I’m really delighted to be here at St Vincent’s Institute. This is not just one of Australia’s, but I think without question one of the world’s great medical research institutes.
Today is World Diabetes Day, and that means it is a day about new hope and new opportunities for people of all ages with diabetes.
I want to acknowledge our incredible medical researchers and others here today, obviously Professor Tom Kay and Professor Helen Thomas.
To our leaders, such as Andrew and Len and Philip and Stu, some of the great medical researchers in Australia, to our philanthropic leads, such as Susan Alberti and Brenda Shanahan, who have given so much over so long to not just diabetes, but to medical research, but perhaps above all else, to our real hope for the future – young David here.
David and mum Jenny, they are shining beacons of hope in action, of saying that diabetes is an enormous challenge, and I come from a family where my father had type 2 diabetes, not the harder condition of type 1, but type 1 was a terrible thing for any parent to hear in the past.
Now it’s still an inconvenience, but this is a moment of hope, where you can live a long, rich, full, majestic life, with challenges, precisely because of the work of our researchers.
Against that background, it’s been our pleasure as a government and across consecutive governments to contribute to research in diabetes.
We know that through the National Health and Medical Research Council there’s been over $820 million allocated to diabetes research since 2000.
We allocate over $500 million a year through the Pharmaceutical Benefits Scheme and related schemes for support of diabetes, and only in the last year, and Susan and Brenda and others were very much a part of this, we were able to invest $50 million in continuous glucose monitoring.
David, I was thrilled to hear that you’re part of the continuous glucose monitoring program. This is about giving parents the confidence overnight that their children will be taken care of, that we can know the situation in terms of blood sugar levels, and I think that’s critical.
The next great step is here today. Tom, to you and your magnificent co-investigators and to all of the team here at St Vincent’s, but bringing together St Vincent’s, Walter and Eliza Hall Institute, the Westmead Institute and the Westmead Clinical School, we bring all of those together and Australia will, in my view, lead the world in diabetes research in the search for a cure.
And so I am delighted to announce $9.46 million under the National Health and Medical Research Council for the St Vincent’s led project to find a cure for type 1 diabetes.
It deals with the cure, it deals with the prevention, and it deals with the treatment, to search for the causes and to find the way of providing permanent treatments.
These things are not impossible anymore. We see that with, across the road, venetoclax and the extraordinary work of Walter and Eliza Hall, the work of Westmead in the way that they’ve been able to lead breakthroughs in children’s cancer and in other areas, the extraordinary history here at St Vincent’s in terms of diabetes, that that which wasn’t possible before is now possible and will be more possible in the future.
So I want to thank and acknowledge all of our researchers and to say that on World Diabetes Day this really is a day for hope going forward.
PROFESSOR TOM KAY:
Thank you very much, Minister, and on behalf of my co-chief investigators, Len Harrison, Phil O’Connell, Andrew Lew, and also our associate investigators, some of whom are here, and all of our teams in particular, we want to say thank you very much to you, Minister, for making this announcement. We’re absolutely excited and absolutely delighted about the grant.
For us, it’s a little bit like being re-elected for a further term. I’m sure there’s a bit of stress and tension in that as well.
And look, I just want to say thank you for your interest and engagement with the tour that we’ve just done, and with talking to David.
It’s fantastic to have a health minister so well informed and so interested in what we’re doing, and I of course acknowledge your past interest in diabetes, particularly I think through the walks that you’ve done around your electorate supporting the JDRF, and your interests more broadly.
Now, I want to say a little bit about type 1 diabetes, although you’ve given us some great background. Type 1 diabetes is an immune system disorder, and what happens in type 1 diabetes is the insulin-producing beta cells in the pancreas are destroyed by the immune system, and that leads to life-long insulin deficiency, a life-long need for insulin injections, as of course David understands.
You paint a very rosy picture of diabetes and because we’re trying to improve it, I’m going to paint a slightly less rosy picture.
Insulin, the delivery of insulin by injection, while it’s undergone some tremendous advances, particularly in recent years with the developments of new technology, it’s not a cure for type 1 diabetes and it leaves people susceptible to the long-term complications of diabetes, as of course Sue Alberti is particularly conscious of because of her personal experience with that, and also the risk of premature mortality.
As we’ve discussed, most people live a full life, a long life, but of course it also comes with significant risks and that’s the business we’re in, trying to improve that outlook.
So, type 1 diabetes is first and foremost an immune system disorder, but nearly 100 years after insulin was first isolated it’s really still treated as a hormone deficiency disease, it’s treated by replacement insulin.
We’re interested in changing that, and we’re interested in changing it so that the treatment is targeting the cause of the disease, so looking at the use of immune system treatments for the treatment of diabetes, and that will bring us closer to a cure for diabetes.
That path to a cure for diabetes is going to be complicated, but there are going to be many advances, many benefits for people with diabetes along that journey, and we believe very strongly that eventually we will get there.
Now, I just want to say a brief word about how and why we were awarded the grant, because one of our colleagues, when we were doing a practice interview for the grant, he said, well, why would they fund four silverbacks, was the word I think he used. And really it’s to do with the teams we lead and the teams that we’re a part of.
We’re part of very large national teams of our own, but also of our collaborators. We’re trying to take a comprehensive approach to the problem of diabetes, from very fundamental research in the laboratory, right through to clinical trials, and that means we need young people with the latest technologies that are involved in medical research, such as genomics, bioinformatics, these new tools of science.
We need well-established expert mid-career scientists, and we need clinicians, both paediatricians and adult endocrinologists. They play an essential role in our research.
And the idea of bringing these teams together is a very important part of what we do. As Helen said, in the lab we try and promote the role of women in science.
Even though the four of us are men, 40 per cent of our team are women. And I particularly want to acknowledge Helen’s work here at St Vincent’s Institute and Jen Cooper’s work at the University of Adelaide, which are very important parts of our team.
So, what we’re all about is thinking about new ideas and new concepts and bringing them to the team.
We’re very much about making a transition from the laboratory into clinical practice, the idea of translating medical researching findings, and we’re very much about developing the next generation of researchers who will play an important role in the future.
What we’re going to do in the course of this grant includes, you saw something about the use of JAK inhibitors for clinical trials, we hope to do clinical trials of JAK inhibitors in this next period.
We’ll be very focussed on improving islet transplantation. We already have this successful program collaboration with Westmead and with the Royal Adelaide Hospital. We’ll continue to try and refine and develop islet transplantation.
And under Len and Jenny Cooper’s guidance, we’re very much involved in a longitudinal study of how children get diabetes, studying relatives of people with type 1 diabetes from the conception of pregnancy, right through pregnancy and through early childhood years to the development of diabetes.
So, I’d very much like to thank the Federal Government, the National Health and Medical Research Council represented today by Julie Glover, and of course the Australian community for their strong support for medical research over many, many years, particularly in recent years the announcement and initiation of the Medical Research Future Fund, being such an important step.
And I also want to acknowledge our other supporters, the Juvenile Diabetes Research Foundation and also Diabetes Australia, who have made a very important contribution to the work we do, and I think it’s opportune to acknowledge their contribution on World Diabetes Day.
So, thank you very much for making this announcement and I can’t tell you how happy and excited we are about it, so thanks a lot.
Happy to take any questions.
How common is type 1 diabetes in Australia?
PROFESSOR TOM KAY:
So Australia has about 150,000 people with type 1 diabetes. Type 1 diabetes is most commonly diagnosed in childhood, between the ages of five and 15, but then people live with diabetes for their whole life.
So actually even though it’s a disease of children, the majority of people in Australia with type 1 diabetes, the majority of our 150,000 are adults.
And it’s worth saying that Australia has got one of the highest frequencies of diabetes in the world, along with the Scandinavian countries, and it’s been well chartered to have increased significantly over the last several decades. So, it’s a significant disease here in Australia.
Is there funding going towards type 2 diabetes as well? I know that there’s an increase in prevalence among those under the age of 40?
PROFESSOR TOM KAY:
Absolutely. So, type 2 diabetes is the more common form of diabetes and mainly it occurs in adults, as you said, but increasingly in younger adults, very closely linked to obesity and lack of exercise, although also strongly genetic.
There is significant funding going to type 2 diabetes, and there’s also a National Diabetes Strategy that’s very much focussed on prevention of type 2 diabetes.
Both these conditions, they’re actually very separate how they come about. They’re quite different diseases. They both result in diabetes. They’re both very important conditions for different reasons.
Type 2 diabetes is a very significant public health issue that threatens the increase in life expectancy that we’ve enjoyed in Australia. Type 1 diabetes is much less common, only about one-tenth as common.
But the key thing about type 1 diabetes, it’s associated with this lifelong burden of insulin injections and blood glucose measurements, and for the individuals that have it and their families, it does pose a much more significant burden.
Just with the type 1 diabetes, why are more people aged over 30 now being diagnosed? Is it because they’ve developed it later in life or because it hasn’t been picked up when they’re younger or?
PROFESSOR TOM KAY:
Right so it’s not that it hasn’t been picked up when they’re younger, it’s a complicated and very interesting question.
People can develop type 1 diabetes at any stage of life. They can develop diabetes in their later decades. It’s much more common for it to be diagnosed in children.
No one’s exactly sure why it’s increased in frequency. It must point to issues to do with environmental factors. I think the idea that if the disease’s frequency changes, can’t be due to genetics, must be due to environment.
Those environmental factors are speculated about and not clearly known and that’s one of the main targets of the work that Glenn Harrison and his colleagues have done, doing in a study called (inaudible) which is being funded by the JDRF and the Helmsley Trust and others.
And also the JDRF’s Clinical Research Network which is an initiative of the Federal Government. So I don’t think we know exactly why.
It’s not because it wasn’t diagnosed earlier. Although interestingly, Nat, we now have the tools to pick up the likelihood of developing diabetes in the future many years before it develops.
Minister, can I just ask you about Jacqui Lambie who’s the latest to resign over this dual citizenship issue? What are your thoughts?
The Constitution applies to all of us. To everyone of us. It’s not a document that people can pick and choose. The High Court has interpreted it and we are all subject to the rulings of that.
So I actually respect and have had a very good relationship with Jacqui and I’m actually sorry for everybody that has been knocked out on this basis because for many people it’s come as a complete surprise that they’ve had a heritage which dates back in some cases 100 years since their parents came to Australia.
But this Parliament will see the cleansing fire of the Constitution work its way through all of the Section 44 cases.
My message to the ALP is the Constitution applies to you equally. Mr Shorten believes that he is above the Constitution. He’s not.
This is not a union document. This is the Constitution of Australia and it’s absolutely clear, having just spoken with the Attorney-General a few minutes ago, that there are two members of the ALP at the very least, and probably a significant number more who should submit themselves either to the people or to the High Court.
Mr Hunt, was your mother born overseas?
No. I’m in the fortunate position that I was born here, both my parents were born here and all four of my grandparents were born here.
Can you see this issue being resolved anytime soon?
Yes I can. The High Court has been absolutely clear in its pronunciations. It’s taken a very literal interpretation in line with the long history of High Court interpretations.
So there’s no criticism or disagreement with that. It’s now up to all of us to accept that. We’ve seen the strong, clear, immediate, decisive action of John Alexander, where he has accepted that his personal history included a sleeping citizenship of which he was not aware.
Jacqui Lambie has done the same thing. It’s now time for the ALP to accept that the Constitution applies to them and immediately, Susan Lamb and Justine Keay should submit themselves either to the people or to the High Court and I am certain that there are other members of the ALP who will not be able to avoid this.
In the end, my message to Mr Shorten is you can run, but you cannot hide from the Constitution.
What do you think about former premier Kristina Keneally announcing her run for the Seat of Bennelong?
This is Eddie Obeid’s protégé.
Eddie Obeid was Kristina Keneally’s patron and you’ve got a comparison here.
One, Kristina Keneally, fought for Eddie Obeid. The other, John Alexander, fought for Australia on the international courts.
So the people of New South Wales should not be played for mugs. They have long memories.
They made a decisive judgment last time but the message is very clear. Eddie Obeid was Kristina Keneally’s patron.
There was no place for Eddie Obeid, there should be no place for his protégé.
There’s currently a small group of refugee rights activists on the roof of your office in Hastings. Do you think that’s an appropriate way to protest?
Well, I would just say simply everybody has a right to protest. Everybody has a responsibility to do it within the law.
What do you have to say to the protesters and we’ve seen a number of protests about Manus Island, refugees being left there in squalid conditions. What’s being done to fix it?
Well the PNG High Court made a decision to actually close down the existing detention centre and in line with the court.
That is being done and there are not just one but there are two new premises immediately available, built to the highest standards and there are some in Australia who deliberately now opposing the closure of the very thing they asked for and demanded over such a long period of time.
So in just the same way as we should respect the High Court of Australia, we should also respect the High Court in PNG. They have made a decision and everybody should acknowledge that decision.
Are you going to have to avoid going back to your office now or?
I’m going on to Canberra today, so that will be a matter for those people, but there’s always a right to protest in Australia and there’s always a responsibility to abide by the law. That’s the theme that applies to all of these questions.
Thank you very much.