Workshop: The State of National Governance Relative to the International Health Regulations (2005)

1. Workshop: The State of National Governance Relative to the International Health Regulations(2005) Australia Ottawa, Canada, 20-21 September 2006.

2. 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

3. World Health Organisation National Surveillance and Response Commonwealth Agencies Implementing Border Surveillance and Response Capacity Advisory Committees IHR National Focal Point State and Territory Surveillance and Response Laboratory Services Local Disease Surveillance and Data Collection Local General Practitioners Local Health Centres Hospitals

4. Background: National Core Capacities Levels Where Activities Are Performed Activity National Regional Local Detection and notification of cases Yes Collection and consolidation of case data Yes Yes Analysis and interpretation Yes Yes Investigation of cases & confirmation of diagnosis: • Epidemiologist Yes Yes • Clinician Yes • Laboratory Yes Feedback Yes Yes Yes Dissemination Yes Yes Yes Response/Intervention Yes Yes Yes

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. The End