type conditions of employment of staff in the CSL pose particular problems. Trading profit was increased to $2million or more in the years 1975-76 to 1977-78, but by 1979-80 it had fallen to just over $0.5million. The purpose of the Commonwealth Serum

Laboratories Amendment Act, passed by the Parliament in 1980, was to remove the requirement that the CSL produce and sell only biological products used for therapeutic purposes. Under the terms of the new Act the Laboratories may explore and develop markets for 'prescribed pharmaceutical products'. These are defined by the Regulations associated with the Act as:

• agents derived from blood and tissue and synthetic analogues of such agents;

91

• agents derived from micro-organisms and synthetic analogues of such agents;

• agents for parenteral therapy;

• antitoxic agents;

. immunological agents; and

. laboratory agents and devices.

These Regulations came into force in April 1981, and it is anticipated that the changes will enable the CSL to achieve its goal of post-tax net profit sufficient to allow for re-investment in the organisation and for a return on capital to the Commonwealth Government.

B.5 The Commonwealth Serum Laboratories Commission has six members, five of whom, including the Chairman and Vice-Chairman, serve part-tim e. The Commission functions as a Board of Directors, and has the responsibility of

accounting to the Minister for Health for the activities of the Laboratories. The Commission's decisions are put into operation through its full-time member, the Chief Executive Officer, who is the Director of the laboratories.

B.6 The Laboratories are organised into three main groups. The Admini­ stration Group has responsibility for finance and supply, personnel, sales, marketing, distribution and export. The Operations Group, which is the largest, undertakes production and production planning, engineering, and packaging and dispensing activities. The Science Group has responsibility for veterinary services,

quality control, and research and development.

Major R&D programs

B.7 The Laboratories carry out research and development (R&D) under two parts of Section 19 of the Commonwealth Serum Laboratories Act 1961. Under Section 19(i)(a), CSL conducts research which is directly related to its manufact­

uring and sales activities. This research is funded from the trading profit, and in recent years some difficulties have been experienced because the Laboratories' gross profit has been both marginal and uncertain. Research conducted under this heading is almost all either strategic or applied research, directed towards new or

improved products or manufacturing processes. A Research and Development Advisory Committee has been established with membership from the senior management of the main operational areas of the Laboratories. It is chaired by

the Director of Research and Development. Potential research projects are generally proposed by 'customers' in the production and marketing areas, and are forward-budgeted and assessed in order of priority. Once the likely total R&D budget for the coming year is known, decisions are made on the projects to be

continued or initiated.

92

B.8 Under Section 19(i)(b) of the Act, the CSL is empowered to undertake research into pharmaceutical products at the determination of the Minister for Health, and to operate as a reference centre for a government or other

organisation, whether Australian, foreign or international. The products research is generally long-term, fundamental or strategic research, the results of which may have commercial potential. The research is funded partly by the

Commonwealth Government through the Department of Health, and the monies provided are subject to repayment to the Government from profits earned when commercially viable results ensue. The reference centre work, which is largely of a service nature, includes such activities as maintaining influenza and serology centres in collaboration with the World Health Organisation, operating a primate centre for use in preparing diagnostic cell lines and in research, collaborating in several areas with the Australian Red Cross blood transfusion services, and maintaining a serum collection reference bank and a national rabies diagnostic centre. All projects in both categories are treated similarly by the internal review processes.

B.9 In 1979-80, research work was carried out by Ministerial determination under the following headings:

. development of new and improved health and viral vaccines for human and veterinary use; • development of new and improved biological products (other than vaccines) for human and veterinary use; . the establishment and maintenance of new cell lines; . development of "in vitro" testing of products; . studies of human plasma proteins; • studies of venoms and improvement in the treatm ent of envenomation; • the operation of a specialised pharmacological unit; • research into new technologies for the production of biological

products;

• rabies research; and

• research associated with blue-tongue-like viruses.

CSL has engaged in active co-operation with other scientific organisations and this has resulted in the establishment of two new areas of biotechnology research, namely recombinant DNA and hybridoma research. External consultants are also involved in areas of bacteriology, virology and immunology.

B.10 Research is now in progress on the production of interferon using

recombinant DNA technology (with Monash University) and on the production of monoclonal antibodies for use in research and diagnostic work. This latter research is closely associated with other activities directed towards the

development of immunodiagnostic and immunoassay procedures.

Staff

B .ll The total staff of the Laboratories is approximately 1,050 of whom

about 200 are in the Administration Group and 600 in the Operations Group. Of the 230 in the Science Group, 60 are concerned with veterinary services and 70 with quality control. About 100 staff are directly concerned with research and development, of whom approximately 40 percent are professionally qualified.

93

Sources and Expenditure of Funds

B.12 Research and development undertaken to improve CSL products or manufacturing processes is supported entirely from trading operations. Research projects undertaken by Ministerial determination, and the operation of reference centres, have also, in the past, been funded as far as possible from trading profit,

with the Commonwealth Government contribution making up any short-fall. However, in 1979-80 the Laboratories' trading profit was such that, for the first time in five years, CSL was unable to make any contribution to the costs of research and other activities carried out under Section 19(i)(b) of the Act. A summary of CSL's revenue, profit and R&D expenditure over recent years is presented in Table B.l, and details of the source of funds for research and

development in Table B.2.

94

TABLE B.l

ANNUAL REVENUE, PROFIT AND R&D EXPENDITURES FOR THE COMMONWEALTH SERUM LABORATORIES, 1975-76 TO 1980-81

Year Revenue Trading

Profit

R&D Expenditure 19(i)(a) 19(i)(b)

$million $million $ million (*)

1975-76 20.167 2.253 0.623 1.422

1976-77 22.871 2.470 0.984 1.623

1977-78 24.961 2.133 1.115 1.965

1978-79 27.189 1.807 1.056 2.177

1979-80 29.496 0.573 1.284 2.305

1980-81 34.324 3.869 2.319 1.595

(* ) 19(i)(a) - R&D related to CSL products and manufacturing processes

19(i)(b) - R&D carried out at Ministerial determination.

TABLE B.2

SOURCE OF FUNDS FOR R&D EXPENDITURE BY THE COMMONWEALTH SERUM LABORATORIES 1975-76 TO 1980-81

Year 19(i)(a) Expenditure 19(i)(b) Expenditure

Amount Percentage Amount Percentage

provided provided

$ million by CSL(*) $million by CSL(**)

1975-76 0.623 100 1.422 64

1976-77 0.984 100 1.623 71

1977-78 1.115 100 1.965 45

1978-79 1.051 100 2.177 14

1979-80 1.284 100 2.305 0

1980-81 2.319 100 1.595 0

(*) Funded solely from CSL’s Trading Profit (**) Remainder provided by the: Commonwealth Government through the Department of Health

95

APPENDIX C

MEDICAL RESEARCH IN OTHER COMMONWEALTH GOVERNMENT ORGANISATIONS

INTRODUCTION

C.l In addition to the Department of Health and the Commonwealth Serum Laboratories, several other Commonwealth organisations undertake or support research in the medically-related sciences. The chief organisations involved, which are discussed in more detail below, are:

Australian Atomic Energy Commission CSIRO Division of Human Nutrition CSIRO Molecular and Cellular Biology Unit CSIRO Division of Protein Chemistry Department of Defence, Malaria Research Unit Department of Science and Technology, Antarctic Division Department of Veterans' Affairs

C.2 The involvement of CSIRO in medical research was considered by the Independent Inquiry into CSIRO which reported its findings in 1977. Following the Inquiry's recommendations and the consequent Government decisions, the CSIRO policy on medical research is:

. except in the field of human nutrition, the Organization will not initiate programs of biomedical research which have the prime objective of solving problems in human health;

. where it becomes evident that results of CSIRO research in the

biological and physical sciences could have relevance to human health, they should be drawn to the attention of the CSIRO Medical Research Liaison Committee, which should consider the possible development of the discoveries, including collaboration between CSIRO and a recog­ nised medical research organisation.

In addition to the Division of Human Nutrition, there are several programs of research within CSIRO which are directly related to medicine or to the medical sciences. These are usually collaborative programs with medical research organisations, often initiated by medical scientists who wish to utilise particular expertise available within CSIRO Divisions or Units.

C.3 Commonwealth Government organisations which have a small expen­ diture on research in the medical sciences, or on research of direct significance to medicine, include:

Capital Territory Health Commission CSIRO Division of Applied Organic Chemistry CSIRO Division of Food Research

96

RESEARCH ESTABLISHMENT, AUSTRALIAN ATOMIC ENERGY COMMISSION

C.4 The Research Establishment of the Australian Atomic Energy Comm­ ission, established in 1953, has always been concerned with the biological effects of radiation on people. These activities were extended in the 1960s to include studies of occupational health, and safety problems associated with the nuclear

industry and with nuclear research. The Commission is undertaking several projects aimed at developing and improving techniques for monitoring the working environment in the nuclear industry. This work is likely to expand further following the establishment of a Health and Safety Division as a result of recommendations made in the Ferguson Report for improving occupational health and safety within the Research Establishment.

C.5 The rapid expansion in the use of radioisotopes in medicine, which also took place in the 1960s, led to a government decision that the Commission would produce radiopharmaceuticals. This required the development of facilities for test animals and a research capability to investigate the production and uses of labelled compounds. The Commission's current radiopharmaceutical research concerns the development of improved processes for the production of the radionuclide technetium 99m and the search for compounds of technetium whose biological properties would make them suitable for use in diagnostic medicine.

Staff and Expenditure

C.6 The staff engaged in medical research amounted to the equivalent of about 12 man-years in 1978-79, of which 38 percent was contributed by research scientists and 44 percent by technicians. Expenditure on medical research in the same period was $370,000.

CSIRO DIVISION OF HUMAN NUTRITION

C.7 The Division of Human Nutrition came into existence at the beginning of 1975 as the result of recommendations made to the CSIRO Advisory Council on the organisation's involvement in fields related to medicine. The Division occupies the buildings and research facilities of the former Division of Nutritional Biochemistry in Adelaide, and many staff also transferred to the new Division. The Division is part of the Institute of Animal and Food Sciences.

Major R&D Programs

C.8 The Division's research interests concern the basic biological principles of human nutrition and the biochemical and physiological mechanisms relevant to good health. There are three main research programs. The Nutrition and Human Ecology Program seeks a better understanding of the influence of diet upon disease aetiology and of the psychological and social determinants of dietary patterns in the Australian population. The objective of the Developmental Biology

97

Program is to study the effects of deficiencies and imbalances of micro-nutrients in developmental and metabolic processes in humans, with emphasis on the supply of iodine, zinc, copper and folate which are considered crucial for proper development of the central nervous system. Investigations in the Lipid Metabolism and the Metabolism of Carbohydrate and Proteins Programs are concerned with

the metabolism of carbohydrates, proteins and lipids in normal and in abnormal nutritional status, so that the processes involved in human disorders can be understood and alleviated.

Staff and Expenditure

C.9 The Division has a total staff of 94, of which 18 percent are research

scientists and a further 21 percent professionally-qualified. The Division's expenditure in 1979-80 was $2.16million.

CSIRO MOLECULAR AND CELLULAR BIOLOGY UNIT

C.10 In 1975 there was a reorganisation within the CSIRO Animal Research Laboratories. The major part of the Division of Animal Genetics was

amalgamated with the Division of Animal Physiology to form the new Division of Animal Production, and the remainder became an independent unit within the Laboratories, called the Molecular and Cellular Biology Unit. The Unit continues to share common administrative, library and laboratory service facilities with

members of the Division of Animal Production who were formerly part of Animal Genetics at the North Ryde site.

Major R&D Programs

C .ll The Unit's research is concerned with the control and development of animal cell growth, and with DNA replication, and mutation. The work has applications in the development of techniques for diagnosis and therapy in humans as well as in animals. The aim of the Molecular Genetics Program is to study

chromosome structure and functions, mechanisms of DNA breakage, repair and mutation, and the evolution of micro-organisms at the molecular level. It is hoped that this will lead to improved efficiency in techniques for pasteurisation and in radiotherapeutics. Compounds are being tested for use in the chemotherapy of cancer and of pathogenic organisms. Work in the Cellular Differentiation Program

is divided between sub-programs on control of lymphocyte differentiation and function, isolation and characterisation of growth factors, the influence of interaction between cells on differentiation, and on compounds which modulate cell behaviour or function. These will result in greater understanding of a range of cell-specific factors which may have potential for treating degenerative conditions associated with ageing, congenital abnormalities or acquired path­ ological conditions.

98

Staff and Expenditure

C.12 The Unit has a total staff of 63, of whom 20 percent are research

scientists and a further 19 percent are professionally-qualified. Total expenditure in 1979-80 was $1.63million.

CSIRO DIVISION OF PROTEIN CHEMISTRY

C.13 The Division of Protein Chemistry is one of three Divisions which

together constitute the CSIRO Wool Research Laboratories, located within the Institute of Industrial Technology. The Laboratories were established in 1949 in recognition of the need for Australia, as a major wool-growing country, to be concerned with the end-use of the product. The role of the Division of Protein Chemistry was to accumulate basic knowledge on the structure and chemical reactivity of wool and their relationship to its processing as a textile. The

majority of the Division's research is still related to wool and its properties; but in recent years other collaborative programs have been established to make full use of the Division's expertise and facilities in protein chemistry. This is true of the Division's medicine-related research, which comprises collaborative projects undertaken at the request of other researchers who wish to make use of the

Division's particular skills.

Major R&D Programs

C.14 Within the program of research on biological applications of protein chemistry, there are three projects in the field of medical research. In the first, studies are aimed at elucidating the nature and mechanism of antigenic variation in influenza viruses in order to provide a basis on which new methods of

controlling influenza may be designed. The purpose of the second project is to assist other research laboratories in the isolation, purification and characterisation of factors controlling the development of non-specific cells into forms char­ acteristic of particular tissues, for example, the differentiation of stem cells of the bone marrow to form granulocytes. In the third project, techniques of protein chemistry are being used to provide pure antigens of helminth parasites of humans and of animals with a view to developing methods of rapid serodiagnosis and, eventually, control through immunisation.

Staff and Expenditure

C.15 The staff involved in medical research projects within the Division amounted to the equivalent of 4.5 man-years in 1979-80, with expenditure of $150,000.

99

DEPARTMENT OF DEFENCE, MALARIA RESEARCH UNIT

C.16 The Army Malaria Research Unit was established in Cairns in 1943 to evaluate the effectiveness of all known anti-malarial drug regimes. The drug treatm ent later introduced for service personnel was a direct result of that research effort. The Unit was disbanded in 1946, partly reconstituted in 1962 and

formally established in 1966 in Sydney at the School of Public Health and Tropical Medicine (now the Commonwealth Institute of Health).

C.17 The Unit conducted further research during the Vietnam conflict and developed a regime of prophylaxis that gave better results than those followed by other allied forces. In June 1970, it was renamed the 1st Malaria Research Unit

(1MRU), its staff was increased and its research program was placed under the supervision of the Army Malaria Research Advisory Board. During 1974, the Unit moved to its permanent work location at Ingleburn, NSW.

C.18 The Unit is affiliated with the World Health Organisation (WHO), is recognised by WHO as a training centre in malariology for technicians and is designated a WHO Collaborating Centre for Malaria Research.

Major R&D Programs

C.19 In continuation of its earlier work, the Unit uses an established mouse model of infection to study the curative effects of alternative drugs and

combinations of drugs with a potentiating effect on malaria parasites susceptible or resistant to chloroquine and to pyrimethamine. Studies of human biochemistry are also made as a preliminary to the subsequent evaluation of the toxic effect of anti-malarial drugs. Short-term cultivation of malaria parasites and prep­

aratory studies for long-term cultivation are being carried out for further pharmacological enzymatic and biochemical studies. Chromosomal and genetic studies on the main malaria vector in the South West Pacific area are undertaken, and the Unit is engaged in the cultivation, study, laboratory and field testing of the fungus Culicinomyces which has shown promise in the control of malaria and viral encephalitis vectors.

C.20 Development plans for the Unit in the immediate future include the continuation and perfection of current research activities and the establishment of an Aotus monkey/human malaria parasite model to further the parasitological,

chemotherapeutic and biochemical studies related to human malaria.

Staff and Expenditure

C.21 The Unit consists of four researchers including the Director, nine

research assistants and technicians and two administrative staff. It does not have its own budget; all financial costs incurred are borne under various votes of the Defence budget.

100

DEPARTMENT OF SCIENCE AND TECHNOLOGY, ANTARCTIC DIVISION

C.22 The Medical Branch of the Department of Science and Technology's Antarctic Division provides medical services for Australian stations in Antarctica, summer field operations and expedition ships, and has the responsibility for carrying out a multidisciplinary program of research on human interaction with the polar environment.

Major R&D Programs

C.23 Joint projects in health research between the Antarctic Division and hospitals and universities in Australia have occurred in the past. The Division is currently involved in work associated with the International Biomedical Expedition to the Antarctic. This expedition, which involved scientists from Australia, Argentina, New Zealand, France and the United Kingdom took place in the summer of 1980-81. Data on the expedition is being processed and will shortly be published. Areas of research during the expedition included behavioural adaptation, environmental physiology, immunology and microbiology, biochemistry,

metabolism and nutrition, epidemiology and sleep.

Staff and Expenditure

C.24 The staff involved in medical research include two medical officers based at the Division's headquarters, and between four and 12 expedition medical staff annually who carry out research projects as a secondary function as well as providing health care. Specific financial allocations for medical research in 1980­

81 totalled $35,000. However, this does not include salaries, allowances or incidental costs for the provision of health care, the primary responsibility of the medical officers.

DEPARTMENT OF VETERANS' AFFAIRS

C.25 The prime function of the Department of Veterans' Affairs in the

medical field is the diagnosis and assessment of incapacity and the treatm ent of eligible veterans and their dependants. Medical research is an essential component of the Department's treatm ent functions, and includes the evaluation of methods for diagnosis and assessment of patients' conditions and the

development of external aids for the disabled. Research funded through the Department is restricted to projects conducted within its own facilities, the General Repatriation hospitals in all States, and to the Central Development (Prosthetic and Orthotic) Unit in Melbourne. Departmental support for medical research is assessed and co-ordinated through the Central Medical Research

Advisory Committee. The number of projects and expenditure on a State by State basis for 1978-79 is provided in Table C .l.

C.26 Expenditure on research projects since 1973 is shown in Table C.2.

101

TABLE C.l

RESEARCH PROJECTS AND EXPENDITURE BY THE DEPARTMENT OF VETERANS' AFFAIRS 1978-79

State Number

Projects of Expenditure

$million

% of Total

Central Office 2 0.041 17

New South Wales 19 0.058 24

Victoria 19 0.094 39

Queensland 9 0.038 16

South Australia 5 0.001 -

Western Australia 6 0.011 4

Tasmania 3 less than 0.001

TOTAL 63 0.243 100

TABLE C.2

ANNUAL EXPENDITURE ON RESEARCH BY THE DEPARTMENT OF VETERANS' AFFAIRS 1973-74 TO 1978-79

Year Salaries

$million

Equipment $million

Other $million

Total Smillion

1973-74 0.063 0.016 0.001 0.080

1974-75 0.089 0.001 0.002 0.091

1975-76 0.114 0.017 0.001 0.133

1976-77 0.194 0.020 0.012 0.226

1977-78 0.214 0.014 0.015 0.243

1978-79 0.192 0.038 0.013 0.243

C.27 Separate from research recommended by the Central Medical Research Advisory Committee, the Central Development (Prosthetic and Orthotic) Unit follows a continuous program of research into methods of improving artificial limbs and surgical appliances. The Unit was established in 1961 with a charter to carry out research and development, as well as evaluation, education and treatm ent, mainly concerned with prostheses, and with other external aids. The staff consists of five professionals and one clerical assistant, and expenditure on research and development in 1980-81 was $0.14million.

102

APPENDIX D

INDEPENDENT AND HOSPITAL RESEARCH INSTITUTES

INTRODUCTION

D.l The development of medical research in Australia in the early decades of this century relied heavily on public benefaction. The independent research institutes founded by this means were not superseded by the formation of the National Health and Medical Research Council (NH&MRC) in 1936, but rather the Council sought to promote research already initiated in the institutes and universities. The rapid development of medical research in the past twenty years or so has seen the establishment of many new institutes, and these have

contributed to the high international standing which Australian medical research enjoys. The independent institutes continue to provide the base for a significant proportion of the country's biomedical research.

D.2 The institutes vary greatly in their size and degree of independence, and in the type of work undertaken. Each of the three largest institutes has an annual budget in excess of $2.0million, whereas the smallest ones have a yearly expenditure of less than $0.25million. Some, such as the Walter and Eliza Hall

Institute of Medical Research, are largely independent; others are not fully independent and may be regarded as akin to a special department of a hospital. Some institutes are concerned primarily with basic biomedical research, some undertake programs of clinically-oriented research, and others have a major diagnostic service function. The patterns of funding of the institutes are similarly diverse.

D.3 The remainder of this Appendix is concerned with descriptions of

several independent research institutes, their organisation, research programs and sources of funds. The coverage is not intended to be complete, but the institutes described give a good appreciation of the range of size and function.

THE WALTER AND ELIZA HALL INSTITUTE OF MEDICAL RESEARCH

D.4 Walter Hall died in 1911 and his estate was left to his wife Eliza who

established the charitable Walter and Eliza Hall Trust. The trustees decided that a portion of the available income would be used to establish an independent medical research institute, in close proximity to the Melbourne Hospital (now the Royal Melbourne Hospital). The first Director took office in 1919.

D.5 The Hall Institute is incorporated in Victoria as a Company Limited by guarantee. It is governed by a Board of Directors, two members being appointed by the Walter and Eliza Hall Trust, two by the Royal Melbourne Hospital, two appointed by the University of Melbourne, two nominated by the National Health and Medical Research Council, and one appointed by the Board itself. The Board also has two Honorary Governors who attend Board meetings but do not vote.

103

D.6 The Institute is affiliated with the Royal Melbourne Hospital and the University of Melbourne. A Clinical Research Unit is jointly serviced by the Institute and the Hospital. The Institute serves as the Department of Medical Biology of the University, and the Director is a Professor and Chairman of that Department. All the senior scientists at the Institute hold Professorial or Senior Associate positions within the University.

Major R&D Programs

D.7 In the period prior to World War II, the Institute achieved recognition for its work on snake-venoms and bacterial and viral diseases. Under the direction of Dr (later Sir Macfarlane) Burnet over the period 1944-1965, the Institute became known as one of the leading research groups in the world, primarily for its work on viruses, including Murray Valley encephalitis, myxomatosis, and influenza. In addition, a new theoretical framework for the understanding of nature's immunological defences was built up, and it was for this achievement that Burnet was awarded the Nobel Prize in 1960. The development of a Clinical

Research Unit for diseases of the stomach, the liver, and the immune system, and a Cancer Research Unit for leukaemia research, were also fostered.

D.8 The scope of the Institute's work has since been expanded to include major groups active in the search for vaccines against parasitic diseases such as malaria, and on the use of 'genetic engineering' to increase knowledge of how the body forms protective antibodies. Immunological research has been strengthened by the establishment of a unit to study the function of the thymus gland in health and disease, by a group active in devising new biophysical methods to study white

blood cells, and by a group investigating the feasibility of pancreatic transplants in diabetes. The Cancer Research and Clinical Research Units have been enlarged and have been more fully integrated into the mainstream of the Institute. As a result of these changes, the Institute's work is relevant to many important diseases including cancer, multiple sclerosis, arthritis, hepatitis, malaria and other

parasitic diseases, kidney and bone marrow transplantation, and other disorders of the blood and immune system.

Staff

D.9 The total staff of the Hall Institute in 1979-80 was 175, of whom

approximately one-third were research scientists. About 60 percent were technical staff and the remainder administrative staff. There were 17 Research Fellows and Visiting Scientists, and 25 postgraduate students.

Sources and Expenditure of Funds

D.10 The Institute has invested capital funds amounting to about $4million, and receives $6,400 per annum from the Walter and Eliza Hall Trust. The bulk of its annual running expenses are met from grants and private fund-raising. Of

the 1979-80 income of $3.9million, 51 percent came from the Commonwealth

104

Government via NH&MRC, nine percent from the Victorian Government, ten per cent from overseas sources, and 30 per cent from Australian non-government sources, of which the largest components were income from investments (12 percent), the Anti-Cancer Council of Victoria (three percent) and private philanthropy of companies, voluntary groups and individuals.

D .ll The annual budget of the Institute over recent years is shown in Table D.l, and details of the sources and expenditure of funds in Tables D.2 and D.3.

ANNUAL EXPENDITURE (OPERATING COSTS) OF THE HALL INSTITUTE 1971-1980

TABLE D.l

Year $million

1971 1972 1973 1974 1975 1976 1977 1978 1979 1980

0.948 1.055 1.328

1.584 2.368 2.272 3.140 3.092 3.669 4.010

TABLE D.2

INCOME FOR THE HALL INSTITUTE FOR 1979-80

Source $million Percentage of

Total

NH&MRC - grants - fellowships

1.969 0.065 0.472 0.419 0.360 0.311 0.268 0.130 (0.055)

51 12 10 9

8 7 3

Income from investments Overseas grants and contracts Victorian Government grants Australian grants and contracts Bequests and Donations General non-government income (Less, income carried forward)

TOTAL 3.939 100

105

TABLE D.3

EXPENDITURE FOR THE HALL INSTITUTE FOR 1979-80

Item Amount

$ million

Percentage of total

Scientific Laboratory Expenditure Salaries 1.627 41

Equipment 0.073 2

Consumable supplies 0.861 21

Other 0.214 5

Sub-total 2.775 69

Provision of Essential Services Salaries 0.643 16

Equipment 0.064 2

Consumable supplies 0.048 1

Other 0.178 4

Sub-total 0.933 23

Administration Salaries Office Equipment

0.163 0.005

4

Fund-raising Expenditure 0.024 1

Other 0.110 3

Sub-total 0.302 8

TOTAL (a) 4.010 100

(a) This figure differs from the income for because of funds brought forward from the year shown in the previous year.

Table D.2

106

THE HOWARD FLOREY INSTITUTE OF EXPERIMENTAL PHYSIOLOGY AND MEDICINE

D.12 Following on from a successful program of research initiated in 1947, at the beginning of 1960 proposals were drawn up by a group of leading Australian citizens, in consultation with the University of Melbourne, for the establishment of a first-class laboratory building to provide facilities for experiments in physiology and medicine involving large animals. Lord Florey consented to the donor's wish to name the laboratories 'The Howard Florey Laboratories of Experimental Physiology' and they were eventually built with Commonwealth Government and private support, and American grants. Subsequently, in 1971, 'The Howard Florey Institute of Experimental Physiology and Medicine' was established by an Act of Parliament.

D.13 The Institute is governed by a Board which comprises eight originating members including the present Director, two members nominated by the University of Melbourne, two representatives of the National Health and Medical

Research Council and one representative of the Government of Victoria.

D.14 In its twenty years of operation, the Institute has gained an

international reputation for its use of sheep as an experimental animal for research into the regulation of body fluids with emphasis on the role of hormones and the brain mechanisms which influence salt and water uptake. The discoveries made have relevance for problems of high blood pressure and of mental disease in modern man. More recently, work on protein hormone analysis and synthesis has gained acclaim.

Major R&D Programs

D.15 The Institute carries out research into many aspects of endocrinology, including the production and action of hormones, the centres in the brain important in hormone-mediated functions, and the effects on target organs.

D.16 One of the major projects of the Institute is to study peptide hormones such as relaxin and human chorionic gonadotrophin, with the aim of synthesising them for use in medicine. Relaxin, an ovarian hormone, has been isolated and analysed and the mechanism of its action is being studied. In addition to an existing program on the biochemical synthesis of the hormone, funds have been provided to establish a recombinant DNA laboratory to produce the hormone from a bacterial culture medium. Synthesis of the side chain of human chorionic gonadotrophin is also being carried out with the aim of producing a contraceptive vaccine.

D.17 The work with sheep and cattle as experimental animals has involved delicate and unique surgical techniques which have been developed by the Institute over the last two decades. These techniques have also been used to study foetal physiology and endocrinology. A further program concerns clinical and repro­ ductive endocrinology and its possible use in countering infertility.

107

Staff

D.18 The total staff of the Institute in 1979 was 86 of whom approximately 45 percent were research scientists, 40 percent technical staff and the remainder administrative. There were two Visiting Scientists, six postgraduate students and

four vacation scholars.

Sources of Expenditure of Funds

D.19 The Institute's major source of income is a grant from the National

Health and Medical Research Council, with lesser amounts coming from the Victorian State Government and from private donors and foundations. Of the 1979 income of $1.9million, 63% was provided by the NH&MRC; 9% by the Victorian Government; 5% each by the University of Melbourne and the National Institute

of Child Health and Human Development (USA) and 9% by private donors and foundations. The annual expenditure of the Institute since 1973 is shown in Table D.4, and sources and expenditure of funds in Tables D.5 and D.6.

TABLE D.4

ANNUAL EXPENDITURE OF THE FLOREY INSTITUTE 1973-1980

Year $million

1973 0.553

1973 0.553

1975 1.039

1976 1.203

1977 1.373

1978 1.720

1979 1.910

1980 2.249

TABLE D.5

INCOME FOR THE HOWARD FLOREY INSTITUTE FOR 1980

Source Smillion Percentage of

total

NH&MRC 1.350 59

Victorian Government Grant 0.165 7

University of Melbourne 0.119 5

National Heart Foundation 0.023 1

World Health Organisation National Institute of Child Health

0.061 3

& Human Development 0.152 7

Muscular Dystrophy Association 0.015 1

Private Donors and Foundations 0.356 16

Interest and Investments 0.045 2

TOTAL 2.287 100

108

TABLE D.6

EXPENDITURE FOR THE HOWARD FLOREY INSTITUTE FOR 1980

Item

Scientific

$ million Percentage of Total

Salaries 0.738 33

Scholarships 0.021 1

Major Equipment 0.112 5

Operational expenses 0.494 22

Sub-total 1.365 61

Technical Salaries 0.299 13

Administrative Salaries 0.110 5

Overhead expenses 0.211 9

Sub-total 0.321 14

Other Salary charges and part-tim e staff 0.213 9

Non-operating expenditure 52 2

TOTAL 2.250

109

THE BAKER MEDICAL RESEARCH INSTITUTE

D.20 The Baker Institute was founded in 1926 as a result of a bequest by

Thomas Baker, his wife Alice, and his sister-in-law Eleanor Shaw. An agreement was entered into with the Board of the Alfred Hospital to assume financial responsibility for establishing a biochemical laboratory which was to be used for research. The Baker Institute later became an autonomous institution but its close affiliation with Alfred Hospital has continued. Thomas Baker's will established a charitable trust, the Baker Benefactions, which until recently was the Institute's

major source of financial support. The original Deed of Settlement provided a statutory minimum annual grant, but the sums provided between 1928 and 1979 have been much larger than the minimum, and exceed $5.5million in total. This support has been provided through annual grants from the Baker Benefactions on

the advice of the Trustees, who also have other regular commitments to different charities and public bodies and are not legally obliged to support the work of the Baker Institute except at the statutory minimum level.

D.21 In 1965 the Institute became affiliated with Monash University for the purposes of promoting teaching and encouraging research amongst undergraduate and postgraduate medical students. This development allowed the Institute to

participate in the University's postgraduate research training program for higher degrees. More recently, the Institute was incorporated under the Baker Medical Research Institute Act, 1980, of the Victorian Parliament. Under this Act the Institute is governed by an autonomous Board of not more than 12 or less than

seven members, with a President and Vice-President and official representatives from the Alfred Hospital and from Monash University. The Director of the Institute is an ex officio member of the Board.

Major R&D Programs

D.22 Under its first two directors a high proportion of the Institute's work

involved the provision of clinical pathology services for Alfred Hospital; but there was always some research. After World War II the Hospital established separate service departments for clinical pathology. The Baker Institute then became fully engaged in medical research. This phase of the Institute's work coincided with the appointment of Dr Thomas E. Lowe as Director of both the Baker Institute and the newly established Clinical Research Unit at Alfred Hospital. This ensured close co­ ordination of basic and clinical research which has continued ever since. During Dr

Lowe's tenure from 1948-1974, research was undertaken in many different fields of medicine, encompassing cardiovascular research, haematology, gastro-enterology, diabetes and other metabolic disorders, and cancer research.

D.23 In 1975 it was decided to concentrate on one important broad field of medical research: cardiovascular research. The Institute is active in basic and clinical research, mainly in the fields of hypertension and abnormalities of fat metabolism and other nutritional disorders that lead to coronary disease, and also has a group working on problems related to cardiovascular surgery. The overall objectives of the Institute's research are to discover the causes of hypertension and atherosclerosis, and to provide insights to the better management of these disorders

through knowledge of the operation of the complex homeostatic system in the body which controls blood pressure and the nutrition of the arterial wall.

110

D.24 The scientific work is at present performed by three main research

groups. The Circulatory Control and Hypertension Research Unit is concerned with the role of the kidney and of the brain and autonomic nervous system in the control of blood pressure, and includes a basic cardiovascular pharmacology laboratory. The

research actitivities of the Cardiovascular Metabolism and Nutrition Research Unit encompass lipoprotein physiology and biochemistry and human nutrition. The recently-established Experimental Cardiac Surgery Laboratory works on basic problems of cardiovascular control related to both cardiac and vascular surgery and on some applied problems of cardiac surgery. In addition, there is a Morphology and Cell Biology Laboratory which studies the structure of the arterial wall in

hypertension and the determinants of arterial wall nutrition, and a Clinical Pharmacology Laboratory which is concerned with particular problems of drug handling in disease, pharmacokinetics, and of drug metabolism in humans.

D.25 The Institute has developed a wide range of basic disciplines, including physiology, biochemistry, pharmacology and cell biology, which are essential for the analysis of complex biological control systems. Some of the applied studies have arisen from problems related to service commitments in the Hypertension Clinic and the Lipid Clinic of the Clinical Research Unit, Alfred Hospital and more recently in the Vascular Service of the Hospital.

Staff

D.26 The total staff of the Baker Institute and the Clinical Research Unit in 1979-80 was approximately 100, of whom 44 percent were research scientists (including postgraduate students), 42 percent were technical staff and the remainder support staff. There were seven Visiting Scientists.

Sources and Expenditure of Funds

D.27 The annual expenditure of the Institute over the past decade is shown in Table D.7.

TABLE D.7

ANNUAL EXPENDITURE OF THE BAKER INSTITUTE 1970-1980

Year $million

1970 0.217

1971 0.236

1972 0.296

1973 0.312

1974 0.363

1975 0.526

1976 0.732

1977 1.082

1978 1.227

1979 1.519

1980 1.678

111

D.28 The sources of income for the Institute in 1981 are shown in Table D.8. Approximately 30 percent of income was derived from program and project grants awarded by the NH&MRC, and 23 percent from the Baker Benefactions. The Institute Endowment Fund, the Victorian Government and the Alfred Hospital

Research Fund provided six to nine percent each, and private donations are expected to provide 14 percent.

TABLE D.8

ESTIMATED INCOME FOR THE BAKER INSTITUTE FOR 1981

Source $ million Percent;

Baker Benefactions - Annual Grant 0.454 24

National Health & Medical Research Council 0.535 29

Victorian Government 0.160 9

Institute Endowment Fund 0.170 9

Alfred Hospital Research Fund 0.119 6

National Heart Foundation 0.073 4

Life Insurance Medical Research Fund 0.030 2

Alfred Hospital Share/Costs 0.039 2

Foundations 0.031 2

Sub-total 1.611

Anticipated Donations 0.260 14

ESTIMATED TOTAL 1.871 100

of total

TABLE D.9

ESTIMATED EXPENDITURE FOR THE BAKER INSTITUTE FOR 1981

Item

Scientific Salaries Consumables Equipment

Sub-total

$million Percentage of total

1.115 0.175 0.130

58 9 7

1.420

Administrative Salaries (support staff) Fund raising/Public Relations General expenditure (power,

stationery, telephone, etc.) Animal Housed' Miscellaneous

0.225 12

0.043 2

0.215 11

0.009 0.020 1

Sub-total 0.512 27

TOTAL 1.932 100

(a) This amount is relatively low because Alfred Hospital accepts about 80% of the running costs although the Baker Institute is by far the largest user.

112

QUEENSLAND INSTITUTE OF MEDICAL RESEARCH

D.29 The Queensland Institute of Medical Research was founded in 1946 as a result of a proposal by Dr E.H. Derrick. His pioneering research from 1935 onwards in Q fever, and his experience with other tropical diseases, made him aware of the need for a laboratory devoted to full-time research into problems of special importance to northern Australia. His proposal to the Queensland Government led to the establishment of the Institute as a statutory institution under the Queensland Institute of Medical Research Act.

D.30 The Institute, which is funded mainly by the Queensland Government, has for more than 30 years had a close working relationship with the University of Queensland, with teaching hospitals and with the State Department of Health. Formal agreements have been concluded for affiliation with the University of Queensland and with the North Brisbane Hospitals Board to enhance links with the academic community and with clinical researchers.

D.31 The Institute is governed by a Council consisting of the Director-

General of Health and Medical Services for Queensland (Chairman) together with one representative each of the State Department of Health, the Queensland Government, the University of Queensland, the Australian Medical Association, the Royal Australasian College of Surgeons, the North Brisbane Hospitals Board, the South Brisbane Hospitals Board and the Mater Misericordiae Hospitals Board.

D.32 In mid 1980, the Queensland Institute of Medical Research Trust was established by amendment of the Queensland Institute of Medical Research Act. The purpose of the Trust is to raise and manage private funds and investments for the Institute.

Major R&D Programs

D.33 Early research in the Institute concentrated on zoonoses (scrub typhus, tick typhus, Q fever, leptospirosis), parasitology (hookworm), entomology (mos­ quitoes and their role as vectors of disease), acarology, bacteriology and mycology. Research in virology commenced in 1950 with studies on the epidemiology of Murray Valley encephalitis. Isolation of the virus in 1960 resulted in a fifteen year period of intensive investigation leading to the discovery of a number of arboviruses, including many of medical and veterinary importance.

D.34 Also during the 1950s, research into some infectious diseases was phased out with the introduction of widespread use of antibiotics; but studies on parasitology and acarology continued. Cancer research began in the early 1950s as an offshoot of zoonoses studies with the isolation of mouse leukemia viruses. It is now a major part of the Institute's research.

D.35 At the present time, laboratories of the Institute are grouped into five sections (Cell Biology, Molecular Biology, Oncology, Tropical Medicine and Virology) which undertake independent research but also participate in collab­ orative research between sections. The three major areas of collaborative research within the Institute cover cancer, its causes and control; viruses, vectors and control; and parasitology.

113

D.36 In cancer research, the Cell Biology Section is carrying out pure basic research and strategic mission-oriented research on cultured populations of cancer cells. Basic mechanisms responsible for unregulated cell division are being elucidated and the identification and exploitation of tumour cell sub-populations are being studied. Sensitivity assays for determining the most effective anti­

cancer drugs are also being used as a guide to therapeutic protocols.

D.37 Work specifically on human cancer is also undertaken by the Oncology Section with the research being divided between the biology of Epstein-Barr Virus and its relation to cancer and a study of malignant melanoma and skin cancer using an extensive library of cell lines. The latte r library is also used by the

Molecular Biology Section in its studies on the genetic predisposition to cancer of some humans.

D.38 Various aspects of virus research are undertaken by all sectors except the Cell Biology Section. The study of arthropod-borne viruses (arboviruses) has been a major research activity of the Institute for over two decades. Early work resulted in the isolation and the characterisation of more than 30 serologically distinct arboviruses some of which were important pathogens of humans and domestic animals. Although the viruses were ecologically and biologically similar,

they constituted a heterogeneous group in respect of antigenic structure and particle morphology. Current research is attempting to relate this diversity to patterns of pathogenesis and virulence in humans and animals. Particular

emphasis is placed on the study of the biology of arboviruses and of dengue viruses, and on the immunobiology of Ross River virus in relation to epidemiology and pathogenesis of epidemic polyarthritis.

D.39 The Molecular Biology Section is studying the molecular genetics of papova viruses with particular regard to viral persistence, the roles of host cells in virus modification and the relation of both phenomena to host cell genetics to clinical disease. The viral persistence studies will interact with related work to

be initiated during 1981 in the Virology Section and with viral persistence studies in disease vectors undertaken by the Tropical Medicine Section. The work on the linkage between viral infection and cancer undertaken by the Oncology Section has already been mentioned.

D.40 Parasitology studies are undertaken by the Tropical Medicine Section with some fundamental research occurring in the Molecular Biology Section. The Experimental Parasitology Unit is currently changing its research direction and is expected to concentrate in future on understanding the ecology and epidemiology of parasites in urban communities in Australia. Another group in the same unit

will concentrate on the filarial parasites of man which have been neglected until recently because of their relatively low importance in many under-developed countries. The Molecular Biology Section's research concerns co-operation with groups in Melbourne, Papua New Guinea and Thailand on means of blocking the

invasion of erythrocytes by malarial merozoites. This will have the ultimate objective of paving the way to effective malarial vaccines.

D.41 To complement the studies on parasites and viruses, work is being

carried out in the Tropical Medicine Section on the taxonomy and biology of mosquitoes and ticks which are major vectors of pathogens.

114

Staff

D.42 In 1981, the staff was nearly 100 of which 22 percent were PhDs or

MDs, and a total of 60 percent had graduate qualifications. Technical staff, including both service and laboratory personnel, accounted for 30 percent of the total. In addition, there were five Visiting Scientists and several postgraduate students.

Source and Expenditure of Funds

D.43 The Institute was initially funded entirely by a grant from the

Queensland Government and this has remained, on an annual budgetary basis, the major source of income. Grants from other sources, particularly the National Health and Medical Research Council, have contributed to the Institute's income for over twenty years and in the past three years have increased substantially. Some sizeable bequests have come to the Institute in the last few years, so that

more than a third of the total budget is now derived from grants and private funds. The changing pattern of financial support is shown in Table D.10.

TABLE D.10

ESTIMATED ANNUAL EXPENDITURE OF THE QUEENSLAND INSTITUTE OF MEDICAL RESEARCH 1970-1981

Year Queensland Government $mil!ion Grants $million

Other $millliion

Total $mil!ion

1970 0.257 0.012 0.269

1971 0.288 0.010 - 0.298

1972 0.309 0.020 - 0.329

1973 0.334 0.011 - 0.345

1974 0.382 0.036 - 0.418

1975 0.492 0.038 0.027 0.557

1976 0.638 0.058 0.001 0.686

1977 0.771 0.071 0.186 1.029

1978 0.895 0.092 0.136 1.124

1979 1.082 0.270 0.078 1.430

1980 1.295 0.424 0.088 1.807

1981 1.611 0.679 0.155 2.445

D.44 The sources and expenditure of the Institute's funds are described in Tables D .ll and D.12.

115

TABLE D .ll

ESTIMATED INCOME FOR THE QUEENSLAND INSTITUTE OF MEDICAL RESEARCH FOR 1981

Source $ million Percentage of total

Queensland Government Grant 1.610 66

NH&MRC - grants 0.411

- scholarships 0.023 18

Queensland Cancer Fund 0.097 4

World Health Organisation 0.020 1

Other Australian grants and contracts 0.129 5

Donations and Investment Funds 0.155 6

TOTAL 2.445 100

TABLE: D.12

ESTIMATED EXPENDITURE FOR THE QUEENSLAND INSTITUTE OF MEDICAL RESEARCH FOR 1981

Item $million Percentage of total

Salaries 1.543 63

Salary Related Costs 0.251 10

Laboratory Related Costs (Consumable Items) 0.296 12

Equipment 0.145* 6

Library 0.033 1

Visiting Scientists Program 0.005 -

Printing/Stationery, Postage/Telephones 0.035 1

Domestic Operations 0.050 2

Repairs/Equipment Maintenance 0.030 1

Animal House 0.023 1

Travel 0.033 1

Miscellaneous 0.003 -

TOTAL 2.447

* This figure includes $80,000 for a computer being purchased in 1981 with funds derived from donations.

116

THE INSTITUTE OF MEDICAL AND VETERINARY SCIENCE

D.45 The Institute of Medical and Veterinary Science (IMVS) was created by an Act of the South Australian Parliament in 1937 and its first building, adjacent both to the Royal Adelaide Hospital and to the Medical School of the University of Adelaide, was occupied in 1939. This was the culmination of a development of pathology services begun in 1902 with the establishment of a laboratory at the

Adelaide Hospital (now the Royal Adelaide Hospital) to carry out bacteriological examinations. The Act made the Institute independent of the Hospital and placed its control in the hands of a seven-man council responsible to the Minister of Health.

D.46 The main function of the Institute was to provide diagnostic laboratory services and related training, and several regional laboratories were subsequently established in country centres in South Australia. In addition the Institute's Act made it clear that it was also to undertake research, specifically, research into the diseases of human beings and animals. Nevertheless the Institute is now predominantly a service laboratory, providing diagnostic facilities in clinical pathology for the Royal Adelaide Hospital and other metropolitan and country hospitals, for public health authorities, for government departments, for industry, and for private medical practitioners. It also undertakes work in veterinary pathology on behalf of the Department of Agriculture, for veterinary practitioners and for stock-owners in South Australia.

D.47 The Institute operates as a Statutory Authority, but maintains a close association with both the Royal Adelaide Hospital and the University of Adelaide. A number of the Institute's specialist staff hold honorary appointments at the Royal Adelaide Hospital. The Head of the Institute's Division of Tissue Pathology is the Professor of Pathology at the University of Adelaide, and the Head of the Medical Virology Division has honorary professorial status in the University.

D.48 The South Australian Government has announced that it proposes to repeal the Institute of Medical and Veterinary Science Act (1937-78), and to introduce a new Bill for an Act to continue the Institute with redefined powers. It is anticipated that the Bill will be introduced in October or November 1981.

Major R&D Programs

D.49 Research is a relatively minor component of the work of the Institute. The main activities, showing the percentage of 1978-79 gross payments attrib ­ utable to each, are given in Table D.15; medical research accounts for only three percent of the expenditure.

D.50 Research at the Institute can be divided into two broad areas: the

development of new and improved diagnostic tests, and the conduct of basic scientific research. The former, funded mainly from Institute funds, has often been initiated by members of the Hospital staff or other medical practitioners seeking new or improved methods to diagnose and manage their patients or, in the case of veterinarians, to obtain surveillance information on diseases. Develop­ ments have also been initiated within the Institute, the usual objective being to improve the quality of service offered.

117

D.51 Basic research has been initiated within the Institute, usually as a result of observations made during routine work. Following the observation in 1969-70 of adverse effects in patients who were being fed intravenously with a variety of sugar substitutes, research was initiated at the Institute which eventually demonstrated the importance of minor metabolic pathways in critically ill

patients.

D.52 The existence of a significant number of cases of bone disease in the South Australian community, contrary to the predictions in medical literature, has led to studies of calcium balance and the general nutritional status of older people and those with certain diseases. These studies are carried out in the Division of

Clinical Chemistry and in the Division of Tissue Pathology where a laboratory specialising in the study of diseases affecting bones and joints is being developed. Current research is concerned with elucidating the reasons for the mechanical

failure of artificial joints.

D.53 Basic research projects at the Institute are funded by outside grants. The NH&MRC is supporting five projects in 1981 at a total cost of $93,000. Grants are also obtained from a variety of other bodies including the South Australian Anti-Cancer Foundation and The Channel 10 Children's Medical

Research Foundation, and several have been obtained from drug companies and from instrument manufacturers.

Staff

D.54 The total staff of the Institute of Medical and Veterinary Science in 1980 was 882 of whom approximately 26 percent were professional staff, 38 percent technical staff and the remainder support staff.

Sources and Expenditure of Funds

D.55 The basis of funding of the Institute has changed many times over the years due to variations in government policy, the introduction of different pathology fee structures and changes in the administration of health services at

both the Commonwealth and State levels. As a predominantly service laboratory most of the income (other than the fees-for-service paid by private patients) of the Institute for its medical work has been provided on a cost-sharing basis by the State and Commonwealth Governments. In the veterinary area most of the

income (other than the fees-for-service paid by private veterinary practitioners) has been provided by the State.

D.56 The annual expenditure of the Institute has increased markedly over the past decade, as shown in Table D.13. The sources of income for the Institute in 1979-80 are shown in Table D.14.

118

TABLE D.13

ANNUAL EXPENDITURE OF THE INSTITUTE OF MEDICAL AND VETERINARY SCIENCE, 1971-1980

Year Expenditure

$ million

1971 2.633

1972 3.042

1973 3.528

1974 4.967

1975 7.178

1976 9.066

1977 11.460

1978 13.492

1979 14.713

1980 16.844

TABLE D.14

SOURCES OF INCOME FOR THE INSTITUTE OF MEDICAL AND VETERINARY SCIENCE 1979-80

Source $ million Percentage of

total

Grants - from State Government 3.213 19

- for specific purposes 0.289 2

Fees and Reimbursement -Pathology for Government hospitals 6.726 39

Non-schedule services for Government hospitals 1.533 9

Pathology for Private Sector 4.366 25

Private Practice Consultations 0.028 -

Interest 0.176 1

Sundry Sales, Recoups, Rents, etc. 0.888 5

TOTAL 17.219 100

119

D.57 The percentage expenditure on each of the Institute's main activities in 1978-79 is shown in Table D.15.

TABLE D.15

PERCENTAGE EXPENDITURE ATTRIBUTABLE TO EACH ACTIVITY IN THE INSTITUTE OF MEDICAL AND VETERINARY SCIENCE, 1978-79

Percentage

Pathology Tests for Individuals 64

Non-Schedule Services (including Patient Management and Teaching) 11

Public Health Services 9

Veterinary Services 6

Production of Media and Animals, etc. for Sale and Sundry Recharge 4

Medical Research 3

Forensic Services 2

Veterinary Research 1

100

Source: Submission to Committee of Enquiry into Pathology Services in South Australia; Part 1, p.21, January, 1980.

KANEMATSU MEMORIAL INSTITUTE, SYDNEY HOSPITAL

D.58 In 1929-30 the shareholders of F. Kanematsu (Australia) Limited provided funds for the establishment of an institute as a memorial to Fusajiro Kanematsu, the founder of the company, and his wife. The institute, called the Kanematsu Memorial Institute of Pathology of Sydney Hospital, was officially opened in 1933.

Initially, its main function was to supply the routine pathology services of Sydney Hospital, but it was felt that facilities should also be provided for medical research.

D.59 In 1935 the Board of Directors of Sydney Hospital decided that the

Institute should have a research function, and the Kanematsu Advisory Committee, appointed by the Board, took steps to establish a research department. The following year representations were made to the New South Wales Minister for Health and the Health Commission, but although the benefit of a research department to the Hospital's progress was recognised, no permanent endowment

fund could be established.

120

D.60 Dr J.C. (later Sir John) Eccles was appointed Director of the Institute in 1937 and held the position until 1943. By 1958 several programs of clinical research had been developed, and the Institute was reorganised into separate departments of clinical pathology and medical research, and its present name adopted.

D.61 The Institute remains an integral part of Sydney Hospital, and is

responsible to the Hospital's Board. The Clinical Pathology Department of the Institute continues to provide pathology services to the Hospital, and is funded almost entirely by the Health Commission of New South Wales. The Medical Research Department is concerned with both applied and basic research, and is administered by an advisory committee of the Hospital Board. Its laboratories are located adjacent to wards which accommodate patients under the care of the

Clinical Haematology, Renal and Cardio-Renal Units of the Department. Because Sydney Hospital is a teaching hospital of the University of Sydney, the Institute has strong links with the Faculty of Medicine at the University. In addition to the teaching programs within the Institute, many senior members of staff also lecture at the University.

Major R&D Programs

D.62 The Medical Research Department of the Institute contains seven units, each of which undertakes basic and applied research and provides clinical services in its particular area of expertise. The Department's research wards have a total of 37 beds, and include facilities for haemodialysis and a self-contained low- pathogen unit.

D.63 The Clinical Haematology Unit includes a group studying bone marrow and the control mechanisms which influence the production of white cells under normal conditions and in patients suffering from leukaemia and other blood disorders. A flow cytometry group is investigating changes which occur in various parameters of the cell cycle of leukaemia cells in bone and marrow, and a solid tumour group is examining the behaviour of cancer cells grown in culture. Other members of the Unit are studying lymphocyte populations and chromosome analyses of patients with leukaemia or lymphoma, and purifying nucleic acids from normal and leukaemic cells and examining their composition and characteristics. The unit provides diagnostic services in cytogenetic analysis, measurement of immunoglobin concentration in plasma, and analysis of T and B lymphocytes; all these are related to, and may assist, its research interests.

D.64 The Renal Unit provides a wide range of clinical services including renal transplantation, dialysis, general nephrology, and other studies of patients with renal failure. The Unit's research interests are closely related to these services, and include studies aimed at improving the long-term success of renal transplants and the optimisation of dialysis procedures, and the establishment of experimental

models of renal failure.

121

D.65 The Cardio-Renal Unit undertakes basic research on the control of renin secretion, and on the role of disorders of cation transport and blood viscosity in hypertension. Applied research has focussed on the evaluation of anti-hypertension drugs and their mechanisms of action, and on the development of a system of computer analysis of data from health screening services and drug trials. The Unit also provides a complete diagnostic service for hypertensive, fluid and electrolyte disorders.

D.66 Members of the Microcirculation and Histopathology Unit are examining the mechanisms which influence cell distribution in the blood microcirculation and the relationships between blood rheology and hypertension and vascular diseases.

About half the Unit's work is service-oriented, primarily histopathology consultat­ ions and development of new histopathological techniques for renal biopsy and the study of lymphomas.

D.67 The research of the Haemorheology and Biorheology Unit centres on the development of methods to identify viscosity factors which influence blood flow and thrombosis formation in ischaemic and occlusive disorders. Particular attention

is being paid to the kinetics and morphology of aggregation of red cells. Certain viscosity factors may, on occasion, be used to predict cardiovascular incidents, and it is intended that a viscosity profile will be developed for different disorders for use as a diagnostic tool. Cancer patients, diabetics and retinopathy patients are referred to the Unit for tests on blood and plasma viscosity and rigidity and aggregation of red cells.

D.68 Research in the Immunology Unit is directed to improved management of patients with malignant tumours. It includes basic research on factors released from tumour cells and their effects on the immune system, and more applied studies to assess host responses to tumours and to develop immunotherapy

techniques and immunodiagnostic assays to monitor tumour growth and detect recurrences. The effects of cigarette smoking on the immune response, and particular states of immunodeficiency, are also being investigated. A routine

clinical immunology service, including assays of immune function, is provided to the Hospital.

D.69 The main research project of the Dietary Research Unit is a comparison of the efficacy of different techniques of haemodialysis of patients whose dietary protein intake is assessed directly and by mathematical modelling.

Staff

D.70 The total staff of the Medical Research Department of the Institute in 1980-81 was 68, comprising approximately 60 percent specialists and research staff, 32 percent technical and nursing staff and 8 percent administrative staff. Taking

into account the time spent on clinical and diagnostic services and on teaching, it is estimated that the research component is equivalent to approximately 30 full­ time research staff.

122

Sources and Expenditure of Funds

D.71 Nearly two thirds of the specialist and research staff are supported by the Health Commission of New South Wales through Sydney Hospital, and about a quarter by research grants; the salaries of the remainder are derived from private donations. Technical and nursing staff are supported by the Health Commission and

from private donations. The Hospital and the University of Sydney provide the Department's infrastructural support including the salaries of administrative staff, accommodation, heating, lighting, cleaning, etc.

D.72 The total expenditure by the Medical Research Department of the

Kanematsu institute in 1980-81 was $1.318million, of which $0.752million was expended on research and activities related directly to it. The Department received research grants from the NSW State Cancer Council and the (USA) National Cancer Institute as well as from the NH&MRC. The major sources of income for 1980-81 are shown in Table D.16.

TABLE D.16

SOURCES OF INCOME FOR RESEARCH IN THE MEDICAL RESEARCH DEPARTMENT OF THE KANEMATSU MEMORIAL INSTITUTE 1980-81

Source $million Percentage i

Support provided through Sydney Hospital Grants -0.491 65

NH&MRC 0.112 15

Others 0.102 14

Miscellaneous 0.047 6

TOTAL 0.752 100

GARVAN INSTITUTE OF MEDICAL RESEARCH

D.73 The Garvan Institute of Medical Research was established with funds raised during the centenary appeal of St Vincent's Hospital in 1957, and was officially opened in 1963. Its name derives from the benefactor of a trust

established in 1962 to provide for the salary of a Director.

D.74 The Institute functions as a self-contained and largely autonomous division of St Vincent's Hospital, and until 1980 was managed by a sub-committee of the Board of the Hospital. The Garvan Research Foundation came into being in 1981, its aims being to acquire funds and to promote scientific and medical research at the Institute. The Foundation is operated through its management committee whose members are drawn from the Sydney business community, the

Hospital Administration and the Hospital Board. The committee now has responsibility for the affairs of the Institute.

123

D.75 In addition to its research activities, the Institute provides diagnostic assays and services, many of which are performed for patients at St Vincent's. As well, since its inception the Institute has adopted a policy of making its expertise and assays available to the New South Wales health service. This started as a

grace and favour exercise, but it grew into an important diagnostic service and in 1978 was approved by the Health Commission as a Clinical Laboratory of St Vincent's Hospital. This service now supplies hormone assays to seventy-four referring hospitals in NSW and is a State Referral Laboratory for Hormone Assays;

the Health Commission has also approved funding for staff of the Clinical Room of the Institute which is used for the collection of blood samples from outpatients and inpatients. Under the terms of the agreement with the Health Commission the clinical laboratory is accommodated within the Institute, has access to its

equipment, and is under the control of the Institute's Director. The Health Commission provides funds for the staff and operating expenditure and for rent to the Institute for use of space and facilities.

Major R&D Programs

D.76 The Institute's research programs are concerned primarily with various aspects of endocrinology, and there is a strong emphasis on the study of diabetes and its treatm ent. Current programs of basic research include: the measurement

of brain transm itter substances, and elucidation of their formation and function with particular reference to psychiatric illness and human drug therapy; a study of the cellular receptors specific for insulin and their significance in the onset of mature age diabetes; an investigation of growth-promoting substances and the control of human growth; and computer modelling of theoretical glucose-insulin interrelationships to allow identification of the most effective procedures for using

insulin in diabetic treatm ent.

D.77 The Institute also has a substantial program of applied clinical research. Work on the treatm ent of diabetes mellitus includes the development of techniques for computer-programmed insulin infusion, studies of autonomic neuropathy and of

susceptibility to hypoglycaemia, and an examination of immune factors which may cause difficulties for diabetic patients being treated with insulin derived from animal pancreas. Other clinical research is concerned with the growth of children and factors which may prevent normal growth, with pituitary tumours and the

influence of contraceptives on their formation, with the role of adrenalin and similar substances in hypertension, and with the relationship of chest infections to asthma attacks. There is also a project whose aim is the development of assays

to allow measurement and functional studies of gut hormones, and another in which assays are being developed for hormones associated with cancers. In collaboration with the CSIRO Molecular and Cellular Biology Unit the Institute is undertaking a project to develop monoclonal antibodies to human hormones for use in diagnostic

immunoassays.

124

Staff

D.78 The total staff of the Garvan Institute is 54, of whom approximately 54 percent are engaged in research or clinical investigation, 26 percent are technical and nursing staff, and 20 percent are administrative and maintenance staff. Approximately 20 staff members are involved primarily in providing diagnostic services.

Sources and Expenditure of Funds

D.79 The main sources of funds for the Institute are the assay service, project grants, fellowships and scholarships from granting bodies and research contracts. The assay service provides income via patients' fees and rent paid for use of the Institute's facilities. As an autonomous organisation the Institute has to obtain its own maintenance funds, and these are derived primarily from fees for assays undertaken for non-hospital, private patients. The total expenditure by the Institute in 1980 was $1.116million, of which expenditure on research was $0.674million. A summary of the sources of income for research in 1980 is shown in Table D.17.

TABLE D.17

SOURCES OF INCOME FOR RESEARCH AT THE GARVAN INSTITUTE OF MEDICAL RESEARCH 1980

Sources Amount Percentage

$millon total

Assay Service (assay fees, rent for facilities) 0.253 38

Grants NH&MRC Project Grants 0.194 29

Fellowships, Scholarships, contracts 0.087 13

Interest on Investments 0.033 5

Bequests and Donations 0.032 5

Miscellaneous 0.075 11

TOTAL 0.674

125

MEDICAL RESEARCH CENTRE, PRINCE HENRY'S HOSPITAL

D.80 The Medical Research Centre was established in the late 1950s as a

result of initiatives taken by members of the medical staff of Prince Henry's Hospital. Financial support was obtained from the Melbourne business community and, together with a grant of $54,000 from the Hospital's Board of Management, this enabled the first suite of laboratories and offices to be built and equipped in

the main Hospital block during 1963-64. The Victorian State Government provided a capital grant of $100,000 to the Centre in 1972, enabling further offices, laboratories and a conference room to be added. During the period 1975-79 the C entre's staff and equipment were progressively moved to a larger laboratory

building adjacent to the Hospital.

D.81 The Medical Research Centre is administered by an Executive Comm­ ittee which is an advisory sub-committee of the Prince Henry's Hospital Board of Management. The Committee consists of 16 members : three representatives of the Board of Management, two representatives of Monash University, two representatives of the Hospital's senior medical staff, the Director and up to eight other members from the spheres of business and industry; the Chairman is elected

by the Committee members. The Executive Committee meets monthly, and considers m atters of policy, particularly funding. The day-to-day administration of the Centre is the responsibility of the Director and Business Manager, with assistance being provided by the relevant Hospital departments for payment of salaries, purchasing etc.

D.82 The Medical Research Centre, being a part of Prince Henry’s Hospital, is automatically affiliated with Monash University, and is recognised for the purposes of postgraduate study. The Centre's Director is an Honorary Professor of Medicine at the University, and senior staff participate in undergraduate as well as

postgraduate teaching.

D.83 The main function of the Centre is to conduct research. In addition, as well as its teaching responsibilities, it provides certain diagnostic services including specialised hormone and steroid receptor assays, and conducts, in collaboration with the Hospital, an infertility clinic which includes facilities for ovulation induction,

semen analysis and artificial insemination.

Major R&D Programs

D.84 The Centre has three major programs of basic research. One is

concerned with the mechanisms of action of steroid hormones, with particular attention to their specificity; this group is also studying the molecular biology and physiology of the opiate peptides. The second program is in the field of

reproductive endocrinology, with emphasis on the regulation of gonadal function and feedback mechanisms from both ovary and testis, and the third is concerned with the mechanism of action of pituitary growth hormone, especially the characterisation of growth hormone receptors and the purification and charac­

terisation of somatomedins.

126

D.85 The Centre also undertakes several programs of applied or clinical research, many of them directly related to its interests in basic research. For example, the study of steroid hormones is allied to an investigation of the clinical significance of steroid hormone receptor assays in cancers of the breast, uterus and prostate, and the Centre has developed a service in such assays to assist prognosis and therapy. Clinical studies in the area of infertility include a search for

improved diagnostic and therapeutic techniques, assessment of new, orally-active androgens, and the characterisation of the testicular response to an injection of gonadotrophin. There is also research into the causes of short stature and the mechanism of growth retardation in thalassaemia, and a study of dietary aspects of diabetic control, including the effects of dietary fibre on insulin receptors.

Staff

D.86 The total staff of the Medical Research Centre in 1981 is 71, of whom 16 are part-tim e. Of the full-time staff, approximately 60 percent are engaged in research or clinical services, 30 percent are technical staff and 10 percent are administrative staff. It is estim ated that the research component of the Centre's

activities is equivalent to approximately 29 full-time researchers, including postgraduate and undergraduate scholars.

Sources and Expenditure of Funds

D.87 The Prince Henry's Hospital provides the Centre's accommodation and also maintenance items such as power, lighting, telephones, and minor repairs; in addition it provides assistance with accounting and purchases and pays the salaries of five staff members, including four who are members of the Hospital's

Department of Endocrinology. Staff engaged in the Centre's clinical services are supported through the fees-for-service collected, as are a proportion of the technical and most administrative staff. The remaining staff are supported from a variety of research grants, including one NH&MRC Program Grant and four

Project Grants. These sources are shown in Table D.18.

TABLE D.18

SOURCES OF INCOME FOR THE MEDICAL RESEARCH CENTRE, 1981 (ESTIMATED)

Source Amount

$mil!ion

Percentage of total

Research grants -NH&MRC (including one program grant) 0.466 44

Primary industry funds 0.040 4

World Health Organisation 0.020 2

Victorian Anti-Cancer Council 0.011 1

Other grants 0.048 5

Fees for clinical and assay services 0.200 19

Victorian State Government (grant requested) 0.100 9

Investments and other income 0.095 9

Donations 0.070 7

TOTAL 1.050 100

127

THE ROYAL NORTH SHORE HOSPITAL, SYDNEY

D.88 At the Royal North Shore Hospital, medical research is carried out by the Rolling Institute of Medical Research and in some 14 other departments. The co-ordination of this research effort is the responsibility of the Medical Research Council of the Hospital. The Council is appointed annually by the Board of the

Hospital, and comprises eight members associated with the Hospital, two executive officers to act as treasurer and secretary, and up to six further

members who need not be closely associated with the Hospital. The functions of the Council are to review all research within the Hospital and make recommend­ ations to the Board on expenditures for research and equipment, to approve appointment of research staff and allocation of laboratory space, and to explore

avenues for raising funds for medical research.

D.89 Research within the departments and professorial and special units of the Hospital covers a wide range of fields including general medicine, surgery, and obstetrics and gynaecology, details of which can be obtained from the biennial reports of research within the Hospital.

D.90 Much of the work of these departments and units is applied clinical research. It is funded primarily through grants from the NH&MRC, foundations and non-government research funds, and from donations by industry and individ­ uals. Total expenditure on research and development within the Hospital during

1980, excluding university departments and the Rolling Institute, was $0.684- million.

ROLLING INSTITUTE OF MEDICAL RESEARCH, ROYAL NORTH SHORE HOS­ PITAL, SYDNEY

D.91 The Rolling Institute has no formal constitution as a medical research institute, but functions as a department of the Royal North Shore Hospital. The Institute's Director is responsible to the Hospital Board in administrative matters, and to the Hospital's Medical Research Council in research and scientific matters. The appointment of the first full-time Director in 1974 was accompanied by a reorganisation of the Institute so that instead of being multidisciplinary, its

research and service activities had a central theme of immunology and related branches of medical science. The Institute has established close links and collaborative research projects with several other departments of the Hospital, including Rheumatology, Oncology, Renal Medicine, the Respiratory Investigation

Unit and the University Departments of Medicine and of Obstetrics and Gynaecology.

D.92 The Rolling Institute provides a service in clinical immunology to the Royal North Shore Hospital and to the Northern Health Region of Sydney; this involves consultations, patient care and laboratory services. It also undertakes several programs of applied and clinical research, for example, on the immuno­

therapy of cancers in humans.

D.93 Basic research at the Institute is centred on cellular and cancer

immunology and immunochemistry. The topics investigated include cell-mediated immunity involving macrophages, the interactions of macrophages and cancer cells, the pathogenesis of autoimmunity, and the potential for immunological control of the tropical disease filariasis.

128

Staff

D.94 The total staff of the Rolling Institute in 1981 was 26, comprising 10 research staff and 16 research assistants and support staff (including five whose primary involvement is with the clinical immunology service).

Sources and Expenditure of Funds

D.95 The Institute receives an annual grant from the Health Commission of New South Wales, together with general funds for the clinical immunology service and for positions from the Hospital's pool of laboratory posts. The Institute's Director is the holder of an NH&MRC Program Grant, and other grants are obtained from Australian and overseas sources. A record of the Institute's expenditure for the years 1975-1980 is provided in Table D.19, and a summary of the sources of income for 1981 in Table D.20.

TABLE D.19

EXPENDITURE BY THE ROLLING INSTITUTE OF MEDICAL RESEARCH, 1975-1980

Year Expenditu

Smillion

1975 0.127

1976 0.176

1977 0.240

1978 0.244

1979 0.279

1980 0.312

TABLE D.20

SOURCES OF INCOME FOR THE ROLLING .INSTITUTE OF MEDICAL RESEARCH, 198Da '

Source Amount Percent of

Smillion total

Fees for assay services 0.130 34

NH&MRC Program Grant 0.153 40

US National Cancer Institute 0.062 16

NSW State Cancer Council 0.032 8

Other Grants 0.007 2

TOTAL 0.384 100

(a) This Table does not include funds for the Institute's clinical immunology service nor for positions drawn from the Royal North Shore Hospital.

129

THE CANCER INSTITUTE, PETER MacCALLUM HOSPITAL

D.96 The establishment of the Cancer Institute by an Act of the Victorian Parliament in 1948 followed on from the formation of the Anti-Cancer Council of Victoria as a statutory body in 1936. From its inception, the Anti-Cancer Council, under the guidance of the Chairman of its Executive Committee, Professor Sir

Peter MacCallum, pressed for a specialist centre devoted to cancer treatm ent and research.

D.97 The charter of the Cancer Institute Board, as set out in the Act, was

for the establishment and management of a Cancer Institute for the purposes of research into and treatm ent of cancer and allied conditions, and for other purposes. The Board accepted three major responsibilities: treatm ent of patients;

education of medical, paramedical and scientific personnel; and clinical and laboratory research. The treatm ent section of the Institute was named the Peter MacCallum Hospital, and there are peripheral clinics in Victoria and Tasmania.

D.98 The membership of the Cancer Institute Board is limited to 14, one of whom is selected by the University of Melbourne and two by the Government of Tasmania; no more than three of the Victorian members may be medical practitioners. The Board's Research Committee advises on research planning and the allocation of funds. The Chairman of the Laboratory Research Division (currently the Head of the Biological Research Unit) is responsible for the day- to-day operation of the laboratory research activities, while the Director of

Medical Services is responsible for clinical research. In addition, all research involving patients requires the approval of the Board's Ethics Review Committee.

D.99 The Cancer Institute is now a comprehensive centre for oncology

comprising four divisions: medical; nursing; laboratory research; and administrat­ ive. It has established formal links with the University of Melbourne and with Monash University, and the Peter MacCallum Hospital is a teaching hospital

affiliated with both. In addition to providing training for M.Sc and Ph.D degrees, the Institute also offers postgraduate training for nurses and clinical training for therapy radiographers.

Major R&D Programs

D.100 The Cancer Institute is participating in several Australia-wide and international clinical trials related to chemotherapy of different cancers. However, its major research effort is undertaken in the Laboratory Research

Division, which has four units: Biological Research; Haematology Research; Experimental Chemotherapy; and Immunogenetics Research. The Physical Sciences Unit of the Medical Division, and the Computer and Bio-statistical Unit of the Administrative Division, are also actively engaged in research.

D.101 The Biological Research Unit is investigating the mechanisms con­ trolling growth and differentiation of normal and malignant stem cells, the effects of x rays on mammalian cell chromosomes, and the effect of electron em itters on nucleic acids. The Haematology Research Unit is examining disturbances of nucleic acid metabolism and of membrance structure in lymphoma cells, the action of drugs used in treatm ent of leukaemia, and improved methods of

preserving human blood cells and testing their function. In the Experimental Chemotherapy Unit the research is concerned with the action of chemical agents

130

on human tumour cells and nucleic acid, and work in the Immunogenetics Research Unit includes the study of retroviral-like particles in human tumours, examination of culture requirements and specific markers of breast cancer cells, and

development of serological markers using monoclonal antibodies for the class­ ification of human leukaemias and lymphomas.

D.102 In the Physical Sciences Unit the main areas of research and

development are in improving techniques for radiotherapy dosimetry, and in examining the tumour affinity of Gallium-67. Staff of the Computer and Bio­ Statistics Unit are developing a computer-based Patient Information Management System.

Staff

D.103 The total staff of the Cancer Institute in 1979-80 was 1,147, comprising 344 scientific and technical staff, 64 medical staff (effective full-time), 248 nursing staff, and 491 administrative and support staff. It has not been possible to estimate the number of staff engaged wholly or partly on research.

Sources and Expenditure of Funds

D.104 The total expenditure of the Cancer Institute for 1979-80 was

$19.6million, of which approximately $1.0million, equivalent to five per cent, was directed to research activities. It has not been possible to identify separately the sources of the research component.

CHILDREN'S MEDICAL RESEARCH FOUNDATION, SYDNEY

D.105 The Children's Medical Research Foundation was established in 1958 at the initiative of the late Sir Lorimer Dods. A committee including prominent Sydney men and women was organised with a brief to establish a research foundation to support and conduct research into the disorders of infancy and childhood. An initial public appeal raised the equivalent of $420,000, and a small research facility was built in the grounds of the Royal Alexandra Hospital for

Children. The facility was extended in 1972.

D.106 The Foundation is a private organisation, whose operations are the responsibility of a Management Committee which is a sub-committee of the Board of the Royal Alexandra Hospital for Children. The work of the Foundation is supported by income from its capital funds and from grants and donations.

D.107 For many years there has been a close relationship between the

Children's Medical Research Foundation and the Commonwealth Government Institute of Child Health; the latter functioned as the Department of Child Health of the University of Sydney, and is also situated in the grounds of the

Royal Alexandra Hospital for Children (see paragraph A.18). The links between the Foundation and the University were strengthened in 1979 with the creation of the position of Lorimer Dods Professor for the Foundation's Director. The present Director of the Foundation is also Director of the research facilities of the Institute of Child Health and it is likely that the two research groups will merge into an integrated unit in one building.

131

Major R&D Programs

D.108 The research activities of the Foundation in earlier years covered a wide range of subjects including rubella, microsurgical techniques, cardiovascular surgery, neonatal physiology, cystic fibrosis, congenital haemolytic anaemia, and several others. However, in view of the likely amalgamation with the research laboratories of the Institute of Child Health, the Foundation's research program has been reviewed and it is planned that future studies will be consolidated into three main areas.

D.109 One such area will be lymphocyte biology, a continuation of the current program at the Institute of Child Health which is concerned with the use of lymphocytes to establish param eters of normal cell metabolism, and to develop assays for a variety of enzymatic activities which will enable rapid diagnosis of

inherited metabolic diseases. The second program, in developmental biology and teratology, will be based on current research within the Foundation on the effects of alcohol and other drugs on the developing mammalian foetus. A new research program in neurobiology will be initiated. Some promising research projects within

the Foundation, for example, gene marker studies for cystic fibrosis, may also be continued. In the past, the Foundation has provided grants for research projects at the Royal Alexandra Hospital for Children.

Staff

D.110 The total staff of the Children's Medical Research Foundation in 1981 was 25, of whom approximately 45 percent were full-time research staff, 20 percent part-tim e research staff, and 35 percent technical and administrative staff. Some vacant staff positions are not being filled until a co-ordinated research plan is effected.

Sources and Expenditure of Funds

D .lll Public donations to the Foundation have been used to establish a capital fund now amounting to approximately $6million, the interest from which is the major source of income. The Foundation also receives grants and donations for specific purposes. A summary of the Foundation's income and expenditure for

1980-81 is presented in Table D.21.

132

TABLE D.21

INCOME AND EXPENDITURE OF THE CHILDREN'S MEDICAL RESEARCH FOUNDATION 1980-81

Amount Percentage

$ million of total

INCOME - Interest and dividends 0.639 73

Donations and contributions for specific purposes 0.224 25

NH&MRC grant 0.015 2

Other 0.003 -

TOTAL 0.881 100

EXPENDITURE - Salaries and wages 0.441 67

Consumables, travel 0.055 8

Maintenance and capital items 0.057 9

Grants made for specific projects 0.104 16

TOTAL(a) 0.657 100

(a) The surplus of income over expenditure is the result of unfilled staff positions.

ROYAL CHILDREN'S HOSPITAL RESEARCH FOUNDATION, MELBOURNE

D.112 The Royal Children's Hospital Research Foundation was established in 1960 under the Companies Act (1958) to administer and finance research within the Royal Children's Hospital, Melbourne. It is administered by a Board of Research comprising four members nominated by the Committee of Management of the Royal Children's Hospital, two nominated by the University of Melbourne, two nominated by the medical staff of the Hospital, two members appointed by the Board, and the Medical Director of the Hospital.

D.113 In 1967, a formal affiliation between the Foundation and the

University of Melbourne, through the Department of Paediatrics, was finalised, allowing postgraduate research students to study in the Foundation, and Foundation staff to be offered formal University titles. The agreement included arrangements for the appointment of a Director of the Foundation, who would

hold the title of Royal Children's Hospital Research Foundation Professor of Paediatrics.

D.114 There have been substantial changes to the administrative operation of the Foundation since its inception. From 1960 to 1972, the Foundation was directed by a chairman elected from heads of its research units. These units worked in the clinical disciplines of thoracic medicine, gastroenterology,

133

urogenital surgery and haematology. During 1972 and 1973, the clinical research units became clinical specialty departments of the Hospital, which continued to do research, but were no longer administered by the Foundation. For the period until 1979, the Foundation comprised only the Growth and Development Unit and

the Genetics Research Unit. In 1980, all research was again brought under the administration of the Foundation. Currently there is one large unit committed to research, the Genetics Research Unit, and there are research activities of varying size attached to a number of specialist clinical Departments and Units

of the Hospital.

Major R&D Programs

D.115 Genetic research, begun on a small scale in the 1960s, has built up to become the major research activity of the Foundation over the last decade. Inborn errors of metabolism constitute the central interest, with particular emphasis upon phenylketonuria and upon genetic disorders of copper metabolism.

The work aims to identify the basic biochemical causes of various genetic diseases, information necessary for the development of precise diagnostic techniques and for a logical approach to treatm ent. It is also valuable in

extending knowledge of normal biochemical and physiological processes.

D.116 Research into respiratory disorders was the first field developed in the Hospital before 1960. Subjects studied included bronchiectasis, cystic fibrosis, asthma and acute bronchiolitis. In recent years, the emphasis has been upon measurement of lung function and development of measurements applicable to children. In gastroenterology, important discoveries were made in coeliac disease, in cystic fibrosis and especially in disorders of sugar digestion and

absorption. In 1973, the most important single cause of infantile gastroenteritis in the world, the rota virus, was discovered. Work on this and other intestinal infections is continuing.

D.117 The Department of Clinical Haematology and Oncology is contrib­ uting to methods of drug therapy of leukaemia and other tumours and is also working on disorders of coagulation, especially haemophilia. The Immunology Department has studied both patients with very severe defects of immune

mechanisms and children whose susceptibility to recurrent infections suggest a less extreme disturbance of immune functions. This research, and that in endocrinology, related especially to androgen functions, have developed mainly in the last five or six years. Research on heritable disorders of connective tissue

has also been a recent development. Other areas of research have included diabetes and obesity.

D.118 The work of the Growth and Nutrition Unit, which commenced in 1973 and terminated in 1980, related to hormonal factors influencing growth at a cellular and biochemical level, with a particular interest in differentiating increase in cell number from increase in cell size and separating increased

synthesis of proteins or nucleic acid from decreased breakdown of these components. Trace-element nutrition in Aboriginals of the Kimberley region was also studied.

134

Staff

D.119 The staff of the Research Foundation in 1981 was approximately 50, including 20 research scientists, 15 postgraduate students, 13 technical staff and research assistants, and three administrative and technical staff. These numbers do not include the time devoted to research by full-time heads of clinical units and by staff of the Department of Paediatrics and the contributions of

secretarial staff in these departments.

Sources and Expenditure of Funds

D.120 The total identifiable expenditure on research by direct payments via the Foundation for the past decade is shown in Table D.22. Those payments made directly from the Hospital in the period 1973-1979 are shown as though paid through the Foundation.

TABLE D.22

ANNUAL EXPENDITURE OF THE ROYAL CHILDREN'S HOSPITAL RESEARCH FOUNDATION, 1971-1981

Year Expenditi

$million

1971 0.306

1972 0.330

1973 0.468

1974 0.537

1975 0.563

1976 0.563

1977 0.736

1978 0.862

1979 0.980

1980 1.019

1981 1.192

D.121 The sources of income for the Foundation in 1681 are shown in Table D.23. The principal source is an annual transfer of funds from the Royal Children's Hospital amounting to 40 per cent of the net receipts of the Good Friday Appeal of the Hospital. Grants for specific research projects from the NH&MRC and other research granting organisations constitute the bulk of the remaining income. The Foundation's anticipated expenditure for 1981 is summarised in Table D.24.

135

TABLE D.23

SOURCES OF INCOME FOR THE ROYAL CHILDREN'S HOSPITAL MEDICAL RESEARCH FOUNDATION, 1981

Source Amount

$million

Percentage of total

Royal Children's Hospital, from Good Friday Appeal 0.640 54

Royal Children's Hospital - special Grant for Equipment 0.100 8

NH&MRC 0.189 16

Leukaemia and Haemophilia Auxiliaries 0.078 7

Anti-Cancer Council of Victoria 0.021 2

Felton Bequest 0.020 2

Other Foundations 0.054 4

Interest and Donations 0.090 7

TOTAL 1.192 100

TABLE D.24

ESTIMATED EXPENDITURE BY THE ROYAL CHILDREN'S HOSPITAL MEDICAL RESEARCH FOUNDATION, 1981

Item Amount

$ million

Percentage of total

Genetics Research Unit 0.432 36

Hospital Departments and Units 0.526 44

Equipment 0.100 8

Animal laboratories and workshop staff 0.038 3

Administrative and overhead costs 0.070 6

Trainee fellowships 0.026 2

TOTAL 1.192 100

136

ST VINCENT'S SCHOOL OF MEDICAL RESEARCH, MELBOURNE

D.122 St Vincent's School of Medical Research was founded in 1952 as a result of a bequest from the late J. Holt, the income from whose estate was to be largely devoted to the establishment of a medical research institution at St Vincent's Hospital in Melbourne. The School began research activities in 1957, and has continued as a biomedical research institute since that time. St

Vincent's Hospital provides space for the School, which at present occupies one floor of the hospital Pathology Building.

D.123 St Vincent's School of Medical Research was incorporated as a

company limited by guarantee under the Victorian Companies Act in 1967, and has been approved as a recipient of tax deductible donations since March 1968. The School is governed by a Council of 13 members who include representatives from the administration and the senior medical staff of St Vincent's Hospital and from the University of Melbourne. The Director of Research of the School is a member of the Council. The School is administratively and financially

independent of the hospital, although there is close co-operation on a day-to-day basis. The School is not affiliated with any university.

Major R&D Programs

D.124 Initially, the major aim of the School's research was the development and application of methods for the determination of protein structure, and this led to the development of the 'protein sequenator' instrument which enables the determination of protein structure to be performed automatically and with a high degree of efficiency. This equipment is now manufactured by Beckman Instruments and is used in laboratories around the world.

D.125 Since 1974 the work of the School has been concentrated in the field of protein chemistry, and has resulted in a broad range of competence in biochemical disciplines, with special expertise in determination of protein structure, x-ray crystallography, and high-performance liquid chromatography.

D.126 The two major research programs of the School are an examination of the role of blood platelets, especially platelet release proteins, in the early stages of vascular disease, and a study of the structural and functional

relationships of polypeptide hormones. The latter program includes an investigation of autoimmune processes which impinge on endocrinology, and also production of supplies of purified human hormones to be used for experimental purposes. The School also maintains its interest in instrument development, and is studying automated techniques in protein chemistry which can be applied at the micro level in tandem with recombinant nucleic acid methods for

determination of macromolecular structure.

137

Staff

D.127 The staff at St Vincent's School of Medical Research numbers

between 15 and 20 people, approximately one-third research scientists, one- third technical staff, and one-third support staff. There are normally one or two visiting scientists.

Sources and Expenditure of Funds

D.128 At the outset the School was funded entirely by the Holt bequest. However this endowment, which averages approximately $55,000 per annum, is now sufficient to fund only the basic administration of the School. With an increase in the size of the School since 1957 and with increasing costs since that

time, the School relies for a major portion of its working income on research project grants and other bequests. At present it receives income for specific projects from grants via the NH&MRC and the National Heart Foundation, which provides salaries for all scientific staff and items of equipment related directly to the projects. The annual expenditure by the School over the period 1970-1980 is shown in Table D.25, and its sources of income and areas of expenditure in

1980 are summarised in Table D.26.

TABLE D.25

ANNUAL EXPENDITURE OF ST VINCENT'S SCHOOL OF MEDICAL RESEARCH RESEARCH, 1970-1980

Year Amount

Smillion

1970 0.068

1971 0.084

1972 0.074

1973 0.057

1974 0.061

1975 0.081

1976 0.081

1977 0.156

1978 0.236

1979 0.219

1980 0.307

138

TABLE D.26

INCOME AND EXPENDITURE OF ST VINCENT'S SCHOOL OF MEDICAL RESEARCH, 1980

Amount Percentage

$million of total

INCOME Legacies and bequests 0.123 43

Grants, including NH&MRC 0.087 31

State Government 0.042 15

Interest, dividends 0.028 10

Other 0.003 1

TOTAL 0.283 100

EXPENDITURE Salaries and wages 0.135 44

Equipment 0.079 26

Consumables 0.037 12

Maintenance 0.027 9

Sundries 0.028 9

TOTAL 0.306 100

MOUNT ROYAL NATIONAL RESEARCH INSTITUTE OF GERONTOLOGY AND GERIATRIC MEDICINE

D.129 In April 1975, an agreement was signed between the University of Melbourne and Mount Royal Hospital to establish a national research institute in the Hospital for the purpose of gerontological research and geriatric medicine. The Hospital agreed to provide facilities and support to the Institute, and the University recognised the Institute and the Hospital for the purposes of graduate research and teaching. As part of the agreement, the Director of the Institute has the status of a Professor within the University. Research operations at the Institute commenced in June 1977.

139

Major R&D Programs

D.130 One of the Institute's objectives is to conduct gerontological research covering social aspects of ageing, physiological and biological aspects and psychological changes, the aim being improved medical and social care of the

aged. In its four years of existence, the Institute has undertaken a series of projects relating to this objective. These can be divided into three distinct fields of interest: clinical geriatric medicine, including some epidemiological studies; nutrition; and social gerontology.

D.131 In clinical geriatric medicine, studies have been made on the

prevalence of Paget's disease, Huntingdon's disease and disturbed behaviour among elderly patients. Clinical investigations into the unwanted effects of drugs, and degenerative arthritis, are also currently underway. Nutrition projects recently completed have included the effect of admission to an

institution on the nutritional status of new patients, and a study on the effect of zinc supplementation on serum albumen concentrations in a group of hypoalbumenaemic and hypozincaemic elderly subjects. Studies are now underway into the effect of vitamin C supplementation of diet, and into the food

intake of patients who feed themselves poorly or require feeding, with the goal of developing a balanced diet which can be fed easily. In social gerontology, projects have been completed on retirem ent migration and its impact on the local community, on waiting lists for and patterns of entry to nursing homes, and on the need for a street visitor scheme for isolated aged people. Current

projects are concerned with investigations of social and economic aspects of retirem ent, of the provision and utilisation of day care in Melbourne, and of patterns of care in the last year of life starting with an analysis of place of death.

Staff

D.132 In 1980, there were four professional staff at the Institute, and a

nutritionist from Deakin University on sessional appointment.

Sources and Expenditure of Funds

D.133 The Institute is very largely dependent on an annual grant provided by the Health Commission of Victoria, with lesser amounts obtained from teaching activities and from the Mount Royal Hospital. The sources of income

for 1979-80 are summarised in Table D.27.

140

ψ

TABLE D.27

SOURCES OF INCOME FOR THE MOUNT ROYAL NATIONAL RESEARCH INSTITUTE OF GERONTOLOGY AND GERIATRIC MEDICINE 1979-80

Source Amount

$mi!lion

Percentage of total

Health Commission of Victoria 0.100 71

Mount Royal Hospital - contribution towards salaries 0.014 10

Teaching income 0.012 9

Research grants 0.008 6

Donations and dividends 0.006 4

TOTAL 0.140 100

THE QUEEN VICTORIA RESEARCH FOUNDATION, ADELAIDE

D.134 The Queen Victoria Research Foundation was established in March 1972 in Adelaide as an autonomous body with the object of supporting research into problems of obstetrics, gynaecology and neonatology. The Foundation is governed by a Council, members of which are nominated by the State Minister

for Health, the State Treasurer, the University of Adelaide, groups in the Queen Victoria Hospital and by the relevant medical colleges. There is also a Research Committee. The Foundation is closely associated with the Queen Victoria Hospital which carries out much of the research of the Foundation.

Major R&D Programs

D.135 During the first few years of its existence, the Foundation funded a limited series of small programs. Some of these consisted of trials carried out by hospital staff and supported by commercial companies which focussed on various aspects of obstetrics and gynaecology. However, in recent years a Pregnancy Environment Program, originally commenced as a pilot study in 1974, has become the major project. The aim of the Program is to build up a data bank of case histories of pregnancies with the eventual aim of determining the risks of specific drugs, stimulants and non-therapeutic chemicals in pregnancy.

Due to financial restrictions, data collection was recently discontinued and emphasis is being placed on analysis and publication of the results.

141

Staff

D.136 The staff currently working on the Pregnancy Environment Program consist of three professionals paid by the South Australian Government and one part-tim e secretary paid by the Foundation. Other staff are engaged

temporarily depending on demand and availability of funds.

Sources and Expenditure of Funds

D.137 The sources of income for the Foundation since it commenced

operations in 1972 are shown in Table D.28. Approximately 60% of income was derived from private donations with much of the remainder coming from the South Australian Government and the Queen Victoria Women's Auxiliary. In addition to the direct expenditures by the Foundation, the Queen Victoria

Hospital has provided, as part of its research program, the salaries of at least two research workers engaged on Foundation programs.

TABLE D.28

INCOME OF THE QUEEN VICTORIA RESEARCH FOUNDATION SINCE 1972

Source

South Australian State Government Queen Victoria Hospital Women's Auxiliary Lions International Pharmaceutical Companies and Industry Annual Subscriptions and Donations

TOTAL

Amount Percents

$million of total

0.025 15

0.034 21

0.004 2

0.005 3

0.096 59

0.164 100

LUDWIG INSTITUTE FOR CANCER RESEARCH

D.138 The Ludwig Institute for Cancer Research is an international

organisation whose purpose is to originate and conduct long-range research programs, to be carried out on a continuing basis in conjunction with hospitals in established medical centres, directed to the ultimate goal of eradicating cancer. It is neither the province nor the intention of the Institute to award grants for the conduct of research by others, in fact its charter excludes this, but rather that all research financed by the Institute should be carried out

exclusively by the Institute itself through its own appointed research staff.

142

D.139 To achieve its purpose, the Institute has adopted an organisational structure that will accommodate its present and future investigations within four main fields: human cancer biology, which is concerned with how and why a normal cell becomes malignant and grows to form a destructive tumour; human cancer immunology, which involves study of the mechanisms by which the emergence and growth of malignant tumours is restrained; human cancer therapy, in which the special properties which make malignant cells vulnerable to attack are uncovered and used to devise new treatm ents; and human cancer prevention, which will involve examination of factors which pre-dispose the body to tumours and application of this knowledge to prevent cancer.

D.140 The organisation was founded by Daniel K. Ludwig. Its basic

components are the Ludwig Branches. Eight already are in operation, two in England, two in Switzerland, two in Australia, one in Canada, and one in Belgium; others are to be established in the near future. Each will constitute a strategically placed research centre functioning as an arm of the Institute's

comprehensive strategy against cancer and conducting its research program within the framework of the four fields. In terms of financing and

administration, each Branch operates as an integral part of the Institute. As such, the full expense of each Branch's research work, including the salaries and other remunerations of the Director and his staff, and the running costs of the program, are met in full by the Institute.

D.141 In terms of scientific organisation and development, each Branch forms a working partnership between hospital staff and the research team, and is housed within an established medical centre. Each is developed within the academic and societal framework of the country where it is to be established.

Furthermore, each Branch will have a standing commmittee, drawn from both professional and lay sectors of the community, to assist the Director in the Branch's scientific development and in m atters of policy.

D.142 The primary planning task of the Institute is to decide what the

programs of the Branches should be, where each Branch should be situated in order to carry out its program most effectively, and who should be chosen to lead each program. It is the responsibility of the Scientific Advisory Committee to search for new opportunities for investigating human cancer, wherever in the world these occur, and to find the leading scientists who, as members of the Institute's research staff, will exploit these opportunities to the full by directing Ludwig Branches.

D.143 It is planned that the links that bind the Branches together will

include every means of communication that serves to foster the interchange of information and ideas; these will range from the effective dissemination of data, to the organisation of staff consultations and meetings to design joint research with distant Branches. The international character of the Ludwig Institute for Cancer Research will become increasingly manifest as the number of Branches grows, and its co-ordinating functions will become an increasing responsibility.

143

Sydney Cancer Therapy Branch

D.144 The Sydney Cancer Therapy Branch of the Ludwig Institute for

Cancer Research was established in Sydney University and at Royal Prince Alfred Hospital and in association with the University of Sydney in 1977. The University has made available laboratory space for an initial period of five years and the Hospital provides 30 beds and Outpatient facilities for the management of cancer patients referred to the clinical staff of the Branch. The Director and Associate Director were granted the honorary University titles of Professor and Associate Professor in a newly formed Department of Cancer Medicine, which is a component of the Faculty of Medicine, and as such they are responsible for co-ordinating undergraduate medical education in oncology for medical students of the University of Sydney.

D.145 From its formation, the clinical staff of the Sydney Branch, together with staff of the Hospital, have constituted the Royal Prince Alfred Hospital Department of Medical Oncology. The Sydney Branch was reviewed by an independent external Scientific Review Committee in January 1981.

D.146 The research program of the Sydney Cancer Therapy Branch was approved by the Sydney Branch Committee of the Ludwig Institute in 1976. The objectives of the research program may be summarised as:

• to evaluate cancer chemotherapy in a variety of tumour types;

• to establish a laboratory research program investigating the basis of selectivity and mechanisms of action of two classes of anticancer drugs, the nucleic acid antimetabolites and antifolates and the non­ steroidal anti-oestrogens.

D.147 The total staff of the Sydney Branch in 1979-1980 was approximately 45, 17 research scientists (including clinical investigators and postgraduate students), 20 technical staff and eight support staff. No financial details are available from the Institute.

Melbourne Tumour Biology Branch

D.148 The Melbourne Tumour Biology Branch of the Ludwig Institute for Cancer Research was established in 1980. It is affiliated with the Royal Melbourne Hospital, the Melbourne University and the Walter and Eliza Hall Institute. The Branch is able to participate both in the Hospital's training programs for medical graduates and the University’s postgraduate research program for higher degrees. It has laboratory facilities in the Clinical Sciences Building of the University and at the Walter and Eliza Hall Institute. The Branch's research program for the first five years will centre around the

molecular and cellular biology of epithelial cell growth. The total staff is expected to be 30, one half of which will be professional scientists and medical research personnel, one third technical staff, and one sixth administrative and support staff. All expenditure will be supported by the Ludwig Institute.

144

NATIONAL VISION RESEARCH INSTITUTE OF AUSTRALIA

D.149 The National Vision Research Institute of Australia was established in 1972 on the initiative of the Victorian College of Optometry, an affiliated College of the University of Melbourne. It was established because the College perceived the need for a new resource for research in the visual sciences that could undertake coherent and intensive programs of research on the disorders of vision. An appeal to optometrists throughout Australia and to industry raised nearly $0,2million which enabled the purchase of land and the construction of the Institute buildings adjoining the premises of the Victorian College of Optometry. This building came into use in December 1974. Additional space adjoining the Institute was leased in 1978 to provide animal housing and an additional laboratory. In 1980 this property was purchased to provide security of tenure and open the possibility of further building development.

D.150 The Institute forms part of the Victorian College of Optometry but is a separate division administered by a Board responsible to the Council of the College but with broad delegated powers. The Victorian College of Optometry is registered under the Victorian Companies Act 1961 and is affiliated to the University of Melbourne. It was founded in 1940 originally for the purpose of providing a four year post-secondary course in optometry, a responsibility since assumed by the University of Melbourne. The present day functions of the

College are to provide programs of continuing education in optometry, to foster research and to operate a public clinic. Under an agreement with the

University, the College accommodates the department of optometry of the University within its premises and provides access to the clinic for teaching and research purposes. The National Vision Research Institute has access to the clinic for research purposes and in addition makes use of the College library, dark room, electron microscope, lecture and conference rooms, and the technical

facilities of the College and the Department of Optometry.

D.151 Anyone with an interest in the work of the Institute may become a member on payment of an annual subscription which is currently $32. The Institute has 454 members, most of whom are optometrists, and membership is national in extent. In addition, corporations may become sustaining members. Both individual and corporate members are also invited to make donations. The Board of the Institute comprises seven members elected by the members of the Institute, one member appointed by the Australian Optometrical Association, a member appointed by the Council of the University of Melbourne, a member appointed by the Optical Distributors' and Manufacturers' Association, and two members appointed by the Governors of certain districts of Lions International. The President, Director and Secretary of the College and the Director of the Institute are ex-officio members of the Board, which usually meets twice yearly.

D.152 Being part of the College, the Institute is automatically affiliated to the University and is an approved laboratory for candidates proceeding to the degrees of Master of Science, Master of Science in Optometry and Doctor of Philosophy. The research staff of the Institute are associates of the University. The College and Institute are negotiating with the University to provide a more

formal liaison between the Institute and the University. An agreement has been drafted which provides inter alia for the Director of the Institute to be eligible for appointment as a professorial associate in the University with the right to use the title of professor.

145

Major R&D Programs

D.153 The initial research of the Institute concerned the visual capabilities of patients with reduced vision due to senile macular degeneration. This project was supported by the NH&MRC and developed useful new strategies for the assessment of the visual capability of people with low-vision which have been

widely adopted in low-vision clinics throughout the world. The second program of work, also supported by the NH&MRC, was an investigation of spatial processing mechanisms of the human visual system. This work was extended to make some far reaching studies of amblyopia, one of the common developmental

disorders of vision. More recently an integrated program of neurophysiological and psychological investigations of the post-natal development of vision has been initiated.

D.154 The current major focus of the Institute is in the area of

developmental disorders of vision. The Institute has established a program which integrates basic research on developing animals with clinical research on children suffering from amblyopia, a common and troublesome disorder of visual

development resulting in partial blindness of one eye. A number of animal models of this disorder have been established to allow fundamental investigation with the microelectrode and microscope. In addition to research on corneal plasticity, projects are being carried out on the dioptrics of the eye, the correal endothelium, and the retinal ganglion cell in one form of amblyopia in cats.

Staff

D.155 The Institute had 18 staff positions in 1981, including three visiting research fellows. There were the equivalent of 7.5 permanent, full-time research positions, five technical or research staff and two administrative and support staff.

Sources and Expenditure of Funds

D.156 The main sources of income for the Institute are membership

subscriptions and donations, NH&MRC project grants, and State Government grants. The Institute's income in 1978 was $0.1million, and in 1980 was $0.298million. The sources of income and estimated amounts for 1981 are summarised in Table D.29.

146

TABLE D.29

SOURCES OF INCOME FOR THE NATIONAL VISION RESEARCH INSTITUTE OF AUSTRALIA, 1981

Source Amount Percentage

$million of total

NH&MRC grants 0.164 56

Membership subscriptions and donations 0.041 14

Endowment income 0.054 18

State Government grant 0.025 9

Other 0.009 3

TOTAL 0.293 100

INSTITUTE OF DRUG TECHNOLOGY

D.157 The Institute of Drug Technology was originally proposed in 1965 and eventually established as a company limited by guarantee under the Companies Act in October 1975. The Institute was established as a contract research company in order to assist the pharmaceutical and related industries and to provide a service to the community. While the Institute is an autonomous company employing its own full-time staff, it is located on the campus of the Victorian College of Pharmacy and utilises the expertise of the staff of the

college.

Major R&D programs

D.158 As it is a contract research company, most of the Institute's research and development is undertaken for clients. Research includes the development and testing of both new pharmaceutical products and reformulations, together with programs involving the synthesis and preliminary screening of new chemical entities. In addition, the Institute undertakes drug testing of both humans and animals. This work involves continual development of techniques for extraction, detection and identification of drugs in biological fluids. The Institute is also committed to long-term research and development in the areas of product mixing and homogeneity.

Staff

D.159 The total staff of the Institute is eight, but is supplemented by a

large number of consultants from the Victorian College of Pharmacy and elsewhere.

147

D.160 The Institute has no shareholders and no capital. All funds are

obtained through contracting of research. Any surplus made is reinvested in research or donated to the Victorian College of Pharmacy to fund research at that institution.

Sources and Expenditure of Funds

NEW SOUTH WALES INSTITUTE OF PSYCHIATRY

D.161 The New South Wales Institute of Psychiatry was established in 1964 by an Act of the State Parliament. It is situated adjacent to Rozelle Hospital and has no formal university affiliations. It does not undertake research itself,

but in fulfilling its role of training postgraduates, medical practitioners and others in psychiatry, it provides Fellowships for research and training. The Research Fellowships are awarded for one, two or three years and the grantees generally undertake studies for the MD or PhD degree; the Institute does not determine the type of research undertaken, nor does it provide supervision.

D.162 The annual income of the Institute is approximately $0.460million, of which nearly 70 percent is provided by the NSW State Government. This is used to provide for the five staff of the Institute, its Fellowships, and the training courses which it organises from time to time.

148