This report published by The George Institute, The wider benefits of SGLT2 inhibitors, shows that making SGLT2 inhibitors widely available in Australia would save lives and reduce costs to society. 

1.7 million Australians have diabetes and around two-thirds also have cardiovascular disease, chronic kidney disease or both. Each year in Australia hospital admissions for cardiovascular disease and end-stage kidney disease cost over $6 billion.

SGLT2 inhibitors, a class of medication developed for the treatment of diabetes, have been shown to reduce the risk of cardiovascular disease and kidney failure.

The report found a $1 billion government investment over 10 years in SGLT2 inhibitor treatments would return almost $5 billion in benefits to society. In other words, every $1 invested returns almost $5 in benefits to society.

 A government investment of $1b in SGLT2 inhibitors treatment would prevent 4284 acute kidney injuries, 8744 end stage kidney disease patients, 4148 heart attacks and 7450 deaths over 10 years.  

This report provides the first estimate of the benefits this investment could deliver to Australian society.

“Our report provides important new data to complement current evidence, supporting prioritisation of investment in SGLT2 inhibitors in Australia, so they are accessible and benefit many more Australians,” Dr Clare Arnott, Senior Research Fellow at The George Institute and cardiologist at Royal Prince Alfred Hospital.  

Diabetes is the most common cause of chronic kidney disease and need for expensive dialysis treatment. People with diabetes and kidney disease are also at extremely high risk of kidney failure, heart attack, stroke and death.

In recent years, trailblazing research by The George Institute has shown that SGLT2 inhibitors not only reduce glucose levels in diabetes patients but also prevent cardiovascular events, such as heart failure, and slow kidney disease progression, reducing the need for dialysis.

The George Institute for Global Health welcomes the opportunity to make this submission to the Data Availability and Transparency Bill 2020 [Provisions] and Data Availability and Transparency (Consequential Amendments) Bill 2020 [Provisions] (bills) inquiry by the Senate Finance and Public Administration Committees.

The George Institute recommends the Senate support the passage of the bills. We believe they will mitigate risk and create opportunity for accredited users, that will most definitely include Australian health and medical researchers, to undertake research and development in line with community expectations.

In addition, The George Institute is pleased to outline as a case study our newly created online research register, Join Us. It is a piece of national research infrastructure that securely stores de-identified health data over the long-term for ongoing health and medical research. The passage of the bills will benefit Join Us as a potential future accredited user, which will help Australia increase its global competitiveness as a location to do world class research.

Read the full submission here (PDF 218 KB)

Over the past year, Australians have been deeply impacted by COVID-19. In response, the Australian Government has delivered stable and decisive leadership, world-leading infection control, economy saving JobKeeper and JobSeeker programs and now a national vaccine program.

The Government has much to be pleased with but the impacts have been large and the 2021-22 Budget will be about economic recovery and ‘building back better’. ‘Building back better’ was first coined by the United Nations in 2015 for risk reduction following disaster and is being applied to the post-COVID-19 recovery plans. The Organisation for Economic Co-operation and Development (OECD) encourages COVID-19 responses that “trigger investment and behavioural changes” and economic interventions that that will “reduce the likelihood of future shocks and increase society’s resilience to them when they do occur.”

To this end The George Institute for Global Health has identified ‘’building back better’’ opportunities in health and medical research. Investment in heathier societies produces broad societal gains but very clear economic returns – health research investment stimulates the economy, with every $1 invested in medical research returns $3.90 to the budget.

The George Institute’s submission, ‘Building Back Better: Investing in Five Medical Research Ideas’ recommends the Australian Government’s Budget 2021-22 supports and prioritises:

• Join Us: a national research register to increase our global competitiveness;
• Sepsis: reducing preventable death and disability;
• Gender equity: reducing sex and gender biases in research
• Aboriginal and Torres Strait Islander health; and
• The Health Innovation Hub: to turn ideas into products.

Download our 2020-2021 Pre-Budget Submission (PDF 484 KB)

The George Institute for Global Health made a submission to the review of the National Health and Medical Research Council’s (NHMRC) revisions to Chapters four and five of the National Statement on Ethical Conduct in Human Research.

The proposed changes in the NHMRC review recommend removing Aboriginal and Torres Strait Islander people as a priority population from section four of the statement.

The Institute’s Aboriginal and Torres Strait Islander Health Program Lead Keziah Bennett-Brook said: “There are clear processes that have been developed for research with and by Aboriginal and Torres Strait Islander researchers, human research ethics committees, representative bodies and communities. Their removal from the National Statement runs risk that these requirements will be completely overlooked”.

“While there are very legitimate concerns around linking vulnerability as inherent to Aboriginal and Torres Strait Islander peoples, completely removing the discussion about the systems and structures in which Aboriginal and Torres Strait Islander peoples experience vulnerability is very concerning”.

“Aboriginal and Torres Strait Islander peoples should not be framed as sick, disadvantaged and pathogenically vulnerable. However, it is still incredibly important that ethical considerations for Aboriginal and Torres Strait Islander peoples and communities are embedded within this National Statement”.

The George Institute awaits the outcome of the review.

The George Institute for Global Health is pleased to make a submission to the House of Representatives Standing Committee on Health, Aged Care and Sport in relation to their inquiry into approval processes for new drugs and novel medical  technologies in Australia.

The George Institute has developed novel medical technologies including Join Us: national research register, The Affordable Dialysis System, Polypill, the FoodSwitch App, and SMARThealth.

We believe there are several incentives the Australian Government can offer to research, development and commercialisation in relation to new drugs and novel medical technologies, particularly for non-communicable diseases. We recommend several measures to make Australia a more attractive location for clinical trials, and make the approval process for new drugs and novel medical technologies more efficient, without compromising safety, quality, efficacy or cost-effectiveness.

The George Institute has been a supporter of the Health Star Rating (HSR) system since its inception and remains keen to see the system achieve its full potential as a critical component of Australia’s response to diet-related disease.

We continue to systematically monitor the performance of the HSR system using our FoodSwitch database and app. While our research suggests the HSR system is performing well overall, it also highlights areas where the system must continue to be strengthened to retain consumer trust and support the achievement of its primary public health goals.

The George Institute welcomes the opportunity to engage with the Secretariat on the updated Calculator and Style Guide. While we broadly support the revised content of this document, this submission highlights areas where further clarity is required to give full effect to decisions made in the Five-Year Review.

To read our full submission please download the attached pdf.

The George Institute for Global Health was pleased to provide a response to the National Preventive Health Strategy (the Strategy) consultation paper in September 2020. 

To read our full response on the importance of a whole of system, life-course and systems approach to prevention please download the attached submission.

The burden of road traffic deaths is disproportionately high in low-and-middle-income countries (LMICs). In India, deaths due to road traffic injuries (RTIs) have increased by 58.7% between 1990 and 2017. In 2019, the Government of India amended the Motor Vehicles Act (MVA) on several counts including a hike in penalties and better enforcement measures to encourage safe road-user behaviour such as helmet and seatbelt use and deter drunk driving, over-speeding, and driving without license. However, several States are experiencing challenges in sound implementation of the act owing to the quantum in penalty hike.

Atal Bihari Vajpayee Institute of Good Governance and Policy Analysis (AIGGPA), Government of Madhya Pradesh requested the RES-TGI team for a rapid evidence synthesis to understand the evidence base behind the effectiveness of penalty measures in decreasing incidence and mortality due to RTIs. This would enable decision-makers in the State to better implement the MVA. The RES was conducted in 6 weeks to serve this purpose and the evidence-informed policy considerations were presented in a policy brief.

Key policy considerations:

1. There is no evidence from interventional studies on effect of financial penalties for violation of helmet and seatbelt laws in reducing road traffic injuries or deaths.
2. Fines in combination with license suspension, vehicle impoundment and demerit point system with or without jail sentences for excessive speeding violations may lead to statistically significant decrease in deaths due to RTI depending on context.
3. Financial penalties alone for drinking under influence of alcohol (DUI) violations does not lead to statistically significant decrease in road traffic fatalities and injuries.
4. Financial penalties in combination with jail sentences with or without license suspension
   for DUI violation leads to statistically significant decrease in road traffic crashes and injuries but in some studies, it was reported that the effect gradually wears over time. To sustain the effect, there is a need for sustained involvement of social groups or civil societies in advocacy and maintaining enforcement through local contextual reforms.
5. Mandatory fines with demerit points for DUI violations was shown to show a large and significant decrease, which was sustained over time in a study from Japan, but the law made both the bartender and the driver legally responsible. Institution of such laws may be considered.

Integration of different departments such as road transport, police, civil societies, judiciary, local bodies of the community groups and media are important in implementing and sustaining interventions.

Download policy brief (PDF 316 KB)

Download supplement document (PDF 452 KB)

The District Medical Officer (DMO), Malappuram, Kerala identified some undesirable and/or harmful postnatal care (PNC) practices being encouraged by post-natal care attendants supporting women for 40 days post-delivery. The DMO, with support from an action group of obstetricians in the district, intends to design and develop training modules to address the harmful practices, particularly in relation to nutrition and breastfeeding.

She requested our RES team to conduct a rapid review that could support her in this policy endeavour. The team together with the DMO concurred on summarising evidence on three relevant components:  recommendation from relevant guidelines on best practices for postnatal care, harmful postpartum beliefs and practices of mothers in India, and training of post-natal care attendants for post-natal care, nutrition and breastfeeding. This would provide the DMO with an evidence base to develop the training modules.

This policy brief provides a focussed summary of recommendations from guidelines on best practices related to Post-Natal Care (PNC) in Low- and Middle-Income Countries (LMICs) on improving nutrition and breastfeeding outcomes.

A few key policy options:

Postnatal visits/contacts

• Healthy mothers and newborns should receive care in the facilities for at least 24 hours post-delivery, if delivered in a health facility.
• The first postnatal contact should be as soon as possible within 24 hours of birth, if birth is at home.

Breastfeeding

• Mothers should be encouraged to exclusively breastfeed for about the first six months of a baby's life, followed by breastfeeding in combination with the introduction of complementary foods until at least 12 months of age.
• Breastfeeding should be continued for as long as mutually desired by mother
  and baby.

Nutrition

• Mothers should be advised to increase their intake of food and fluid, and to take foods rich in calories, proteins, iron, vitamins and other micro-nutrients.
• Iron and folic acid supplementation is recommended for at least three months
  post childbirth.

Family planning/Contraception and Immunisation

• Parents should be counselled on family planning, and the various contraceptive options available.
• Parents should be provided appropriate information on the benefits of immunisation.

Use of lay health workers in providing postnatal care

• Lay health workers should be used to promote exclusive breastfeeding, adequate nutrition and for providing iron and folate supplements during pregnancy.

Appropriate training should be provided to lay health workers and their trainers and supervisors on various key aspects of postnatal