Online version of the 2014-15 Department of Health Annual Report

Outcome 9: Biosecurity and Emergency Response

Preparedness to respond to national health emergencies and risks, including through surveillance, regulation, prevention, detection and leadership in national health coordination

Page last updated: 16 October 2015

Major Achievements

  • Effectively led Australia’s domestic response to the West African outbreak of Ebola Virus Disease (Ebola) and provided advice to Government with regard to appropriate Ebola preparedness activities, including national guidelines and border protection measures.
  • Developed Australia’s first National Antimicrobial Resistance Strategy in response to the serious threat to both human and animal health posed by the increasing resistance to antibiotics.
  • Managed Australia’s response to the outbreak of Middle East Respiratory System coronavirus (MERS-CoV) in the Middle East and Korea, including active monitoring and development of response and preparedness plans, and the provision of high quality tailored, public information.
  • Coordinated the national public health response to an outbreak of hepatitis A, associated with the consumption of a particular brand of imported frozen mixed berries, through the Department’s National Incident Room (NIR). This response covered multiple key issues including the OzFoodNet multi-jurisdictional outbreak investigation, safety of the national blood supply, national hepatitis A vaccine supply and publication of communication material.
  • Developed the human health aspects of the Biosecurity Act 2015 (the Act). The Act will fully replace the Quarantine Act 1908 in managing biosecurity risks at Australia’s international borders, including the movement of people, goods and conveyances.
  • Continued protection of human health through advice to the Australian Pesticides and Veterinary Medicines Authority (APVMA) on the public health effects of human exposure to, and toxicology profile of, chemicals regulated as veterinary medicines and pesticides.

Challenges

  • Ongoing monitoring and surveillance against the risk of an imported case of Ebola, MERS-CoV and other emerging infectious disease.
  • Maintaining Australia’s highly effective tuberculosis (TB) control.
  • Improving the Department’s regulatory capacity to process licences and permits to import, export and manufacture controlled drugs and substances in a timely manner, in a worldwide environment of escalating emerging drugs and a rise in usage, while ensuring regulatory compliance and meeting international reporting obligations.
  • Adapting to legislative and process changes from the APVMA, while maintaining an effective health and safety review of agricultural and veterinary chemicals.

Looking Ahead

The Department will undertake a number of key activities in 2015-16, including continuing work to revise the National Action Plan for Human Influenza Pandemic, continuing to work with the Department of Agriculture and State and Territory health departments in the implementation of the Biosecurity Act 2015, working with key stakeholders to develop an Implementation Plan for the National Antimicrobial Resistance Strategy 2015-2019, and developing a national laboratory containment plan in line with the World Health Organization (WHO) global action plan to minimise poliovirus facility-associated risk.

The Department will continue to support effective and efficient regulation of pesticides and veterinary medicines by the APVMA by providing expert and timely advice relating to the health and safety of people using or exposed to agricultural and veterinary chemicals.

Programme Contributing to Outcome 9

Divisions Contributing to Outcome 9

In 2014-15, Outcome 9 was the responsibility of Office of Chemical Safety, Office of Health Protection and the Therapeutic Goods Administration.

Programme Performance

In 2014-15, the Department worked to achieve this Outcome by managing initiatives under the programme outlined in the following pages.

Trends

In 2014-15, the Department achieved an improvement in the proportion of its human health risk assessments for the APVMA completed on time compared to the previous two years, resulting in the best performance since 2009-10. This was achieved through actively recruiting and training regulatory scientists, and working closely with the APVMA on prioritisation of assessment tasks.


Figure 9.1: Human health risk assessments

The figure shows the number of Human health risk assessments from 2011-12 to 2014-15. In 2014-15, assessments met timeframe compliance 68% of the time.

Programme 9.1: Health Emergency Planning and Response

Programme 9.1 aims to provide national health emergency planning and response, improve biosecurity, drug and chemical safety, and minimise the risks posed by communicable disease by monitoring and assessing current and emerging population health risks.

National health emergency planning and response

As part of the ongoing work on national health emergency planning and response, the Department works closely with the States and Territories via the Australian Health Protection Principal Committee (AHPPC) to ensure timely and well-coordinated responses to domestic and regional health incidents. The Department also coordinates health responses to public health events of national significance from the National Incident Room.

In 2014-15, the Department led the domestic response to the West African outbreak of Ebola Virus Disease (Ebola). The Department provided advice to Government with regard to appropriate Ebola preparedness activities including national guidelines and border protection measures. In consultation with other Government agencies, the AHPPC and its standing committees, a number of measures were implemented to ensure that Australia was well prepared to manage an imported case of Ebola including infection prevention and control, emergency management, nursing and communicable diseases control. The Department worked in collaboration with the WHO and other Government agencies to increase preparedness, and minimise any impact of an imported case of Ebola to the region, with a focus on Timor-Leste, Papua New Guinea and Pacific Island countries.

The Department was also the lead agency in the management of Australia’s response to the outbreak of Middle East Respiratory System coronavirus (MERS-CoV) in the Middle East and Korea. As part of this role, the Department undertook active monitoring and development of response and preparedness plans, and prepared high quality, tailored public information.

Health responses were undertaken for two international emergencies in the region, specifically Vanuatu and Nepal. An Australian Medical Assistance Team (AUSMAT) was deployed to provide primary and emergency care to Vanuatu following Cyclone Pam in March 2015, and two AUSMAT trained medical personnel were deployed to Nepal to assist health coordination and assessment efforts in the wake of the earthquake in April 2015.

Also in 2014-15, the Department continued to fund and guide the National Critical Care and Trauma Response Centre (the Centre) to ensure the Centre was able to respond rapidly to major incidents in both Australia and South East Asia. The Department also developed the Australian Clinical Guidelines for Acute Exposure to Chemical Agents of Health Concern: A Guide for the Emergency Department Staff, and is in the process of reviewing the national response guidelines for smallpox.

The National Action Plan for Human Influenza Pandemic is being revised, following Exercise Panda in 2014, in which key stakeholders from Commonwealth, State, Territory and local Governments discussed whole-of-government pandemic influenza arrangements. Initial consultation of a draft revised plan has commenced. The formal process of approval is expected to commence in late 2015.

Qualitative Deliverable: Develop, exercise and refine national health emergency policy under the National Health Emergency Response Arrangements.
2014-15 Reference Point: National Health Emergency Response Arrangements will be exercised and revised and an emergency response plan for communicable diseases and environmental health threats of national significance will be developed.
Result: Met
In August 2014, the Department brought together stakeholders from Commonwealth, State, Territory and local Governments for a discussion exercise – Exercise Panda, the results of which were used to inform a major review of Australia’s national influenza preparedness.

The Department participated in two regional Ebola response workshops in January and March 2015 to examine the processes and actions around deploying physical assistance under the Ebola Regional Contingency Plan, in particular to clarify entities’ roles and responsibilities and identify potential gaps in preparedness and deployment procedures.
Qualitative KPI: Containment of national health emergencies through the timely engagement of national health coordination mechanisms and response plans.
2014-15 Reference Point: National responses to health emergencies are successfully managed.
Result: Met
During 2014-15, the NIR responded to 154 health related incidents, compared with 158 incidents in 2013-14. The NIR’s most frequent type of response was to assist States and Territories and other National Focal Points conduct contact tracing of travellers who had been exposed to disease through contact with an infected person. Tuberculosis was the most common disease that triggered contact tracing in 2014-15, followed by measles. The NIR was also activated to assist with an OzFoodNet multi-jurisdictional outbreak investigation into 33 cases of hepatitis A, linked to the consumption of a particular brand of frozen mixed berries.

Information exchange, including sensitive personal information, is vital for coordinating a response. The Department is required to report annually on the exchange of personal information in accordance with the National Health Security Agreement. Personal information was exchanged with Responsible Bodies and National Focal Points in relation to 108 incidents during 2014-15.

National Medical Stockpile

In 2014-15, procurement activities were undertaken to replenish expired items in the National Medical Stockpile.

$7.4 million was invested to support the replenishment of 13 pharmaceuticals, and fund disposal of expired stock and the annual insurance premium. Ongoing implementation of key reform activities were also undertaken to a total value of $15.4 million. As at 30 June 2015, the value of the National Medical Stockpile was approximately $210 million.

Reforms to the National Medical Stockpile are continuing. An open tender process was released by the Department on 30 January 2015, and at 30 June 2015 negotiations were about to commence with the preferred tenderer for a Prime Vendor for the Stockpile. Negotiations have also commenced with the States and Territories for a new National Stockpiling Agreement.

A new four year strategic plan and revised risk management framework have also been developed for the National Medical Stockpile.

Improve biosecurity, drug and chemical safety

The Department is responsible for ensuring that Australia fulfils its obligations under the international drug conventions relating to the import, export, and manufacture and use of internationally controlled drugs.

As required by the international drug conventions, in 2014-15 the Department monitored the stock and manufacture of internationally controlled drugs and monitored approximately 4.5 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 licences and permits under the Narcotic Drugs Act 1967 to regulate the 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 chemical 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 2014-15, there were 971 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, 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, however focus has been on ensuring access to essential medications is maintained.

The Australian Government continued to administer the Security Sensitive Biological Agents Regulatory Scheme which aims to limit the opportunities for acts of bioterrorism or biocrime to occur using harmful biological agents. During 2014-15, there was a high level of compliance demonstrated by the regulated community with 327 reports submitted and 29 inspections conducted under the Scheme.

The Security Sensitive Biological Agents Regulatory Scheme continues to work with entities handling biological agents to support national security objectives.

Qualitative Deliverable: Update and maintain the Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP).
2014-15 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.
Result: Met
All decisions requiring amendments to the SUSMP were published within acceptable timeframes.
Quantitative Deliverable: Percentage of applications for the import, export, and manufacture of controlled substances that are assessed and processed within agreed timeframes.
2014-15 Target: 95%
2014-15 Actual: 85%
Result: Substantially met
During 2014-15, 85% of applications were assessed and processed. Relocation of the Drug Control Section in August 2014 led to unexpected disruptions to the infrastructure required to issue licences and permits. Processes were affected for several months, however these issues have since been rectified.

In 2014-15, the Department issued a total of 7,272 licences and permits authorising the import, export and manufacture of controlled drugs, a decrease of 7.8% of total issued licences and permits from 2013-14, primarily due to the cessation of issuing import permissions for khat for personal use.

The Department also issued 971 pre-export notifications and provided 214 statements to law enforcement agencies.
11-1212-1313-14
75%90%99%
Qualitative KPI: Perform human health risk assessments and regulate access to chemicals and drugs.
2014-15 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 2014-15, the Department, through the Office of Chemical Safety, continued to undertake human health risk assessments for the APVMA. The Department completed 100 assessments, and recommended against granting some applications on human health grounds. Timeframe compliance increased to 68%, which is the highest timeframe compliance rate since 2009-10.

Minimise the risks posed by communicable diseases

The communicable disease issues facing Australia are diverse, including those associated with foodborne diseases, zoonoses, antimicrobial resistant (AMR) bacteria, sexually transmissible infections, blood borne viruses, vector-borne diseases, bacterial infections and vaccine preventable diseases. In 2014-15, the Department responded to international disease outbreaks, such as the Ebola outbreak in West Africa, and continued to respond to diseases, such as MERS-CoV, that pose a potential public health threat to Australia (for further information refer to National health emergency planning and response in this chapter).

Quantitative KPI: Percentage of designated points of entry into Australia capable of responding to public health events, as defined in the International Health Regulations (2005).
2014-15 Target: 100%
2014-15 Actual: 100%
Result: Met
The Department continues to develop national guidelines for the public health management of communicable diseases. In 2014-15, the Department coordinated the development of national guidelines for seven nationally notifiable diseases – Dengue fever, Ebola, hepatitis C, Human Immunodeficiency Virus (HIV), Invasive Meningococcal Disease, Measles and MERS-CoV.
11-1212-1313-14
100%100%100%
Surveillance

The Department continues to work in collaboration with other Australian Government entities and State and Territory Governments to ensure the collection of quality surveillance data in order to monitor and respond to public health risks. The Department also works with States and Territories through committees such as the Communicable Disease Network Australia to ensure the national coordination of communicable disease surveillance, prevention and control. Robust and timely disease surveillance ensures that Australia is able to detect, assess and respond to both domestic and international communicable disease threats.

The Department continues to provide national surveillance on 66 communicable diseases through the National Notifiable Diseases Surveillance System allowing timely detection and response to outbreaks and trends.

To support the national Human Papillomavirus (HPV) Program, in 2014-15, the Department implemented a national surveillance system to monitor the prevalence of HPV in the population, a first in Australia.

Border and Port Surveillance

The Department continues to ensure that all ports and airports are able to respond to public health events, in compliance with the WHO International Health Regulations (2005). The Department works with border entities including the Department of Agriculture and the Department of Immigration and Border Protection to implement human health policies at the border and develop strategies for raising public awareness of travel health issues and emerging diseases that may impact on travellers.

The new Biosecurity Act 2015 (the Act) received Royal Assent on 16 June 2015, and will subsequently commence operation on 16 June 2016. The Act will fully replace the Quarantine Act 1908 in managing biosecurity risks at Australia’s international borders. In 2015-16, the Department will continue working with the Department of Agriculture and State and Territory health departments to develop subordinate legislation, work instructions and policy to support the implementation of the Act.

In 2014, the Australian Government committed to the WHO End Tuberculosis (TB) Strategy and its ambitious targets to end the global TB epidemic by 2035. Australia has had excellent TB control since the mid-1980s but our proximity to high-incidence countries in the Asia-Pacific region and its increasing migrant intake means domestic TB control continues to be a challenge. Although Australia has a robust pre-migration screening programme, excellent health care systems, strong governance frameworks and surveillance systems already in place, achieving the goals set by the WHO to reduce incidence will be challenging. Australia is already a low-incidence country and efforts to further reduce TB incidence domestically will likely require an increased focus on screening for latent TB infections in both pre and post migration settings.

Influenza Surveillance

In 2014-15, the Department funded the National Influenza Surveillance Scheme to collect, analyse and report on influenza data throughout the influenza season. Reports were provided fortnightly during the influenza season. The Department worked with the National Influenza Surveillance Committee to develop national influenza surveillance systems to ensure that the epidemiology and virology of influenza across Australia can be measured.

OzFoodNet

OzFoodNet is funded by the Department to enhance surveillance and investigation of foodborne disease in Australia in conjunction with jurisdictions. From February to May 2015, OzFoodNet conducted a multi-jurisdictional investigation into an outbreak of hepatitis A associated with the consumption of a particular brand of imported frozen mixed berries, leading to a voluntary recall of the product. The Department’s NIR was activated to coordinate the national public health response in the early stages of the outbreak. At the close of OzFoodNet’s investigation on 27 May 2015, there were 33 notified cases from 6 jurisdictions. The berries were the only common exposure for all cases.

During 2014-15, OzFoodNet also continued to closely monitor an increase in the incidence of salmonellosis which began in late 2013. OzFoodNet liaised with stakeholders, including investigating the effect of changing laboratory methodologies on foodborne disease notifications.

Exotic Mosquito Surveillance

In 2014-15, the Department also continued to fund a programme to monitor and control the spread of exotic mosquitoes (Aedes albopictus) in the Torres Strait. Reports submitted by Queensland Health showed progress towards project objectives, having supported cross border communications between Queensland and Papua New Guinea to reduce communicable disease risk in the Torres Strait. Ongoing surveillance indicated that there was no mainland detection of albopictus during the reporting period, thus restricting the spread of dengue fever and other mosquito-borne diseases in the region.

Antimicrobial Resistance (AMR)

In 2014-15, the Department established the Australian Strategic and Technical Advisory Group (ASTAG) on AMR. ASTAG provided technical, scientific and clinical advice to inform the development of the National Antimicrobial Resistance Strategy 2015-2019. ASTAG will also provide strategic advice to help ensure actions under the Strategy are effectively and efficiently implemented. The Strategy was released in June 2015. The Department continued to fund the Australian Commission on Safety and Quality in Health Care to improve national surveillance of antibiotic usage and resistance; and provided funding to the WHO to support regional and global initiatives to respond to AMR.

Qualitative Deliverable: Stakeholders are consulted on the development of the National AMR Strategy.
2014-15 Reference Point: A discussion paper on the National AMR Strategy released for stakeholder input by the end of 2014.
Result: Met
Developing a National Antimicrobial Resistance Strategy for Australia: A Discussion Paper from the Australian Antimicrobial Resistance Prevention and Containment Steering Group was provided to around 160 stakeholders in October 2014. Around 60 stakeholders provided submissions, which helped to inform development of the final National Antimicrobial Resistance Strategy.

Outcome 9 – Financial Resource Summary

  Budget
Estimate
2014-15
$’000
(A)
Actual
2014-15
$’000
(B)
Variation
$’000
(B) - (A)
Programme 9.1: Health Emergency Planning and Response1
Administered expenses
Ordinary annual services (Appropriation Act No. 1)nfp39,477N/A
Non cash expenses - write down of assets23,2283,2357
Special accounts
Human Pituitary Hormone Special Account16018222
Departmental expenses
Departmental appropriation323,65523,114(541)
Expenses not requiring appropriation in the current year41,2371,623386
Total for Programme 9.128,28067,631N/A
Outcome 9 Totals by appropriation type
Administered expenses
Ordinary annual services (Appropriation Act No. 1)nfp39,477N/A
Non cash expenses3,2283,2357
Special accounts16018222
Departmental expenses
Departmental appropriation323,65523,114(541)
Expenses not requiring appropriation in the current year41,2371,623386
Total expenses for Outcome 928,28067,631N/A
Average staffing level (number) 121 121 -
  1. This Programme includes National Partnerships payments to State and Territory Governments by the Treasury as part of the Federal Financial Relations Framework.
  2. Non cash expenses relate to the write down of the drug stopckpile inventory due to expiration, consumption and distribution.
  3. Departmental appropriation combines ‘Ordinary annual services (Appropriation Act No. 1)’ and ‘Revenue from independent sources (s74)’.
  4. ‘Expenses not requiring appropriation in the budget year’ is made up of depreciation expense, amortisation, make good expense and audit fees.