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Chief Medical Officer's Report

Strengthening Australia’s rural health

Addressing inequities in access to high quality medical care has been a longstanding challenge in Australia. Despite many policy initiatives over a number of years, some rural and remote locations still have demonstrably poorer access to health services than metropolitan areas.

During 2018-19, the Department commenced implementation of the Stronger Rural Health Strategy, a series of complementary measures to improve the quality of Australia’s health workforce and meet rural and remote community needs. There is abundant evidence to correlate the length of time doctors are taught and trained in rural areas with their likelihood of adopting a long term career in these locations. Through the More Doctors for Rural Australia program, end-to-end medical school programs will take school leavers straight into rural medical schools, where they can complete almost all of their undergraduate training in the rural community. Expanded junior doctor and specialist training programs will ensure that young doctors can remain working and training in these areas for longer. Additional funding for rural and remote nursing, pharmacist and other allied health positions and continued support funding to retain qualified general practitioners in these areas round out supplementary measures to the package.

Additionally, a new National Medical Workforce Strategy was scoped in early 2019. This exciting initiative, supported by all state and territory governments and medical stakeholder groups, will guide collaborative future medical workforce planning and policy reform at all levels. Key priorities have been identified to support a sustainable, highly trained and appropriately distributed medical workforce.

This will be one of the most comprehensive health workforce reform packages ever implemented in Australia. It will provide clear, understandable and effective means of delivering better health services to rural and regional Australians, reducing geographic disparities in patient access and matching our training and migration pipeline to the needs of the nation.

Elimination of cervical cancer initiative

Australia is a global leader in cervical cancer control and is one of the few nations currently on track to eliminate cervical cancer by the year 2035. The National Cervical Screening Program aims to prevent cervical cancer through early detection.

On 1 December 2017, Australia was one of the first countries in the world to transition to a five yearly human papillomavirus (HPV) screening test for women aged 25–74 years, replacing the previous two yearly Pap test offered to women aged 18–69 years. This change also introduced the option of a self-collected test for under- screened people. The introduction of a HPV vaccine onto Australia’s National Immunisation Program was a world first. The program commenced in 2007 for girls aged 12-13 and expanded in 2013 to include boys. In 2018, Australia switched from using the 4-valent Gardasil vaccine to 9-valent Gardasil vaccine, further protecting against an additional five strains of the virus.

The World Health Organization (WHO) has recognised that cervical cancer is one of the few cancers for which there is a realistic prospect of elimination through vaccination, screening and treatment.

New research predicts that if current vaccination coverage and screening participation is maintained, Australia is set to become the first country in the world to eliminate cervical cancer.

Reducing the incidence of blood borne viruses and sexually transmissible infections

Australia is making progress to reduce the transmission and impact of blood borne viruses (BBV) and sexually transmissible infections (STI). Through their listing on the Pharmaceutical Benefits Schedule, availability of effective treatments for BBV and STI, such as antiviral treatments for hepatitis C and pre-exposure prophylaxis for HIV prevention, has increased. However, we still face challenges.

To provide a national framework for our continued, active response to BBV and STI, the National BBV and STI Strategies 2018–22 were released in November 2018. The suite of five strategies include the:

  • Eighth National HIV Strategy;
  • Fifth National Aboriginal and Torres Strait Islander BBV and STI Strategy;
  • Fifth National Hepatitis C Strategy;
  • Fourth National STI Strategy; and
  • Third National Hepatitis B Strategy.

These strategies recognise and build on the extensive work already being progressed and set out ambitious goals to reduce the transmission of BBVs and STIs, increase diagnosis and treatment rates and improve the quality of life for people living with them. We are working in partnership with our state and territory counterparts, researchers and community stakeholders to deliver these outcomes.

Combating flu season with increased vaccine availability

While there was some geographic variation across Australia, the 2018 influenza season in general saw very low levels of activity compared to recent years. Conversely, since November 2018 there has been an unusual increase in interseasonal influenza activity reported by most states and territories. This activity has transitioned into a very early influenza season for 2019.

To combat this, a record 12.9 million doses of seasonal influenza vaccines were released for the 2019 Australian influenza season, including:

  • over 7.5 million doses for government programs, including the National Immunisation Program and state and territory programs; and
  • over 5.4 million doses for the private market.

This is more than any other year, up from almost 11 million doses in 2018 and 8.3 million doses in 2017.

Aboriginal and Torres Strait Islander Australians experience a significantly higher burden from influenza infection and are much more likely to be hospitalised with the disease. In 2019, for the first time, all Aboriginal and Torres Strait Islander Australians from six months of age are eligible to receive free influenza vaccines through the National Immunisation Program.

Building domestic and regional health security

In 2018-19, the Department supported the Government in continuing to secure and maintain the contingency levels of products in the National Medical Stockpile (NMS). The availability of a range of protective medicines, equipment and biosecurity products within the NMS continues to play a critical role in the preparedness, response and protection of Australians in a public health emergency. It also considers assisting Asia-Pacific regional countries in a critical public health situation of international concern.

The Department recently published Australia’s National Action Plan for Health Security 2019–2023 (NAPHS). NAPHS provides a framework for the implementation of 66 recommendations from the 2017 Joint External Evaluation (JEE) of Australia’s compliance with the International Health Regulations (2005). Implementation of NAPHS will utilise existing structures, committees and policies to build on Australia’s already strong capacity to prepare and respond to significant health threats in our global region. NAPHS has been published on the Department and WHO websites and regular progress reports will be provided to the Australian Health Protection Principal Committee.

The Department is also working with partners including the WHO (Regional Office for the Western Pacific) and the Indo-Pacific Centre for Health Security to further build on health security within the Asia-Pacific region. Australian health experts attended JEE missions in New Zealand, the Philippines, Timor-Leste and the Federated States of Micronesia to assist in identifying opportunities to strengthen their health security. Australia will continue to contribute to additional JEE missions throughout 2019-20.

Professor Brendan Murphy

Chief Medical Officer
September 2019