BackgroundThe National Blood-borne Virus (BBV) and Sexually Transmissible Infections (STI) Surveillance and Monitoring Plan is a supporting document to the National Strategies for BBVs and STIs. The Plan has been developed to measure progress towards reaching the goals of the National Strategies.
National Strategies, 2010-2013On 22 April 2010, the Australian Health Ministers’ Conference endorsed a suite of National Strategies for the prevention and management of HIV, STIs, hepatitis B and hepatitis C, including in Aboriginal and Torres Strait Islander communities. The National Strategies are:
- Sixth National HIV Strategy 2010 – 2013
- Second National Sexually Transmissible Infections Strategy 2010 – 2013
- Third National Hepatitis C Strategy 2010 – 2013
- National Hepatitis B Strategy 2010 – 2013
- Third National Aboriginal and Torres Strait Islander Blood Borne Viruses and Sexually Transmissible Infections Strategy 2010 – 2013. The aims of these National Strategies are to reduce the transmission of HIV, STIs, hepatitis B and hepatitis C, and to reduce the morbidity, mortality and personal and social impacts they cause. Each of the National Strategies outlines a set of indicators for monitoring progress towards these goals. The development of a surveillance and monitoring plan for reporting against these indicators was identified in the National Strategies as a key step in the implementation process.
Development of the National BBV and STI Surveillance and Monitoring PlanThis National BBV and STI Surveillance and Monitoring Plan details how each of the indicators in the National Strategies will be measured and reported, and outlines the next steps that need to be taken for measures that are not currently reported. The development of the National BBV and STI Surveillance and Monitoring Plan was led by a steering committee under the auspices of the Communicable Diseases Network Australia (CDNA). The formal process consisted of these key actions:
- Consultation with key national policy and surveillance organisations from all jurisdictions
- Establishment of the National BBV and STI Surveillance and Monitoring Plan Steering Committee. The Steering Committee was chaired by Dr Christine Selvey, the Queensland Representative on CDNA, and reported to CDNA. The Steering Committee included experts from all jurisdictions and from a range of backgrounds including researchers, policy officers, surveillance officers, and other stakeholders (see Appendix).
- Establishment of five area-specific working groups (one for each of the National Strategies) that made recommendations of how to measure the indicators for the five National Strategies, and identified potential barriers and resource burdens for measuring each indicator. Recommendations were made to vary some of the indicators in the National Strategies to make them more relevant and feasible.
- The working groups, Steering Committee and other stakeholders met at a national workshop in April 2011. The purpose of the workshop was to prioritise data collection for each of the indicators, review the resource burden of the proposed measures, and to discuss implementation, reporting and governance of the National BBV and STI Surveillance and Monitoring Plan.
- The Plan has been endorsed by the Australian Health Protection Committee and the Australian Population Health Development Principal Committee.
Implementation and governanceImplementation of the National BBV and STI Surveillance and Monitoring Plan will require substantial work and will be overseen by the National BBV and STI Surveillance Sub-Committee of CDNA. The Sub-Committee will provide advice to CDNA on the staging of the implementation of the National BBV and STI Surveillance and Monitoring Plan, and oversee the annual implementation and reporting on the Plan.
Key implementation and governance issues include:
- Establishing new data collections: Some data components identified in this National BBV and STI Surveillance and Monitoring Plan rely on the establishment of new surveillance systems, new models or data linkage between existing data sets. Some new data collections can only proceed should new resources become available. In some cases, multiple organisations may have the capacity to develop and implement the surveillance system, should resources become available.
- Management of data sources with non-recurrent funding: Some of the data sources named in this National BBV and STI Surveillance and Monitoring Plan do not have recurrent funding and thus may not be reportable on an ongoing basis. A mechanism is required for routine monitoring of data sources that have non-recurrent funding sources.
- Improving representation of marginalised groups: It is important to ensure that data collections represent the entire population of interest, and additional efforts are required to ensure the inclusion of marginalised groups in existing and new data collections. Key areas for action include:
- Improving the representation of Aboriginal and Torres Strait Islander people in surveys
- Improving the completeness of recording of Indigenous status in notification data, Medicare and other data collections.
ReportingReports for the National BBV and STI Surveillance and Monitoring Plan will be published annually for the life of the National Strategies, being until 2013. The data required for these reports will be collected by a range of organisations and from different populations.
The Kirby Institute will be responsible for collating the annual reports. Where data defined in the plan is not currently available, the Kirby Institute will consult with key stakeholders and organisations with capacity to provide these data, and present CDNA with recommendations for obtaining these data. Another agency may be requested by CDNA to provide this advice to CDNA if considered more appropriate.
Indicators will be reported by jurisdiction for the previous calendar year unless otherwise specified in the Indicator Table (Section 2 of this document). Where data are available for some but not all jurisdictions, data will be reported for jurisdictions where available. For some indicators, it may be possible and appropriate to present more detailed analyses stratifying by age, gender and other variables. As part of the reporting process, the Kirby Institute will determine the most appropriate stratification for each indicator. The Kirby Institute may also, where appropriate, include data from sources not currently named in the Indicator Table, for example new data that becomes available during the life of this Plan.
The indicators presented in this report are drawn directly from the five National BBV and STI Strategies and provide information about how Australia is progressing in controlling BBVs and STIs in terms of disease incidence, morbidity and risk behaviours. However, the indicators are not a comprehensive set of data that measures all aspects of the BBV and STI ‘landscape’ in Australia. What is not well-represented in this Plan is the myriad of social factors and complex human behaviours that underlie the transmission of BBVs and STIs, or the clinical environment in which BBV and STI testing and treatment takes place. An understanding of these factors is crucial to our national response to BBVs and STIs.