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Australian National Centres for Disease Control (Australian CDC)

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Ratification Date: 08 Dec 2022

Policy

  1. The AVA calls for the establishment of an Australian Centres for Disease Prevention and Control (CDC) or equivalent, based on a One Health approach.
  2. The One Health framework requires transdisciplinary collaboration between human, veterinary and environmental health sectors.
  3. This will improve disease prevention, preparedness, response and wellbeing in humans, animals and plants in their shared environment. It should provide cost-effective management of communicable and non-communicable diseases, as well as other issues of local, regional and global impact such as antimicrobial resistance (AMR) and food security.
  4. A national CDC will promote and enhance collaborative trans-disciplinary research between centres of excellence as well as supporting regional One Health capacity building.

Background

Globally, infectious disease poses a significant threat, impacting human and animal health, economic stability and the environmentl,2. The effects of infectious diseases are compounded by the burden of non-communicable diseases, such as obesity, mental health, cardiac disease and cancer3.

The One Health paradigm recognises the interconnectedness of human, animal and environmental health, necessitating a trans-disciplinary, multi-sectoral and collaborative approach between the human and veterinary health sectors. This is of particular importance in the management of zoonoses and emerging infectious diseases (EIDs), antimicrobial resistance (AMR), and food security4,5 and can also improve outcomes in non-communicable diseases6.

Human, animal and plant health are influenced by multiple factors beyond the absence of infectious disease, including socio-economic, political, evolutionary and environmental determinants3.

The continuing threat of current and emerging diseases requires a coordinated national One Health approach to global health security, disease surveillance and effective national preparedness and response3,7,8. Within this, strengthening of animal health systems for livestock, wildlife and companion animals is critical due to the zoonotic origin of many EIDs, and is necessary to achieve sustainable development goals9.

COVID-l9 has highlighted gaps in preparedness and response nationally, regionally and globally, and as a result a One Health approach has become more widely accepted by political leaderslO. Formation of a One Health CDC or equivalent, engaging experts from animal, human and environmental health disciplines, is crucial for developing capacity to manage future emerging diseases and pandemics. This should include representatives from wildlife, agriculture, veterinary companion animal and livestock health, public health, environmental research institutions, biodiversity, natural resource management, social scientists and other relevant disciplines to ensure a truly trans-disciplinary approach to health.

Australia is the only country in the Organisation for Economic Co-operation and Development (OECD) without a central national health governance body to provide leadership and coordinate emergency health responses, such as a Centres for Disease Prevention and Control (CDC)11.

Currently, there are few formal cross-sectoral structures across human and animal health in Australia11; though dialogue has commenced in federal, state and territory jurisdictions, and more of this collaboration is encouraged. There is a need for stronger relationships between human, animal and environmental health, particularly at a governance level, which could be provided by a CDC based on a One Health approach.

By providing national leadership, a One Health CDC model would provide centralised co-ordination of rapid responses by state and federal organisations to emerging threats to animal, human and environmental health.

A CDC would act to coordinate detection and response to new and emerging health threats by providing training in leadership and public health, using science and technology in disease prevention, and mitigating risks leading to poor health outcomes12. By providing an avenue for input from and to research bodies and non-government organisations it would allow greater opportunities for consultation and collaboration for professional bodies such as the AVA.

Recommendations

  • Funding is required from federal and state governments to establish an independent national CDC or equivalent, with One Health governance. This is imperative to enable effective management of communicable and non-communicable diseases, in particular emergent and current disease threats.
  • The AVA supports the calls for a national CDC which have been made by other health-based organisations, including the Australian Medical Association and Public Health Association of Australia11,13. Due to the ongoing threat of emerging zoonotic diseases such as COVID-19, a One Health structure is necessary.
  • Equitable representation of all stakeholder groups is necessary for a holistic One Health approach to emerging disease threats, AMR, food security and other health needs.
  • Establishment of national data collation including One Health surveillance and disease reporting of significant zoonotic diseases is essential. This will require compatibility of reporting systems across sectors. Current efforts towards One Health AMR surveillance in Australia can inform this.

References

  1. World Health Organization, Food and Agriculture Organization of the United Nations, World Organisation for Animal Health. Taking a Multisectoral, One Health Approach: A Tripartite Guide to Addressing Zoonotic Diseases in Countries. 2019.
  2. Kelly T, Machalaba C, Karesh W et al. Implementing One Health approaches to confront emerging and re-emerging zoonotic disease threats: lessons from PREDICT. One Health Outlook 2020;2:1-7.
  3. Wildlife Conservation Society. The Berlin Principles on One Health, 2019. https://oneworldonehealth.wcs.org/About-Us/Mission/The-2019-Berlin-Principles-on-One-Health.aspx. 2019. Retrieved 14 July 2021.
  4. Gruetzmacher K, Karesh WB, Amuasi JH et al. The Berlin principles on one health – Bridging global health and conservation. Science of The Total Environment 2021;764:142919.
  5. One Health Commission. What is One Health?https://www.onehealthcommission.org/en/why_one_health/what_is_one_health/. 2021. Retrieved 20 April 2021.
  6. Centers for Disease Control and Prevention. One Health Basics. https://www.cdc.gov/onehealth/index.html. 2021. Retrieved 15 November 2021.
  7. United Nations Environment Programme and International Livestock Research Institute. Preventing the Next Pandemic: Zoonotic diseases and how to break the chain of transmission. https://www.cbd.int/doc/c/084c/e8fd/84ca7fe0e19e69967bb9fb73/unep-sa-sbstta-sbi-02-en.pdf. Nairobi, Kenya., 2020.
  8. Africa CDC. Framework for One Health Practice in National Public Health Institutes. https://africacdc.org/download/framework-for-one-health-practice-in-national-public-health-institutes/. 2020. Retrieved 29 July 2021.
  9. Action for Animal Health. A Call to Action for Animal Health. https://actionforanimalhealth.org/wp- content/uploads/2021/09/AFAH-Call-to-Action-single-corrected.pdf. 2021.
  10. Seifman R, Kaplan B. Seismic Shift by G in Recognizing One Health as Critical to Everyone’s Health. https://impakter.com/g7-recognizing-one- health/?fbclid=IwAR1hLM3woEhcYp1VsrA6z0z86G0L4dIBvjw0je9ZjbE9jicLpru1Db5hWdM. 2021.
  11. Australian Medical Association. Australian National Centre for Disease Control (CDC) - 2017. https://ama.com.au/position-statement/australian-national-centre-disease-control-cdc-2017. 2017. Retrieved 2 April 2020.
  12. Centers for Disease Control and Prevention. Mission, Role and Pledge. https://www.cdc.gov/about/organization/mission.htm. 2019. Retrieved 29 July 2021.
  13. 13. Public Health Association of Australia. Public Health Association of Australia submission on COVID-19. https://www.phaa.net.au/documents/item/405. 202