Volume 193 - Issue 10
Australia needs a national centre for disease control
Authors: Paul M Kelly, Kamalini Lokuge, Hassan Vally and Alexander S Cameron
Med J Aust 2010; 193 (10): 623-624. || doi: 10.5694/j.1326-5377.2010.tb04086.x
Published online: 15 November 2010
Published online: 15 November 2010
To the Editor: Givney’s recent letter restated the case for a national centre for disease control.1 His arguments for national planning, and particularly for a non-politicised approach to coordination and modification of responses to public health threats based on evidence, will be welcomed by many. A clear example of the validity of his case is provided by the recent pandemic (H1N1) 2009 influenza. In hindsight, despite certain risk groups being severely affected,2 the 2009 influenza season was generally mild.3,4 However, the public health response, based on the agreed pre-pandemic plans, was personnel-intensive and long-lasting.5 Crucially, there was a need for a well trained, flexible epidemiological workforce to rapidly analyse data to inform any response. Here, we highlight the contributions of Master of Applied Epidemiology (MAE) staff and students to this component of the response.
The MAE program has operated as Australia’s only field-based epidemiology training program since 1991. MAE staff and students were enlisted to the response within days of the pandemic alert, as they constitute the only readily available epidemiological capacity in Australia. A survey conducted in February 2010 indicated that between April and December 2009, 18 students and five MAE staff members contributed 1159 person-days (3.2 person-years) to the response at local, state and national levels and internationally in New Zealand and with the World Health Organization.
Contributions included establishing and evaluating surveillance systems, data analysis and reporting, training and supervision, rapid assessment and longer-term research projects. Areas covered included: border screening; investigation of clusters of cases related to air arrivals; school, prison and household transmission studies; analysis of state and national data; and establishment of a hospital-based sentinel surveillance system. Research findings have been disseminated widely via government reports, seminars, conference presentations and peer-reviewed publications.
During the pandemic, the MAE program provided epidemiological “surge capacity”. This vital technical input to higher-level analysis allowed policy responses to changing evidence, a contribution that needs to be maintained and strengthened if Australia is to respond appropriately to future emerging disease threats.
A logical home for a field epidemiology training program such as the MAE would be a national centre for disease control, with strong linkages to one or more academic institutions. We therefore echo Givney’s call for the establishment of an Australian centre, providing independent, evidence-based advice to governments, and incorporating a strong commitment to workforce capacity building and sustainability.
Acknowledgements
The MAE has been funded by the Australian Government Department of Health and Ageing under the now discontinued Population Health Education and Research Program. Paul Kelly has received a National Health and Medical Research Council Development Award. We acknowledge the contributions of MAE students and their field supervisors to the work described in this letter.
References
- Givney RC. A pandemic response to a disease of predominantly seasonal intensity [letter]. Med J Aust 2010; 192: 722-723. 0_BEACFFGC
- Bishop JF, Murnane MP, Owen R. Australia’s winter with the 2009 pandemic influenza A (H1N1) virus. N Engl J Med 2009; 361: 2591-2594. 0_CBBIBHGF
- Collignon PJ. A pandemic response to a disease of predominantly seasonal intensity [letter]. Med J Aust 2010; 192: 358. 0_pgfId-2208779
- Kelly HA. A pandemic response to a disease of predominantly seasonal intensity. Med J Aust 2010; 192: 81-83. 0_CBBGBFED
- Kotsimbos T, Waterer G, Jenkins C, et al. Influenza A/H1N1_09: Australia and New Zealand’s winter of discontent. Am J Respir Crit Care Med 2010; 181: 300-306. 0_CBBBDDDJ