Study identifies flaws in disease surveillance

New research from James Cook University has shown flaws in Australian systems responding to disease outbreaks and sparked calls for a change in priorities if the nation is to be prepared for the next pandemic.

Professor Stephanie Topp and colleagues from JCU’s Australian Institute of Tropical Health and Medicine and JCU’s College of Public Health, Medical and Veterinary Sciences conducted case study research examining how four different disease groups are managed in Northern Queensland (NQ).

Topp said NQ is an interesting area in terms of communicable disease control.

“It’s located within the Tropics, so it experiences higher rates of communicable disease outbreaks. It’s the only region of Australia that has an international border — with PNG. It’s also a vast geographic area, positioned quite far from the policymaking centres of Brisbane and Canberra,” Topp said.

Over 18 months, the team analysed the responses to four different disease groups in the region: COVID-19, tuberculosis, sexually transmissible infections, and arboviruses.

The researchers found the NQ surveillance and response systems for all four disease groups face at least three challenges in common, Topp said.

“There is weak coordination within and between sectors, leaving the systems prone to error or breakdown, especially in times of stress.

“Secondly, a shift in funding has reduced the resources available to maintain and adapt surveillance and response systems in the face of new or shifting threats.

“Thirdly, limited funds and a lack of priority during non-crisis times has left public health units short-staffed for all but the most basic functions,” Topp said.

She said the findings could be used to strengthen health systems for future pandemic preparedness and other public health crises.

“At a local level, I’d like to see more discussions around how to ensure public health units are better positioned and resourced within Queensland’s Hospital and Health Services (HHS) to conduct routine surveillance and be capable of a rapid response.

“At a state level, I would like to see an investment in stronger mechanisms of accountability, including a more robust set of public health indicators that help track and support HHS performance.”

Topp said decision-makers in the health systems are often captive to electoral cycles.

“So, funding tends to follow such things as hospital bed availability and ramping rates — not the harder-to-quantify but more impactful population health strategies that could prevent or mitigate the next pandemic,” Topp said.

She said preventing ill health and promoting good health ought to be a key focus of all health systems.

“In the end it’s vastly more cost efficient and produces better outcomes for the community — both locally and nationwide.”

Image credit: iStock.com/Krerksak Woraphoomi