20 years of influence

For two decades, The George Institute has searched for new ways to influence health decision makers so that lives can be improved around the world, says Executive Director of The George Institute, Australia, Professor Bruce Neal.

When Bruce, a researcher specialising in cardiovascular disease, came to the Institute as its first research employee in 1999, he never dreamed what the team would have achieved 20 years later. But nor did he foresee the challenges they would need to overcome to ensure that the Institute's research breakthroughs were translated into real impacts on people’s lives.

Major early discoveries at the Institute came with the PROGRESS study and the ADVANCE trial which redefined the optimal approach to managing blood pressure in high risk patients. Together, the results from these studies had direct implications for the care of hundreds of millions of patients with diabetes or a history of stroke. But it soon became clear that many who might benefit were missing out.

“Early on, we just did science and tried to make research discoveries – did this drug prevent stroke? Did that lifestyle change improve blood pressure?” Bruce explains. “But we quickly realised this wasn’t enough. Because while our work was getting published in top journals, it wasn’t changing how people got treated. We had to go the next step and start figuring out how to get our discoveries used.”

“This has been a big focus for the second decade of the Institute. We still spend a lot of time trying to discover new treatments, the CANVAS studies in diabetes being a great current example. But we now put at least as much effort into figuring out how to influence the practical end of medicine – getting doctors to use treatments more effectively and getting patients access to life-saving treatments.”

The Institute put significant effort and resource into ensuring new discoveries were translated from academic journals into the clinical guidelines that doctors use to define patient care.

Work also began on new research programs designed to find innovative ways to influence government policies that could improve the use of medicines and consumer access to health care. This shift into the policy space soon spilled over into nutrition with Institute researchers starting to work increasingly hard on the behavioural and environmental causes of chronic conditions like diabetes, kidney disease and heart attack.

A major milestone in 2012 was the launch of the FoodSwitch program, developed by Bruce and the Food Policy Research Group. The FoodSwitch smartphone application allows the Institute to directly target the health behaviours of consumers and put the team on the map as key players in food policy in Australia.

FoodSwitch is a technology platform that collects and processes data about packaged foods. Currently active in 12 countries it holds detailed information on around 650,000 different food items. This information is shared with consumers through a mobile phone app, which has been downloaded by more than 500,000 users in Australia alone. Consumers can scan barcodes and see the healthiness of foods for themselves, at the same time receiving suggestions about healthier items they might want to switch to.

However, the broader objectives of the FoodSwitch program go beyond just influencing consumers.

“FoodSwitch allows us to bring accountability and transparency to the food system in a way that wasn't possible before. We know exactly what each company is selling, if it’s changing, whether it’s getting better or worse, and how one company stacks up against another,” Bruce explains.

FoodSwitch already has the potential to help millions of people live healthier lives, but Bruce believes that even more can be done to create a 'food revolution' and ultimately prevent many more people suffering from chronic illness.

“My dream is to have data that describes and tracks the entire world's food supply and to use this data to positively influence the way food is made, manufactured, consumed and marketed around the world,” says Bruce.

The Institute’s innovative approach of harnessing technology to combat chronic disease was recognised in 2016 when its program, TEXTCARE, won the Google Impact Challenge. TEXTCARE is a personalised text messaging program designed to support people with a range of chronic diseases. It uses sophisticated algorithms to deliver SMSs that encourage people to take their medications as prescribed, stop smoking, exercise or eat better.

The Institute also co-hosted the inaugural International Digital Health Symposium in 2018 with UNSW Sydney and the Australian Digital Health Agency, which brought leaders from 13 countries together with representatives of the World Health Organization, universities, industry and clinical medicine. Participants learned different global approaches to using digital innovation to develop inclusive, sustainable and high-quality healthcare systems.

Along with SMARThealth this suite of projects seeks to use technology to change the systems underpinning health care and change the way that we approach the treatment and prevention of chronic diseases all around the world.

“The Institute has a vision that encompasses the health system in its entirety, from the political, commercial and environmental factors contributing to ill health, right through to the care and behaviours of individuals,” Bruce says. “Alongside our huge geographic reach, the potential for positive impact on health is enormous.”

“By moving beyond just discovering the science, to figuring out how to also get things implemented, we’ve moved beyond many other organisations working in this space. It’s been a really important point of difference for us.”

Celebrating 20 years: Bruce’s top moments

• Landmark trials - “One of the very first studies we did was a stroke trial called PROGRESS, which identified a new treatment option applicable to about 50 million stroke survivors. Likewise, the ADVANCE and CANVAS trials identified effective new interventions that could improve the care of literally hundreds of millions of people with diabetes.”
• Inspiring better eating en-masse – “FoodSwitch is bringing unprecedented accountability and transparency to the food system. We now know exactly what manufacturers are selling, whether it’s getting better or worse – and how one company stacks up against another.”
• Becoming trailblazing influencers – “Committing large amounts of resource, time and effort to working on chronic diseases in China and India made The George Institute a standout on the global scene. Many other organisations have now followed our lead but we were out there at the pointy end.”