Key Strategic Directions for 2005-06
Ensuring the Security of the Australian Population against Biosecurity and Disease Threats
Office of Health Protection
The Department established the Office of Health Protection in December 2005 to expand its health emergency response capacity. The Department, through the Office of Health Protection, is driving operations in three key areas: improved provision of information on disease patterns and disaster events to support decision making; enhanced networks to effect responses; and tools to provide the most comprehensive responses.
The Department works to keep diseases out of Australia and to ensure that the nation can manage any diseases which might breach that first line of defence.
The Department completed the review of the Australian Management Plan for Pandemic Influenza 2005 in May 2006 and made significant contributions to work on the parallel National Action Plan prepared for the Council of Australian Governments. The revised Australian Health Management Plan for Pandemic Influenza was launched by the Minister for Health and Ageing on 30 May 2006, after extensive community and expert consultations. It is a detailed, plain English national health action plan that will guide Australia’s response to pandemic influenza. The plan is available on the internet
and in hard copy on request
. The strategies are based on epidemiological modelling which suggests that containment strategies could buy time until a vaccine becomes available.
The plan gives the community the information it needs to start to prepare for a pandemic and flags the actions, including the proposed communication strategy, which will come into operation should the pandemic threat escalate. The Department has been working with health providers and manufacturers to ensure that stakeholders have the necessary information to assist in their business continuity planning.
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During 2005-06, the Department began preparing a major simulation exercise for responding to a pandemic. The exercise is planned to take place in October 2006, with lessons learnt feeding into planning refinements.
The Department is producing a series of annexes to the plan, which provide the detailed guidance on pandemic influenza sought by professional groups, using advice from expert working groups under the National Influenza Pandemic Advisory Committee. The Interim Infection Control and Clinical Care Annexes were released by the Department in June 2006; the Primary Care and Funeral Industry Annexes are in progress and are due for release in late 2006.
During 2005-06, the Department conducted the selection process which resulted in the Victorian Infectious Diseases Reference Laboratory becoming the new host of the WHO Collaborating Centre for Reference and Research on Influenza in Australia. The new host will take over the operation of the Centre from its existing host, CSL Ltd, later in 2006. As one of five global WHO collaborating centres for influenza, the Centre is an important source of flu expertise in Australia and the southern hemisphere. The Centre has direct access to the WHO global network and early warning systems, and is regarded by the Australian Government as a significant asset to Australia’s pandemic preparedness and response activities.
During 2005-06, the Department substantially increased the range and number of items in the National Medical Stockpile for use in an emergency or an outbreak of pandemic influenza. In the event of a pandemic, over 4 million courses of antivirals are available. By mid 2007, the stockpile will hold 8.75 million courses of antiviral drugs. Further purchases in 2005-06 by the Department for the stockpile included 50 million needles and syringes with support equipment for administering a vaccine when developed, and 40 million surgical masks to add to the existing 2 million P2 respirator masks. Twenty five thermal imaging scanners, personal protective equipment for border workers and 314 respiratory ventilators have also been stockpiled in 2005-06. The Department is currently in the process of purchasing personal protective equipment for workers at high risk of infection and negative pressure units to isolate patients in treatment centres and minimise risk of infection for other patients.
The Department provided funds in 2005-06 to enable CSL Ltd to fast track its development of a prototype pandemic vaccine for supply to the Australian population.
CSL’s accelerated program aimed to submit a prototype pandemic vaccine to the Therapeutic Goods Administration (TGA) in September 2006 for registration, 16 months ahead of time. CSL’s first phase clinical trials to select the prototype pandemic vaccine formulation commenced in 2005. Preliminary results released in February 2006 indicated that the prototype vaccine was well tolerated and demonstrated some efficacy. However, the doses trialled did not generate the level of immune response required by the TGA when assessed against the usual seasonal influenza vaccine criteria. A second phase of clinical trials will test higher doses of the vaccine to establish dosage and efficacy and expand the trial cohort to include children and the elderly. It is now expected that CSL will submit a core pandemic vaccine dossier to the TGA in early 2007.
Communicable Disease Surveillance
The Department’s international surveillance effort is Australia’s forward defence in health protection, providing early warning of communicable disease threats worldwide. In 2005-06, the Department led the development of the Biosecurity Surveillance System and Syndromic Surveillance System, to improve the detection and response to national communicable disease outbreaks, including pandemic influenza. The first component of these systems, the Health Alert Network, commenced operating in June 2006 and provides a secure communication system for the public health community to share information on communicable disease outbreaks and public health emergency events. The Department expects to fully implement the remaining components of these systems, including a national outbreak management system and improvements to the National Notifiable Diseases Surveillance System, by 2008.
The Department has produced and distributed 182 international avian influenza situation reports since July 2005, with a total of 400 since the start of the H5N1 outbreak in late 2003. These reports have summarised human and animal cases of the highly pathogenic avian influenza H5N1 and recently detailed the limited human-to-human transmission of the infection in Indonesia.
During 2005-06, the Department provided advice on international disease outbreaks to a number of government departments, including the Department of Foreign Affairs and Trade travel advisories. The Department also provided expert advice on building regional capacity to detect and control infectious diseases to AusAID (Australia’s development assistance program), thus reducing the threat posed to Australian health.
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Of particular concern to Australia’s security is the potential for deliberate misuse by terrorists of chemical, biological, radiological, or nuclear (CBRN) materials. The Department drew on advice from agencies such as the Office of Chemical Safety, the Australian Radiation Protection and Nuclear Safety Agency and the Office of the Gene Technology Regulator to contribute to the Council of Australian Governments Review of Hazardous Materials, which has continued throughout 2005-06. Implementation of review recommendations is expected to result in higher standards of security in all facilities handling CBRN materials. The Department will have a major role in the implementation of security measures for biological hazards. The review of this is being managed by the Department of the Prime Minister and Cabinet and is due to be taken to the Council of Australian Governments in late 2006.
In 2005-06, the Department continued work on the Australian Government’s 2004-05 Budget initiative to develop a register of laboratories that store high risk biological agents. Finalisation of the register will take account of the recommendations of the Review of Hazardous Biological Materials after consideration by the Council of Australian Governments; however this will not occur before the end of 2006. The register scheme will drive better laboratory biosecurity and biosafety measures to help prevent both deliberate and accidental release of harmful pathogens and materials.
The Department also managed the development of Chemical Treatment Guidelines and Radiological Treatment Guidelines, under the direction of the Australian Health Protection Committee (AHPC). These will assist clinicians to treat people who may be affected by a CBRN incident. The Department intends to distribute the guidelines in late 2006.
To keep Australia free from disease entry at the border and to reduce the risk of the introduction of potentially harmful biological materials into the community, the Department provides human quarantine policy advice to the Australian Quarantine and Inspection Service (AQIS). The Department also conducts human health risk assessments relating to requests for the importation of human biological materials. In 2005-06, the Department received twice as many referrals from AQIS for assessment than in the previous year. The Department also provided advice to AQIS on the importation of human remains, managed the quarantine hotline (footnote
) and liaised with AQIS, the Australian Customs Service, the Department of Transport and Regional Development, the Department of Immigration and Multicultural Affairs and other Australian Government agencies on quarantine issues.
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The Department finalised arrangements in March 2006 to establish the Royal Darwin Hospital over the next four years as a National Critical Care and Trauma Response Centre. The centre will be activated when action is required beyond the normal capacity of local health agencies. The Royal Darwin Hospital has recruited staff members for the centre. Significant facilities, including up to 10 operating theatres, are available for use by the hospital in an emergency. The hospital has commenced several detailed reviews of key capabilities and plans are well advanced for formalising partnership arrangements with key agencies and upgrading facilities and training. Two Clinical Chair positions, one in Trauma and Critical Care, and the other in Emergency Preparedness and Response, have been established by the hospital and recruitment to the positions has commenced.
The Department’s response to the violence in East Timor in May 2006 and the earthquake in Indonesia that same month clearly demonstrated that the Department's emergency response capacity continues to mature. Working with the AHPC in coordinating national health resources, the National Incident Room, which is located in the Department, was able to quickly organise 15 essential medical evacuations from Dili to Darwin, and then subsequent movements to Adelaide and Brisbane. The Department also worked with the AHPC to assist AusAID and Emergency Management Australia, the national response agency within the Attorney-General’s Department, in deploying two Australian medical assistance teams to Java, following the earthquake.
The Department also funded relief environmental health staff as part of the response to two other emergency events in 2005-06 – flooding and Cyclone Monica in the Northern Territory.