Professor William Gallagher:

I will respond to the question on the limits on what you can do and what we are planning. One thing to note is that a cancer could have started ten or 15 years earlier as an altered cell in the body and it has taken time to develop into a presentable cancer. The study of cancer is, therefore, a long-term issue. It takes time to study it. We are trying to accelerate, fast-track and bring innovations closer, but sustainability is needed in terms of a research programme. The stop-start nature of research programmes has been a challenge in an Irish context. We have fantastic research programmes and I have led a few of them where things were great for five or six years but then everything stopped, and then you had to start to reinvent and do it again. That is not how cancer research is done effectively.

The Cancer Moonshot in the US was a game changer. A decision was made to do it, substantial resources were provided and there was a long-term vision. To me, we need a long-term vision that is a minimum of ten years and probably 20 years. The funding agencies do not really have that mindset and it is generally between three and five years, so that is why an integrated approach is needed. That is what we are doing. We are using a bottom-up initiative to define the key issues we want to address. At the moment we are using a piecemeal approach to identifying opportunities and bidding for those which fit that plan, but that is not ideal. We very much want a unified approach.

As Professor Lawler mentioned, the national development plan contains plans to create all-island research centres. There are pre-existing examples of these substantive centres working very effectively in Ireland. For example, the Insight Centre for Data Analytics involves several hundred people and it has shown significant impacts in terms of economic impact. The APC Microbiome Ireland Science Foundation Ireland Research Centre in Cork is a world leader in researching the microbiome and its interesting role in cancer. We want something similar in the cancer space because we need such a mechanism to integrate people. In the absence of that, we will keep going forward but the scenario is not ideal. We have the vision to do this but need the mechanisms to bring this forward.

The PEACE Plus programme is fantastic because it has the potential to fund elements of the healthcare intervention aspects, but we need a component. We have shown what we can do, for example, with the breast predict programme. We received €7.5 million from the Irish Cancer Society, which came from people putting coins in buckets and companies donating money. With that €7.5 million, an additional €50 million was leveraged in EU and external funding, which had very significant long-term impacts in terms of clinical trials and new diagnostics. Unfortunately, the programme has ended and it is very hard to have that legacy. Some of the fruit that was developed fell off the tree and you can only take certain things forward. We want to change that and keep those things going forward.