Introduction by Croakey: The Public Health Association of Australia has said that without clear resource allocation and timelines, the future of the Australian Centre for Disease Control “remains unclear”.
Commenting on the 2024/25 Federal Budget, Public Health Association of Australia CEO Adjunct Professor Terry Slevin said the absence of any budget line item for the Australian CDC “suggests pandemic amnesia four years after the lives of everyone in Australia was upendedâ.
Dr Michael Moore AM, former CEO of the PHAA and the Immediate-Past President of the World Federation of Public Health Associations, said the Federal Budget is a “serious blow” to hopes for an independent, well-funded Australian CDC.
Below, Moore provides some timely advice for the public health sector on maintaining advocacy for the Australian CDC.
Michael Moore writes:
The Federal Budget offered a serious blow to our hopes for an independent, well-funded Australian Centre for Disease Control (ACDC). In the lead up to the last election there was increased hope as Labor promised to deliver the very thing for which, for more than a decade and a half, so many health associations and public health professionals have been lobbying.
So why has the Government effectively reneged on its promise?
A driving factor, in my opinion, is the prevention paradox. The term was originally used by Professor Geoffrey Rose to indicate the problem when prevention returns very little immediate advantage to the individual â as is the case with immunisation.
In this case the paradox is the more successful are prevention strategies, the less important they seem to the community as a whole.
The promise of the Albanese Government in establishing an ACDC was to âensure ongoing pandemic preparedness, lead the Federal response to future infectious disease outbreaks, and work to prevent ongoing non-communicable (chronic) as well as communicable (infectious) diseasesâ.
The community is no longer feeling the pain of the pandemic. The recent Federal Budget typifies the prevention paradox. The pressure is off, the spread of infection is slowing, the hospital systems are not having to deal with pandemic overloading. Why worry?
In a nutshell, with the pressure off â the Government is able to argue that they have formed an ACDC. It is up and running and is employing people. The trouble is that it is not the ACDC that has been sought by health groups and promised by the Government. It has its own website â but it is part of the Department of Health and Aged Care.
For well over a decade the Public Health Association of Australia (PHAA) has been arguing for an effective ACDC. At a series of PHAA Conferences, despite changes in Chief Medical Officers, arguments have been put as to why such a body would prove expensive and not necessary. I believe the pandemic put the lie to that argument.
Coordinated efforts
Advocacy for an ACDC has not failed.
As Professor Rob Moodie at Melbourne University has argued for years, âthere are the three Ps of advocacyâĤPersistence, Persistence and Persistenceâ. Emeritus Professor Mike Daube of Curtin University puts it a different way: âovernight success â it takes timeâ.
The establishment of an independent ACDC is a big ask. It could also be a big feather in the Governmentâs hat.
However, it has been long resisted by senior public servants. Why?
First, it takes power away from the Federal Department of Health and Aged Care. Second, it will require a serious investment. Third, it does require cooperation from all other jurisdictions.
Keep in mind the Government has sort of met its commitment. Sort of!
However, everyone in the sector, and the Minister, is aware that a type of ACDC buried within the depths of the Department of Health and Aged Care and staffed by bureaucrats will not meet the demands of those who have been lobbying for this centre for years.
The Federal election is not so far away. Public health advocates need to remain on the job.
First up is to let Health Minister Mark Butler know that the sector is very unhappy. The current framing of the ACDC is not what was sought nor understood by Laborâs promise. Well-funded. Independent. That is what the sector has always been demanding.
This sort of pressure will actually assist the Minister in arguing in Cabinet for appropriate funding for the ACDC.
A coordinated effort, which has been the hallmark of the ACDC campaign so far, needs to be refreshed in readiness for the upcoming election.
One possible action is a full-page advertisement in a national paper featuring a supporting letter by about a hundred significant community leaders in health and including a reference to the numbers of other people who have signed a petition. This would be a good start. The petition should be directed to the Health Minister.
It is important not to lose sight of the brilliant work that Mark Butler has done. He deserves recognition for his efforts on vaping reform â ensuring a system of âcontrolled availabilityâ that allows access for those who need vapes to quit smoking but reduces the extent of exposure of youngsters.
Sell the urgency
A roundtable organised well before the election, inviting Minister Butler and Chief Medical Officer Professor Paul Kelly, along with the state and territories Chief Health Officers, would assist in keeping the issue on the agenda.
The biggest challenge will be selling the urgency of the issue.
Speaking at the General Assembly of the World Federation of Public Health Associations in Geneva recently, World Health Organization Director Dr Ruedigar Krech pointed out the urgency of being prepared for the next pandemic. He was referring to the âpandemic treatyâ.
Nevertheless, the urgency is real. It does also apply to the establishment of an appropriate ACDC as soon as possible.
The irony of the prevention paradox is that failure to receive support indicates that a fairly good job has been done in preventing harm. Health professionals worked so hard to deal with the COVID pandemic, and Australian efforts were amongst the most effective in the world.
However, we can do better â and the building and funding of an appropriate ACDC as quickly as possible will be one of the ways that a better outcome can be achieved.
Read more here about the University of Canberra’s Public Health Advocacy Short course, led by Dr Michael Moore AM and Dr Aimee Brownbill.
See Croakey’s archive of articles on the Australian Centre for Disease Control.
