Preliminary pages
Foreword
The movement of people across international borders is
increasing rapidly.
As the numbers travelling to and from Australia rises, so
too does the risk for transmission of infectious disease across international
borders. One thing is certain: infectious diseases do not respect international
borders. What is less certain is whether Australia is equipped to respond to
emerging infectious disease threats of national concern.
Infectious diseases take many forms and spread in many
different ways. In a rapidly changing environment, it is difficult to predict
when the next pandemic will occur, how severe it will be or how long it will
last. Based on available evidence, countries around the world, including
Australia, are preparing to respond to another influenza pandemic. Other
emerging disease threats of national and international concern are slower to
progress, but equally of concern to infectious disease experts. Such threats
include the emergence of antimicrobial resistant diseases both in Australia and
abroad, such as multi-drug resistant tuberculosis in Papua New Guinea. In this
inquiry, the Committee considered how Australia responds to the challenges
posed by emerging infectious disease threats. The Committee reviewed health screening
measures implemented at Australia’s borders; Australia’s ability to respond to
a national or global health crisis; and Australia’s role in controlling the
spread of infectious disease within the Asia-Pacific region. The Committee also
considered the porous border between the Torres Strait Islands and Papua New
Guinea, and how this impacted on Australia’s ability to control the spread of
infectious disease from international sources.
Lastly, the Committee debated a question looming large among
infectious disease experts in Australia – should Australia have a national
centre for communicable disease control? In attempting to answer this question,
the Committee considered what role such a centre would play, what structure the
centre could take, and how such a centre could improve national oversight of
infectious disease issues.
On behalf of the Committee, I extend thanks to all of the
roundtable participants. Your insights and knowledge of emerging disease
threats in Australia was invaluable in assisting the Committee with its
inquiry.
The Committee thanks representatives of DIAC, the Christmas
Island Hospital and IHMS for providing the Committee with a tour of the health
facilities at the hospital and within the immigration detention centres on
Christmas Island. A number of these individuals also took time away from their
busy schedules to participate in the roundtable discussion.
The Committee also thanks the Administrator of the island,
Mr Jon Stanhope, Councillor Kelvin Kok Bin Lee and other representatives of the
Shire of Christmas Island for their assistance regarding the Committee’s visit
to the island and participation in this inquiry.
Ms Jill Hall MP
Chair
Membership of the
Committee
Chair
|
Mr Steve Georganas MP (to
27/11/12)
Ms Jill Hall MP (from
27/11/12)
|
|
Deputy
Chair
|
Mr Steve Irons MP
|
|
Members
|
Mr Mark Coulton MP
|
Mr Geoff Lyons MP
|
|
Ms Deborah O’Neill MP
|
Mr Ken Wyatt MP
|
Committee Secretariat
Secretary
|
Dr Alison Clegg
|
Inquiry
Secretary
|
Ms Renee Toy
|
Research
Officer
|
Ms Belynda Zolotto
|
Administrative
Officers
|
Ms Fiona McCann
|
|
Ms Kathleen Caruso
|
Terms of reference
Increasing
globalisation and climate change pose unique challenges for population health.
Growing global interconnectedness and close proximity to regional neighbours
increases Australia’s exposure to imported infectious diseases and to the risk
of epidemic or pandemic disease outbreaks.
Recognising
the need to protect Australians, the Committee will inquire into and report on
screening, surveillance and control practices for infectious diseases, with a
particular focus on:
a) screening,
surveillance and control processes that are applied to:
i. Australians travelling to
and returning from overseas;
ii. international visitors
entering Australia, including asylum seekers;
b) Australia’s
preparedness to respond to a national or global health crisis involving the
spread of infectious disease, including:
i. how Australia’s planning
processes compare with World Health Organisation standards and recommendations;
ii. how Australia plans and
manages drug and vaccine stockpiles to respond to epidemic or pandemic infectious
disease outbreaks;
iii. Australia’s role and
responsibility for coordinating with regional neighbours and other countries to
prepare for and respond to the threat of epidemic or pandemic infectious
disease outbreaks.
In examining
each of these issues, the Committee will consider the roles and
responsibilities of Commonwealth, state and non-government agencies and
coordination of their activities.
List of
recommendations
2 Infectious disease policy framework
Recommendation 1
The relevant government agencies that have a significant role
in managing the biosecurity threat develop a coordinated approach which
addresses the health threats to Australians and recognises the impact on the
economy.
3 Screening, surveillance and control of infectious
disease
Recommendation 2
The Department of Health and Ageing review the existing
evidence base to evaluate the cost-effectiveness of its policy to use heat
scanners at ports of entry as a measure to mitigate the risk of infectious
disease importation.
Recommendation 3
The Australian Department of Health and Ageing work with the
states and territories to provide a uniform notifiable diseases list across
Australia, with consistent reporting requirements across each state and
territory and consistent public health information on infectious diseases
disseminated to the public. This work should be a priority of Australian Health
Ministers’ Advisory Council (AHMAC).
Recommendation 4
The Australian Government work with the state and territory
governments to assess the viability of providing a centralised refugee and
migrant health service in each state and territory, which would automatically
refer people who move from immigration detention into the wider Australian
community.
Recommendation 5
The Royal Australian College of General Practitioners provide
resources and training to general practitioners on the complex health needs of
migrants and refugees, with a focus on identifying infectious diseases which
are notifiable in Australia, or diseases which are of specific concern to
refugee and migrant communities.
Recommendation 6
The Australian Government, coordinated by the Department of
Health and Ageing and in consultation with the wider Australian community,
develop a national public awareness campaign to better inform and engage the
travelling public about infectious disease issues.
This campaign should cover the risks associated with
travelling overseas, preventative measures that can be undertaken to minimise
these risks, and screening measures used at the border to prevent the
importation of infectious disease.
Subject to consumer input and feedback, this campaign could
include a range of materials and platforms, including:
- videos,
which could be published via YouTube, Smartraveller, international flights
and/or other relevant access points;
- reading
material such as brochures which can be provided at travel agencies, passport
offices, on international flights and other relevant access points; and
- targeted
ongoing engagement with consumers via social media and on travel websites.
4 International cross-border issues
Recommendation 7
Having regard to the terms of the Torres Strait Treaty, the
Department of Health and Ageing, Queensland Health, AusAID and the Papua New
Guinea Government:
- establish
a set of protocols and procedures for the identification and treatment of
tuberculosis and other infectious diseases in Papua New Guinea and the Torres
Strait Islands; and
- consider
what clinical services should be available in both Papua New Guinea and
Australia for the identification and treatment of tuberculosis and other
infectious diseases.
Recommendation 8
The National Health and Medical Research Council, in
conjunction with key stakeholders, work collaboratively to provide more support
for initiatives to increase international infectious disease research
collaborations and build research capacity, particularly with neighbouring
countries in the Asia-Pacific region.
5 Pandemic planning and preparedness
Recommendation 9
The Australian Government test Australia’s ability to respond
to a widespread outbreak of infectious disease other than influenza, by
undertaking a pandemic exercise across the relevant Commonwealth, state and
territory government agencies.
Recommendation 10
The Australian Government, in consultation with consumers and
other relevant federal, state and territory agencies, develop a national
communication strategy for consumers to be used in the event of an infectious
disease outbreak.
Recommendation 11
The Australian Department of Health and Ageing consult with
members of the general public or representatives of health consumers in the
pandemic planning process, including in pandemic exercises designed to test the
ability of government to respond to a pandemic event. Consumer involvement
should include testing the ability of any communication strategy designed to
inform and engage consumers about a pandemic event.
Recommendation 12
The Commonwealth Government support the growth of vaccine
development and production capacity for vaccines in Australia, to enhance
Australia’s preparedness to respond to outbreaks of infectious disease in
Australia, and in particular, pandemic influenza.
Recommendation 13
The Australian Government coordinate the development of a
highly skilled workforce which can respond effectively to a sustained pandemic
in Australia.
6 Does Australia need a national centre for communicable
disease control?
Recommendation 14
The Australian Government, in consultation with state and
territory governments, conduct a comprehensive national audit and mapping
exercise to:
- identify
all of the agencies (not limited to those within the health portfolio) and
expert committees/working groups involved in managing infectious disease risks;
- clarify
roles, responsibilities and map hierarchies and lines of communication;
- identify
all relevant infectious disease policies and plans, explain how these operate
in relation to one another;
- identify
any duplication and present options for streamlining; and
- identify
any policy or response gaps that need to be addressed.
The outcomes of the audit and mapping exercise should be made
publically available.
Recommendation 15
The Australian Government, in consultation with state and
territory governments, commission an independent review to assess the case for
establishing a national centre for communicable disease control in Australia.
The review should outline the role of a national centre and
how it might be structured to build on and enhance existing systems. It should
examine different models, considering a range of options for location,
governance and staffing. The review should incorporate a cost-benefit analysis
for each of the models presented.
The outcomes of the review should be made publically
available.