Australia's National Action Plan For Health Security 2019-2023

Objectives

Australia’s National Action Plan for Health Security provides a five-year, high-level framework for implementing recommendations from the 2017 Joint External Evaluation of the International Health Regulations (2005).[1]It aims to build on national strengths to maintain and develop health-security capacities, reduce morbidity and mortality from public health events, and enable coordinated, adaptable and resilient systems to prepare for, prevent, detect and respond to acute threats.[2][3]The plan applies One Health, all-hazards, whole-of-government and whole-of-society approaches, connecting human, animal and environmental health expertise and engaging communities and partners.[2][3]

• Strengthen prevention through regulation, biosafety and biosecurity, points of entry, immunisation, surveillance and action on antimicrobial resistance and zoonotic diseases.[3]
• Improve preparedness through tested emergency plans, national hazard and resource mapping, linked cross-sector response arrangements, medical countermeasures and deployable personnel.[3][4]
• Enhance rapid detection through interoperable human and animal surveillance, laboratory testing, genomic data, risk assessment, communication and reporting.[3][5][6]
• Strengthen response and recovery through coordination, trained workforces, joint exercises, information-sharing, risk communication and incorporation of lessons from emergencies.[3][7][8]
• Build strategic domestic and international partnerships and provide regional and global leadership in implementing the International Health Regulations.[3][2]

The plan prioritises all 66 Joint External Evaluation recommendations through a Planning Matrix and aligns implementation with existing strategies, legislation and governance mechanisms.[9][10]Key alignment instruments include the Australian Government Crisis Management Framework, the Biosecurity Act 2015, the National Health Security Act 2007 and the National Antimicrobial Resistance Strategy.[5]The Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies provides the regional action framework for International Health Regulations core capacities.[9][11]

• Maintain measles immunisation coverage, particularly for hard-to-reach populations, towards the 2020 target of 95%, and address vaccine hesitancy through communication.[12]
• Establish a single National Vaccination Registry for population-based coverage analysis and reporting across national, state, territory and local levels.[12]
• Develop an all-hazards health protection framework, strengthen human-animal health linkages and establish interoperable electronic disease surveillance.[5]
• Advance integrated food safety surveillance and outbreak management, antimicrobial resistance surveillance and stewardship, and coordinated zoonotic disease preparedness.[13][14]
• Enhance preparedness for chemical incidents and radiation emergencies through surveillance, hazard assessment, capability registers, standards and multisectoral exercises.[15][16]

Implementation

Implementation is designed as a multisectoral, multijurisdictional model embedded in existing policies, plans, legislation, committees and business processes rather than a separate delivery system.[2][1]The Department of Health coordinates the National Action Plan for Health Security, while the Department of Agriculture and Water Resources is a principal governance and delivery partner; state, territory and local governments retain major roles as funders, policy developers, regulators and service deliverers.[2][9]The Australian Government leads coordination of plan progress and implementation.[10]

• Use the Planning Matrix to record each Joint External Evaluation recommendation’s implementation status, mechanism, lead stakeholder, key stakeholders and priority ranking.[10]
• Rank actions as high, medium or low according to scope, impact, efficiency, stakeholder involvement, project status, completion timeframe and resourcing.[10]
• Integrate prioritised actions into the Department of Health business planning cycle and use available resources efficiently.[10][5]
• Fund most actions through existing budget processes and allocations, with activities costed case by case.[5][17]
• Use existing governance structures, including the Australian Health Protection Principal Committee, Health and Agriculture committees, and formal Health-Agriculture meetings, to coordinate and oversee delivery.[5]

Delivery relies on collaboration across health, agriculture, food safety, laboratories, environmental and chemical regulation, emergency management, defence, security, foreign affairs, border agencies, research institutions, private organisations and communities.[1][10]Existing human and animal public health networks and committees support cohesive operations, while the National Incident Room manages the National Focal Point for International Health Regulations communication and state and territory health departments retain primary operational responsibility within their jurisdictions.[9]

• Strengthen joint Health-Agriculture processes, zoonosis structures, laboratory case definitions, information-sharing and cross-jurisdictional mechanisms for antimicrobial resistance assessment, planning and response.[13][14]
• Deliver immunisation through the National Immunisation Program, the National Partnership on Essential Vaccines, the Australian Immunisation Register, communications campaigns and contractual arrangements with companies.[12]
• Develop workforce capability through public health workforce definition and planning, sustainable epidemiology mechanisms, international experience, joint training and multisectoral exercises.[4][7]
• Clarify points-of-entry responsibilities through a memorandum of understanding annex between Health and Agriculture, electronic traveller information-sharing, sustainable biosecurity training and facilities for assessing ill travellers.[7][8]
• Maintain regional cooperation with the World Health Organization, the World Organisation for Animal Health and other Member States, including support for health-security capacity in other countries through the Indo-Pacific Health Security Initiative.[2][9]

Monitoring combines domestic implementation tracking with International Health Regulations accountability mechanisms.[11]The International Health Regulations Monitoring and Evaluation Framework uses Joint External Evaluation, annual reporting, simulation exercises and after-action reviews.[11]Progress is monitored through six-monthly Planning Matrix reporting, mainly led by Department of Health areas, and regular reports to the Australian Health Protection Principal Committee.[5]Australia also undertakes mandatory annual reporting to the World Health Assembly and maintains communication and transparent reporting with the International Health Regulations Secretariat.[11]

• Review and update emergency plans using findings from exercises and after-action reviews, and share relevant lessons with stakeholders.[13]
• Conduct whole-of-government after-action reviews after significant events and develop recommendations for improvement.[11]
• Test assessment, decision-making, coordination and communication through national and regional simulation exercises.[11]
• Monitor community engagement activities, develop Poison Information Centre reporting and integrate chemical monitoring into a national common operating picture.[8][15]

No consolidated quantitative indicator set, independent evaluation timetable, total budget, funding gap or detailed allocation schedule is specified.[5][17]

Monitoring & Evaluation

Monitoring and accountability are centred on the International Health Regulations (IHR) Monitoring and Evaluation Framework, the 2017 Joint External Evaluation (JEE), and a Planning Matrix that manages implementation of all 66 JEE recommendations.[11][10]The framework combines annual reporting, simulation exercises and after-action reviews, while the matrix records implementation status, mechanisms, responsible stakeholders and priority rankings.[11][10]

• Use the 2017 JEE as the baseline assessment for strengthening IHR capacities; it was informed by consultations involving more than 25 Australian Government agencies and all eight state and territory governments, followed by site visits and technical-panel discussions.[11]
• Submit mandatory annual reports to the World Health Assembly and maintain transparent communication with the IHR Secretariat to support mutual accountability between State Parties and the Secretariat.[11]
• Monitor implementation through six-monthly reporting in the Planning Matrix, principally led by relevant areas within the Department of Health.[5]
• Provide regular progress reports to the Australian Health Protection Principal Committee to support strategic leadership, advice and assistance during implementation of the five-year plan.[5]
• Track dependencies between recommendations so that implementation can be adjusted when progress on one action affects another.[5]
• Review activities, plans and strategies in response to lessons learnt, emerging evidence, changing health threats, policy developments and legislative change.[10]
• Conduct whole-of-government after-action reviews following significant events and develop recommendations for improvement.[11]
• Test event assessment, decision-making, coordination and communication through national and regional simulation exercises, including the World Health Organization Western Pacific Region’s annual IHR Crystal communications exercise.[11]
• Maintain Department of Health processes and an internal SharePoint platform for lessons identified, with monthly review involving the national focal point and the Australian Health Protection Principal Committee.[13]
• Provide annual stakeholder feedback and an annual report on IHR implementation, and use exercise and after-action-review findings to update emergency plans and share relevant lessons.[13]
• Strengthen surveillance, laboratory testing, communication and risk assessment to enable rapid, accurate detection and assessment of outbreaks and public health events.[3]
• Develop interoperable surveillance, reporting and laboratory systems across human and animal health, including animal antimicrobial-resistance reporting, integrated food surveillance, information-sharing between Agriculture and Health, and comparable laboratory data.[13][14]
• Track measles immunisation coverage against the 2020 target of 95%, particularly among remote, Indigenous, migrant and lower-coverage populations, and use a National Vaccination Registry to analyse and report coverage by age and geography.[12]
• Improve laboratory-data consistency, quality and completeness through better denominator data, information-sharing and use of interoperable outbreak-management systems and whole-genome sequencing.[6]
• Establish mechanisms to monitor community-engagement activity across jurisdictions, share lessons for emergency risk communication, develop Poison Information Centre reporting, and integrate multisectoral chemical surveillance into a national common operating picture.[8][15]

The Planning Matrix includes progress-tracker and project-priority fields, but supplied tables do not show completed progress or priority information.[13][14][12][6][8][15][16]A consolidated quantitative indicator set, quantified performance targets beyond measles coverage, a detailed evaluation timetable and independent evaluation arrangements are not specified.[3][5]

Costing & Financing

Financing is intended to be managed principally through prioritisation, integration with existing business planning and case-by-case costing, rather than through a published plan-wide budget.[1][5][17]Most activities are expected to be funded through existing budget processes and allocations, with recommendations incorporated into Department of Health business plans to use available resources efficiently.[5][17]

• Prioritise recommendations using criteria that include scope, impact, efficiency, stakeholder involvement, project status, completion timeframe and resourcing.[10]
• Use prioritisation to support transparent resource allocation, prudent planning and avoidance of duplicated activity over the five-year plan period.[1]
• Contribute voluntary flexible funding to the World Health Organization and support regional investments through the Health Security Initiative for the Indo-Pacific over the following five years.[9]
• Use the regional initiative to help prevent and contain communicable-disease outbreaks with potentially adverse national, regional or global economic effects.[9]
• Identify resource mapping of rapid-response teams and stockpiles against identified gaps as a preparedness activity, without assigning a monetary value.[4]
• Recognise a need for further resourcing for the Australian Radiation Protection and Nuclear Safety Agency to coordinate or conduct broader multi-jurisdictional exercises and potentially re-establish a national sealed-source register.[16]

No total budget, quantified activity costs, funding allocations, funding gaps, additional funding requirements, costing methodology or economic assumptions are specified for the National Action Plan for Health Security or its workforce, preparedness, surveillance, response, communication, points-of-entry, chemical or radiation actions.[5][4][7][8][15][16]