KEY STRATEGIC DIRECTIONS FOR 2004-05
Australia’s Preparedness and Response Capability in the Event of a National Health Emergency
Tsunami - Effective Health Coordination
The Department played an important role in providing emergency assistance to countries affected by the Indian Ocean earthquake and tsunami on Boxing Day 2004. The Department worked in partnership with State and Territory health departments through the Australian Health Disaster Management and Policy Committee, and in conjunction with Emergency Management Australia to coordinate the deployment of nine civilian medical teams to affected countries to conduct emergency surgery, run primary care clinics and provide public health assistance and laboratory diagnosis. These teams comprised 128 doctors, nurses, paramedics and other emergency aid personnel. The Department will continue to play a role in the Australian Government’s on-going and long-term reconstruction programs in affected countries by providing expert advice to the coordinating agency, AusAID.
Providing emergency assistance to our regional neighbours affected by
the 2004 Boxing Day Indian Ocean earthquake and tsunami.
Influenza Pandemic Preparedness
During 2004-05, the Department continued to monitor the avian influenza virus outbreaks in Asia. The National Incident Room remained activated and further developed its communication and response capabilities in the event of an influenza pandemic or other health disaster. On 6 June 2005, the Department released the Australian Management Plan for Pandemic Influenza. The Department further increased the range of items in the National Medicine Stockpile and developed detailed arrangements for the rapid deployment of stockpile items during an incident or disaster, in consultation with State and Territory governments and with other relevant agencies. The Department maintains one of the largest stockpiles of antiviral medicines per capita in the world, for use in the event of an influenza pandemic. The national stockpile also contains essential medicines and antidotes to be used in the event of a deliberate or accidental chemical, biological or radiological incident or disaster.
Communicable Disease Surveillance
The Department commenced the development of the Biosecurity Surveillance System to improve national communicable disease surveillance. Detailed scoping and analysis work was undertaken to engage stakeholders and ensure the success and effectiveness of a system suitable for both emergencies and routine surveillance. The system will be completed by 2008 and will incorporate:
- a secure Outbreak Case Reporting System;
- improvements to the National Notifiable Disease Surveillance System;
- redevelopment of the Sentinel GP Surveillance System; and
- facilities and infrastructure to support secure communications for the public health community (Health Alert Network).
An interim solution for the Outbreak Care Reporting System was trialled and implemented in 2005. This interim system was used for the investigation of national foodborne disease outbreaks, and is available should an emerging communicable disease outbreak occur, such as pandemic influenza or Severe Acute Respiratory Syndrome.
Laboratory Capacity Enhancement
In 2004-05, the Department enhanced Australia’s public health diagnostic laboratory capacity including detection of biological agents that could be used in a bioterrorist attack. This has included the purchase and distribution of equipment and rapid diagnostic test kits to key public health laboratories in each State and Territory. The Department has also worked with State and Territory governments to enhance security at Australia’s highest containment laboratories which handle high risk biological agents, and is investigating the development of a national registration and auditing regime for all laboratories handling high risk biological agents. This initiative is closely aligned with, and has informed, the Council of Australian Governments’ (COAG) Review of Hazardous Materials, which is examining existing controls on biological laboratories.
New Public Health Outcome Funding Agreements
In 2004-05, the Department successfully negotiated new PHOFAs with all State and Territory governments. These agreements provide significant resources for the administration and delivery of major population health strategies and programs.
The public health outcome areas targeted under the PHOFAs include HIV/AIDS and related sexually transmissible and blood borne diseases, breast and cervical cancer screening, and health risk factors including alcohol and tobacco programs, women’s health, and sexual and reproductive health.
The Australian Government contribution to the new PHOFAs totals $812 million (adjusted annually for indexation) over five years (2004-05 to 2008-09). A key feature of the PHOFAs is that funding is broadbanded, allowing each State and Territory some flexibility in making service funding decisions in line with local needs and priorities.
New National HIV/AIDS, Sexually Transmissible Infections and Hepatitis C Strategies 2005-2008
During 2004-05, the Department worked with the Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis, State and Territory governments, community organisations, medical professionals and researchers to develop the fifth National HIV/AIDS Strategy 2005-2008, the second National Hepatitis C Strategy 2005-2008 and the first National Sexually Transmissible Infections Strategy 2005-2008. The Minister for Health and Ageing launched the three strategies during June 2005. They are being implemented from 1 July 2005.
The new National HIV/AIDS Strategy will revitalise Australia’s response and continue to build upon partnerships with affected communities, governments and medical, scientific and health care professionals. The new hepatitis C Strategy will focus on education and prevention in key target groups, increasing rates of treatment of people with hepatitis C and improving surveillance of hepatitis C. The new National Sexually Transmissible Infections Strategy recognises that other Sexually Transmitted Infections (STIs) also cause substantial morbidity and mortality in Australia and sets a framework for continued national action.
With the launch of the strategies, the Minister announced a number of new initiatives. These include:
- continuation of funding until the end of June 2008 of $8 million per year for the national research centres for research in HIV, hepatitis C and STIs;
- HIV diagnostic testing to be available under the Medicare Benefits Schedule;
- funding of $12.5 million over four years for increased awareness, improved surveillance and a pilot national testing program for chlamydia; and
- funding of $1.8 million for improved surveillance of hepatitis C.
The National Immunisation Program
Under the National Immunisation Program (NIP), free vaccines are provided to the Australian community to protect against 12 vaccine preventable diseases.
In November 2004, the Department concluded negotiations on the new Australian Immunisation Agreements 2004-09 (AIAs) which provide $671 million over five years to State and Territory governments for the purchase of NIP vaccines. In addition, the Australian Government directly purchased $161 million of childhood pneumococcal vaccine for distribution to State and Territory governments for the first two years of this ongoing program.
Two new vaccination programs developed by the Department successfully commenced on 1 January 2005:
- the National Childhood Pneumococcal Vaccination Program which provides free vaccine for all children born after 1 January 2005 at two, four and six months of age, plus catch-up vaccinations in 2005 for all children born between 1 January 2003 and 31 December 2004; and
- the National Pneumococcal Vaccination Program for Older Australians which provides free vaccine for all Australians aged 65 years or older.
Further activities by the Department in 2004-05 included:
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- initial work to implement revised immunisation policy advisory arrangements announced in the 2005-06 Federal Budget, including the revision of membership, terms of reference and standard operating procedures for the Australian Technical Advisory Group on Immunisation and preparing the legislative changes to allow the Pharmaceutical Benefits Advisory Committee to make recommendations on the funding of vaccines under the NIP;
- ongoing support for NIP Support Activities, including additional funding for the National Centre for Immunisation Research and Surveillance to undertake research and evaluation of immunisation programs and surveillance of vaccine preventable diseases, and also funding for the Australian Childhood Immunisation Register to collect and report on the vaccination status of Australian children;
- development of new programs for free chickenpox vaccine and the replacement of oral with injectable polio vaccine which will commence on 1 November 2005; and
- development of a four year funding agreement with the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases to provide technical support to the Australian Technical Advisory Group on Immunisation and the National Immunisation Committee, and undertake research in the field of immunisation.
The Department continued to support the work of the National Obesity Taskforce, through provision of secretariat services, and implementation of initiatives from the Taskforce’s national action plan: Healthy Weight 2008
: Australia’s Future - the National Action Agenda for Children and Young People and Their Families.
In 2004-05, the Department focussed on implementing a number of strategies from Healthy Weight 2008
- new physical activity recommendations for children and young people;
- redesigned Physical Activity Guidelines for adults; and
- a resource kit for schools to promote healthy eating and physical activity.
The Department has also contributed work on:
- the promotion of Healthy School Canteens;
- the establishment of a network of Whole-of-Community Healthy Weight Demonstration Sites; and
- a review of the evidence for actions to reduce obesity in adults and older Australians.
On 29 June 2004, the Prime Minister announced funding of $116 million to 2008, for the Healthy and Active Australia Initiative, to address childhood obesity. On 23 July 2004, the Department sent out over 9,600 Healthy School Communities application kits to all schools in Australia. Non-government organisations associated with the school (such as the Parents and Citizens Association or School Canteen) were invited to apply for a grant of $1,500, to initiate healthy eating activities. On 25 May 2005, the Department issued a further 8,000 reminder letters and application forms to schools. As at 30 June 2005, a total of 2,492 applications had been received by the Department.
The Prime Minister’s initiative also included funding for a national fruit and vegetable promotion campaign. The Department coordinated the development and implementation of the national campaign, which is based on the Western Australia Department of Health’s ‘Go for 2 & 5TM
’ initiative. The national campaign was launched in April 2005. The campaign aimed to encourage Australians to increase their consumption to two serves of fruit and five serves of vegetables each day, as outlined in the Australian Dietary Guidelines.
The National Drug Strategy 2004-09
National Tobacco Strategy 2004-09
Australia has had a National Tobacco Strategy since 1999. The revised National Tobacco Strategy 2004-09, which builds on initiatives undertaken by the Department in the previous strategy was endorsed by the Ministerial Council on Drug Strategy at its meeting on 12 November 2004. The Strategy reflects evidence about the health effects of tobacco and the views of experts about the best ways to reduce those effects in society. The strategy also reflects common agreement between the Australian Government and the States and Territories as to the broad policy directions that are needed to reduce tobacco related disease. This includes a balance of educational effort together with essential regulations such as advertising bans and health warnings on tobacco products.
New Graphic Health Warnings on Tobacco Products
Regulations were gazetted by the Treasury on 26 August 2004 requiring new graphic health warning labels to appear on all manufactured and imported tobacco product packaging from 1 March 2006. The Department worked with the Treasury in developing the new health warnings. The Department has policy responsibility for the health warnings, while the warnings are administered by the Australian Competition and Consumer Commission. Amendments to the Trade Practices (Consumer Product Information Standard) (Tobacco) Regulations 2004
enable the introduction of the new graphic health warnings. From 1 March 2006, all manufactured and imported tobacco product packaging must be printed with the new graphic health warning labels. Until then, tobacco products can carry either the current warning messages or the new graphic messages.
Key features of new health warnings measures include:
- a new set of 14 health warnings developed by the Department comprising graphic images and explanatory messages which cover 30 per cent of the front and 90 per cent of the back of the pack, with graphics to appear on both the front and back of cigarette packets;
- inclusion of the national number and website address on the back of packs to provide a contact for smokers for assistance with quitting; and
- a new rotation system developed by the Department for health warnings in order to optimise consumer learning and awareness of the health effects of smoking. This involves the rotation of each set of 7 warnings alternatively, every 12 months.
Focusing on Youth and Illicit Drug Use Across Australia
The Department developed the current phase of the National Illicit Drugs Campaign Youth Initiative in 2004-05 which aimed to educate young people about the risks and negative consequences of illicit drug use. It also encouraged and reinforced protective factors in young people’s lives including parental involvement and engagement with support services for those with greatest need. Key outputs included concept testing of creative material with youth and parents; a major print and electronic media campaign; production and dissemination of resource material for parents and youth, people from non-English speaking backgrounds and Aboriginal and Torres Strait Islander audiences, service providers and stakeholders; and responding to 5,000 calls to the campaign information line.
Youth Alcohol Use Trends
The 2004 National Drug Strategy Household Survey (Footnote 1)
found that young people aged 14-17 years continue to show risky alcohol use patterns. About one third of young people consumed alcohol at a risky or high risk level at least once in the last 12 months.
About 80 per cent of all the alcohol young people drink is consumed at risky or high risk levels as defined by the Australian Alcohol Guidelines
for adults. Compared to adults, young people are at a much greater risk of alcohol related harm due to their smaller physical size, and their emotional and intellectual inexperience.
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The Department continued to increase its engagement in the Asia Pacific region. This has been driven by Australia’s interests in supporting its regional neighbours and the whole-of-government agenda to promote and protect Australia’s health interests in the region.
In November 2004, the Torres Strait Health Issues Committee was established and is chaired by the Department. The Committee is adopting a combined agency approach to reduce the risk of communicable disease in the Torres Strait arising from the increased movement of traditional inhabitants through the Torres Strait Treaty Zone. The Committee has agreed to the development of a capacity building program between the Western Province and Far North Queensland which is expected to commence in October 2005.
The first meeting of the Pacific Senior Health Officials Network took place in November 2004. The Network provides a unique opportunity to strengthen senior level linkages between the Department and Pacific Ministries of Health with the aim of supporting governance in the region. The first meeting was held in November 2004 covering a wide range of health topics. Follow-up activities on safety, quality and nutrition are expected to take place in 2005.
In March 2005, the Department accompanied AusAID on a joint China Country Program Health Scoping Mission. A range of areas for collaboration were identified in the health sector, with a particular focus on communicable diseases.
In May 2005, the 58th World Health Assembly adopted the revised International Health Regulations
(IHRs). The Department negotiated a whole-of-government response to inform Australia’s participation, as a collaborating country in the revision of the IHRs. The IHRs are a World Health Organization (WHO) Treaty, and the primary global, legally binding framework to manage public health emergencies of international concern. The intention of the revised IHRs is to prevent, protect against, control and provide a public health response to the international spread of disease, while minimising interference with world travel and trade. Australia played a leading role in the negotiations, representing the Western Pacific region on the bureau established to manage the negotiation process.
The Department hosted the annual Australia-Indonesia Ministerial Forum Health Working Group Meeting in March 2005. During the meeting, future capacity building activities were explored with the Indonesian Ministry of Health under the Plan of Action. It was agreed that a joint secretariat would be established to manage Plan of Action activities with a particular focus on communicable disease surveillance and control.
The Organisation for Economic Co-operation and Development is conducting a two year project that builds on previous work to address some of the key challenges in improving the performance of member countries health and long term care systems. The Department is a major contributor, with the Secretary co-chairing a group to manage the project. The studies address policy issues important to Australia including cost of long term care, economics of preventive health, efficiency of hospital services, pharmaceutical pricing, health related technologies and the development of quality health care indicators.
The Department has also provided input on the health related aspects of Australia’s Free Trade Agreements consistent with domestic policies and regulations to ensure access to safe and affordable health services and products.