Terry Slevin, PHAA CEO
Here’s hoping that, as you read this, you retain some of the reinvigorating glow of a restful festive season, which most I knew desperately craved after the phenomenon of 2020.
But it is hard to envisage how 2021 will be any less complex and frenetic than its predecessor, although we all hope it to be better. In fact, much better.
The uncertainty continues
No one really expected the magic of new years to fundamentally change the mood and circumstances to turn 2021 into nirvana. It is obviously so that public health will remain a dominant theme of the new year and the new decade. And it will be vitally important that we continue to make the case for evidence-informed policy being implemented through an equity lens to ensure the best path forward through these challenging times.
Travel, work practices, social gatherings, connections with family and friends and the fundamental life blood of our social existence continues to be buffeted by uncertainties. New virus strains, emerging evidence, quickly changing and evolving public policy, border controls, all make the normal processes of planning our work, our lives another order of magnitude more difficult.
Vaccines
The issue du jour (for the week, the month and maybe the year) will be about the role a COVID-19 vaccine can play to return the world to some level of pre-2020 “normalcy”. Of course, the planning and implementation of the biggest vaccination program the world has ever seen is another core public health function.
PHAA President Tarun Weeramanthri has laid his thoughts out on the controversy this week that followed after some experts challenged the government vaccination program plans, and particularly the use of the Astra Zeneca vaccine. While the majority of the public health community expressed support for the national COVID-19 vaccination strategy, these public debates will continue as evidence emerges on the safety and efficacy of the current and future raft of vaccine candidates.
Respectful scientific debate about issues as important as a national vaccination program are a valuable and necessary part of reaching the best possible outcome. Australia has benefited greatly from its strong level of scientific expertise and the willingness of policymakers to adopt it in their pandemic response. But those participating in these debates do have a responsibility to be mindful of the impact of conducting them in a manner that further enflames an anxious community looking for clear and reliable guidance on complex issues at a time of such heightened vulnerability. This is not an easy balance to strike, but careful thought of the broader implications of such commentary is warranted.
So too is the importance of taking a less parochial approach. Now is a vital time to give due regard to peoples and countries with fewer resources and capacity. Many of them are far worse off than Australia with regard to the ravages of the pandemic. The resources we demand (e.g. an 80-100% vaccination rate) will inevitably come at the price of more vulnerable people being unable to access these resources.
“Old” Public Health measures remain essential
Regardless of which vaccines we use and how quickly they can be rolled out, there remains a vital need to protect and continue the benefits gained by decades-old public health strategies. We must persist with the use of distancing, promoting basic hygiene practices, use of masks, reducing social gatherings, and the continuation of the excellent testing, tracking and tracing regime, data monitoring and reporting, border management, public messaging, quarantine management and all the other essential public heath functions which have served Australians so well in 2020. And the non-covid related benefits of these practices, such as a dramatic reduction in influenza in 2020, invite consideration of some being actively promoted in the long term.
Workforce
And in 2021 it is time to press harder than ever before to ensure that the future of public health capacity in Australia is not only protected but enhanced. Weaknesses have certainly been exposed. No Australian jurisdiction was geared up to respond to the outbreak experienced in Victoria through the mid to later part of 2020. Broader problems in the public health workforce have been apparent for a long time.
Now is the time to address that vulnerability. And surely 2020 has taught all policy makers that investment in Public Health is an investment in an essential underpinning of the entire society and economy.
What has previously been seen as a low order priority must now come to the fore with genuine commitment and investment by all governments – state, territory and national. We must ensure this pandemic and the public health emergencies, outbreaks and challenges of the future can be faced by a highly trained public health workforce with sufficient capacity and expertise to guide the country through those inevitable assaults, be they of rapid onset or chronic and slow moving.
National Preventive Health Strategy
When it comes to chronic disease issues an opportunity is at hand in the form of the National Preventive Health Strategy. An advanced draft of the strategy is due out soon for final public consultation. While the final draft version to be released is yet to be confirmed, recent versions I am aware of give some cause for encouragement. While any recommendations to improve such strategies are welcome and should be contributed to the process, I also urge those with expertise in the field and any contributors willing to invest time to review it, to also identify and reinforce the things they think are of value or are worthwhile in the draft when it is released.
Back to normal – but what’s the new normal?
Meanwhile, in truth no one knows exactly what “normal” looks like in 2021. We will all need to draw upon our best instincts and energy to remain positive, constructive, flexible and innovative to continue to proudly serve the Australian community. I am confident we will do so in the best traditions of public health that, on the whole, have served us very well in the confronting year from which we’ve just emerged.
Terry Slevin is the CEO of the Public Health Association of Australia, and is also Adjunct Professor in the School of Psychology at Curtin University and Adjunct Professor in the College of Health and Medicine at the Australian National University.