Australian Health Management Plan for Pandemic Influenza (2009)

A. Decision making structures

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The Council of Australian Governments (COAG) will lead the national whole of government response supported by the National Pandemic Emergency Committee (NPEC). These arrangements are outlined in the NAP, which is available from www.pmc.gov.au.

Health sector coordination at a national level

A range of committees have provided advice for the development of health sector pandemic plans at a national level. These planning and preparedness committees are described in Part 3, Section A1.

Some of these committees will continue to have an operational role in the event of a pandemic. However, to ensure rapid and streamlined decision making in a pandemic, the number and composition of the committees will be changed once the DELAY phase begins. A description of the streamlined response committee structure that would be operational from DELAY onwards is outlined in Part 3, Section A2.

A1. Planning and preparedness structure

Coordination of national health sector preparedness in the ALERT phase

Figure 3 outlines the health sector committees that are operational in the ALERT phase. A description of the terms of reference and membership of each committee is detailed in the text that follows.

The committees broadly fall into three different functional categories:

• strategic decision making committees
• expert advisory committees
• operational committees.

These functional categories are represented by different colours. The figure describes the major linkages and reporting lines. The cross communication linkages that occur between many groups and networks depicted in the bottom row of the diagram are not shown.

Figure 3: Health sector coordination in the ALERT phase


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Health sector strategic decision making at a national level

The AHPC is chaired by a Deputy Secretary from the DoHA and membership includes the CMO, the Chief Health Officers (CHO) of the states and territories, and representatives of Australian Government organisations involved in emergency management and response. The AHPC reports through the Australian Health Ministers’ Advisory Council (AHMAC), to the Australian Health Ministers’ Conference (AHMC) to advise them on preparedness activities to achieve the health sector goal.

Health sector expert advice

The AHPC is supported by technical advisory committees:

• The Communicable Diseases Network Australia (CDNA) is a subcommittee of the AHPC and provides communicable disease and epidemiological advice. Membership of the CDNA comprises human health and veterinary representatives from the Australian Government, human health representatives from the state and territory governments and from organisations in the communicable diseases field, as well as academic experts.
• The Public Health Laboratory Network (PHLN) is a subcommittee of the AHPC that comprises representatives of the major public health laboratories in all the states and territories. It provides advice to the AHPC around the laboratory aspects of pandemic planning.

In addition to the technical advisory committees that report directly to the AHPC, the CMO also provides technical advice to the AHPC. The CMO is supported in this role by a number of technical advisory committees including:

• The EAG provides medical, scientific and epidemiological advice to the CMO on the pandemic phase and the triggers that should be considered when a decision is made to change the phase.
• The Chief Medical Officer’s Scientific Influenza Advisory Group (SIAG) provides medical, scientific and evidence based advice to the CMO, and has developed and will continue to review the pandemic planning assumptions during the ALERT phase and the implications for planning and response across all Operational Objectives (except Operational Objective 2.4 Vaccination). Membership comprises experts in the fields of influenza clinical management, epidemiology, public health, virology, animal health management and influenza research.
• The Chief Medical Officer’s Vaccine Advisory Group (VAG) provides advice to the CMO on aspects of vaccines that could be used to control a pandemic virus—Operational Objective 2.4 Vaccination.

Health sector operational advice:

The following groups provide operational advice to the CMO and the AHPC in the ALERT phase:

• The Inter-jurisdictional Pandemic Planners Working Group (IPPWG), whose membership includes the person responsible for pandemic planning in each state and territory, work to ensure national consistency, where required, in jurisdictional operational responses except those relating to vaccination.
• The National Health Emergency Media Response Network (NHEMRN) provides advice to the AHPC and coordinates the public communications response in a pandemic (Operational Objective 1.2). The NHEMRN comprises media liaison managers in Australian Government, state and territory agencies, the medical colleges and professional associations.
• The Chief Quarantine Officers (CQO) group provides operational planning for border activities (Operational Objective 2.2).
• The Australian Health Protection Committee/National Immunisation Committee (AHPC/NIC) Pandemic Vaccine Working Group on vaccines provides operational advice to AHPC on the use of pandemic vaccines (Operational Objective 2.4). Members of the National Immunisation Committee are national immunisation coordinators.

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A2. National response structure

Australia’s emergency management arrangements are based on partnerships between the Australian Government, state, territory and local governments and the community. State and territory governments have the constitutional responsibility for emergency management within their jurisdictions. Through cooperative arrangements with states and territories, the Australian Government may be requested to help and can provide:

• a communication hub
• support for states and territories to develop capacity for dealing with emergencies and disasters
• assistance to states or territories when requested by using national assets or coordinating sharing of other state and territory assets
• the services of EMA to coordinate national response and recovery activities.

These arrangements allow all levels of Australian Government to work together to prevent, plan, respond to and recover from a range of emergencies such as a pandemic. These arrangements and governance are formalised in a range of emergency planning and response documents maintained by EMA.

Coordination in health sector from the DELAY phase onwards

One of the outcomes from Exercise Cumpston ‘06 was the need to streamline decision making in the emergency response phase. This section will outline how the committee structures described above will be rationalised during an influenza pandemic.

Once DELAY is announced, the committees will merge to enable a streamlined process for emergency decision-making (Figure 4). Note the figure describes major linkages and reporting lines–cross linkages have not been shown.

Figure 4: Key health sector committees during the response to a pandemic


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<h3>]National health sector strategic decision makingFrom the DELAY phase onwards, the Secretary of the DoHA and the CEO from state and territory Departments of Health, will join the AHPC at decision points, such as when making major strategic decisions or when developing advice to inform a whole of government response including to the National Pandemic Emergency Committee (NPEC).

This group will meet at turning points in the development of a pandemic overseas and will meet regularly if a pandemic spreads to Australia. Within each jurisdiction, members of this group will advise their own Minister for Health. However, Health Ministers may meet as part of AHMC if extraordinary measures are required, or if the expanded AHPC strategic decision making committee cannot reach consensus.

Health sector expert advice

The expanded AHPC strategic decision making committee will receive expert technical advice from the CMO as required.

The CMO will be supported by the following technical advisory committees:

• The EAG will continue to advise the CMO on the pandemic phases.
• The Chief Medical Officer’s Scientific Pandemic Advisory Group (SPAG) will review the pandemic planning assumptions and the medical and scientific basis for health sector interventions, and provide advice to the CMO on the need to modify response policies in light of any new information. SPAG will combine expertise from:
  • SIAG
  • VAG

Health sector operational advice

The NHEMRN will provide advice to the AHPC on the implementation and coordination of the public communications response to a pandemic for the health sector. The expanded AHPC will consider operational and expert technical advice from the Pandemic Control Network (PCN) as part of their strategic decision-making. In addition, the expanded AHPC committee may request the PCN to coordinate specific operational elements of the national response as required.

The PCN will combine expertise from the following groups:

• CDNA
• PHLN
• CQO
• IPPWG
• AHPC/NIC.

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This information is current for 21 May, 2013
This information was issued on 01 November, 2010