PATRICIA KARVELAS, HOST:
The COVID 19 pandemic is far from over, with 40 per cent of the world population still unvaccinated. Here at home, more than 200,000 cases are circulating in the community, while well over 9000 people have died. Against such a backdrop, Health Minister, Mark Butler, is taking part in a G20 meeting of the world's richest countries to thrash out ways to better prepare and respond to future disease threats. He joins us now from our Parliament House studio. Good morning, Minister.
MARK BUTLER, MINISTER FOR HEALTH AND AGED CARE:
Good morning, Patricia.
KARVELAS:
You are meeting with health ministers from across the globe. Is there any sense of when the pandemic will be over? When will we finally be able to declare COVID 19 - well, the pandemic element - over?
BUTLER:
It's a time away still and I think we understand that - particularly in Australia, we still have many thousands of new infections every day. There are still more than- almost 3000 people in hospital with COVID and we're seeing dozens of deaths still every day as well. So we still have quite a way to get through this pandemic. But we're obviously moving into a new phase, particularly in a country like Australia with very high levels of vaccination, although we could do better on booster rates. We're obviously moving to a new phase, and at the G20 Health Ministers meeting that I've been attending over the last 24 hours, we're starting to work out ways where we can learn the lessons of the past two and a half years and put new systems in place that not only help us deal with the next phase of this pandemic, but particularly prepare us better for the next global health emergency.
KARVELAS:
Forty per cent of the world population is still unvaccinated. In some poorer countries the inoculation rate is as low as 16 per cent. I mean, it's just unbelievable. Why is it proving so slow and difficult to roll out vaccine doses under international initiatives such as COVAX?
BUTLER:
We can't say often enough the dictum that none of us is safe until all of us are safe, none of us is protected until all of us are protected across the globe. Because until then, we will see this virus continue to mutate and continue to spread across the world into populations, even with relatively high vaccination rates like Australia. That's why we're very forward leaning as a country to support global vaccination efforts. We've already contributed more than 40 million vaccines into our own region with more to do by the end of this year. But I think one of the challenges we're seeing now across the world is not so much the supply of vaccine doses. There's, as Jane Halton has said over the last 24 hours, lots of vaccine to go around. But we're really experiencing the challenge of health systems in some of the very poor countries of the world, and not only not just getting vaccines into their ports, but getting them into their health facilities and hospitals, and ultimately into people's arms. So that's the sort of thing that we're also talking about at this G20 Health Ministers meeting.
KARVELAS:
The World Trade Organisation has finally agreed to waive patents on COVID vaccines for five years, and of course the pharmaceutical industry isn't happy. Will this enables poorer countries to manufacture their own generic vaccines?
BUTLER:
That's the next challenge. I think countries haven't done this lightly. This has been a very challenging debate over the last little while since the idea was first raised by a number of poorer countries in the world who do have challenges having their own domestic manufacturing operations set up. And we did support this - not lightly, but we did support this as a measure to improve the spread of vaccines through the world. So the next challenge is to make sure not only that there is this waiver of patent, but that we are able to get manufacturing operations spread equally through the rest of the world.
KARVELAS:
The whole point of the G20 meeting is to better prepare for future disease threats, right? But have we truly learned the lessons of COVID 19? Have we strengthened health systems enough to cope with future pandemics?
BUTLER:
No, I don't think we're through the pandemic yet, and I think ultimately we're going to have to get through to the back end of this pandemic before we have the deepest possible view of what we did well and, frankly, what we need to do better into the future. That's why I think there will be a debate in due course about a Royal Commission or some other type of very deep enquiry here in Australia into our response to the pandemic. Of course, there must be, given the enormous dislocation, distress, economic loss that this caused, it would be unthinkable, I think, not to have some very deep process to learn the lessons. Not just what we did well, but importantly what we must do better into the future. And I think that goes for the rest of the world as well. That's the sort of thing we've been talking about at this G20 meeting. How do we make sure that some of the lessons, particularly the inequality that you see time and time again between the richer parts of the world and the poorer parts of the world, not just in terms of vaccine, but the access to treatments and many other aspects of a first class pandemic response?
KARVELAS:
You mentioned a Royal Commission, and in fact a Royal Commission was recommended by a Labor-dominated Senate enquiry into the pandemic. So will you launch one?
BUTLER:
Anthony Albanese said before he was elected as Prime Minister that it would be unthinkable not to have a very deep enquiry into what's happened. You know, the amount of money spent, the death, the dislocation. We know a very long tale of mental and physical distress will be coming our way over the next couple of years. It would be unthinkable not to have a very deep look at how we responded to that and learn the lessons of that. But right now our focus is on getting through the winter, lifting our booster rates. There are still more than 6 million people who are eligible for a booster rate who haven't yet got it. We need to get the message out that you're not fully protected against, particularly the Omicron variant, unless you have three doses. We need to do better on getting that fourth dose out in aged care. We need to do better on getting the treatments, the fantastic treatments that are now available to prevent severe disease and death among very vulnerable people, get that through the health system. But we need to get through winter, and ultimately at some point we will have a discussion about the sort of Royal Commission or enquiry that makes sure that we learn the lessons and we're better prepared next time.
KARVELAS:
So what's your timing for a Royal Commission then?
BUTLER:
We haven't really started to discuss that as a Cabinet yet. We're only a few weeks into government. As I said, my priority as Health Minister right now is getting through this winter. There are still very serious challenges right now with COVID. We've got influenza as well, on the back of that, as I said –
KARVELAS:
Oh, absolutely. I understand that you say we've got to get through the winter, and I couldn't agree more, as someone who had COVID not very long ago. And it's not, you know, it's not something that anyone wants to contract, and especially numerous times. So when we get through this winter, will it be by the end of the year that you start a Royal Commission? What kind of time frame are we talking about, to start learning these lessons?
BUTLER:
I don't have a time frame to put to you today, Patricia, or to your listeners. It is something that we identified before the election that we would need to do over the course of this term. But I think your listeners would want me, and our government, focused on the immediate health challenges. Once we start to reach a phase in the pandemic where it is appropriate to start to look back, rather than focus on the challenges of the day, then we'll have that, we'll reach out to clinicians. Obviously, state governments are critically important in this process, and we'll start to set up a proper evidence based enquiry.
KARVELAS:
The death toll continues to climb. Older people are especially vulnerable. Only about half of aged care residents have received a fourth vaccine dose. And you've already, in this interview, raised your concerns about the fourth vaccine dose, and then the take up, also, of the third. How will you speed up that rollout? Other than writing to providers to tell them to get a move on? Do you have any other strategies?
BUTLER:
I've asked for advice from my department about what the Commonwealth can do to start to accelerate the uptake of the fourth dose. I mean, there are some complications in the sense that you can't have that fourth dose until four months after you've had the third dose, and people had the third dose at different times in aged care. But it should not be beyond the wit of the Commonwealth, which regulates aged care, to make sure that we're out doing what we can to make sure that the doses are in people's arms as soon as possible.
We also need, obviously, to ensure that influenza vaccinations are delivered in aged care facilities, given the vulnerability of that population to that virus as well. So I've asked for advice from our department about what we can be doing. As you indicated, Anika Wells, the Aged Care Minister for our Government, and I, have also written to facilities to remind them of the importance to get that rate up, 54 per cent, which I think is the latest advice I've got of the number of aged care residents who've had that fourth dose, is not good enough this far into winter.
KARVELAS:
And a fourth dose for the general population - my listeners to RN Breakfast are red hot on this. Is that something you expect will be recommended?
BUTLER:
Right through this pandemic, I think one of the, outstanding parts of Australia's response has been to listen to the health advice, and not to have politicians seek to substitute their views about the response over the views of health experts. And we've had this matter considered by the Advisory Committee on vaccinations. They've presented their advice. It largely reflects advice around the rest of the world, which is that the fourth dose at this stage needs to be focused on older members of the community, and other members who are particularly vulnerable, particularly if they have compromised immune systems. And that is the advice that we've accepted as a government.
Now, that advisory group has also indicated they'll continue to monitor the situation. They'll monitor the research that is coming out around the world about the efficacy, or the effectiveness, of a fourth dose for the more general population. And I expect that advice will develop over time.
KARVELAS:
Now, on children under five, when will they start to receive their first jab?
BUTLER:
Right through this pandemic, you've generally seen a sequence whereby the American authorities will consider vaccines first of all, then the Europeans, and then countries like Australia. And the American authorities, only in the last 24 hours, the CDC has finally given approval for the Moderna vaccine to start to be given to under five year olds in that country. And we expect that will start to roll out in coming days. Now the TGA, our equivalent authority, the Therapeutic Goods Administration, has an application from Moderna which they're currently going through. If that is approved, then that will go, as I said, to our advisory group on vaccinations. Now, I don't control that time frame. I think it's appropriate that those authorities feel that they are able to conduct their work, their legislative work, in a time frame that's proper. And I'd expect that to happen over coming weeks. Now, the former chair of the advisory group on vaccines, I know, said over the last couple of days it might be a month or two until we finally see those vaccines going into the arms of under five year olds. But that ultimately is a matter for them.
KARVELAS:
The states want 50/50 funding split, as you know, for health funding. But National Cabinet ended on Friday with a commitment to review health funding and only extended the 50/50 split to the end of the year essentially. Is that a genuine effort to come up with reforms, or are you just trying to keep the states at bay?
BUTLER:
The 50/50 split, as you describe it, was extended to the end of the year, was particularly focused on COVID cases. And I think that was an extension that was welcomed by all states, all Premiers, Liberal and Labor alike, because finally the heads of our governments across the country were able to have a discussion about health policy in the National Cabinet. The former Prime Minister had refused to even list health and hospital policy on the National Cabinet for some time. So this was, as I think a number of them described, a refreshing change. This is one of the very real challenges state systems are having. Their hospitals are under very real pressure. Obviously, partly because of COVID and influenza cases, but also, frankly, because of the rundown we've seen in systems like primary care, Medicare, general practise, and aged care, over the last decades of cuts and neglect, the last decade of very substantial cutbacks to the care that people should be getting out in the community, rather than going to hospital to receive.
KARVELAS:
If you're just tuning in, Mark Butler, who's the new Health Minister, is my guest. Just finally, swimming's world governing body, FINA, announced yesterday that transgender athletes will need to complete their transition by the age of 12 to compete. Very controversial decision. It effectively bans transgender people from swimming, women from swimming. Will you, as a Health Minister, invest in more research into trans health? Because it seems that the research is highly contested here.
BUTLER:
The first thing I'd say is this is a highly sensitive debate that needs to be conducted as respectfully as possible. And we've said over the last few months, as some people try to politicise this debate, frankly, that we need to be very careful not to politicise, and not to put vulnerable Australians in the middle of a political debate. We've also said, though, that ultimately, sports governing bodies need to govern the operations of their sport, particularly at an elite level, and that those sports have had the legal tools available to them for many years here in Australia, to make decisions about participation in their sport, particularly where their sport involves factors of strength and stamina. And that's apparently happened at a global level in relation to swimming. So that's as it should be. Sports should be able to govern –
KARVELAS:
They need the best research though. So my –
BUTLER:
They need the best research; they need their legal tools –
KARVELAS:
question was to you as Health Minister, do you think that there needs to be more investment in trans health and outcomes?
BUTLER:
I think this is an area that is being researched more now than it was in the not too distant past, frankly. The expenditure of our research dollar is largely driven in a peer reviewed way by experts, rather than politicians making decisions about a particular research project. That's long been the case in Australia. It's why we have one of the best health and medical research systems in the world. But I would be very surprised if there was not a continuing emphasis on understanding these issues better.
KARVELAS:
Thank you so much for joining us this morning.
BUTLER:
Thanks, Patricia.
KARVELAS:
Mark Butler is the new Health Minister.