Annual Report - Outcome 14 – Biosecurity and Emergency Response

Table of contents

Part 3: Management Arrangements

Part 4: Accountability Reporting

You may download this section of the document in PDF format:

PDF printable version of Outcome 14 – Biosecurity and Emergency Response (PDF 162 KB)

Outcome Summary

Outcome 14 aims to protect the health and wellbeing of all Australians through coordinated arrangements that are capable of responding effectively to national emergencies. It focuses on strengthening the nation’s capacity to identify, monitor and implement effective and sustained responses to national health threats or emergencies, including communicable disease outbreaks, terrorism, natural disasters or environmental hazards. The Department worked to achieve this outcome by managing initiatives under the programs outlined below.

Programs Administered Under Outcome 14 (Program Objectives in 2008–09)

Program 14.1 – Health Emergency Planning and Response

Prepare for, and respond to, national public health emergencies such as communicable disease outbreaks, terrorism or natural disasters.
Acquire and maintain a strategic reserve of medical equipment supplies and pharmaceuticals for rapid deployment.
Maintain the expert infastructure required to provide high level policy advice to the Australian, State and Territory Goverments on preparing for a health emergency, and the capability to coordinate the national response through the National Incident Room and appropriate national advisory structures.

Program 14.2 – Surveillance

Inform the Australian Government of the burden of communicable diseases regionally, nationally, and internationally, and interventions protecting the safety of all Australians.

This chapter reports on the major activities undertaken by the Department during the year, addressing each of the key strategic directions and performance indicators published in the Outcome 14 chapters of the 2008–09 Health and Ageing Portfolio Budget Statements and 2008–09 Health and Ageing Portfolio Additional Estimates Statements. It also includes a table summarising the estimated and actual expenditure for this outcome.

The Office of Health Protection was responsible for Outcome 14 in 2008–09.

Major Achievements for the Outcome:

Strengthened Australia’s capacity to respond to health emergencies through the release of the revised, nationally agreed, Australian Health Management Plan for Pandemic Influenza, and implementation of this plan in the initial response to pandemic (H1N1) 2009 (Swine Flu) (see Ensuring Plans, Policy, Communications and Reporting are Based on the Latest Evidence); and
Reduced the threat of the misuse of security sensitive biological agents, by introducing a new regulatory scheme to track and control their use (see Effective Communicable Disease Control and National Biosecurity).

A Challenge for the Outcome:

Protecting the community from the outbreak and spread of pandemic (H1N1) 2009 (see Maintenance of the National Medical Stockpile).

Key Strategic Directions for 2008–09 – Major Activities

Maintenance of the National Medical Stockpile

To ensure that Australia is highly prepared to respond to an outbreak of an influenza or viral pandemic, or a chemical, biological or radiological incident, the Department managed the National Medical Stockpile which supplements the existing supplies of pharmaceuticals and medical equipment held by the states and territories for use in an emergency. This involves storing pharmaceuticals and equipment, and developing relevant policy and guidelines for managing the stockpile.

Stockpiling Medicines

In 2008–09, the Department managed the national stockpile by purchasing, storing and deploying pharmaceuticals and equipment. To ensure the viability of the stockpile, the Department monitored expiry dates and audited stocks to maintain the accountability of the stockpile. During the year, the Department started to replenish items from the National Medical Stockpile that were due to expire in 2008–09 and 2009–10. The Department replaced a substantial quantity of expiring influenza antivirals and is in the process of purchasing new supplies of H5N1 Influenza (Avian Influenza) vaccine. A range of other items will be replaced in 2009–10 as they expire.

A challenge for the Department was dealing with the expiry of the shelf life of the antiviral components of the stockpile. A substantial proportion of the antivirals were purchased in 2004 with a five year shelf life which resulted in the expiry date being reached in June 2009. The Department dealt with this issue by making arrangements with the manufacturer for the expiring drug to be exchanged for new stock on favourable commercial terms. In addition, at the manufacturer’s request, in May 2009 the Therapeutic Goods Administration approved an extension of the shelf life of the drugs from five years to seven years and thereby automatically extended the shelf life of the drugs still held in the stockpile.

On 30 April 2009, the Department began deploying items from the stockpile in response to the pandemic (H1N1) 2009 outbreak. As at 30 June 2009, the Department was continuing the deployment of pharmaceuticals and equipment following the World Health Organization’s declaration of the status of pandemic (H1N1) 2009. The Department worked with state and territory health authorities to ensure that stockpile items were used in line with agreed national plans.
Top of page

Policy Advice

In order for the Government to make informed decisions about the management of the stockpile, and ensure that Australia continues to be well prepared to deal with pandemics, it is vital that it has information on the current and future risk environment and developments in new technology. During the year, the Department provided advice to the Government, and considered developments and the best available scientific evidence, to ensure that the stockpile was appropriate and used effectively and efficiently.

In December 2008, the Department published the updated Australian Health Management Plan for Pandemic Influenza 2008, which includes a revised approach to the most appropriate use of antivirals in an influenza pandemic. The efficient and effective use of antivirals taken from the stockpile is essential in ensuring that the public has access to these medicines when and where they are most needed.

A challenge during 2008–09 was the need for an additional alert level to develop a policy response to the arrival in Australia of the pandemic (H1N1) 2009 strain. The Department developed the PROTECT level to reflect a more appropriate response to the outbreak. The aim of the PROTECT level is to identify people who may have a severe reaction to the disease, and provide medical care and interventions to reduce likely suffering. Following advice from the Department, on 17 June 2009 the Minister for Health and Ageing announced the move to the new PROTECT phase, as part of Australia’s response to the pandemic (H1N1) 2009 outbreak. This provided for the targeted use of antivirals from the stockpile for early treatment for people identified as vulnerable; those with moderate or severe disease; and especially those with respiratory difficulty. The Department will continue to provide advice to the Government in 2009–10 on Australia’s response to pandemic (H1N1) 2009.

Funding for the above activities was sourced from Program 14.1 – Health Emergency Planning and Response.

Key Fact for 2008–09: Pandemic (H1N1) 2009

The Department activated its National Incident Room on 25 April 2009 after the World Health Organization (WHO) announced outbreaks of a novel strain of influenza virus in the United States of America and Mexico. The WHO raised its pandemic alert to phase 6, (the highest level) on 11 June 2009, where an influenza virus involves human to human, or human to animal, infection and causes sustained community level outbreaks in two WHO regions. The virus is now called ‘Pandemic (H1N1) 2009’.

The Department, with advice from the Australian Health Protection Committee, carefully monitored unfolding events and activated border measures in the early phase of the outbreak. The Department worked closely with border agencies, state and territory public health units, airlines and airports to ensure border measures were introduced in a timely and consistent manner across the country. These border measures delayed entry of the disease into Australia for several weeks.

The Department also deployed various components of the National Medical Stockpile, purchased an additional 1.6 million courses of the antiviral drug Relenza (zanamivir) which bolstered the supply of medicines to treat pandemic influenza and placed an order with CSL Ltd to secure supplies of the first batches of pandemic (H1N1) 2009 vaccine.

The current phase of the response, PROTECT, provides a basket of measures which recognises the variability in disease patterns across Australia, which is mild in most, severe in some and moderate overall.

Building the Capabilities for National Health Emergency Response

The Department aimed to build capabilities by addressing gaps in Australia’s emergency response plans and maintaining a state of readiness to respond to national and other health emergencies. The Department used training exercises and real events to identify gaps in national response plans and entered into surveillance sharing arrangements.

Implementation of Lessons Learned

In 2008–09, the Department implemented lessons learned from its participation in exercises or involvement in real events. The Department ensured that a continuous improvement cycle underpins the way in which it prepares and responds to national health emergencies. This continual refinement of processes ensures that the Department is well placed to provide optimal services to the community.

Specific lessons that have been implemented during the year include: improved collection of data from jurisdictions, through the development of agreed data collection tools; improved communication of information to the public, specifically through websites; developed contracts for the activation of call centres; and improved decision making processes within national governance arrangements. These activities ensured that the Australian health system was able to respond effectively to national health emergencies by providing the public with timely and accurate information, and coordinating the provision of appropriate health services.

The Department also developed national health emergency response arrangements, which the Australian Health Protection Committee will review in July 2009. These arrangements articulate the strategic governance arrangements and mechanisms for the coordination of the Australian health response to an emergency of national consequence. Unlike a plan that is activated in times of need, the arrangements remain in place at all times. The Department has established a writing group to develop a National Trauma Plan which will incorporate outcomes of a review of the national burns plans.

The Department will continue to participate in exercises in 2009–10 and implement the lessons learned from these and the pandemic (H1N1) 2009 outbreak and response.
Top of page

National Health Security Agreement

Information exchange is vital in coordinating a response to health emergencies and in 2008–09, the Department exchanged information ten times through the National Health Security Agreement, which underpinned the level of information sharing that occurred during various responses and ensured that there are agreed frameworks for this exchange. The arrangements are working well as demonstrated by the effective national response to the pandemic (H1N1) 2009 outbreak.

Funding for the above activities was sourced from Program 14.1 – Health Emergency Planning and Response.

Strengthening Communicable Disease Surveillance Systems

The Department provides effective surveillance and early warning of international and domestic communicable disease threats to protect the health of the community. The Department’s focus in 2008–09 was on maintaining and expanding national, regional and international cooperative arrangements for communicable disease surveillance.

Gastroenteritis and Foodborne Illness

Surveillance of gastroenteritis and foodborne illnesses is an important part of the Department’s work in protecting the community from harm. The most recent assessment on the burden of foodborne illness in Australia estimated that 17 million cases of gastroenteritis occur nationally each year. Of these, nearly 5.4 million cases are due to foodborne disease, which cost the Australian economy an estimated $1.2 billion dollars. During 2008–09, the Department conducted surveillance for outbreaks of gastroenteritis and foodborne disease through OzFoodNet, a collaborative initiative with state and territory health authorities. Through OzFoodNet, the Department seeks, detects, assesses and, where required, responds to multi-jurisdictional outbreaks of foodborne illness. In 2008–09, OzFoodNet continued to enhance surveillance for foodborne illness in Australia, coordinating the investigation of 14 potentially multi‑jurisdictional outbreaks of foodborne illness.

In 2008–09, the Department undertook the National Gastroenteritis Survey II to estimate the incidence of foodborne illness in the community. Data collection for this survey was completed in February 2009 and analysis is currently being undertaken through OzFoodNet and the National Centre for Epidemiology and Population Health at the Australian National University. Data collection for a parallel survey into the incidence of gastroenteritis in aged care facilities in New South Wales was also completed in 2008–09 and the analysis is currently underway. Results from this survey will be used to plan initiatives to reduce the incidence of foodborne illnesses in the community.

OzFoodNet also completed studies into foodborne disease agents in Australia. These studies examined risk factors for foodborne disease agents, and will provide information for future prevention strategies. A study of Campylobacter estimated that 50,500 Australian cases of Campylobacter infection in persons aged five years and older each year can be directly attributed to the consumption of chicken. A study into Shiga-toxin producing Escherichia coli infections highlighted risks associated with eating hamburgers and occupational handling of raw meat.
Top of page

Partnerships with Regional Countries

Establishing relationships with other countries in the Asia-Pacific region is important to improving Australia’s disease surveillance system. During 2008–09, the Department collaborated with the World Health Organization, especially the Western Pacific Regional Office, in a number of areas contributing to strengthening global and regional communicable disease surveillance efforts. Specific activities during the year included participation in the bi‑regional (Western Pacific Regional Office and South-East Asia Regional Office) Asia Pacific Technical Advisory Group on Emerging Infectious Diseases, and hosting discussions with visiting World Health Organization Headquarters and Western Pacific Regional Office specialists. These occasions provided an important opportunity to share information and strategies, which can be used to combat the spread of communicable diseases both within Australia and the Western Pacific Region.

The Department worked with AusAID, through the Tuberculosis Clinical Management and Laboratory Capacity Building Project, to strengthen tuberculosis surveillance in the Western Province of Papua New Guinea. The project will develop laboratory capacities and train staff to improve the detection and diagnosis of normal and multi-drug resistant tuberculosis. The appointment of a Western Province Communications Officer has also improved surveillance through clinical outreach visits to village aid posts and health centres along the South Fly Coast.

In 2008–09, the Department, through OzFoodNet, provided training at three regional capacity building training courses held by the World Health Organization Global Salmonella Surveillance Network – one in the Pacific Region, one in Guam, and one in Thailand. These training courses focused on building laboratory and epidemiological capacity to enhance the surveillance of foodborne disease in the region.

Information Sharing, Sustainable Partnerships and Agreed Priorities

The Department continued to foster and strengthen communicable disease surveillance partnerships through the Australian Health Protection Committee and its subcommittees, in particular the Communicable Disease Network Australia. The Communicable Diseases Network Australia and its subcommittees are key partners for effective sharing of communicable disease information between the Department and the states and territories. These ongoing partnerships ensure that the Department continues to effectively conduct surveillance for communicable diseases in Australia. The Department utilised the expertise of the Communicable Diseases Network Australia to identify, respond to and provide advice during national outbreaks, such as the response to the pandemic (H1N1) 2009 outbreak.

Northern Border Regions Health Protection

In 2008–09, the Department worked to minimise risks posed by communicable disease threats by identifying and exploiting opportunities to strengthen Australia’s vulnerable northern border regions. The Department worked with other Australian Government agencies and the Queensland and Papua New Guinea Governments, through the Torres Strait Cross Border Health Issues Committee, to develop a package of measures to address cross border health concerns. Significant progress was made in developing measures to strengthen health services in the Torres Strait and Western Province of Papua New Guinea and thereby reduce the incidence and transmission of communicable diseases into Australia. The Department will continue to work with other stakeholders through the Health Issues Committee to finalise the package’s development.

Implementation of some elements of this package commenced this year, such as the Tuberculosis Clinical Management and Laboratory Capacity Building Project. These included a clinical workshop to provide training, support and mentoring in December 2008; scoping work by bioengineering specialists to facilitate capital upgrades to the Central Public Health Laboratory in Port Moresby; the appointment of a Western Province Communications Officer to provide clinical outreach visits to village aid posts and health centres along the South Fly Coast; and support for the follow-up and treatment of Papua New Guinea nationals diagnosed with tuberculosis in Torres Strait island clinics.

The Department supported mosquito control operations to ensure mosquitoes capable of spreading diseases, such as dengue fever, are eliminated before they become established in mainland Australia. This included providing funding to Queensland Health for its work in the Torres Strait outer islands to control exotic Aedes albopictus mosquitoes, a known carrier of dengue virus.

Funding for the above activities was sourced from Program 14.2 – Surveillance.
Top of page

Ensuring Plans, Policy, Communications and Reporting are Based on the Latest Evidence

The Department aims to ensure that Australia’s protection is supported by a body of evidence-based plans, policies and reports to provide the most up-to-date protection of the community. In 2008–09, the Department reviewed its planning operations, and monitored pandemic and pre-pandemic vaccine use, as well as global efforts to improve preparedness.

Review of Pandemic Influenza Planning

A major achievement for the Department was its review of the Australian Health Management Plan for Pandemic Influenza 2008 to ensure that it reflects the latest evidence, best practice, and expert opinion (available at www.health.gov.au). The new plan, released in December 2008, provides the health sector with a strategic framework to guide preparedness and response activities to any influenza pandemic.

The Australian Health Management Plan for Pandemic Influenza 2008 represents a significant step forward in Australia’s pandemic planning. Key innovations in the planning framework include: more flexible policy; a greater emphasis on a multi‑pronged strategy to sustain the health system; revised phases that reflect increased confidence in vaccine technology; and enhancements to the National Medical Stockpile. The new plan also incorporates the lessons learned from Exercise Cumpston, which was a large-scale live simulation exercise by the Australian, State and Territory Governments, run in 2006 to assess the health system’s capacity and capability to respond to a pandemic. The 2008 plan was developed in close consultation with the states and territories through the Australian Health Protection Committee. This coordinated approach helped limit the spread of the pandemic (H1N1) 2009 strain. The new approach will guide the Department’s response to the virus in 2009–10.

The Department also participated in reviewing and updating the National Action Plan for Human Influenza Pandemic, which outlines a whole-of-government framework for responding to an influenza pandemic.

Monitoring of Pandemic and Pre-pandemic Vaccines

The Department monitored the global use of vaccines, and their performance in clinical trials as well as the global market for pandemic and pre-pandemic vaccines.

In 2008–09, the Department worked with the World Health Organization’s Intergovernmental Meeting on Pandemic Influenza Preparedness to develop a new framework for sharing influenza viruses and access to vaccines and other benefits. The Intergovernmental Meeting, chaired by Secretary Jane Halton PSM, was mandated by the World Health Assembly to help resolve issues surrounding the operation of the World Health Organization’s Global Influenza Surveillance Network and the lack of access by developing countries to relevant vaccines and antivirals.

The Department participated in forums and facilitated discussions between groups to find common ground on key virus sharing issues. The Intergovernmental Meeting reached consensus on most elements of the framework, including: improvements to the governance and transparency of the World Health Organization’s network of four expert influenza laboratories, which includes one in Melbourne; and arrangements for access to vaccines and antivirals in developing countries.

Global Preparedness

To ensure that Australia’s plans reflect best practise, the Department regularly liaised and participated in international meetings, and contributed to the global preparedness and response to health emergencies, such as an influenza pandemic, as a signatory to the International Health Regulations. Through the International Health Regulations, Australia exchanges reports of communicable disease incidents of international concern. These notifications assist countries to rapidly respond to cases of communicable disease, prevent outbreaks, and minimise the impact on the community.

Funding for the above activities was sourced from Program 14.1 – Health Emergency Planning and Response.
Top of page

Effective Communicable Disease Control and National Biosecurity

The Department supports effective communicable disease controls through policy, legislation and regulation, and strengthening national biosecurity. Throughout the year the Department cooperated with inter-departmental reviews, managed quarantine arrangements and established a regulatory scheme for security sensitive biological agents.

Australia’s Biosecurity Arrangements

Strengthening Australia’s biosecurity arrangements is an important means of protecting the public from the spread of exotic pests and diseases. The Independent (Beale) Review of Australia’s Quarantine and Biosecurity Arrangements, commissioned by the Department of Agriculture, Fisheries and Forestry, made recommendations that will affect human health arrangements. The review called for a rebuilding of Australia’s biosecurity systems. Of greatest importance was the immediate replacement of the Quarantine Act 1908 with new biosecurity legislation and a shifting biosecurity regime shaped by scientific risk assessment and investments made on a ‘risk return’ basis. The Department worked closely with the Department of Agriculture, Fisheries and Forestry to develop responses to the Beale Review that ensure human biosecurity arrangements are modernised and integrated within the new regime. This work will continue throughout 2009–10.

In 2008–09, the Department continued to manage the National Incident Room, which is the designated Australian focal point for the International Health Regulations, introduced by the World Health Assembly in 2007. The regulations aim to help the international community prevent and respond to acute public health risks that have the potential to cross borders and threaten people worldwide. The National Incident Room has responsibility for communicating with the World Health Organization as well as coordinating the implementation of the regulations. From 1 July 2008 to 30 June 2009, three formal and 11 informal notifications were made under the regulations. This year also saw the development of a training package to raise awareness among governments about Australia’s obligations under the regulations.

Human Quarantine Policy

Maintaining strict human quarantine policies is an effective way to strengthen Australia’s biosecurity arrangements. The Department collaborated with State and Territory Government health agencies and relevant Australian Government agencies to develop arrangements and instructions to activate border health measures to protect Australia from the introduction of serious communicable diseases. The resulting Border Health Measures Guide was instrumental in the successful activation of Australia’s border response to pandemic (H1N1) 2009.

During the year, the Department reviewed national requirements for vaccination of travellers who have recently arrived from countries with a risk of yellow fever transmission. Following expert medical advice on the international spread of yellow fever and the response required by Australia, the Department established a new list of yellow fever declared places. This new list will maximise the effectiveness of vaccination requirements in preventing the introduction of yellow fever virus into Australia, and will commence from 1 August 2009.

Security Sensitive Biological Agents

Maintaining strict control of security sensitive biological agents is vital to ensuring the safety of the public. A major achievement occurred in 2008–09 when the Department implemented the Security Sensitive Biological Agent Regulatory Scheme. The scheme raises awareness of the potential misuse of biological agents for terrorist purposes and strengthens biosecurity controls by establishing a regulatory regime for laboratories handling biological agents of high security concern.

In 2008–09, the Department also introduced the National Health Security Regulations 2008 and the Security Sensitive Biological Agent Standards, both of which provide further operational details for the scheme. The Department consulted widely on these legislative instruments and collaborated with the Australian Government and State and Territory Governments on the Security Sensitive Biological Agent education and awareness raising campaign. The Department introduced the regulation of biological agents of the highest security concern on 31 January 2009.

The Department’s priorities for 2009–10 include: the commencement of regulation of biological agents of high security concern in January 2010; the introduction of an amended National Health Security Act 2007; a review of the National Health Security Regulations 2008; and a review of the Security Sensitive Biological Agents Standards.

Funding for the above activities was sourced from Program 14.1 – Health Emergency Planning and Response.

Strategic Management of Environmental Threats to Human Health

The Department aims to provide strategic support for evidence-based, consistent approaches to manage environmental threats to human health and protect the community from unnecessary harm. During the year the Department developed consistent approaches to environmental health, and contributed to a national system for regulation of chemicals and controlled substances.
Top of page

Environmental Health Protection

The Department is committed to preventing environmental threats to human health. In 2008–09, the Department worked with the states, territories and other key national stakeholders on the implementation of the National Environmental Health Strategy 2007–2012 (available at www.health.gov.au). The strategy underpins the development of consistent approaches to environmental health around the country, which: saves resources by sharing developments in environmental health sciences; reduces duplication of effort in national policy development; and ensures that the environmental health workforce has access to peer reviewed guidelines to increase their ability to apply their skills and knowledge to benefit the health of Australians. The Department also included the development of a National Environmental Health Workforce Action Plan in the implementation of the strategy, to underpin new policy work. The Department obtained agreement on key workforce initiatives that will be pursued over the next five years, including the development of case studies on the role of environmental health workers in emergency management, to clarify responsibilities at the local level and possibly promote the uptake of educational and employment opportunities in this field.

In 2008–09, the Department provided funding to support the review and updating of two key enHealth committee documents: Environmental Health Risk Assessment – Guidelines for assessing human health risks from environmental hazards (2002) and Guidelines for the control of public health pests – Lice, fleas, scabies, bird mites, bedbugs and ticks (1999) (available at http://enhealth.nphp.gov.au). These guidelines will assist health agencies to develop strategies and minimise risks in order to prevent environmental hazards from harming the public. This work will be completed in 2009–10.

In 2008–09, the Department supported projects addressing specific environmental health issues in Indigenous communities, including environmental heath education programs, dog control and dust suppression. Additionally, the Department provided support for activities specifically targeted at Indigenous Environmental Health Workers, including the development of guidance material, a pilot mentoring program and the conduct of the 7th National Aboriginal and Torres Strait Islander Environmental Health Conference.

Chemical Safety

During 2008–09, the Department provided human health and safety risk assessment advice on new and existing chemicals to the Australian Pesticides and Veterinary Medicines Authority. These assessments contribute to the regulation of agricultural and veterinary chemicals to minimise the risk posed to the public by exposure to chemicals. Also in 2008–09, the Department managed a consultation process for the introduction of a Globally Harmonised System of Classification and Labelling of Chemicals.

Discussion relating to other chemical safety initiatives can be found in the Outcome 1 Population Health chapter.

Prohibited and Controlled Substances

The Department monitors and controls prohibited and controlled substances in Australia in order to prevent their diversion to illicit use. In 2008–09, the Department contributed to the National Drug Strategy Project Cohesion by implementing the International Narcotics Control Board’s Pre‑Export Notification online system. Australia and participating countries provide notification on all substances specified under international drug treaties which have the potential to be diverted into illicit drug manufacture (precursor substances). This system will improve information sharing between jurisdictions which will allow the Department to prevent precursor substances from entering Australia and being used in the production of illicit substances.

Funding for the above activities was sourced from Program 14.2 – Surveillance.
Top of page

Performance Information for Outcome 14 Administered Programs

Program 14.1 – Health Emergency Planning and Response
Indicator:	Containment of disease outbreaks and biosecurity incidents through: timely engagement of national health coordination mechanisms and implementation of response plans; and capacity for timely deployment of the National Medical Stockpile.
Reference Point/Target:	Impact of disease or biosecurity incident on the community mitigated, if it occurs. Deployments of the stockpile, either through exercises or live deployment, meet the six hour response benchmark.
Result: Indicator met.
In 2008–09, the Department activated national health plans on three occasions. In each case, the plans were activated as soon as it was clear the incident was of such magnitude that required it. For six emergencies, the Australian Health Protection Committee was convened to coordinate the national health response. The Department managed approximately ten biosecurity or disease related incidents per month. Mitigation of the threats are managed through rapid risk assessment and close cooperation with responsible bodies under the National Health Security Act 2007, and the National Health Security Agreement; and with international bodies under the International Health Regulations. In December 2008, the Department worked with the New South Wales Department of Health to undertake a deployment drill from the National Medical Stockpile, which met the six hour response benchmark. Deployment of the stockpile over an extended period in response to the pandemic (H1N1) 2009 outbreak also demonstrated the capacity for timely action.
Indicator:	Use of biological agents for terrorist purposes limited through: the registration of facilities which are working with identified security sensitive biological agents; compliance with mandatory standards; and successful engagement with industry.
Reference Point/Target:	100% of facilities registered and compliant with standards.
Result: Indicator substantially met.
The regulation of Tier 1 agents under the Security Sensitive Biological Agent Regulatory Scheme commenced on 31 January 2009. Facilities handling Tier 1 agents were required to register with the Department by 3 March 2009 to meet their obligations under the National Health Security Act 2007. In 2008–09, 60% of facilities were registered. The Department is developing processes to ensure the timely resolution of all outstanding registrations. The implementation of an inspection scheme will occur in 2009–10 to underpin control arrangements and to ensure that registered facilities are compliant with standards. The Department ran an education and awareness raising campaign in 2008–09, to build relationships with industry and to reach out to stakeholders potentially affected by the scheme. The campaign consisted of a national road show, targeted training workshops, the distribution of a newsletter and further development of the scheme’s website (accessible at www.health.gov.au).
Indicator:	Enhanced national approaches to environmental health hazards. Measured by Commonwealth, state and territory implementation of the National Environmental Health Strategy and other national environment and health initiatives.
Reference Point/Target:	Progress against the key performance indicators in the National Environmental Health Strategy.
Result: Indicator met.
In 2008–09, the Department made significant progress towards the key performance indicators in the National Environmental Health Strategy 2007–2012, particularly those related to environmental health workforce initiatives, environmental health surveillance development and climate change adaptation.
Indicator:	Alignment of Australian, State and Territory Government pandemic influenza health management plans.
Reference Point/Target:	State and Territory Governments endorse the Australian Health Management Plan for Pandemic Influenza through the Australian Health Protection Committee.
Result: Indicator met.
The Australian Health Protection Committee endorsed the Australian Health Management Plan for Pandemic Influenza 2008 prior to its release on 5 December 2008. Following the completion of the plan, states and territories worked to update their jurisdictional plans.

Top of page

Program 14.2 – Surveillance
Indicator:	Effective surveillance, analysis and management of domestic and international incidents and outbreaks of communicable and foodborne diseases. Measured through reporting of such incidents and outbreaks within agreed protocols and agreed timeframes.
Reference Point/Target:	Early and accurate analysis of national data within agreed timeframes. Reports on communicable disease incidents and outbreaks are produced within agreed timeframes. The impact of communicable and foodborne disease is reduced as measured by medium and long term trend analysis of the National Notifiable Disease Surveillance System and OzFoodNet data.
Result: Indicator met.
In 2008–09, the Department conducted national surveillance on important communicable diseases using the National Notifiable Diseases Surveillance System which collects data on 65 communicable diseases. The Department analysed the trends in notifications of all 65 diseases and produced and disseminated reports to the relevant stakeholders in a timely manner. In 2008–09, the Department detected several outbreaks of communicable diseases, including measles and pertussis outbreaks, which were referred to relevant committees for enhanced monitoring. Three of the four quarterly reports of Communicable Disease Intelligence were released in 2008–09 (available at www.health.gov.au). The final quarterly report was delayed as a result of the pandemic (H1N1) 2009 response. In 2008–09, the Department, through OzFoodNet, investigated 14 potentially multi-jurisdictional outbreaks, including salmonellosis, shigellosis, Shiga-toxin producing Escherichia coli, and hepatitis A. The Department responded to 101 requests for information or data regarding nationally notifiable communicable diseases. Multiple enhancements to surveillance systems simplified reporting of national notifiable diseases, outbreaks and influenza-like illness in Australia.

Top of page

Performance Information for Outcome 14 Departmental Outputs

Output Group 1 – Policy Advice
Indicator:	Quality, relevant and timely advice for Australian Government decision-making measured by ministerial satisfaction.
Reference Point/Target:	Ministerial satisfaction.
Result: Indicator met.
Ministers were satisfied with the quality, relevance and timeliness of advice provided for Australian Government decision-making.
Indicator:	Production of relevant and timely evidence-based policy research.
Reference Point/Target:	Relevant evidence-based policy research produced in a timely manner.
Result: Indicator met.
In 2008–09, the Department supported all policy work with the best available scientific evidence, generated through support for research activities, research organisations and expert committees. For example, the Department supported the National Health and Medical Research Council to commission influenza pandemic preparedness research, the outcomes of which have guided the Department’s policy development and response to the pandemic (H1N1) 2009 outbreak.

Top of page

Output Group 2 – Program Management
Indicator:	Administered budget predictions are met and actual expenses vary less than 0.5% from budgeted expenses measured by comparison of actual expenses against budget.
Reference Point/Target:	0.5% variance from budgeted expenses.
Result: Indicator not met.
The actual Administered expenses for Outcome 14 were 32.0% less than budgeted expenses. This underspend was largely due to less than anticipated write down and impairment of assets in Program 14.1 Health Emergency Planning and Response.
Indicator:	Stakeholders participate in program development through a range of avenues, such as surveys, conferences, meetings, and submissions on departmental discussion papers.
Reference Point/Target:	Stakeholders participate in program development.
Result: Indicator met.
Relevant stakeholders from across all sectors, including other Australian Government agencies, State and Territory Governments, industry, academic and research institutions, expert bodies and community groups, were consulted on policy and program development matters as appropriate.
Indicator:	Evaluations of the human health aspects of pesticides, veterinary medicines and other chemicals, and setting of human health standards for these chemicals, are made within agreed timeframes.
Reference Point/Target:	98% of evaluations and 100% of standards on human health safety are made within agreed timeframes.
Result: Indicator substantially met.
In 2008–09, 90% of new and 100% of existing chemicals evaluations were conducted within agreed timeframes. The Department assessed new and existing pesticides and veterinary medicines for human safety under a fee-for-service agreement with the Australian Pesticides and Veterinary Medicines Authority. The target ensures that the Authority receives expert human health advice to support its ongoing registration and review programs on the safety of new and existing agricultural chemicals. The Department continued to assess new products for human safety. It initiated new reviews on chemicals about which concerns have recently arisen and completed older reviews.
Indicator:	Make recommendations for standards relating to the supply of human medicines, pesticides, veterinary medicines and other chemicals.
Reference Point/Target:	Meet statutory deadlines.
Result: Indicator met.
While the Department provided some advice to the Australian Pesticides and Veterinary Medicines Authority outside agreed timeframes, all statutory deadlines were met. The Department made recommendations on the registration of 80 new pesticides and veterinary medicines. It established two Acceptable Daily Intakes and one Acute Reference Dose, 12 First Aid Instructions and 47 sets of Safety Directions. Reviews of existing chemicals resulted in major changes to public health standards for 10 chemicals. The Department provided advice to the National Health and Medical Research Council on guidelines for safe levels of 128 pesticides that may be found to contaminate drinking water.
Indicator:	Issuing and reporting of permits and licences for controlled and other substances within target timeframes.
Reference Point/Target:	98% of permits and licences completed within agreed target timeframes.
Result: Indicator met.
In 2008–09, the Department granted a total of 5,364 licences and permits authorising the import, export and manufacture of controlled drug substances. The Department issued 99.3% of licences and permits within the applicable timeframe. Over 2.6 million legitimate movements of controlled drugs between establishments were monitored and reported to state and territory health agencies within agreed timeframes. The Department fully met the reporting requirements of the United Nations International Narcotics Control Board through the provision of estimates and statistical data concerning the scientific and medical use of drugs.

Top of page

Outcome 14 – Financial Resources Summary

	(A) Budget Estimate 2008–09 $’000	(B) Actual 2008–09 $’000	Variation (Column B minus Column A) $’000	Budget Estimate 2009–10 $’000
Program 14.1: Health Emergency Planning and Response
Administered Items
Annual Appropriation Bill 1 (Ordinary Annual Services)	21,206	17,057	(4,149)	21,635
Annual Appropriation Bill 2 (Other Services)	7,566	7,565	(1)	-
Unfunded expenses	100,309	61,425	(38,884)	26,801
Departmental Outputs
Annual Appropriation Bill 1 (Ordinary Annual Services)	14,567	15,800	1,233	14,521
Revenues from other sources	2,356	2,176	(180)	2,371
Subtotal for Program 14.1	146,004	104,023	(41,981)	65,328
Program 14.2: Surveillance
Administered Items
Annual Appropriation Bill 1 (Ordinary Annual Services)	4,751	4,672	(79)	4,296
Annual Appropriation Bill 2 (Other Services)	506	506	-	-
Departmental Outputs
Annual Appropriation Bill 1 (Ordinary Annual Services)	11,981	12,995	1,014	11,943
Revenues from other sources	1,937	1,789	(148)	1,950
Subtotal for Program 14.2	19,175	19,962	787	18,189
Total Resources for Outcome 14	165,179	123,985	(41,194)	83,517
Outcome 14 Resources by Departmental Output Group
Department of Health and Ageing
Output Group 1: Policy Advice	18,338	21,208	2,870	19,930
Output Group 2: Program Management	12,503	11,552	(951)	10,856
Total Departmental Resources	30,841	32,760	1,919	30,786
Average Staffing Level (Number)	209	214	5	200

Top of page

| TOC | next page

Help with accessing large documents

When accessing large documents (over 500 KB in size), it is recommended that the following procedure be used:

Click the link with the RIGHT mouse button
Choose "Save Target As.../Save Link As..." depending on your browser
Select an appropriate folder on a local drive to place the downloaded file

Attempting to open large documents within the browser window (by left-clicking) may inhibit your ability to continue browsing while the document is opening and/or lead to system problems.

Help with accessing PDF documents

To view PDF (Portable Document Format) documents, you will need to have a PDF reader installed on your computer. A number of PDF readers are available through the Australian Government Information Management Office (AGIMO) Web Guide website.