Malta is the ideal place for clinical trials, researcher says

Demand for health services is expected to increase in the coming years and a strong research focus is important to find new and innovative ways to address the challenges of the future, says Paediatrician Victor Grech. He says Malta offers a unique environment for medical research, as well as for medical devices and drug trials that could lead to breakthroughs in the science and healthcare sectors.

Prof Grech, can you tell us about your recent research interests and its outcomes?

Childhood obesity is very common in Malta, and we just conducted a study measuring all children aged 5 to 17 in Malta’s schools. We were the first country in the world to measure the entire school-aged population as opposed to using a sampling method. Our findings confirm that 40% of children are overweight or obese, which was a very shocking result. If we compare it with previous studies, we also see that the situation seems to be getting worse, and more children experience weight problems today. In another study, we examined schoolbag weight and back pain in children. The methodology was different and data was collected using a questionnaire and structured interviews. A total of 4,005 participants were included in the study. Over 70% of these had a school bag that exceeded the recommended 10% bag weight to body ratio, with more than 30% complaining about back pain.


What lessons can be learnt from these studies?

Well, when it comes to schoolbag weight, one possible solution is for schools to provide lockers, while the obesity problem requires more draconian measures in my opinion. One of the most obvious measures would be to introduce a sugar tax in Malta to curb consumption.

This has already been done in many other countries. Soft drinks are actually one of the main causes of obesity. We need to find ways to influence choices, without imposing them. But we need to act fast. We also saw that the proportion of obese children exceeds those who are overweight, indicating that the weight problem is getting worse over time. Obesity also has an economic impact as it means rising costs for medial treatment, as well as an increase in a person’s sick days. I am warning my colleagues that in a few years’ time we will see a meteoric rise of cardiovascular diseases and the like. It is going to be a major problem.


Is the situation in Malta worse than in other countries?

It is only slightly worse than in other southern European country, but as I already mentioned, it was also the first time that a country measured all its children. We also did this in a scalable way, and other countries can easily replicate our study, irrespective of their size. All children were measured during their PE lessons, making the process really easy. But we don’t want to stop here. I have now put forward a proposal to the health minister, which is being backed by the European Association of Paediatrics. I would like to send an invitation to all health and education ministers of the EU countries to do the same study in their countries and then to set up a data collection centre in Malta. Many countries in Europe are battling with unhealthy diets and physical inactivity, and I’d like to encourage greater collaboration.


On a general level, how would you assess Malta’s medical research landscape and where do you see opportunities for growth?

There are quite a few things going on at the University of Malta, although quite a bit is theoretical and has no immediate application. But there are a few interesting developments happening. Next year for instance we are going to do a study on a new 24 hour ECG Holter monitor to measure heart activity. This product is currently being developed, and we have been approached to test it. Malta is really the ideal place for such a study. Our health system is open to clinical trials, and we have the potential to develop into a pharma and medtech hub.  

Our commitment to this can also be seen in our Life Sciences Park, which today hosts lab space and offices. Academics and industry should also look at Malta because it is easy to conduct long-term population-based studies here. People don’t tend to move away as this is often the case in some of Europe’s larger cities. They are accessible most of the time.


What are the key challenges that medical research is facing in Malta?

At times we have to deal with excessive bureaucracy. In the world of science and research, it is important to have access to the right people. The situation is no different in Malta. You need to find people who believe in your idea and can help finance it. Resources are traditionally limited. To get support, researchers need to publish their work in medical journals. We have actually developed a course aimed at academics to help them write a scientific paper. It is actually a unique course worldwide that goes into all the details of scientific paper writing. The ability to write up research in the form of a paper that can withstand the test of peer review is a crucial and critical requisite for academics. You can do the best research, but if you don’t publish it, no one will know about it and your ideas are worthless. On the opportunity side, I would also like to market this course abroad and attract people to Malta to attend it. We are already running the course in London and are planning to take it to the Middle East in 2018.


If you could make a few recommendations to government about how to support the sector, what would they be?

I think we need to do more to encourage industry to bring their devices and drugs here for testing. I would also like to see a bit more financial support for our university. There are no guarantees that any research will yield results, but significant funding is required to do proper research. It would also be great to have additional resources for researchers to attend more international conferences as these are so important for networking and the development of new ideas.


What’s your future outlook for the sector?

The future is good because the potential is great. All we need are ideas, either generated by industry or academia. I believe Malta can become a hub with global reach if we foster greater cooperation between scientific minds. In the short to medium term, Brexit might also turn out to be an opportunity. While the UK’s exit from the EU might lead to difficulties for researchers in the UK in terms of accessing EU funds, other EU member states, including Malta, might benefit. Now is a good time to promote Malta as a hub for pharmaceuticals and medical technology solutions. 



Prof. Victor Grech is a consultant paediatrician with a special interest in paediatric cardiology. He has a PhD in this field and another in science fiction. He is the editor of the journals Images in Paediatric Cardiology, the Malta Medical Journal and the Malta Medical School Gazette, and co-chairs HUMS, the Humanities, Medicine and Sciences Programme at the University of Malta. He is also the creator and coordinator for the Write a Scientific Paper (WASP) course.




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