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The Health Wrap: post-election health policy news; deadly pathogens; seeking solutions; justice & equality

This fortnight’s Health Wrap is compiled by Frances Gilham, Digital Communications Manager at the Sax Institute. Enjoy the Wrap and tweet us via @SaxInstitute if you have any ideas for future issues.


Health policy news as election dust settles

Over the past fortnight, the news was full of speculation about what the newly re-elected Coalition Government would mean for Australia.

As both major parties reconsidered their cabinet and shadow cabinet positions, the SMH reported that Tanya Plibersek was being urged to step back into the critical health portfolio – Opposition Leader Bill Shorten is expected to announce portfolios on Saturday.

When the Prime Minister outlined his cabinet changes, as reported by The Guardian, we heard that health was to remain with Sussan LeyCroakey said that many would no doubt see this as a positive, as health groups would know what to expect and be able to continue to develop a relationship already forged, rather than starting from scratch.

Croakey also provided some background on new Assistant Minister for Rural Health, David Gillespie.

At the same time, The Mandarin announced the retirement of Australia’s Chief Medical Officer, Chris Baggoley, saying the role would be taken up by Austin Health chief executive Brendan Murphy in October; also reported on by Croakey.

There was also a lot of coverage of what would be next for health policy.

The Conversation had its policy experts predict how the election outcome would impact on policy areas as diverse as jobs, tax, superannuation, primary care, Medicare, hospitals, private health insurance, welfare reform and social policy, Indigenous affairs, and more.

Also on The ConversationIan McAuley from the University of Canberra wrote that Malcolm Turnbull would face the challenge of reconciling the political sensitivity of Medicare with the need for fiscal discipline; and the Grattan Institute’s Stephen Duckett provided some pointers on addressing growing out-of-pocket healthcare costs.

Croakey’s Melissa Sweet wrote the PM an open letter with some ideas for securing his legacy as a “visionary leader for health” including the establishment of a Minister for Health in all Policies, to be charged with working across all portfolios to assess the impact of all policies upon the population’s health, and particularly upon health inequities.

In The Australian (paywalled), GP and deputy chairman of the Medical Benefits Schedule Review Taskforce (as well as former head of the AMA) Dr Steve Hambleton expressed his disappointment in the Prime Minister’s ruling out any changes to the Medicare payments system in response to the Opposition’s “Medi-scare” campaign, saying:

Who cares who processes the Medicare payments? When Malcolm Turnbull came to power, he said ‘I’m here, I know about IT, I know about finance, I know about business, I think we need ­innovation.’ In health, that’s what we need.”

ABC News reported that current AMA president Michael Gannon had suggested re-visiting the idea of a co-payment, a move “slammed” by health groups in this Croakey post.

An article in MJA Insight described the danger of dismantling the long-running primary care research program Bettering the Evaluation and Care of Health (BEACH), running alongside an MJA perspectives piece outlining the importance of measuring general practice activity.

In The Conversation, paper author Gerard Gill said more high quality primary care research was needed to ensure GPs have the best evidence to support their practice. He wrote:

…interventions (such as medications and other treatments) are often tested in hospitals and other settings where the patient cohort is markedly different to the one seen in primary care.”

Meanwhile, NHMRC chief executive Professor Anne Kelso told The Australian (paywalled) that more work needs to be done in improving healthcare delivery, and suggested that focused health services research could address issues of efficiency and efficacy while ensuring the best results for patients. She commented:

The great majority of our funding is going currently to clinical research and biomedical ­research, a smaller proportion to public-health research and a smaller proportion still to health- services research. There is a need for more funding for health-services research in this country to guide better health-service delivery.”

Further afield, in international public health policy news, Croakey rounded up “the best in Brexit health coverage”.


The fight against deadly pathogens

Big news this fortnight: the Sydney Morning Herald reported that Australia’s peak AIDS organisations and scientists announced an end to the AIDS epidemic.

Croakey also covered this news, including analyses from experts who, while welcoming the news, said the announcement obscures the reality of ongoing, smaller AIDS crises in particular groups, and that AIDS ceased to be a notifiable disease in Australia some years ago.

And in a follow-up article for The Sydney Morning Herald, Scientia Professor David Cooper, director of the Kirby Institute at UNSW, wrote that while we may have tamed AIDS at home, we have not yet developed the golden bullets to prevent or cure HIV infection. He said:

It’s worth remembering that around the world, and particularly in those countries where homosexuality and sex work remain illegal, the presence of undiagnosed HIV and AIDS stalks everyone.”

In a bid to help reduce stigmatisation around HIV, Prince Harry underwent testing live on Facebook, according to ABC News. (His result was negative.)

The Guardian published an article on this year’s International AIDS Conference, reporting that while numbers of people with HIV infection had been dropping, they have now stalled — and are rising in some countries. Just under 2 million people become HIV positive every year, so the epidemic continues to grow and the cost of keeping people alive continues to rise, it said.

This article in The Conversation described the different approaches researchers are taking to find a cure for HIV — it is well worth a read.

In more promising news, The Australian (paywalled) reported on an experimental cancer drug that could treat superbugs and a range of deadly viruses from HIV to Ebola, by breaking down the machinery of viruses and cancers in damaged cells while leaving the rest of the body unharmed. So far though, this is just a set of remarkable results in test tubes and a long way from human use.

An article on STAT News reported on the lessons we can learn from the fading Ebola crisis, and BBC News reported that the Zika epidemic will end in three years.

And The Hill reported that US politicians are considering setting up a new emergency fund to tackle crises like Zika and Ebola, which would give the administration’s top disease control official “immediate access” to the money — calling it a “FEMA for public health”; a reference to the Federal Emergency Management Agency that helps communities hurt by disasters.

Closer to home, journal Public Health Research & Practice published research suggesting ICUs could be an untapped resource for public health surveillance of infectious pathogens.


Diseases of the non-communicable type

It was National Diabetes Week in Australia from 10-16 July, with Diabetes Australia urging federal and state governments to take action to address the heavy toll from diabetes amputations.

Writing in The Australian, Monash researcher Paul Zimmet said there were problems with the way we collect and report diabetes data (nationally and internationally) and that Australian data may underestimate diabetes prevalence by 25 per cent.

And MJA Insight reported that subsidised glucose self-testing strips would no longer be available to certain groups of people with Type 2 diabetes, following a review of the evidence.

Will 2016 be the year of the sugar tax? MJA Insight suggested it could be, reporting here on various international initiatives in this area.

But Glasgow researchers warned against focusing too much on sugar, saying people who eat fewer calories from one type of food simply compensate by eating more of another type — known as the sugar-fat seesaw, BBC reported.

And one state in India has now implemented a a “fat tax” on burgers, pizzas, doughnuts and tacos served in branded restaurants, also reported by the BBC.

Unhealthy marketing practices also featured in the news this fortnight, with reports emerging that the Australian Competition and Consumer Commission had fined Unilever Australia and The Smith’s Snackfood Company for misleading healthy food representations, according to ABC News.

CHOICE has also pointed the finger at snack bars for misleading consumers, with SMH reporting on a review that found big-brand snack bars with images of fruit on their packaging contain minimal actual fruit ingredients and often fail to disclose added sugars, with Kellogg’s and Aldi named as two of the worst offenders.

New research from the Cancer Council NSW, described in an article on The Conversation, has revealed that almost 90 per cent of food and beverage sponsors of children’s sports development programs in Australia are classified as unhealthy.

And Croakey published this piece by Carl Heslop from the Alcohol and Drug Foundation looking at how drinking culture is permeating Australian sport sponsorship to the highest levels.

The Sydney Morning Herald reported that the latest NSW Chief Health Officer’s report shows 16 to 24-year-olds are the least likely to drink daily, and that the biggest daily drinkers in the state are overwhelmingly over 65.

In the research arena, two new animal studies featured in the news: the first linking artificial sweeteners to weight gain and the second suggesting that obese fathers could pass on metabolic issues to their offspring.

SMH reported on the outcomes from the Household, Income and Labour Dynamics in Australia (HILDA) survey of 17,000 people — including findings that men do about twice the amount of high impact exercise as women at nearly every stage in life, and smokers and drinkers did more exercise than those who abstained.

And last but not least, an unexpected winner for health promotion has emerged with the recent launch of app-sensation Pokemon Go, which requires users to go outside and get moving, even if it has been reported elsewhere to be somewhat of a health hazard.


Seeking solutions

This fortnight Croakey reported that each Minister in the Queensland Government Cabinet has been assigned unique responsibility for a discrete Aboriginal and Torres Strait Islander community in Queensland to improve communications with Government and drive better outcomes.

Communication and partnership was also the focus of an ‘In Practice’ paper published in Public Health Research & Practice which described the Study of Environment on Aboriginal Resilience and Child Health (SEARCH), called an ‘action partnership’ and a long-term platform for closing the gap.

In contrast, Croakey shared a less optimistic post from Melissa Stoneham, Deputy Director of the Public Health Advocacy Institute WA, in response to the Western Australian Government’s recently released ‘roadmap’ for the state’s regional and remote communities. She voiced concerns about whether a community would be forced to close if it was unable to become self-sustaining.

This comes after a powerful speech given by NAIDOC Person of the Year Indigenous education expert Professor Chris Sarra called on the Prime Minister to negotiate a treaty, as reported by The Guardian and Croakey.

There were also calls this fortnight for a royal commission into the high suicide rates among Indigenous people, reported by ABC News and The Guardian.

The National Aboriginal Community Controlled Health Care Organisation (NACCHO) chairman, Matthew Cooke, is quoted as saying:

It’s time there was a full royal commission into failings in the system that are driving so many people in our communities to such levels of despair that suicide is the only answer.”

And research from the Telethon Kids Institute found Aboriginal mothers were 17.5 times more likely to die from homicide than non-Aboriginal mothers in WA.

Aboriginal health professor Rhonda Marriott, from Murdoch University, said in an interview with ABC that the report was painful to read and raised questions about how society values Indigenous women.


Crime, justice and equality

Almost 4,000 ex-prisoners on parole will be offered intensive individual support in a bid to prevent them returning to jail under the latest “social impact investment” scheme launched by the NSW government, according to an article in The Sydney Morning Herald. 

Evaluation of the program will be important, after news came that another program aiming to reduce re-offending, this time in young offenders, found no improvement in re-offending outcomes.

The Australian Bureau of Statistics released new figures this fortnight in a report entitled Recorded Crime – Victims, which showed reports of sexual assault have reached a six-year high.

These figures are probably due to more public discussion of sexual and family violence, according to social workers in this Guardian article.  ABC News also reported on the new data, highlighting that more than a third of sexual assaults and homicides recorded in Australia last year were domestic violence-related.

In happier news, we heard that Sir Michael Marmot — a leading global advocate for action on the social determinants of health and health inequalities — would be coming to Australia in September to deliver the ABC’s 57th Boyer Lectures Series. Croakey wondered what impact this might have upon the dominant debates around health and policy.

And following his presentation at a Sydney conference looking at health inequities, the Sax Institute’s Don Nutbeam was interviewed for Croakey. In the video below he discusses why we need to improve the health of the poorest fastest if we want to start bridging the health divide.


Lastly…

Other stories on Croakey you might have missed:

And a few bonus stories that might be of interest:

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