In 2007–08, the Department focused on addressing gaps in Australia’s emergency response plans and maintaining a state of readiness, to ensure that Australia has the capacity to respond effectively to health emergencies at national and international levels.
A major achievement was the development of the National Health Security Act 2007 to provide for the exchange of public health surveillance information between health authorities. This Act received Royal Assent in November 2007, and improves health authorities’ identification and response capacities to public health events of national or international significance, such as an influenza pandemic. Signed by Health Ministers in November 2007, the National Health Security Agreement supports the Act’s practical operation and formalises decision-making and coordinated response arrangements to prepare for health emergencies.
The Department also finalised work on the Quarantine Amendment (National Health Security) Act 2008, which was passed by Parliament in June 2008. Australia now has the necessary legislation to comply fully with the World Health Organization’s International Health Regulations (2005) requirements relating to vaccinations and prophylaxis, health certificates and charges levied on travellers for health measures. This gives Australia improved tools to protect public health, both under normal circumstances and in the event of an outbreak of a disease of international concern.
In 2007–08, the Department replaced elements of the National Medical Stockpile that will expire over the next two years. A major achievement was the purchase of 1.2 million doses of H5N1 influenza pre-pandemic vaccine. Until a pandemic specific vaccine becomes available, this vaccine will be used for the protection of those at highest risk of infection, such as health care workers, in the event of an influenza pandemic.
The Department financially supported the development of a prototype pandemic vaccine by the Commonwealth Serum Laboratories, which has now been registered by the Therapeutic Goods Administration1 for use in adults and the elderly during an officially declared pandemic. The Department also administered funding to the Environmental Health Committee (part of the Australian Health Protection Committee), to develop Disaster Management: An Environmental Health Practitioner’s Guide to Operational Disaster Response, a practical manual for environmental health practitioners working in disaster management. It uses an ‘all hazards’ approach and risk management principles to guide planning for, and response to, disasters. The manual will assist environmental health officers in ensuring that the health of people affected by disaster is protected and maintained.
1Further discussion on the Therapeutic Goods Administration can be found in the Outcome 1 - Population Health Chapter.
In 2007–08, the Department worked to incorporate the lessons learned from health and disaster management exercises, such as Exercise Cumpston ’06, and Exercise Southern Rebound, which evaluated the deployment of the National Medical Stockpile in April 2008, into pandemic influenza preparedness plans so that they will be effective tools in the event of a real pandemic. The Department also funded technical advice to ensure informed policy development, communications and reporting.
The Department worked in consultation with the states and territories to successfully implement the lessons learned from Exercise Cumpston ’06 – Australia’s largest ever health exercise, and one of the first ‘whole-of-health system’ exercises on pandemic influenza, conducted by the Department in 2005–06.
The report on Exercise Cumpston ’06, released in June 2007, made 12 recommendations to improve Australia’s preparedness for an influenza pandemic. The Department implemented the health sector recommendations through the Australian Health Protection Committee. It also developed a strategic and ethical framework for pandemic preparedness and response, which included streamlining decision-making structures.
To address some of the 12 recommendations from Exercise Cumpston ’06, the Department established an inter-jurisdictional pandemic planning working group, to help develop consistent operational plans, and a Scientific Influenza Advisory Group to provide scientific and medical advice to the Chief Medical Officer on national pandemic planning. In addition, the Department started to revise the Australian Health Management Plan for Pandemic Influenza so that it is based on the latest available evidence, and also began to develop a Surveillance annex to the plan. The Department expects to finalise the Australian Health Management Plan for Pandemic Influenza in late 2008.
In 2007–08, the Department continued to support the World Health Organization Collaborating Centre for Reference and Research on Influenza in Melbourne, to play a key role in the identification of influenza viruses and the formulation of vaccines. The centre is an important source of influenza expertise in both Australia and the southern hemisphere, and contributes significantly to the development of pandemic influenza policy and preparedness.
The Department also provided funding for the construction of the centre’s new state-of-the-art facility at the Victorian Infectious Diseases Laboratory. While construction has been slower than anticipated, there was progress during the year, and the centre is expected to be completed in late 2008.
In addition, the Department established the Australian Counter Bioterrorism Laboratory Network to maintain and expand collaborative technical links between public health and law enforcement agencies. The network will advise on issues relating to the detection and analysis of security-sensitive biological agents.
During the year, the Department and the Department of Agriculture, Fisheries and Forestry were subject to an Australian National Audit Office review of Australia’s preparedness for a human influenza pandemic (full details may be found in the Auditor-General Audit Report No.6 2007–08, accessible at <www.anao.gov.au>). The Department agreed with, and commenced implementing, several of the audit’s recommendations regarding the management of the National Medical Stockpile. This included codifying risk management plans, formalising standard operating procedures and undertaking regular exercises to test the stockpile’s deployment capacity.
In Australia, communicable disease surveillance systems exist at national, state and local levels. The national surveillance system detects and manages any outbreaks affecting more than one jurisdiction, and monitors the need for, and impact of, national control programs. It also guides national policy development and resource allocation, and describes the epidemiology of rare diseases. State and local surveillance systems are crucial to the timely and effective detection and management of outbreaks, and in assisting with the effective implementation of national policies.
During 2007–08, the Department enabled the passage of the National Health Security Act 2007 and oversaw the endorsement by State and Territory Ministers of the National Notifiable Disease List which specifies those diseases about which protected surveillance information can be exchanged by jurisdictions. The Department worked to refine these systems to ensure effective surveillance and warning of communicable disease threats. This included formalising existing surveillance systems with the states and territories through the National Health Security Agreement, which established a framework for clear, quick and informed decision-making to support a coordinated national response to public health emergencies.
The Department also maintained its effective working relationship with jurisdictions through the Communicable Disease Network Australia and its subcommittees, and developed protocols to assess, monitor and report public health events based on the World Health Organization disease algorithm. The Department also continued to support specific communicable disease surveillance activities, including the surveillance of 68 communicable diseases such as tuberculosis, measles and sexually transmitted infections, under the National Notifiable Diseases Surveillance System. Furthermore, the Department enhanced Australia’s capacity to monitor, analyse and report on notifiable diseases by developing a data warehouse for this system.
The Department’s Communicable Diseases Intelligence report used surveillance system information to provide valuable information through its website (accessible from <www.health.gov.au>). The Department also collected influenza surveillance data from hospitals, as part of the syndromic surveillance system; evaluated national call centre data; and provided early alerts for seasonal and pandemic influenza.
A priority in 2007–08 was to minimise the risks posed by communicable disease threats, particularly where there was potential for diseases to enter Australia through its vulnerable northern border regions; and to strengthen national biosecurity initiatives, for example by efficiently managing the human health risk of biological imports.
The National Health Security Act 2007 provides for the exchange of surveillance information, including personal information, between jurisdictions and with the World Health Organization to enable early identification of, and timely responses to, national or international public health emergencies. These events include communicable disease outbreaks, chemical, biological or radiation dispersal terrorism, and overseas mass casualty incidents.
Personal information was obtained, used or disclosed by the Department on 20 separate occasions in 2007–08. The majority of these disclosures (18) were to assist the jurisdictions with contact tracing of Australian nationals exposed to communicable disease whilst overseas. The remainder (two) were disclosed to the World Health Organization in order to assist with international outbreak investigations.
In recent times, Australia has seen Papua New Guinea citizens travelling to health clinics in the Torres Strait Treaty Zone such as in Saibai and Boigu, to access care. A significant number of these people have been treated for tuberculosis for Australian public health and humanitarian purposes.
This year has seen an increased level of focus on cross border issues in the Treaty Zone.
A major initiative undertaken by the Department was the funding of a tuberculosis capacity building project for an area of Papua New Guinea, within the Treaty Zone. This will help guard public health in Australia and ease pressure on Queensland Health services in the Torres Strait.
The Department supported mosquito control operations to ensure mosquitos spreading disease 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, vectors of dengue virus in South-East Asia. A project team has worked in the area since February 2006, and additional funding will see this program continue until July 2009. The Department also administered support in 2007–08, for the successful Aedes aegypti mosquito eradication program on Groote Eylandt to prevent dengue fever in this area.
The Department contributed to the control of foodborne illness through the management of OzFoodNet, Australia’s national foodborne illness surveillance system. A highly successful model of communication and cooperation between the Department and State and Territory Governments, OzFoodNet responded to 13 multi-jurisdictional outbreaks of foodborne illness during the year, including five international outbreaks that required a high level of international communication. The Department improved the operational success of OzFoodNet by conducting national and international training courses on investigating communicable disease outbreaks.
The Department participated in the Food Chain Assurance Advisory Group to address issues of food security in crises such as pandemics or infrastructure failures. The Department also provided technical and strategic advice to the Food Standards Australia New Zealand Standards Development Committees, to assist in the development of a range of food standards; and to the Implementation Sub-Committee of the Food Regulation Standing Committee that directed study and survey priorities in the states and territories. These activities have helped reduce the incidence of foodborne illness through more effective food safety standards and by identifying areas of the food service chain for enforcement by state and territory regulatory authorities.
Work with the Department of Agriculture, Fisheries and Forestry to administer the human health aspects of the Quarantine Act 1908 continued in 2007–08. In November 2007, the two departments signed a Memorandum of Understanding, reaffirming collaborative arrangements for addressing human health screening at the border, managing the health risk of biological imports, and providing policy guidance to the Australian Quarantine and Inspection Service for human quarantine operations.
In December 2007, the Department, in concert with the Australian Quarantine and Inspection Service, implemented Ship Sanitation Certificates under the World Health Organization’s International Health Regulations (2005). The Ship Sanitation Certificate strengthens human health protection on international shipping entering Australia.
In 2007–08, the Department led the development of the National Environmental Health Strategy 2007–2012 through the Environmental Health Committee. The strategy is focused on addressing key environmental health risks in Australia including: emergencies and disasters; climate change; increasing pressure on drinking water supplies; the intensity of urban development; and the lack of effective environmental health infrastructure in Aboriginal and Torres Strait Islander Health.
The Department supported the committee’s work on improving the environmental health workforce by developing a National Environmental Health Workforce Action Plan. This plan was endorsed by the Environmental Health Committee in April 2008 and identifies eight key actions designed to address the current workforce shortfall and align with various strategies in the National Health Workforce Strategic Framework. As part of this, the successful video My Job, Better Environmental Health was transferred to DVD format, with 300 copies distributed to state and territory health departments for their use.
The Department administered funding to the Community Services and Industry Skills Council to work with the Environmental Health Committee on the development of a resource kit to support the training of Indigenous environmental health workers. These workers will benefit from other committee projects funded by the Department; including: the Conducting Dog Health Programs in Indigenous Communities: a guide for environmental health practitioners; and the establishment of an Aboriginal and Torres Strait Islander Environmental Health Practitioners’ Association. The project involves identifying governance arrangements and setting up a website for the Aboriginal and Torres Strait Islander Environmental Health Practitioners’ Association to enhance communication and exchange of information between Indigenous environmental health workers.
The Department also supported a hand washing project, developed to address the high rates of infectious diseases among Aboriginal babies and children in the Northern Territory. Formative research was used to guide the development of the highly successful ‘Didya wash ya hands?’ social marketing campaign, which included advertisements, posters, stickers, and point of sale displays in the community stores of targeted intervention communities. The long term goal of the project was to reduce the person-to-person, and environment-to-person, transmission of pathogenic organisms that cause diarrhoea, skin sores and respiratory disease. There has been improved hand washing behaviour and an improved level of awareness in all communities (both intervention and comparison groups) of the benefits of hand washing and an improved understanding of how diseases are spread, following the mass media campaign.
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