This content relates to a former minister

Doorstop interview on 25 October 2020

Read the transcript of a press conference with Minister Hunt and AMA ACT President, Dr. Antonio Di Dio about funding for new treatments for cancer and multiple sclerosis and COVID-19.

The Hon Greg Hunt MP
Former Minister for Health and Aged Care

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Good morning everybody, and well done for making it after a glorious Richmond premiership last night, which gives hope to all Australians.

I’m actually delighted to be joined by Dr. Antonio Di Dio, the President of the ACT chapter of the Australian Medical Association today.

And today is in fact a day of real hope for all Australians on many fronts.

Through the course of what has been the most challenging health year since the Spanish flu and in many ways the most challenging year for Australians since the Second World War, Australians have done an extraordinary job and our medical professionals have been heroic in the course of our coronavirus response.

At the same time one of the most critical things has been to maintain our commitment to and our engagement in supporting the broader health needs of Australians.

One of the more essential services, which was provided for in the Budget, but more generally, is the Pharmaceutical Benefits Scheme that supports the provision of medicines to Australians, which they might otherwise have never been able to have afforded.

In this Budget, we were very pleased to announce support for Lynparza for ovarian cancer; 300 women who would otherwise have to pay $140,000 are now able to afford that medicine.

Equally, we were able to support a combination for liver cancer of Avastin and Tecentriq. Five hundred Australians will have access to a lifesaving medicine, life-improving medicine, which would otherwise cost $170,000.

Today I am delighted to add to those announcements with the news that from the first of November for patients with multiple sclerosis, in particular with secondary regressive multiple sclerosis, 800 patients will have access to Mayzent.

This would otherwise cost $25,000 per year, beyond the reach of the vast majority of Australians. And instead, under the Pharmaceutical Benefits Scheme they’ll pay either $41 or, at the most, $6.60 as a subsidised payment per script.

What that means is that this medicine will be life-changing for so many families, and Anthony was talking to me about his work with patients with MS.

At the same time, we’ll also be supporting patients with a form of cancer, cutaneous T-cell lymphoma.

It generally presents as a dermatological condition. And Uvadex will be made available for, it’s only 75 patients a year that will benefit.

But a medicine which would otherwise cost almost $3,400 a year will become available and that makes a massive difference to the lives of these patients.

So when you think of liver cancer, ovarian cancer, lymphoma and, in particular, today we focus on multiple sclerosis, a condition where over 70 per cent of the patients are women, which is progressive and degenerative and which can have such an impact on people.

These are life-saving or life-changing medicines.

At the same time, whilst we make this progress on our health front and we see the real hope that’s being provided, there’s great hope around Australia in our response to coronavirus.

We know that in the last 24 hours there have been 7 cases and zero lives lost. Around the world, we have now seen four consecutive days of over 400,000 cases and the last three full days of figures have been the three highest days ever recorded, with regards to COVID-19 numbers.

Outside of Australia the world is facing enormous challenges. Inside Australia the bubble that we’ve created, the work of our medical professionals, the work of our community, the work of all Australians is something that should give us an immense sense of hope.

We can do this, we can continue to work our way through this.

We know, however, that at the same time there are immense challenges for mental health.

In the last week, we’ve seen the figures coming out of Victoria: a 31 per cent increase in MBS subsidised mental health services compared with the previous year, a 77 per cent higher rate of use of mental health services for Beyond Blue.

And of deep concern, it’s a real personal cause and passion, is the fact that eating disorders for younger Victorians are up 40 per cent year on year in terms of presentations. And that’s an insidious and agonising condition.

So that says that what we’re facing in Victoria is a dual challenge: working our way through COVID-19, and the numbers have reduced dramatically and I think in a way which provides deep hope, and at the same time supporting people for mental health.

It says that the balance has changed. That which has been achieved has allowed us to move forward.

So what we see now in Victoria is a 14-day rolling average of under five; well under the standard set by Victoria, well under the standard set by the Commonwealth Chief Medical Officer.

And on that basis the Commonwealth position is that Victoria should be recognised for where it is now; that it’s in a position where numbers are low and with a strong testing and isolation regime.

It’s therefore in a position to take the next steps to opening up safely, and we hope and we commend to Victoria that the Commonwealth will support them in moving to those next levels of reduced restrictions, in line with New South Wales.

We’ve seen how a strong testing, tracing and isolation system can allow a state to manage through the challenges of this.

Over 400,000 cases a day for the last four days, consecutively, globally.

In Australia, seven states and territories, zero community cases yesterday. One state, with seven.

And that means we are in a strong position, and there should be no barrier to Victoria taking those steps in line with New South Wales.

And they have improved their systems and we want to commend and acknowledge that improvement.

Obviously there is more to go, but they have significantly improved to a level where, in our view, they are capable of managing small case numbers, because if we do not do that, then we see the risks to mental health and health, which have been so sadly evident in the numbers.

But all up, it’s a day of great hope. Antonio?


Thank you, Minister. We at the Australian Medical Association are always delighted to see our patients supported, particularly those who are most vulnerable and those for whom we have identified a potentially tragic outcome and for whom there is some help.

That help is tantalizingly out of reach almost always due to financial or logistical considerations.

One of the things that has broken my heart on a regular basis over the last 25 years is the journey that you make with your patient over months or sometimes many years from a presentation to a diagnosis, to a treatment, to a treatment that has failed, to a second and a third and a fourth treatment that has failed.

And you finally are able to say to your patient: look, something new has come along, it’s experimental, it’s now no longer experimental, it’s going to work.

And the patient looks at you with hope and happiness in their eyes and then you take that hope away from them by saying how expensive it is and suddenly they wish that you hadn’t even told them at all.

So whenever these sorts of announcements come along when something that is truly out of reach of a whole range of patients suddenly becomes accessible, it is something that we should all celebrate.

In particular with multiple sclerosis, which is a lot commoner than some of the other conditions listed here. But I think all of my GP colleagues have patients with progressive illness who simply have a very, very difficult life for themselves and for their families. So we’re delighted with this announcement today.


Happy to take any questions.


I guess I have two questions. One for Dr. Antonio and one for yourself. Dr. Antonio, I guess my question on this is – you spoke about patients who will benefit.

I know you can’t talk about specifics but just aside from the cost what are the other benefits of a drug like this for someone with MS?


From a pragmatic point of view, you look at your patient as a whole person within a whole family.

And so if you are able to relieve the suffering, the symptoms specifically, that’s a fantastic benefit to the whole patient.

If you’re able to restore mobility or restore the ability to return to the workplace or restore ability to reconnect with family and friends, not only does that benefit the patient, but it usually benefits a long-suffering carer and a family of children and loved ones who all have their quality of life increase.


Minister, I just wanted to ask you. Karen Andrews this morning said on Insiders that the production of a successful vaccine could take up to 12 months if it was non-protein based.

Is that consistent with what you understand?


We have a range of options, so there’s no difference there. But we’re in a fortunate position.

We have a protein-based medicine in terms of AstraZeneca, the Oxford University vaccine. Their trials have recommenced in the United States and we’ve seen that they’re going through that process.

So our advice remains that the first reception is likely to be in the first quarter of 2021.

And there’s no surprise here that the earliest patients will, on the advice of the medical expert group, be those primarily within the health sector.

We have a million health workers in Australia and if the indication is approved for this purpose, obviously for the most frail elderly, but that’s dependent on the approval. So it’s progressing well.

We also have the University of Queensland molecular clamp that the Prime Minister visited and was just amazed at the ingenuity of Australia’s researchers.

CSL is aiming to make sure that that vaccine is available during the course of next year about the middle of the year. So we have a pipeline of vaccines.

In addition to that we have the COVAX Facility. COVAX means we’re part of an international grouping which allows us access to about 25.5 million units of any of the potentially successful medicines.

So we’re actually in a strong place for commencing the delivery in the first quarter of next year.


Dr. Antonio, just on the MS drug, how does it actually work and does it basically just improve the quality of life?


I wouldn’t even pretend to be able to describe to you exactly how it works, but the functional outcomes are what we are excited about.

Most drugs operate either by improving quality of life or quantity of life or both.

That’s their raison d’être and that’s how they get themselves into a position where they can negotiate with government about saying we are worth the money that you’re spending on us.


Minister Hunt, we understand that Victoria is not going to make significant announcements today.

What Daniel Andrews said yesterday that people should be tempering their expectations and (inaudible) they’re worried about these smaller clusters.

What would be your reaction to that if there isn’t a significant easing today?


I think many people would be deeply disappointed given the mental health impacts, given the health impacts, given the profound consequences for people who’ve invested their life savings.

We’ve reached the time when Victoria said that they were looking to move forwards. Their own time frame, their own timetable.

We’ve always said that there’s a Commonwealth definition of 10 cases according to the Chief Medical Officer, a rolling average. It’s below five cases on the rolling average, which is the Victorian Government’s own definition.

And the only reason they wouldn’t open up is if they didn’t have confidence in their own contact tracing system.

We have confidence that the Victorian contact tracing system has improved significantly.

Obviously it had very grave challenges in June and July. Over 400 Commonwealth Australian Defence Force personnel joined that process. The Chief Scientist of Australia Alan Finkel contributed to the redesign. We had expert health officials from Western Australia and from Queensland and from elsewhere assist them, and it has improved significantly.

There are some challenges. We saw that in relation to the case of the family where there were mixed messages given by the Victorian public health system which led to a breach this week. We need to be honest about that.

But equally the Victorian contact tracing response to that breach, I think was excellent, and all credit to them for that response.

So in that you can see the improvement, you can also see the challenge, but all up we believe that their contact tracing system has improved significantly. Jonathan?


Why would they be concerned or have concerns about their own Health Department system? We have seen this go on for months now. Yesterday we saw that the Health Department was going back to asking businesses to collect their own data.

If the Victorian Government gets to a point today where it doesn’t ease up to its own expectations, why wouldn’t they have trust in their own systems?


Well, that’s one obviously which only the Premier can explain.

On the question of businesses contact tracing, if it’s additional to the public health unit then that’s a positive development.

If it’s in place of the public health unit then that would be something of a concern.

I’m hopeful and we’re seeking information that this is supplementary to and additional to the work in the public health unit.

More generally, though, we’ve seen improvements, we’ve worked on assisting Victoria to improve the strength of their contact tracing.

The only reason we can identify why Victoria would not open further is if they did not have confidence in their contact tracing.

We actually believe that it has reached a level where, at these case numbers, it should be able to open.


You’ve had Alan Finkel in there having a look at it, as you’ve mentioned. I want to go back to that point, what do you think would give them a lack of confidence in their tracing system?

You’re saying that system’s fine. If they don’t open up you’re saying it’s because they have a lack of confidence in their own system. What gives you that belief? What are the areas, the challenges?


There were three areas of improvement, which were still to be completed. One was the localisation of the public health unit and tracing response.

Two, the full digitisation, which is in particular where the Chief Scientist worked.

And three is in relation to the case management of individuals, as we saw this week in relation to the family in the northern suburbs of Melbourne.

So that was an example of where there is still some development. But I have to say the contact tracing response and the isolation response was excellent.


Minister, just on manufacture of the vaccine, with Minister Andrews advising that it could be 12 months if the best option is for a non-protein based solution, is that widespread delivery, manufacture of the vaccine through CSL the key to continued winding back of any restrictions in Australia, getting back to normal life?

Is that what we should be preparing ourselves for, the potential that we go for a non-protein based and maybe wait a year until that’s available?


No, and I don’t think, respectfully, that that’s what Karen was saying. When asked the hypothetical about non-protein vaccines, Karen was absolutely right that some of the mRNA ones will take longer.

However we’re in a very strong position with the AstraZeneca protein-based vaccine. That remains on track for first quarter commencement and significant rollout during the course of the year. So our time frames are unchanged.

On the hypothetical of if there were no protein-based vaccine, Minister Andrews was 100 per cent correct. But when you take away that hypothetical, when you look at the broad reality, Australia is on track for first quarter commencement of that rollout.

And it will take time progressively, but we’re very strongly placed, we have two high-quality vaccines for which we’ve already contracted, we have further investigations which are highly advanced and we’re part of the international buying facility which is the COVAX Facility.


Minister, I came in late. Sorry if this has already been asked, but the Victorian Premier Daniel Andrews has now said that there won’t be a reopening today.

What’s your message to Victorians who have been holding their breath, been working so hard and waiting for this day, and yet again have their hopes dashed?


I think that a further delay in Victoria would be profoundly disappointing and deeply concerning, the reason being as I set out the mental health consequences, a 31 per cent increase in MBS presentations in Victoria year-on-year, a 77 per cent higher utilisation of Beyond Blue services compared with other states right now, and a 40 per cent increase in eating disorders and presentations by young Victorians.

This is an insidious condition for which, it’s clear, it has been worsened in its gravity by the conditions of the lockdown.

And so we have confidence that Victoria’s contact tracing system has improved considerably, that the Commonwealth Chief Medical Officer’s definition of under 10 cases has been met, and Victoria’s own definition of under a rolling 14-day average of 5 cases has also been met.

And so in that circumstance it is possible, it is desirable, it is simply the case that on the balance of evidence and risk, Victoria is in a sufficiently strong place to replicate that which has occurred in New South Wales.

I should note that New South Wales had a rolling average of over 10 cases a day for 24 consecutive days in late July and early August, and yet they were able to manage being predominantly open through a gold standard, world class contact tracing process.


Would you say the Premier has failed the state?


I’ll leave that for the Premier to speak, I haven’t directly heard the Premier’s words.

I would say this, that for the health and mental health of Victorians, unless there was no confidence from the Victorian Government in their own contact tracing system, then there’s no reason not to move to the next level.


Minister, back on the vaccine, you said that planning for a successful mRNA vaccine is hypothetical. But with the vaccines, aren’t all of these hypotheticals? While there are two that you’ve already got the deals on that are promising, they’re not over the line yet.

So is it a possibility that if it’s not a protein-based vaccine that is the first to be successful, because we can’t manufacture it here straight away that we leave ourselves in a position in Australia where we aren’t in control?


No, the world has never had an mRNA vaccine before. No one in the world has ever had that. So that’s a new technology around the world. It’s a promising technology, it’s one of a series of different technologies.

We have the AstraZeneca vaccine, we have the molecular clamp. We’re in the fortunate position that as a country we have taken steps over time and CSL has taken steps to prepare for a moment such as this.

They have the manufacturing capability right now, they’re preparing that manufacturing capability right now.

We have 3.8 million units of vaccine which are expected in Australia in the first quarter from AstraZeneca and the Oxford vaccine. In addition to that the clinical trials are progressing well.

We have a very positive response with regards to antibodies and T-cell response in relation to both the Oxford and Australia’s own University of Queensland vaccine.

So we’re in a strong position, we’re progressing, there’s never a guarantee.

But what we know, and we’ve been very clear about that, what we know is that we’ve been exceptionally cautious in relation to the vaccines and each day the evidence is stronger and the proximity to distribution of that treatment is closer.


Minister Hunt, are you able to make any representations on behalf of the Government directly to the Victorian Government to encourage them to reopen, given the context?


The Prime Minister has done that in the last week directly to the Victorian Government.


Just by way of comparison, for a protein-based vaccine, what type of timeframe are we looking at for manufacturing that?

So if AstraZeneca is successful and we were to bring that, I know patent is the wrong word, but we were to bring that formula over.


The license, yep.


How long would that take to manufacture?


So, CSL’s in a position both to manufacture the AstraZeneca vaccine in the first quarter of 2021, as well as us bringing 3.8 million units.

So the contracts are 51 million units for the University of Queensland vaccine to be manufactured here in Australia during the course of 2021, and we had 34.8 million units of the Oxford-AstraZeneca vaccine, sorry 33.8 million units.

3.8 million units will be brought in from overseas early in 2021 and then that’s subject to the approvals both in the United Kingdom and in Australia.

And then secondly the Australian manufacturing will be able to commence and be well underway in that first quarter of 2021.

So our time frames are unchanged, the evidence is growing, the confidence of delivery is increasing.


Minister, just a last one on Victoria. Are you concerned the longer that this goes on, if there is not an easing of restrictions when the Premier makes his announcement in the next few minutes or so, about social unrest issues in Victoria? (inaudible) view on that?


No. I think whilst there would be deep and profound disappointment, what Victorians have shown is an utter commitment to recognising and respecting the decision-making role of governments.

And so whilst we believe that Victoria is well-placed to move to the next step, it is fundamental that we all continue to adhere to the law, to adhere to those decisions and to respect that.

And one of the things that I’ve seen as somebody who’s been living in a community that has been in deep lockdown, I’ve seen in the midst of the frustration still a resolute commitment to the process.

And that’s a tribute to our doctors, where I started today, our nurses, our health workers, our pathologists, our pharmacists.

But it’s above all else a tribute to that Australian spirit as embodied in the conviction of Victorians to get through it.

So we’ll get through it, I just hope we’re in a position to provide hope to Victorians today. Thank you very much.

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