Three key takeaways from our investigation into a $20b medical research fund

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In case you missed it, The Age and The Sydney Morning Herald last weekend published the findings of an investigation into the $20 billion Medical Research Future Fund (MRFF).

It’s a three-parter:

• A centre never built and a hospital that missed out: the Coalition’s ‘unusual’ $20b research fund
• ‘Conga line of scientists’: How $500m went to winners of a one-horse race
• ‘Not how you run a $1b scheme’: Science fund backers lead chorus for reform.

And you can read the wash-up here: ‘Everyone is incredibly cynical’: Momentum builds for overhaul of $20b medical research fund.

I spent several months working on these articles, interviewing more than 50 people and obtaining leaked documents as well as papers under Freedom of Information laws.

Here are three big takeaways:

Science funding is meant to be competitive, but the MRFF spent more than half a billion dollars on non-competitive grants that hadn’t been peer reviewed.

Of $2.28 billion given away by the MRFF between when it was established by the Abbott government in 2015 and September 20, 2022, some $449 million was in so-called “ad hoc” grants, plus another $56 million in non-competitive grants.

Ad hoc grants are non-competitive as well. They are generally meant to be reserved for urgent matters.

The MRFF itself, along with government grant guidelines, sets competition and peer review as cornerstones, as does the scientific community. Scientists don’t like being peer reviewed, but they accept it as a necessity.

“If there’s someone who’s better at doing the research than I am, even though it would sting, I’d rather they got the money,” Professor James Whisstock, deputy dean of research at Monash University’s Faculty of Medicine, told me.

If you’re going to run a non-competitive process, the projects you fund should be extraordinary and beyond reproach.

This was not always the case.

Millions of dollars in microbiome research funding flowed to a charity with little track record in the area.

A Centre for Excellence in Rural and Regional Health was announced in a marginal seat – but was never wanted and never built.

And tens of millions of dollars in non-competitive funding went to a vaccine development project, shocking other groups who were working on vaccines for the same virus.

Through his spokesman, former health minister Greg Hunt defended his administration of the fund, saying 91 per cent of project grants were peer-reviewed and awarded after a competitive process. All departmental funding recommendations were followed, he said.

Scientists knew about problems with the MRFF, but most were too afraid to speak out. That’s not healthy.

Dr Lesley Russell, an associate professor at the University of Sydney’s Menzies Centre for Health Policy, was one of the first to raise problems with the MRFF in 2019. Her analysis then was prescient.

Money had been allocated outside the fund’s established priorities, perhaps for political purposes, with a lack of transparency, she wrote for Croakey Health Media. But Russell could never get anyone to criticise the fund on the record. “No one spoke out loudly enough to be heard,” she said this week.

Since our investigation was published last week, scientists have been loudly proclaiming they knew about the problems all along.

So why the reluctance to speak out?

“The reality is that no one would have spoken [on] the record in case it jeopardised their chances with the minister,” Professor Felice Jacka, director of the Food and Mood Centre at Deakin University, wrote on Twitter, describing it as a “shocking situation”.

And researchers who did win MRFF funding “[worried] about upsetting the department and/or the minister,” one veteran science communicator, speaking anonymously so they could discuss the matter freely, told me this week.

“They get the department to review their media releases. And they make videos thanking MRFF.

“The ministerial influence wasn’t just at the funding stage. It continued through the projects.”

While that’s all within the MRFF guidelines, it’s unhealthy for science and for society. The scientific community should think about ways of ensuring any concerns in the future are raised.

Despite its flaws, the MRFF is really important. Getting rid of it isn’t the solution.

The big government agencies charged with funding science in Australia are “bottom-up funders”. Scientists put in their best ideas, and the agencies try – using peer review – to pick the best projects.

You can see the problems. Every scientist thinks their research is the most important. And you can end up funding high-quality but esoteric research.

And if there’s an area that is poorly researched, the researchers won’t have a track record – so they will struggle to get funded. A chicken-and-egg problem.

An Australian priority-driven funder has a really important role to play because it allows society to direct research.

It’s especially important because science is global, while our problems are often local.

Consider dementia versus, say, climate change. Whether or not Australia makes big advances, the global field of dementia research will continue pushing ahead.

But Australia faces a range of unique climate crisis risks that aren’t being researched globally. We can invest in the research we need to tackle the particular problems we face.

Australia’s Indigenous population has unique health needs and only we can do the research needed to tackle them.

One area our investigation did not touch on is the MRFF’s priorities, but it’s not clear these are set correctly either.

Consider the MRFF’s “missions” – their biggest research efforts: brain cancer, cardiovascular health, dementia and stem cell therapies.

These are not local problems – they are global. And Australia is a scientific minnow compared with the US or China.

As Professor Eric Morand, dean of clinical and molecular medicine at Monash University, told me: “The idea Australia will solve one disease because we throw a huge amount of money at it – the world just does not work that way.”

Liam Mannix’s Examine newsletter explains and analyses science with a rigorous focus on the evidence. Sign up to get it each week.