How Melbourne’s medical precincts are contributing to global health

Director of the Peter Doherty Institute for Infection and Immunity, Professor Sharon Lewin on left.

Our city is developing a name for itself as a leading proponent in the race to cure HIV, according to infectious disease expert, Professor Sharon Lewin. Here she talks about the ongoing investment needed to cure HIV, preparing for global pandemics, and how Melbourne’s emerging medical precincts are contributing.

Sharon is a vital cog in the HIV research chain. She is not only the inaugural Director of the Peter Doherty Institute for Infection and Immunity, but also a Professor of Medicine at the University of Melbourne, and a National Health and Medical Research Council (NHMRC) Practitioner Fellow. "We have a large network of researchers and clinicians working on finding a cure for HIV," she explains, and the global community is sitting up and taking note. "Melbourne’s recognised internationally for the work we’re doing in basic science, clinical research and social research to cure HIV and our strong partnerships with the community of people living with HIV."

Sharon was awarded an Officer of the Order of Australia earlier this year, namely for her service to medical research, particularly HIV/AIDS. In this area she is internationally renowned, but the scope of her own work, as well as Victoria’s world health credentials more generally, extend far beyond HIV research thanks to dedicated medical precincts.

"Melbourne’s biggest capability when it comes to breakthroughs in urgent global health is our outstanding physical infrastructure for medical research at several precincts across the city," she explains. "For example, the Melbourne Biomedical Precinct has over 10,000 researchers co-located in Parkville working in hospitals, research institutes, industry and universities and is a real hub for undergraduate and post-graduate training in medical research."

Located in the centre of this precinct is the Doherty Institute, where Sharon leads more than 700 staff who work on infection and immunity. The institute is a joint venture between the University of Melbourne and the Royal Melbourne Hospital. "We have state-of-the-art laboratories equipped to handle highly infectious pathogens with experts in viruses, drug-resistant bacteria and the immune system," says Sharon. "Our staff are also expert at tracking and predicting infectious diseases in the community and in hospitals. Many also train lab staff working across the Asia Pacific – skills critical for responding to infectious diseases regionally and globally."

Then there’s the Monash precinct in Clayton and research hubs surrounding leading hospitals such as The Alfred and St Vincent’s, she adds. “This means large, expensive equipment can be shared and a critical mass of researchers can collaborate and drive innovation. We’re home to some of the most successful biotechnology companies including CSL and most importantly, have a healthy culture of collaboration across the city. This is quite unique and special. Big global problems are best solved by large teams and we are well placed in Melbourne to do this very well.”

Sharon is also a leader in the response to infectious disease outbreaks. As chief investigator of the Australian Partnership for Preparedness Research on Infectious Disease Emergencies (APPRISE), she leads a national network of experts involved in medical, scientific, public health and ethics research to inform Australia's emergency response to infectious diseases. APPRISE was established in 2015 and includes over 20 centres nationally. It came into being after a particularly aggressive influenza epidemic, known as H1N1, occurred in 2009.

Sharon says there was some concern we could have done better in responding to this outbreak. "This led to the government partnering with the NHRMC – Australia’s peak body for health and medical research – and establishing a research network that would allow us to be better prepared in the event of a new outbreak.” Sharon explains that by linking research groups across Australia like this, we can detect and respond to any future infectious disease challenges.

And those challenges are severe. According to Sharon, it’s a matter of "when", not "if". "We’re seeing new infectious diseases emerge globally, such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), and infectious diseases occurring in new areas, such as Zika and Ebola. Combined with climate change, global travel and over-use of antibiotics, we’re likely to have more challenges ahead.

"Infectious diseases know no borders and can move rapidly from country to country. Australia’s a rich country surrounded by countries with far weaker health systems and I believe we need to be working in partnership with our neighbours in the Asia Pacific to ensure every country – rich or poor – are better prepared."

A cure for HIV: Sharon explains

Sharon LewinGiven Sharon’s expertise, just how far off are we from an HIV cure, then? "Unfortunately, I think we’re many years – probably decades – away," Sharon ventures. "But that doesn’t mean we shouldn’t be investing heavily in solving this problem. HIV’s a clever virus with lots of tricks up its sleeve: it has evolved to persist forever once someone is infected. I’m an optimist and have faith in the power of science. I’m sure we’ll eventually work out a way for people living with HIV not be bound to lifelong treatment."

For Sharon and her team, their work spans laboratory studies through to interventional clinical trials. "The overall goal of our program is to understand where and how the virus hides while a person living with HIV is being treated with antiviral drugs. We do this by looking at the genetic code of the virus and where it is hiding in a person’s DNA. This is giving us clues to understanding how it can survive for many years in hiding. We are also very interested in finding ways to lure the virus out of its hiding place and kill the infected cells. We call this 'shock and kill' ".

"Finally, we are actively pursuing ways to boost a person’s own immune system to keep the virus under control. We are doing this through testing new drugs that have been developed for cancer. These drugs activate the person’s immune system and can lead to control of cancers such as melanoma. We are investigating whether this same approach works against HIV."

To learn more about Professor Sharon Lewin’s work, visit the Doherty Institute website.