Australia will be vulnerable to the threat of infectious diseases unless we follow the lead of other countries and establish an independent authority for communicable disease control, according to a new analysis in the Australian Health Review.
Dr Bradley McCall from the University of Queensland writes…
Australia is now unique in being the only Organisation for Economic Co-operation and Development country without a recognised separate authority for national scientific leadership in communicable disease control. This has been recognised by a range of health experts and was the subject of a recent Inquiry by the House of Representatives Standing Committee on Health and Ageing. This Inquiry recommended a national audit and mapping exercise followed by an independent review to assess the case for establishing a national centre for communicable disease control.
A number of recent public health threats have prompted calls for the establishment of an Australian Centre for Disease Control (or similar body). These include: the 2009 H1N1 influenza A pandemic; the identification in April 2010 of febrile convulsions in young children following administration of seasonal influenza vaccine; and the 2011 outbreak of Hendra virus in horses across Queensland and New South Wales.
Each of these events presented unique challenges and all placed a strain on our current level of resources and expertise at both federal and state/territory level. This highlights the need for a body to provide overall leadership and coordination on emerging communicable disease threats, including the efficient allocation of resources, timely reports to Government, health services and the community and prioritisation of national research efforts.
There are a range of models for such a body, from the extensive and well-resourced United States Centers for Disease Control and Prevention (USCDC) to more modest enterprises such as the Health Protection Agency in the UK, the European Centre for Disease Prevention and Control. Given Australia’s federal governance structure, perhaps the most pertinent example in terms of comparable legislative frameworks is Canada’s Public Health Agency.
While different nations have different models to deliver this function, all are composed of professionals with a degree of independence from government, to ensure that there is a clear separation between politically sensitive decision making, and the advice and tools needed to inform best practice from a technical perspective.
Current arrangements for managing communicable disease issues have very limited scope for ongoing analysis and interpretation of national data, development of new surveillance methods, routine review of international findings, evaluation of policy and program impact, and the training and mentoring of the public health workforce that must be kept in readiness for the communicable disease threats that may emerge in a decade or a week’s time.
Despite being one of the richest countries in the world, our current communicable disease control arrangements are leaving us surprisingly vulnerable to outbreaks of infection, whether due to recurrent, known pathogens, or those that are yet to be identified. The establishment of an Australian CDC would bring us into line with the situation in other countries of similar wealth, and provide much needed insurance against the disaster that may never happen or be just around the corner. The time has come for an Australian CDC.