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National Leadership Development Seminar

Professor Jim Bishop AO, Chief Medical Officer, Department of Health and Ageing, addresses the Australian Medical Students Association 2009

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Slide 1 - National Leadership Development Seminar

Professor James Bishop AO
MD MMed MBBS FRACP FRCPA
Chief Medical Officer
Australian Government
Australian Medical Students Association 2009








Slide 2 - Cancer in NSW 1972 - 2005 Males


Slide 3 - Cancer in NSW 1972 - 2005 Females


Slide 4 - Changes in death rates in males using joinpoint analysis

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Slide 5 - Changes in deaths rates in females using joinpoint analysis


Slide 6 - Cancers with reducing death rates 1997 to 2006 – all ages

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Slide 7 - Milestones in Cancer

• Adjuvant treatment of breast, lung and bowel cancer
• Study of new anti-cancer and symptom control drugs
• Public health measures in smoking reduction
• Enhancement of cancer research and support in NSW
• Data linkage and analysis

Slide 8 - Projected YLLs – Three scenarios, Australia, 1980 - 2016


Slide 9 - Cost effectiveness of smoking cessation pharmacotherapies in males

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Slide 10 - Results: Comparison of total costs by stage of disease (per cent deviation from average costs)


Slide 11 - The difference between localised and regional extent of disease at diagnosis


Slide 12 - Modelling Cumulative cancer deaths from 2006 in NSW

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Slide 13 - Burden of major disease groups, 2003


Slide 14 - Broad cause mortality trends, Australia

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Slide 15 - Australia compares well among OECD


Slide 16 - Australian Government Cancer Related Initiatives

• Preventative Health Task Force
• Primary Care Strategy
• National Health and Hospital Reform Commission
• National Health Care Agreements - $64billion over 5 years

Slide 17 - PANDEMIC (H1N1) 2009
Impact and Response in Australia


Slide 18 - The Australian Health Management Plan for Pandemic Influenza (AHMPPI)

• The AHMPPI (2008): third edition of the national health management plan
• Revised as a result of Exercise Cumpston 06

–Addressing policy gaps
–Streamlined decision making
–More flexible policy
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Slide 19 - Phases
ALERT – preparation
DELAY – prevent entry from overseas
CONTAIN – limiting early spread
SUSTAIN – waiting for vaccine
CONTROL – using vaccine to control spread
RECOVER – returning to normal

Slide 20 - Pandemic H1N1 2009 Timeline
24 Apr - Who announces novel human influenza
27 Apr - WHO moves to Pandemic phase 4
28 Apr - Australia moves to Pandemic DELAY
29 Apr - WHO moves to Pandemic phase 5
22 May - Australia moves to Pandemic CONTAIN
03 Jun - Victoria moves to MODIFIED SUSTAIN
11 Jun - WHO moves to Pandemic phase 6
17 Jun - Australia moves to Pandemic PROTECT

Slide 21 - DELAY Phase


Slide 22 - Australian Health Protection Committee (AHPC)

• The key decision-making body for health emergencies

– Chaired by DoHA Deputy Secretary
– Commonwealth CMO, S/T Chief Health Officers
– Experts in mental health, emergency medicine, communicable diseases

• Preparedness role

–Develops national health emergency policies and plans

• Response role in health emergencies

– Inter-jurisdictional coordination
– Supported by the National Incident Room and expert advisory groups
– Manages the National Medical Stockpile
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Slide 23 - CONTAIN phase
Actions taken during CONTAIN included:

• Continuation of the measures commenced in DELAY, including border measures, and case and contact management

– Keep measures under review to determine when they are no longer effective or need modification

• Increase public messaging
• Consider other measures in the pandemic plan such as school closures and cancelling mass gatherings.

Slide 24 - H1N1 Influenza 09, mild in most and severe in some (the vulnerable)

Evidence supports focusing efforts on protecting the ‘vulnerable’

Australia's response is continual informed by the emerging evidence around the virus and effectiveness of control measures

• ALERT - (pre 24 April 09)
• DELAY - (24 April 09)
• CONTAIN - (22 May 09)
• SUSTAIN - Victoria moved to a MODIFIED SUSTAIN (on 3 June 2009)
• CONTROL
• RECOVER

Slide 25 - H1N1 Influenza 09 information for PROTECT

• Highest attack rates in younger age groups

– Unlike seasonal influenza

• Majority have mild symptoms
• Approximately 2% develop severe illness or complications
• Severe illness more likely in vulnerable groups

– including some not seen with seasonal influenza, e.g. morbid obesity

• Geographic variation

– Little or no transmission in some regions and communities
– Containment strategies feasible to protect vulnerable in some areas
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Slide 26 - Key Statistics
As of 31 August 2009:

• 35,474 Confirmed Cases
• 4,559 Hospitalisations (Total)
• 69 ICU Admissions (Current)
• 161 Deaths

Slide 27 - Figure 1. Laboratory confirmed cases of pandemic (H1N1) 2009 in Australia, to 21 August 2009, by jurisdiction.


Slide 28 - Figure 2. Influenza activity in Australia, by reporting week, years 2007, 2008 and 2009

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Slide 29 - Figure 3. Rate of ILI reported from GP ILI surveillance systems from 2007 to 16 August 2009, by week


Slide 30 - Figure 4. Number of Emergency Department presentations due to ILI in Western Australia from 1 January 2007 to 16 August 2009, by week

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Slide 31 - Figure 5. Rate of ILI diagnosed in people presenting to selected Emergency Departments, NSW 1 January 2005 to 7 August 2009, by month


Slide 32 - Figure 6. Rates of absenteeism of greater than 3 days absent, National employer, 1 January 2007 to 12 August 2009, by week

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Slide 33 - Figure 7. Hospitalisations of pandemic (H1N1) 2009, 15 June to 21 August 2009, Australia


Slide 34 - Figure 8. Age specific rates of hospitalised confirmed cases of pandemic (H1N1) to 21 August 2009, compared with average annual age specific rates of hospitalisations from seasonal influenza 2004-05 to 2006-07, Australia


Slide 35 - Key lessons so far
1. Value of planning
2. Leadership and co-ordination
- NPEC
- AHPC
3. Flexibility
4. Medical innovations
5. Communication
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