Professor Maeve Lowery:

On behalf of all of us, we agree with Ms Mulroe.

The HPV vaccine is a brilliant example of how research informs clinical care and reduces cancer burden worldwide. At some point, somebody figured out that the HPV causes cervical cancer. It sounds simple but it was not a simple thing to discover. It was due to laboratory-based research. It was only figured out because somebody was able to take samples of a patient's cancer, interrogate them in a laboratory, do the correct laboratory techniques to identify the cause, develop a vaccine, and bring it back in a safe manner through clinical trials in order to roll that vaccine out to patients worldwide. A whole lot of research went into that, including fundamental research, translational research - bridging the lab and the clinic - and clinical research, which are the trials that brought that vaccine safely to patients. It is a perfect example of how research can inform clinical care and have a major impact worldwide on cancer burden. Everybody should have that. I cannot comment on the costings of it, but it is a prime example of how research can improve cancer outcomes.

Access to drugs and equity of access were mentioned. I second Ms Mulroe's points around that. There is an issue worldwide around equity of access for patients to innovative new cancer drugs. There is a big time-lag between a new treatment being developed in the laboratory and actually reaching the point where it can benefit a patient. That is where good clinical research, and proper infrastructure and clinical trials infrastructure, can speed up that process an awful lot. No more than anything else, clinical trials and an access basis to drugs are about processes, infrastructure and the right people in the right places. Doing that together on an all-island basis will help us to provide equal access for patients to innovative new drugs as best we can.

There are very good international examples of that, which we will pick up later and perhaps now. Many of our European colleagues have come together to develop innovative new ways to bring new cancer treatments to patients. Typically, in clinical trials, we think about one disease type and one drug. That is the old-fashioned way of doing clinical trials. It works very well if there is a particular common cancer type and a particular drug available that might help. However, if there is a rare cancer type or a rare subtype of a common cancer, it is much harder, especially on a relatively small island, to identify a clinical trial that might help. To solve that, we need patients being able to mobilise to access clinical trials across the Border. That is obvious and clear. We have been saying it for a long time but it is very important.

The second element in research is about developing a cross-Border infrastructure for larger clinical trials through a newer, more modern, futuristic-looking model of clinical trials, whereby we actually identify novel treatments and provide them to patients on an individual basis, but also learn and record that interaction to learn why that might benefit a patient and when it does and does not work. That is something we have discussed. We submitted an expression of interest under the PEACE PLUS programme regarding developing such an infrastructure. It has been done in Finland, Norway, Denmark and the Netherlands, with a lot of success. Many EU collaborative bodies are now coming together to co-develop these initiatives. It is about providing the right drug to the right patient at the right time.