Tuesday, December 19, 2017

Climate change, health and the NH&MRC

A 2017 article in Nature Climate Change discusses the difficulty of obtaining support from the National Health and Medical Research Council (NHMRC) for climate change research; this was amplified in Australia by Sydney Morning Herald environment reporter Peter Hannam.

In this article Prof Andy Pitman commented that “scientists are deterred from applying to NHMRC grant panels for broad-ranging matters such as climate and health, which takes in physics, human physiology, sociology and economics”. I agree that research into climate and health requires an appreciation of these multiple dimensions. 

Nobel Laureate Prof Peter Doherty noted the subjectivity of the NHMRC review process. 

In 2007 the late Prof TonyMcMichael was awarded an NHMRC Australia Fellowship, on a climate change related topic. Its value was about $4M. I was employed by Tony under this grant for 4 years.

To my knowledge, six NHMRC “Centres of Research Excellence” grant applications concerning climate change have been submitted in recent years (2012, 2013,  2014 (*2), 2015 and 2016). Each of these involved 10 principle investigators and additional associate investigators. Of these six, only one (submitted in 2013) was short-listed. Each bid was very laborious and detailed, consuming hundreds, if not thousands, of person hours of effort of research scientists and university administrative staff. 

Most of these bids involved the two surviving Australian contributors to the health chapter of the IPCC (myself and Prof Helen Berry); the first also included Prof McMichael, who passed away in 2014. However, only one (the first in 2012) was led by a chief investigator based at a G-8 university (the ANU). A substantial fraction of the NHMRC assessment marks depend on the “research environment” – by definition non-G8 universities are disadvantaged, trapped in a kind of Catch 22. When I was at the ANU I did not pay much attention to that; when I moved to the University of Canberra in 2012 I became acutely aware of this handicap; not because the research environment (at least for climate change) was in fact lower, but because I felt we were judged more harshly.

I have long felt that the NHMRC’s funding priorities are unduly politicised; as Prof Simon Chapman pointed out, it seems hardly fair to identify wind turbines as a health priority, but not climate change (though I disagree with Prof Chapman about the  safety of wind turbines; I do think they can have minor adverse health effects for some people).

In 2014, discouraged by the reaction to the third NHMRC Centre of Research Excellence bid concerning climate change with which I had been involved (and the only I led), and a subsequent appeal, I wrote an essay about the NHMRC and climate change research called “Is Australia's NHMRC grant assessment process corrupted?

I truly felt our assessors in 2014 lacked more than a rudimentary understanding of the disciplines needed to fairly assess our application. Today, I feel exactly the same. Consistent with Prof Pitman’s comment, since early 2014 I have expended minimal effort in seeking NHMRC funds for climate change and health research, though I am aware others indeed have since tried very hard.

Climate change has been called the greatest risk to human health this century. While I think that is simplistic, and better framed as “climate change is a major health risk multiplier”, including for the global refugee crisis, nonetheless the NHMRC should have paid this issue much more attention, and have been far more supportive.

Let us hope this changes.

PS (added January 6, 2018)

Our proposal included the funding of 15 climate and ecological change related health projects (10 PhDs, 5 Post docs). I have included the titles and in some cases more details (the intellectual property of those with more detail is largely mine, though shaped in discussion with others).

These questions remain important and poorly understood; perhaps someone else will one day be funded to explore them.

Our team included the Australian Dept of Defence, several state health departments, the Red Cross and the Chief Veterinary Officer, as well as leading Australian researchers on these topics.

PhD 1 Emerging infectious diseases (EIDs), environmental change and new metrics
PhD 2 EIDS, environmental change and One Health in northern Australia

PhD 3 Environmental change, heat, Lissa virus and other EIDs. The Blood Service must maintain high confidence in its products in the face of changing EID risks. Research Question Do EIDs, including Lissa virus, threaten Australian blood safety? More bat-human contact is likely from environmental and social change.

PhD 4 Dengue fever and demographic an ecological change in northern Australia
PDP 1 Biodiversity and environmental change: health policy challenges for vector-borne disease
PDP 2 Integrated science strategies for management of human, livestock and wildlife health in Australia
PhD 5 Emergency events and the health system

PhD 6 Occupational health of Defence personnel exposed to extreme heat. Research Question: does a fit population, exposed to extreme heat, but without heat stroke, suffer harm? Method: Analysis of unique, rich occupational health dataset of Defence Health records, of sufficient size and quality, combined with Bureau of Meteorology (BOM) data (including humidity) to detect or exclude with high confidence currently unknown heat health effects. Comparison of work attendance patterns of Australian Defence personnel exposed to extreme heat in Australia with a more sedentary group of Defence employees largely in air-conditioned environments. These personnel, widely distributed in the continent, provide a unique natural experiment. Results globally relevant to emergency workers and others with enforced heat exposure, even if entirely negative, i.e. reassuring.

PDP 3 Falls, vulnerable urban populations and extreme heat. RQ: do vulnerable urban populations experience increased falls after extreme heat? M: analysis of linked meteorological and age-adjusted hospital admission data in major Australian cities comparing normal and “hot” summers. Excess death from heat is known, but the burden of disease from morbidity even more? Results also of global importance and may improve health system efficiency.

PhD 7 Urban transformation for health, resilience and adaptation. RQ: what approaches best support urban resilience, adaptation and transformation for health? Relevant issues include trade-offs between green space, heat islands, risk of bushfire and VBDs, car dependency and other urban determinants of chronic disease. M: Synthesis of the literature and case study approach analysing required transitions to infrastructure, governance and lifestyles to allow cities to become more resilient to environmental change.

PhD 8 Transforming health services in the context of environmental change.
PhD 9 Shrinking the health budget by increasing demand for well-being.
PhD 10 Health determinants and environmental change 
PDP 4 Health determinants and security
PDP 5 Environmental degradation and health