SPEECH: 2022 Health and Medical Research Awards

08 December 2022

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Firstly, I would like to make the most important acknowledgement of all.

Tonight we gather on the lands of the Wurundjeri people of the Kulin nation, and recognise their thousands of years of custodianship of lands and waterways that has this country so beautiful.

I pay my respects to first nations past, present and emerging for the privilege of meeting in this place tonight.

It is a great privilege to be a part of a Government who is committed to implementing the Uluru Statement from the Heart in full. Voice. Treaty. Truth.
Friends and colleagues, honoured guests. It is an honour to be asked to present the keynote for Research Australia’s 19th Annual Health and Medical Research Awards.
Australia has long punched above its weight when it comes to medical research.
Despite our small population, there are big brains and mighty teams at work in Australian universities and research institutes.
From the bionic ear – to the cervical cancer vaccine. From Howard Florey’s role developing penicillin to major advances in heart transplantations.

Australia has proven itself, time and time again.

And Research Australia – and its fabulous leadership, with Nadia Levin at the helm as CEO and Managing Director – do amazing work championing our medical researchers.
So much is done to nurture the next generation of researchers who can push new frontiers as well.
And we have so many of the giants of medical research here with us tonight.
I want to acknowledge all the researchers shortlisted as well as those who will go on to win awards tonight.
You are all life savers and heroes, tackling so many different health and medical issues, to improve the lives of not just Australians, but people right around the world.
So, thank you.
Now, I want to talk to you all about women’s health. A great passion of mine.
On the internet, where formalities are somewhat lighter there is an extraordinary hashtag: “#MedicalMisogyny”.
Here, women collate experiences of sexism impacting their medical treatment.
I recommend a search. It is eye-popping.
One woman writes:  “My story of medical misogyny is going to the doctors 5 times with "side pain" and being told it's "just period pain" or "IBS”. When I finally got a scan it was an "ovarian cyst the size of a potato". By the time I was booked in for surgery, it ruptured.”
A writer from Western Australia reveals that she spent from 1995 to 2002 told that her ongoing complaints of exhaustion were just malingering, she had a cold, suck it up. “It would take ‘til 2005 before they diagnosed fibromyalgia,” she says.
It’s a global problem. A horrific story from England relates the experience of a young woman whose sudden episodes of screaming were diagnosed as panic attacks from mental illness. She was placed in institutional care and underwent three rounds of ECT under general anaesthetic. But she was not mentally ill. She had encephalitis.
The Australian journalist, Gabrielle Jackson, was motivated by her own experience of a fourteen-year journey for diagnosis and treatment of her endometriosis to write her powerful book “Pain and Prejudice”. It’s about how our culture treats the pain and suffering of women.
To quote Gabrielle:

'Women are in pain… they're in pain with their periods, and while having sex; they have pelvic pain, migraine, headaches, joint aches, painful bladders, irritable bowels, sore lower backs, muscle pain, vulval pain, vaginal pain, jaw pain, (and) muscle aches… (but) women's pain is all too often dismissed, their illnesses misdiagnosed or ignored.”
“In medicine, man is the default human being (and) any deviation is atypical, abnormal, deficient.”

Let me be clear; as a woman, as a trained nurse and as a member of parliament, I do not believe that there is any nefarious conspiracy amongst groups or individuals getting together in basements and plotting to make women suffer.
But I do I agree with Gabrielle Jackson and the leading researchers in this field (so many of whom are in this room tonight) that women have been seriously under-served by medical systems that are supposed to give them both equity and confidence in their healthcare.
A combination of persistent social prejudice, medical ignorance and research exclusion is a health catastrophe for women. And while as individuals and a community we can express horror that this is the case, a structural reality exposed by researchers in this field explains why and how the horror continues.
A fantastic recent paper from Zoe Wainer illuminated that gender trouble in healthcare isn’t limited just to the ancient stereotypes and prejudices that misdirect treatment and dismiss women’s pain.
Zoe Wainer writes of growing international evidence from pre-clinical and clinical research demonstrating there are significant differences between genders in their susceptibility to common diseases and response to treatment, as well as their experience of adverse affects.
She explains how men and women are affected by different epigenetic, genetic, endocrine, environmental, social, economic and behavioural factors. Ignoring sex and gender differences across the research lifecycle - from grant submissions through to clinical translation - can compromise the accuracy of medical science itself.
What results from this incomplete approach science?
Collecting research data from male subjects and merely generalising to the female health experience has resulted in detrimental health outcomes, increased health costs, and negative social impacts for women.
In a 2020 report, a Victoria University and Mitchell Institute report identified that a health funding, policy and service system that fails Australian women affects their workplace participation, compromises their economic opportunity, reduces their productivity and impacts the cost and the adequacy of social services and aged care.
And we can’t ignore there’s a painful, personal cost for women and their families. Behind every individual statistic is a real person who suffers.
Research reported in The New York Times shows that both doctors and nurses prescribe less pain medication to women than men after surgery, even though women report more frequent and severe pain levels. 
Women’s pain also is more likely to be diagnosed as “psychosomatic” with an insistence it results from their emotional state. Little wonder that a cardiology study conducted by Yale discovered women hesitate to seek help for actual heart attacks because they worry people will think they are hypochondriacs.
Another study found that women complaining of symptoms consistent with heart disease were twice as likely to be diagnosed with a mental illness compared to men with identical symptoms.
Is it unsurprising that women are three times more likely to have a heart attack than men?
In a survey of more than 2,400 women with chronic pain, 83 percent of respondents said they had experienced gender discrimination from their health care providers. This, while in Australia, women are more likely than men to live with at least two chronic conditions.
The Royal Australian College of General Practitioners declared last year that merely being female indicates higher risk criteria for some of medicine’s most challenging conditions.
Of the 8% of the global population with autoimmune disease, 78% are women.
We are three times more likely than men to develop rheumatoid arthritis.
We are four times more likely to be diagnosed with multiple sclerosis.
Women make up two-thirds of people with Alzheimer’s disease, and women are at least twice as likely to suffer chronic pain conditions such as fibromyalgia and chronic fatigue syndrome.
And yet, as the growing body of evidence shows us again and again, these conditions overwhelmingly affecting women are the ones that most go under-researched, undiagnosed or untreated.
Don’t get me started on what we still don’t know about women’s reproductive healthcare, periods, endometriosis, perimenopause or menopause, even though one in three women will suffer from a reproductive or gynaecological health issue in their lifetime.
The health disparities between men and women compound healthcare challenges for women and girls who already face additional disadvantage – including First Nations women, the LGBTIQ+ community, migrant and refugee communities, and those who live in rural and remote regions.
Structural problems require structural solutions.
The Australian Government is committed to maximising the impact of Australian health and medical research investments and addressing iniquities - because doing so is to the benefit of all Australians.
The Government supports a thriving health and medical research sector for everybody.
This is why our October budget confirmed over $1.5 billion available through the National Health and Medical Research Council and Medical Research Future Fund for the coming year.
We have also announced major reforms to the way NHMRC awards Investigator Grants, so they are awarded equally to women and men.
The Department of Health and Aged Care will also regularly review variations in MRFF funding outcomes by gender to mitigate against any biases in funding that may emerge.
At the same time, the Australian Government has committed to deliver a National Strategy to Achieve Gender Equality, to be led by our fabulous Minister for Women, Katy Gallagher.
The strategy is our opportunity to join the dots between women’s health and wellbeing, women’s economic equality, women’s safety and women’s leadership, representation and rights.
Because our experience of health and well-being cannot - and should - not be separated from our experience of gender equality.
So, tonight, I have the humble honour of announcing that the Albanese Government is creating a National Women’s Health Advisory Council to make expert, strategic advice directly to the ear of Government.
I will have the privilege of chairing this council, committed to guiding Australian expertise towards improving local health outcomes, reducing post-treatment complications and to providing targeted and effective healthcare for Australian women.
Ours is an Australia-wide approach to reducing inequalities and improving health outcomes for all women and all girls.
The Council’s work will complement existing Commonwealth initiatives that aim to address sex differences in the health system, including through the National Health and Medical Research Council and the Therapeutic Goods Administration’s Women’s Health Products Working Group.
Our policy remit includes consideration of sex and gender in health and medical research, clinical trials, investigational testing and distribution of research funding, with a focus on ensuring women have improved health outcomes where disparities exist.
We’ll address the evidence base for diagnosis, treatment and management of health conditions where outcomes are known to differ by sex and/or gender, identifying differences in respect to clinical guidelines, diagnostic tools, medical devices and medical consent.

We’ll consider active measures to improve health and wellbeing outcomes for women in priority populations, such as First Nations women; lesbian, bisexual, transgender, intersex and queer people; culturally and linguistically diverse people; lower socio-economic; regional and remote communities; and those with a lived experience of disability.
Our remit will include assessing the accessibility and affordability of sexual and reproductive healthcare, opportunities to reduce clinician bias through workforce education and improving the health literacy of women and girls.
And that’s just at the first meeting!
But, seriously: Government is pursuing a wide-ranging policy agenda because to talk about women’s healthcare in Australia is to acknowledge the experience of a historically-marginalised majority, and an unjust suffering born of bias and exclusion.
Every woman I talk to has a story or an experience – of their pain being dismissed, or not getting the help they sought.
And we owe it to the women who’ve suffered – and those who should never have to – as much as we do to the higher standards we demand of ourselves, to be bold, to be fair, and to have ambition.
As a Government, this is a frontier we need to push.
And let me again commend everyone in this room – Research Australia, the award winners and all the medical researchers – for the frontiers you push in your work.

You improve the world for so many people.

Thank you.