Transcript Structure of Governance

Workshop:
The State of National Governance Relative
to the International Health Regulations
(2005)
Australia
Ottawa, Canada, 20-21 September 2006.
Background: Political Structure
& Public Health Governance
Australia is a Federation
• separation of powers between Commonwealth and
States & Territories
Australian Commonwealth Constitution
• no specific powers to legislate with respect to
public health activities
States and Territories Constitutions
• general powers for public health activities
World Health Organisation
Advisory
Committees
National Surveillance and Response
IHR National Focal Point
State and Territory Surveillance and
Response
Local Disease Surveillance
and Data Collection
Local General
Practitioners
Local Health
Centres
Hospitals
Commonwealth
Agencies
Implementing Border
Surveillance and
Response Capacity
Laboratory
Services
Background:
National Core Capacities
Levels Where Activities Are Performed
Activity
National Regional Local
Detection and notification of cases
Collection and consolidation of case data
Analysis and interpretation
Yes
Investigation of cases & confirmation of diagnosis:
• Epidemiologist
• Clinician
• Laboratory
Feedback
Yes
Dissemination
Yes
Response/Intervention
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
IHR Negotiation & Approval
• Section 61 Australian Commonwealth Constitution gives
the power to enter into the IHR treaty
• Existing legislation and administrative practices provide a
strong foundation for Australia to comply with the
obligations of the IHR
• Consensus approach with States & Territories
implementing through their own legislation
Development of Surveillance
Systems
 Public health measures for the surveillance and response to
disease at a regional level are mandated through State and
Territory Public Health legislation
 Surveillance at Australia’s borders is mandated through
Commonwealth legislation – routine exit screening will be
put in place through administrative measures.
 States & Territories have agreed to implement the IHR in
their jurisdictions
Detection, Notification,
Verification and Reporting
 Voluntary agreement between the Commonwealth
Government and the States and Territories
 Each jurisdiction forwards health data for the purposes of
national communicable disease surveillance - Privacy Act
(Cth) 1988
 Verification is undertaken at the regional level
 WHO Focal Point has been incorporated into the
surveillance system
Response to a Public Health
Emergency of International Concern
• Quarantine Act 1908 (Cth)
-
Commonwealth has a range of powers in cases of a
declared epidemic or disease emergency
-
Reporting obligations on incoming ships and aircraft
-
Range of powers for persons ‘subject to quarantine’
• Public health and emergency laws States &
Territories
-
General powers eg to restrict movement in or out of an
area, disinfect or destroy goods
Coordination of Reporting and
Response Requirements
Well established mechanisms for consultation between
Commonwealth and States & Territories
• Australian Health Ministers’ Advisory Council
• Australian Health Protection Committee
• Communicable Diseases Network Australia
Financing and/or Cost Sharing
• Australia will build on existing surveillance and reporting
infrastructure
•
Has committed funds for its enhancement
• Annual transfer of funds to States and Territories through
Commonwealth/States Health Funding Arrangements
• Special Purpose Appropriation Arrangements eg Royal
Darwin Hospital as the national pandemic response and
trauma hospital
Comparing Strategies
Challenges for Australia in the implementation of the IHR
• Privacy issues around transfer of personal health data
across jurisdictions and to the WHO
• National emergency response capacity to non-disease
threats needs to be strengthened
Summary & Conclusions
Australia’s commitment to the IHR motivated by
awareness of:
• the continuing serious public health threat from a
pandemic
• the need for a joint effort with closer regional and
international partnerships & collaboration
Regional Co-operation
• Australia is a Member of the WHO Western Pacific
Regional Office
• Committed to the Asia Pacific Strategy for
Emerging Diseases, including IHR and Avian
Influenza
The End