It’s been 35 years since the call for an Australian Centre for Disease Control began. How did it start? What have been the hurdles along the way? How much longer will it take?
Many might think the push for an Australian Centre for Disease Control (CDC) only began following the onset of the COVID-19 pandemic. Yet the call was instigated 35 years ago, at a meeting of the then newly formed Australasian Epidemiological Association (AEA).
1987, AIDS, and disease control
Prof Stephen Leeder, Dr (now Prof) Robert ‘Bob’ Douglas, and other experts at that 1987 meeting discussed various weaknesses of Australia’s capacity across many sectors critical to disease prevention and control.
Acquired immunodeficiency syndrome
Dr Julian Gold discussed the public health challenges related to acquired immunodeficiency syndrome (AIDS), such as a lack of coordination of data collection for risk factors. Dr Gold also raised concerns with the ability to evaluate national education campaigns with existing surveillance systems.
Dr Douglas noted that although mortality from infectious disease was relatively low, there was great room for improvement, particularly regarding loss of work productivity related to infectious disease.
Prof Stephen Leeder spoke on cardiovascular disease control, emphasising that an Australian CDC’s scope should include developing plans related to prevention of cardiovascular disease. He said the Australian CDC could also ‘oversee’ smoking and nutrition-related policies.
That meeting highlighted key weaknesses surrounding the prevention and control of both infectious disease and non-communicable disease and presented a possible solution in a national entity.
AEA delegates resolved:
“This inaugural conference of The Australasian Epidemiological Association has carefully considered the issue of Disease Control in Australia. It believes that Disease Control activities are presently seriously inadequate and that some rearrangement of resources and institutions will be needed to ensure that the task of controlling and preventing disease is properly addressed.”
A prevention agency that burned bright, then was extinguished
Many of the issues highlighted 35 years ago remain, with ongoing weaknesses in surveillance and data coordination between jurisdictions. As these issues continued, so have calls for the Australian CDC to be enacted by organisations including PHAA, the Australian Medical Association, and the Australasian Faculty of Public Health Medicine.
From 2011-2014, there was a national entity for preventive and public health – the short-lived Australian National Preventive Health Agency. It provided some hope of improving public health in Australia. But the agency was swiftly shut down following a change in federal government. It didn’t have the chance to help produce long-term outcomes for which it was created.
Pandemic catches Australia off-guard
Enter the COVID-19 pandemic in early 2020, which made clear the importance of public health, and the weaknesses in our national public health coordination and leadership. This appeared to drive significant interest in establishing a national centre, as people became aware of its potential significant benefits for addressing pandemics and other crises.
The October 2020 pre-election commitment of the Australian Labor Party to the establishment of an Australian CDC that focused both on communicable and non-communicable disease was perhaps the most promising development for the public health community in many years.
Following Labor’s election in May 2022, its first budget in October allocated $3.2 million for initial consultations prior to the Australian CDC’s establishment. It gave the public health community hope that this would be no idle agency. The Federal Government on 10 November released a discussion paper, and is consulting various entities across the country, including with public health leaders from many organisations, among them PHAA. The CDC may be established in 2024, the discussion paper said.
A Senate estimate for preventive health
Finally, the recent Senate Budget Estimates hearings discovered approximately $12 million still allocated to the Australian National Preventive Health Agency, despite it ceasing operations in 2014.
Turns out we have an "Australian National Preventive Health Agency" which, despite being shut down by Former PM Tony Abbott in 2014, still has $12m in the bank & gets audited every year! 👻😂🤷🏼♂️#Utopia #SenateEstimates pic.twitter.com/RYaujbCn5p
— David Pocock (@DavidPocock) November 10, 2022
PHAA suggests that this $12 million be invested, rather than be left idle in a bank account. Spend it on non-communicable disease prevention by transferring these funds for use in the new Australian CDC. This investment would boost policies and programs focused on preventing cancer, obesity and other key chronic diseases, and would in turn create a healthier and more economically productive society.
This would be an accelerant to the new Australian CDC and would help improve the lives of all people in Australia, for the long-term.
For almost 40 years, the field of public health has known the key weaknesses that are limiting all people in Australia’s potential for better health. Now is our chance to address this, and improve everyone’s lives.