Call for new CDC to fast-track disease prevention strategies

A high-profile public policy thinktank has warned it will be a ‘wasted opportunity’ if chronic disease prevention is not immediately central to the new Centre for Disease Control (CDC) promised by the Federal Government.
 
The Grattan Institute released its ‘The Australian Centre for Disease Control: Highway to Health’ report on Sunday, in which it pushes for preventing chronic disease to be a focus from the outset.
 
It notes that in a consultation discussion paper, Federal Health and Aged Care Minister Mark Butler said an initial phase would address the National Medical Stockpile, communicable disease surveillance, prevention and response.
 
He said that the CDC ‘is likely to be established over several phases’ given the range of complex capabilities that it could include.
 
Citing Australian Institute of Health and Welfare (AIHW) figures suggesting chronic diseases are a factor in the vast majority of deaths in the country, the Grattan Institute authors argue that prevention should feature in the CDC from the start.
 
AIHW data suggests that 10 of the most common chronic conditions contributed to almost 90% of deaths in 2020.
 
‘The [CDC] is a once-in-a-generation opportunity,’ the Grattan Institute authors conclude.
 
‘It will be a wasted opportunity if chronic disease prevention is not built into its DNA, and if a plan for its full role is deferred for more than a year.
 
‘Because every year that we wait locks in more disease, disability, and death in decades to come.’
 
The establishment of an Australian Centre for Disease Control was a commitment first made by the Labor Party (ALP) in 2020. In its pre-election plan, the ALP cited its purpose as being ‘to improve pandemic preparedness and response’.
 
However, the Department of Health and Aged Care (DoH) discussion document also includes references to chronic disease prevention, and a section on preventive health leadership.
 
An RACGP submission on the proposed CDC last December also drew attention to the urgency of addressing chronic disease.
 
‘We reiterate that while the COVID-19 response is currently at the forefront of challenges facing our healthcare systems and has been an impetus in establishing the CDC, its spotlight must not overshadow the importance of the inclusion of chronic disease prevention and management in this country,’ the submission states.
 
It also said the CDC could be an opportunity for a national public health agency to incorporate communicable and non-communicable disease prevention and control strategies.
 
‘The CDC could provide similar function to the former Australian National Preventative Health Agency [Promoting a Healthy Australia], while also incorporating coordination of communicable diseases and disaster responses,’ the RACGP said.
 
‘This is achievable, as evidenced by similar agencies in other countries, and would allow for better visibility, stability and continuity of preventive health programs.’
 
The Grattan Institute report authors say investment in preventive approaches will reduce the chronic disease burden and have a positive economic impact. They state that around 38% of the burden of chronic diseases ‘is caused by … modifiable risk factors’, including smoking, obesity, poor nutrition and social isolation.
 
‘The most disadvantaged fifth of Australians are twice as likely to have two or more chronic diseases compared to the least disadvantaged fifth of Australians,’ they wrote.
 
They also said chronic disease accounts for around 80% of the life expectancy gap between Aboriginal and Torres Strait Islanders and non-Indigenous Australians.
 
‘Even small changes to modifiable risk factors can achieve significant health and economic gains across a broad population – as is shown by Australia’s past success in reducing rates of smoking and skin cancer,’ the report states.
 
The CEO of the Public Health Association of Australia, Adjunct Professor Terry Slevin, backs the Grattan Institute’s findings and has warned of an ‘incoming tsunami of chronic disease’.
 
‘It’s ironic that governments are spending more and more money treating sick people, while investment in measures that stop people getting sick in the first place has remained low,’ Adjunct Professor Slevin said.
 
‘Even during the height of the pandemic, total government spending on prevention was just 3.7 % of the total health budget, well below the modest 5% recommended in the National Preventive Health Strategy.’
 
He also said he would expect around $600 million to be invested in the CDC in the May Budget for it to emulate similar organisations in countries such as Finland and Norway.
 
A spokesperson for Minister Butler’s office said investment in preventive health is due to rise to 5% of total health expenditure by 2030 under the National Preventive Health Strategy, which they said is currently undergoing an implementation and evaluation plan.
 
‘The Australian Centre for Disease Control will ensure ongoing pandemic preparedness, lead the Federal response to future disease outbreaks, and work to prevent both infectious and chronic disease,’ Minister Butler told newsGP in a written response.
 
‘All Australians will benefit from improved pandemic preparedness response and a renewed focus on preventing chronic disease.’
 
The Grattan Institute report said the measures on pandemic preparedness are ‘essential steps’ to address shortcomings in the COVID-19 response but argues chronic disease prevention should be ‘a core function from day one’ or risk being sidelined.
 
The Minister’s spokesperson said that the DoH and the Minister ‘will continue to consider further avenues to support preventive health, to ensure funding is ongoing and sustainable’.
 
Minister Butler’s office did not address a request for further details on timelines for establishing the CDC.
 
Australia is currently the only country in the OECD without a CDC or a similar organisation.
 
The RACGP has advocated that GPs have ‘formal and permanent representation’ in the governance of any future CDC.
 
The RACGP’s Red Book for preventive activities in general practice is available on the college website.
 
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