Brad McCall: We need our own CDC

AUSTRALIA remains vulnerable to the threat of infectious diseases unless we follow the lead of other countries and establish an independent authority for communicable disease control.

As pointed out in a recent article which I coauthored and published in Australian Health Review, Australia is now unique in being the only Organisation for Economic Co-operation and Development country without a recognised separate authority for national scientific leadership in communicable disease control.

This has been recognised by a range of health experts and was the subject of a recent inquiry by the House of Representatives Standing Committee on Health and Ageing.

The inquiry recommended a national audit and mapping exercise followed by an independent review to assess the case for establishing a national centre for communicable disease control.

There have been a number of recent public health threats that have prompted these calls for the establishment of an Australian Centre for Disease Control (or similar body), including the pandemic (H1N1) 2009 influenza; the identification in April 2010 of an excess of febrile convulsions in young children following administration of seasonal influenza vaccine; and the 2011 outbreak of Hendra virus in horses across Queensland and NSW which has led to the deaths of four people since 1994.

Each of these events presented unique challenges and all placed a strain on our current level of resources and expertise at both federal and state/territory level.

If there was a body to provide overall leadership and coordination on emerging communicable disease threats, including the efficient allocation of resources, it could provide timely reports to government, health services and the community and prioritise national research efforts.

We have a range of models to choose from, including the extensive and well resourced US Centers for Disease Control and Prevention (CDC) as well as more modest enterprises such as the UK Health Protection Agency and the European Centre for Disease Prevention and Control.

Given the federal governance structure in Australia, perhaps the most pertinent example in terms of comparable legislative frameworks is the Public Health Agency of Canada.

While different nations have different models to deliver this function, all are composed of professionals with a degree of independence from government to ensure that there is a clear separation between politically sensitive decision making and the advice and tools needed to inform best practice from a technical perspective.

Current arrangements in Australia for managing communicable disease issues have very limited scope for ongoing analysis and interpretation of national data, development of new surveillance methods, routine review of international findings, evaluation of policy and program impact, and the training and mentoring of the public health workforce that must be kept in readiness for the communicable disease threats that may emerge in the next decade … or week.

Despite being one of the richest countries in the world, our current communicable disease control arrangements are leaving us surprisingly vulnerable to outbreaks of infection, whether due to recurrent known pathogens or those yet to be identified.

The establishment of an Australian CDC would bring us in line with the situation in other countries of similar resources, and provide much-needed insurance against the disaster that may never happen or may be just around the corner.

The time has come for an Australian CDC.

Dr Brad McCall is the Queensland Public Health Medical Officer.

This article was written with assistance from health policy analyst Jennifer Doggett.