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Medical research

by Derek Dow

In the quest to understand the human body and keep communities well, New Zealanders have been embarking on important medical research projects since the late 19th century. Some research is funded privately and some by the government.

Early days, 1890s to 1930s

Early researchers

Medical research in New Zealand was initially conducted on a personal level and in an ad hoc fashion. The first substantive work was by John Halliday Scott, who was professor of anatomy at the Otago Medical School in Dunedin from 1877 to 1914. In 1893 he published research into the biological origins of Māori.

In the 1910s Henry Pickerill, dean of the Otago Dental School, investigated immunity to dental disease among the Urewera people, a study partly funded by London’s Royal Society of Medicine.

Pioneering plastic surgeons

Harold Gillies and Henry Pickerill were pioneers of facial reconstructive plastic surgery. Both treated war casualties at St Mary’s Hospital at Sidcup, England, in 1918. Gillies, born in Dunedin, studied medicine at Cambridge. Pickerell was English, but had been dean of the Otago School of Dentistry since 1907, and returned to the position in 1919. Gillies ran another British plastic surgery unit during the Second World War, assisted by New Zealanders Archibald McIndoe and Rainsford Mowlem.

Health Department

The report of the 1919 New Zealand Influenza Commission stressed the importance of medical research work. It recommended attaching a representative to the newly formed British Medical Research Council to report back to the New Zealand government. The Health Act 1920 duly specified that the Health Department should promote or carry out research into public health and preventing or treating disease.

In 1926 Robert Makgill of the Health Department, while visiting Britain, talked to the British Medical Research Council and the Ministry of Health. His aim was to find ways of co-ordinating research with British institutions and to extend his own department’s research.

Iodine deficiency

In 1920–21 Charles Hercus and Eleanor Baker, working for the Health Department, researched iodine deficiency and goitre among Canterbury school children. Muriel Bell’s 1926 Otago Medical School thesis on basal metabolism in goitre provided still more information. These studies, along with major research by Robert Shore and R. L. Andrew of the Dominion Laboratory, helped persuade the government to introduce iodised salt to combat iodine-deficiency goitre. The effective proportion of iodine to be added to salt was determined by further research at Otago by Herbert Dudley (Dick) Purves. This knowledge led to the virtual elimination of goitre in New Zealand.

Otago Medical School

By the mid-1920s the Otago Medical School was conducting research into:

  • cancer
  • rheumatoid arthritis
  • acute poliomyelitis
  • Māori tuberculosis.

Charles Hercus, a strong advocate of medical research, was appointed professor of public health and bacteriology at the Otago Medical School in 1921. Hercus became Dean of the Otago Medical School in 1937, and held the position until 1958. He made research a priority for the school, and at the time of his appointment as Dean he called for the creation of a medical research council, to coordinate ‘all epidemiological, clinical and laboratory research on medical and dental problems.’1

Refugee researchers

The Nazi persecutions of the 1930s brought a number of significant medical researchers to New Zealand. Franz and Marianne Bielchowsky were forced to leave Germany because of Franz’s Jewish ancestry. After medical work in Spain during the Spanish Civil War, they came out to New Zealand. The Bielchowskys became noted researchers at Otago, with Franz working on cancer and Marianne on immunology. Walter Griesbach was another researcher who fled Nazi Germany and ended up at Otago. Griesbach worked with Dick Purves on important thyroid research.

Foundation of the Medical Research Council

In the mid-1920s the Health Department began investigating ways of supporting more research. The Labour Party’s 1934 health manifesto, drawn up by Dr Gervan McMillan, called for adequate health research funding. With the election of a Labour government in 1935, the director-general of health, Michael Watt, pushed ahead with plans for a medical research council. The New Zealand Medical Research Council held its first meeting in December 1937. In a public announcement soon afterwards, Health Minister Peter Fraser stressed the value of a centralised organisation to avoid overlap and unnecessary expense.

    • Auckland Star, 20 January 1937, p. 5. Back

Medical Research Council, 1937 to 1990

Research at Otago

Medical Research Council (MRC) funding was at first restricted to £5,000 per annum, with a large portion of the research work to be carried out at the Otago Medical School in Dunedin. The MRC chose to focus initially on four areas of investigation, each with a separate oversight committee:

  • nutrition
  • goitre
  • hydatid disease
  • dental caries.

Research was expanded in 1939 to investigate tuberculosis and obstetrics.

Each of these fields reflected existing research. The Otago Medical School, for example, already had a Hydatid Disease Research and Prevention Department headed by Professor Louis Barnett, who had pursued this interest since the 1890s. Charles Hercus directed Otago research into goitre.

Nutrition, under Muriel Bell, assumed increasing importance during the Second World War.

Despite the constraints of war, there was further expansion in the 1940s. Clinical medicine was added, under Horace Smirk. A future Nobel Prize winner, John Eccles, led neurophysiology and neuropathology research during his six years in New Zealand. An acceptance of wider responsibility for the south-west Pacific saw the creation of an Islands Territories Research Committee in 1946.

Muriel Bell and public health

Muriel Bell’s research into nutrition had a significant impact on public health. She delivered dietary advice through the popular press during the Second World War. Bell became an advocate for milk in schools, for adding fluoride to public water supplies, and for diets that would reduce cholesterol. Her public health campaigns often met concerted opposition, but ‘battle-axe Bell’, as she dubbed herself, fought on regardless.

Consolidation and expansion

In the 1950s and 1960s the range of medical research carried out in New Zealand expanded considerably. The MRC, formerly within the Health Department, achieved independent status under the Medical Research Council Act 1950. From 1951 the MRC assumed both an advisory and a controlling function. Initially the council focused on consolidating ongoing projects, but by 1954 the time was ripe to expand into new fields of research.

The MRC introduced fellowships to promote research by attracting dedicated young researchers. The first was awarded in 1949 to Raymond Blakley, who later worked on biochemistry in Australian National University’s John Curtin School of Medical Research. By 1961, 10 junior research scholarships at the University of Otago were also funded by the MRC. The number of fellowships and scholarships increased markedly during the early 1970s, from one in 1969 to 23 in 1974.

In 1961 the council established 14 research units or equivalent groups. By 1975 six of the original groups had been disbanded, including Nutrition (on the retirement of Muriel Bell in 1964) and Hydatids (transferred to the Ministry of Agriculture and Fisheries in 1972). The MRC was by this time responsible for 102 units, groups or projects, and had a forward planning committee to help identify priority areas.

From the early 1970s the council instituted a process of systematic scientific review to evaluate all research proposals.

Sheep, seals and premature babies

By investigating the hormones of foetal sheep, Graham ‘Mont’ Liggins made a discovery that saved the lives of tens of thousands of premature infants. He found that administering corticosteroids to women about to give birth to premature infants helped develop the foetal lungs, preventing the newly born babies dying from respiratory distress syndrome. Liggins’s foetal research also included a summer in Antarctica. There he studied how deep-diving female Weddell seals were able to supply their foetuses with enough oxygen.

Significant research

Dick Purves became director of the Thyroid Research Department at the University of Otago, later renamed the Endocrinology Research Unit. Purves and Walter Griesbach greatly advanced the understanding of the gland’s physiology and cytology (cell structure and function). Working with T. H. Kennedy and Duncan Adams, Purves identified the cause of Graves’ disease and the drugs that could treat it.

In 1963 William Liley conducted the first successful intrauterine blood transfusion. His research into Rhesus haemolytic disease led to new ways of detecting the severity of the condition in utero and treating it prior to birth.

Ian Prior was the founder of epidemiology in New Zealand. Appointed inaugural director of the Wellington Medical Unit (1960–72), Prior concentrated initially on Māori health before conducting the first epidemiological research in Rarotonga and establishing the Tokelau Island Migrant Study in 1967. His work linked lifestyle diseases to migration, and to social and environmental factors.

Independent research bodies, 1920s to 2010s

A number of independent research bodies were established in the 1920s and 1930s. These included:

  • the New Zealand Obstetrical Society, founded in 1927
  • the Otago Medical School Research Society, set up in 1928
  • the New Zealand branch of the British Empire Cancer Campaign, founded in 1929, which established a cancer research laboratory at Otago the following year, directed by pathologist Andrew Begg.

Researchers also sometimes received funding from overseas, such as that awarded to Harold Turbott by the British Medical Research Council in 1934 for a study of Māori tuberculosis. The New Zealand Health Department hoped this might be the forerunner of more co-operation with British researchers.

The Life Insurance Medical Research Fund of Australia and New Zealand was set up in 1951 in the belief that there was a critical lack of original research in the two countries. One of its first grants was to Horace Smirk for his work on the physiology of hypertension (high blood pressure). Smirk, who arrived in Dunedin in 1942, played a leading role in developing drug treatment of hypertension. From the early 1960s his research was jointly funded by the Medical Research Council (MRC) and the Wellcome Trust, which paid for Dunedin’s Wellcome Medical Research Institute.

Medical Research Foundations

In 1955 a group of Auckland doctors and businessmen, guided by Douglas Robb, decided to wrest some research funding away from Dunedin. They founded the Auckland Medical Research Foundation (MRF). Wellington and Palmerston North MRFs were founded in 1960. Similar organisations were established in Hawke’s Bay (1961), Taranaki (1965), Southland (1967), Otago (1968) and Waikato (1986).

A one-day conference organised by the MRC in 1972 was attended by representatives of 39 funding organisations. At this time the provincial MRFs dispensed around $80,000 annually, with Golden Kiwi, the Cancer Society and the National Heart Foundation donating larger sums.

Other foundations

From the 1960s further research foundations were formed, including:

  • the National Diabetes Association in 1962 (to carry out fundraising for research), which later became Diabetes New Zealand
  • the New Zealand Dental Research Foundation in 1964
  • the National Heart Foundation of New Zealand in 1968
  • the Child Health Research Foundation in 1971
  • the Diabetes Foundation in 1980 (to coordinate diabetes education and research spending).

Cellular ‘cannibalism’ for gout?

Malaghan Institute researchers Jacquie Harper and Stefanie Steiger found that cellular ‘cannibalism’ might help treat gout. Neutrophils, a type of white blood cell, respond to gout crystals by releasing substances that cause pain and inflammation. Harper and Steiger found that neutrophils would also ‘eat’ other neutrophils that had died after contact with gout crystals. The ‘cannibal’ neutrophils then released a chemical that reduced gout-associated pain and tissue damage. This research, carried out in the early 2010s, was partly funded by the Wellington Medical Research Foundation.

Malaghan Institute and Liggins Institute

The Wellington Cancer and Medical Research Institute was opened in 1979. Later renamed the Malaghan Institute of Medical Research, it became part of Victoria University of Wellington. The Malaghan Institute focused on finding cures for cancer, arthritis, multiple sclerosis, infectious diseases, asthma and allergies. In the 2010s Malaghan researchers Graham Le Gros and Franca Rochese carried out important research into asthma. Their aim was to develop an immunological treatment or a vaccine for asthma.

The Liggins Institute was set up at the University of Auckland in 2001 as a centre for research into developmental biology and human health.

New Zealand Brain Research Institute

The New Zealand Brain Research Institute, which incorporates the Van Der Veer Institute for Parkinson’s and brain research, is based in Christchurch. It funds a wide range of brain research, including the world-recognised work of Maggie-Lee Huckabee. Her research group investigates rehabilitative techniques for people suffering from dysphagia – problems with swallowing after strokes.

Health Research Council, 1990 to 2010s

In 1988 the Medical Research Council posited the concept of a more broadly based Health Research Council (HRC), to give greater prominence to public health research. The HRC came into existence on 1 October 1990 under the Health Research Council Act 1990, with four statutory committees:

  • Biomedical Research
  • Public Health Research
  • Māori Health
  • Ethics.

Shifting priorities

The HRC’s first triennial report, for the years 1991–93, spelled out a fundamental change in the balance of funding. With restricted funding available for research, greater emphasis was to be placed on public health issues, including Māori health. This contrasted with the former predominance of funding for biomedical research.

By 2003, the HRC had established nine distinct research portfolios:

  • biological systems and technologies
  • communicable diseases
  • determinants of health
  • health and independence of population groups
  • health sector management and services
  • injury and rehabilitation
  • mental health and neurological disorders
  • non-communicable diseases
  • rangahau hauora Māori (Māori health research).

Further administrative change occurred in 2005 when the HRC became a Crown agent, charged with putting into effect government policy in relation to health research. Oversight of these committees was entrusted to a council of 10 members, five of whom had been actively engaged in health research and five with expertise in community affairs, administration, law, management or the perspectives of patients.

An old boys’ club?

Health Minister Helen Clark was critical of the research priorities of the old Medical Research Council, in particular its lack of emphasis on public health. During the 1990 parliamentary debate on the transition to the Health Research Council, she described the MRC as an ‘old boys’ biomedical club’.

HRC-funded research

Among the many projects funded by the HRC in the 2010s were:

  • The Dunedin and Christchurch Health and Development longitudinal studies examine the health of cohorts of people, from early childhood through their lives. The Dunedin study focuses on people born in 1972-3, while Christchurch follows a group born in 1977.
  • The Edgar National Centre for Diabetes and Obesity Research at the University of Otago is researching ways that lifestyle changes involving diet and exercise can reduce the risk of diabetes. Diabetes has become a major problem in New Zealand, particularly among Māori and Pasifika communities.
  • Whakauae Research Services, a team established by Te Rūnanga o Ngāti Hauiti, works to develop Māori health research with an emphasis on primary health care.
  • Le Ala project is a collaborative project aiming to increase awareness among Pasifika communities of drug and alcohol-related harm and seek remedies. The project encourages community members to tell stories of their experiences.

Housing and health

In the early 2010s Otago University’s He Kainga Oranga, the Housing and Health Research Programme, was an example of an HRC-funded public health project. The multi-disciplinary study involved researchers from the fields of public health, medicine, building science, architecture, and Māori health and development. The study was based on the idea that physical and mental health is strongly dependent on the housing conditions people experience.

Funding problems

The MRC’s annual budget rose from an initial £5,000 to £55,000 in 1956 and £97,000 in 1960. In 1975 the Otago and Auckland medical schools each received approximately one-third of the total funding. This did not compare well internationally, and by the 1970s New Zealand researchers had gained a reputation for carrying out world-class research on very limited funding. In a 1973 study, John Borrows, technical secretary of the MRC, analysed research funding since the early 1950s. He argued that inflation meant funding increases had been minimal, and New Zealand still lagged behind comparable countries such as Australia, Britain, Canada and the US.

Mark Richards from the Christchurch School of Medicine pointed out in 2000 that health research accounted for only 1% of the national health budget. Studies in 2008 and 2014 confirmed that New Zealand’s spending on health research was significantly lower per capita than that of Australia, the UK or the US. The 2014 study warned that urgent, sustained action was needed if hospitals and universities were to retain clinical and academic staff.

External links and sources

More suggestions and sources

How to cite this page: Derek Dow, 'Medical research', Te Ara - the Encyclopedia of New Zealand, (accessed 24 July 2024)

Story by Derek Dow, published 22 October 2014