‘Disappointing news’: Government pulls Clinical Taskforce funding

The Federal Government will cease funding the National Clinical Evidence Taskforce at the end of the year.
 
Professor Mark Morgan, who is the co-Chair of the Taskforce’s Primary and Chronic Care Expert panel, as well as representing the RACGP on the Guideline Leadership Group, described the decision as ‘disappointing news’.
 
‘Since early in the pandemic, the Clinical Evidence Taskforce has been providing impactful, careful and independent treatment guidelines for COVID-19,’ he told newsGP.
 
The Department of Health and Aged Care (DoH) informed the Taskforce this week that it will not be contracted to produce COVID-19 clinical guidelines beyond 31 December.
 
The DoH is understood to be the main funding source for the Taskforce, which was set up in response to the COVID-19 pandemic to give ‘living guidelines’ for caring for and treating those with the disease. The DoH did not address a newsGP query about the exact funding it contributed.
 
The Taskforce currently has 35 member organisations, including the RACGP.
 
‘Our 200+ clinicians and consumers have developed more than 200 recommendations and 22 flowcharts for the management and care of people with COVID-19 covering mild, moderate, severe and critical COVID-19, as well as care for people after COVID-19 and with long COVID,’ the Taskforce said on Thursday.
 
‘We believe up-to-date guidance to support clinicians caring for people with COVID-19 continues to be vital, especially at a time of rising cases and increasing pressure across the health system.’
 
In response to a newsGP inquiry, the DoH said other bodies provide ‘rigorous analysis of evidence’ for COVID-19 treatments, including the Therapeutic Goods Administration (TGA) and the Pharmaceutical Benefits Advisory Committee (PBAC).
 
The Taskforce was set up as a ‘temporary advisory body’, the DoH said – and pointed to a recent recommendation in the Halton Review, which was set up to look at COVID-19 vaccine and treatment purchasing and procurement, to explain the rationale behind the decision.
 
‘The recent Halton Review found that having multiple advisory bodies providing clinical recommendations to decisionmakers was not required, and the Review recommended that COVID-19 advisory structures should be streamlined, and advice integrated to ensure decision makers have greater clarity when making decisions about treatments,’ the DoH spokesperson stated.
 
They said the DoH ‘will continue seeking the best clinical advice on COVID-19 treatment from our independent experts in permanent bodies like the TGA and PBAC’.
 
Professor Morgan, however, queries whether the Taskforce’s work can be undertaken in the same way elsewhere.
 
‘I wonder if there is any group able to replace the scientific rigour and processes to keep a living guideline alive,’ he said.
 
‘I am certainly not aware of another group able to replicate this work and certainly not with the support of so many member organisations.’
 
In October this year, Taskforce Chair Professor Caroline Homer and Executive Director Associate Professor Steve McGloughlin announced the organisation would broaden its scope beyond COVID-19 to provide ‘evidence-based guidance for urgent and emerging diseases’.
 
So far, guidelines for the treatment of mpox have been published.
 
Professor Morgan praised the ‘remarkable’ input from the clinician volunteers and consumers to the Taskforce’s work.
 
‘It has been an honour to work with some amazing expertise and hundreds of years of cumulated experience across the breadth and depth of primary care and rehabilitation,’ he said.
 
‘The Taskforce was set up to do the unthinkable – to update an evidence guideline on a weekly cycle.’
 
According to Professor Morgan, the independence of the Taskforce based around clinical consensus is a crucial factor in formulating trusted guidelines, particularly those involving controversy.
 
‘Remember the politics around ivermectin?’ he said.
 
Professor Morgan cites the Taskforce guideline to not routinely use the COVID-19 oral antiviral molnupiravir (sold as Lagevrio) as ‘perhaps the hardest and most nuanced’ to put together.
 
‘There is broad agreement across Government, the Pharmaceutical Benefits Advisory Committee and the Taskforce that Paxlovid is the preferred oral treatment when it is safe to use,’ he said.
 
‘I attribute the rise in use of Paxlovid to the Taskforce guideline.
 
‘It now sits at 35% of oral antiviral use. All the data points to this change saving lives.’
 
In its statement, the Taskforce said it is ‘seeking sources of funding to continue our work in 2023’.
 
The health economics of providing living guidelines are clear, according to Professor Morgan. 
 
‘Without a trusted source of evidence synthesis there would be over-treatment, under-treatment and wrong treatments leading to human and health system costs,’ he said.
 
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