Concerns were raised at the Australasian Epidemiological Association meeting in Sydney yesterday about the demise of the Masters of Epidemiology program at the ANU, and how this will compromise Australia’s ability to respond to future infectious diseases threats.
Below is a statement from Emeritus Professor Bob Douglas, who was the Founding Director of The National Centre for Epidemiology and Population Health at the ANU from 1989 to 2001.
Bob Douglas writes:
“Australia is dismantling its flying squad capacity for the control and prevention of epidemics of infectious diseases at a time when the effects of climate change will multiply epidemic and pandemic threats.
The $1.9 million program that is based at the ANU recruits outstanding students from the health professions to undertake a paid apprenticeship for 21 months in the surveillance and control of communicable diseases.
Trainees spend about 11 weeks in coursework at the ANU and the remainder of their time as full-time registrars in Indigenous and communicable diseases agencies in the states and the Commonwealth. They constitute a flying squad, available to work both together and separately with their agencies on surveillance and epidemic infectious disease outbreak activities.
The Australian program was established in 1992 with the assistance of the US Centres for Disease Control and in turn has helped to establish similar programs in a number of countries in Asia during the past 15 years. The supervisory team at ANU works closely with federal and state health authorities and mobilises trainees to work together in locations where a particular threat is perceived to warrant their contributions.
Like its counterpart program in the United States, the graduates of the Australian program have become public health leaders in Australia and internationally. At the time of the SARS epidemic in 2003, trainees and graduates of the Australian program played a leading role internationally in containing the epidemic. Repeated reviews of the ANU program and its impact on Australian infectious diseases control have been positive and the program has won praise and prizes for its practical contributions and its teaching and practical excellence.
About five years ago, for administrative convenience, the funding for the program was rolled into a funding pool known as the Public Health Education and Research Program (PHERP), which also funded other training programs in public health in academic institutions around the country.
For perhaps more justifiable reasons, the Commonwealth had placed a time limit on federal funding for the PHERP program and when in 2009 cabinet decided to terminate that program, the ANU program was terminated along with it.
A review of the program in February 2010 firmly recommended that it should be continued and that to discontinue its current role would leave serious gaps in Australia’s capacity. While acknowledging the benefits to Australia, federal authorities make the point that the most importantbeneficiaries of the program are the state governments and that they should contribute if such a program is to be maintained. (Sound a familiar argument?)
Meanwhile, the program is winding down with no replacement capacity in sight.
The flying squad capacity has always been a key strength of this program.
It has been central to the nation’s capacity to respond rapidly to epidemic threats such as the recent swine influenza outbreak and it is about to expire. It leaves Australia exposed and vulnerable at a time of growing threats from infectious diseases. It seems to be another instance of policy failing because of our complex federation of states.”
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The epidemiologists yesterday resolved to take their concerns to the Health Minister, Nicola Roxon.
But perhaps the PM herself should intervene. At the conference dinner last night, those musos of public health, The Faux Pas, ended their set with a special tribute to J-U-L-I-A (in the vein of Gloria).
This course has produced some of Australia’s finest epidemiologists who are now making a major contribution to infectious diseases and vaccine policy around the country.
Let us not also forget the late Aileen Plant and her role as founding director of this course and the contributions she made to the successful control of SARS internationally.
It would be an insult to her legacy to close the course.
As a graduate of this program, I guess I am somewhat biased. Also, other Public Health/Epi courses will produce some outstanding practitioners in this field. However, it is worth remembering that:
1. The MAE was modelled on the successful training program run by the USA’s Centers for Disease Control and Prevention – arguably the best outbreak program in the world.
2. One of the MAE’s prime purposes was to create a group of “disease detectives” to respond to outbreaks of infectious diseases, which continue all the time on a low key and sometimes high key scale
3. Even during our training, we weren’t in the classroom but were actively attached to a public health unit, working full-time while we studied. In my first week of the MAE, SARS began – we didn’t even know the cause of it at that stage! And in our first weeks in the program, many of my colleagues were thrown into the deep end, sent to assist the national and international response to SARS. Some went to the Situation Room in the Health Dept in Canberra, others to the Manila office of the WHO, some to Hong Kong and Vietnam – two of the epicentres of SARS. Even as trainee students, many of these colleagues contributed significantly to the investigation and containment of SARS. Many continue to contribute meaningfully now in the field of epidemiology and infectious diseases. One of my cohort has even received awards from PM Rudd for her work.
4. The article reports that the MAE program costs $1.9 million. It is worth remembering the billions of dollars that SARS and, more recently, swine flu would have cost the global economy. Also given how many hundreds of millions of dollars are spent on various government programs, some more successful than others, at the end of the day, is $1.9 million dollars so much? Please be aware that avian influenza has quietly continued to cause human infections during the swine flu pandemic and even now. If that ever becomes a pandemic, $1.9 million dollars for a group of highly trained “disease detectives” won’t seem so much.
It would be wonderful if the government did reconsider their decision to close this wonderful program.
Sanjaya Senanayake.
ANU