Scientists propose system redesign to improve access to clinical trials

Ensuring that the latest clinical research opportunities, and the healthcare benefits that flow from them, are available to all New Zealanders is at the heart of a new report.

Enhancing Aotearoa New Zealand Clinical Trials is the result of 18 months of work by a team of researchers funded by the Ministry of Health and Health Research Council of New Zealand.

Professor Frank Bloomfield, director of the University of Auckland’s Liggins Institute says there is inequitable access to clinical trials around New Zealand.

“In particular, Māori, Pacific and rural New Zealanders are more frequently missing out both on participating in clinical trials and on their benefits,” Professor Bloomfield says.

“Outside of large research groups or large, research-intensive hospitals, of which there are not many, there is limited capacity or resource to support clinical trials taking place or even participation in, for example, a larger national or international trial.”

The report proposes establishing a new National Clinical Trials Infrastructure Centre that would provide a ‘front door’ for anyone planning a clinical trial, as well as executive leadership, in partnership with Māori and consumers.

New regional Clinical Trials Coordinating Centres would support local trial development and conduct to ensure equity of access for researchers and participants.

Professor Lisa Stamp, of the University of Otago, Christchurch, explains that clinical trials are a central element of a modern, high-functioning health system. Clinical trials can provide access to novel treatments for patients and deliver cutting-edge healthcare.

“Not only would a national clinical trials model give patients access to trials, but international evidence is clear that patients involved in clinical trials do better health wise - their health will benefit,” Professor Stamp says.

“The newly emerging structure for the New Zealand health system as a whole represents an opportunity to embed research into the heart of our health services developing a learning health system that works to the highest level for the benefit of people in Aotearoa.”

Dr Matire Harwood, head of the department of General Practice at the University of Auckland, says that a particular issue identified through questionnaires, research and hui leading up to the report is a need to develop the Māori and Pacific research workforce, and support research led by Māori and Pacific providers.

“As well as partnering with Māori and Pacific communities, we need to upskill our tauiwi researchers to conduct culturally responsive and safe trials,” Dr Harwood says.

The report also calls for a national health data system that provides culturally appropriate long-term storage of data and tissue samples, and supports translation of research findings into clinical care.

Professor Stamp says, with the right investment, there is potential to recognise the unique contribution of Māori and Pacific mātauranga to clinical research, while also developing our international reputation for excellence in clinical trials.

Professors Bloomfield and Stamp co-led the report together with Associate Professor Matire Harwood (Ngāpuhi) and Professor Stuart Dalziel, both of the University of Auckland, and Professor Katrina Sharples, of the University of Otago.

In response to the report, Manatū Hauora, Te Whatu Ora (Health New Zealand) and Te Aka Whai Ora (Māori Health Authority) are establishing a senior cross-agency working group to consider how the recommendations can be integrated within the health system, with each agency appointing a lead for the work. See Manatū Hauora statement.

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