Healthier Lives – He Oranga Hauora is one of New Zealand's eleven collaborative research programmes known as National Science Challenges. Running from 2015 to 2024, the focus of Healthier Lives National Science Challenge research is cancer, cardiovascular disease, obesity, and diabetes in the New Zealand population, encompassing prevention, treatment, and reducing health inequity, and including precision medicine techniques, and culturally-centred health programmes for Māori and Pasifika.
Establishment and governance
The New Zealand Government agreed in August 2012 to fund National Science Challenges: large multi-year collaborative research programmes that would address important issues in New Zealand's future. The funding criteria were set out in January 2014, with proposals assessed by a Science Board within the Ministry of Business, Innovation, and Employment (MBIE). In April 2015 Jennifer McMahon was appointed the first Chair of the 7-member Governance Group for Healthier Lives, which held its first full meeting on 27 October 2015. In August 2015 MBIE approved funding for the Heathier Lives National Science Challenge (HLNSC), with a budget of $31.26 million over 10 years. University of Otago Professor Jim Mann was appointed as director, and the programme was launched at a ceremony at Ōtākou Marae on Otago Peninsula on 4 December 2015. HLNSC was to be hosted by the University of Otago, with other research partners around New Zealand including AgResearch, Auckland University of Technology, ESR, the Malaghan Institute of Medical Research, Massey University, the University of Auckland, the University of Canterbury, the University of Waikato and Victoria University of Wellington.
A 4-member Kāhui Māori was established in 2016, and on 19 October this group proposed a co-governance arrangement with the Governance Group, to be trialled for a year; HLNSC became the first National Science Challenge to adopt co-governance. A review in May 2018 endorsed co-governance arrangement and in February 2019 it was formalised in the Collaboration Agreement with other institutions. A single 8-member entity, the Governance Group and Kāhui Māori, was established. In 2020 at the end of the first 5-year funding period Jennifer McMahon stepped down, and Sir Jerry Mateparae was appointed Chair.
Research
The focus of Heathier Lives is four chronic, non-communicable diseases: cancer, cardiovascular disease, obesity, and diabetes, which together account for one third of total death and disability in New Zealand. At the time of establishment, the goal of Healthier Lives was to reduce the overall burden of these diseases on New Zealand's health system by 25% by the year 2025. At the halfway point HLNSC underwent a public consultation process and a research review by six international scientists to develop its 2019–2014 research strategy. This strategy addressed three areas: precision medicine for cancer and cardiovascular disease; culturally-centred health programmes for Māori and Pasifika; and healthy food and physical activity environments. Big or linked data was a focus of research. At the end of the review, MBIE commented that HLNSC had "developed exemplary methods of community engagement, and has co-created 40% of its research with stakeholders, which means implementation of research is more likely."
Precision medicine
A study led by Rod Jackson created new and more accurate equations for predicting the risk of cardiovascular disease. The clinical study of 400,000 New Zealanders aged 30–74 revealed differences in risk from socioeconomic factors and ethnicity: Māori, Pacific, and Indian patients had a 13–48% greater risk of cardiovascular disease than Pākehā, but Chinese and other Asian New Zealanders had a 25–33% lower risk. The research replaced risk prediction equations developed from a much earlier US study of just 5,000 people which significantly overestimated risk for the healthy majority, while underestimating risk factors in others, potentially leading to under-treatment of vulnerable, high-risk groups. The Ministry of Health adopted the new equations into its 2018 guidelines and issued a new data standard, which was incorporated into MedTech, the medical records system widely used by New Zealand GPs.
Healthier Lives has also supported the development of precision medicine techniques, using tumour-derived DNA circulating in the blood (ctDNA). Parry Guilford and Cris Print have developed sensitive ctDNA assays for colorectal cancer and melanoma, both prevalent in New Zealand, and the technology is being applied to breast, stomach, lung, prostate and neuroendocrine cancers to detect early relapse and allow timely treatment.