Overview

Health and the health system

As stated within the National Health and Medical Research Council Act 1992, NHMRC’s purpose is to pursue activities designed to raise the standard of individual and public health throughout Australia. NHMRC’s stated mission is ‘Building a healthy Australia’.

Individual and public health within Australia involves a broad range of factors, including population demographics, socio-economic status, education and international events. Another important factor is the health system.

Australia’s national health system is complex and made up of many components including (but not limited to): public education campaigns, general practice medicine, public and private hospitals, health screening and immunisation programs, community health services, public dental clinics, ambulance and emergency services, allied health, diagnostics, pharmacy, regulation and health protection.¹

Australia’s national health system is one of many globally. These systems are members of the World Health Organisation and other international collaborative bodies and programs, enabling collective action to address global health issues.

Research and innovation system

Constant research, translation and implementation efforts are necessary to ensure that health system components are as strong and functional as possible. It is through research that problems and opportunities are identified, and it is through translation and implementation that the new knowledge created through research is applied to address health system challenges and generate positive impacts on health.

As with the health system, Australia’s research and innovation system both benefits from and contributes to the knowledge generation, translation and implementation occurring internationally. This includes implementation of improvements relating to clinical practice, public health policy, health-related technology and pharmaceuticals. Notably, NHMRC plays a leadership role in global health research policy.

The research and innovation system includes a broad range of types of organisations including universities, research institutes, research translation organisations, research infrastructure providers and research funders.

Funding

NHMRC is one of a number of sources of Australian Government funding for health and medical research (HMR). Other sources include:

• the Medical Research Future Fund
• R&D Tax Incentive
• Research Block Grants
• Australian Research Council
• the Cooperative Research Centres program.

Apart from the Australian Government, other sources of HMR funding in Australia include state and territory governments, the private sector and philanthropy. Some Australian research is supported by funding sources located overseas.

NHMRC’s grant program

While NHMRC fosters medical and public health research and research training in a range of ways, a key mechanism is its investment in research using funding from the Medical Research Endowment Account (MREA).²

Objectives and outcomes

NHMRC’s objectives when funding health and medical research are to:

• ensure that Australia undertakes the research needed to meet current and future health challenges, improving population health, patient outcomes and the effectiveness and efficiency of the health system
• ensure that Australia has the research capability and capacity needed to underpin a world-class national health care system
• support research of unique importance to Australia that is unlikely to be undertaken elsewhere.

The intended outcomes of this support are a national health system that is:

• increasingly effective and efficient in meeting current health challenges
• innovative and agile enough to respond to emerging and unforeseen health challenges
• able to support needs of unique importance to Australia and the public.

Informed by Strategic, Health and Structural Priorities, NHMRC seeks to meet its funding objectives by primarily supporting an investigator-led funding system that provides maximum flexibility about how and what research is undertaken, including by supporting research:

• that is high quality leading to scientific discovery, innovation and improvements in individual and public health
• with breadth across the spectrum from basic science, clinical medicine and science, public health and health services
• in diverse environments including in laboratories, clinics, hospitals and the community
• through the pipeline from discovery, to translation, implementation and commercialisation
• in single disciplines, or interdisciplinary and multidisciplinary
• for individuals, teams, networks, collaborations and partnerships
• led by researchers spanning career stages from early, to mid and more established
• that enables national and international collaborations.

Applicants apply for funding through NHMRC-accredited Administering Institutions (AIs) that can demonstrate the necessary infrastructure (policy, ethics, financial, and so on) to appropriately manage high quality research.

NHMRC allocates funding using competitive processes of peer review where scientific and other experts independently assess applications against published assessment criteria. To receive funding, individual applicants or teams of applicants must demonstrate to reviewers that they will generate important new knowledge and that they have the capability to do so.

The process of peer review involves experts assigning scores to grant applications, with those applications receiving the highest aggregate scores being the ones funded. For some schemes structural priority funding is allocated to support additional high-quality applications in priority areas (for example, Aboriginal and Torres Strait Islander researchers and research or gender equity).

There are usually far more fundable applications (that is, applications deemed of sufficient quality to merit funding) than there is funding available to support them.

Grant schemes

NHMRC’s grant program was last revised in 2019 (details about the review are available on the Australian Web Archive, Trove). It consists of a portfolio of schemes. The schemes were designed in consultation with the HMR sector and with the approval of the Minister for Health.

Each grant scheme differs from the others with respect to:

• its objectives and intended outcomes
• who is eligible to apply
• its assessment criteria and criteria weightings
• the amount of total MREA funding that it is allocated.

While schemes are designed to achieve different but complementary outcomes, the use of a range of schemes of different types also helps to mitigate against the risk that valuable research will not receive funding because it is not competitive within the context of a particular type of grant scheme. Differences between schemes exist so that the schemes can, collectively, ensure broad health research system capability and capacity.

Most NHMRC grant schemes use an ‘investigator led’ funding approach where the research topics within grant applications are chosen by the applicants. However some, such as NHMRC’s Targeted Calls for Research (TCR) and International Collaborative Schemes, use a ‘priority driven’ funding approach which involve a call for applications focused on a particular topic (for example, a disease area). Priority topics are also sometimes run through other schemes.

The process for selecting TCRs involves identification of possible topics by NHMRC’s committees, the Australian Government, States and Territory governments or community and professional groups. Proposed TCR topics are prioritised by NHMRC’s CEO in consultation with relevant committees and once approved the detailed scope of the TCR is developed in consultation with experts.

People and projects

Each component of the grant program supports both people and projects.

Cumulative scores provided by peer reviewers indicate the level of excellence, of either people or the project described in an application, against the assessment criteria for a given scheme, with the most excellent people and promising ideas being those that are ultimately funded.

While the specifics of assessment criteria differ between schemes, there are also broad commonalities across the schemes.

People

Assessment criteria related to people include:

• Track record – publications, past research outputs and research impacts
• Leadership – contributions to the research project; supervision, mentoring and training; peer review of publications and grant applications; engagement and advocacy
• Capability – access to resources, infrastructure, equipment and facilities; expertise; experience and training; team diversity, multidisciplinarity and collaborative gain.

Projects

Assessment criteria related to the project include:

• Research quality – project aims and proposed research plan, underlying hypothesis/rationale, study design and approach, management of scientific and technical risks
• Innovation and creativity – level of expectation that the project will result in substantial shift in the current paradigm, and/or lead to breakthroughs or impact in the research area
• Significance, relevance and likelihood to influence policy and practice – proposed research addresses issue of importance to advance the research or health area
• Knowledge transfer – project will transfer research outcomes into knowledge gain, health policy and/or practice
• End-user involvement – project involves consumers and the community in the planning, implementation and uptake of the research program
• Workforce development – project provides opportunities to advance the training of new researchers and to develop the health and medical research workforce
• Facilitate collaboration – project will include working collaborations, intellectual exchange and relationships with other groups in the particular fields of research; integration and cohesiveness of the team; the capacity to develop and/or sustain a strong partnership
• Indigenous excellence – designed to ensure that proposed research into Aboriginal and Torres Strait Islander health is of the highest scientific merit and is beneficial and acceptable to Aboriginal and Torres Strait Islander peoples and communities.

Principles and policies

The grant program is also underpinned by principles and policies, each of which may be subject to evaluation.

NHMRC operates on the assumptions that:

1. teams of researchers and health-system workers, whose work is relevant to all areas of the national health system, are able to apply for NHMRC funding and will do so when appropriate
2. funded research teams will seek to generate important new knowledge and, where possible, to translate and implement it through one or more pathways to impact
3. the implementation of this new knowledge will contribute to improvements to health and wellbeing.

Given these assumptions, NHMRC’s primary goal, with respect to the administration of its grant program, is to provide funding opportunities to all research relevant for human health, while also removing any obstacles or barriers, both actual and perceived, that may exist to research teams being able to apply for and/or attain funding. NHMRC also seeks to ensure that it has not, itself, embedded obstacles within the program.

In order to accomplish these goals, NHMRC works with Administering Institutions, funded research teams and peer reviewers, to ensure that they operate in accordance with certain principles and policies.

Principles

Principles – such as those listed in Box 1 below – are aspirational statements relating to how an organisation operates or the desired outcomes of its activities. As these are aspirational statements, NHMRC can hold itself to account, or be held to account by a stakeholder, with regard to whether it has behaved in accordance with them. A principle might also be considered as an ‘antidote’ to a behaviour or an outcome that would be more likely if NHMRC didn’t have that principle for guidance.

Policies

While maintaining flexibility and breadth, NHMRC policies support better sector practice and contribute to the sector’s social licence to operate in Australia and consumer confidence in the research NHMRC funding contributes to. These policies include those relating to:

• the responsible conduct of research
• the role of human beings, children and animals in research
• ethics, integrity and probity
• intellectual property and open access
• safety monitoring and reporting in clinical trials involving therapeutic goods.

¹ Australian Institute of Health and Welfare. Health system overview. Release Date: 2 July 2024. Accessed from Health system overview - Australian Institute of Health and Welfare

² The MREA is a 'Special Account' for the purposes of section 80 of the Public Governance, Performance and Accountability Act 2013 (PGPA Act) as per section 49 of the National Health and Medical Research Council Act 1992 (NHMRC Act).