A view on the future of biological therapeutics

Today was very much an Indian day.  It started with a breakfast meeting with the Australia India Business Council, followed by a meeting with the High Commissioner to India, and will end with discussions with the Senior Vice President for Research and Development of Biocon India.

Dr Narendra Chirmule has recently joined Biocon after many years in the United States and brought to the breakfast discussions interesting insights on the future of the biological industries.  He pointed to  the differences between biologics and small molecules that have been the traditional therapeutic drugs from the pharmaceutical industry.  The biologicals are more complex to manufacture and to maintain their  consistent composition and therefore need to have a different thought process for acceptance in the clinic.  Specifically he suggested that increasingly the clinical trials that are involved for Biologics will have to adapt to the ongoing outcome of the trial rather than have fixed endpoints.  In this way the information that is obtained in a Phase I trial can be used to modulate the endpoint which would be most beneficial for the treatment of patients.  The manufacturing processes for biologics also are complex and therefore there will have to be greater flexibility in manufacturing than had traditionally been the case for small molecules.

The technical details behind this are still being worked out but it is not a simple matter to scale a process and have a similar outcome at the end.  The side effects of biologics are generally less dramatic than those of small molecules but they are still responsible for about one third of the compounds that fail on their way to the clinic.  Having greater knowledge and being able to predict these perhaps even on an individual basis will be important.  This will give rise to much more involvement of companion diagnostics such that the products are targeted to the right individuals. The growth in this area seems to me to be inevitable and the manner in which it happens, either within the Biologicals producing companies or in parallel with it will be interesting to watch.  Finally because of the manufacturing complexities and the more delicate nature of biologics they will have to have a number of smaller manufacturing units worldwide and hence a global structuring of this industry in the future.

The stress by Biocon on affordable medicines was another aspect that is instructive and the future of Biosimilars will be fascinating to watch particularly in light of the complexities of maintaining a defined product in this particular area.

The visits by our Indian colleagues are another reminder of the great potential that is India and elsewhere in South East Asia and that are of direct relevance to research and industry prospects in Australia.  It also pointed to opportunities arising from the recent trade agreements. As Australia has very efficient regulatory processes and very high quality standards it could benefit by becoming a new manufacturing location for biologicals. The overview from Biocon also reminded me of the various steps that have been taken to date; Small chemical molecules have been the start of the pharma industry. Next were some biologicals that corrected deficiencies in patients (insulin or growth hormone for example) that grew from biotech companies initially. The current growth area is in molecules (biologicals) that can indirectly influence disease outcome by modulating or stimulating the immune response and in parallel with these there are a number of examples where cell therapy is being used either by modifying cells or by stimulating them before injection to the patient.

QIMR Berghofer is very active in delivering understanding, clinical trials and solutions to these later developments. Exciting times are ahead!

Being 70

No it’s not about me although, I can see that on the horizon.  The three scores and ten in this case refers to the QIMR Berghofer Medical Research Institute in Brisbane.  We are celebrating our 70^th birthday (anniversary) this year and a special event will be a Gala Dinner Saturday 31 October.  You are all invited!  (The cost is $225 per person).  70 is a significant time period for the existence of a research institute.  We are not the oldest in world, nor Australia, but we are up there as a very long-standing research location. So we should have a Gala to celebrate.

We have come a long way since 1945. The start of QIMR Berghofer came from a realisation that there were infectious diseases in Northern Australia (i.e. Queensland) that were not getting research attention from the rest of the researchers in the country.  Malaria, for instance, was present in Queensland in the 1940’s and was eventually eliminated in 1981.  At the start, the Institute was an external part of the Department of Health in Queensland.  This connection remains strong with the Director, Deputy Director and the Council being appointed by the Minister for Health acting in conjunction with the The Governor of Queensland in Council and the Executive Council in Queensland. Serious official engagement is assured in that way and then authority to act is delegated to the Council and through it to the Director and others in the Institute.

The first home of the Institute was in a prefabricated ex-army hut close to the Royal Brisbane Hospital.

I have worked in prefabricated huts earlier in my career in Galway and their practical use is continued much longer than their natural lifespan.  But this is where QIMR Berghofer started with a great emphasis on infectious diseases and an early interest in Epstein-Barr Virus and Ross River Virus.  It is interesting that the Epstein-Barr Virus work is still carried through very actively at the Institute and is the basis of some of the most recent immunotherapy clinical trials that we are engaged in.

The Institute eventually found a permanent home on the land of the Royal Brisbane and Women’s Hospital and the first building (Bancroft building) soon became full.  By then the leadership of the Institute had expanded the range of activities such that the new possibilities to study and work towards treatments of cancer were added to the Institute.  It also had great strengths in epidemiology and genetics.

Inevitably growth occurred in all of these burgeoning areas as did the reputation of the Institute.  This resulted in a second 12 story block (Clive Berghofer Cancer Research Centre) being built with the significant support from Chuck Feeney and Atlantic Philanthropies and also Clive Berghofer, a very generous developer from nearby Toowoomba.  Again within  10 years the now two buildings were very full and the State and Federal funds together with another major contribution from Chuck Feeney resulted in the building of the Central block which joined the pre-existing parts of QIMR Berghofer.

At the same time the Institute added mental health as an area of importance and continued to remain true to its mission of working to address health problems in Queensland and of course mental health has joined cancer as being a very major problem worldwide.  Now we have three buildings but a single Institute.

Buildings are important, but it is what goes on inside that is most significant. And every week the 700 workers here add to our contribution to science and to its translation.

So on Saturday 31 October we will celebrate all of these achievements, and the researchers and employees that have allowed them to happen.  70 is a noble age when maturity and wisdom are well established.  Our task is to point the way forward to the next decades and in doing so we hope that many, like you will join as supporters along the way. I hope to see you the Gala Dinner.

Tribulations and a Trial

In 2002 Rajiv Khanna, at the QIMR Berghofer Medical Research Institute, started work on the potential of a relatively common virus, Cytomegalovirus (CMV), as a target that could stimulate the immune system to attack cancers.  That was a long sentence but each part of it carries with it a subtext of discovery, clarification, testing, trialling, generating materials, getting funds, applying for grants, publishing papers until eventually it came to the stage where Rajiv was aware that he had established how to use the CMV to trick the immune system to tackle some cancers.  That also is a long sentence but unfortunately some cancers are a very short sentence with a very high probability of death soon after detection.  Glioblastoma, the most common brain cancer, is one such example.

This was one of the targets of Rajiv’s work and he carried out his research with a very strong connection to a clinician, neurosurgeon Professor David Walker, at Newro Foundation and Wesley-St Andrew’s Research Institute.  The long wait to do some initial tests had a preliminary end four years ago.  Then, patients who were at the most advanced form of secondary recurrence of glioblastoma were tested with the CMV driven therapy.  The effects were positive in some patients and too late in others but in all cases there were no side effects.  In other words the treatment was safe.  Again saying something is safe is a short sentence but it is built upon layers and layers of hard work.  The process involves taking white blood cells from the patient and growing them in a laboratory under very specialised and very sterile conditions in the presence of the CMV trigger before they are reinjected into the patient.  QIMR Berghofer has extensive certified cellular therapy laboratories of a quality that is rarely found elsewhere world-wide where this work can be performed.

New hope for Michael

Having carried the initial safety tests on extreme cases of glioblastoma, today was the start of a much more relevant trial.  The first patient in the trial, Michael O, had been diagnosed with glioblastoma recently.  He had the standard treatments of surgery, radiotherapy and chemotherapy.  In parallel with that, white blood cells from a blood sample were being challenged by Rajiv’s treatment at QIMR Berghofer and grown to a stage where they could be reinjected into him.  The first treatment with this new combination of therapies started today. It was a moving moment with his mother and wife present. A simple injection by Professor David Walker that carried 37 million activated white blood cells into a path through his body to seek and hopefully destroy the tumour cells that escaped chemo and radiation treatment.

Rajiv and some of his team attended this culmination of years of work. The Queensland Minister for Health  Cameron Dick and the media also came to see this significant milestone, but it was not a “circus” event. Too much is at stake for Michael. Fingers are crossed in the hope that this will in fact be a significant change to the outcome in GBM.  The clinician, David Walker at the Wesley Hospital, is very aware of the need for these treatments and has been a great partner in the process but the development of this new treatment also would not have been possible without significant contributions from the public and support from Queensland Health.

So here we have a great combination, a dedicated researcher (Rajiv Khanna), a successful applicant for research funding from the NHMRC and other sources, an aware clinician, David Walker, funding from the community and the State culminating in a new treatment and new hope for a patient.  This is translational research in action and typifies the work that is ongoing at the QIMR Berghofer Medical Research Institute.

New hope

Opportunities for Australia and India

The setting was unusual.  The High Commissioner of India was visiting and the Asia Pacific Council at the Queensland Art Gallery organised a presentation of some of their very extensive Indian art to an invited group.  This was yet another occasion where a guide explaining the art proved that you see more when you hear more!

But the event was not simply a lead up to the Asia-Pacific triennial of contemporary art.  It was an opportunity seized upon by Randeep Agarwal, President of the Australia India Business Council Queensland, to launch into a spontaneous discussion on different facets of interactions between the two countries.  With India being a very major market with its economy growing at 7% per annum and Australia being a “neighbour” in global and time zone terms there are significant opportunities for both parties.

Unexpectedly I was the first one on to whom the microphone was passed and asked the question about what should be done to seize these opportunities.  I immediately recalled my recent visits to India where two powerful mantras were repeated: “Frugal innovation”  and “More for Less for More”.  The latter meaning that more disease treatments had to be made available at less cost for more people.  This is allied to the great successes of Indian companies in establishing generic products which has changed the future of the pharmaceutical industry.

But another message from India was that having achieved victories in the “100m sprint” to manufacture generic products they now needed to have a different strategy to complete the “marathon” of discovery and development of total novel products.  And this is where the opportunity with mutual benefit arises.  Australia has terrific research and a less well developed development pathway.  Indian pharmaceutical companies have mastered the development and manufacturing processes and have a growing number of strong researchers  but could benefit from close collaborations with Australian colleagues in order to define exactly how a particular therapeutic product is working.  In doing so, the generous research tax benefits available in Australia could act as a further economic argument for close connections.  In addition, the task to get a new product to the “first-in-man” stage of clinical trials is significantly easier in Australia than most other countries and currently than in India.

As we nibbled cheese and admired the gallery surroundings, it appeared that my comments gave food for thought.  At QIMR Berghofer Medical Research Institute we have been acting to build these connections for four years and progress has been made with one company and I am sure that many others will follow suit.

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More than one lane for career choices

A retreat is a time of reflection but, also, if you get like-minded people together, it’s a great way for new contacts to be made, friends to be forged and, in our world of science possibilities – of new collaborations identified.  I attended the QIMR Berghofer PhD Student Retreat in the Tamborine Mountains.  The GPS said it would take two hours. It hadn’t factored in 20 km of single road laneway where trees defined the edges and part of the task was to avoid wallabies jumping around the place.  But the view from the top of the mountain was spectacular.  Indeed it still is surreal for me to see bright red and blue plume parrots flying around the place.

Blue plume parrots flying around the place

But I wasn’t there for the nature.  I was there to talk to the 100 or so PhD students from the Institute.  I spent time bringing to their attention career choices that follow a PhD.  This is essential in a period when the linear career path from PhD to independent research Group Leader is a low probability for most.  I put particular emphasis on identifying possible commercial opportunities in their research.  By getting into the habit of making disclosures of ideas that they think may be worthwhile, they will not miss something of real benefit.  I linked this to the sore need in Australia to establish start-up companies and thereby generating a new line of employment possibilities for those with PhDs.  A final point of emphasis in my talk  was on the need for highest quality of performing their research as the problem of selective presentation of data or, worse, the fabrication of data appears to be growing worldwide.

After this opportunity to talk to them I had a series of casual conversations over dinner and afterwards.  It struck me, and this is a contrast from other years, that many of them really wished to have a career in the biotech sector.  Their questions were more about how to get started, where can these opportunities be realised etc.

I think that the retreat for me signalled an advance/change in the thinking of the young researchers.  They now recognise that there are diverse career pathways and some of these jobs are very interesting and challenging and should be considered, in addition to the standard path of aiming to run research groups in institutes or universities.

When I woke this morning the valley below was bathed in sunshine and my spirits were lifted by a wonderful evening with great young people. Then I had to drive back down the one lane road!

Remembering Galway as a student in the sixties

Perhaps it was the discussions, when I visited  the National University of Ireland Galway recently ,about celebrating Biochemistry Department’s 50^th Anniversary, or maybe the driving primal forces of the storm on the Prom., but for the first time in years I was back in the late sixties in my mind. Pleased with my past, unsure of my future I am a student in Galway. Sharing a room with Noel (now dead) and Paul ,linoleum on the floor, a two-barred electric heater in the living/dining room, water to wash in the morning in a big willow patterned pitcher, toilet out the back. “Frugal comfort” my mother had defined it in DeValeresque terms when she chose it before I moved there.

The pleasant short walk to the Uni-thenUCG- was along the canal where fish darted and distracted me from rehearsing the metabolic pathways that could be a question in an exam. Studying in the room beside the Latin hall, full of serious medics of the future but then frowning at massive books was my work place. My class mates were Willie and Willie and Tommie and Moya and Eithne and Joe. Margaret, now dead, was my special friend. We were all happy and hopeful and challenged. Our curriculum was “all that was known about Biochemistry”!

We sang in the choir and famously won at the Cork International Choral Festival. Brendan, ”the fuzz” lead us out on the stage  and the crowd always giggled. He had an Afro before the name was invented and we looked  an unlikely bunch. But Fintan had us trained to be exquisite. Des kept us laughing with jokes ….and made a good career out of that later, while also being a Maths professor. Everything was indeed possible.

Going for a run in the wet and dark evenings was compensated by a ladies finger or a chocolate éclair in the Galleon. Maine was a nun and fun and was part of the gang that had slightly intellectual tendencies.  Was the new Vatican statement on birth control right or wrong ? Should the Irish language be revived?  Were Anne and Michael off their heads pushing Mao’s  little Red Book at the entrance of the quad ?…and what did Mao know about Irish farming in the first place? And Brian with a pipe that wafted atmosphere (secondary smoking had not been discovered then), took discussions on long erudite roads that lead to his then (but not now) Opus Dei convictions. Nobody was “recruited” but the hunt was persistent. The Lit and Deb was full of cut and clever thrust with performers like Michael D (now president of Ireland), Richard (later played a major role in peace talks in the north)  and the guy who became a music composer whose name escapes me. Politicians were formed there at the same rate as school teachers; Seamus, (now dead),Pat, a minister today and Frank the backroom manipulator for decades stand out.

And going to the pictures was the Saturday night-indeed week- highlight and before it the long haired singer treating the queue to modern ballads ( in the inevitable rain) as if it was a Carnegie Hall audience was the most memorable a part of the enjoyment. Pubs were not a significant part of life, strangely, and a Club Orange was the thirst quencher as the Showbands of the day belted it out in Seapoint or the Hanger.

Overall it was a simple life…now gone for all , now either dead or retired ,mostly. The Galway of then was one where everybody knew everybody. Studying was the prime activity and set us up for the work life.. Debates and discussions formed the real part of our minds. Remembering brings the sadness of nostalgia , overpowered by a happy glow  of recollecting special people and places. Maybe we should have had more fun. Maybe we should have more fun now. “We look before and after and pine for what is not”. (Shelley)

Savouring Sri Lanka

Savouring Sri Lanka

Having gone to the Fish Market and selected Yellow Fin Tuna, Prawns and Seer fish, we returned to the outdoor kitchen at the hotel. It was day one of a two week Taste of Sri Lanka tour focussing on cooking and culture organised by Renaissance Tours Sydney.  Our guide/chef Paul van Reyk pointed out the different spices and ingredients;Turmeric, cinnamon ,ginger ,garlic ,chillies, cloves, curry leaves curry powder and so on to a total of about 15 components. From different combinations of these, cooked outdoors, came three exquisite and different  dishes. All were spicy but not macho hot. At first I thought that the food aspect of the trip might be boring as there was a chance that 15 days of curries would have reduced me to craving for a Hamburger. But just as an alphabet with 26 letters or a piano with a limited number of repeating notes can yield an infinite range of outcomes, so too it was with the wonderful spices used in Sri Lankan food.

We were a small group (13) made up of 4 overlapping “prior” friends. There were the Melbournes, the Sydneys, the Tasmanians and the Brisbaners. But quickly we were one busload who exchanged stories, asked questions, told jokes, learned about history, religion ,cultures and saw a lot as we followed the road from the coast to the highlands,  through the cultural triangle, into the wild life parks, onto the beach areas and into small villages and bustling cities. Traffic chaos was a constant but so were high quality hotels all organised by Jetwing tours(Sri Lanka). The tour guide Hetti and tour leader Paul swopped great  stories about Sri Lanka as it was in the sixties and as it is today and good humour was matched by high content of information. In the end the curry of memories from the trip includes very diverse ingredients;

• An Elephant by the roadside when we were on Safari, spraying sand on its back
• Birds of every  possible colour and size (we saw over 60 different species of which approximately 30 are found only in Sri Lanka-Hetti is a bird expert)
• The smell of Tea in the tea making  Centre
• The fireworks at a beach wedding (of a Yorkshire couple) we happened upon
• The friendship  of locals when we made a toilet break at (unwittingly) a private house
• The landscape defined architecture of Geoffrey Bawa and his brother Bevis
• The devout believers who made the pilgrimage to the Temple that housed Buddha’s tooth in Kandy
• The surprise of finding a visiting Irish music and dance group in our hotel in Colombo and the great session that followed after the ‘official’ concert
• Swimming in the infinite pools designed by Bawa at the Lighthouse Hotel in Galle or outdoors in a secluded pool in Sigiriya 
• The co-existence of Buddhist and Hindu  temples almost everywhere
• The chants of Allah coming from the Muslim mosques as we eat under candle-light during a power failure in Galle
• The school children everywhere all dressed in white
• The Eagle, close by,  casually eating an Antelope rat (or a Mouse) it had caught
• The beautiful brides (we saw at least 12) smiling patiently for the multiple cameras
• The demonstration of how they mine for blue moonstone using methods from two centuries ago
• The demonstration of ten different uses for coconut trees and coconuts
• The blue flash of Kingfishers and the verdant Green Bee-eater birds
• Drinking coconut milk, prepared for us from fresh coconuts ( using a Machete) at the side of the road,
• Climbing  200 feet to the top of Sigiriya  to see the temple ruins and cave paintings…and the view
• The massive reservoirs (tanks) built centuries ago to provide  irrigation

And so it goes on.  All on the trip could add a new top twenty list , but the general impression, I expect, is common to all; A diverse combination of vignettes that will last in our minds.

We did not visit the North where the Tamil troubles seem to have become a painful period of history and less of a today story. There was almost no sign of the military. Therefore, if a peace dividend is something tangible, it would appear that Sri Lanka is now reaping it and hopefully the benefits will be shared by all on the Island. Tourists (and their spending) visiting there will be an important part of a healing process.

Lines I wrote in 1968 get an airing

Lines I wrote in 1968 get an airing

Recently I was the speaker at a graduate conferring ceremony at the University of Queensland here in Brisbane Australia. That’s a nice event to be part of … even if the graduates probably had luncheon celebrations on their minds rather than words of supposed wisdom from the speaker who ends the event. But when invited it is rude not to perform. There was plenty of material with which to work. This group had just received degrees in Agriculture and Economics, Environmental studies, Geography and town planning and various combinations of the above .It was interesting to consider what they might end up doing in the near future. I reminded them of the need for more food in the world with 1 in 8 people hungry or close to a billion undernourished people from a total population of over 7 billion. And as the population grows, so will the hunger. The humanitarians among them might see the need to provide food as a driving motivation. Others will see it as a great opportunity for Agri business. The reality s that both aspirations will have to be satisfied and the trick will be to get the balance right. This is not easy, as exemplified by the prevailing situation in the EU where farmers are paid not to produce food (to keep the prices high) even though there are real human needs in countries where they provide aid to offset the poverty and hunger of the people.

A further balance will be needed to decide how best to use the land where both farming and resources are found in abundance as is the case in Queensland. Coal, minerals, natural gas, seam gas and other natural resources are significant sources of income but so also is the use of land for food production. When choices have to made, which will dominate? Yes many PhDs will be needed to untie that Gordian knot – but with over 60 new PhD’s conferred on the day, there may be a bigger supply than demand unless such complex decisions are taken on a balanced evidence base rather than in response to media campaigns or political opportunism .

But the address to the graduates also has to carry some other “non-professional” messages. In the moments that I had used to anticipate what I might say at the ceremony I recalled an article that I had written about “Graduation Day” a few years ago. When I re-read it however I found that my reflections on that day were grim, as I imagined their future struggles for jobs that matched their skills more clearly than their own imagined future successes. That message would not suit the beaming optimism on the gleaming faces of graduates and parents that I anticipated would be the audience at the conferring. Then I started to wonder what I had on my mind at the same stage of life. I recalled the conferring in Galway on the West coast of Ireland. The choir, of which I was a member, belted out Gaudeamus Igitur as we entered the Aula Maxima. It was a lovely sunny day. My family and close friends are clearly there in the memory … and some are no longer alive today. I moved from that bitter sweet moment to a recollection that seemed to match the needs of the speech I was preparing and recalled that I written a piece when I was 21 that should be a contemporary assessment of their situation although written in 1968. And I found the note book where I had written my thoughts in one flow of words and, without a perfection seeking correction. It had travelled the world in between and ended up in Brisbane. A number of ironies struck me. The sixties are now taxidermised into a wild rave, but I, sober and analytical was perhaps more typical in my reflection on the transition to independence than the liberation driven mini-skirted drug investigating caricatures of the official chronicles. Also I was, and am, a scientist so somebody who sits on the morning of his 21st birthday to capture his thoughts on that symbolic day does not fit that easy professional identikit either.

I worried about “going public “with my previously secret writing. And then I thought I should; after all it was their day of transition and the names on the base were their families, communities and the University. So I share them with you, as I also shared with them, my poemish words

Lines written at 9.13am on the morning of my 21st Birthday……….2nd Dec. 1968

On a frosty night in December, a wet slurry of potter’s clay was delivered – shapeless, formless and amorphous but the potters congratulated themselves with glee.

Immediately they began to fashion the clay in their own imitations…….. to their own limitations.

At first the work was slow, but soon the clear outline of the maturing body was clearly seen.

Then they worked on the head, the slight pressure of their fingers forced the clay first in one direction then the other…….……the statue maintained the compromise of these pressures.

As the years went by the clay dried out. It lost its pliability, and when the potters tried to fashion it further it tended to crack and come away clinging to their fingers.

Then one year they found that their clay was dry – their influence lost, they looked sadly at each other saying; after 21 years our statue begins to die.

………… not to die my friends – but live. The Frankenstein you have moulded has now awoken – The statue breathes and thinks.

It will act independently of you from now on……………but whether it does good or bad, it will always reflect on you – the potters name cannot be erased from the base.

Surviving a cycle with survivors

It was 6am on a chilly Brisbane morning two weeks ago. I looked out at 1370 cyclists and welcomed them to the first “Rio Tinto Ride to Conquer Cancer Cycle”. Each had raised over $2500,(Euro 1750) they were ready to go, most in their yellow cycling gear. But first they had to have a few speeches. They must have welcomed that-not. They knew why they were there. They knew that they faced two days and “over 200 kilometres” of cycling and that the $4.7 million (3.3 million Euro) collected by them and sponsors would make a difference to the research that would be performed by the Queensland Institute of Medical Research (QIMR) the beneficiary of the cycle. I was on the podium because I am the Director of QIMR . I also was in unfamiliar cycle gear together with re-inforced black lycra shorts because participating seemed to be the right thing to do. Maybe I should have thought more about that a few weeks previous. Maybe I should have bought a bicycle in time to get a little training. The fact was that I had three cycles on the flat, all less than about 20 Km. And a cycle that should have been 40 Km except that I got lost and don’t know how far it was really. Those that I spoke to at work and were in the crowd ready to go, had regularly put 100Km cycles together to build up their stamina. They all welcomed the playing of a rousing national anthem that signalled the start and then they streamed away.
I had to do some media interviews before I could get myself together to get on the road…..I was last away, according to the helpful volunteer at the first road junction. I cycled with the intention to go as far as my body allowed and at a pace that was mine. And so, like Forrest Gump, I just kept going. There were hills. Later in the day when they were too tough I got off and walked. By then I was in the middle of other pools of cyclists and got into the mood of the event. I spoke to some, especially when at the pit stops that turned up welcomingly every 20Km. Most said they were there because of a commitment to a friend, a daughter, a parent that had cancer or had not survived it. Some had a yellow flag flying on their bikes. These were the survivors. They were brave and strong and full of hope. The burden on the researchers to do better could not be more eloquently pleaded for than by their persistence going up hills that I funked. Others rode because it is a sport they enjoyed or because the ride was a motivation to them to get fit. I did not see them as they were too far ahead.
Surprisingly I completed the first day. Also surprisingly it was 120Km and not 100. Not surprising I was in no shape to do day two and my left knee was a new weak spot in my body. It said during the last “extra”20 Km that it was not going to help me do another “100”Km the next day.
Cycling for about 8 hours, (with 4 stops to replenish liquids and take on more energy bars), gives you a lot of time to think. I cycled on my own most of the way as I did not want to delay others and the thought developed that my lack of preparedness was a metaphor for all those that are visited by a cancer. They are not prepared for it nor are they in training when they hear the dreaded words for the first time. But they have no choice but to get on the bike that would bring them to radio or chemo or a new special treatment with all the emotional and physical demands that it makes on them and their families. It takes them to places that they would not wish to learn about. Compared to that, my day cycling in the nice countryside does not count as a challenge. I remember the bravery and stoicism of my mother when I told her what she had suspected. And the fighting spirit and practical ”what do I do next” attitude of a great friend T when I had to point him to the realisation that his “little” problem was not so small. My mother went very quickly and Cancer did not really become a part of my life then. But T is still going strong many years later and through him I have had a sniff of an understanding of how demanding it can become. I thought of them and saw the hills that we faced on the cycle as the set-backs that come to them in the race to overcome the cancer and be a real survivor. And how welcome are the free-wheeling downhill periods when all is going well. The flat parts between the awful and great periods can be even more demanding as they can have a boring but brooding feeling of wondering would they end mixed with the concern about what will be around the next corner.. Yes and some, like me could not keep going. The cycle can end prematurely as they ran into a physical or psychological wall. It happens for too many that face the real life cancer challenge.
We camped overnight beside a Dam. That was an indication that we had a net uphill day in the saddle. Hot showers, real food (not muesli bars), some music and then to the tents. Most seemed buoyed by the fact that they had done something that was hard on the day (and before that when raising money) . Symbolically, the difficulty of the day felt right as it mirrored the difficulties faced by those with cancer. Everybody was in bed by 8…and the guy in the tent next to mine was snoring like a champion almost immediately. And he had stamina, as it lasted all night. I know that because I was not in training for camping either and have been spoiled for years by comfortable beds and warmth. But it was a short night. At 5 before dawn the place was buzzing. We were all friends now; a community that got engaged to do something.
I watched a little sheepishly as they all set off to cycle back to Brisbane. It started to rain. The bus was an escape from that reality; another luxury not available to those with a cancer But at the finishing line, the exuberance of those that came smiling through was a benefit that they got as compensation. They were survivors, And the yellow flags got a double benefit. I hope that they will be back next year. There will be new ones also and that is the sad statistical fact. With an aging population it is projected that 1 in 2 of those in their eighties will succumb to a cancer. More and better research is the only answer. The cycle was a timely reminder of the urgency and need for us in the medical research area to do much better and do it quickly.

Manpower shortages in Ireland

I read reports on the annual statement from the American Chamber of Commerce that points to the large number of jobs that are unfilled in American companies in Ireland. Isn’t that amazing, presuming that it is true? It confirms the anecdotes I heard when in Ireland from leaders of industry. Even large employers had to “import” some groups of employees as they could not find them in Ireland. This is very bad for Ireland as “available talented graduates “ is one of the core attractants overseas investors. It is not the only one of course, but it is essential if high value jobs are to be created.
It should not be like this. Ireland has one of the highest percentages world-wide of young people that go onto third level education (over 50% last time I saw statistics). Indeed the stated plan is for the number to increase to over 70%. So I conclude that the students are not taking the courses that are needed for the economy, or that the third level courses are not delivering the goods that are needed. The second possibility suggests that there should be some analysis of the match and relevance of the courses and the colleges “encouraged” to adjust their offerings if they are not what is needed. A survey of the companies that are currently looking for people would allow a quick identification of gaps if they exist.
The first, and I suspect real, problem is that the laissez faire attitude towards the selection of courses by students leaves no possibility for manpower planning. The country subsidies these studies and should end up having the right skilled workforce in return. Who is responsible for getting this equation right? Many would argue that any form of third level education is of benefit and I would agree……but it is not a civil right and it would be very non-interventionalist if steps are not taken to try to get a more appropriate return on the investment. With fees and variations on the wording of that theme becoming a reality there may be an acceptable way forward; courses that match the man-power needs could attract a lower fee than those that don’t ,with the state providing the balancing funds to the colleges .
There are a number of follow on questions that arise; is the policy of proving third level studies to such a high percentage of school leavers the right one today? have the third level colleges got the right balance between education in general and education that is sufficiently aligned with the needs of the economy ? how should the courses that get this deontas be selected and will it work against the arts and humanities (and that is not an automatic outcome)? But the biggest question is whether something should be done……or should there be a fatalistic avoidance of action?