more_vertA plan to expand immigrant children detention centres requires money from medical research and health programmes. Susan Jaffe, The Lancet’s Washington correspondent, reports.
Preference: Statistics, epidemiology and research design
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Father of Medicare dies
Professor John Deeble AO, the man universally known as the “Father of Medicare” has died at the age of 87.
Most recently, Emeritus Fellow of the Australian National University, Sax Medallist, and Patron of the Deeble Institute for Health Policy Research – the research arm of the Australian Healthcare and Hospitals Association, of which Professor Deeble was a life member – it was his much earlier work that gave him nickname.
In 1968, together with Dr Dick Scotton, Professor Deeble co-authored the original proposals for universal health insurance in Australia.
He subsequently became the architect of the reintroduction of universal healthcare in Australia – Medicare – in 1984.
His other appointments included First Assistant Secretary in the Commonwealth Department of Health, Founding Director of the Australian Institute of Health and Welfare, and from 1989 to 2005, Senior Fellow in Epidemiology and Adjunct Professor in Economics at the National Centre for Epidemiology and Population Health at the ANU.
He was Special Adviser to the ministers for health in the Whitlam and Hawke governments, chairman of the planning committees for both Medibank and Medicare, and a commissioner of the Health Insurance Commission for 16 years.
In addition, Professor Deeble was a World Bank Consultant on healthcare financing in Hungary, Turkey and Indonesia, and for more than10 years to 2005, an adviser to the government of South Africa.
MoU heralds new research collaboration
An agreement signed between Australia and the Texas Medical Center (TMC) in the United States has opened the way for a new level of collaboration between world-class medical researchers from both countries.
The research agreement focuses on clinical trials and reaching high-level medical breakthroughs.
A Memorandum of Understanding (MoU) between the Federal Government and the renowned TMC was signed in Canberra late in October.
It will enable Australian medical researchers to better develop clinical practice and commercial opportunities in the areas of genomics, rare cancers, brain cancer research and current and emerging clinical trials.
Negotiations began in June this year, and Australia is now the first country to form such an agreement with TMC, home to the world’s largest children’s hospital and the world’s largest cancer hospital.
Health Minister Greg Hunt said the MoU demonstrates the Government’s commitment to supporting Australia’s world-class health system.
“It will provide economic opportunities and Australian patients could potentially be given earlier access to breakthrough medical technologies and treatment,” he said.
“Medical Research is currently a $1 billion industry in Australia and it is expected to triple in size, if not quadruple, in the next five years delivering huge economic outcomes, but more importantly lifesaving results.”
[Comment] Prevention, detection, intervention: the big wins for mental health
Around the world, media news bulletins and headlines are dominated by the health scourges of our time: cancer, diabetes, obesity, malaria, and heart disease. Governments rightly focus our international efforts on improving prevention, diagnosis, and treatment, and all are in the sights of clinical experts, scientists, and researchers who, with enough time, resources, and manpower, might just find a cure for them all.
[Comment] Sex and gender analysis for better science and health equity
Despite growing recognition of the imperative to address gender disparities and inequity in health, researchers, funders, and editors do not treat the gendered aspects of health research and practice as a priority. It is unacceptable that members of the scientific community, who are putatively committed to rigour and objectivity, undervalue the importance of the gender bias in academic research and neglect to act. Is this because gender has become equated with feminism, which some argue has no place in science?1 Is it a reflection of the long-standing marginalisation of women in medical research where they have been the subjects of attention mainly in matters relating to reproduction? Or it is that, historically, science has been built around a hierarchical and androcentric logic, whereby the white male body is the gold standard against which all else is measured?
[Comment] Towards a new era for mental health
The new Lancet Commission on global mental health and sustainable development1 raises important issues at a time when many countries in the Global South are re-examining their national priorities in mental health. With its broad vision, the Commission shows why mental health is a public good that is a crucial part of the Sustainable Development Goals (SDGs). The Commission’s report emphasises the need to take a dimensional approach to mental health problems and their treatment; to allocate resources where they will be most cost-effective; to consider a life-course approach; and to build on existing research that will pave the way for better understanding of the causes, prevention, and treatment of mental health problems.
[Comment] No benefit of chlamydia screening in primary care?
Chlamydia trachomatis is the most common sexually transmitted bacterial infection worldwide. Persistent, untreated infection with C trachomatis leads to pelvic inflammatory disease (PID) and other complications, including ectopic pregnancy and tubal factor infertility. Researchers have shown that interventions that shorten the duration of infection through timely detection and treatment decrease PID incidence by 32%.1 On the basis of that and other evidence, many high-income countries support annual screening and treatment programmes for chlamydia in young women, repeated screening of those who are infected, and expedited partner treatment.
Commissioner appointed for aged care
Australia’s first Aged Care Quality and Safety Commissioner is a former acting head of Northern Territory Health Department.
Aged Care Minister Ken Wyatt has named Janet Anderson as the Commissioner. She will start her role as the sector’s regulator next year.
Mr Wyatt said the appointment marked a significant milestone in the journey towards a better, safer aged care system.
“Highly respected and experienced health sector leader Janet Anderson will oversee establishment of the Commission, as it prepares to start intensified compliance monitoring from 1 January 2019,” he said.
“The new Commission will have a budget of almost $300 million over four years, employing dozens of additional senior compliance officers.”
Ms Anderson was First Assistant Secretary, Health Services, in the Commonwealth Department of Health 2012-2015, and Director, Inter-Government and Funding Strategies in the New South Wales Department of Health 2006-2011.
For the past two years, Ms Anderson has held the positions of Deputy Chief Executive and acting Chief Executive of the Northern Territory Department of Health.
In 2009, she was awarded the Public Service Medal for outstanding work in health policy development and reform.
Ms Anderson was only recently appointed as the new head of ACT Health, but stepped down from the role almost immediately.
She is currently working with the NT Government to implement recommendations from the royal commission into the protection and detention of children in the territory.
Ms Anderson will be assisted by aged care medical expert Associate Professor Michael Murray, who is working as the new interim Chief Clinical Advisor to support key establishment activities.
Associate Professor Murray has a broad range of management, clinical and clinical teaching experience in aged care as the medical director of Continuing Care and head of Geriatric Medicine at Austin Health, Melbourne.
He is also the President of the Board of Directors at the National Ageing Research Institute, Associate Professor at Melbourne University and Adjunct Associate Professor Australian Centre for Evidence Based Aged Care and La Trobe University.
The permanent appointment of a clinical advisor to the Commission will be a matter for the new Commissioner.
The establishment of this agency is in addition to the recently announced royal commission into the aged-care sector.
Life expectancy predictions changing around the world
Australia ranks tenth on a list of global life expectancy by 2040, according to recently published new research.
With the average life expectancy of Australians projected to be 84.1 years, the nation sits high on the table, but it is Spain that is predicted to rise to the top by 2040, overtaking Japan’s long-held first ranking.
The study, first published in Lancet, also shows the United States is set to take a dive in the life expectancy stakes to 64th place, down from 43rd in a 2016 study – the biggest drop of all high-income earning countries.
The US will be passed by China, which will jump 29 places to be 39th on the table.
The average global rise of life expectancy is 4.4 years, while Americans will only live an average 1.1 years longer at 79.8 years of age.
According to the study, People in Spain will live for 85.8 years on average by 2040, while the Japanese will live an average of 85.7 year, followed by Singapore (85.4) and Switzerland (85.2).
The United States will take the biggest drop in ranking of all high-income countries, falling from 43rd in 2016 to 64th by 2040, with an average life expectancy of 79.8.
China will rise 29 places to 39th in the table, to reach a life expectancy level of 81.9 years.
Americans will live only 1.1 years longer on average in 2040 compared to 2016, well below the average global rise of 4.4 years over that same period.
A sharp increase in obesity rates and drug related deaths in the US are the main determining factors in its decline in life expectancy.
Diet, disease, and the standard of healthcare are reported to be the major contributors to each nation’s life expectancy ranking, with the Mediterranean diet helping to propel Spain to the top of the list.
It is also considered a factor neighbouring Portugal’s rise to number five on the list. Portugal has the biggest jump in the top 20, going from 23rd place to number five and adding an average 3.6 years to 84.5.
Researchers found that high blood pressure, high body mass index, high blood sugar, tobacco and alcohol use to be major causes of premature mortalities.
African nation Lesotho has dropped to last place of the 195 countries rated, with a life expectancy of 57.3 years by 2040.
The low ranking of poorer nations points to the inequality in healthcare and sanitation services around the globe.
Lead author of the study, Dr Kyle Foreman of the Institute for Health Metrics and Evaluation noted, however, that the future of the world’s health was not pre-ordained, and there remains a wide range of plausible trajectories.
“Whether we see significant progress or stagnation depends on how well or poorly health systems address key health drivers,” Dr Foreman said.
Top Ten
- Spain (85.8 years)
- Japan (85.7 years)
- Singapore (85.4 years)
- Switzerland (85.2 years)
- Portugal (84.5 years)
- Italy (84.5 years)
- Israel (84.4 years)
- France (84.3 years)
- Luxembourg (84.1 years)
- Australia (84.1 years)
CHRIS JOHNSON
[Perspectives] Ana Pilar Betrán: seeking the optimum use of caesarean section
What is the “correct” rate of deliveries in which birth should be by caesarean section? There is no clear-cut answer to the question, and the success of recommendations intended to raise or lower an existing caesarean section rate is not easily judged by reference to a predetermined numerical goal. As one of the key contributors to this issue’s Lancet Series on optimising the use of caesarean section, Ana Pilar Betrán of WHO’s Department of Reproductive Health and Research finds herself in territory characterised by uncertainty.