Transcript: MJA Podcast interview with Professor Anne Kelso AO on her term as NHMRC CEO

Listen now: MJA Podcast 2022 Episode 46: Towards gender equity in research funding, with Prof Anne Kelso AO

Cate Swannell: From the Medical Journal of Australia, I’m Cate Swannell. Welcome to the MJA Podcast. This podcast is recorded and produced on the lands of the Giabal and Jarowair peoples. I would like to acknowledge the Traditional Owners of this land, their elders past, present and emerging.

In about five months’ time, Professor Anne Kelso will step away from the role of CEO of the National Health and Medical Research Council, a position she has held since 2015.

The NHMRC has just announced a new approach to gender equity in the granting of research funds which will start to bear fruit in October of next year, when successful applications are announced.

We invited Professor Kelso to have a chat with us today about that new program as well as to reflect on her time as boss of the NHMRC and what might come next.

Cate Swannell: Been an age!

Professor Anne Kelso: Absolutely. We talked very soon after I started.

Cate Swannell: Yeah, 2015 it must have been. As you said when we last talked to you, you were fresh into the job by couple of weeks I think. How's it look now?

Professor Anne Kelso: Well, I am looking back on seven and a half years of it now and with just five months to go before I’ll finish my term, I’m not seeking reappointment, because I think you know there’s a right time for these things and really important not to stay too long. I hope by the time I’m finished people won’t be saying, ‘You stayed too long’.

Cate Swannell: Have you reached the goals you wanted to achieve back in 2015?

Professor Anne Kelso: I came into the role not really thinking, you know people always say what’s your vision and my feeling was, I understand NHMRC from an outsider’s point of view and as an applicant and I’d been on some committees and I was on Council, but I don’t actually understand the agency as a thing and so I spent a bit of time trying to, well, obviously, learn about the place and learn about the job and also just to listen to people and try to understand what the biggest issues were.

So that’s not like coming in with a big vision where I'm going to fix this but I did see that we were, the whole funding program was under huge pressure.

We then talked a lot internally about how to review that, how to consider the best way to reshape it. And I decided the best thing to do, rather than getting one of the big consultancy firms to do a review for us, that I’d pull together a bunch of terrific people from around the country who are researchers in different ways from different types of institutions, different fields, to talk this through and so the big thing I did in those first couple of years was to have the expert advisory group and they advised us on the redesign of the grant program and then we had a huge project of redesigning the grant program.

Cate Swannell: And then of course COVID turned up.

Professor Anne Kelso: Yeah and of course [that was] predictable and unpredictable. I come from the flu world so I knew pandemics happen but you can never say when they’re going to happen, you don’t know how big they’re going to be. So we just obviously experienced something absolutely huge from a global point of view.

It’s interesting looking back, you know, would we have disrupted so much of our grant program at that time if we knew we were about to face that disruption? Well, no, probably we wouldn’t. The new grant program started in 2019 and the first grants started in January 2020.

Cate Swannell: There you go. Bang.

Professor Anne Kelso: One of the consequences of that is really hard now, four years into the new grant program, to look back and say well what’s worked and what hasn’t worked, because we’ve had this enormous disruption by COVID. So I think it will take a bit longer to be able to say okay, well you know what needs adjustment? What's going well.

Cate Swannell: It has been a huge disruption of many things. You’re an immunologist, I mean basically, and you come from the vaccine technology world as well I believe. What have you made of it all?

There have been terrific advances with the mRNA vaccine platform etc. How do you feel personally rather than from an NHMRC point of view? How do you see the progress we’ve made in terms of vaccine technology and where we still have to go?

Professor Anne Kelso: Well, I think it was a fabulous demonstration of what you can achieve in an emergency and we all wish you could achieve at such pace in normal times and it’s kind of unrealistic to expect that kind of pace.

I mean leaving aside mRNA vaccines that came along and are truly transformative. Think about the fact that we had the Astrazeneca vaccine produced so soon into the pandemic, a more conventional vaccine, but an absolutely extraordinary piece of work in a very short time that meant at every level of that invention and production process people had to take risks not knowing whether it would work, not knowing whether the funding would come through, but absolutely driven by the public health need, and I just think that was brilliant.

So even before we had the thrill of finding out the Pfizer and Moderna mRNA vaccines were actually effective, we had already had something that worked.

Cate Swannell: From a grants and research funding point of view, is COVID dominating?

Professor Anne Kelso: We continue to get requests for funds and we also have been very flexible in our advice to people who already had funding that if they wanted to pivot their research towards COVID, you know, there were a lot of virologist, immunologists, epidemiologists already funded and many of them pivoted their work and that was completely okay with us, that was the right thing to do.

NHMRC didn’t rule out special funding for COVID but the Medical Research Future Fund did and so we had a complementary role there.

We talked a lot at NHMRC about what to do early in the pandemic what to do about our grant program. Would people be able to do research? Would peer reviewers be available to view grant applications? So we trimmed some things back, we streamlined, we pulled in extra money where we could to provide extra funding which mainly rolled out in 2021.

So mainly what we decided to do was to try to keep things as stable as possible so that people would continue to have a place to go to, to apply for funding rather than totally disrupt our way of doing things. So we just tried to get a balance between continuity and a bit of trimming back to reduce the load. A pragmatic rather than an exciting approach ...

MRFF really covered off on extra funding for vaccine development and a whole lot of other things which were very good.

Cate Swannell: Let’s talk about the gender equity situation because you've just published with the MJA a perspective about what the NHMRC is going to be doing in terms of gender equity for research funding. What's the current situation and what did you feel needed doing?

Professor Anne Kelso: Well, this is something that probably when I came into NHMRC … actually, let me step back. When I was first offered the job of CEO of NHMRC I met with the then Minister for Health, who was Peter Dutton. We forget now all these years on that he was the Minister for Health for some time. And when he met with me, the first question he asked me was, “What are you going to do about women?”

I was a bit taken aback because it was not the top of my agenda, you know, I was a female researcher, but I was not particularly aware of how bad the data were. And it was only really when I came into NHMRC and saw the data and saw particularly in our fellowship scheme how women simply disappeared from the scheme that I started to see that actually, there was a substantial problem here.

So we, I mean Warrick Anderson as CEO before me had started a number of gender equity initiatives because he was really aware of the problem towards the end of his own tenure, and we continued with those and in 2017 we started doing something new with our Project Grant scheme at that time and that was to give what most people would call near miss funding.

So we would go below the funding cut off with an extra budget to fund some extra grants that were led by women. They were still very highly ranked, highly scored, you know, really excellent applications, it wasn’t a question about their quality, it was simply a way to boost the opportunities for women and to reduce the gap between men and women in that which was our biggest scheme at the time. So we have continued doing that for several schemes since, but it hasn’t been enough.

And we introduced in the new grant program … the Investigator Grant scheme is a different type of Fellowship scheme. It's still a fellowship but it has a research support package as well, so the overall funding into that scheme is a lot bigger than it was in Fellowships because of these packages being part of the deal as well. But it is still a scheme which funds people at every career stage from early post-doctoral all the way through to the most senior professorial people in the country with five stages there.

And so it showed just exactly like the old Fellowship scheme that more women than men are applying in the post PhD years and then sometime in mid-career just a few years later that the women are disappearing fast and by the time you get to the most senior level you've got about four times more applications coming from men than from women.

Cate Swannell: I know that there are some quarters of the medical research profession would say oh well that’s women’s choice, they go off and have babies and they do the family thing and so why should we treat them, that’s their choice, why do we need to give them help.

Professor Anne Kelso: Yeah, and I think in many cases there may well be people who for very positive reasons make a change and decide that this is not going to suit the way they want to live their lives, but I think we know from the experience in many professions and in many countries like our own as well as in Australia that many women are leaving the sector or leaving the fellowship applicant pool, which is a subset of the sector, because of the uncertainty, the insecurity, and because of the ways in which their contributions are not always recognised at the level that their male colleagues are.

A fantastic study in the US that was published in Nature in August, [a] huge study about when you correct for all the different parameters and differences, [found] women were still receiving less credit as authors or as inventors on patents than their male colleagues. So I think there’s that sort of issue.

I think there is also a hidden issues [that’s] just been coming more in recent years and that is of harassment which will tend to be of men versus women. You know, sexual harassment and abuse of various kinds or all the milder sorts of harassment that are belittlement or those sorts of issues.

We hear more and more now, of course it’s also partly because of the Me Too movement, but we hear more and more the stories of women who will leave a lab or will leave a profession because of the environment. Now I have no idea how large that issue is, but I think it is just one of many factors which are kind of hidden. We know about them but they’re really hard to measure. But they all add up to what we have called, and what many people would call, systemic disadvantage for women. I think this is a really important factor in the disappearance of women from our senior workforce.

And a really important issue here is, you know, many people are saying, and I understand the reasons, surely this is just a matter of time … all these brilliant energetic young women coming into our research workforce in significant numbers post PhD, and it's just a matter of time, they'll all appear [in higher] levels … if we wait 20 or 30 years.

We have pretty good data back to the year 2000s, and that’s 22-23 years and we have had more women applying for fellowships since 2001. So that’s 20 years, 21 years of women entering our particular bit of the workforce in larger numbers than men and that bubble that has not come through as a bubble and we've seen very little progress.

Cate Swannell: I'm chatting today with Professor Anne Kelso, the CEO of the NHMRC, about her years at the top and a new system for improving gender equity in medical research funding.

Professor Kelso recently wrote on this topic in the MJA and you will find the full link to that article in the show notes to this podcast. Don't forget you can find all our previous episodes at mja.com.au/podcast. And you can guarantee you won't miss any upcoming episodes by searching for Medical Journal Australia at your favourite podcast platform and hit the subscribe button.

Back to our chat.

Professor Anne Kelso: I think this thing about credit is really interesting. You know, and in the end we collect anecdotes because it's so hard to get a data, but we did have somebody, an academic from a regional university, talk to us at one of our leadership roundtables during our consultation in August and she talked about the fact that she worked as a researcher in labs both in Australia and the US. And her experience was that her male colleagues at the same stage were asked by the supervisor to write the grants and she was told to get on and produce the data.

And you know it's an anecdote, but it's the sort of thing that means she's the technician and the male colleague, who's at the exactly the same stage, is being given the opportunity to advance as an independent researcher.

We have to not make too much of the anecdotes but they do help to bring home what that means at the level of each person. If there are many people having that kind of experience.

Cate Swannell: Talk to us about the new special measure that the NHMRC is going to bring in next year.

Professor Anne Kelso: Well, because this is a pipeline effect and because we don’t really have an issue at the early stage of this Investigator Grant scheme because this is where women are coming in, they’re doing well, but they start to disappear.

So we’re focussing on the more senior levels of the scheme and have simply made the decision to aim to award equal numbers of grants to men on the one hand and women and non-binary researchers on the other.

We did modelling of if we'd done that in the first three years of the scheme what would the outcomes have been and of course, you know, it means fewer men get funded more women get funded. It has very – at least in the modelling – has very little impact on merit because there's a great bunching of applications of very similar score through peer review that are essentially indistinguishable.

So our modelling showed that if you went further down that distribution to pick up more women, to award more grants to them, you would only reduce the funding cut off for them by about 0.13 out of 7.

So we have a 7 point scale and you are going down by about 0.13. And the cut off for men would go up about a similar amount. So you're at the point where actually there's no real difference in quality when you're talking about 0.1 out of a 7-point scale. The merit issue is a minor one here because that's the other, of course, the other concern that people raise, well, you know, now you’re funding on gender not on excellence.

Well, from what we understand of the distribution of the scoring when we look at the first few years of the scheme, this is not going to undermine excellence. We will still be funding absolutely excellent people but we will be making a relatively small adjustment for that systemic disadvantage that women have experienced and continue to experience.

Cate Swannell: So male grant applications will be competing against other males rather than against women as well.

Professor Anne Kelso: That’s correct.

Cate Swannell: Cool.

Professor Anne Kelso: We essentially make two separate competitions.

Cate Swannell: When will that start happening, Anne?

Professor Anne Kelso: Well that's for a scheme that's opening in late January and so it takes a good part of the year for people to put in their applications then for them to go through peer review and then for the funding recommendations to be developed and to go through approval and ultimately approval by the Minister. So we would expect that probably [it’s] going to be around October next year that we would be announcing those outcomes.

Cate Swannell: Why now?

Professor Anne Kelso: Why wait? I think the only question will be should we have done it in a staged way where instead of going to equal numbers you go to say 75-25 and spread it over two or three years. That would have been a possibility.

When we consulted with the sector there wasn’t a lot of enthusiasm. There was some support but not a lot of enthusiasm for doing it in a staged way. I think you know if you look back over more than 20 years of data with very little shift you think well, let’s get on with it. The sooner we get on with it the sooner we get the ripple effects. I am really interested to see how this plays out.

The first ripple effect I hope for is that more women will have the confidence to have a go. Our problem at the moment is that women aren’t applying so of course they can’t get funded. The more women that apply, the more chance they have of getting funded, you know, based on merit of course.

There’s another ripple effect that I want to mention too and a couple of people brought this up with me and I’m really pleased to hear it and that is institutions might start to think it's useful to recruit women and not only men. Because this is a strategic and a financial decision that institutions make when they decide who to try to recruit and who to provide resources to, to enable them to succeed.

And I think this sort of step even though it's just one scheme from one funding agency, it's the sort of step that might make people think, well, actually, female researchers are just as valuable as our male researchers.

Cate Swannell: Have you had fun?

Professor Anne Kelso: This job is an extraordinary job. It’s a huge privilege to have a job like this. Clearly, I have the chance to influence policy and it’s not just my decision I don’t do everything on my own.

We have wonderful advice from our council and our committees, and I report to a Minister who ultimately makes the decision on everything important. In a role like this you have the chance to influence policy about something that you care about.

I think the other thing is that having come from an academic background and some engagement in global public health through influenza, I've now worked inside government for a few years and that gives you a different perspective on the world and it teaches you something about how the world works that I think is just extremely interesting and useful.

Cate Swannell: What's next, for you, do you think?

Professor Anne Kelso: Well, I'm not looking for a job, so I think the first thing to do is to take a break. I mean in the meantime I still have several months left to go and I’m very focused on how effectively I can use those remaining months.

Cate Swannell: For sure, yes.

Professor Anne Kelso: That’s the most important thing. And as I get nearer the end of those months, I will get more focused on what’s going to be important next. But I hope that my experience is valuable in some way beyond what I've done up till now but I'm so not in a rush to fill the hours of the day because there’s so many interesting things to do in life and in the world.

Cate Swannell: I think if the Federal Government managed to get a national CDC off the ground, I suspect you might be a good candidate?

Professor Anne Kelso: Well, I don’t know but I’m very interested to see how that develops. COVID has told us a lot about our needs as a country and what works and what doesn’t work and what fabulous assets we have. And of course, from an NHMRC perspective, we have an extraordinary asset in our research sector. We also clearly have challenges of a federation and there are many issues that I hope that an Australian CDC would be able to address.

Cate Swannell: Anything else?

Professor Anne Kelso: Well, when I think about gender equity, I mean it's an interesting experience for me because I will have left NHMRC by the time that the first round [of Investigator Grant outcomes since the gender equity intervention was introduced] is announced. I think that at that time we'll need to think very carefully about what the impact of the initiative as it will be important to monitor it very closely.

And I will certainly hope NHMRC will be very transparent about the outcome so that everybody can engage in a discussion about how that's going and what the impact has been across the sector. That will be a very important time for us.

Cate Swannell: I think transparency has been one of the hallmarks of your reign. Don't you think it's been something that seems to be very important to you?

Professor Anne Kelso: It has been important to me and I think it's assisted by the fabulous data team we have here but also by the development of data technologies because the work that would have been needed 10-15 years ago to be able to put out the level of data that we can now would have been really very, very heavy. Of course, it’s still a big job.

We are greatly assisted by the fact we can collect data, and analyse data, so much more effectively today. So, I also naturally hope that NHMRC will be able to continue to put out a lot of data about what’s happening. It gives the sector insight and I think it helps us develop better policies as well.

Cate Swannell: Thank you so much for the last eight years. It has been fabulous to work with the NHMRC during that time. You have been always so accessible, so I really appreciate that and I’m sure our listeners do too.

Professor Anne Kelso: Thanks very much, Cate. It’s been good to talk with you.

Cate Swannell: Thanks to my special guest today. Don't forget that all our podcasts are open access and available at www.mja.com.au/podcasts or you can subscribe to our feed at iTunes. My name is Cate Swannell, and we'll see you next time.