Medical Research Future Fund: can it deliver for rural and remote Australia?

Announced in the 2014-2015 Federal Budget, the $20 billion Medical Research Future Fund (MRFF) is the single largest boost to research funding in Australia’s history. But can it deliver real improvements in health for rural and remote Australians?

Rural and remote Australians continue to experience poorer health outcomes than those in major cities. This is associated with levels of disadvantage across a range of factors, including education and employment opportunities, income and access to health services.

The MRFF is a landmark investment in research to improve health outcomes across Australia while fueling jobs, economic growth and exports. It has significant potential to stimulate research and innovation in rural and remote Australia and improve health outcomes.

As outlined on the Department of Health website, the MRFF is governed by the Australian Medical Research Advisory Board, which is responsible for developing a five-yearly Australian Medical Research and Innovation Strategy and a two-yearly set of Australian Medical Research and Innovation Priorities.
 
The Strategy and Priorities are largely silent when it comes to the unique health issues facing rural and remote Australians. Of the seven programs where the MRFF has invested, only one – the Rapid Applied Research Translation Program - has an explicit focus on the health of those Australians living outside major metropolitan areas. The Rapid Applied Research Translation Program provides funding to accredited Advanced Health Research and Translation Centres (AHRTCs) and Centres for Innovation in Regional Health (CIRHs).

AHRTCs and CIRHs are internationally peer reviewed and accredited by the National Health and Medical Research Council (NHMRC). Based on the internationally recognized model of ‘Academic Health Centres’, AHRTCs and CIRHs bring together universities, research institutes, health services and other stakeholders for the provision of research-based  and evidence-based health care and health education. There have been seven AHRTCs recognized in Australia, with the majority based largely in metropolitan areas. Together they have been allocated over $40 million in funding over three years from the MRFF.

The CIRH initiative was established to recognise leadership in health research and translation health research of direct relevance and benefit to regional and remote areas of Australia. Two centres have achieved designation: NSW Regional Health Partners; and the Central Australia Academic Health Centre. Each of these CIRHs has been allocated $6.1 million over three years to deliver research programs of relevance to the communities they serve.

The CIRH initiative provides much needed recognition of rural, remote and regional Australia as a place where excellence in research, education and health care can thrive. However, the current imbalance between the number of designated CIRHs and AHRTCs brings into question whether the initiative is an effective means by which rural and remote areas can access and engage with the MRFF. The NHMRC has announced another designation round for AHRTCs and CIRHs to open in October 2018 and this may go some way to addressing the current imbalance.

The MRFF is a significant milestone in the evolution of health and medical research funding in Australia. As outlined by the Australian Government, its aim is to deliver improved health for all Australians, support a more sustainable health system and build the economy. But if rural and remote Australians are unable to engage effectively with the MRFF, there is a real risk that the MRFF will contribute to a further widening of the gap in patient experience and outcomes between rural/remote and metropolitan areas of Australia.

The 2018-2020 MRFF Priorities are currently under development. It is hoped these Priorities will deliver further opportunities for rural and remote Australia to benefit from MRFF investment.