Opinion_

# Cancer research in the age of COVID

7 September 2020
The impact of COVID-19 on the wider cancer and research ecosystems in Australia
Professor Hugh Harley of the Cancer Council and University of Sydney reflects on the challenges and opportunities facing cancer research and care.

I doubt there is a single executive involved in not-for-profits or tertiary education in Australia who is not agonising about the difficulties for long-term viability posed by the COVID-19 crisis.

The challenge is not just to channel that energy to the right ends; it is to do so in a way which looks beyond individual institutions to the wider environment in which we all operate.

In cancer, for instance, the ecosystem is a complex mix of local health care workers, hospitals, specialists, researchers, philanthropists, governments, universities, charities, and, most importantly of all, patients and families. Tweaks in one place can ripple through the whole system.

A breakthrough by Cancer Council NSW’s Adjunct Professor Karen Canfell demonstrates this. She and her team, with collaborators, demonstrated how a shift from Pap tests for cervical cancer screening to DNA testing for the HPV virus could better combine with HPV vaccination to speed up the elimination of cervical cancer and save health care costs.

This single change to policy and practice required major adjustments across the health ecosystem including to laboratories, clinics, GP practices and the information provided to the general public. It means Australia now has the potential to be the first country in the world to eliminate cervical cancer.

Similarly, modelling work by Cancer Council’s NSW and Victoria teams shows that if participation in the federal government’s National Bowel Screening Program increased to 60 percent, 84,000 lives could be saved over a 25-year period, while also saving costs as the need for expensive colorectal cancer treatments falls.  As before, achieving that opportunity would require system-wide adjustments including public awareness.

At Cancer Council Australia, we are acutely aware that COVID-19 is having a profound impact on the wider cancer and research ecosystems in Australia.  We also hear loud and clear the Government’s gentle advice to the not-for-profit sector that we each need to become ‘match fit’.  In the early stages of the pandemic’s emergence in 2020 we convened one of the first major collaborations across cancer charities.  It ensured consistent messaging to cancer patients on how to manage their specific needs given their increased risk of death if infected.

Such collaboration is vital and our relationship with the university sector is critically important. The Cancer Council couldn’t do what it does without the deep and multi-pronged relationships it has with tertiary research institutions and teaching hospitals across Australia.

The Cancer Council couldn’t do what it does without the deep and multi-pronged relationships it has with tertiary research institutions and teaching hospitals across Australia.

For example, the Cancer Council in Queensland was one of the funders of the work by Professor Ian Frazer and Dr Jian Zhou to develop the HPV vaccine to eliminate cervical cancer.

We know what to say and do in response to crises impacting cancer because of the strong research collaborations we have with universities across Australia, delivering us the evidence-base we need for our policy and advocacy work.

This is not just the universities’ expertise, but their direct, tangible financial contributions. To cite an example I know well, for every $1 of research funding obtained from external bodies by the University of Sydney, the University will contribute an average of an additional$1.58 to cover expenses such as labs, equipment and salary components.

A reduction in research investment in universities will have a detrimental impact on the entire cancer ecosystem. It will undermine the Cancer Council’s capacity to do vital work, as well as the international impact of Australia’s research.  In thinking about the future, we can’t lose sight of why we do this – to reduce the burden of disease on patients and families.

At its core, the university system over the last two decades has been one where student fees subsidise university research. Of course, there are other legitimate approaches. But let’s not go down a new path without understanding all the impacts on the system, not just the immediately visible ones.

Professor Hugh Harley is Chairman, Cancer Council Australia and Professor of Practice (Global Economy) at the University of Sydney.