 Well, Eric, thanks again from me too for the invitation here. And I think hearing the different country approaches from big and small, from advanced developing countries has been surprisingly useful in terms of setting the framework, I think, in which we need to be thinking about tomorrow. So thank you for that. Now, I'm not sure if Australia is a small or a large country. We're the same size geographically as the 48 states, so that's large. But we're half the population in the whole country, half the population of Tokyo, way less than the population of Jakarta, way less than the population of Shanghai. So I think we're small, at least I'm going to try and get away with that. The second thing I think that's come out very strongly is that this is going to be pulled more than push. When we think about this, we're going to be thinking about the needs of the population and decision makers in what they need and what they want. And it's, I think, very easy. Put it this way. I have very cynical people in the Department of Finance and Treasury in Australia. And you can make all the arguments that if you do this now, it'll save money later. And their eyes blank over, and they say, bugger off, worry. So if we want to do anything new in most countries facing deficits and concerns about the sustainability of funding their health systems, I think we're going to be really smart in the shorter term rather than the longer term in making the economic argument. Yeah, that's my little sermon. So I'm going to cover the following. Now, we're a bit different probably to most of the funding bodies in this room because we do fund research. That's objective number three. But we play a central role in Australia's health system as well. So we do clinical guidelines, public health guidelines. I spend my day worrying about breast cancer surgery or ADHD guidelines or Australia's water quality and so on. And we also have ethics firmly within the NHMRC. So of the equivalent of the Presidential Committee on Bioethics. And that's the top committee there, the Australian Health Ethics Committee. We also have a government appointed committee on human genetics. We fund about $1 billion of research each year. And we have two committees, one on clinical and one on public health issues. And I report directly to the Minister for Health. So we don't escape any part of this issue around human genetics, ethics, clinical application, and the funding of research. This is the amount of money we've been putting into research that has been classified by the researchers purely as genomics. But I'd say that three quarters of our grants now have some genetics or genomic component. And even the most applied health services research, as the bottom points there, decision-making tools, that sort of research has some genomics component. And nearly all our public health research does as well. These are the three big international bodies we're already involved in this. I'd also just put on the agenda, the Global Alliance for Chronic Disease Research, which is not in this area, really. It's about implementation research. It's the UKMRC, NIH, CHR, us, India, South Africa, where we're trying to learn in areas of chronic disease in lower-middle-income countries how we implement the things we know what to do, but how do we implement them in low-resource settings. So there are probably some relevance in that alliance as well. That's my favorite map of the world. Apparently, it's really important to show where your country is. So we're at the top left. I want you to notice that. Now, the imperialists from the Northern Hemisphere have think, of course, the Northern Hemisphere is the top of the world. But my understanding of astronomy is there's no top or bottom. So this is just as legitimate as all the other versions that we've shown today. And the only other point I wanted to make is that in Melbourne today, it's going to be 35 Celsius, which is a damn lot hotter than it is here. So a few words about the Australian health system. And this is one of the challenges, I think. We all have different health systems. And the policymaking around them all is different. And I'm going to talk about some of the challenges we have in Australia. First of all, it's a mixed system. It's both public and private. It is an open access for all. Everybody has the right to get medical treatment. But some treatments, it's best if you pay for them additionally. And you can take private insurance for that if you don't have to. There's a lot of subsidized access for on equity grounds. The system's full of incentives for clinicians and health care networks to do something that is seen to be in the public interest. And there's a lot of complexity around the infrastructure. And that is because Australia only became Australia 114 years ago. And before that, we had states, thanks to the British. And they've kept only a few Wales and Scotland. And some of those might go. But in Australia, we still have eight individual parts of what we now call Australia. And those states and territories run the health system. And the Commonwealth provides the money. So the complication is around who gets to pull the levers, the states, and who provides the money, the Commonwealth. And that's really in the slide. So these bits are government support, Commonwealth and states that pay for most of it. Health insurance pays for a little bit. So that's individuals paying policies, of course. And then this is out-of-pocket expenses by individuals. So it's primarily a government funded health system available to all. What do we spend the money on? Well, like everybody else, mainly on hospitals, so public and private hospitals. I said earlier, the private hospital system plays an important role. And in fact, 50% of procedures that occur in hospitals in Australia occur in the private health system. But the private hospital system is also available to you no matter whether you have private insurance or not. Yes, it's complicated, and probably rational when somebody started out some years ago. So genomic and genetic testing in Australia, just a few comments about that. I've already said how things are complicated because of the split between government and non-government body. The majority of clinical genetic services are provided by governments, by the state and territory governments, and mainly in public hospitals. You can get funding reimbursement for those. The numbers of those that you can get reimbursements will be small, around about 20. But they represent 25% of all genetic test conducted. The TGA, which is kind of like the FDA here, is the regulator of genetic tests. And there's a rigorous process around that. Everybody has their favorite cartoon. This is mine. And I think this does reflect, at least, many of the clinicians that we talked to at the NHMRC, saying, God, we know something's about the hitters, but can you help us make some sense of it? So thanks for the rest of the world for helping us out. That's great. How are we positioned? Well, in a mixed sort of way. One of the problems we face is around electronic health records. There's been a troubled political history around electronic health records in Australia, I suppose, everywhere else as well. But a government once fell on the basis of this. And so it's made governments very wary. And so a very major process is underway to introduce national electronic health records. But it's optional. And it says they're personal controlled. So that means that each individual will control access to their personal records. We're just going to make a little bit of a nightmare. However, I think, like we were talking about earlier, you can get around that. But you need workarounds. Yeah. Well, you have to know Australian politics, probably, to get it really played in a robust sort of way. So about 1986, a government decided to introduce what they called the Australia Card, which was a way that all personal health records and other social security matters could be kept on a national database with an individual sort of an identity card. And Australians being somewhat individualistic, I thought that was an invasion of their privacy. And that was big brother coming and so on. And it got too complicated to talk about. But our Senate is a mad thing. And it was ours. Yeah, I wasn't going to comment on a comparative basis. But anyhow, it blocked the bill. And the Australian Constitution, the government has to go to an election if it wants to get it through and went to an election lost. So long story. But it has resonated on for 20 years. And so the reason that this particular form of electronic health records is being introduced, very much pushed by the medical system, by the health system who want electronic health records. But governments are dancing around it in terms of making it mandatory. It's going to be a problem. On the other hand, Australia has huge and accessible databases under our government funding of pharmaceuticals or medical services and so on. So it's not the end of the world. As elsewhere, the professional workforce is worried about where they are up to it. The group that are leading change, I think, in Australia are the pathologists who are seeing an opportunity but also seeing the need to change. As somebody said earlier, if you can get the whole thing for less than the cost of one genetic test, then nobody's going to do one from now on. So that's an interesting space that we're involved in. We don't really have a coherent way to next generation sequencing. It's mainly at the research area. There is one large national body, the Australian Genome Research Facility, but people often just send it overseas, for example, the Beijing Institute and so on. Some of the things that we are trying to come to grips with are one of the evidential standards. We've talked about that today, education. We've talked about that. Big issue in Australia has been direct-to-consumer DNA testing. So we are very interested, I should say please, probably to see FDA's addressing of that. But it's got a way to go and the consumer groups that are represented on all our committees, so all those principal committees I showed you earlier, have strong public and consumer involvement, are very hot about these particular issues and, of course, many ethical, legal and social issues which are being grappled with by our Health Ethics Committee. Our own framework, we've made it our major priority for the year. He interrupted me, it's not my fault. The key challenges are, I guess, we've yet to develop a lot of national interest. And one of the things that worrying our funders, our governments, are the pressures that are coming from industry and what it says they're enthusiastic clinical researchers. Fortunately, one of them's just gone to Scotland, so that's helped. But to fast-track genomic tests into clinical practice and then get a reimbursement from that. This is our framework, our own framework, the NHMRC. They're the things that we're planning to meet and we have a major consultation with both professionals but also with the community in a couple of months' time in autumn. Last year's slides, I think, these are the things we're currently working on about return of genomic results under the sort of ethics area. I've spoken about testing offered to the consumer, developing position paper for government on that. The issue of genetic discrimination around insurance, this is not health insurance, but it's illegal health insurance is available to anybody but life insurance. And then we've kept a steady supply up of documentation on things, both for health professionals and also for the general public on issues around genomics. Thanks very much. Excellent. That's a public document. Yes, it is. And I can provide a link that you can distribute if you wish, yeah. Do you know, in the spirit of some of the things we've been talking about here, does it contemplate the notion of some sort of pilot projects and implementation? Yes. Yes, it does. In fact, at that meeting in March, I'll be taking some plans, aware that this could be public, so I'm trying not to give any of my Australian colleagues early heads up before they should, but some plans on what we could do, probably working state governments who are responsible for implementation as some pilot studies in this area. Yeah, I'm being obtuse, aren't I? Deliberately. You mentioned that there's interest in an electronic medical record or a personal health record that would be voluntary and the individual controls access. In the US, it seems as though particularly the generation that's just now coming out is very willing to share really strikingly personal things. Do you have the same kind of thing going on in Australia and do you see that as a real promise for this? Well, it's a two-twenty-something door that's sharing strikingly personal things I can really relate to, yeah. Yes, I do think there's a generational change and the PCHR, the personal control, personal control, electronic health record, has set up huge resources so that it will be possible, already is possible, if people have their own sequencing done to put it in their own record. So there's some good things about it and as you're indicating, I think that this is partly a generational change thing but because of the harassment in the 1980s and the politicization of it, it's become a bit of a left and right political matter so we have to work carefully to make sure that we get support. I should say the other thing is that the strongest support we have actually is from the organized consumer health movement in Australia. It's very strong, very organized, has millions of Australians involved. They're represented all my committees and they are going to government to say, get over it. I'd probably say applied, not likely than that but you need to do this for the sake of people with ill health. Yeah, and maybe I could just, was there another question? Aravinda will be much better than mine. I'm wondering if I can have you or we can have your perspective on being from another sort of part of the world. I just wonder what your views are given that our genetic constitution, however you define our, but particularly in countries such as yours or Canada or the US and obviously in many parts, some parts of Western Europe with a massive immigration happening, increasing with widespread admixture as to do you think this is our predicting rates of disease, incidence of disease, presentation. After all, we are talking about genes and variants. So if you discount all the somatic ones and de novo mutations, do you think this is something that in doing this kind of genomic medicine we should worry about or you worry about? So I've been in this job seven years and four times a year I have to go before the Senate and answer political questions and I got a feeling that might have some commonality with that so I've learned very well how not to answer the question. But look, I'd answer it in the following way. So Australia has an indigenous population, Aboriginal and Torres Strait Islander people, very diverse group of people in themselves, been on the continent about 60,000 years, were isolated mainly except from Timor and some south part of what we now call Indonesia for most of that period of time. And they've been on a very interesting journey. So 20 years ago, absolutely nothing to do with genetics just weren't going to and were strongly opposed. Big changes occurred and I can't speak for them and I shouldn't speak for them but I think it's along the lines of common humanity. Diversity is just diversity and learning about ourselves is an important part of being in this case Aboriginal, Torres Strait Islander. So I'm personally not worried about it. I think that in countries that are immigrant countries like Australia there's a rich set of experimental circumstances, a population that can be studied in a way that is harder in countries that haven't got a big immigration policy but you can't underestimate the ethical and cultural side of this and it's really, really important. It's been emphasized many times. It just got to keep the community involved from day one. You have to make sure that the people who are going to be participants in this either as getting healthcare or in research are there taking the journey with us and more than taking the journey with us are really setting the goals because at the end of the day they're going to be the ones who convince governments and others that this is for the future and it's worth funding. Sorry, I'll work. John Wong from Singapore. You mentioned that having five states is a challenge. If you worked with one state to perhaps champion this whole issue, would that be one strategy whereby no one wants to get left behind? So John, there are actually six states and two territories that just makes it a bit harder than the five. Look, I think it's right and we have started dialogue on a state-by-state basis and Australia is a pretty diverse country in many ways. Careful, Warwick. Some states have a more intellectual base. For example, 45% of all our funding on a competitive basis goes to the state of Victoria and the city of Melbourne and other places in Victoria. So it's probably, if you were to start somewhere, you would start there. But it's not really the research base that's important. I guess that's the implication of your question. It's the attitude of the decision maker and the policy makers towards any change in the health system no matter what they have to do. And something that at first sight just looks like, oh God, that all sounds expensive, is the sort of first barrier. So we're now working directly with the heads of the state health departments to say, you know, what's your problem? Let us see if we can turn the paradigm around and get them to identify how it might help them and then bring all the brainy beggars around research to help them. Thanks. We're gonna travel back here.