Minister for Health and Aged Care - press conference - 20 February 2024

Read the transcript of Minister Butler's press conference on the Australian Government funding $50 million to develop world-leading artificial hearts.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks very much for coming out here to The Alfred, Australia's leading research hospital, although every time I say that someone from Sydney's RPA rings and says, “no, we're Australia's leading research hospital.” We're happy to have two leading research hospitals in this country. The Alfred has so many areas of expertise and one we're really pleased to talk about today is their long history in cardiac technology and cardiac research in clinical practice. I'm delighted to be here with Sharon Pickering, the new Vice Chancellor of Monash University congratulations, Sharon on your appointment. We're delighted to see it. We look forward to your leadership at this really important university. Peter who's just got off the exercise bike – 50 minutes, so he's going to have to sit down for a little bit, thank you for joining us. Professor David Kaye and others from Alfred here. I'm delighted to make an announcement today from the MRFF, the Medical Research Future Fund’s Frontiers Program. This is a program as the name suggests that's really designed to help researchers, universities, clinicians, push the frontiers of our current understanding of technology and best clinical practice.
Only a couple of weeks ago I announced a $35 million grant to the University of Sydney from this program for bioengineered corneas, dealing with a real supply and demand challenge we have around the world that of the 70 people around the world who need a corneal transplant, 69 of them can't get it because there simply aren't enough natural transplants available on the market, if I can use those terms. So, being able to manufacture bioengineered corneas will deal with a whole lot of unmet demand out there for corneal transplants. That's precisely the sort of thing the Frontiers Program from the MRFF is designed to do, obviously help with clinical practice and health outcomes, but also in a way that allows Australia's great ideas, great inventions to be commercialised in a way that we've seen with something like the cochlear and today's announcement for me is very reminiscent of the story of cochlear.
Today's announcement is for a $50 million grant from the MRFF Frontiers Program. This is the third largest grant the MRFF has ever provided in its 10-year history. It's a very significant moment in the fund’s Frontiers Program. I can't think of a more deserving program than the one that we are announcing here today. I'll ask Sharon and David to talk more about the details of it, but essentially, it deals with one of the most pressing public health challenges, not just that we have here in Australia, but that we have worldwide. About 60,000 Australians every year are diagnosed with heart failure. Heart failure kills millions of people around the world every year and about one Australian every three hours, on average. At The Alfred some of our great world leading research has been working for decades to deal with this challenge. One obvious solution is for a patient with heart failure to receive a transplant, but there are only enough hearts available for transplant in Australia every year to provide about 100 or maybe 120 patients with that transplant, a very small fraction of the demand that is there. There's also been for some decades, increasing technology in artificial hearts, particularly for the left ventricle, but they have very significant limitations as well, which I'm sure David can talk about if you have questions.
Today's announcement is a genuine game changer, a revolutionary technology that uses magnetic levitation technology which will be more durable, that will also hopefully in time reduce the very significant risk of infection that existing artificial hearts have with them - because they've got to be connected to an external pump - and also have a much more variable rate that will allow patients to have a higher quality of life. This truly is a game changer invention by genuinely a brilliant young engineering student and then engineer Daniel Timms who trained in Queensland. Daniel's story more than 20 years ago, as I said, is really reminiscent of Graeme Clark's cathartic moment - or epiphany really - well more than 40 years ago because he was thinking about ways in which to deal with hearing loss, motivated by his father's hearing loss.
Daniel Timms came to this again through his father's story of heart failure and brought a really genuinely innovative way to think about the way in which a total artificial heart could operate using, frankly, the same sort of technology you use in water pumps. This grant is something that I genuinely am confident will change the lives of many, many Australians and people right around the world - better clinical practice better health outcomes for them, but also I genuinely hope in a way that taps into that ingenuity of Australians in a way that leads to a commercial success, like we've seen with playing Graeme Clark’s invention going on to underpin the Cochlear company. So, without further ado, I'm going to ask Vice Chancellor Pickering to talk about this this great partnership which is led by Monash.
SHARON PICKERING, MONASH UNIVERSITY VICE CHANCELLOR AND PRESIDENT: Thanks very much to the Minister. I'd like to acknowledge the extraordinary collaborations made possible because of the terrific work of The Alfred Hospital, the Baker Institute and Monash University, but also collaborating with Australia's world leading research intensive universities including UNSW, UQ, and indeed, Griffith University. What this is really about though, is the development of a device that will change the lives of so many Australians and their families. There are very few Australian families that have not suffered the intergenerational consequences of heart failure of one form or another. My own aunt died in this hospital of heart failure that would have been redressed by precisely this device. This device won't just impact Australian families. It is going to impact hundreds of millions of people around the world that suffer from heart failure that we currently cannot keep alive and have them thrive.
It is made possible because of the brilliance of the two professors that stand behind me now. Professors David Kaye and Shaun Gregory, bringing together the very best medical and engineering minds to create devices and take them through to commercialisation. The opportunity here is for Australia's great universities to be on the absolute leading edge of commercialising solutions that will make a difference, and that Australia is absolutely home to the development of cutting edge medical devices. Again, my thanks to the excellent collaborations across our hospitals, our institutes and our universities that have brought this together, but in particular, my sincere thanks to the brilliant researchers that have made this possible. Thank you.
PROFESSOR DAVID KAYE, THE ALFRED HOSPITAL: I’d like to thank the Minister and Professor Pickering, as they both say, this collaboration and the grant that we have support for represents just a unique partnership between clinicians and engineers. If we look across the changes in healthcare over the decades, many of the advances have in fact come from partnerships between engineers like my colleague, Shaun, and myself and my clinical colleagues phrasing the problems one of the problems that we face today in the clinic. And in my own clinical practice, and here at The Alfred we face patients with advanced heart failure. And as the Minister said, for many of those, there are no options. Heart transplant is available to 100 or so Australians through the year, and many patients unfortunately have few alternatives for the care of advanced heart failure.
And what we plan to do with this $50 million program is to address and provide new solutions. We have a platform of what we call life saving artificial heart technologies. But there are many gaps for patients who have other forms of advanced heart failure and that's what we're planning to address in this program. The BiVACOR device developed by Daniel Timms is just a game changing technology that provides support to both chambers of the heart at the same time. It's really unique, but there are other types of heart failure that are not currently addressed. In fact, 50% of all heart failure patients have a different type of heart failure. These are all the patients with stiff small hearts, which current technology cannot address, and Shaun and his team will develop a truly unique mini pump which is already well underway to provide solutions to patients - older patients, older Australians - with advanced heart failure. We have a great team of clinicians and engineers. And in developing these new technologies, we hope also to encourage the growth of a new industry, providing new technology that can then be used to support other types of technology leveraging off the learnings from our program. So thank you again, Minister. We're really excited to undertake this work.
JOURNALIST: What was it that convinced you, Minister, in the timeline here that made you think this is worth $50 million bucks?
MINISTER BUTLER: The importance of our health and medical research funding system, for decades, has been it is an open, competitive, but peer reviewed process. And although for most of us, this grant looks like an absolute no brainer, the important thing about this is that the team, the consortium of universities, BiVACOR, and the clinical partners had to go through an open competitive process. They did that, they proved this case worthy of as I said the third largest investment in the 10-year history of the MRFF.
JOURNALIST: Is that over a period of time that $50 million, or do you do a funds transfer today?
MINISTER BUTLER: I don’t think I’ve got my cheque book or my Visa card. It’s not just handed over in one fell swoop, but it is a significant investment by government. Given the sort of step change and technology that's involved in this remarkable invention by Daniel Timms, by BiVACOR, that the runs on the board that these clinical and university partners have to translate that into good clinical practice, I'm really confident this is this is going to be a terrific investment by Australian taxpayers.
ASSOCIATE PROFESSOR SHAUN GREGORY, MONASH UNIVERSITY: I'm the codirector of the Artificial Heart Frontiers Program, and we're looking to develop the next generation of cardiovascular technologies to address all patients with heart failure.
JOURNALIST: And the one that stands out, of course, here is what looks like a car part particularly, the total artificial heart. Tell us about that and why it's so significant, what is the impact to be made in terms of treating people with end stage heart failure?
ASSOCIATE PROFESSOR GREGORY: At the moment, artificial hearts work with essentially having a balloon inside the case, and that balloon squeezes and releases for every heartbeat. But you can imagine squeezing and releasing a balloon 30 to 40 million times per year, it's going to wear out eventually. And so, the idea of this device is that it doesn't need that balloon, it uses a different pumping mechanism with a spinning disk, it's magnetically levitated and rotated, that can push blood around the entire body and completely replace the native heart. So, this is not just an evolution of existing devices, this is a true revolution of what's out there.
JOURNALIST: And they're going to be implanted into – I understand the FDA in the States has given approval to fund 10 patients over there - how exciting is it, that next step to actually implant this technology into people?
ASSOCIATE PROFESSOR GREGORY: It's incredibly exciting that BiVACOR now have the opportunity to take the device to the next step into patients, and I'm sure we'll see significantly improved outcomes for all.
JOURNALIST: How long has it been to get to this point where we can trial it with humans?
ASSOCIATE PROFESSOR GREGORY: My first interaction with Daniel Timms was about 20 years ago, when he was in the early stages of developing the artificial heart.
JOURNALIST: Did you meet with him at Bunnings?
ASSOCIATE PROFESSOR GREGORY: I’ve been to Bunnings many times with Daniel.
JOURNALIST: Take us through – I know it’s a bit of a laugh - but take us through, you know how creative that became in the isle there at Bunnings, for instance?
ASSOCIATE PROFESSOR GREGORY: Yes, so a lot of what we do from Bunnings in testing these devices is we create sort of mock patients on a bench. So, it's a mock cardiovascular system on a bench. And if you think about the heart arteries, it's kind of just like pipes and so the idea is we put a bunch of pipes together to create this sort of mock patient on a bench to test these devices.
JOURNALIST: Pipes from Bunnings.
ASSOCIATE PROFESSOR GREGORY: Pipes from Bunnings, literally built on the floor of Bunnings some of them.
JOURNALIST: And what, why are we not having these trials on humans in Australia?
ASSOCIATE PROFESSOR GREGORY: So, the BiVACOR device obviously is rolling this out in the US first, the company is based in US and Australia. And it's important that they address both populations.
JOURNALIST: So, the first one will be this year?
ASSOCIATE PROFESSOR GREGORY: Very soon. Third quarter here in Australia.
JOURNALIST: And that will be all 10 at once, or it will be staggered?
JOURNALIST: And is there a simple way to explain how the magnetics work?
ASSOCIATE PROFESSOR GREGORY: It's kind of similar to a Japanese train, so it's essentially having magnets that sit within the device and also magnets in the spinning rotor and they essentially separate the device from the casing and provide a gap there for the blood to move through. And this essentially means that you have no mechanical wear at all, we don't have any moving contacting parts, you only have a spinning impeller within the bloodstream. So the device can theoretically last for a very long time.
JOURNALIST: The devices we've got now they're not quite as responsive to bodily functions is that correct? And this one's a little bit more acutely responsive?
ASSOCIATE PROFESSOR GREGORY: Yeah, so existing devices run at a constant mean speed. So that means that the output from that device is held relatively constant.  But we all know that as our hearts increase, so if we go for a run our hearts increase, rates raise and force contraction to meet what the body needs with that blood flow.
The BiVACOR device does this through a really unique mechanism with its hydraulic system, so it doesn't have to change its speed or anything like that to automatically adapt the blood flow. Whereas the other devices within our program will likely use a control system that detects what the patient is doing and automatically updates its performance to meet what the patient needs.
JOURNALIST: What has your testing shown so far that makes you so confident that this will be successful in human trials?
ASSOCIATE PROFESSOR GREGORY: We take these devices through extensive array of tests. We take them through benchtop tests on the parts, obviously they’re not just from Bunnings, but much more sophisticated test loops than that. Then we take them through blood testing and we take them through a lot of preclinical other testing as well. All of the testing so far has demonstrated tremendous results, even durability testing and keeping these devices running for years.
JOURNALIST: And that's cows and sheep so far?
JOURNALIST: In terms of its makeup, it is titanium and what else, magnets?
ASSOCIATE PROFESSOR GREGORY: The device is essentially made in a titanium case and it has magnets and implantable electronics on the device.
JOURNALIST: What does it mean for those who have it? What does it mean for the human pulse?
ASSOCIATE PROFESSOR GREGORY: Existing devices run pretty much at a constant speed, so the patients don't really have much of a pulse, but you don't really need a pulse to live, you just need the blood circulating around the body, that's just the way our bodies have evolved. But our devices will also run at a constant speed, but you can also put a pulse into them so we can quickly ramp up the speed and then up ramp it down, up and down to create an artificial pulse for these patients if it's going to be beneficial.
JOURNALIST: And what's the exterior part?
ASSOCIATE PROFESSOR GREGORY: The device itself, which is fully implanted into the chest currently has a cable that comes from the abdomen, which attaches to a controller and battery packs that are worn in a small bag by the patient that weighs about two to two and a half kilograms. And so, it allows the patient to do pretty standard daily activities as we saw before, with Peter riding the bike and going for a run.
JOURNALIST: The controller, can you explain what that does?
ASSOCIATE PROFESSOR GREGORY: The controller is essentially what makes the device run. It controls the speed of the device - it's a little box that controls the speed, it monitors the power consumption, all of those sort of things. So, it keeps the device running.
JOURNALIST: Is it better than a heart transplant?
ASSOCIATE PROFESSOR GREGORY: I wouldn't say that yet. I think we still have a little way to go to be better than a heart transplant, but it's definitely on the path.
JOURNALIST: And so, is it 20 years it will last for? 30 years? A lifetime? What's the expectation?
ASSOCIATE PROFESSOR GREGORY: The current devices are showing that they can support patients for 10 to 15 years, a couple are showing a little bit more in the US. So, we're anticipating similar to possibly even better lifetimes with our devices and obviously as your follow up.
JOURNALIST: How long does it take to make a single device? I'm probably getting ahead of myself, but in terms of that mass production?
ASSOCIATE PROFESSOR GREGORY: We’re still going through the manufacturing at the moment, you know, working out how we can manufacture it in Australia as well, because we want to bring that industry here to Australia. But yes, they do take quite a while to manufacture because they are so precise.
JOURNALIST: How did you go with finding the 10 to participate in the trial, did they put their hands up?
PETER CALLINAN, PATIENT: I'm Peter, I’m 48 years old and I'm currently on the existing heart device, that's the latest and greatest at the moment, I’m excitedly listening to all this take place obviously.
JOURNALIST: Would your ideal be a heart transplant at this stage? Are you on the list?
CALLINAN: I'm on the list for a heart transplant. I've been on the list since about June/July last year. That's obviously a very inexact science and only 100 or so Australians are lucky enough to receive a transplant each year. So, this would be something extremely exciting for those of us who are waiting for transplants.
JOURNALIST: Have you eyeballed the device? It looks like a little bit like a car part.
CALLINAN: I saw one with David the other day and it looks a lot better than the ones that they used to put in many years ago. No, it looks fantastic. And it's wonderful that these things are being researched and funded here in Australia. It's a wonderful thing.
JOURNALIST: Are we able to ask you about your health history?
CALLINAN: Certainly, I was born with a congenital heart defect, and I had surgery when I was about 18 months old at the Children's Hospital here in Melbourne. And they did a great job and they got me through to 48, 49 on Saturday. Got me through to this point and that could only keep me going for so long. In effect my heart was working overtime for all those years. So, I suppose this day was inevitable, but you never think it's going to happen, and still it is happening, it's real, heart failure is a term I'm coming to terms with as many thousands are around Australia, but to be here in Australia couldn't be in a better spot for potentially having things rectified.
JOURNALIST: You can't be part of the trial, but has your mind at all strayed to think, “if I could be part of that, I would be?”
CALLINAN: Yeah, I have been thinking a little bit about that because it's obviously, you know, the next technology, the next wave is very exciting, and if I'm here today talking about it, it means that people in the future are going to be very aware of their heart health and perhaps you know, we get to do these amazing things here in Australia it would be fantastic.
JOURNALIST: Would you wish to be part of the trial for instance, or do you think that's a step too far for you?
CALLINAN: You’re asking me whether I want to be a patient?
JOURNALIST: In your imaginings?
CALLINAN: Absolutely. Because ultimately, at the moment the options are limited. So I'm open. I'm open.
JOURNALIST: Does this technology give you hope?
CALLINAN: 100 per cent, because there isn't perhaps that technology available at the moment, if it was available, that can only be a wonderful thing for people in my situation it does give me hope.
JOURNALIST: And why is that?
CALLINAN: Well, I think anytime you get to add to your life expectancy for people in my situation - I have a young family. And if I can sort of add to that that's a no brainer for me. You know, I think to give people quality of life, too, is really important. I'm back at work, I can't swim yet because I've still got the cord, and all those sorts of things. But these sorts of advances would be just amazing for people who are suffering heart failure.
JOURNALIST: Can I ask one more thing just about your level of confidence, just how sure you are that this device is everything that you hope it to be?
PROFESSOR KAYE: Shaun articulated it really well. Any device or medicine, particularly artificial heart technology, goes through rigorous testing, on the bench, maybe at Bunnings, in preclinical studies and others. So, by the time it comes to the clinic, for me as a clinician, we often follow the development very closely, we know that engineering details and preclinical information. I'm often the one who submits the application to the ethics committee, and I can say honestly this, this product is ready to be tested.
JOURNALIST: And where would you be without the federal government's $50 million?
PROFESSOR KAYE: Oh look, this has revolutionised what we're able to do. We're addressing the whole portfolio of patients with heart failure, not just a small group, we want to be able to address all of them. And this funding allows us to bring a huge group of clinicians, engineers, people working in regulatory affairs, all of the things in areas that you often don't think of, manufacturing, metallurgy, that's what's going to bring this project forward and deliver it to patients.

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