Looking back over what’s universally recognised as a most extraordinary year, the National COVID-19 Clinical Evidence Taskforce represents something greater than the sum of its parts. On one hand, the contributions of member organisations, expert panels and evidence teams can be expressed in a string of impressive figures. Think: 240 people; 14,000+ volunteer hours; 7,000+ global studies screened, synthesised and summarised; 130 expert panel meetings convened; 114 clinical recommendations published; and 200,000+ people from 180 countries accessing weekly updates to clinical guidelines and flowcharts… You begin to get an idea of the scale of time, effort and shared industry this undertaking has involved. On the other hand, there are many less tangible but equally remarkable achievements to highlight in any evaluation mix. Chief among them, is the genuine cross-disciplinary collaboration, good will and unity of purpose the Taskforce has both engendered and facilitated across the worlds of health, government and philanthropy in Australia this year.
There are perhaps few people better placed to reflect on this than Craig Connelly, CEO of The Ian Potter Foundation. As the chief executive of a philanthropic funder, a financier and a former critical care patient he brings a unique perspective to assessing the kinds of people, projects and ideas that deliver the best social, economic and health outcomes for Australians from all walks of life. The Ian Potter Foundation was an early and enthusiastic supporter of the Taskforce in 2020, signing off an initial grant of $500,000 as the first instalment of a larger $2.5 million grant supporting the Australian Living Evidence Consortium (ALEC). This critical support set the scene for additional leveraged contributions from fellow philanthropic organisations and governments state and federal throughout the year.
‘Not everything we fund has the capacity to impact nearly every Australian,’ Craig says. ‘But the Foundation recognised early on that the National Clinical Evidence Taskforce actually does. In the context of the unfolding COVID-19 pandemic back in March, our preferred approach was to support leading experts we already knew had a proven track record of delivering the maximum benefit and greatest good through innovation and real national leadership. Taskforce Director Julian Elliott falls squarely into this category, having previously impressed us greatly with the development of Covidence, an innovative technological development that will be an integral component of the work to speed up research translation in Australia through ALEC. This concept of ‘living evidence’ that distils all the learnings coming in from around the world in near-real time and disseminates them to frontline health workers at the coalface represents clear, immediate and far-reaching impact.’
‘And perhaps most critically, Professors Richard Larkins and Fiona Stanley – who are both Foundation Board members and pre-eminent national health experts – advised the full Foundation Board at the time, that the Taskforce could be the single most significant grant we could fund in support of efforts to alleviate the impact of COVID-19 on both frontline clinicians and patients who might be afflicted with the virus in the months or years to come.’
As Professor Larkins himself notes, one of the biggest challenges in delivering effective healthcare is ensuring it’s based on the best available evidence. ‘Clinical guidelines attempt to make evidence-based advice accessible to clinicians in a user-friendly and timely format,’ he says. ‘But the challenge has always been to ensure they are up-to-date and accurate, which is a particularly difficult task given the proliferation of new information and data from clinical trials around the world. The NHMRC and many other international bodies have wrestled with this problem for many years.’
‘In this context, the new concept of ‘living guidelines’ promises a transformational approach by combining innovative technologies with expert panels to enable real time assessment of evidence and frequently updated clinical recommendations that are valid and contemporary. As we have seen this year, the ability of ALEC and the Taskforce to pivot to focus on COVID-19 and evaluate a very large number of trials and studies in this way demonstrates the effectiveness of this model and provides an invaluable resource as we continue to tackle this global health crisis here in Australia and around the world.’
In broader social as well as health terms, Craig sees additional bigger picture benefits flowing from the Taskforce’s real-world demonstration of how living guidelines can improve future health and medical care – particularly in the context of access and equity for all Australians. Access and equity are two key concerns on both a professional and personal level, given Craig’s own first-hand and often harrowing experiences of healthcare systems. Feeling a little unwell during an overseas holiday back in 2005, what he first thought would be a quick trip to a Quebec hospital ended with a shock leukaemia diagnosis and began a long and difficult patient journey. In the year that followed, Craig endured an incredibly intensive chemotherapy regime, countless failed treatment attempts and more than one brush with death during long stints in regional and metropolitan hospital ICUs.
‘My diagnosis and ensuing treatments certainly rocked my world,’ Craig reflects. ‘And after many critical experiences I won’t detail here, I ended up being the first ever successful recipient of non-familial white blood cells – thanks to a life-saving donation from my wife – at the Royal Melbourne Hospital. The care I received there was truly amazing, and it contrasted sharply with some of my experience in regional hospitals. It probably goes without saying then that these experiences will influence my outlook on health until the day I die, no question. This is in large part because they made me appreciate how different my experience might have been if, instead of living five minutes from a world class metropolitan hospital, I lived in rural or regional Australia. How would my family been able to visit and care for me? Would my doctors, nurses and allied health professionals have had access to the most up-to-date information and resources? These are the real equity issues and questions I see in terms of the healthcare available to people from different socio-economic backgrounds and geographic locations around this country.’
‘So bringing this back to the present and looking at this issue through the lens of my role as CEO of The Ian Potter Foundation, I see our current support for the Taskforce underpinning and facilitating learnings that will flow back into the Australian Living Evidence Consortium. If this assists in continuing to improve our national capacity to innovate and ensure the delivery of high quality, accessible health services for all Australians, that’s exactly the impact The Ian Potter Foundation, in partnership with outstanding organisations, aspires to achieve.’
‘And if you take that a step further, looking back on this extraordinary year, you can certainly conclude that from any angle the National COVID-19 Clinical Evidence Taskforce represents the best kind of investment in people and technological innovation that might actually deliver improved healthcare outcomes for many Australians.’
And that is quite the equation.