Introduction by Croakey: In this global week for action on non-communicable diseases, the Australian Chronic Disease Prevention Alliance is urging the Federal Government to invest in chronic disease prevention, as an “ethical and economical imperative”.
Members of the Alliance, Chris Forbes, Emma Lonsdale and Justine Cain, outline below how the numerous National action plans and strategies developed over the past few years provide a “rich source of evidence-based ideas” for the way in which chronic disease prevention is managed.
However, “they urgently need government commitment to action and investment at levels that will drive change”, they said.
According to Forbes, Lonsdale and Cain, with the upcoming ‘wellbeing’ Budget and a Government committed to addressing disease prevention and primary care reform, “now is the time to take these plans off the shelf and invest in a future that prioritises our health and wellbeing.”
Chris Forbes, Emma Lonsdale and Justine Cain write:
Earlier this year, the Treasurer Jim Chalmers announced that Australia would develop its first-ever ‘wellbeing’ budget, building on the standard economic indicators to incorporate additional measures of wellbeing, like health outcomes and education.
The rationale behind this is to measure ‘what matters.’ The ‘wellbeing’ budget invites a fresh perspective on the purpose of government investment and its value for the Australian population, now and into the future.
Ahead of the budget, this week we join the global chronic disease community in calling for governments to ‘Invest to Protect’ as part of the Global Week for Action on non-communicable diseases (chronic disease).
Chronic diseases are the leading cause of death and disability in Australia and around the world.
More than 11 million Australians have a chronic disease and one in five of us are living with multiple conditions. However, nearly 40 percent of disease burden could be prevented by reducing risk factors like tobacco, unhealthy diets, overweight and obesity, alcohol, physical inactivity, and high blood pressure.
Despite this, chronic disease prevention is consistently underfunded by governments in Australia and around the world.
Prevention is an ethical and economic imperative.
With our health system stretched to the seams, investment in prevention is crucial to keep people well for longer and improve outcomes.
More than half of all people admitted to hospital have a chronic condition like heart disease, stroke, cancer, diabetes, or kidney disease. Billions of dollars are spent treating chronic diseases and associated complications, when much less could be spent to prevent disease and improve health and wellbeing.
Prevention accounts for less than two percent of national health spending each year, even though there are both health and economic benefits in keeping people well, productive, and out of hospital for longer. Indeed, for every $1 spent on prevention, there is an expected return on investment of $14.
Investment should be evidence-based
We want to be active partners in our own care, advocates for better kidney health, and finally we want to know that our efforts and the work of clinical carers and researchers will lead to better outcomes for future patients.”
This quote, on the front cover of the National Strategic Action Plan for Kidney Disease, is a powerful reminder of the people behind the Plan, the reason for the Plan.
More than 2,500 people and organisations contributed their time and expertise to shape the Kidney Disease Action Plan. Patients, community members, health professionals, and academics shared personal experiences, knowledge, and research to develop priorities to prevent kidney disease and improve outcomes.
But since its release in early 2020, COVID-19 has dominated news cycles and health funding. And the Action Plan remains underfunded, gathering dust and limiting its impact.
This is not unique to kidney disease.
More than ten other Action Plans and Strategies have been developed over the past few years to address the significant burden of chronic disease on the Australian community.
This includes the National Strategic Action Plan for Heart Disease and Stroke, the National Strategic Action Plan for Lung Conditions, the Australian National Diabetes Strategy, National Strategic Action Plan for Childhood Heart Disease, and ongoing work to develop an Australian Cancer Plan.
Beyond these Action Plans are recent strategies to address broader health issues, including the National Preventive Health Strategy, National Obesity Strategy, National Asthma Strategy and Australia’s Primary Health Care 10 Year Plan.
We are still awaiting the release of the new National Tobacco Strategy, after the last strategy expired in 2018. A National Dementia Strategy is also in progress.
These Action Plans and Strategies provide a rich source of evidence-based ideas for change, developed in partnership with the chronic disease community. But they urgently need government commitment to action and investment at levels that will drive change.
Momentum for prevention
Unlike many of the Action Plans, the recent National Preventive Health Strategy has the benefit of momentum. Released late last year, work is underway to develop implementation and evaluation plans, along with frameworks to guide investment.
In addition, national strategies for consumer engagement and health literacy are being developed to integrate the voices of people affected by disease into this work.
Underpinning the Strategy are the aims to improve population health and wellbeing, address inequities, rebalance funding towards prevention, and provide children with the best start to life.
To achieve these aims, the Prevention Strategy is packed with low and no cost initiatives that would have a huge impact in terms of improving health and reducing the pressure on our health system.
This is particularly important as we seek to mitigate the long-term effects of COVID-19, to reduce the ongoing impacts on individuals, communities, workplaces, and the health system more broadly.
Support for primary care
Primary care is a crucial pillar supporting patients to prevent and manage chronic conditions, but the system is under strain. Patients are unable to access the care they need, and GP practices are struggling to keep up with the demand.
And this problem isn’t going away. Over the next ten years, the GP workforce is expected to decline, while patient demand grows by around 38 percent.
At the same time, there are stories of ambulance ramping and workforce shortages across hospitals, demonstrating the urgent need for a strong primary care system to help people to manage their health in the community and avoid preventable hospitalisations.
Earlier this year, the government announced a new Strengthening Medicare Taskforce to build on the recent Primary Health Care 10 Year Plan. The Taskforce and $750 million in funding are much-needed steps towards repairing the health system.
Importantly, prevention and management of chronic conditions has been identified as a priority area, along with improving access and affordability, and reducing pressure on hospitals.
With Government commitment to progressing prevention and primary care reform, there is an opportunity to leverage the disease-specific National Action Plans and Strategies, which are full of priority actions to prevent disease and improve outcomes, informed by the voices of people interacting with, and working in, the health system.
Now is the time to take these Plans off the shelf and invest in a future that prioritises our health and wellbeing.
About the authors
Chris Forbes is Chair of the Australian Chronic Disease Prevention Alliance and CEO of Kidney Health Australia. Emma Lonsdale is Executive Officer of the Australian Chronic Disease Prevention Alliance. Justine Cain is Group CEO of Diabetes Australia.
The Australian Chronic Disease Prevention Alliance (ACDPA) brings together Cancer Council Australia, Diabetes Australia, Heart Foundation, Kidney Health Australia, and the Stroke Foundation to advocate for the long-term health and wellbeing of Australians by providing a powerful voice for those living with, or at risk of, chronic disease.
See Croakey’s extensive archive of articles on chronic disease prevention.