Adj Assoc Prof Priscilla Robinson and Hon Assoc Prof Leanne Coombe
Following the release of the COVID-19 Response Inquiry Report last week, there has been plenty written about Australia’s response to the pandemic.
Commentaries have explored the ongoing impacts on mental health through to the erosion of public trust in science and government.
The Inquiry acknowledges that the pandemic uniquely affected every one of us. While Australia performed relatively well in some areas, there are clearly areas where we must improve for next time.
There are 19 immediate actions suggested in the Inquiry Report (see Summary Report here) and seven mid-term actions. In particular, the public health community has welcomed and celebrated the support for an independent Australian Centre for Disease Control.
However, what appears to have been underreported in the media and analysis is the Inquiry actions in the report that directly relate to public health workforce issues – specifically, Actions 5, 6, 7, 12, and 23.
The Inquiry Report highlights the need for a clearly identified, trained, capable and accessible workforce.
These issues have been addressed in detail at an international level with the World Health Organization (WHO) Roadmap for national workforce capacity for essential public health functions.
The Roadmap was developed in response to the COVID-19 pandemic as well as other challenges such as climate change, the rising burden of noncommunicable diseases, antimicrobial resistance, and increased cost of living.
The Roadmap provides a set of tools for identifying both the core and auxiliary parts of the public health workforce and detailed analysis of the competencies, skills, and knowledge this workforce needs to be able to address emergencies – man-made and natural – as they arise.
WHO recently hosted the fourth Roadmap Steering Committee meeting, during which it became very clear that most countries are calling for a trained and flexible public health workforce.
As recommended in Chapter 12 of the COVID-19 Response Inquiry Report, the Roadmap should be used to benchmark Australia’s workforce to prepare and plan for a more robust workforce that is able to deliver core services and respond to future emergencies.
The Inquiry Report addresses the need for a whole-of-government response, which includes the entire response workforce, including essential workers. This aligns with the WHO Roadmap definition of the workforce which acknowledges that preparation and response is not just about the public health or even health workforce.
It is heartening to see the ‘nine response pillars’ in the Inquiry report – minimising harm; planning and preparedness; leadership and coordination; evidence and evaluation; agility and innovation; relationships; trust; equity; and communications.
These fit well with the attributes of the public health workforce identified in the WHO competency-based education framework – community-centredness; decision-making; communication; collaboration; evidence-informed practice; and personal conduct.
The Inquiry Report reflects on what happened during the pandemic response with recommendations for remediation – but the WHO documents provide detail on the ‘how’ and ‘who’.
When the pandemic was in full swing, a commonly heard phrase was ‘we will never forget the lessons the pandemic has taught us’.
It was accepted that washing hands, social distancing and so on were the new normal.
How quickly these lessons have been forgotten by the public – but more concerningly, how quickly Governments seem to have forgotten the need to invest in our public health workforce and be prepared for next time.
Public health is arguably in a worse state than before the pandemic. The expansion of resources for public health in the last few years were COVID-19 specific and short lived.
Although billed as a ‘one-in-100-year event’, in reality, the next health emergency could occur at any time.
It might not be a communicable disease– a major climate event or civil disruption will have the same effect. It’s a matter of when, not if, this will occur.
Australia must not waste this opportunity to prepare for next time, whenever and whatever that might be, with a well-equipped and resourced public health workforce.