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Australia needs its own CDC to coordinate health advice, say experts

The Australian Health Protection Principal Committee (AHPPC) is made up of the country’s chief medical officers to assist in managing diseases and illnesses. Chaired by federal CMO Professor Paul Kelly, it’s achieved prominence during the pandemic as governments have sought the most current (and reliable) health advice to ensure coronavirus doesn’t cause as much harm in Australia as it has in other countries.

Kelly and his AHPPC colleagues have spent time deliberating on and issuing a raft of statements related to the status of the pandemic and the measures it believes will help mitigate or minimise the risk of spreading the virus. Statements cover a broad range of issues related to pandemic management, including guidance on who is permitted to return to work in specific contexts, the impact of the coronavirus in various social settings such as schools and kindergartens as well as how rapid antigen tests should be used and by whom.

AHPPC decisions go to the federal government and the national cabinet, along with any recommendations made by the Australian Technical Advisory Group on Immunisation (ATAGI), which is responsible for providing advice on vaccination programs. 

The national cabinet, of course, was set up to offer some semblance of national coordination during this rare global medical conundrum. It’s been a mixed experiment in cooperation between the leaders of the eight jurisdictions, given the difference in views on lockdowns and other pandemic measures.

The Australian Healthcare and Hospitals Association (AHHA) says the pandemic has revealed weaknesses within the existing system for making health policy decisions. “Inconsistent messaging and conflicting state and territory expert advice led the Australian government to circumvent Australia’s existing pandemic arrangements and establish a national cabinet,” the AHHA said in an early review of the pandemic response published in October 2020. 

“National cabinet provided an effective intergovernmental process to respond to an urgent public need. However, while guiding Australian, state and territory government coordination, the implementation of the ‘cabinet-in-confidence’ process has removed public transparency and oversight of crucial disease control decision-making processes.”

Improving efficiency and transparency

The AHHA isn’t alone in its criticism of the inefficiencies and absence of transparency of the current process. Other associations representing professionals in the health sector are demanding the federal parliament considers a shake-up of how pandemics are managed.

What do some of these groups want to see?

The US Centers for Disease Control and Prevention (CDC) has several fans among those that have submitted to the parliamentary committee looking at Australia’s response to the coronavirus pandemic. The Australian Medical Association (AMA) observed that the institutional arrangements need to work better.

“Australia is the only country in the OECD that does not have an independent or dedicated centre for disease control,” said the AMA, which has advocated for a CDC since 2017. “Establishing a national CDC would enable Australia to play a global role in combating infectious diseases and potential threats.”

The AMA believes pandemic threats would be coordinated better with an institution such as a CDC, although it would need to be adequately funded to conduct research, look at risk profiles and ensure there were rapid assessments on easily transmitted diseases. 

“A CDC would have standard communication packages and resources prepared ahead of time,” said the AMA in its submission. “For example, clear messaging on best practice for attending a general practice in the midst of a predictable droplet borne condition would have prevented significant confusion at the early stages of Australia’s response, as well as reducing duplication of efforts which occurred in each state and territory.

“Resources for clinicians, such as flow charts on the management of patients, were also developed in different jurisdictions in the early stages of the pandemic, creating some confusion.”

The Public Health Association of Australia (PHAA) has also backed the idea. It told the committee that Australia’s ability to dodge the numbers of deaths and coronavirus cases could be misinterpreted by some to say institutional structures are fine.

“There are many factors which worked in our favour in controlling COVID-19, including our geography and the dominance of travel-related cases as opposed to community transmissions,” the PHAA said. “While the AHPPC mechanism was pre-existing and able to be utilised quickly, our response would have benefitted from having a centralised agency to support and advise the AHPPC.”

In 2013, a parliamentary committee inquiry report called “Diseases have no Borders: Report on the Inquiry into Health Issues across International Borders” contained a recommendation for the federal government to investigate the feasibility of establishing a CDC in Australia. The government didn’t act on the advice because it believed the national communicable diseases framework would help integrate responses. 

Australia has seen the emergence of single-issue extremist groups spreading conspiracy theories during the pandemic that relate to impacts of vaccination, coronavirus treatments and general scuttlebutt about the ultimate objective of health orders such as mask mandates. Various groups and public channels sprang up to spread misinformation, recruit followers and organise protests and similar activities designed to amplify opposition to coronavirus measures.

The PHAA said a CDC-style agency would assist in mitigating the impact of rogue messaging from anti-government, anti-vaccination and anti-mask mandate groups. “An independent agency to provide advice and education to the public about COVID-19 (in this instance), and to coordinate relevant health advice to the public would assist with protecting against inconsistent information and misinformation,” the PHAA said.

How the pandemic has tested public sector collaboration

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