Online version of the 2012-13 Department of Health and Ageing Annual Report
- The increasing resistance to antibiotics poses serious risks to our health. To respond to what is described by the World Health Organization as “a looming crisis”, the Department, along with the Department of Agriculture, Fisheries and Forestry, established the Australian Antimicrobial Resistance Prevention and Containment Steering Group.
- Australia continues to be well placed to deal with new and emerging threats, following our response to the 2013 avian influenza outbreak. The Department worked closely with the World Health Organization, other Australian Government agencies and stakeholders to implement systems to detect, collect information and report on cases should they occur in Australia.
- Maintain the Department’s regulatory capacity to process the increase in applications for licences and permits to import, export and manufacture controlled drugs and substances.
- Provide an effective regulatory response to the emergence of synthetic drugs.
42.9% SUBSTANTIALLY MET
0% NOT MET
|Period||Met||Substantially met||Not met|
Program contributing to Outcome 14
Outcome 14 aims to strengthen the nation’s capacity to identify, monitor and implement effective and sustained responses to national health emergencies and risks. In 2012-13 the Department worked to achieve this Outcome by managing initiatives under the program outlined below.
Program 14.1: Health emergency planning and response
Program 14.1 aims to provide national health emergency planning and response, improve biosecurity, drug and chemical safety, and minimise the risks posed by communicable diseases.
National health emergency planning and response
The Australian Government’s capacity to support a response to a health emergency was maintained through replenishment of pharmaceuticals and personal protective equipment for the National Medical Stockpile. In 2012-13, the Department worked collaboratively with BioCSL to ensure the national capacity for antivenom production was maintained. In addition, the Department provided increased funding to BioCSL to guarantee the continued production and distribution of antivenom products to state and territory health departments.
The Department works collaboratively with states and territories to ensure Australia has the capacity to detect, assess and respond to the spread of disease, and to provide an appropriate public health emergency response. The Department also supports developing countries and countries with economies in transition to build, strengthen and maintain their core public health capacities.
In 2012-13, the Department continued to fund and collaborate with the National Critical Care and Trauma Response Centre based at Royal Darwin Hospital to maintain and improve a state of preparedness for response to major onshore and offshore incidents both in Australia and South East Asia. The Centre enhances preparedness nationally through a variety of activities such as trauma and disaster training for local and interstate clinicians. In addition, the Department continues to fund the Australian Red Cross Society for a broad range of health-related humanitarian work and community development activities. These include disaster preparedness and response, first aid and refugee support services nationally.
Deliverable: Develop, exercise and refine national health emergency policy under the National Health Emergency Response Arrangements
2012-13 Reference Point: National Health Emergency Response Arrangements will be exercised and revised and an annex detailing health response to a terrorist incident will be developed
Result: Substantially met
- In 2012-13, the Department developed and revised plans and guidelines underpinning the National Health Emergency Response Arrangements, including the development of a Criminal and Terrorism Incident Annex to support the Domestic Response Plan for Mass Casualty Incidents of National Consequence.
The Department is also close to finalising the new Health Chemical, Biological, Radiological and Nuclear Incidents of National Consequence (CBRNINC) Plan. The Health CBRNINC Plan is the domestic response plan which provides an agreed framework and mechanism for the effective national coordination, response and recovery arrangements for chemical, biological, radiological and nuclear incidents of national consequence. The final CBRNINC Plan and the Chemical Guidelines are scheduled to be finalised by November 2013. The Anthrax and Radiological Guidelines have been finalised and are available on the Department’s website.94 The Smallpox Guidelines is scheduled to be available in April 2014.
Revision of the Australian Health Management Plan for Pandemic Influenza (AHMPPI)95
The AHMPPI presents a framework that allows for tailored measures appropriate to the severity of any pandemic and the availability of resources. The AHMPPI is being revised and is incorporating recommendations made in the Review of Australia’s Health Sector Response to Pandemic (H1N1) 2009: Lessons identified. The revised AHMPPI will focus on the government health sector, building on existing seasonal influenza systems and governance mechanisms. It is based on a targeted emergency response approach, which will assist decision makers to communicate more easily with others outside the health sector. It also allows for a more flexible public health response, which can be varied to suit the level of impact of the pandemic and the needs of the community.
Extensive stakeholder consultation has been undertaken with health sector advisory bodies, industry peak bodies, Australian and jurisdictional government agencies and clinical stakeholder groups.
A Surveillance Plan for Pandemic Influenza is also being developed in collaboration with the states and territories as a component of the revised AHMPPI. This will ensure that a national plan is available for the timely and efficient collection of the data necessary to implement a pandemic response.
A full draft is expected to be available by the end of 2013.
KPI: Containment of national health emergencies through the timely engagement of national health coordination mechanisms and response plans
2012-13 Reference Point: National responses to health emergencies are successfully managed
- The Australian Health Protection Principal Committee, chaired by the Chief Medical Officer of the Department, coordinates and supports national health emergency management. In 2012-13, the committee considered and agreed to policies on Australian Medical Assistance Team arrangements, pandemic influenza preparedness and asbestos guidelines for householders and the general public. The committee held five short notice extraordinary meetings to discuss heatwave and burns preparedness, preparedness for a potential avian influenza outbreak, the Asbestos – a guide for householders and the general public and a shortage of the HospiraŽ – DBL Morphine Sulfate Injection.95
On 31 March 2013, Chinese authorities notified the World Health Organization (WHO) of the identification of avian influenza A (H7N9) in three people. As this was the first time H7N9 had been identified in humans, immediate monitoring and surveillance of this influenza strain was activated by the WHO. In the last official update provided by the WHO on 7 June 2013, 132 people had laboratory-confirmed infections of H7N9 and 37 people had died. The majority of people infected with H7N9 displayed influenza-like symptoms such as fever, cough, headache, muscle ache and fatigue. The virus has shown no evidence of sustained or efficient human-to-human transmission. The Department responded to this outbreak in collaboration with other Australian Government agencies, the states and territories, and health experts through key committees and working groups.
The Department’s immediate response to the H7N9 outbreak was to coordinate the development of a working case definition, the review of relevant border measures, review of stocks of personal protective equipment, the preparation of public health laboratory capacity and procedures, and the development of public health communication materials.
The Department also provided regularly updated information on its website, including general information for the public, specific advice for Australians travelling in or returning from China, and advice to clinicians, laboratories and GPs. The Department’s daily surveillance activities and epidemiological analyses informed a regular situation report that was distributed to key internal and external stakeholders including the WHO.
Leaflets providing information for travellers with specific advice about H7N9 and what to do if feeling unwell were prepared for distribution at international airports across Australia.
In coordinating the response to this outbreak, the Department engaged with WHO, the Australian Health Protection Principal Committee, the Communicable Diseases Network of Australia, the Public Health Laboratory Network, the Pandemic Review Implementation Advisory Committee, the Department of Foreign Affairs and Trade, the Australian Customs and Border Protection Service, and the Department of Agriculture, Fisheries and Forestry.
The actions demonstrate that the Department has built on the success of the national response to the 2009 influenza pandemic and is well situated to deal with new and emerging threats, with systems in place to detect, collect information and report on cases should they occur in Australia.
Improve biosecurity, drug and chemical safety
The Department undertakes human health risk assessment policy and practice for veterinary medicines and pesticides on behalf of the Australian Pesticides and Veterinary Medicines Authority (APVMA).
The Department is responsible for updating and maintaining the Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP). The SUSMP publishes the schedules which form a national classification system that controls how medicines and poisons are made available to the public.
The Department is responsible for ensuring that Australia fulfils its obligations under international agreements relating to the regulation of chemicals and for collecting statistics about chemicals.
The Department continued to provide advice to the APVMA about the public health effects of human exposure to chemicals and pesticides. The Department also considered the toxicology profile and intended uses of chemicals (and the products that contain them) and provided recommendations to APVMA on whether they were safe for use.
KPI: Perform human health risk assessments and regulate access to chemicals and drugs
2012-13 Reference Point: Chemical assessments completed in a timely manner and authorisation to access drugs and chemicals issued in accordance with legislative requirements
Result: Substantially met
- In 2012-13, the Department, through the Office of Chemical Safety, continued to undertake human health risk assessments for the APVMA. The Department conducted 81 assessments, and recommended against granting some applications on human health grounds. The Department continued to develop and maintain the database of health standards arising from these assessments (for example, acceptable daily intake and acute reference dose values, which provide reference points against which agricultural and veterinary chemicals are regulated).
The assessments of agricultural and veterinary chemicals provided to the APVMA were comprehensive, accurate and of good quality. Ongoing difficulty in recruiting appropriate staff meant that the Department did not meet its timeframe target –– 2012-13 (52%) compared to 2011-12 (61%). Timeframe compliance is expected to continue to improve in 2013-14.
Deliverable: Update and maintain the Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP)
2012-13 Reference Point: SUSMP to be amended as soon as practicable after the Secretary’s, or the Secretary’s delegate’s, final decision under the Therapeutic Goods Regulations 1990
- In 2012-13, a total of 82 scheduling decisions were made under the Therapeutic Goods Regulations 1990, with 45 being delegate-only decisions and 37 being made following advice from an advisory committee. All decisions requiring amendments to the Standard for the Uniform Scheduling of Medicines and Poisons were published within acceptable timeframes.
Management of controlled substances
Australia is a signatory to three international drug conventions – the Single Convention on Narcotic Drugs of 1961, the Convention on Psychotropic Substances of 1971 and the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988. These conventions enable international cooperation in ensuring access to essential medications, while minimising the potential for diversion into illicit use.
Under these conventions, the Department is the Competent National Authority for Australia, and administers a framework for controlling the manufacture, import, export and supply of internationally controlled drugs in Australia. It does this with cooperation from the Australian Customs and Border Protection Service, law enforcement agencies and states and territories.
As required by the international drug conventions, in 2012-13 the Department monitored the stock and manufacture of internationally controlled drugs and monitored approximately 3.6 million wholesale transactions of these drugs within Australia. The data collected contributed to Australia’s reporting obligations, under the international drug conventions, and assisted states and territories with monitoring potential drug diversions.
Australia is a major global producer of narcotic materials from poppy cultivation, providing almost half the world’s legal supply. Careful control and supervision of all stages of poppy growing and production of narcotic raw materials is required under the international drug conventions. To facilitate this, the Department issued manufacturing licenses and permits under the Narcotic Drugs Act 1967 to regulate supply of narcotics, and provided regular reports on the cultivation areas, harvest and narcotic production to the International Narcotic Control Board to enable better regulation of global narcotic drug supply.
The Department cooperated with other countries to control the export of chemicals (precursors) that have the potential to be used to manufacture illicit drugs. Pre-export notifications provide an early warning system to countries and customs authorities of chemical shipments which may be diverted from licit channels. In 2012-13, there were 1,691 pre-export notifications processed by the Department for all precursor substances controlled under the international drug conventions.
An escalation of emerging drugs, including new psychoactive substances (NPS), and a continued rise in import and export activities has continued to present a challenge to the Department’s capacity to process applications to import and export drugs in a timely manner while ensuring regulatory compliance and meeting international reporting obligations. For 2012-13, the focus was on ensuring access to essential medications was maintained. This resulted in a 15% increase from 2011-12 in applications completed on time.
In 2012-13, the Department started regulating new drugs, which included six classes of synthetic cannabinoids and eight NPS. In addition, the Department moved to harmonise the import regulations with controlled drugs and prohibited drugs which are scheduled in the Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP). The SUSMP provides the states and territories with guidance to enable consistent drug controls. By aligning the import regulations with the SUSMP, the Department and Customs add a further level of control at the Australian border, which assists drug control activities.
Deliverable: Percentage of applications for the import, export, and manufacture of controlled substances that are assessed and processed within agreed timeframes
2012-13 Target: 95%
2012-13 Actual: 90%
Result: Substantially met
- In 2012-13, the Department issued a total of 7,955 licences and permits authorising the import, export and manufacture of controlled drugs, an increase of 4.7% from 2011-12. This increase and related activities contributed to processing being outside the target of 95%.
The Department also issued 1,692 pre-export notifications (a decrease of 2.6% from 2011-12) and recorded an 18% increase in formal statements provided to law enforcement agencies.
With the increasing challenge of NPS, international obligations and the need to ensure regulatory compliance to avoid regulatory failure, applications completed within timeframes will be placed under further stress for 2013-14.
Minimise the risks posed by communicable diseases
The communicable disease issues facing Australia are diverse and associated with foodborne diseases, zoonoses, antimicrobial resistant (AMR) bacteria, sexually transmissible infections, vector-borne diseases, and vaccine preventable diseases. New and emerging diseases, such as Middle Eastern Respiratory Syndrome Coronavirus also pose a potential threat to public health.
The Department conducted national surveillance on 65 communicable diseases through the National Notifiable Diseases Surveillance System (NNDSS) which enabled health authorities to respond to outbreaks in a timely manner. Additional surveillance data were also collected through the National Influenza Surveillance Scheme and OzFoodNet.Top of Page
Deliverable: Collect and disseminate data in the National Notifiable Disease Surveillance System (NNDSS) and monitor data quality in accordance with the National Health Security Act 2007
2012-13 Reference Point: Data is collected and available for regular reporting by the Commonwealth and adhoc requests by stakeholders, including for publication in the Department’s journal Communicable Diseases Intelligence
- The Department continued to support the ongoing and systematic collection, analysis and reporting of surveillance data related to domestic and international incidents of communicable and foodborne diseases. The Department used relevant data sources, including the NNDSS and links with WHO to identify outbreaks and predict communicable disease trends.
In 2012-13, the Department provided relevant and timely surveillance data and reports to the Communicable Diseases Network Australia and other relevant committees for enhanced monitoring. Communicable disease surveillance reports were completed and disseminated on schedule. These included the National Arbovirus and Malaria Advisory Committee annual report, fortnightly reports through the Communicable Diseases Network Australia, seasonal influenza reports during the 2012 influenza season and monthly measles and annual tuberculosis and polio reports to the WHO. Four quarterly issues of the journal, Communicable Disease Intelligence, were also published in 2012-13.
In collaboration with states and territories, the Department’s National Surveillance Committee and other subcommittees worked to improve the quality, timeliness and completeness of national surveillance data. States and territories also collaborated with the Department on the Case Definition Working Group to ensure that nationally agreed case definitions were used by all jurisdictions for consistent case notifications.
Throughout the influenza season, influenza data were collected from all components of the national influenza surveillance system, and was analysed and reported fortnightly to decision makers, health professionals and the public.
The Department continued to work with the Influenza Surveillance Strategy Working Group to develop the national influenza surveillance systems to ensure that the epidemiology and virology of influenza across Australia can be measured.
In addition, the Department continued to fund Queensland Health to monitor and control the spread of Aedes albopictus mosquitos in the Torres Strait. Reports submitted by Queensland Health showed progress towards project objectives. In 2012-13, ongoing surveillance indicated that there was no established exotic mosquito (Aedes albopictus) population on mainland Australia, thus restricting the spread of dengue fever and other mosquito-borne diseases.
The Department funded OzFoodNet to enhance surveillance and investigation of foodborne disease in Australia in conjunction with jurisdictions. In 2012-13, OzFoodNet conducted an outbreak investigation of listeriosis with 34 cases, from six jurisdictions identified linked to products from a Victorian manufacturer of soft cheese. The Department liaised with state and territory authorities, the Communicable Diseases Network of Australia, and Food Standards Australia and New Zealand to identify the link between the consumption of soft cheese and these cases. Data from OzFoodNet’s National Enhanced Listeriosis Surveillance System was used to identify and monitor this outbreak.
OzFoodNet also continues to gather evidence on outbreaks of gastroenteritis associated with the consumption of raw or minimally cooked eggs. Foods commonly served with an uncooked raw egg ingredient such as chocolate mousse, tiramisu and sauces (aioli and mayonnaise) have been linked to outbreaks of salmonellosis. Data from the OzFoodNet Outbreak Register show that in 2011, around 20% of the outbreaks investigated by OzFoodNet were linked to the use of raw or minimally cooked egg.
Antimicrobial resistance (AMR) occurs when a microorganism (including bacteria, fungi, viruses and some parasites) becomes resistant to an antimicrobial medicine to which it was originally susceptible. The WHO describes AMR as a “looming crisis” in which common and treatable infections are becoming life threatening with potential for substantial increases to health care system costs and financial burden to the community. In 2012-13, the Department began to develop a national antimicrobial resistance strategy. This will benefit all Australians by preserving the usefulness of antibiotics important to human and animal health and reducing costs to the health care system.
In 2012-13, the Biosecurity Bill 2012 was introduced into Parliament to replace the century old Quarantine Act 1908. This Bill sought to provide a modern regulatory framework to better manage biosecurity risks, including human health risks entering, establishing and spreading in Australia. The Bill was to be jointly administered by the Department and the Department of Agriculture, Fisheries and Forestry.
KPI: Percentage of designated points of entry into Australia capable of responding to public health events, as defined in the International Health Regulations
2012-13 Target: 100%
2012-13 Actual: 100%
- All airports and seaports designated under the International Health Regulations must have an emergency plan in place to address human health emergencies.
(A) Budget Estimate 2012-13
(B) Actual 2012-13
Variation (Column B minus Column A)
|Program 14.1: Health Emergency Planning and Response 1|
|Ordinary Annual Services (Annual Appropriation Bill 1)||26,883||22,998||( 3,885)|
|Non cash expenses - write down of assets 2||38,147||36,297||( 1,850)|
|Human Pituitary Hormone Special Account||150||150||-|
|Departmental Appropriation 3||24,208||23,151||( 1,057)|
|Expenses not requiring appropriation in the current year4||1,515||1,769||254|
|Total for Program 14.1||90,903||84,365||( 6,538)|
|Outcome 14 Totals by appropriation type|
|Ordinary Annual Services (Annual Appropriation Bill 1)||26,883||22,998||( 3,885)|
|Non cash expenses||38,147||36,297||( 1,850)|
|Departmental Appropriation 3||24,208||23,151||( 1,057)|
|Expenses not requiring appropriation in the current year 4||1,515||1,769||254|
|Total expenses for Outcome 14||90,903||84,365||( 6,538)|
|Average Staffing Level (Number)||163||160||( 3)|
- This program includes National Partnerships paid to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.
- Non cash expenses relate to the write down of the drug stopckpile inventory due to expiration, consumption and distribution.
- 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.