SPEAKERS
Dr Megan Robertson, Russell Basser, Sharon Lewin
Welcome to Country 00:00
We acknowledge the traditional Aboriginal owners of country throughout Victoria, Australia, and their ongoing connection to this land. We pay our respects to their culture, and their Elders past, present, and future.
Dr Megan Robertson 00:21
Hello, everyone, and welcome to Global Victoria Healthtech Talks, a show that's about healthtech business and opportunities in Melbourne and across Victoria in Australia. Victoria has a unique and globally competitive healthtech ecosystem, that's thriving and open for business. In this podcast series will provide insights into the strengths within our ecosystem that are attracting global attention. Want to explore the expertise, engage with experts, identify markets or learn about how you can team up with top Aussie healthtech companies, then you're in the right place. I'm your host, Dr. Megan Robertson. And today on global Victoria healthtech talks were covering the fabulous topic of infectious diseases.
Dr Megan Robertson 01:09
I have two terrific guests today that I'm thrilled to introduce to you. First up I will be talking to Dr. Russell Basser. And my second guest is Professor Sharon Lewin. Today my guests will share their perspectives on the infectious diseases sector, and discuss the strengths and capabilities of Victoria in this area. I now have the pleasure of welcoming Dr. Russell Basser. Russell has very recently retired, but previously was Senior Vice President of Research and Development at Seqirus, since its inception in 2015. Russell joined Seqirus parent company CSL in 2001, and led Clinical Research and Development at CSL for many years. Russell has a distinguished and varied career, beginning in clinical medicine and academia and transitioning to industry. He's worked in Melbourne as well as internationally, and has an extensive and thorough understanding of the Victorian infectious diseases ecosystem. Hi, Russell. Thanks for joining me.
Russell Basser 02:22
G'day Megan, it's a pleasure to be here.
Dr Megan Robertson 02:24
Now with the COVID 19 pandemic that we have lived through these last two years, the field of infectious diseases has got quite a lot of attention. But let's start off by talking about what it actually covers. So what is the area of infectious diseases?
Russell Basser 02:42
I guess Megan, the in a broad sweeping sense. It's really about germs, if you like that bacteria, viruses, parasites, etc. That can be transmitted between people, between organisms, animals, and the impact they have on human health in a very broad sense.
Dr Megan Robertson 03:03
So it really covers anything you can catch effectively.
Russell Basser 03:06
Yeah, that's right.
03:07
Okay. So, Seqirus and CSL, or CSL in particular, has been a global success story out of Melbourne. Tell us a bit about the background of Seqirus and CSL,
Russell Basser 03:20
So yeah, so maybe just starting with CSL which started life in about 1916 as the Commonwealth Serum Laboratories, which was a government agency really formed on the back of the Spanish flu outbreak, to give Australia health capabilities, healthcare capabilities, that were too distant in those days, we actually made what was referred to as a vaccine, but was in fact an antiserum back then. And over the years, in fact, played a pivotal role in the introduction as a government agency of insulin to Australia porcine insulin, polio vaccine, measles vaccine, influenza vaccine in the 60s, which we've been making since the 60s and and then, about probably the 70s or so, was getting really left behind by new science. To the extent that in 1990, the government privatised CSL became listed in 94. And on the stock exchange was known purely as CSL. over the 30 years, the company has grown largely through its plasma therapeutics division, globally to be now the largest plasma therapeutics division, but more recently with the formation of Seqirus that I'll get onto later, has become one of the largest influenza vaccine manufacturers in the world. The focus in terms of CSL and its growth since 1990 in manufacturing has been initially locally so to big manufacturing plants for influenza vaccine based on the old egg technology where you grow the virus in eggs and purify it and making a vaccine and a large plasma fractionation facility in the outer suburbs of Melbourne. From maybe for this conversation from the infectious diseases perspective, CSL had probably four main sort of areas of activity in those 30 years I think a notable one was working collaboratively with the Ian Fraser and his team at University of Queensland to capture the intellectual property around human papilloma virus vaccine. And then partner with Merck research laboratories that ultimately created what's now the world's most important HPV vaccine Gardasil, which got licensed in 2006 and saved hundreds of 1000s of lives of women by preventing HPV and its associated cancers. The probably the next big thing that we've that we were involved with was the 2009 swine flu pandemic where we, we created the vaccine that helped protect Australia from swine flu. And then the formation Seqirus, which was which has been a very flu orientated flu vaccine orientated company. And I guess maybe the fourth thing I was alluding to was just our role in helping Australia be prepared for, and address, COVID initially with a partnership with University of Queensland, unfortunately which the vaccine which fell over but then more more laterally manufacturing in our plants that we have here in Melbourne, the AstraZeneca vaccine under license that was in the major vaccine in the early vaccine rollout for Australia.
Dr Megan Robertson 06:48
You mentioned the flu vaccine program which has been a major global success for CSL. How has the sector the infectious diseases sector, both academic and industry, in Victoria learnt from that experience?
Russell Basser 07:02
So, just a little bit more specific history that I was alluding to before around Seqirus, which we formed in 2015. By joining together, the flu division of CSL which was company we called by CSL at the time, and married at with the acquisition of the Novartis influenza vaccine business. Two businesses that were both struggling and to be honest, up until the mid teens 2015 2016 influenza vaccine for many years was seen as a lost leader for most companies. And the economically the very unattractive and, and an area where not many dollars are being put into innovation. What we theorised and I guess in the establishment of Seqirus, it was a bit of an experiment, we theorised that focusing on flu with a larger portfolio with scale. And with some innovative technologies and investment innovation, we could turn that around. It was a bit hairy. And for the first couple of years it was really hairy. And what does innovation mean in influenza? Well, it meant. So we've been making influenza vaccine, everybody is an industry by growing the virus in embryonated chicken eggs. We process in our company a million eggs a day in the season, globally. So it's a lot of chicken eggs and growing the virus and then isolating it and purifying and processing it into a vaccine. It's an OK vaccine. It certainly got a very substantial public health benefit but it in an individual level, its efficacy is not fabulous. So two things we're doing one was we are giving a combining it with an adjuvant, so an immune stimulant and especially as we get older and I'm in that category almost as we get older, our immune system doesn't respond as well to vaccines by so in giving a boost to the immune system by adding this immune stimulant or adjuvant. You can improve the efficacy of the vaccine. And so we in that portfolio we rolled out more globally, it was Novatas had this vaccine in southern Europe had been there for about 10 or 20 years. And we roll that out into Europe, mainland Europe and America and the rest of the world. And that's been very beneficial. We also acquired in that portfolio a method of making influenza vaccine where we grow it in cell culture not in embryonated chicken eggs. And the manufacturer that addressed a really important challenge we face as an industry in the egg vaccines. To get the virus to grow, you need to adapt that a bit from the human strains. And one of the important A strains that what we found was with one of the important A strains that, that adaptations met, the vaccine isn't very good in in a strain called H3. And the cell culture was not only an efficient technology, but was able to overcome that maladaptation. And, and so what we so we focused on, there was a factory in North Carolina that we acquired, and we focused on getting that up to scale, it was only making a few million doses a year. We're now pumping out about 35 million doses a year. And we're able to now to, and we're now able to bring that vaccine to light if you like. And, and then I guess, we're applying that to pandemic vaccines as well for flu. And then I guess the other challenge was, because flu viruses shift around every year and the vaccines efficacy, you know, waxes and wanes, actually measuring the health impact, as you vaccinate 10s of millions of people is really important. And we're really focused on innovating in the capturing what's referred to as "real-world evidence", so using databases, public health databases, healthcare organisation databases, to actually understand the health impacts, and really importantly, the economic impact of new technologies, which are more expensive on the face value. But if you can understand their health, their economic impact, maybe they're actually beneficial to society, even economically. And we've been able to do that and show that the cell culture vaccines anywhere in a season between 5% and 30%, better than the egg vaccine, and the adjuvant of vaccines, probably 10% to 20%, better than we'd had previously.
Russell Basser 11:45
I'm sort of rolling out the story. So you can hear how we've approached it. But I think what we what we've done is it's been a really forensic focus. And I guess for us, and with our collaborations, it's the focus on influenza and all the bits that go into making a complex system run as efficiently as possible. And to be the most effective that we can make it that has been the success. And why Seqirus is now I think driven the change from what we perceived before what was understood before as flu is a crappy place to be in the industry, to something now where it's actually quite an exciting place to be where companies are pouring hundreds of millions of dollars into innovation, because they see there's lots of opportunity. And I think we've been in the centre of that. So innovation focus, really, really understanding what you know what the challenges are in a really intricate way of being the key to our success. And I hope we could with an overtime with collaborations, I hope we can help bring that those lessons to our collaborations.
Dr Megan Robertson 12:54
There's almost three parts to that there's the innovation, so the new technology, and exploring that new technology. There's the scale. So as an industry, so the innovation happens with your R&D partners, the scale is being able to actually bring it to a global level. And then you've got the measurement of the actual effect. So it's quite a sophisticated system.
Russell Basser 13:18
Yeah, look flu's really complex. And it's probably more, it's probably the most complex of the infectious disease vaccines sort of areas to work in because of the variations year-to-year because of the imperfect manufacturing. And because of the other factor I haven't mentioned, but it's very important to us in our yearly sort of manufacturing and performance cycle is we have two seasons, one southern hemisphere, one northern hemisphere. And the WHO, which sort of advises governments on the strains that should go into the vaccines. We have weeks literally, to be prepared each for the two halves the seasons. So you've got to get that coordination as right as you can, as efficiently as you can. So you can get the vaccines to the public when they want them when they need it. So yeah, it's a really intricate system.
Dr Megan Robertson 14:07
And I expect all the learnings that you take from that can actually be applied to some extent, to other vaccines such as COVID vaccines into the future, although they might be different vaccines, the systems of learning about the rapid response and the measurement of effect could be more broadly applied.
Russell Basser 14:26
Yeah, I think you're right. Look, there are some generic systems and part of the reason I think we could be successful with Seqirus is because CSL the plasma space is not it has some fundamentally similar fundamental similarities to flu in its complex you got to collect plasma, you got to process it going to put it to people, you got to test it and things. It doesn't have the timeliness issue but yeah, that those lessons of focus of deep understanding of the area of of the need for scale which, which I think is going to be a real challenge for the COVID response in the future. Because, you know, we don't know what the role of boosters is going to be in the longer term. And we've got a lot of factories now churning out a lot of a lot of doses. But the repeated cycle of manufacturing year-in-year-out and honing that system that we're just discussing, for us, in our experience with flu has been really important in our ability to respond to flu. Now, we weren't part of the initial COVID response in making your own vaccine but our ability to pivot, I think was. So yeah, those lessons are really important. I think, as a global community, it's going to be interesting to see how we can maintain those as we start to address all those other economic issues that are coming to play. And we're going to push COVID response sort of a little bit more to the background.
Dr Megan Robertson 15:50
Thank you for that. And just to move to another area, you have a clinical background in Melbourne as an oncologist and you then moved into industry. Hhow do you find the working relationships across clinical, academic and industry in the Victorian health system, and how has that benefited both CSL and Seqirus?
16:12
So as an academic, I learnt, I was, I had a great mentor, in a guy called Dick Fox and another guy, Michael Green. And they at a time when there was a lot of skepticism, they embrace collaborations with industry. And in the 90s, we were working a lot with a few companies. And one or two specifically where we had this very, almost like a partnership relationship where we were both involved respecting each other's each other's role and strength. And I think what I've experienced at CSL over the years, is a very similar approach. We know we're proudly Australian-based and specifically Melbourne-based with we have huge manufacturing over the last 10 years, we've we've expanded that by over a billion dollars worth of more new manufacturing in plasma and, and more recently, we've committed to building a new Cell Culture Facility in Melbourne. So we and we've embedded our basic research group of about 300 scientists into the Bio21 Precinct in Parkville. So we we've, I think that we've appreciated one, one of the strengths is appreciating the geography. Whilst it's not the be-all-and-end-all it can be really important. So being close. And I think being in Australia, and setting up and having that notion that we're partnering rather than licensing in ideas, or funding somebody else's research, it means that we truly have, we truly, truly try to partner so you know, the an academic collaborator will do will do some research, and we'll do some some validating sort of experiments and awesome experiments where we have the right equipment or the right expertise and insights that will help move it towards some yes or no answers around, is this something that could be developed into an asset for an a medicine or a vaccine? So I think my experience has been that it's, we don't repatriate IP away from the collaborators, we we maintain that, that that working relationship. And as a scientist, people want to be involved in their babies, they don't want to just send it off for it to disappear somewhere. And we try to do that as much as possible. I think that's yeah, but the 20 years I was at CSL and the period of, I think my experiences that's a really powerful aspect of of our presence here. And, you know, we were able to do that with groups in Adelaide and Queensland. So geography isn't the only thing but it's, it's being in the in Australia and, and sharing cultural perspectives and being able to, you know, go out and visit and etc. I think that's been a really important thing for both sides.
Dr Megan Robertson 18:56
So that collaboration and interaction between the academic health and medical research sector and the industry sector in Melbourne and across Victoria is actually a really important part of what we do. And I think you know, you've mentioned CSL, but there's a couple of other great examples, one of the very famous ones that I think you were involved in some of the early work with was, of course, G-CSF coming out of the Walter and Eliza Hall Institute (WEHI), and more recently, also out of WEHI Venetoclax. Absolutely. So there's been some very successful partnerships there. And there's a good path a good path to follow on a model to follow.
19:37
Yeah, and look that and they were, I mean, outstanding scientists. You know, Dick, I mentioned Dick Fox, George Morstden, of course. The team at WEHI led by Don Metcalf, we were all working together on on the growth factors G GMC7 and other growth factors. And there was this and I was in my formative Because I just saw the power of that engagement and that Amgen, which was one of the major collaborators in the 90s just respected that, that intellect and people would, they'd bring their experts. And they'd sit around table with it with the people here in Melbourne, discussing how can we make this relevant to clinical care in a way that, you know, it's all about the patient's all about health outcomes. And I think Andrew Robertson, the team WEHI did that with Venetoclax, in the most brilliant, possible way imaginable. And the ink and the impact has been extraordinary on healthcare, both of those two programs.
Dr Megan Robertson 20:36
So what's in the current Seqirus pipeline? You mentioned mRNA previously. How's that working for you?
Russell Basser 20:44
Yeah, so just in the pipeline, there's still a long way to go with getting the optimal use of our fluenza the current technologies, focusing on influenza, so we're combining the adjuvant I mentioned with the cell culture product. We already have a licensed vaccine using those two technologies for as a pandemic readiness vaccine for flu, but we're now developing in we're in the late last stages of clinical development, a seasonal vaccine with those two technologies. We are we do have a second, if you like a second gen mRNA technology, you know, mRNA has been fabulous, I mean it's saved the world's bacon in many ways. One or two technologies really come to the fore, that work was underdeveloped, or sorry, it was early development, as COVID struck, but was ready to be accelerated. And what we've learned is it's very adaptable from manufacturing sense, you can make the constructs pretty quickly, you can sort of identify the genotype of the virus or the target antigen and slot that into the manufacturing quite readily. And they're very effective. They make very effective vaccines, at least in COVID. But what we also saw with mRNA vaccines in the current way they're made, to keep them stable you're going to add that mRNA to some lipid which, and together, they cause a bit of inflammation, and there's quite a reaction, whether it be at the site of the injection, or some chills, and other things that can be for a day or two. And what we know it's flu, it's very well tolerated. And if you're going to give it year-in-year-out, then those reactions that we're seeing with COVID, where people tolerate them, because we're all feeling that existential threat. They're probably a bit too bit too big for a routine vaccine. So our second gen approach that we're developing is what's called self-amplifying mRNA, where it does what it says, but it's about somewhere between 50 and 100 fold more potent. So you need less of that stuff to keep it stable the lipid to keep the flu the mRNA stable, which, theoretically in at least in preclinical experiments should lead to less reactogenicity, which is the term for causing side effects. And the other thing that we see is it it causes a really nice antibody responses in preclinical flu experiments and with other people's technology, we've seen that as well. But the self-amplifying stimulates the T cell side of the immune system. So the the side of the system of the immune system that can help reduce severity, not just prevent disease as you do with antibodies in a really profound way that we haven't been able to do previously with vaccines. So we're going to phase one, Seqirus going to phase one later this year. I think mRNA is really exciting. I do think COVID was a fantastic system for developing a new technology. I think we're going to learn a lot more about the technology, whether we go into flu or CMV, or RSV, whatever other diseases, it's not going to be quite the same straightforward, I think Coronavirus has proven to be great targets of vaccination, as we've learned with other platforms as well as a mRNA. But it is exciting. We have a program we've got some research going on here in Melbourne as well as in the US that will that will progress that program. And we plan as I mentioned, we plan to start out phase one here in Australia later on this year.
Dr Megan Robertson 24:27
So you've worked both here and in the US. What do you think attracts global partners to Victoria, you've mentioned the partnership between academia. What other things attract people to coming and collaborating in Victoria?
Russell Basser 24:40
I think a few things I think the precincts very powerful, you know, the Parkville Precinct, the Monash Precinct, The Alfred Precinct, and I think that and they've evolved at different at a different pace and each of those but I do think that they have really helped and really, you know, there's a real focus of expertise and collaboration, which, which is something that is actually a little bit unusual and exists in other places, but it's not commonplace. I think nationally, we have a very strong regulatory framework that encourages early development without as much bureaucracy as you'll meet elsewhere. So that and that, so that that timeliness and ability get in and test your treatments in early phases, is really powerful in Australia. But, you know, Victoria has really played a strong part in that. I think, the bipartisan consistent support of biotech, and that engagement between industry and academia by successive governments, state governments, is just just gives an environment of reliability, we know that it's not just gonna flick, you know, when politics changes. And so, you know, we can commit, and I think other companies have had this would have the same view, you can commit to a place like Victoria, because, you know, it's going to still be supporting that ecosystem and try to expand it and improve upon in the future, because it's so valuable, there are so many people employed now, there are so many, so many parts to it, you know, BioMelbourne Network, you know, you go to the meetings, you see, wow, there's just a lot more depth. And I, you know, when you blink, there's a lot more depth here than you I remember the last time since I came, which was, you know, pre-pandemic. So I think all those all those factors help and and you sort of get this sort of snowball effect of engaged experts who, you know, mentor people like me, they mentor other people, and, and you do get, you get very engaged experts who aren't, who aren't just thinking, well, they're going to do it all. And they know all the tricks, the understand that it requires multiple hands, you know, drug development requires a village. It's not, it's not a game for any one individual. And I think they just that snowballs, and there's that recognition. So I think, you know, seeing seeing in the US and UK, and Europe, I think it's very powerful here. It's not unique, no, but it's very powerful. And it's competitive with the most of the great centres in the world.
Dr Megan Robertson 27:18
So I think you raise a couple of really important issues there. One is the depth and consistency of the health and medical research sector in Victoria. It has, if we look at the Walter and Eliza Hall Institute set up in the 1920s, CSL established in 1916. There's a long history of commitment to health and medical research, as you say, and that builds a sector where you have experience and the capacity to then mentor and bring new companies and younger people into the sector and help them grow. The second thing you mentioned was the regulatory process. And of course, it's very important that in Australia, you do not need an IND to start your clinical trial. You need all the preclinical work. But you do not need to go through a regulatory process with our TGA. It's a notification system. So just honing in a little bit on that, from an industry perspective, what makes Victoria such a strong place for infectious diseases in particular.
Russell Basser 28:23
Look, I think, I think The Doherty Institute is sort of the bellwether for us. And then Sharon, who will speak to shortly and her team have really shone through COVID. And I think the, the investment in establishing The Doherty Institute 10 years ago or so, has really come to come to light, you know, the wisdom of that has, has really shone during COVID. And they've just been extraordinary what they've contributed. And I know, they're looking to grow and expand on from the lessons and the opportunities in the forthcoming years. And so that's, that's a powerhouse. And that's got the WHO Influenza Centre, the main centre, the Coordinating Centre, the only one in the southern hemisphere is embedded in The Doherty, the Department of Epidemiology and Public Health as well from the university. So it's an all encompassing, fantastic center. That's, and I'm sure their capabilities have grown through COVID as well. So that's very powerful. The Burnett is another great academic centre, I think, virology and immunology as you talked about before immunology at the WEHI. And at Monash University as well is very powerful. And the other the other group that I think is probably a little little less well recognised publicly is the Monash School of Pharmacology and Pharmacy. Colin Pouton's done doing some really innovative work in mRNA and formulation and and that's, as people we're reading the press recently, has been sort of labeled as one of the top school pharmacy schools or pharmacology schools in the world. So That's an that's also got its campus in the Parkville Precinct even though it's attached to Monash. So it's really I mean, these are things that stick out globally, not just competitive but globally-leading to me that make this a really, really interesting and powerful place for infectious disease research.
Dr Megan Robertson 30:18
It's interesting, you mentioned the Monash School of Pharmacy, being recently cited as one of the top in the world. Because of course, Melbourne is also very lucky in that we've got two universities in the top 100 in the world. So both Monash University and Melbourne University, and despite the fact that there's a bit of friendly competition, there's a huge amount of collaboration across the scientists and industry embedded at both sites. So it's actually a very strong academic centre.
Russell Basser 30:51
Yeah. And then there's BioCurate, which is a collaborative group and lead up that was led up by Glenn Begley, who was an old colleague of mine, but who had 10 to 15 years of experience internationally with Amgen, working in industry and brought that in his academic credentials, to establishing that joint venture between the two. So yeah, as you say, friendly ribbing. But I think the overall the overall feel and culture in Melbourne is very collaborative, across hospitals, universities, you know, we're all in this together, and the stronger any one of us is, means the rest of us are strong.
Dr Megan Robertson 31:28
Exactly. So from your perspective, how to industry access the broader health and medical research sector in Melbourne, be it basic science, collaborators, clinicians or even service providers, if they don't actually have a personal link?
Russell Basser 31:45
Yeah, you know, it's I do think commitment to the environment is really important. And you know, taking my my parochial CSL Seqirus hat off, and actually relaying my experiences in other places where we've gone in and talk to academics where we haven't had a committed presence, we make zero impact, to be honest. Whether it be Japan or places in Europe, if you're committed people commit back and I think, you know, I described before our basic research labs are embedded within the Bio21 area. We've got 300 scientists, we're committed. And I think people you know, scientists aren't stupid, they just because they don't work in industry doesn't mean to say they don't see what's going on. And they see if you're flying in and flying out or you're you got tokenistic, one or two people here that are sort of looking for intellectual property, but essentially, they're office scientists, they're not, you know, lab-based wet-scientists. So I think you've really got you've got to commit to environment and show not just in words, but enacts that you're going to truly partner. Yes. It's not the only thing. But I think it makes a huge in a long term sense makes a huge difference.
Dr Megan Robertson 33:01
We have a saying at St. Vincent's in Melbourne, that we don't want our research harvested, we want to partner with people. And I think you're very right. I think the other thing about this health and medical research sector, you mentioned the BioMelbourne Network, but it is very connected. And it's also very friendly. So that it is it's not hard to get access to specialised advice, be it regulatory, industry, you know, manufacturing, or even clinical access, you know, for clinical trials. It's a friendly sector. And I would encourage people to reach out. Be it through our government links or others, because there's a huge, huge capacity in Melbourne to participate and move things forward.
Russell Basser 33:49
Absolutely. I couldn't couldn't agree with you more.
Dr Megan Robertson 33:51
Thank you, Russell. That's been wonderful.
Russell Basser 33:53
A pleasure, Megan. Thanks for inviting me along.
Dr Megan Robertson 34:00
Australia's Research and Development Tax Incentive provides up to a massive 43.5% cash refund, which is available to both local and international companies.
Dr Megan Robertson 34:18
Next up, we will be talking to Professor Sharon Lewin. Sharon is the Director of The Peter Doherty Institute for infection and immunity, known locally as simply, The Doherty. Sharon is a leading infectious diseases expert and the inaugural Director of the Doherty Institute. She is the Melbourne Laureate Professor of Medicine at the Melbourne Medical School, University of Melbourne. A Consultant Infectious Diseases Physician at both The Alfred Hospital and The Royal Melbourne Hospital, and a National Health and Medical Research Council Practitioner Fellow. In 2019, Sharon was appointed an Officer of the Order of Australia in recognition of Her distinguished service to medical research, and to education and clinical care in the field of infectious diseases, particularly HIV and AIDS. Hi, Sharon, and thank you for joining me.
Sharon Lewin 35:13
Hi, Megan. Hi, listeners. It's great to be here.
Dr Megan Robertson 35:17
So Sharon, tell me what specific areas in infectious diseases is Melbourne strong in? What are our, what are our high points?
Sharon Lewin 35:25
Well, Melbourne is strong in all infectious diseases. Just to give you a sense of the expertise. About 50% of Australia's funding through the National Health and Medical Research Council (NHMRC) on infectious diseases comes to Melbourne and Victoria. So that's a pretty significant share of expertise around the country. Some areas that I think have had a long standing history of strength include influenza. Coming off of CSL has expertise and the WHO Collaborating Centre for Reference and Research and Influenza been here since the mid 40s, and now part of The Doherty Institute and extensive capabilities and influenza across virology, immunology, clinical trials. Malaria also has had a strong presence in Victoria with many research institutes having significant programs in malaria. Viral hepatitis, particularly for hepatitis B, long standing interests. I'd also put HIV in there as well, with again, expertise across virology, immunology, and infectious diseases. So really a very big critical mass of people working in infectious diseases. And now of course, COVID.
Dr Megan Robertson 36:35
Yes, where The Doherty has really come into its own and become very engaged in public health and public health communications around infectious diseases.
Sharon Lewin 36:45
When COVID hit in January 2020, we were really quite prepared for something like that. The Doherty Institute was built almost specifically to respond to a pandemic, with the mix of research, education and public health all in one Institute. And also we had been strong members of a network called APPRISE, the Australian Partnership and Preparedness for Infectious Disease Emergencies. A network that I've led since 2017. And as a result of both of those activities, we've done a lot of thinking around a new infectious disease, the diagnosis of it, mathematical modeling, potential clinical trials, pre-approved protocols to do those observational studies. And so we were sort of thrown in the midst of it from day one. And part of what we do, and something I'm particularly passionate about, is that science can't be done in ivory towers and in isolation. And in that, especially that early period of early 2020, when there was so much uncertainty, and people were getting information from all different sources, we became very active in public communication. That's what we should be doing as scientists.
Dr Megan Robertson 37:58
So The Doherty is a joint institute between the University of Melbourne and the Royal Melbourne Hospital. So it combines that academic and clinical stream, how has that been important and how it's been able to progress your research?
Sharon Lewin 38:12
Yeah, The Doherty Institute's a joint venture of the University of Melbourne and Royal Melbourne Hospital. So we have about 850 staff and about 60% University and 40% Hospital. In my mind, it makes no difference if you're a university or hospital, we need to embed research in everything we do. But what is a unique feature of The Doherty is it brings this service components of the response to infectious disease, particularly diagnostics or public health reference laboratories, and the clinical response side-by-side with people that, you know, primarily work in research and education. So it's got that great multidisciplinary mix. What that meant in the pandemic, in addition to the collaboration was that we were able to surge in our response in ways that we never really appreciated. So for example, when the diagnostic testing demands became very intense in that early 2020, we were able to mobilise PhD students from across the institute into the diagnostic labs. And that was a real strength for us at the time.
Dr Megan Robertson 39:22
So, during the COVID pandemic disease modeling by The Doherty was pivotal. You mentioned the mathematical modeling, but what other areas in pandemic management group at The Doherty you did some work around mRNA vaccines and other new technologies as well?
Sharon Lewin 39:36
Yeah, we were pretty active across the spectrum, starting with a very large program on diagnostics. So VIDRL the Victorian infectious Diseases Reference Laboratory, a core laboratory within The Doherty, established diagnostic testing right through January 2020. While you and I were probably on a beach somewhere, they were designing and and developing a diagnostic test or COVID. And by mid-January, most public health laboratories around the country are already doing the test. So we were perfectly placed by the end of January to diagnose that first case. Now, diagnostic testing, which was at the beginning was just traditional laboratory RACE PCR testing, but we did a whole lot of innovation, Deb Williamson led an effort around saliva testing, one of the first in the world to show that it was beneficial. We did work on 3D swabs, because at the time, there was concerns there wouldn't be enough swabs. We established genomics for around the country that was led by Ben Howard and from the microbiology diagnostic unit where his team used genomics in that mid-2020s, to identify the link to a community outbreak to the hotels. We've had a big and active program in vaccine development and one of our vaccines, has just gone into phase one clinical trial, literally just last week, that was a partnership with Monash. Monash developed an mRNA form of the vaccine, and we developed a protein form of the vaccine, and we're comparing those head-to-head as boosters. We also didn't have done a lot of immunology, we're the first to describe the immune response to COVID, in the world, actually. Back in February 2020. And then there's been quite a lot of public health and social research being done at The Doherty as well. So really, across the spectrum.
Dr Megan Robertson 41:32
That's a fabulous body of work at a time when really, most of the health system was under a fair amount of pressure. So to be able to step up that, that manpower for one, but also pivot so quickly, you must be immensely proud of your workforce?
Sharon Lewin 41:49
Oh, yeah, the people were just incredible, especially in those early days. People that were traditionally working in influenza, or HIV or hepatitis or fundamental mouse immunology, all chipped in. Of course, we had people that were established experts in Coronavirus, but there weren't many. Back in the early days, we literally had one that was Kanta Subbarao, who's Head of our WHO Centre for Influenza, she had worked on Coronavirus, but none of the others had.
Dr Megan Robertson 42:20
So that's an important skill really, isn't it that you've got a workforce and I think it reflects well on the the workforce in Melbourne in infectious diseases, the capacity that it can pivot, and it can move to address urgent needs when required.
Sharon Lewin 42:38
Yeah, I think that's relatively underappreciated by the community that this highly skilled workforce. They're not just neurology and immunology, I'm talking about clinical triallists, the mathematical modellers, epidemiologists, these are a very skilled workforce takes decades to build up those sorts of capabilities. And then have people established enough that when something new comes along, they can literally, you know, switch directions straightaway, because of the size of their groups, the amount of funding they've got, etc.
Dr Megan Robertson 43:10
And the depth of the knowledge involved, as you say, both across basic science, from diagnostics to vaccine development, right across to the clinical setting. And that must have been a real strength for the for The Doherty having both that academic and clinical focus.
Sharon Lewin 43:28
Yeah, I mean, one thing that served us very well, and this came from a lot of the thinking through the APPRISE Network was to have pre-approved protocols. So there were groups across The Doherty, and actually that we will collaborate collaborating with nationally, that had ethics approved protocols of observational, potentially interventional, studies that we could do if a new infectious disease landed in Australia. That's how those protocols were designed and written. One of those was led by one of our clinicians, Irani Thevarajan, which meant that meant the first few cases of COVID we could enroll in a clinical trial in February, no need to we didn't have to go through that sort of long process, which became shorter over COVID for ethics approval. And other pre-approved protocol actually led by Steve Webb from Monash and University of Western Australia was a pre-approved protocol for management of severe respiratory infection in intensive care units, which ultimately was REMAP-CAP, which was a very, very successful international study. But those pre-approved protocols were all part of the thinking, pre COVID. And that put us in a great position once COVID hit.
Dr Megan Robertson 44:39
Now your own research over many years has really focused on HIV. How's this been supported and advanced by the local Melbourne health and medical research ecosystem and the global links in the local system?
Sharon Lewin 44:53
Well, yes, that's correct. I've worked on HIV most my career and my main focus is on finding a cure for HIV. So very ambitious and highly technical area. And I'm a big believer that you can't tackle big problems like that in isolation. So I've always been very, my lab's collaborated very widely, both nationally and internationally. And I think in in Victoria, because we've had this tradition of very good virology, the great response to HIV in the early days, I should add back in the early 80s, when we had a dedicated infectious diseases hospital Fairfield, but we have a generation of of very, very skilled and devoted scientists and clinicians, and also a community of people living with HIV that have been very supportive of the research. So across Victoria, we might have about 100 scientists working directly in HIV that we all meet once a month, we work in different institutions. And then I have a lot of collaborative programs primarily with the US, but also groups in Europe, South Africa, Asia, etc.
Dr Megan Robertson 46:02
So you've raised two interesting points there that that Russell and I have discussed previously. One is the long history of health and medical research in Victoria, which means that there is this strength and depth, as you say, of you know, there's a there's a long history of virology research and strength in that area. So that you've got senior mentors, being able to teach the juniors, the juniors then grow up, become senior themselves. And there's that process of building on a structure that's been there for quite some time. The second issue is the importance of collaboration. And, really, I think that's one of the benefits of Australia, and Melbourne in particular, is that we collaborate very well, regardless of the fact that we've got two universities in the top 100, which do compete for each other with each other. But that's a friendly competition. It's really, you know, in your example of the 100 researchers across Melbourne, they will be in multiple institutions, which theoretically compete for funding, but actually, none of them are going to be funded without collaboration.
Sharon Lewin 47:12
Yeah, you're right. You know, the history is strong. And the collaborative spirit is strong. Having said that, medical research is a tough business. And it's a tough career raod for all of us. I do think there's lots that we can do to make it even better. We've got the right culture in Victoria, top down funding to get people to work in networks is good. I mean, that was an advantage of APPRISE. It was funded to make sure that we collaborated. And I think we need more of that kind of funding. I don't think we saw enough of that during COVID, actually.
Dr Megan Robertson 47:48
So what are the major strengths of Victoria's infectious diseases ecosystem, from your perspective? Why would international groups or companies want to come here to work?
Sharon Lewin 47:59
Well I'd start with people, that we've already discussed, so a highly skilled workforce. I think also infrastructure has been invested in over decades in Victoria. So The Doherty Institute, for example, is quite young. The building only opened in 2014. But we have fantastic facilities to be doing infectious diseases research many high containment facilities. So if you work with viruses, like HIV or COVID, or Ebola, you need to be in a specialised facility. We've got similar very highly specialised facilities down at Geelong. CSIRO, the Australian Centre for Disease Preparedness. So you've got the physical infrastructure as well. We've got partnerships with industry, CSL being based here and other smaller companies, and a strong history of clinical trials too and that clinical leadership means that you the partnerships can be established to try and get products all the way through.
Dr Megan Robertson 48:58
So really, we have the capacity, the capacity and the capability in Victoria in infectious diseases, to take things from a very early concept phase, right through to clinical trials, and then actually clinical implementation.
Sharon Lewin 49:14
That's right, we've got a great example of that, which is the rotavirus vaccine, which was, rotavirus was discovered at the Royal Children's Hospital by Ruth Bishop and her team and that led on to development of appropriate vaccine and ultimately, evaluation and commercialisation. So it's a really nice example of going the whole way, that of course, that journey, took about 30 years, which is the journey that you'd imagine but we've got other similar success stories with Relenza and influenza in infectious diseases.
Dr Megan Robertson 49:44
So The Doherty has been a part of several collaborative projects, including the recently announced Australian Institute for Infectious Diseases. What do you think makes collaboration in Victoria so strong?
Sharon Lewin 49:56
Well, I think it's culture and history and mentorship. So people have grown up in that environment. The government drives collaboration, very much, because they want us to work together. And so we, we, there's incentives to work together. And, you know, I think there's a history of success by collaborating so people see the benefit of it.
Dr Megan Robertson 50:24
What about collaboration with industry? How do you find that in infectious diseases?
Sharon Lewin 50:32
Well, there's some great success stories. And we've got a fantastic industry here that has expertise in infectious disease, as I mentioned earlier.
Dr Megan Robertson 50:42
So can you tell us a bit about collaboration with international partners in basic science and preclinical research at The Doherty? What are the factors that facilitate these collaborations? And what are the barriers as you see it?
Sharon Lewin 50:56
Yeah, international collaboration is extensive, or I would say almost every researcher has an international collaborator who is co-published with an international collaborator, and I see that coming two ways. Bottom-up and top-down. Bottom-up, just the organic interactions that every scientist has with groups around the world that's part of science. But then there's top-down initiatives that can drive collaboration internationally. We've had a few of those programs at The Doherty. One of them is a program that we've had for the last four years with Fudan University in China specifically around infectious diseases. Through over 2020, we launched something called the Sino-Australian collaborative partnership on COVID, which linked The Doherty to again Fudan University Hong Kong University and Tsinghua University in China. And we've got a joint PhD program that's run out of University of Melbourne, but its primary focus is on infection immunity, and that's with Bonn University. And I should add, over the last few years, we've strengthened our ties to The Institut Pasteur. Institut Pasteur is based in Paris, they have a very similar mandate to The Doherty research, education, public health, they also have an international network and a big footprint in Asia. So we've got formal partnerships with Institut Pasteur - Cambodia and Institut Pasteur - Korea. So there's some of the top down initiatives to which provide funding or opportunities for people to reach out and make collaborations that they might not have thought of before.
Dr Megan Robertson 52:31
So if you were an international industry collaborator, who were looking to link into The Doherty, how do people make contact? How if you don't have a direct personal link? How do they establish contact with The Doherty?
Sharon Lewin 52:48
Well, we've got a pretty good website that's got all the details there. We have a full-time Business Development Manager who manages our international partnerships. That's Martin Elhay, and that would be the way in or through any of our Department Heads, of course, as well.
Dr Megan Robertson 53:04
Yeah, for specific areas. And I expect that they're very responsive to international collaborations.
Sharon Lewin 53:10
Indeed, they are, I have to say through COVID, we were absolutely slammed with requests, especially in the early days. So we might not have been so responsive in March and April 2020. But generally, yes, we're very responsive.
Dr Megan Robertson 53:23
Slammed with respect with requests, but also slammed with work at the time!
Sharon Lewin 53:27
Yep.
Dr Megan Robertson 53:27
So yeah. Thank you very much, Sharon.
Sharon Lewin 53:30
Pleasure. Thanks, Megan.
Dr Megan Robertson 53:38
Catch us on Twitter, at Global underscore Vic.
Dr Megan Robertson 53:41
We've heard some fascinating information today. Let's finish the podcast with a short panel discussion with both of today's guests. Welcome back, Sharon and Russell. So we've heard a lot of overlapping and complementary information from our discussion with both of you and might pick up on a couple of those areas. So Sharon, you mentioned having a highly trained workforce, and how important that was to progress your research. Obviously, being an academic institution, you run quite an extensive PhD program. Russell, how does industry benefit from that academic base and training?
Russell Basser 54:33
I think it comes back to what what we've been discussing both Sharon and I which is the the ability for the industrial end of things where we apply and hopefully develop success medicines that successfully improve health outcomes in the most sort of insightful and appropriate manner. Insightful, as in how do we understand the science? How do we focus the the ongoing steps of development and make sure that what we do we is relevant. And so having a very strong sort of expert and deeply knowledgeable expert team, we can't we can't do that all. As Sharon alluded to it's a village in anything you do, and going to experts is really advantageous. So yeah, it's sort of self-perpetuating, self-improving cycle that we would that we tap into.
Sharon Lewin 55:22
And we, as you mentioned, Megan, we have about 120 PhD students. And what we've been doing recently is trying to expose them to different career tracks, post PhD. So very few of the PhD students we train end up in academia running their own laboratories. It doesn't suit everyone. Pretty tough road. And we've been actively introducing our PhD students to alternatives like a career in industry, with the plan of doing internships, for example, in big pharma and small pharma and diagnostic labs, etc. And I think that will be critically important for those industry partnerships that we were talking about, you need the workforce, they need to be highly trained. And, you know, our PhD, students need to see that there's a whole lot of different options for them out there, not just one track through academia.
Russell Basser 56:18
And that's a good point and why CSL continues to invest in manufacturing infrastructure, especially in Melbourne, because of the flow of PhDs, you know, highly trained PhDs, not just in the biomedical sciences, but in engineering and other areas that takes to run sophisticated modern manufacturing facilities.
Dr Megan Robertson 56:37
So Sharon and Russell, you've both raised the benefit of being able to conduct clinical trials in Melbourne, sort of very close to where you're doing your basic science. How has that helped your scientists having that link into the clinical perspective, and that knowledge that they can progress their developments through to that?
Sharon Lewin 56:58
Yeah, I think there's a few different pathways here, there's first just the collaboration with a clinician allowing for access to samples for observational studies, which is still very, very important for our basic scientists. The second is investigator initiated clinical trials that have largely funded through competitive funding, which Victoria has been strong on. And the possibility of a fundamental scientist getting into a clinical trial, though I have to say that is a rare pathway. But it's still possible. And we've just done that, as I said, with the phase one study on a COVID vaccine. And the third aspect of clinical trials in Victoria, I think, is an attractive place for companies to do their research here. And that's because of cost, I guess, you know, quite an economical place to do a clinical trial, and also skill set and mindset of clinicians to support and encourage clinical trials.
Russell Basser 58:02
Yeah, and we discussed about the regulatory framework being helpful for those early studies. But from the industry perspective, there's the expertise that can help as we've discussed. Cost is is probably a little less of a driver these days, but quality is a huge driver. So what we get we believe the audits we need to do on clinical data are always at the top level of data that come out of Australia. And it gives us confidence that it's money well spent, and strongly expert groups of people conducting that research even so not so much for early stage, but especially for the late stage studies that you're trying to do quickly and at high quality.
Dr Megan Robertson 58:48
And that data, that Australian data, of course, is very well accepted by both the FDA and the EMA and other regulatory bodies across the world.
Russell Basser 58:57
Sure, absolutely.
Dr Megan Robertson 58:57
So it's it's data you can take internationally.
Dr Megan Robertson 59:00
So as a final question to you both. If you could share one thing with the world about Victoria and infectious diseases research, what would it be? Sharon to you first.
Russell Basser 59:00
Sure.
Sharon Lewin 59:13
Well, I would say to the world that in infectious diseases, you've got everything right here, you've got fantastic infrastructure and physical capabilities, you've got a great workforce, you've got a very collaborative environment and real depth across the big infectious diseases that we really care about today.
Dr Megan Robertson 59:32
Thank you. And Russell, over to you.
Russell Basser 59:35
I think that there's an ongoing long term commitment, bipartisan political commitment, both at the government level, but also at the industry and academic level for enhancing our systems and our framework so that we can be as competitive as anyone in this space.
Dr Megan Robertson 59:50
Thank you. So thank you very much, Sharon, and Russell for joining me today and being part of this discussion. And thank you as well to you to our listeners.
Dr Megan Robertson 1:00:04
If you like what you've heard today and are keen on more information, then check out the links and information in our show notes. And remember, Victoria is a great destination for all things healthtech. We're open for business, and only an email or phone call away. I'm Dr. Megan Robertson. Join me in the next episode of Global Victoria Healthtech Talks.