IN 1943, during the darkest days of World War II, senior army doctor Bill Keogh lobbied Australia’s war cabinet to establish domestic manufacture of a promising new drug, penicillin.
Military field trials of the new antibiotic, developed in Oxford by Australian pharmacologist Howard Florey and colleagues, had shown near-miraculous success in prevention and treatment of infection in wounded soldiers but supplies were scarce.
The government took Dr Keogh’s advice and the task of producing the drug in Australia was entrusted to then publicly owned pharmaceutical manufacturer CSL, where Keogh had worked before the war.
CSL veterinarian Val Bazeley was brought back from army service in New Guinea to lead the charge. Returning from a visit to US manufacturers in December 1943, Bazeley set himself a deadline of six weeks to get local production underway.
Ten weeks after Bazeley’s return from the US, CSL produced enough penicillin to save the life of a soldier with septicaemia, as described by infectious disease expert Professor Ian Gust.
Just two months later, in April 1944, Australia became the first country in the world to provide penicillin to its civilian population.
What, you might ask, has happened to us?
Writing about the COVID-19 pandemic over this past year, I have mostly held off from criticising our federal or state governments.
They, like all of us, have faced an unprecedented and unpredictable situation. Decisions have had to be made quickly and, inevitably, have sometimes proved to be wrong. Mistakes have been made.
The closure of our international border caused much pain, personal and economic, but was effective in protecting us from the pandemic. The expensive and much-hyped COVIDSafe app, on the other hand, didn’t deliver. But it’s easy to be wise in hindsight.
The bungled vaccine rollout, though, is a different level of failure.
Australia lags well behind most of the world in vaccinating against COVID-19, with just 6.48% of our population having received a first dose of vaccine as of last week, according to this Oxford University data aggregation site.
The rollout has been slow even for some of the people identified as most vulnerable, such as those in specialist disability accommodation, the ABC has reported.
The low overall vaccination rate here compares with almost 50% of the UK population and around 40% in the US, according to the Oxford data. Even India, with its far larger population and considerable logistical challenges, is ahead of us at 8%.
It’s true those countries face a greater imperative to vaccinate quickly given their burden of disease, but Australia appears to be at risk of squandering the advantage so far conferred on us by our geographical isolation and the swift closure of our international borders.
Our success to date may explain why Australia has lacked the motivation and effort to get its population vaccinated quickly, infectious disease researcher Professor Robert Booy told the New York Times last week.
“We need to recognise the complacency that’s building,” he said. “We’re just one super-spreading event away from trouble.”
It’s hard to understand how things can have been allowed to get to this point. As the various vaccines against COVID-19 were being developed last year, it should have been obvious it would be unwise to put all our eggs in one basket.
The accelerated development of the vaccines combined with massive global demand meant problems were pretty much bound to occur, whether those were supply issues, unexpected side effects, or effectiveness issues, including against new viral variants.
To manage those risks, most countries with the means to do so made deals with multiple manufacturers. Australia to a large extent did not, pinning its hopes on a single vaccine manufactured by AstraZeneca.
On top of that, little was done to boost the domestic technological or manufacturing capacity that might have helped to assure supply in this and future infectious disease outbreaks.
The federal government poured more than $100 billion in stimulus money into the economy to stave off a pandemic-initiated downturn.
This was a good and necessary move, but a disappointingly small amount of the funding went to projects that will deliver lasting benefit to the nation.
Given the level of debt this will impose on all of us for decades to come, it would have been good to see more focus on building national assets and less on subsidies for private home renovations.
Last week, we finally saw an announcement that Victoria would move to establish manufacturing capacity for mRNA vaccines.
This new technology is the basis of the COVID-19 vaccines manufactured by Pfizer and Moderna. While there are still some issues to be ironed out, such as storage constraints, mRNA vaccines offer the major advantage of being able to be designed or modified more quickly than adenovirus vector vaccines like AstraZeneca’s in response to new diseases or variants.
Given this technology is likely to be central to future management of infectious disease, and that the current pandemic has exposed the risk of relying on imports during a health crisis, it’s worth asking why this did not happen in 2020, and why it has taken a state government to do it.
As we saw with the catastrophic bushfires of 2019–20, it has mostly been state governments who have done the hard yards during the pandemic.
They’ve made mistakes, of course – the Ruby Princess in New South Wales, mismanaged hotel quarantine in Victoria – but by and large what we have seen is Premiers and their teams working tirelessly, making difficult decisions and facing the criticism when things went pear-shaped.
The federal government in contrast has often seemed more focused on making announcements – who can forget the repeated claim that we were “at the front of the queue” for COVID-19 vaccines – than on actual delivery.
We should expect more from our elected representatives. Time perhaps to bring back the spirit of 1943.
Jane McCredie is a Sydney-based health and science writer.
The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.