We need to be in better health before next pandemic

Ultimately, if a CDC is to be effective in protecting Australians from the next pandemic, it must focus on infectious diseases and chronic disease prevention. Picture: iStock

As the federal government plans the design and implementation of its promised new health agency, the centre for disease control, it will be critical to learn from the tough but formative lessons of the past two years. One key lesson that risks going unnoticed is the deep link between the emergence and societal virulence of the novel virus and chronic disease.

Diseases such as diabetes, heart disease and cancer are the leading drivers of death and poor health outcomes for Australians. They account for about 90 per cent of all deaths nationally. Most of us will endure 11 years of poorer quality life as a result of these largely preventable but debilitating diseases.

In short, they kill most of us earlier than we should die and inflict a decade or more of suffering in our final days. They also strain our healthcare systems.

It’s easy to think Covid was simply an infectious disease pandemic – that its potency, pace and impacts had little to do with the pre-existing health of Australians and simply reflected the virulence of a rapidly spreading and novel virus.

But while we think of these chronic, non-infectious diseases as quite distinct from viral illnesses, they are two sides of the same clinical coin. To respond effectively to Covid and any future infectious disease pandemics, we must redouble our efforts at preventing this group of chronic and overwhelmingly preventable diseases.

Ultimately, if a CDC is to be effective in protecting Australians from the next pandemic, it must focus on infectious diseases and chronic disease prevention.

Health experts have been calling for an Australian CDC for more than three decades. We are the only member of the OECD without one.

As the pandemic evolved, the presence of existing chronic disease became a standout factor when considering those at risk of severe Covid-19 symptoms or death. If an individual had an existing and largely preventable chronic disease, it soon emerged as a leading determinant in how they would fare if they contracted the virus. This is because of the long-term physiological strain and inflammation these conditions place on our bodies. If most of us are living with a level of cardio-metabolic stress, it makes sense that we are less able to withstand a significant further physiological insult.

One of our best protections against severe Covid was starting the pandemic in good health.

The best preparation for a future pandemic – which will come – is to lift the baseline health of our population. We must invest in prevention and address the growing and significant burden of chronic disease among Australians. This is not about blaming or shaming individuals but about providing national policy and scientific leadership to guide governments to address the long-known and preventable structural drivers of ill health.

Actions such as working to improve access to affordable, fresh foods; doubling our support for those quitting smoking; and boosting youth participation in sport and active recreation will return about $14.30 to the economy for every dollar we invest. They will also have the significant dividends of reducing the burden on our healthcare system, and safeguarding our population and economy from the next viral pandemic.

The National Preventive Health Strategy recommends spending on preventive health should rise from 1.3 per cent to 5 per cent of total health expenditure by 2030. This equals 0.13 per cent of gross domestic product, which is considerably lower than other OECD countries such as Canada, Britain and New Zealand.

In a 2013 study, Australia ranked 16th for per capita expenditure on prevention and public health, 19th for expenditure as a percentage of GDP and 20th for preventive expenditure as a percentage of health expenditure.

Australia’s CDC must be fit for purpose and include a strong focus on the prevention of chronic disease. Anything less will fail to heed key lessons of the past two years – and risks failing Australians.

Sandro Demaio is the chief executive of VicHealth.