The Australian visionary innovator wants to give millions of blind people the gift of sight

Fitz: Who did you choose? And how? It must have been very difficult to make such monumental decisions, as well as to tell other hopefuls that they haven’t made your surgical cut?

GS: [Very softly]. I chose the younger people, the ones who, ultimately, would get the most benefit for the longest time.

Fitz: Can you describe what it’s like, the day after the operation when you peel back the gauze and a seven-year-old girl blinks and can see her mother’s face for the first time?

GS: [With a slightly broken voice] I get tearful even talking about it. It’s very humbling. And I’m very grateful that I have the chance to do that sort of thing, while also being aware I’m just the very last in a long line of people who have made that commitment to giving people back their sight. And we all rely on the work of previous generations, particularly giants like Fred Hollows.

Fitz: Did you work with him?

GS: I met him, found him inspirational, and was once funded by the Hollows Foundation to do work in Cambodia, just after the Khmer Rouge had been booted out. That was a wild and dangerous time, with armed gangs roaming the streets, and death threats. But that time in Myanmar with 1000 people needing corneas and only four corneas to give them, was the most transformational experience of my life. Clearly what was needed was to set up their own cornea bank and train more ophthalmic surgeons. And we raised the money and did that but it was simply never enough. So I realised that the only way we’re going to actually solve this problem and cure the corneal blindness was if we were going to actually come up with something from left field that was going to allow us to send as many corneas as was needed to these places, as well as in Australia. And that’s when I decided to try to focus my efforts on helping develop the bioengineered cornea.

Fitz: Was anybody doing work on that anywhere around the world?

GS: Yes, lots of people, but little of it was being co-ordinated, and instead of having different research programs and scientists trying to tackle specific and different problems, there was a lot of duplication and no cohesion. So with Sydney University backing us, and a bit of money from the NSW government, we set up the Australian Corneal Bioengineering Consortium – Bienco – and began co-ordinating the research with scientists from across Australia. From places like Wollongong University, Melbourne University, Centre For Eye Research Australia, NSW Organ and Tissue Donation Service and Queensland University of Technology – all collaborating with my team at Sydney Uni.

Fitz: There must have been a Eureka moment?

GS: There were many Eureka moments. But all of them were built on many, many years of hard work. People often talk of the breakthrough moment with penicillin with Sir Alexander Fleming in 1928, noticing the blue-green mould on a plate had killed all the bacteria around it. Eureka! But from that moment it was the Australian, Howard Florey, who worked for 15 years to actually perfect that – even after Fleming had given up – and get it to the point where we could use penicillin as an antibiotic. And the first time he tried it on an English policeman, it worked at first. But the bobby died because there was not enough penicillin. That’s been what working on this has been like. I would not like to suggest that I have been the inventor of this. But I’m an innovator and my team are innovators. And we have improved it. And we now have a product, which is our product. We now have something which we think can actually make an impact on blindness around the world.

Fitz: Now, without using big words like “corrugated iron” or “marmalade jam,” can you explain, how does it actually work?

GS: OK, so, the basic human building blocks are made of collagen and what we set out to do was find a way to grow it from skin so that it is not opaque like skin, but see-through like a cornea. So to take it from not-see-through to see-through was the critical challenge, do you get that?

Fitz: Yes, professor.

GS: And once we had done that, and produced that basic substance – that liquid, that gel made up of the collagen – we can actually “bio print” it in many thin layers that together make a structure like mille-feuille pastry. And so now, instead of one donated cornea curing one eye, it means that with just one piece of skin from a donor, we can actually cure blindness in 30 people.

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Fitz: How did you get the money to make it happen on the scale you want?

GS: A decade ago Joe Hockey – when he was federal treasurer – set up the Medical Research Future Fund: basically to have the funds to put Australia at the forefront of medical research, and also to maximise chances of a commercial return. We approached them in 2021, and there were lots of great proposals, with ideas for everything from breast cancer to dementia to cardiothoracic problems to atherosclerosis and 10 groups got a million bucks. But there was still $35 million to be given to one group that they particularly believed in.

Fitz: And …?

GS: And the chair of the interview panel of 30 people was Ian Frazer, who developed the vaccine for cervical cancer. And after we’d given our presentation, he said, “thanks, Gerard, but why should we give you the money rather than one of the other groups?” And I said, and I genuinely believe this, “because we could potentially be like Cochlear, and be the Australian company that is innovative and capable of producing treatments that are going to affect the lives of people not just in Australia, but around the world”. It proved to be a persuasive argument and I think we’re going to be producing transplants that can treat corneal disease and injuries within three to four years and make an impact on blindness around the world. If we can achieve that, I’m done.

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Fitz: Not so fast. Two more things. Let’s say it works on the scale you dream and it will be Australians who have developed Cochlear to make the deaf hear again and Bienco to make the blind see again. Why is it we Australians making such achievements in a field already awash with seriously accomplished graduates?

GS: Because we’re just a very innovative people and we think incrementally about ways to improve things in a society that encourages thinking outside the square and both encourages and rewards success. We don’t have a society that is hyper critical of people who are trying to do something different. We’re a very, very highly educated society. And we have the capacity to make a significant commitment, not just in medicine, but in all areas of science and endeavour. I genuinely believe that. And so to have a government who was prepared to invest this amount of money in us, shows what a superbly innovative country we can be, with a global impact. We Australians like to criticise governments for their lack of courage but I have to say that the people in Canberra, like the health minister Mark Butler, have truly understood how important this discovery was and they’ve backed us.

Fitz: And if you can grow corneas on a mass scale, might the day come when you can grow kidneys, livers and even hearts?

GS: Yes. At the very least this research will facilitate that kind of research in other areas of medicine and grow things like heart valves. But, for now, our dream is to create a facility that can provide the expertise for an entirely new industry in Australia. Why can’t we be the bioengineering centre of the world? We can be.

Fitz: Thank you, and bravo. You are, dare I say, a visionary.

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