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30 Apr 2019

Victoria’s Chief Health Officer chimes in

This piece by Victorias Chief Health Officer, Dr Brett Sutton, first appeared in the Doherty Institute Public Health Laboratory newsletter. Subscribe to receive the latest updates from the Doherty Institute Public Health Laboratories.

As a way of engaging more closely and helping bring greater understanding across our respective work areas I’ve been offered this opportunity to write something for the Public Health Laboratory newsletter.

By way of introduction, however, I’d like to just begin by saying how much I admire the work of the Doherty Institute and the passionate and committed staff who do so much to protect public health. It’s obviously hugely aligned with our work here in the Victorian DHHS Health Protection Branch and helps to achieve so much that we’re seeking to do in the communicable disease space in particular.

For those who may not be familiar with my role, the Chief Health Officer (CHO) has statutory functions under health, food and emergency-related legislation and is responsible for: developing and implementing strategies to promote and protect public health; providing advice to the Minister and the Secretary; publishing a comprehensive report on public health and wellbeing in Victoria; and performing the functions or powers specified in the Public Health and Wellbeing Act 2008. At a more routine level, most of the CHO’s real response work is done through community and sector engagement, including CHO alerts or advisories, and radio and TV.

So what challenged us in 2018? And what will 2019 bring? From my perspective, there was much to celebrate, but also significant ongoing challenges and emergent threats. On the positive side, we continue to see a real decline in notified cases of HIV, in particular newly-acquired cases and in those who are Australian-born. The challenge will be to reach overseas-born and CALD community members at risk of transmission, as well as respond to an increasing proportion of heterosexually-acquired disease. Newly-acquired cases of Hepatitis C have halved in the last two years; an extraordinary result driven by direct-acting antivirals, ‘treatment as prevention’, and concerted efforts to engage, follow-up and treat people who inject drugs.

I’m sure 2019 will be a year where we see some familiar and new challenges. Sexually transmitted Infections will need continued efforts and focus; it’s gratifying to know that a state-wide strategic review of reproductive and sexual health services is underway. Antimicrobial resistance is going to continue to challenge – Candida auris was seen for the first time in Victoria in 2018 and Carbapenemase-producing Enterobacterales are slowly increasing in number and complexity of outbreaks. We have an excellent system of combining epidemiological and genomic data and therefore identifying and responding to local transmission events rapidly, but this needs to be a system that can deal with any new priority organism and must be part of an integrated national network with national guidelines for surveillance, genomic analysis and response.

For the Health Protection Branch there are also broader challenges related to climate change. Recent incidents highlight that our climate has already changed significantly. We’ve seen fires threatening our water catchments and air quality; blue-green algae outbreaks across the state; and record heatwaves, including into autumn. Communicable diseases are not immune from such changes, with exotic mosquito incursions finding a more receptive environment in Victoria over time. The Branch is working on a 2030 strategic plan to work more proactively to address these issues and will look to Doherty Institute colleagues in 2019 to input to this significant piece of work.