Online version of the 2013-14 Department of Health Annual Report

Outcome 14: Biosecurity and Emergency Response

Preparedness to respond to national health emergencies and risks, including through surveillance, regulation, prevention, detection and leadership in national health coordination

Page last updated: 17 July 2019

Major Achievements

  • In 2013-14, Australia achieved World Health Organization (WHO) verified measles elimination. This means that Australia has no local strain of measles circulating in the community and we have well-performing surveillance systems to rapidly detect and respond to measles cases. The Department’s National Immunisation Programme (Outcome 1) contributed significantly to this achievement by ensuring high levels of vaccination coverage for measles in Australia. In December 2013, measles coverage at five years of age was 92.2%. In July 2013, the second measles containing vaccine was moved from four years of age to 18 months of age. This will provide two dose protection earlier in life and is expected to improve coverage rates.
  • The Department completed two response plans – the revised Australian Health Management Plan for Pandemic Influenza and the Domestic Response Plan for Chemical Biological Radiological and Nuclear Incidents of National Consequence. These will ensure Australia continues to be well placed to meet current and future health protection challenges.
  • The response capacity of the National Medical Stockpile was maintained through the replenishment of expired stock. This ensures that Australia has ongoing access to a range of pharmaceuticals for use in response to a major health emergency.
  • The Department contributed to international emergency response efforts through the successful deployment of two Australian Medical Assistance Teams, following the category five Typhoon Haiyan, in November 2013 to Tacloban in the Philippines.
  • The Department has provided national leadership and coordination in planning and preparedness activities including for a potential case of Middle Eastern Respiratory Syndrome coronavirus (MERS-CoV) in Australia and assisting in the contact tracing of potentially infected people in Australia from the significant January 2014 measles outbreak in South East Asia.

Challenges

  • Imported cases of communicable diseases continue to pose a threat to Australia’s public health and our ability to maintain control of eliminated and low incidence diseases such as measles, polio and tuberculosis.
  • There has been a significant increase in the number of chemical substances referred for scheduling as a result of the introduction by the National Industrial Chemicals Notification and Assessment Scheme of the Inventory Multi-tiered Assessment Prioritisation Framework.

Looking Ahead

In 2014-15, the Department will continue to work closely with the Department of Agriculture to finalise Australia’s first National Antimicrobial Resistance (AMR) Strategy. The Department will also contribute to the work of the World Health Organization to develop a Global Action Plan for AMR.

Under the 2014-15 Budget Measure Reinforcing Australia’s Health Protection, the Department will replenish expired items in the National Medical Stockpile and start implementing reforms to improve the management and operational efficiency of stockpiling arrangements. This measure also provides funding to secure Australia access to a timely supply of antivenoms, Q fever and pandemic influenza vaccines.

Containment of any future national health emergencies will continue to be a major focus for the Department.

Programme Contributing to Outcome 14

  • Programme 14.1: Health Emergency Planning and Response

Divisions Contributing to Outcome 14

In 2013-14, Outcome 14 was managed by the Office of Health Protection.

Outcome Strategy

Outcome 14 aims to strengthen the nation’s capacity to identify, monitor and implement effective and sustained responses to national health emergencies and risks. In 2013-14, the Department worked to achieve this Outcome by managing initiatives under the programme outlined below.

Programme 14.1: Health emergency planning and response

Programme 14.1 aims to provide national health emergency planning and response, improve biosecurity, drug and chemical safety, and minimise the risks posed by communicable diseases.

National health emergency planning and response

As part of the ongoing work on national planning and response, the Department works closely with States and Territories under the Australian Health Protection Principal Committee to maintain national emergency response plans and strategies which ensure timely and well-coordinated responses to domestic and regional incidents. The Department also coordinates health responses to national emergencies from the National Incident Room (NIR).

In 2013-14, the Department continued to fund and collaborate with the National Critical Care and Trauma Response Centre (the Centre) to ensure the Centre was able to respond rapidly to major incidents in both Australia and South East Asia, and provide trauma and acute care services through fully self-contained field hospitals. The Centre enhanced its ability to quickly deploy skilled personnel through a variety of activities such as national trauma and disaster training sessions for volunteer clinicians.

Qualitative Deliverable
Develop, exercise and refine national health emergency policy under the National Health Emergency Response Arrangements
2013-14 Reference Point
National Health Emergency Response Arrangements will be exercised and revised and a paediatric annex detailing the national health response arrangements to a mass casualty incident with paediatric casualties will be developed
Result
Met
Qualitative KPI
Containment of national health emergencies through the timely engagement of national health coordination mechanisms and response plans
2013-14 Reference Point
National responses to health emergencies are successfully managed
Result
Met
The Australian Health Protection Principal Committee (AHPPC), chaired by Australia’s Chief Medical Officer, coordinates and supports national health emergency management. In 2013-14, the Committee considered and agreed to a series of key national plans and strategies to enhance current arrangements, including the National Framework for Communicable Diseases Control, the Australian Health Management Plan for Pandemic Influenza, and the National Blood Borne Viruses and Sexually Transmissible Infections Strategies 2014-17. The Committee held extraordinary meetings at short notice to discuss Australian Medical Team arrangements to support rapid disaster responses within the region, namely Philippines and Solomon Islands, and national preparedness arrangements related to potential cases of avian influenza virus, poliovirus, and Middle Eastern Respiratory Syndrome coronavirus.

During 2013-14, the NIR responded to 158 health related incidents, compared to 114 incidents in 2012-13. These incidents ranged from tracing people who had been potentially exposed to a disease, to coordinating national and international health emergency responses. The category five Typhoon Haiyan that hit the Philippines on 8 November 2013 led to the most significant response by the Department in this reporting period. The Department’s response to this disaster centred on the deployment of two civilian health teams known as Australian Medical Assistance Teams (AUSMATs) from 13 November 2013 to 9 December 2013.

The NIR’s most frequent type of response involved assisting with the contact tracing of people potentially infected with a communicable disease. Contact tracing assists in containing the spread of a disease by contacting individuals with lengthy exposure, for example during air travel, to a person with a communicable disease. These potential contacts are then offered appropriate health advice by clinicians in their home state or territory. Measles was the most frequent illness requiring contact tracing, largely due to an ongoing outbreak of measles affecting much of South East Asia. There were 17 measles contact tracing incidents during January 2014 compared with an average of three measles incidents per month during the rest of 2013-14.

Information exchange, including sensitive personal information, is vital in coordinating a response to national and international health emergencies. Under the National Health Security Agreement, the Department is required to report annually on the exchange of personal information and this occurred on 128 occasions during 2013-14.

Improve biosecurity, drug and chemical safety

Chemical safety

The Department is responsible for ensuring that Australia fulfils its obligations under international agreements relating to the regulation of chemicals and for collecting statistics about chemicals.

The Department is responsible for updating and maintaining the Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP). The SUSMP publishes the schedules which form a national classification system that controls how medicines and poisons are made available to the public.

Qualitative Deliverable
Update and maintain the SUSMP
2013-14 Reference Point
SUSMP to be amended as soon as practicable after the Secretary’s, or the Secretary’s delegate’s, final decision under the Therapeutic Goods Regulations 1990
Result
Met

The Department undertakes human health risk assessments for veterinary medicines and pesticides and provides advice to the Australian Pesticides and Veterinary Medicines Authority (APVMA) on the public health effects of human exposure to chemicals and pesticides. The Department also considered the toxicology profile and intended uses of chemicals (and the products that contain them) and provided recommendations to APVMA on whether they were safe for use.

Qualitative KPI
Perform human health risk assessments and regulate access to chemicals and drugs
2013-14 Reference Point
Chemical assessments completed in a timely manner and authorisation to access drugs and chemicals issued in accordance with legislative requirements
Result
Substantially met
In 2013-14, the Department, through the Office of Chemical Safety, continued to undertake human health risk assessments for the APVMA. The Department conducted 86 assessments, and recommended against granting some applications on human health grounds.
Management of controlled substances

In 2013-14 the Department monitored the stock and manufacture of internationally controlled drugs and monitored approximately 4.2 million wholesale transactions of these drugs within Australia. The data collected contributed to Australia’s reporting obligations, under the international drug conventions, and assisted states and territories with monitoring potential drug diversions.

The Department cooperated with other countries to control the export of chemicals (precursors) that have the potential to be used to manufacture illicit drugs. Pre-export notifications provide an early warning system to countries and customs authorities of chemical shipments which may be diverted from licit channels. In 2013-14, there were 1,166 pre-export notifications processed by the Department for all precursor substances controlled under the international drug conventions.

Australia is a major global producer of narcotic raw materials from poppy cultivation, providing almost half the world’s legal supply. Careful control and supervision of all stages of poppy growing and manufacture of narcotic raw materials is required under the international drug conventions. To facilitate this, the Department issued manufacturing licences and permits under the Narcotic Drugs Act 1967 to regulate supply of narcotics, and provide regular reports on the cultivation areas, harvest and narcotic production to the International Narcotic Control Board to enable better regulation of global narcotic drug supply.

In 2013-14, the Department continued to work closely with the international community and Australian law enforcement agencies on regulating new psychoactive substances. Further amendments to the list of drugs controlled within the import and export regulations are under consideration for 2014-15 due to the continued emergence of new psychoactive substances of risk and the corresponding actions taken by international regulators.

Qualitative Deliverable
Review the Commonwealth legislation underpinning the uniform system of controls for goods containing scheduled substances as required under s52EC of the Therapeutic Goods Act 1989
2013-14 Reference Point
Review to start no later than 1 July 2013 and to be completed within six months
Result
Met
The review commenced on 12 March 2013 and concluded within six months.
The report, Review of arrangements for the scheduling of substances under Part 6-3 of the Therapeutic Goods Act 1989, was tabled in both Houses of Parliament on 10 December 2013 consistent with s52EC(7) of the Therapeutic Goods Act 1989.
The review produced eight recommendations which are currently under consideration by the Department.
Quantitative Deliverable
Percentage of applications for the import, export, and manufacture of controlled substances that are assessed and processed within agreed timeframes
2013-14 Target
95%
2013-14 Actual
99%
Result
Met
In 2013-14, the Department issued a total of 7,888 licences  and permits authorising the import, export and manufacture of controlled drugs.In 2013-14, the Department issued a total of 7,888 licences and permits authorising the import, export and manufacture of controlled drugs.

Minimise the risks posed by communicable diseases

The communicable disease issues facing Australia are diverse and associated with foodborne diseases, zoonoses, antimicrobial resistant (AMR) bacteria, sexually transmissible infections, blood borne viruses, vector-borne diseases, bacterial infections and vaccine preventable diseases. In 2013-14, the Department responded to international disease outbreaks, such as the Ebola hemorrhagic fever outbreak in West Africa, and continued to respond to new and emerging diseases, such as Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV), that pose a potential public health threat to Australia.

Quantitative KPI
Percentage of designated points of entry into Australia capable of responding to public health events, as defined in the International Health Regulations
2013-14 Target
100%
2013-14 Actual
100%
Result
Met

The Department continues to develop national guidelines for the public health management of communicable diseases. In 2013-14, the Department coordinated the development of national guidance for six nationally notifiable diseases – Haemophilus Influenza type b, Murray Valley encephalitis, rabies and other lyssaviruses (including Australian bat lyssavirus), syphilis (interim guidelines), trachoma and tuberculosis.

Surveillance

The Department works in collaboration with other Australian Government agencies and State and Territory Governments to ensure the collection of quality surveillance data in order to monitor and respond to public health risks. The Department also works with States and Territories through committees such as the Communicable Disease Network Australia (CDNA) to ensure the national coordination of communicable disease surveillance, prevention and control. Robust and timely disease surveillance ensures that Australia is able to detect, assess and respond to both domestic and international communicable disease threats.

The Department conducted national surveillance on 65 communicable diseases through the National Notifiable Diseases Surveillance System (NNDSS) which enabled health authorities to respond to outbreaks in a timely manner. Additional surveillance data were also collected through the National Influenza Surveillance Scheme and OzFoodNet.

Influenza Surveillance

Throughout the influenza season, influenza data was collected from all components of the national influenza surveillance system, and was analysed and reported fortnightly to decision makers, health professionals and the public. The Department continued to work with the Influenza Surveillance Strategy Working Group to develop the national influenza surveillance systems to ensure that the epidemiology and virology of influenza across Australia can be measured.

Exotic Mosquito Surveillance

The Department continued to fund a programme to monitor and control the spread of exotic mosquitoes (Aedes albopictus) in the Torres Strait, through a partnership with the Queensland Government. In 2013-14, ongoing surveillance conducted by Queensland Health indicated that there was no established Aedes albopictus population on mainland Australia, restricting the spread of dengue fever and other mosquito-borne diseases in the region.

Qualitative Deliverable
Manage and control exotic mosquito populations to reduce the risk of disease transmission in the Torres Strait and mainland Australia
2013-14 Reference Point
Regular mosquito surveillance to indicate whether the mosquito population has declined in the Torres Strait and not spread to the mainland
Result
Met
OzFoodNet

In 2013-14, the Department continued to fund OzFoodNet to provide enhanced surveillance and investigation of foodborne disease in Australia in conjunction with jurisdictions. In September 2013, OzFoodNet worked closely with Australian and New Zealand food safety officials, the United States (US) and international agencies to monitor an outbreak of acute non-viral hepatitis, potentially linked to dietary supplements, in the US with two possible cases in Queensland. In October 2013, OzFoodNet conducted a multijurisdictional investigation into a Salmonella Typhimurium outbreak with 22 cases from four jurisdictions linked to consuming food at a sporting institute in the ACT. In 2014, OzFoodNet continues to closely monitor an increase, from late 2013, in the incidence of salmonellosis and regularly liaises with key stakeholders on this issue.

Antimicrobial resistance

The prevalence of antimicrobial resistance (AMR) is increasing both in Australia and internationally at a pace that exceeds the pharmaceutical industry’s capacity to develop new antimicrobial drugs.

Australia is developing a National AMR Strategy, to provide national and international leadership on this significant global health priority.

The National AMR Strategy will address: infection prevention and control; surveillance; antimicrobial stewardship; communication and education; research and development; international engagement; and governance.

Surveillance has been identified as the initial priority area for action. In 2013-14, the Government provided funding of $9.9 million over three years to implement enhanced arrangements for surveillance in human health. The Department entered into an agreement with the Australian Commission on Safety and Quality in Health Care to undertake this work, which will include establishing passive and targeted surveillance systems for AMR and antibiotic use in humans that build on existing surveillance systems, and a national alert system to inform clinicians and policy-makers about emerging AMR trends that could impact on public health.

In addition, Australia has provided funding to the WHO to support the development of a Global Action Plan for AMR. The draft Plan is due to be submitted to the Sixty-eighth World Health Assembly in May 2015.

Outcome 14 – Financial Resource Summary

(A) Budget Estimate1
2013-14
$’000
(B) Actual 2013-14
$’000
Variation (Column B minus Column A)
$’000
Programme 14.1: Health Emergency Planning and Response 2
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)
20,695
18,857
( 1,838)
Non cash expenses – write down of assets 3
17,301
6,660
( 10,641)
Special accounts
Human Pituitary Hormone Special Account
150
130
( 20)
Departmental Expenses
Departmental Appropriation 4
26,059
25,676
( 383)
Expenses not requiring appropriation in the current year 5
1,401
1,333
( 68)
Total for Programme 14.1
65,606
52,656
( 12,950)
Outcome 14 Totals by appropriation type
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)
20,695
18,857
( 1,838)
Non cash expenses
17,301
6,660
( 10,641)
Special accounts
150
130
( 20)
Departmental Expenses
Departmental Appropriation 4
26,059
25,676
( 383)
Expenses not requiring appropriation in the current year 5
1,401
1,333
( 68)
Total Expenses for Outcome 14
65,606
52,656
( 12,950)
Average Staffing Level (Number)
157
154
( 3)

1 Budgeted appropriations taken from the 2014-15 Health Portfolio Budget Statements and re-aligned to the 2013-14 programme group structure.

2 This programme includes National Partnerships paid to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework. National Partnerships are listed in this chapter under each programme.

3 Non cash expenses relate to the write down of the drug stopckpile inventory due to expiration, consumption and distribution.

4 Departmental appropriation combines ‘Ordinary annual services (Appropriation Bill 1)’ and ‘Revenue from independent sources (s31)’.

5 ‘Expenses not requiring appropriation in the budget year’ is made up of depreciation expense, amortisation, make good expense and audit fees. This estimate also includes approved operating losses – please refer to the departmental financial statements for further information. Some reclassifications have been made to the Budget estimates to more accurately reflect the allocation of departmental depreciation by outcome.

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