Outcome 15: Biosecurity and Emergency Response > Part 1 Outcome Performance Report

Major Achievements

• Strengthened Australia’s capability to respond to national health emergencies. Integral to this was the conduct of Exercise Cumpston 06, Australia’s largest ever health exercise and one of the first ‘whole-of-health system’exercises on pandemic influenza conducted by any country, shortlisted for the United Nations Public Service Award.
• Enhanced coordination arrangements for national health emergencies by expanding the capacity of the National Incident Room. This also included building new facilities with state-of-the-art technology.
• Worked towards improved chemical, biological, radiological and nuclear safety by finalising the Council of Australian Governments’ (COAG) Report on Regulation and Control of Biological Agents. The Department also developed a Bill to establish a national regulatory scheme for laboratories holding security sensitive biological agents.
• Further consolidated the National Medicines Stockpile as a key national health resource by acquiring 8.75 million courses of influenza antiviral drugs and significant stocks of personal protective equipment.

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Challenges

• Preparedness for pandemic influenza, as the avian influenza virus continued to undergo changes. Changes to viruses over time happen naturally due to mutations but the changes can complicate laboratory identification and make comparisons between specimens from different areas and countries more difficult. This can impede surveillance and the containment of outbreaks.
• Maintenance of high quality surveillance to identify emerging disease threats from Australia’s northern neighbours. Countries to Australia’s north have many communicable diseases not found in Australia. Due to their proximity, the continual movement of people, birds and insects between these countries and Australia provides a mechanism for introducing outbreaks of exotic disease into Australia with little warning.

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Key Strategic Directions for 2006–07

Development of Communicable Disease Surveillance Systems

Communicable Disease Surveillance Reporting

The Department established fortnightly international communicable disease surveillance reports during the year to increase awareness of major overseas disease outbreaks that may pose health threats to Australia or to Australians travelling abroad. It also continued to produce and distribute international avian influenza situation reports three times weekly, and as of June 2007, had produced 554 reports since the start of the H5N1 outbreak in late 2003. The reports summarised human and animal cases of the potentially deadly avian influenza H5N1 (bird flu) and detailed any human-to-human transmission of the infection. Regular and frequent reporting on avian influenza is required to provide early warning of changes in the epidemiology of avian influenza; particularly the emergence of person-to-person transmission, to Australian health authorities.

Support continued for specific communicable disease surveillance activities which included the surveillance of 68 communicable diseases, such as tuberculosis, measles and sexually transmitted infections, under the National Notifiable Diseases Surveillance System. A Data Warehouse for the system is almost complete and will improve Australia’s capacity to monitor, analyse and report on notifiable diseases. The Department used system information to produce fortnightly reports on the Department’s website and in Communicable Disease Intelligence. Surveillance, for example, has shown the positive gains made through Australia’s vaccination program with the continuing downward trends in the number of people affected by vaccine preventable diseases such as meningococcal disease. The Department also maintained an effective working relationship with jurisdictions through the Communicable Disease Network Australia and its sub-committees.

Disease Surveillance System

To detect and respond to communicable disease threats, the Department developed a number of disease surveillance systems during 2006–07 which included elements of the Biosecurity Surveillance System Program to detect and respond to the threat of infectious disease outbreaks within Australia. The Health Alert Network was also implemented to provide the health surveillance community with access to a secure communication system for sharing information. Meetings of the National Influenza Coordinators Network assisted in maintaining a high level of cooperation and preparedness for a potential influenza pandemic and the Department put into place an improved disease outbreak management system which was tested during Exercise Cumpston 06.

Food Borne Illness Surveillance

During 2006–07, the operational efficiency of OzFoodNet, the national food borne illness surveillance and investigation system that is managed by the Department, was improved by conducting national and international training courses on investigating communicable disease outbreaks and putting in place protocols to improve the analysis of national food borne disease data sets. OzFoodNet responded to 13 multi-jurisdictional outbreaks.

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Support for Effective Communicable Disease Control and National Biosecurity Initiatives

Legislation and Regulation

In 2006–07, the Department developed legislative and regulatory measures to support effective communicable disease control and national biosecurity initiatives. The National Health Security Bill 2007 was prepared following a review of existing health security legislation. It provides a statutory framework to formalise and enhance existing voluntary arrangements for information sharing between jurisdictions in relation to communicable disease outbreaks, releases of chemical, biological or radiological agents, overseas mass casualty situations and other public health events of national or international significance.

The Bill also includes the recommendations of the COAG Report on the Regulation and Control of Harmful Biological Agents to establish a national regulatory scheme for laboratories holding security-sensitive biological agents to minimise the security risks they pose. Its implementation will improve chemical, biological, radiological or nuclear security by limiting opportunities for illegal and/or unauthorised use of biological agents. The Department is contributing to an assessment of the need for additional legislation to respond to health emergencies or mass casualty situations requested by COAG at its April 2007 meeting.

Technical Support

The Department continued to write and contribute to communicable disease management guidelines to assist clinicians and professionals. The Department also wrote and reviewed laboratory case definitions in a timely manner for all notifiable diseases. In addition, the Department, in conjunction with the Communicable Diseases Network of Australia, started developing guidelines for investigating
multi-state outbreaks of food borne illness. The Department commenced work on further advisory annexes for the Australian Health Management Plan for Pandemic Influenza for various sectors: the funeral industry; surveillance; the blood sector; and Aboriginal and Torres Strait Islander health. These annexes cover a range of issues which may be encountered by a variety of occupations, circumstances and industries.

Health Infrastructure for Counterterrorism

The Department worked to strengthen the health infrastructure for counterterrorism by supporting the Health Infrastructure Assurance Advisory Group’s work to safeguard the supply chain for key health products. In addition, the Department participated in the Food Chain Assurance Advisory Group and provided input into the COAG Report on the Regulation and Control of Harmful Biological Agents. It played a critical role in finalising the report’s development. COAG has since agreed for the Department to be involved with implementing the recommendations of the council’s Hazardous Materials Review of biological agents.

Responding to Threats

Laboratory capability and capacity are essential infrastructure for responding to major disease outbreaks and other biological threats. In 2006–07, the Department replenished stockpiles of diagnostic kits and funded additional staff training in the use of these kits for responding to an outbreak of pandemic influenza. This has resulted in nationally consistent capability and capacity to respond to this threat.

To respond to the threat of vector-borne diseases, the Department engaged the northern states to initiate and commence mosquito control operations in Queensland and the Northern Territory utilising expert advice through the National Arbovirus and Malaria Advisory Committee.

In addition, the Department developed and implemented social marketing communications to encourage hand washing and promote the importance of safe disposal of faecal matter in selected remote and disadvantaged communities in the Northern Territory.

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Provision of Technical and Strategic Advice to Inform Policy Development

Advice to Stakeholders

In addition to the information sharing activities discussed earlier in this chapter, the Department provided technical and strategic advice during the year to a number of committees and other government agencies. For example, the Joint Steering Committee developing the National Guidelines for Water Recycling received advice which ensured that the guidelines contain appropriate measures to protect public health where water recycling programs are developed. The Department also provided human health risk assessment advice to Biosecurity Australia and the Australian Quarantine and Inspection Service which contributed to their process for assessing import permits for various laboratory pathogens, and for the development of new import policies for certain primary products.

Through its representation on Food Standards Australia New Zealand Standards Development Committees, the Department provided technical and strategic advice to assist in the development of a range of Primary Product and Processing Standards including for dairy, poultry and eggs. It also provided advice to the Implementation Sub-Committee of the Food Regulation Standing Committee that led to a number of changes to policy and regulatory interventions by state and territory authorities.

Furthermore, the Department engaged in high level discussions through the National Counter Terrorism Committee and relevant Chemical, Biological, Radiological and Nuclear committees responsible for the development of response planning for a bioterrorist act.

Contribution to Health Policy Development

The Department actively ensured its clinical and scientific knowledge-base was up-to-date by monitoring research papers on a daily basis, using a range of electronic search mechanisms relevant to pandemic influenza and other emerging diseases. It also maintained a database and library of related papers and drew on in-house expertise and contacts to provide policy advice and briefing material to portfolio Ministers.

The Department continued during 2006–07 to monitor global developments in clinical trials related to prototype pandemic vaccine and the manufacture of pre-pandemic vaccine. It also provided strategic advice to Government to inform vaccine policy development and vaccine procurement decisions.

In addition, the Department drew on the advice from agencies such as the Office of Chemical Safety and the Australian Radiation Protection and Nuclear Safety Agency, in the development of clinical treatment guidelines. These guidelines will assist clinicians to treat people who may be affected by the impacts of a chemical, biological, radiological or nuclear incident.

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Strengthened Capability to Respond to National Health Emergencies

Exercise Cumpston 06

Focus in 2006–07 was on strengthening Australia’s existing capability to respond to national health emergencies. At the forefront was Exercise Cumpston 06, which tested preparedness for responding to an influenza pandemic involving widespread human-to-human transmission of a new strain of the influenza virus. The exercise also provided a significant test of many response elements contained in the new version of the Australian Health Management Plan for Pandemic Influenza, and state and territory pandemic plans.

Exercise Cumpston 06 comprised a series of discussion exercises, a desktop exercise, and live drills involving all levels of government and a range of non-government and private sector organisations. It successfully validated Australia’s plans for responding to an influenza pandemic. A large number of international observers witnessed the activities and the Department has been open in sharing the lessons learnt with other countries. The Department is continuing to refine and enhance areas identified during the exercise, specifically crisis and communications coordination, information systems and the sustainability of response.

The National Incident Room, which provides a focused hub for the Department’s operational activity, was integral to the success of Exercise Cumpston 06. In 2006–07 the Department expanded the room’s capacity to enable efficient coordination of the Department’s emergency response and to permit rapid liaison with other Government agencies, state and territory health authorities and international agencies such as the World Health Organization.

National Medicines Stockpile and Health Protection Activities

Other work in 2006–07 which strengthened Australia’s capability to respond to national health emergencies included refinements to the Health Alert Network to ensure secure electronic communication amongst the Commonwealth, and State and Territory governments and the acquisition of items for the National Medicines Stockpile.

During the year, the Department completed planned acquisitions of 8.75 million courses of influenza antivirals and purchased personal protective equipment for workers at high risk of infection with pandemic influenza. It also supported research and development of a prototype pandemic vaccine and made arrangements for an initial purchase of H5N1 vaccine for the stockpile when it becomes available.

In addition, the Department established stronger links with Government border agencies to support early warning and intervention for preventing the introduction of diseases of public health concern into Australia.

World Health Organization Collaborating Centre

The Department facilitated the transfer of the World Health Organization Collaborating Centre for Reference and Research on Influenza from CSL Limited to the Victorian Infectious Diseases Laboratory in 2006–07. The Government has provided funding to establish a new host and state-of-the-art facilities. While the centre remained at CSL premises, the design for new facilities for the centre at the Victorian Infectious Diseases Laboratory premises were finalised and the centre will physically relocate to the Victorian Infectious Diseases Laboratory premises in 2008. The centre is an important source of flu expertise in Australia and the southern hemisphere. It has direct access to the World Health Organization global network and has a key role in influenza strain isolation and in determining strains for the vaccines for both the northern and southern hemisphere’s influenza seasons.