Online version of the 2012-13 Department of Health and Ageing Annual Report
- Australia is a world leader in tobacco control. Taking full effect from 1 December 2012, all tobacco products are required to be sold in plain packaging and have new, larger health warnings.
- Every day, the National Bowel Cancer Screening Program is saving lives through early detection. The Department has successfully negotiated with service providers to expand the program to include people turning 60 from 1 July 2013.
- Australia is the first country to introduce a national Human Papillomavirus (HPV) vaccination program. In early February 2013, the program was extended to include males. Eligible females and males aged 12 to 13 years are receiving the vaccine free of charge through the ongoing school-based vaccination program and a two year catch-up program for males aged 14 to 15 years.
- The nation’s obesity crisis is being tackled head-on. The 2013 Australian Dietary Guidelines and 2013 Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children were released to help health professionals improve nutrition, treat obesity and overweight and improve community health and wellbeing.
- The potential impact of industrial chemicals on human health and the environment is being reduced. Using the Inventory Multi-tiered Assessment and Prioritisation (IMAP) Framework (introduced in July 2012), the National Industrial Chemicals Notification and Assessment Scheme (NICNAS) conducted close to 1,000 assessments for industrial chemicals already in use in Australia, making recommendations on a significant number of chemicals.
- While Australia’s anti-smoking message is being increasingly heard around the world, the fight is not yet over. Australia will continue to respond to international legal challenges to the new requirements for plain packaging of tobacco products.
- It is crucial that public confidence in the safety of the National Immunisation Program is maintained. Ongoing monitoring of correct administration of vaccines to children will continue.
- Adult overweight and obesity rates are continuing to rise, with 62.8% of Australians aged 18 years and over being overweight or obese, according to the 2011-12 Australian Health Survey. The development of revised national guidelines will promote prevention of overweight and obesity.
- Supporting a whole of government response to new psychoactive substances, which often mimic the effects of longstanding illicit drugs.
- Continuing to balance both industry and community considerations as the assessment of the impact of new industrial chemicals becomes increasingly complex.
23.7% SUBSTANTIALLY MET
5.1% NOT MET
|Period||Met||Substantially met||Not met|
Programs contributing to Outcome 1
- Program 1.1: Prevention, early detection and service improvement
- Program 1.2: Communicable disease control
- Program 1.3: Drug strategy
- Program 1.4: Regulatory policy
- Program 1.5: Immunisation
- Program 1.6: Public health
More than nine out of every 10 Australian children are now immunised. Immunisation rates continue to be high. Childhood immunisation rates are measured at one, two and five years of age with five year olds having the lowest rate. In 2011, the fully immunised coverage rate for five year olds reached almost 90% with a rate of 89.84%. This has steadily increased and in 2012, for the first time, the five year old coverage rate exceeded 90% with a rate of 90.80%. In 2013, the rate increased to 91.54%.
See graph under Program 1.5.
Outcome 1 aims to reduce the incidence of preventable mortality and morbidity throughout Australia by tackling lifestyle factors associated with chronic illness, detecting disease earlier when it does occur, and reducing the spread of infectious disease. In 2012-13, the Department worked to achieve this Outcome by managing initiatives under the programs outlined below.
Program 1.1: Prevention, early detection and service improvement
Program 1.1 aims to reduce the incidence of chronic disease by encouraging Australians to lead healthy lifestyles, supporting early detection and prevention of cancer, and improving chronic disease management.
Reduce the incidence of chronic disease and promote healthier lifestyles
Chronic disease is responsible for a significant portion of disease burden in Australia. The Department is tackling this in a number of areas, including asthma and diabetes.
Chronic Disease Prevention and Service Improvement Fund
Established in July 2011, the Chronic Disease Prevention and Service Improvement Fund provides a flexible funding pool for initiatives related to chronic disease service improvement and prevention, particularly within the primary and community sectors.
During 2012-13, the Government provided $67 million for a range of chronic disease prevention and service improvement activities in accordance with the fund guidelines.
These included community education programs and training of school and preschool teachers, medical, allied health and aged care staff on asthma and linked chronic respiratory conditions. Aboriginal and Torres Strait Islander health workers located primarily in rural and remote areas were also trained to provide accurate diabetes-related pathology testing on site to better manage diabetes.
Deliverable: Conduct a grants round under the Chronic Disease Prevention and Service Improvement Fund
2012-13 Reference Point: Negotiation of new funding agreements to be completed by June 2013, to enable funding to commence from 2013-14
- During 2012-13, the Department conducted a targeted grants round for musculoskeletal activities. Funding agreements were executed with Arthritis Australia and Osteoporosis Australia, with funding commencing from June 2013.
KPI: Effective implementation of the Chronic Disease Prevention and Service Improvement Fund activities
2012-13 Reference Point: Regular progress reports on key milestones from contracted organisations indicate that activities are being implemented effectively in accordance with contractual arrangements
- The Department monitored implementation of funded activities through regular progress reports from the funded organisations. Progress was demonstrated across a range of activities, from large well-established national projects, such as quality assurance for Aboriginal and Torres Strait Islander medical services and asthma management, to newer projects addressing specific areas of need, such as macular degeneration and epilepsy activities.
Support early detection and prevention of cancer through screening initiatives
Bowel Cancer Screening
In the 2012-13 Budget, the Australian Government committed to expand the National Bowel Cancer Screening Program to include 60 year olds from July 2013 and 70 year olds from July 2015. The phased implementation of biennial screening for all Australians aged between 50 and 74 years of age will begin from 2017-18.
In 2012-13, the Department worked with program partners, including state and territory governments, to implement the expansion. This included providing information and advice about the changes to the program to GPs and Medicare Locals, and consumer information in 19 different languages.
Deliverable: Implement new contract for the provision of faecal occult blood tests and pathology services for the National Bowel Cancer Screening Program following completion of Request for Tender process
2012-13 Reference Point: Timely implementation of new contract by March 2013
- The contract was signed in February 2013.
KPI: Percentage of people invited to take part in the National Bowel Cancer Screening Program who participated
2012-13 Target: 41.0%
2012-13 Actual: Data not available
Result: Data not available
- Eligible Australians who turned 50, 55 and 65 years of age in 2012 were invited to undertake screening in the National Bowel Cancer Screening Program between 1 July 2012 and 30 June 2013. As there is a time lag between an invitation and the return of a test, the participation rates for 2012 will be reported in the Australian Institute of Health and Welfare (AIHW) National Bowel Cancer Screening Program Annual Monitoring report published in June 2014. In 2011-12, 35% of invitees returned a test, compared with 37% in 2010-11.
National Bowel Cancer Screening Program
Australian lives are being saved as a result of the National Bowel Cancer Screening Program.
The program provides free bowel cancer tests (faecal occult blood tests, or FOBTs) to mature age people. In 2012-13, the program provided screening to people turning 50, 55 and 65.
Screening to detect cancer before it shows symptoms is important because bowel cancer is one of the most common forms of cancer in Australia. Around 80 Australians each week die from bowel cancer, but it can be treated successfully if detected in its early stages.
The following is a letter received by the Department from one Australian man who is very thankful that he took up the offer of a free bowel cancer test.
Testimonial for the National Bowel Cancer Screening Program
I have always been fit and healthy and had not suffered any symptoms of bowel cancer, so I had no reason to think there was any urgent need for carrying out the FOBT. In fact, when I received the kit I read the instructions and thought it was a good idea, but didn’t get round to doing it for many months. When I did, the results were sent to me within a few days informing me of a positive FOBT result. After a consultation with my GP, I was referred for a colonoscopy which detected cancer. I subsequently had bowel re-section surgery to remove the cancer, and have since been informed that there are no indications of the cancer having spread. I therefore consider myself very fortunate that the cancer was detected in its early stages and that it could be treated. Without the screening program, I would have been totally unaware of the cancer until the symptoms had become life threatening and would have required more extensive surgery and on-going treatment.
I have since learned that the first signs of bowel cancer are invisible and only detectable microscopically. In addition, the earlier the cancer is detected the simpler the procedure to treat it. The screening program aims to detect any cancer at an early stage, prior to any symptoms, so that they can be treated and cured more easily.
I highly recommend the screening program to anyone, and to carry out the simple non-invasive test as early as possible. I very much support and endorse the fantastic work that the NBCSP team do, as they are quite simply saving people’s lives.
Michael Wade, aged 51
People eligible to participate in the program receive an invitation by mail. They can complete the simple test in the privacy of their own home and mail it to a pathology laboratory for analysis.
More detailed information can be found on the Department’s cancer screening website.15
Anyone, including younger people, who have concerns about their risk of developing bowel cancer, should discuss their health with their general practitioner.
Breast Cancer Screening
Screening for breast cancer saves lives. From 2013-14, BreastScreen Australia will be expanded so that women 70-74 years of age will be actively invited to participate in free breast screening.
During 2012-13, the Department continued to work with the states and territories to provide free screening, targeted at women 50-69 years of age.
Deliverable: Review and update BreastScreen Australia’s accreditation system
2012-13 Reference Point: Review completed by June 2013
Result: Substantially met
- In 2011-12, the Department undertook to review BreastScreen Australia’s accreditation system, including the 173 National Accreditation Standards, to streamline the system while maintaining quality of services.
In 2012-13, all aspects of the system were reviewed and in-principle approval for a revised system was provided by the Standing Committee on Screening (SCoS) in November 2012. The pilot of this revised system will be evaluated, and the final accreditation system will be subsequently provided to the SCoS for approval in late 2013.
The revised system will be more streamlined, reduce duplication and increase accountability and transparency in how services are rated. It is anticipated that from 1 January 2015, all BreastScreen Australia services will need to submit applications under the new system.
Deliverable: Undertake a BreastScreen Australia project to improve workforce retention and recruitment of radiographers and radiologists through the provision of development and training opportunities
2012-13 Reference Point: Project completed by June 2013
- The BreastScreen Australia workforce project was undertaken to increase the supply, recruitment and retention of the BreastScreen Australia workforce, and to support the rollout of digital mammography. Initiatives included support to complete postgraduate studies in Breast Sonography and the Certificate of Clinical Proficiency in Mammography. Other workforce initiatives included the development of a Graduate Diploma in Mammography and online courses and programs for radiographers and radiologists in order to monitor their performance, assist in professional development, and provide quality assurance training.
KPI: Percentage of women in the target age group participating in the BreastScreen Australia Program
2012-13 Target: 55.2%
2012-13 Actual: 54.6% (for two year period from 2010 to 2011)
Result: Substantially met
- From 2010 to 2011, 54.6% of women in the target age group participated in the program. This compares to 55.2% during 2008 and 2009, and 56.1% during 2006 and 2007.
Since the introduction of BreastScreen Australia in 1991, there has been a reduction in breast cancer mortality in women 50-69 years of age of 36.5%.16 This is attributable to early detection through screening and advances in the management and treatment of breast cancer. The BreastScreen Australia Evaluation Report 2009 found a 25% decrease in mortality which is directly attributable to screening.
In Australia, five-year survival rates from breast cancer have increased from 72% between 1982-1987 to 89% between 2006-2010.17
The Department continued work in the areas of early detection and prevention of cervical cancer through the National Cervical Screening Program. Since the introduction of this program in 1991, there has been a 50% reduction in deaths from cervical cancer.18
An evidence-based review of the national cervical screening policy and program is being managed by the Department. A draft review of the evidence was released for public consultation in June 2013 and the review will be completed by June 2014.
KPI: Percentage of women in the target age group participating in the National Cervical Screening Program
2012-13 Target: 58.6%
2012-13 Actual: 57.2% (for two year period from 2010 to 2011)
Result: Substantially met
- Cervical screening rates are typically reported over a two year period in Australia, in line with the policy for women to have a pap smear every two years. The two year participation rate for women aged 20-69 years from 2010 to 2011 is 57.2%. The three year participation rate from 2009 to 2011 for women aged 20-69 years was 70%, which is among the best participation rates internationally.
The number of women aged 20-69 years participating in cervical screening increased by 5,269 in 2010-11. While overall participation is very good, it is thought that HPV vaccinated women may be screening less often, reflecting a slight drop in overall participation rates. The Department is continuing to educate younger women that regular pap tests are important for the prevention of cervical cancer.
National HPV Vaccination Program
Young Australian women and men are now seeing the benefits of the Human Papillomavirus (HPV) vaccination program.
HPV is one of the most common sexually transmissible infections in Australia. It is highly contagious, passed on through sexual contact. Most people who have the virus are unaware of it, but four out of five Australians are likely to have a HPV infection at some stage in their life. There are different types of HPV. Vaccination can prevent the types which cause genital warts and others associated with cancers such as penile, anal, cervical, vulval, and vaginal cancers. Australia was the first country to introduce an ongoing, government-funded National HPV Vaccination Program. It began with girls and women up to the age of 26 with an ongoing program for girls aged 12-13 years. In February 2013, the program was extended to 12 and 13 year old school boys, with a catch-up program for boys up to 15 years. Vaccinating males helps to protect them from a range of HPV-related cancers and genital warts, and will continue to reduce rates of cervical cancer among females through ‘herd immunity’ effects.
More than 70 per cent of Australian girls aged 15 years have received all three doses of HPV vaccine, one of the highest rates in the world.
More than seven million doses of the vaccine have been distributed in Australia so far. The safety profile of the vaccine is closely monitored, with rapid reporting to the Therapeutic Goods Administration of acute adverse events.
Since the program began in 2007, there has been a significant reduction in HPV-related infections in young women and girls. The incidence of genital warts – caused by HPV – has also fallen among both females and males, as boys and men have been protected by ‘herd immunity’, ie less exposure to HPV.
More detailed information can be found on the Department’s HPV website.19
Chronic disease management and support
The Department continues to tackle the nation’s diabetes epidemic – including managing the largest randomised controlled trial involving diabetes patients ever conducted in Australia. In 2012-13, the Department worked with a consortium led by McKinsey and Company to implement the Diabetes Care Project in identified sites across Queensland, South Australia and Victoria. The pilot project will test new ways of providing more flexible and better coordinated care, with the aim of improving the management of care for people with diabetes.
The project is piloting four key changes in how care is delivered to people with diabetes:
- a new care facilitator role to collaborate with the care team to support patient care;
- an education and training program to support practitioners and people with diabetes;
- a new chronic disease management IT tool to support care planning, enable information sharing and reduce administration; and
- a new funding model.
The Department will continue to implement the pilot in 2013-14. This will include ongoing data collection to inform formal evaluation starting in February 2014. The evaluation of the pilot will help the Department to identify the most effective models of care for diabetes and other chronic diseases.
Deliverable: Oversee implementation of the Diabetes Care Project to test a more comprehensive, patient-centred approach to improve the care of patients with diabetes
2012-13 Reference Point: Implementation of the Diabetes Care Project in identified sites across three states – Queensland, South Australia and Victoria
- In 2012-13, general practice enrolment was completed, with more than 150 practices participating in identified sites across Queensland, South Australia and Victoria. Baseline clinical data (HbA1c,20 blood pressure and cholesterol) has been collected for participating patients. Care plans have been developed and care facilitation is being provided. Implementation, including clinical data collection, will continue until February 2014, when a formal evaluation of the project will begin.
KPI: Number of patients enrolled in the Diabetes Care Project21
2012-13 Target: 10,000
2012-13 Actual: 7,909
Result: Substantially met
- Up to a maximum of 10,000 patients could be enrolled in the pilot. Based on voluntary enrolment of 150 practices, a target of 7,500 patients was established, and this was achieved with 7,909 enrolments. A minimum of 3,750 patients is required for evaluation purposes. This is the largest randomised controlled trial for patients with diabetes conducted in Australia.
Program 1.2: Communicable disease control
Program 1.2 aims to reduce the incidence of blood borne viruses and sexually transmissible infections.
Reduce the incidence of blood borne viruses and sexually transmissible infections
Blood borne viruses and sexually transmissible infections are preventable. The Department continued to support education and prevention programs under the National Blood Borne Viruses (BBV) and Sexually Transmissible Infections (STI) Strategies 2010-2013 which aim to better connect safe sex and prevention messages with the people most at risk. The strategies aim to improve knowledge, attitudes and behaviours among target groups. These include Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse Australians, youth, people in rural and regional areas, and people who inject drugs.
In October 2012, the Department published a mid-term review of the Implementation Plan: National Strategies 2010-2013 for BBVs and STIs.22 Recommendations included addressing increased transmission of HIV among people from, and travelling to, high prevalence countries; scaling up treatment capacity for hepatitis C as new treatments become available; scaling up hepatitis B antiviral treatment to meet demand; and eliminating syphilis in Aboriginal and Torres Strait Islander peoples.
Deliverable: The priority actions contained in the National BBV and STI Strategies 2010-2013 are being undertaken
2012-13 Reference Point: Have completed or commenced 90% of all the priority actions contained in the National BBV and STI Strategies 2010-2013 as measured by the mid-term review
Result: Substantially met
- The Department continues work in this area. A highlight is the registration of the first HIV point of care test23 for use in Australia. It is anticipated that this testing will increase the number of people who voluntarily seek HIV testing. In addition, the Department has continued to increase awareness of BBV and STI issues in Aboriginal and Torres Strait Islander health. For example, in the Torres Strait Island region, the Department is funding a culturally appropriate sexual health campaign, and improving clinical service delivery on Saibai Island.
KPI: Funding provided to non-government organisations under the Communicable Disease Prevention and Service Improvement Grants Fund supports programs which are effective in reducing the spread of communicable disease
2012-13 Reference Point: Regular progress reports on key milestones from contracted organisations indicate that activities are being implemented effectively in accordance with contractual arrangements
- During 2012-13, non-government organisations that focus on BBVs and STIs have been supported through the Communicable Disease Prevention and Service Improvement Grants Fund. These organisations deliver a variety of prevention and education activities aimed at raising awareness of BBVs and STIs, encouraging safe sex and injecting practices, improving access to testing and treatment of BBVs and STIs, reducing discrimination and improving wellbeing of those living with BBVs and STIs, as well as ensuring Australians continue to have access to a safe, high quality national blood supply. All organisations that received funding provided progress reports on milestones within the agreed timeframes.
KPI: Percentage of laboratory tests which are positive for Chlamydia infection
2012-13 Target: <12%
2012-13 Actual: 7.7%
- Chlamydia infections are most prevalent in young people. Based on the number of notifications reported to the National Notifiable Diseases Surveillance System and the number of chlamydia testing services reported under the Medicare Benefits Schedule, an estimated 7.7% of laboratory tests were positive for chlamydial infection. This is a slight decrease from previous years where the proportion of positive tests for chlamydia has been around 8%.
As more than 80% of chlamydia infection notifications are among people aged 15-29 years, the Department continues to support promotion of STI testing. This enables early detection and treatment, and reduces the longer term complications that can be associated with untreated chlamydia.
KPI: Number of newly diagnosed cases of HIV infection
2012-13 Target: <1,100
2012-13 Actual: 1,253 (2012 calendar year)
Result: Not met
- Numbers of HIV cases are increasing. The number of new HIV diagnoses in Australia in 2012 was 1,253 – up from 719 cases in 1999.
Recent trends in the population rate of newly diagnosed HIV infection show that transmission of HIV in Australia continues to occur primarily through sexual contact between men (67%). Exposure to HIV was attributed to heterosexual contact and injecting drug use in 25% and 2% of diagnoses, respectively.
KPI: Number of newly diagnosed cases of hepatitis C infection
2012-13 Target: <12,250
2012-13 Actual: 10,17324
- Number of hepatitis C infection cases are decreasing. The number of newly diagnosed25 cases of hepatitis C infections notified to the National Notifiable Diseases Surveillance System in 2012-13 was 10,173. A peak in the notification of cases occurred in the late 1990s. Since 2000-01, total rates have declined by around 50%. In 2011, an estimated 304,000 people living in Australia had been exposed to the virus, with around 226,700 having chronic hepatitis C infection.
Program 1.3: Drug strategy
Program 1.3 aims to reduce the harmful effects of tobacco use, reduce the harm caused to individuals and communities from excessive alcohol consumption and combat illicit drug use.
Reduce the harmful effects of tobacco use
The world’s first tobacco plain packaging legislation, the Tobacco Plain Packaging Act 2011 and the Tobacco Plain Packaging Regulations 2011, took full effect from 1 December 2012. The legislation prohibits tobacco industry logos, brand imagery, colours and promotional text other than brand and product names in a standard colour, position, font style and size appearing on retail packaging of tobacco products. Tobacco product retail packaging is required to appear in a drab dark brown colour in a matt finish. Under the Competition and Consumer (Tobacco) Information Standard 2011, requirements for new, larger health warnings on all tobacco products took full effect from 1 December 2012, in line with plain packaging requirements.
Compliance and enforcement activities under the Tobacco Plain Packaging Act 2011 began on 1 October 2012 for manufacturing and packaging offences, and on 1 December 2012 for supply and sales offences. These include inspections of manufacturers, retailers and suppliers based on information received by the Department. Enforcement action undertaken under the legislation is proportionate to the breach and involves a range of actions including, as appropriate, educational visits, verbal or written warnings, infringement notices and prosecutions. The Tobacco Plain Packaging Enforcement Policy explains the approach to enforcement and is available at www.yourhealth.gov.au.
During 2012-13, the Department, along with the Attorney-General’s Department and the Department of Foreign Affairs and Trade, continued working to defend the international challenges to the tobacco plain packaging legislation.
Also in 2012-13, the Department developed a new National Tobacco Strategy to guide efforts to reduce the harm caused by tobacco smoking. The Department continued to run social marketing campaigns to raise awareness of the dangers of smoking and encourage attempts to quit among high risk and hard to reach populations.
Deliverable: Implement public awareness activities for the introduction of tobacco plain packaging
2012-13 Reference Point: Public awareness activities to be developed by mid-2012 and evaluation activities by late 2012
- Extensive communication activities have increased awareness of the requirements under the Tobacco Plain Packaging Act 2011 and Tobacco Plain Packaging Regulations 2011 to support the compliance and enforcement framework. This included providing an information kit and tear pad to 35,000 suppliers of tobacco products. There was also a reminder letter, press and online advertising in late 2012. A letter and frequently asked questions document on the packaging of cigars were sent to tobacco suppliers in 2013.
An evaluation of the range of communication activities ran from October to December 2012. This evaluation found that the campaign messaging was clear and successfully delivered to the intended target audience.
Deliverable: Develop new National Tobacco Strategy in conjunction with states and territories
2012-13 Reference Point: New National Tobacco Strategy to be finalised by 30 June 2013
- The National Tobacco Strategy 2012-2018 was developed during 2012 as a sub-strategy under the National Drug Strategy 2010-2015. It was approved by Health Ministers in November 2012 and published on the National Drug Strategy website26 in January 2013.
Deliverable: Implement social marketing campaigns to raise awareness of the dangers of smoking and encourage and support attempts to quit
2012-13 Reference Point: Deliver the National Tobacco Campaign – More Targeted Approach within agreed timeframes
- As part of the National Tobacco Campaign – More Targeted Approach (MTA), a new pregnancy campaign was launched in November 2012. This targeted women who smoke, who are pregnant or planning to become pregnant within the next two years, and their partners. This target audience included people from socially disadvantaged, Aboriginal and Torres Strait Islander and culturally and linguistically diverse backgrounds. Advertising comprised of two TV, print and digital commercials, a radio advertisement, and an iPhone and Android App. A second round of advertising started on 19 May 2013 and ended in mid-June 2013. As part of the broader MTA campaign, a range of public relations and sponsorship activities were undertaken throughout 2012-13, targeting hard to reach audiences.
KPI: Percentage of population aged 18 years of age and over who are daily smokers
2012-13 Target: <16.4%
2012-13 Actual: 16.3%
- Fewer Australians are smoking on a daily basis. Rates of daily smoking have continued to drop to 16.3% of people aged 18 years and over (2.8 million people) in 2011-12, from 19.1% in 2007-08, 21.3% in 2004-05 and 22.3% in 2001.27
Reduce harm to individuals and communities from excessive alcohol consumption
Under the guidance of the National Drug Strategy 2010-15, the Department continues to partner with a range of stakeholders to increase awareness and promotion of responsible alcohol consumption.
This includes raising awareness among health practitioners of the Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Point of sale information has targeted a range of groups – including patrons of liquor retailers, clubs, pubs and hotels; and pregnant women and women who are breastfeeding – through distribution of over one million brochures. This work has been undertaken in the context of broader activity to reduce the impact of Fetal Alcohol Spectrum Disorders.
Substance Misuse Service Delivery Grants Fund
The Substance Misuse Service Delivery Grants Fund aims to improve the health and social outcomes of Australians with substance misuse issues. The fund supports drug and alcohol treatment services across Australia, to build capacity and effectively identify and treat coinciding mental illness and substance misuse. The fund also supports services targeting Aboriginal and Torres Strait Islander peoples and vulnerable groups, including people from rural and remote locations and those experiencing homelessness.
The Non Government Organisations Treatment Grants Program (NGOTGP) provides funding to improve drug and alcohol treatment outcomes, increase the number of available treatment places, strengthen the capacity of non-government organisations to deliver quality treatment services and to fill geographic service delivery gaps, especially for at-risk groups. The NGOTGP activities complement and support those undertaken through the Fund.
Deliverable: Fund and support drug and alcohol treatment services to strengthen the capacity of service providers across Australia
2012-13 Reference Point: Drug and alcohol treatment service providers receive funding and support through the Substance Misuse Service Delivery Grants Fund
- In 2012-13, the Department provided funding to more than 150 organisations to provide alcohol and other drug treatment and prevention services. The funded organisations include large not-for-profit organisations, community controlled treatment services and non-government organisations offering a range of treatment options including counselling, brief interventions and residential rehabilitation programs across urban, regional and remote Australia.
Early Intervention Pilot Program
The Early Intervention Pilot Program (EIPP) aims to get youth who have been participating in under-age drinking back on track before more serious alcohol-related problems emerge. Working with all state and territory police and health departments, young people are moved from engagement with police to the health system, where they receive information and are offered counselling to encourage a change in attitudes and behaviours.
KPI: Early Intervention Programs reduce reported re-offending rates of under-age drinking
2012-13 Reference Point: Reports from jurisdictions indicate there are less underage drinkers re-offending
- The EIPP ended in June 2013 with a number of intervention activities embedded into both police and health programs. Early evaluation findings demonstrate that more young people are learning to resolve issues without alcohol. Fewer young people are re-offending after being provided with alcohol education information.
Combat illicit drug use
The National Drugs Campaign continues to educate the public on the risks and harms associated with illicit drug use through targeted information and resources for youth and parents.
Deliverable: Provide up-to-date information to young people on the risks and harms of illicit drug use
2012-13 Reference Point: Dissemination of materials and delivery of the National Drugs Campaign and providing information through the National Cannabis Prevention and Information Centre on the risks and harms associated with cannabis use
- In 2012-13, under the National Drugs Campaign, comprehensive developmental research was undertaken to provide further understanding of current youth attitudes and behaviours to a range of illicit drugs. This research will guide development of future campaign activity.
The Department continued to fund the National Cannabis Prevention and Information Centre’s (NCPIC) efforts to educate the community about the harms of cannabis use. The NCPIC continued to develop and distribute, on a national scale, a large number of free resources and training materials. NCPIC also provides extensive training through clinical, community and youth training sessions to deal with cannabis affected clients.
In 2012-13, the Department continued support for new research and data about the harms of illicit drug use and alcohol misuse and prevention of illicit drug and alcohol use in young people. This included sponsoring a virtual collaborative network of three major research institutions – the National Centre for Education and Training on Addiction, the National Drug and Alcohol Research Centre and the National Drug Research Institute – to work together in undertaking joint research, developing new research approaches and establishing an evidence base to inform responses to new and emerging drug issues.
The Department has provided funding to Edith Cowan University to establish an Aboriginal and Torres Strait Islander Peoples Alcohol and Other Drugs Knowledge Centre. This knowledge centre will promote and disseminate high quality culturally appropriate information and provide practical support to communities and those working to prevent and reduce the impact of alcohol and other drugs on Aboriginal and Torres Strait Islander peoples and their families.
KPI: Percentage of population 14 years of age and older recently (in the last 12 months) using an illicit drug
2012-13 Target: <13.4%
2012-13 Actual: Data not available
Result: Data not available
- Data for 2012-13 is currently not available, as it is taken from the National Drug Strategy Household Survey (NDSHS), which is published every three years. Results from the next NDSHS will be available in 2014 and will be based on 2013 data.
In 2013-14, the Department will continue to work with law enforcement agencies, state, territory and local governments, treatment service providers, housing and homelessness services, and local communities under the National Drug Strategy 2010-2015. The strategy aims to build safe and healthy communities by minimising alcohol, tobacco and other drug-related health, social and economic harms among individuals, families and communities.
Program 1.4: Regulatory policy
Program 1.4 aims to provide direction and national leadership in food and gene technology regulatory policy issues, maintain and improve the therapeutic goods regulatory framework, and provide for the safe and sustainable use of industrial chemicals.
Food regulation policy
Develop food standards and food regulation policy
Food standards and regulation ensure the health of Australians is protected and supported by a safe food supply.
The Department continued to undertake activities to support the development of food standards, food regulation policy and advice. This involved working with stakeholders including industry representatives, Food Standards Australia New Zealand (FSANZ), states and territories and the New Zealand Government.
In 2012-13, the Department reviewed and responded to advances in scientific knowledge and evidence, stakeholder feedback and developments in food regulatory practice at a national level. The Department also helped influence the development of food regulation at the international level through membership of the Codex Committee on Food Labelling.
The Department continued to implement the Government response to Labelling Logic: Review of Food Labelling Law and Policy (2011) in consultation with portfolio agencies including FSANZ, other Australian government departments, states and territories and New Zealand.
Deliverable: Develop an interpretive front-of-pack labelling system for foods
2012-13 Reference Point: New labelling system developed by December 2012
Result: Substantially met
- In 2012-13, the Department led the development of a front-of-pack labelling system so that Australians will be able to tell at a glance which processed foods represent the healthiest choices. This will help, in the long term, to alleviate the burden of chronic disease, overweight and obesity issues in Australia.
In 2013-14, the Department will continue to implement the labelling system, including preparing a social marketing campaign. Industry actively participated in the development of the new system and it is expected it will voluntarily adopt the system by June 2015.
Deliverable: Develop advice and policy for the Australian Government on food regulatory issues
2012-13 Reference Point: Relevant, evidence based advice produced in timely manner
- The Department provided advice and policy to the Australian Government, via the Legislative and Governance Forum on Food Regulation, in relation to food regulation issues. Key food regulatory issues for 2012-13 included health and nutrition-related claims, expanding country of origin labelling to all unpackaged meat products and front-of-pack labelling.
KPI: Promote a nationally consistent approach to food policy and regulation
2012-13 Reference Point: Consistent regulatory approach across Australia through nationally agreed policy and standards
- In 2012-13, the Department continued to work with the Food Regulation Standing Committee (FRSC) and the Implementation Sub-Committee (ISC) to develop and implement consistent food policies and regulations. Both FRSC and ISC met twice during the year and considered a range of policy and regulatory issues, with the Department providing advice.
Front-of-Pack Labelling System
Australians will soon be able to tell at a glance which processed foods represent the healthiest choices, thanks to a new front-of-pack labelling system.
Eating too much salt, saturated fat and sugar, coupled with inadequate physical activity, has led many of us to develop chronic health conditions which reduce our quality of life and can even be fatal.
Labelling on processed foods can make it easier to make the right choices to maintain a healthy weight and healthy body. But the variety of labelling systems and styles developed by food manufacturers is confusing and, at times, misleading.
The solution is a single, interpretive front-of-pack labelling system for use on packaged foods sold in Australia.
A star rating system was developed by the Department in 2012-13, in collaboration with governments, industry, nutrition experts, public health and consumer groups.
This new five star rating scale will apply to all packaged, manufactured or processed foods presented ready for sale in retail shops (with some exceptions). At a glance, consumers will be able to see the overall nutritional content of the product, as well as the energy (kilojoules) in the product and easy-to-read information about saturated fat, sugar and salt (sodium) content.
The star rating system supports preventative health by providing consumers the information they need to make healthy eating choices. In the long term, it will help Australians to reduce their burden of chronic disease and other issues related to overweight and obesity. In 2013-14, the Department will continue to work on the labelling system, which is expected to be adopted voluntarily by the food industry by June 2015.
Ensure that therapeutic goods are safe, effective and of high quality
The Therapeutic Goods Administration (TGA) ensures the quality, safety and efficacy of therapeutic goods in Australia. In 2012-13, the TGA continued to regulate therapeutic goods under a national framework, using a risk management approach. Assessment and monitoring were carried out to ensure therapeutic goods available in Australia were of an acceptable standard, and manufactured in accordance with the principles of Good Manufacturing Practice. This included assessment of annual reports from sponsors of Class III and implantable devices following entry on the Australian Register of Therapeutic Goods (ARTG).28 At the same time, the TGA continued to ensure that the community had access, within a reasonable timeframe, to therapeutic advances.
Deliverable: Percentage of alleged breaches received that are assessed within 10 working days and an appropriate response initiated
2012-13 Target: 100%
2012-13 Actual: 100%
- The TGA assessed all alleged breaches of the Therapeutic Goods Act 1989 within 10 working days and initiated an appropriate response in 100% of the instances notified.
KPI: Percentage of evaluations and appeals regarding the entry of therapeutic goods onto the ARTG made within legislated timeframes29
2012-13 Target: 100%
2012-13 Actual: 100%
- The TGA completed all 39 section 60 reviews regarding the entry of therapeutic goods onto the ARTG within legislated timeframes. This compares to 96% in 2011-12, and 97% in 2010-11.
KPI: Percentage of licensing and surveillance inspections completed within target timeframes:
2012-13 Target: Domestic: 100%
2012-13 Actual: 73%
Result: Not met
2012-13 Target: Overseas: 90%
2012-13 Actual: 71%
Result: Not met
- In 2012-13:
- 181 of 247 inspections of Australian manufacturers were completed within target timeframes (69% in 2011-12 and 87% in 2010-11); and
- 77 of 109 inspections of overseas manufacturers were completed within target timeframes (60% in 2011-12 and 82% in 2010-11).
KPI: Percentage of prescription medicine evaluations completed within target timeframes:30
2012-13 Target: Category 1: 100%
2012-13 Actual: 99.7%
2012-13 Target: Category 3: 100%
2012-13 Actual: 100%
- In 2012-13:
- 388 of 389 of Category 1 evaluations for prescription medicines were completed within the legislated timeframe of 255 days (99.5% in 2011-12 and 99.4% in 2010-11); and
- all 1,391 Category 3 evaluations for prescription medicines were completed within the legislated timeframe of 45 days (99.4% in 2011-12 and 99.8% in 2010-11).
Implement the TGA Reform Blueprint
Delivering reforms – Implementation plan for TGA Reforms: A blueprint for TGA’s future was published on the TGA website31 in July 2012 and significant progress has been made in delivering the Blueprint recommendations in accordance with the detailed plan.
Deliverable: Implement reforms that enhance TGA’s current regulatory processes
2012-13 Reference Point: Reforms implemented in accordance with the published plan
Result: Substantially met
- At 30 June 2013, 28 of the Blueprint recommendations have been implemented. These include:
- Establishment of the Australian Therapeutic Goods Advisory Council;
- Publication of:
- Advertising Regulatory Framework – Options for Reform;
- Consultation principles for therapeutic goods regulatory reforms;
- TGA External Communication and Education Framework: priorities and projects 2013–15;
- a clear explanation of the TGA’s risk based framework on the TGA website;
- further information on the role of statutory advisory committees and clarification of their reporting arrangement;
- target dates and reports on the completion of key complementary medicines guidance documents;
- a new Compliance Review Framework for Complementary Medicines and a list of cancelled listed complementary medicines;
- a paper for comment on the TGA’s approach to the disclosure of commercially confidential material; and
- a consultation paper incorporating proposals for future regulation of advertising.
- Providing access to online information on Australian and New Zealand adverse event data for medicines and medical devices; an early warning system of potential risks with medicines and medical devices; and publication of product recalls information; and
- Implementation of regulatory changes to re-classify hip, knee and shoulder joint replacement implants.
- Recommendations relating to complementary medicines; and
- A recommendation relating to investigations of advertising breaches.
Establish the Australia New Zealand Therapeutic Products Agency
The Australian and New Zealand Governments are creating a joint regulatory scheme for therapeutic products in Australia and New Zealand. The scheme will safeguard public health and safety, further economic integration, and benefit industry in both countries.
In 2012-13, the Department continued working with the New Zealand Ministry of Health and other Australian and New Zealand Government policy agencies to establish the arrangements for the Australia New Zealand Therapeutic Products Agency (ANZTPA), which will administer the joint regulatory scheme.
TGA and New Zealand’s Medicines and Medical Devices Safety Authority (Medsafe) implemented joint regulatory projects. These resulted in:
- a publicly searchable, joint database of adverse event notifications for medicines and for medical devices;
- increased capability to conduct inspections of manufacturing practices;
- a common early warning system for advising the public about investigations into potential safety concerns associated with medicines and medical devices;
- a common recalls portal; and
- common administrative processes for evaluation of over-the-counter medicine registrations in both countries.
The first stage to implement a single entry point for businesses and consumers was launched in November 2012. In January 2013, the TGA and Medsafe released a public consultation paper on a possible joint regulatory scheme for therapeutic products under ANZTPA.
Deliverable: Implement a program of work sharing and joint operations
2012-13 Reference Point: Agree with Medsafe (New Zealand) to share scheduled Good Manufacturing Practice inspection reports and coordinate inspection schedules by January 2013
- In 2012-13, five projects between the TGA and Medsafe were completed. These are:
- Joint Medicine and Medical Device Adverse Events Notifications Databases – In November 2012, a publicly searchable database for medicine adverse events reported in Australia and New Zealand became available on www.ANZTPA.org. In June 2013, a joint database of medical device adverse event notifications was launched. These databases improve access for consumers, health care professionals and industry to information about the performance of medicines and devices.
- The Recalls Portal – In April 2013, a publicly searchable database about recall actions undertaken in Australia and New Zealand for therapeutic products began operation. This provides stakeholders with greater transparency and access to information about product recalls.
- Integrated Good Manufacturing Practice (GMP) Inspections – In January 2013, a shared capability to facilitate manufacturing practice inspection planning was completed. It allows the TGA and Medsafe automatic access to all inspection reports through a secure information sharing portal. This improves alignment of inspection priorities and makes best use of scarce inspection resources.
- Early Warning System – In June 2013, an agreed system to communicate potential safety concerns with therapeutic products was delivered. This scheme will operate in parallel in Australia and New Zealand.
- Over-the-Counter (OTC) medicine reforms – Business processes for the evaluation of OTC medicine registration applications were reformed and an integrated common approach in the TGA and Medsafe was established.
Ensure that uses of industrial chemicals are safe for human health and the environment
In 2012-13, the Department, through the National Industrial Chemicals Notification and Assessment Scheme (NICNAS), continued to protect human health and the environment by promoting safe and sustainable use of industrial chemicals.
This was achieved through 281 pre-market assessments of new industrial chemicals. In addition, NICNAS assessed 727 industrial chemicals already in use, through its Existing Chemicals Program (through the Inventory Multi-tiered Assessment and Prioritisation [IMAP] framework, or as Priority Existing Chemicals [PEC], or when an introducer of a chemical that had been previously assessed advised NICNAS of new information about the chemical [‘secondary notification assessment’]).
To promote the safe use of chemicals, NICNAS continued to engage with its key stakeholders – the chemical industry, the community (including employees who work with chemicals), the Australian Government and state and territory governments – through national networks, advisory committees and information sharing activities.
Under a Better Regulation Ministerial Partnership (BRMP) between the Minister for Health and the Minister for Finance and Deregulation, the Department progressed the review of NICNAS.
The Department held consultations in July and August 2012, which discussed possible reform options. Following key stakeholder workshops in October 2012, a draft Regulatory Impact Statement was released in June 2013 on the possible impacts of reform options. The complex nature of the industrial chemical regulatory environment and the diverse views of industry and community stakeholders present challenges to the development of a preferred package of reform.
The Department will continue to work with NICNAS and other stakeholders to develop a regulatory reform package that would rebalance the industrial chemical regulatory framework to enhance both the competitiveness of the Australian chemical industry and public health and environmental outcomes.
Deliverable: Implement the Inventory Multi-tiered Assessment and Prioritisation (IMAP) framework
2012-13 Reference Point: IMAP framework governance arrangements in place, ongoing stakeholder engagement and communication strategies are effectively implemented
- The IMAP framework was introduced in July 2012. NICNAS held a forum during that month to increase stakeholder understanding of the IMAP framework and explore opportunities for greater international and national collaboration. Stage One of the implementation of the IMAP framework, running over four years, involves the evaluation of 3,000 existing chemicals that were prioritised for assessment. Australian scientific experts independently reviewed the IMAP framework and both the chemical industry and interested members of the public have been given the opportunity to comment on IMAP assessments. Publication of assessment reports was communicated through NICNAS consultative committees, the NICNAS website, the Chemical Gazette and targeted e-mails. Fact sheets, the IMAP framework and pilot evaluation papers for the framework were also published on the NICNAS website, providing public information on the methodologies used in risk assessments.
Deliverable: Implement approach for introducing substitutes for perfluorinated32 chemicals
2012-13 Reference Point: Framework for the assessment of new perfluorinated chemicals implemented
- A framework for the assessment of new perfluorinated chemicals was implemented. Several assessments were undertaken for new shorter chain perfluorinated chemicals proposed as substitutes for long chain perfluorinated chemicals that are known to accumulate in the environment.
Deliverable: Contribute to the international harmonisation of assessments, regulatory approaches and methodologies by adjusting, as appropriate, Australian industrial chemicals assessment and management systems
2012-13 Reference Point: Review international assessments, regulatory approaches and methodologies for their application to NICNAS risk assessments from three key subcommittees of the OECD Chemicals Committee
- NICNAS participates in chemical safety initiatives sponsored by the World Health Organization (WHO) and represents Australia on key chemical sub-committees of the Organisation for Economic Co-operation and Development (OECD) Chemicals Committee, which reviews international regulatory approaches. This international engagement ensures that NICNAS assessments are scientifically robust and international experience is applied to improve our regulatory systems. In 2012-13, NICNAS participated in the:
- WHO International Programme on Chemical Safety – through the establishment of an international network of risk assessors;
- OECD Task Force on Hazard Assessment – revising guidance on forming chemical categories to increase the efficiency of chemical assessments. This guidance assists in selecting appropriate analogue chemicals, which can provide useful information to assess the likely hazards of a new chemical. NICNAS also contributed to the ‘avoiding duplication’ project by sharing with other regulators its current schedules for existing chemical assessments (PEC and IMAP). In addition, NICNAS participated in the Cooperative Chemical Assessment Program by reviewing the dimethylanilines category of six chemicals of interest to NICNAS and other regulators;
- OECD Working Party on Manufactured Nanomaterials (WPMN) – ensuring that the view of Australian regulatory agencies was reflected in the draft OECD Council recommendation (2013) that “approaches for the testing and assessment of traditional chemicals are in general appropriate for assessing the safety of nanomaterials, but may have to be adapted to the specificities of nanomaterials”. Participation in the WPMN ensures that NICNAS’s approach to hazard and risk assessment and regulation of industrial nanomaterials is science-based and internationally harmonised; and
- OECD Clearing House on New Chemicals – by reviewing the list of low concern polyesters.
Deliverable: Introducers of industrial chemicals aware of their obligations through NICNAS Registration
2012-13 Reference Point: Registration of all identified introducers
- In 2012-13, 99.7% of all identified introducers (5,303) were registered. NICNAS conducted 27 site visits to ensure introducers were complying with their obligations. More than 1,200 desktop audits were undertaken to identify unregistered introducers, contributing to more than 800 chemical introducers registering with NICNAS for the first time.
KPI: Effective use of international information
A. For new chemicals: finalise lessons learnt from US bilateral agreement and explore options for further developing arrangements.
B. For existing chemicals: through implementing the IMAP framework, developing guidance and training on the use of international information
- A. More than 30 United States Environmental Protection Agency reports have been provided for NICNAS New Chemicals assessments since the start of the bilateral arrangement. The sharing of this information has helped NICNAS in its assessments and resulted in efficiencies for NICNAS and reduced costs to industry.
B. NICNAS liaised with international regulatory agencies to access information and expertise to assist with the IMAP assessments. Sharing assessment data with other agencies and acquiring expertise in the use of information technology tools have contributed significantly to the successful implementation of the IMAP framework in its first year.
2012-13 Target: 20%
2012-13 Actual: 24%
- In 2012-13, NICNAS undertook 984 assessments for a total of 72335 chemicals (261 were assessed for both human health and environmental impacts) using the IMAP framework. Recommendations to Australian Government and state and territory agencies for additional regulatory controls and/or further assessments have been made for a significant number of chemicals, demonstrating that the IMAP framework is operating effectively.
KPI: Percentage uptake by industry of options to introduce new chemicals that are a lower risk to human health or the environment
2012-13 Target: 80%
2012-13 Actual: 80%
- The regulatory requirements for chemicals being introduced into Australia were revised in 2008-09 to facilitate the introduction of less hazardous and lower risk chemicals. The percentage of new chemicals assessed that are safer and less hazardous increased by 3% from 77% in 2011-12 to 80% in 2012-13.
KPI: Percentage of those introducing over $500,000 of industrial chemicals assessed for compliance with new chemicals obligations
2012-13 Target: 30%
2012-13 Actual: 30.3%
- In 2012-13:
- 16 on-site audits were conducted to determine compliance with new chemicals obligations;
- 17 audits were closed where the company was able to demonstrate compliance with obligations; and
- 5 audits are continuing where the company has agreed to provide evidence of compliance within an agreed timeframe.
Gene technology regulation
Protect the health and safety of people and the environment by regulating dealings with genetically modified organisms
The Gene Technology Regulator, supported by the Office of the Gene Technology Regulator (OGTR), administers a national scheme for the regulation of gene technology to protect the health and safety of people and the environment by regulating certain dealings with genetically modified organisms (GMOs).
In 2012-13, OGTR monitored scientific knowledge and developments in regulatory practice to ensure the assessments of applications required under the gene technology legislation were robust, based on current science and represent international best practice. OGTR engaged in international cooperation activities that included the harmonisation of risk assessment of GMOs. OGTR also consulted with experts and key stakeholders on the assessment of licence applications for the release of GMOs into the environment.
In consultation with stakeholders, OGTR conducted reviews to ensure that regulations, guidelines and processes remain current with advances in gene technology and understanding of risks. In 2012-13, OGTR also consulted with the community to resolve issues of concern, for example, risk management of GMOs.
OGTR continued bilateral arrangements with other Australian Government regulators, such as FSANZ; the TGA; the Australian Pesticides and Veterinary Medicines Authority; Department of Agriculture, Fisheries and Forestry; and NICNAS to improve coordinated decision making and avoid duplication in regulation of GMOs and genetically modified products. These activities deliver a risk-based, responsive, efficient and effective regulatory system that protects Australian people and the environment.
Deliverable: Review Risk Analysis Framework to support the assessment of licence applications for the release of GMOs into the environment
2012-13 Reference Point: Review completed by 30 June 2013
- The revised Risk Analysis Framework was launched at the 5th National Institutional Biosafety Committee Forum in June 2013.
Deliverable: Risks posed by GMOs or gene technology assessed and managed appropriately
2012-13 Reference Point: Risk assessment and risk management plans prepared for all applications for licensed dealings
- In 2012-13, the Gene Technology Regulator prepared comprehensive risk assessments and risk management plans for proposed dealings with GMOs involving intentional release into the environment and in contained facilities. The Regulator imposed stringent conditions to ensure containment of GMOs and management of identified risks for four licences for release into the environment and eight licences for dealings in contained facilities. OGTR monitoring activities demonstrated a high level of compliance with the gene technology legislation and risks to human health or the environment were managed appropriately.
Deliverable: Percentage of field trial sites and higher level containment facilities inspected
2012-13 Target: 20%
2012-13 Actual: 42%
- In 2012-13, OGTR inspected 42% of field trial sites, to monitor compliance with licence conditions ensuring risks to human health and the environment are minimised. The sites inspected were in the Australian Capital Territory, New South Wales, Victoria, Queensland and Western Australia. Genetically modified crop field trials inspected included canola, Indian mustard, wheat, barley, cotton, sugarcane, Perennial Ryegrass/Tall Fescue and white clover.
The OGTR also inspected 25% of higher level containment facilities to ensure compliance with certification conditions. These inspections focus on the integrity of the physical structure of the facility and on the general laboratory practices followed in that facility.
KPI: Protect people and the environment through identification and management of risks from GMOs
2012-13 Reference Point: High level of compliance with the gene technology legislation and no adverse effect on human health or environment from GMOs
- Routine monitoring of the regulated community demonstrated a high level of compliance with the gene technology legislation. The OGTR identified a small number of minor non-compliances or alleged breaches during routine monitoring of containment facilities and licensed dealings involving GMOs. In all instances, the Regulator determined that findings of non-compliances presented negligible risk to human health and safety or the environment, were minor in nature, involved negligible or zero culpability, and were resolved by reminders, education and/or cooperative compliance. No adverse effects on human health or the environment were reported.
KPI: Facilitate cooperation and prevent duplication in the implementation of GMO regulation
2012-13 Reference Point: High degree of cooperation with relevant regulatory agencies
- The Regulator consulted with other regulatory agencies before making decisions for all intentional release licence applications for GMOs to ensure that any risks to human health or the environment were managed effectively through coordinated action plans. The Regulator also maintained Memoranda of Understanding with these agencies to facilitate exchange of regulatory science information and cooperation.
The Regulator and OGTR facilitated cooperation and harmonisation through the Regulatory Science Network, Regulators Forum, the Regulators Community of Practice Forum and through bilateral cooperation with individual regulators.
OGTR engaged in international forums focusing on the harmonisation of the risk assessment and regulation of GMOs including with the OECD, WHO and Cartagena Protocol on Biosafety.
OGTR contributed to capacity building workshops and conferences on risk assessment and regulation of GMOs including in the region covered by the Association of South/South East Asian Nations, Ghana, United Kingdom, Japan, USA and Europe. OGTR also hosted a study tour for delegates from Bhutan.
KPI: Percentage of licence decisions made within statutory timeframes
2012-13 Target: 100%
2012-13 Actual: 100%
- The Regulator made decisions on all licence applications within the applicable statutory timeframes, maintaining the 100% record of previous reporting periods. There were no appeals of decisions made under the gene technology legislation.
Program 1.5: Immunisation
Program 1.5 aims to strengthen immunisation coverage and ensure a cost-effective process for the supply of vaccines.
Strengthen immunisation coverage
Australia has high rates of immunisation, with more than nine out of 10 children being fully immunised. In 2012-13, the Department continued to provide free vaccines to the Australian community through the National Immunisation Program (NIP).
High immunisation rates were maintained in 2012-13 with more than 91.3% of children at one, two and five years of age fully immunised – a steady improvement on the previous year. This was further strengthened in 2012-13 by linking eligibility with the Family Tax Benefit Part A supplement to encourage parents to fully immunise their children. The Australian Government, through the Department, rewarded all states and territories with incentive payments as they had met performance targets listed in the National Partnership Agreement on Essential Vaccines.
However, while overall immunisation rates remain high, the proportion of Aboriginal and Torres Strait Islander children fully immunised at one year of age remains lower than all other children of the same age. Over the past decade, there have been significant increases in the immunisation coverage rates for Indigenous children across all age groups, with coverage for children over five years improving from just under 60% in 2004 to just over 92% in 2013.
The National Partnership Agreement on Essential Vaccines between the Commonwealth and the states and territories has a specific performance benchmark aimed at increasing immunisation coverage rates for Indigenous children. In July 2012, parents’ eligibility for the Family Tax Benefit Part A supplement was linked to the immunisation status of their children at three age check points – one, two and five years of age. These arrangements create a strong financial incentive for parents to ensure their children are fully immunised.
Figure 1.1: Immunisation coverage – proportion of children fully immunised,36 by age, and Indigenous status, 2004-2013
In 2013, the Department saw an increase in demand from those eligible to receive free influenza vaccination under the NIP. More than 4.27 million doses of influenza vaccine were ordered by states and territories compared to an average of 3.7 million doses in previous years. There was also increased demand for influenza vaccine for the private market. The Australian Government has worked closely with vaccine providers to ensure enough influenza vaccine is available for those most at risk of severe influenza.
Following a series of adverse events in 2010, namely febrile convulsions in children, bioCSL Fluvax® was not approved by the TGA for use in children under five from late 2010. The 2013 seasonal influenza campaign communicated the correct use of influenza vaccines in children to GPs and immunisation providers. However, a small number of GPs and immunisation providers administered the bioCSL Fluvax® influenza vaccine to children under five years of age. These providers were followed up by state and territory health authorities. The Department has implemented several measures during 2013 to address this issue and will build on these in 2014. Actions include packaging alerts on bioCSL Fluvax® syringes; targeted messaging to all immunisation providers and monitoring of incorrect vaccine usage through the Australian Childhood Immunisation Register to promptly identify and follow-up with providers where bioCSL Fluvax® was given to children under five years of age.
All states and territories started implementing the extended National Human Papillomavirus (HPV) Vaccination Program in schools in early 2013. The Department led a national communication campaign, developed in consultation with states and territories. To better monitor adverse events following immunisation for HPV, the Department enhanced the existing surveillance system. This included implementation of a rapid school-based reporting of four acute types of adverse events. As expected, there was an increase in reported adverse events due to the increased number of vaccinations being given. However, no unexpected adverse events occurred and no safety concerns have been identified in males or females.
The HPV vaccine coverage rate for Australian girls aged 15 years who have received all three doses is 71.2% and remains among the best in the world, with vaccination coverage already resulting in significant disease prevention. The prevalence of vaccine-preventable HPV type infections in cervical specimens of females aged 18-24 years decreased significantly from 29% to 7%, four years after the female vaccination program began. This will lead to a reduction in the burden of illness and death due to cervical cancer over time.37 There is already a substantial decline in genital warts amongst females under 21 years (92.6%) and aged 21-30 years (72.6%); and heterosexual males under 21 years (81.8%) and aged 21-30 years (51.1%).38 The National Immunisation Strategy 2013-18 builds on the past successes of the NIP and identifies the following eight key strategic priority areas aimed at strengthening the NIP:
- improve immunisation coverage;
- ensure effective governance of the NIP;
- ensure secure vaccine supply and efficient use of vaccines for the NIP;
- continue to enhance vaccine safety monitoring systems;
- maintain and ensure community confidence in the NIP through effective communication strategies;
- strengthen monitoring and evaluation of the NIP through assessment and analysis of immunisation register data and vaccine-preventable diseases surveillance;
- ensure an adequate skilled immunisation workforce through promoting effective training for immunisation providers; and
- maintain Australia’s strong contribution to the region.
The Department, in conjunction with states and territories, will start implementing the strategy in 2013-14.
Deliverable: Release the National Immunisation Strategy
2012-13 Reference Point: Strategy released by 30 June 2013
Result: Substantially Met
- The strategy covering the period 2013-18 was endorsed by the Australian Health Ministers’ Advisory Committee in June 2013 but is yet to be considered by the Standing Council on Health and has not been released. Development of the strategy was overseen by the National Immunisation Committee which reports to the Australian Health Protection Principal Committee through the Communicable Diseases Network Australia.
Deliverable: Develop and disseminate information for health professionals, providers and consumers on immunisation programs
2012-13 Reference Point: New edition of the Australian Immunisation Handbook released Inform parents about changes to eligibility for Family Tax Benefit Part A supplement related to immunisation Nationally agreed protocols for identifying and responding to adverse events following immunisation developed
- In 2012-13, the Department developed materials to inform health professionals, immunisation providers and consumers.
The 10th edition of the Australian Immunisation Handbook, was released in 2013 and distributed to all Australian immunisation providers including GPs, relevant specialist doctors, nurses, midwives and Aboriginal health workers. The handbook provides clinical guidelines for health professionals and is based on the best available scientific evidence. The latest edition provides the most up-to-date clinical information on the safest and most effective use of vaccines in Australia.
The Department reminded parents and immunisation providers of the need for parents to fully immunise children during the financial years that each child turns one, two and five years of age, to obtain the Family Tax Benefit Part A supplement for that period.
The Department distributed a number of communication materials to immunisation providers and parents in preparation for the rollout of the new combined measles-mumps-rubella-varicella (MMRV) vaccine on 1 July 2013.
The 5th edition of Myths and Realities – Responding to arguments against vaccination was distributed to relevant health care professionals in June 2013. This booklet responds to some common myths and concerns encountered by health professionals when discussing vaccinations with parents or patients.
To support the launch of the extended National HPV Vaccination Program, the Department ran a national communication campaign which included fact sheets for parents, adolescents and health professionals; information kits, including brochures and posters, for schools; and a HPV website.39 In addition, an ongoing communication campaign was implemented for Aboriginal and Torres Strait Islander students and parents, as well as targeting culturally and linguistically diverse communities.
Deliverable: Number of completed tenders under the National Partnership Agreement on Essential Vaccines (Essential Vaccines Procurement Strategy)
2012-13 Target: 2
2012-13 Actual: 3
- During 2012-13, the Department finalised three tender processes as it continued to centralise procurement and contract management processes for vaccines provided under the NIP. The tenders were for the extension of the HPV vaccine program to males and continuation of the vaccine for females; meningococcal C/Haemophilus influenzae type b vaccine; and MMRV vaccines.
KPI: States and territories meet requirements of the National Partnership Agreement on Essential Vaccines
2012-13 Reference Point: The performance benchmarks are used to assess state and territory performance and consist of:
1. maintaining or increasing vaccine coverage for Indigenous Australians
2. maintaining or increasing coverage in agreed areas of low immunisation coverage
3. maintaining or decreasing wastage and leakage
4. maintaining or increasing vaccination coverage for four year olds
- All states and territories met benchmarks and were eligible to receive reward payments.
KPI: Maintain the immunisation coverage rates among children 12-15 months of age
2012-13 Target: 91.8%
2012-13 Actual: 91.3%
Result: Substantially met
- Immunisation rates in 2012-13 continued to be high with the national immunisation rate for children aged 12-15 months at 91.3%. This compares to 91.8% in 2011-12 and 91.5% in 2010-11.
KPI: Maintain the immunisation coverage rates among children 24-27 months of age
2012-13 Target: 92.7%
2012-13 Actual: 92.4%
Result: Substantially met
- Immunisation rates in 2012-13 continued to be high with the national immunisation rate for children aged 24-27 months at 92.4%. This compares to 92.6% in 2011-12 and 91.9% in 2010-11.
KPI: Improve the immunisation coverage rates among children 60-63 months of age
2012-13 Target: 88.5%
2012-13 Actual: 91.5%
- Immunisation rates in 2012-13 continued to be high with the national immunisation rate for children aged 60-63 months at 91.5%. This compares to 90.0% in 2011-12 and 89.2% in 2010-11.
Improve the efficiency of the National Immunisation Program
The Review of the management of adverse events associated with Panvax® and Fluvax® (Horvath review) was undertaken following the 2011 flu season, during which a number of children who were immunised with these vaccines experienced adverse reactions. All seven recommendations of the review have been substantially implemented. Specifically, the Advisory Committee on the Safety of Vaccines was established to advise the Department on vaccine safety and regulatory matters. An improved national system for timely reporting of adverse events was put in place, along with a National Protocol for Program Action which will operate in the event a safety signal arises from an unwanted or unexpected event following administration of a vaccine under the NIP.
In 2012-13, tender processes were completed for the supply of meningococcal C and varicella (‘chicken pox’) vaccines. These vaccines are now included in the list of vaccines that are needed for a child to be considered ‘fully immunised’ to receive Family Tax Benefit Part A. Both the meningococcal C and varicella vaccines are now provided as part of combination vaccines for young children, reducing the overall number of immunisation injections which need to be provided.
Further tender processes will be undertaken in 2013-14 for vaccines under the NIP and in accordance with the Essential Vaccine Procurement Strategy.Top of Page
Program 1.6: Public health
Program 1.6 aims to increase the health of the public through a range of targeted health programs.
Increase the evidence base for the development of targeted health programs
The Department continues to gather information through several national health surveys to ensure that health programs and policies are based on strong evidence of the health issues affecting the community.
Australian Health Survey
A series of reports with results from the 2011-13 Australian Health Survey on the general population have been released during 2012-13: first results in October 2012, health service usage and related actions in February 2013, and updated results in June 2013. Results on the physical activity component of the survey were released in July 2013 and results from the biomedical component of the survey were released in August 2013.
Key findings from the survey include:
- 90% of Australians aged two years and over did not meet the recommendations for fruit and vegetable intake in 2011-12;
- 72% of two to four year olds, 19% of 5-17 year olds and 43% of adults met the physical activity recommendations for their age group in 2011-12;
- Adults living in areas of greatest disadvantage were less likely to meet the physical activity recommendations (34%) compared with those living in areas of least disadvantage (52%);
- In 2011–12, 5.1% of Australians aged 18 years and over had diabetes. This comprised 4.2% with known diabetes and 0.9% with diabetes newly diagnosed from the results of their blood tests;
- In 2011–12, one in three Australians aged 18 years and over (32.8% or 5.6 million people) had abnormal or high total cholesterol levels according to their blood test results; and
- People who were obese were nearly five times as likely as those who were of normal weight or underweight to have high triglycerides (25.3% compared with 5.3%) and more than twice as likely to have lower than normal levels of HDL ‘good’ cholesterol (36.2% compared with 14.1%).
Further results from the survey are available from the Australian Bureau of Statistics website: www.abs.gov.au.
Deliverable: Undertake the Australian Health Survey
2012-13 Reference Point: High level results for the survey in the general population will be available in October 2012, with more detailed results available from May 2013 The survey in the Aboriginal and Torres Strait Islander population will be conducted throughout 2012-13: commencing in May 2012 and continuing to July 2013
- The Department has funded the Australian Bureau of Statistics to undertake the Australian Health Survey. The Department has worked with the ABS to guide the development of the survey and dissemination of outputs. Survey results for the general population were released during 2012-13. First results were released in October 2012. Health service usage and related actions were released in February 2013 and updated results were released in June 2013. Physical activity results were released in July 2013 and biomedical results for chronic disease were released in August 2013. Nutrition results for the general population will be released in 2013-14. The Aboriginal and Torres Strait Islander component of the survey was conducted in 2012-13. First results from this collection will be released in late 2013.
Australian Longitudinal Study on Women’s Health
The sixth Australian Longitudinal Study on Women’s Health (ALSWH) major report Adherence to Health Guidelines: Findings from the Australian Longitudinal Study on Women’s Health, was released in September 2012. The report covered preventative health behaviours around issues such as smoking, overweight and obesity, physical activity and diet, as well as selected health screenings such as mammography, pap smear and bowel cancer.
Among women participants in the ALSWH, adherence to guidelines on smoking, alcohol consumption and most health screens has steadily increased or has remained high since the commencement of the study. However, there are substantial differences between recommended health guidelines and actual behaviours relating to energy balance (diet, physical activity, and obesity).
Further results for the ALSWH are available from the ALSWH website at www.alswh.org.au.
Australian Longitudinal Study on Male Health
As field work is still underway for the Australian Longitudinal Study on Male Health (ALSMH), results from this study are not yet available.
Deliverable: Undertake the Australian Longitudinal Study on Male Health (ALSMH) and the Australian Longitudinal Study on Women’s Health (ALSWH)
2012-13 Reference Point: ALSWH: Recruitment of the new young women’s cohort (born 1989-94) will commence in October 2012 ALSMH: A dress rehearsal of the ALSMH survey instruments will occur in late 2012. Wave 1 data collection40 will commence in early 2013 and be completed by June 2013
Result: Substantially met
- Recruitment of the ALSWH new young group began in October 2012. ALSMH Dress Rehearsal (pilot testing) occurred in October 2012 and Wave 1 data collection began in mid-2013. This was later than anticipated as pilot testing did not produce the desired survey response rates and further work was required to identify a survey recruitment approach that would provide higher response rates. Wave 1 data collection will be completed by mid-2014.
KPI: Strengthened evidence base to inform targeted health policy and program activities
2012-13 Reference Point: Results from the Australian Health Survey, Australian Longitudinal Study on Women’s Health and Australian Longitudinal Study on Male Health increase the amount of information available to researchers and policy makers
Result: Substantially met
- Information continues to be gathered through the surveys detailed above in order to inform targeted health policy and program activities.
Improve child and youth health
The Department continues to work with states and territories to develop meaningful guidelines and frameworks to strengthen and improve child and youth health.
Deliverable: Completion of the Clinical Practice Guidelines for Antenatal Care
2012-13 Reference Point: Module Two of the Guidelines (covering the second and third trimesters of pregnancy) will be completed by June 2013
Result: Substantially met
- Module One of the Guidelines (which covers the first trimester) was released in March 2013 and is available on the Department’s website. A complete draft of Module Two was released for public comment on 1 June 2013. Following consideration of feedback and completion of any amendments, Module 2 will need to be approved by the Australian Health Ministers’ Advisory Council, its relevant subcommittees and the National Health and Medical Research Council before its anticipated public release in mid-2014.
KPI: Delivery of health services for children in out-of-home care is consistent, evidence based and appropriate
2012-13 Reference Point: State and territory governments report on the successful implementation of the National Clinical Assessment Framework for Children in Out-of-Home care
Result: Substantially met
- State and territory governments are at different stages of implementing the National Clinical Assessment Framework for Children and Young People in Out-of-Home Care. The Department continues to monitor this work through the Standing Committee on Child and Youth Health. This committee works collaboratively with the Department of Families, Housing, Community Services and Indigenous Affairs to monitor the ongoing implementation of the framework and to strengthen it further.
Improve men’s and women’s health
An increasing range of innovative programs – many of them lifestyle related – are contributing to the health and wellbeing of Australian men and women.
In 2012-13, the Department continued to fund activities to support men’s health. These included the National Shed Development Program and other support for Men’s Sheds, promoting Men’s Health Week and funding Andrology Australia to address men’s sexual and reproductive health needs.
The Department also continued to facilitate meetings of the Minister’s Male Health Reference Group, and to liaise with other Australian Government agencies on cross-agency issues affecting men’s health, such as employment and workplace safety.
The Department also maintained its support for women’s health activities, including the Jean Hailes Foundation and a number of new initiatives. Key among these was the Department’s support for targeted action on female genital mutilation (FGM). This included facilitating a summit, which brought together representatives across government, peak bodies and community groups. A National Compact on FGM was issued following the summit, to reinforce Australia’s position on FGM and encourage collaborative action to best support the women and girls in Australia affected by FGM and help prevent it from occurring to a new generation. The Department funded FGM grants to support further action. Grants were focused on community awareness and education, workforce training and evidence building activities to help increase understanding of FGM, improve health services and support, and help communities move towards abandoning the practice.
Promote healthy lifestyle choices
The Department continues to deliver policies which encourage healthy lifestyle choices, including healthy eating and physical activity.
Deliverable: Number of grants to local governments administered through the Healthy Communities Initiative
2012-13 Target: 92
2012-13 Actual: 92
- The Healthy Communities Initiative provided funding to 92 local government areas to implement a range of community-based healthy lifestyle programs that facilitate increased access to physical activity, healthy eating and healthy weight programs and activities for adults predominately not in the paid workforce. All 92 local government councils implemented a range of healthy lifestyle programs for the target group in their communities.
During 2012-13, the Department began the revised Stephanie Alexander Kitchen Garden National Program which aims to improve nutrition and develop lifelong healthy eating habits in primary school children. The program now allows teachers to deliver the program as well as specialist staff, provides online support and has also relaxed infrastructure requirements. The changes will result in a greater number of primary school children being taught about growing, harvesting, preparing and sharing healthy food.
|Program||(A) Budget Estimate 2012-13
|(B) Actual 2012-13
|Variation (Column B minus Column A)
|Program 1.1: Prevention, Early Detection and Service Improvement|
|Ordinary Annual Services (Annual Appropriation Bill 1)||92,377||93,179||802|
|Expenses not requiring appropriation in the current year2||461||767||306|
|Total for Program 1.1||107,947||109,071||1,124|
|Program 1.2: Communicable Disease Control|
|Ordinary Annual Services (Annual Appropriation Bill 1)||10,653||9,628||( 1,025)|
|Departmental Appropriation1||4,962||4,810||( 152)|
|Expenses not requiring appropriation in the current year2||148||239||91|
|Total for Program 1.2||15,763||14,677||( 1,086)|
|Program 1.3: Drug Strategy|
|Ordinary Annual Services (Annual Appropriation Bill 1)||208,704||195,588||( 13,116)|
|Departmental Appropriation1||27,461||27,251||( 210)|
|Expenses not requiring appropriation in the current year2||833||1,385||552|
|Total for Program 1.3||236,998||224,224||( 12,774)|
|Program 1.4: Regulatory Policy|
|Ordinary Annual Services (Annual Appropriation Bill 1)||5,177||4,899||( 278)|
|Departmental Appropriation1, 3||17,439||17,594||155|
|to Special Accounts||( 11,854)||( 11,854)||-|
|Expenses not requiring appropriation in the current year2||153||326||173|
|OGTR Special Account||8,001||7,848||( 153)|
|NICNAS Special Account||14,532||13,186||( 1,346)|
|TGA Special Account||131,310||119,543||( 11,767)|
|Expense adjustment4||( 7,448)||3,330||10,778|
|Expenses not requiring appropriation in the current year2||-||38||38|
|Total for Program 1.4||157,310||154,910||( 2,400)|
|Program 1.5: Immunisation|
|Ordinary Annual Services (Annual Appropriation Bill 1)||25,259||27,101||1,842|
|to Australian Childhood Immunisation Register|
|Special Account||( 2,847)||( 3,047)||( 200)|
|National Health Act 1953 - essential vaccines||80,278||81,157||879|
|Australian Childhood Immunisation Register Special Account||6,457||9,174||2,717|
|Departmental Appropriation1, 3||4,927||4,540||( 387)|
|Expenses not requiring appropriation in the current year2||160||224||64|
|Subtotal for Program 1.5||114,234||119,149||4,915|
|Program 1.6: Public Health|
|Ordinary Annual Services (Annual Appropriation Bill 1)||16,009||15,902||( 107)|
|Other Services (Annual Appropriation Bill 2)||15,226||14,980||( 246)|
|Expenses not requiring appropriation in the current year2||231||386||155|
|Total for Program 1.6||39,082||38,899||( 183)|
|Outcome 1 Totals by appropriation type|
|Ordinary Annual Services (Annual Appropriation Bill 1)||358,179||346,297||( 11,882)|
|to Special Accounts||( 2,847)||( 3,047)||( 200)|
|Other Services (Annual Appropriation Bill 2)||15,226||14,980||( 246)|
|Departmental Appropriation1||77,514||76,951||( 563)|
|to Special Accounts||( 11,854)||( 11,854)||-|
|Expenses not requiring appropriation in the current year2||1,986||3,327||1,341|
|Special Accounts||146,395||143,945||( 2,450)|
|Total expenses for Outcome 1||671,334||660,930||( 10,404)|
|Average Staffing Level (Number)||1,227||1,223||( 4)|
- Departmental appropriation combines ‘Ordinary annual services (Appropriation Bill 1)’ and ‘Revenue from independent sources (s31)’.
- ’Expenses not requiring appropriation in the budget year’ is made up of depreciation expense, amortisation, make good expense and audit fees. This estimate also includes approved operating losses - please refer to the departmental financial statements for further information.
- The budget estimate for the departmental appropriation to support the Australia and New Zealand Therapeutic Products Agency has been correctly reclassified from program group 1.5 to program group 1.4. 4
- Special Accounts are reported on a cash basis. The adjustment reflects the difference between cash and expenses.