The George Institute thought leadership program

How can we
think differently about health?

To help end preventable illnesses?

And improve the lives of millions of people worldwide?

Ideas into impact

At The George Institute for Global Health we are focused on tackling the world’s biggest killers: non-communicable diseases (NCDs) and injury. We’re a 600+ person, world-class medical research organisation, operating in 50 countries with four major centres in Australia, China, India and the UK.

Our mission is to improve the lives of millions of people around the world. We believe that practical, cost effective approaches to managing non-communicable disease offer unparalleled opportunities to help people live longer, healthier lives.

We conduct high quality research, develop answers and solutions, and drive impact.

Our model

To complement our world class research, The George Institute’s unique global health policy thought leadership effort focuses on non-communicable diseases and injury, and improved systems for prevention and treatment. We share our insights, challenge the status quo and foster the kind of debates and discussions that lead to improvements in health outcomes. The think tank program involves current researchers at The George Institute as well as non-resident Distinguished Fellows – external experts who are leaders in their respective fields.

Our priority areas

The George Institute’s think tank program priority areas of focus are:

Guiding principles

Our think tank advocacy work follows these guiding principles:

  • Challenge the status quo;
  • Drive critical analysis and reflective thinking;
  • Develop networks and collaborations to enact real change;
  • Target global epidemics, particularly of non-communicable diseases and injury; and
  • Focus on vulnerable populations in both rich and poor countries.

Distinguished Fellows

Do you want to be part of this? Are you a leading health researcher, health policy expert, policy maker or health advocate?

Through The George Institute’s Distinguished Fellows program, you can contribute to the global debate. As a George Institute Distinguished Fellow, you’ll stay right where you are at your own organisation. We’ll support your thought leadership work, helping to amplify your insights to key stakeholders around the world.

Our Fellows will be driving the conversations around non-communicable diseases and injury, and improved systems for prevention and treatments. You will do this through blogs, public talks, videos, social media and discussion papers. We’ll even support you leading an event that will highlight specific challenges and solutions or sponsor your conference presentation or similar announcements related to your research. Our Fellows can also seek the opportunity to engage directly with stakeholders through our offices in Beijing, Delhi, Oxford or Sydney. Our social media, design, events and media teams will help you throughout.

The George Institute Distinguished Fellows Program: Ideas and solutions to reduce the burden of NCDs and injury and improve people’s health.

To apply or find out more, contact Jacqui Webster +61 2 8052 4520 or [email protected]

Who we are: Associate Professor Jacqui Webster

Head, Public Health Advocacy and Policy Impact, The George Institute for Global Health

You are a passionate healthy eating advocate. What inspired you to work in health research?

I have always been interested in food. I grew up on a farm in North Yorkshire in England. Everything was home cooked or from the farm or garden. Mum thought that buying anything like jam or packet gravy from the shop was cheating.

I studied Sociology and then International Development which was when I first became aware of the massive inequalities in relation to food security globally. My first job was advocating for food policies to improve health for people on low incomes in the UK. Later I worked for the UK Food Standards Agency where I helped establish the UK government’s successful salt reduction strategy.

The George Institute’s researchers are leading thinkers on global health. What do you see as the most pressing goals for public health?

A lot of my research to date has been on reducing population salt intake by supporting companies to take salt out of foods and meals. But increasing the focus and spending of governments on prevention policies more broadly is urgently needed. This includes improving environments to support healthier living through better food and nutrition, improved mental health and reduced injuries.

What would you like to see come out of your work with the new think tank?

The George Institute’s research focuses on low cost solutions that have the potential to improve the health of millions of people globally. Our new think tank initiative is about ensuring our research influences policy and practice and ultimately affects people’s health. We will tackle this through cross-cutting issues including healthy living environments, improved health systems, women’s health inequalities and social enterprises. We will engage a suite of different channels including digital media and events to share insights, challenge the status quo and foster the kinds of debates that can deliver real impact in relation to health, both in Australia and globally.

What do you find most intriguing about healthy eating research?

Every individual is different and the factors that influence food choices are complex and changing. The move towards personalised nutrition is fascinating but probably only relevant to a small minority of self-motivated people – for the vast majority of people the food environment, including price, availability, culture, knowledge, and skills, is what influences their daily food choices. Telling people what to eat won’t have much of an impact unless we can change the food environment.

What kind of diets would you like us all to be eating in the near future?

There’s no one size fits all when it comes to diets but in general it would be good to see a shift towards increased consumption of fresh foods and less processed foods. The VicHealth Salt Reduction Partnership tagline, “If it’s packed, chances are it’s packed with salt,” says it all. We need to enable people to eat more fresh foods, including fruits and vegetables, and less processed foods. Obviously, not everyone is going to be able to cook from fresh at home every day so we need to be ensuring that manufacturers increase the healthiness of processed packaged foods and that restaurants and food outlets sell healthier meals.

How have you changed your lifestyle as you learn more about diet through your work?

There isn’t really much I won’t eat occasionally. I love food and enjoy eating out and entertaining. So I try to balance this out by bringing healthy lunches to work and making sure we only have healthy meals and snacks at home most of the time.

When do you think health initiatives work best? Can you give an example of how our research has made a big impact on people's lives, such as with regards to better dietary choices?

Certainly, one of the reasons for the success of the UK salt reduction strategy (that has already reduced salt by 15% and estimated to be saving around 9000 lives a year) was the fact that research, advocacy, government and industry were all brought together on the same page. Plus, the main focus was changing the food environment – in this case reducing salt levels in foods and meals – which was key to success.

Salt reduction programs also have great potential in developing countries and sometimes changes can be made quite quickly. As part of a visit to Mongolia I visited a bread factory and discussed the importance of reducing salt with the manager who immediately reduced the amount of salt added to the bread in the factory – which was producing 50% of the bread in Mongolia.  This would have had an immediate and significant impact on people’s health in Mongolia.

But not all changes are that easy. Processed foods are increasingly available in many countries, and I’m concerned about the rising consumption of products like instant noodles, which may be cheap and convenient, but contain huge amounts of salt.

What keeps you motivated to keep helping people eat better?

Initially my interest was in tackling malnutrition in the form of people not having enough to eat. But over the last 10-15 years my priority has shifted to the growing problem of people eating too much, or the wrong kinds of foods, leading to non-communicable diseases such as diabetes or cardiovascular disease. It’s not difficult to stay motivated. Food systems are complex and there is always something new to learn. Plus, everyone loves to talk about food and health.

The George Institute researchers mainly focus on prevention and low-cost solutions, which ones are you most excited about?

One example is the new affordable dialysis machine that has the potential to massively increase access to this life-saving treatment for people with kidney disease globally.

Meanwhile, SMARThealth provides an exciting opportunity to improve efficiency of patient healthcare in many countries and our trials of a new combination pill (that combines treatments for multiple risk factors) will help to increase adherence and has the potential to dramatically cut costs to health budgets around the world.

These are just some of the examples of low-cost solutions that can deliver impact in relation to healthcare choices, treatment and improving efficiencies of healthcare systems. Our challenge now is to make sure the right people know about them so that they are integrated into policy and practice and ultimately impact people’s health and save lives.

Who we are: Kelly Thompson

Program Manager, Women’s Health, The George Institute for Global Health

What inspired you to work in health research, and what keeps you motivated?

I obtained a great deal of satisfaction from being a bedside nurse but it was really tough work in a challenging system and towards the end I often felt like I wasn’t doing “enough”. I’ve always had an intrinsic knowledge that my purpose in life is to be of service to others and in research I can do this on a large scale and without the burnout that often happens when working on the frontline. Knowing my purpose is what keeps me motivated.

If you hadn’t gone into health, what would you have done instead?

As soon as I stepped foot into my first job after school as a medical receptionist, I knew I would always work in health so I can’t imagine myself working anywhere else. 

What do you see as the most pressing goals for women’s health?

It’s such a vast area with so much work to be done but the bottom line is about making real, measurable progress towards achieving gender equality in every possible context worldwide. In some contexts it’s about ensuring women are given the same opportunities and in others it’s about women being given the same basic human rights as men.

What would you like to see come out of your work with the think tank?

I’d love to see a really strong advocacy program to support the dissemination of women’s health research outside of traditional models so we can have the biggest possible impact.

When do you think health initiatives work best? Can you give an example of how our research has made a big impact on people's lives?

I think public health initiatives work best when they are designed (from the outset) in consultation with the communities they serve, like all of the Aboriginal and Torres Strait Islander Health research done at The George Institute– that really inspires me.

The George Institute researchers mainly focus on prevention and low cost solutions, which ones are you most excited about?

Obviously – the low cost dialysis project is a mind-blower. It is such an innovative model and will drastically improve the lives of people not previously able to access or afford dialysis. This is particularly important for women who are less likely to access and receive life-saving treatments like dialysis due to gender inequality.

Who we are: Professor Trish Greenhalgh

Professor Trish Greenhalgh, is our inaugural Distinguished Fellow and Professor of Primary Care Health Sciences at Nuffield Department of Primary Care Health Sciences at the University of Oxford.

What inspired you to work in health research, and what keeps you motivated?

I think I’ve always had a ‘research brain’. Even at my university interview back at age 17, I was asking the interviewers more questions about their research than they asked me! Research is the systematic search for new knowledge. Whether qualitative or quantitative, research is characterised by careful selection of the appropriate methods to answer the question posed, rigorous application of those methods to the highest standard achievable, reflexive awareness of the possibility of error and measures taken to minimise and take account of error. I guess what keeps me motivated is the excitement of discovery. And by that, I don’t mean dramatic Eureka moments but the more incremental enlightenment we get as we deepen our understanding of complex phenomena.

If you hadn’t gone into health, what would you have done instead?

If I hadn’t been accepted for medicine, I would have kept applying until I got in. I wanted to be a doctor from age 3. I never had a Plan B.

What do you see as the most pressing goals for public health?

The 17 Sustainable Development Goals announced last year by the United Nations are pretty good. One “good health and well-being” is explicitly about health; the other 16 e.g. “end poverty”, “reduce inequalities”, “reduce climate change” are all health-related in some way. I think those of us who are interested in the strategic direction of public health are shifting from single-issue approaches to a more ‘health in all policies’ mindset. I once heard Sir Andy Haines give a brilliant lecture on planetary health; he talked about how he’s working increasingly with zoologists, soil scientists and other experts outside health to try to address global challenges.

When do you think health initiatives work best and can you give an example?

Health initiatives tend to flop when they’re too narrowly conceived e.g. not sufficiently interdisciplinary, and when they fail to take account of context and practicalities. Indeed, I worry about the medical mind-set whose basic script is the ‘drug for a disease’ model. Physician researchers over-use randomised controlled trials – which focus the analysis on demonstrating internal validity (‘can it work’) at the expense of external validity (‘is it going to work here?’). Yes you’re right that research, advocacy and policy need to come together, but I would also say that these streams of activity need to co-evolve from the outset so that – for example – the researcher is writing the grant application with a clear and respectful idea of where the policymakers and advocates are coming from, and that research as it unfolds takes continual account of its intended end-users, ideally through ongoing, cross-sector dialogue.

Here’s an example. My team have been doing a series of studies, mostly secondary research and modelling, on how best to prevent type 2 diabetes through both individual and population measures. We worked from the outset with local policymakers and also from an early stage national policymakers to shape the questions we were asking. They told us that they found existing systematic reviews unhelpful because the questions posed were of academic interest but did not tell them for example which options were likely to be affordable, given local contingencies. Our recent publications, and more in the pipeline, have been tightly focused on providing the kind of answers that policymakers will find useful. See for example:

What recent research excites you and why?

I love Richard Osborne’s work on health literacy. He’s extended the term ‘health literacy’ from the narrow meaning of 'can the person understand medical terms' to a much broader meaning that embraces capacity to access care - including such things as ability to navigate the system, social support, digital access/literacy and what I’d call self-advocacy - and various additional dimensions of being unmotivated, downhearted and downtrodden. These of course relate to the traditional social determinants of health such as poverty and social exclusion. In the OPHELIA project, Osborne’s team have developed high-quality survey instruments to assess these wider aspects of health literacy in a particular community and use those to target different aspects of service development and community support. See for example:

What would you like to see come out of your work with the think tank?

I’m keen to develop some ideas on system-level change and what we might do to complement and/or replace the dominant randomised trial approach. Don’t get me wrong – I owe my life to randomised trial research and I believe these designs have a crucial place in healthcare. But I think The George Institute for Global Health is now at the stage where it’s asking what other methodologies might be helpful in addressing global grand challenges, and how can we apply these appropriately. One of my specific interests is large-scale IT projects and why they so often fail or, if they don’t fail completely, why they so often don’t achieve the benefits anticipated. Whilst I’d be happier studying successful IT projects, I think we’ll have plenty of material to chew on as we consider why some of the tech initiatives funded by The George in recent years have been partial rather than unqualified successes.