Australia is a step closer to having its own national agency to inform and coordinate public health responses – a permanent Australian Centre for Disease Control.
Long-awaited draft legislation was tabled in parliament last week to create this permanent CDC, which is to start from 1 January 2026.
It’s a milestone for public health in Australia.
This national agency will help protect us against immediate issues including avian influenza (bird flu), falling immunisation coverage and health misinformation. Down the track it’s expected to address other areas of public health such as cancer, diabetes and heart disease.
But there’s much we don’t know about how the agency will run. We also need to ensure safeguards are in place against political interference in public health, which we’re seeing play out in the United States.
Almost 40 years in the making
Public health experts have been calling for an Australian CDC since at least 1987.
At that time, the Australasian Epidemiological Association noted the fragmentation of disease control efforts across the country. It was particularly concerned about the lack of timely data to inform the public health response to HIV/Aids.
More than three decades later, the Covid-19 pandemic also exposed weaknesses in Australia’s public health system.
The Covid-19 response inquiry found that an Australian CDC could have helped. It could have been a trusted voice for governments and the public; it could have clearly summarised evidence and data as it became available to inform policy and the public; and it could better prepare and coordinate responses to future pandemics.
The long path to the Australian CDC
1987
Epidemiologist Prof Bob Douglas asks in the Medical Journal of Australia Does Australia need a centre for disease control?
2011
Public Health Association of Australia and the Australasian Faculty of Public Health Medicine release a discussion paper about the need for an Australian CDC
June 2020
Then opposition leader, Anthony Albanese, calls for an independent Australian CDC
October 2022
Federal 2022–23 budget includes $3.2m towards designing an Australian CDC
May 2023
$90m allocated over two years to establish an Australian CDC
January 2024
Interim Australian CDC begins work in the Department of Health and Aged Care
October 2024
Covid-19 response inquiry report recommends that the government establishes permanent Australian CDC. Th government allocates $251m over four years
3 September 2025
Australian Centre for Disease Control bill 2025 and Australian Centre for Disease Control (consequential amendments and transitional provisions) bill 2025 introduced into Australian parliament
1 January 2026
Australian CDC to start
Based on a summary of events provided by the Public Health Association of Australia
How will the Australian CDC help?
The federal government has committed more than $250m over four years to fund the CDC’s overall activities.
But how will a new national agency help tackle public health challenges? Let’s take vaccination as an example, which is already coordinated nationally.
Under the national immunisation program, all levels of government have roles to play. The federal government assesses and buys vaccines; state and territory governments distribute them; and all levels of government fund the providers who administer vaccines. Independent experts, such as the Australian Technical Advisory Group on Immunisation (of which I’m a past member), develop advice on immunisation, supported by the National Centre for Immunisation Research and Surveillance.
But the lack of a CDC highlights some of the system’s weaknesses.
States and territories collect data about vaccine-preventable diseases but not all data is shared nationally. So we don’t always have a complete picture.
Funding for vaccines can also vary across the country. For example, all people aged six months and older in Queensland and Western Australia could get a free flu vaccine in 2025. But eligibility in most other jurisdictions is limited to high-risk groups.
An Australian CDC could help with providing evidence on what the best strategy would be to best reduce illnesses due to influenza (including vaccination but also other potential measures), develop national communications to increase vaccination uptake and evaluate outcomes to inform ongoing control efforts.
How can we protect against political interference?
As experience in the US reminds us, government agencies can be subject to political interference.
Allegations or evidence of political interference have affected or threaten to affect US policies on topics as diverse as mRNA vaccines, scientific research, foreign aid for HIV/Aids and alcohol labelling.
But political interference in the US isn’t a new phenomenon. In the 1990s political opposition led to the US CDC having to stop examining gun violence, clearly a major public health issue.
Closer to home, many in the public health community remember the short-lived Australian National Preventive Health Agency. This was established in 2011 but defunded a few years later.
Ultimately, the CDC will need to have a close relationship with the government. It will need appropriate funding, to provide input into government policies, and to be accountable for its work.
Yet it needs to be independent and transparent. Safeguards in the draft legislation mean, for example, the CDC director general must, under most circumstances, publish advice to government and the associated rationale and evidence.
So if any governments make decisions against the advice of the CDC, this would be clear. This is similar to the Victorian pandemic legislation – the health minister makes decisions but is required to consider and release advice from the chief health officer.
So early signs for the Australian CDC are positive.
What don’t we know yet
Many questions remain. The draft legislation is understandably vague in defining the scope of public health so as not to limit its activities.
For example, would hospital-acquired infections be regarded as a public health issue (and come under the remit of the CDC), or a healthcare quality issue (and be addressed by another agency)?
The relationship of the Australian CDC to existing agencies, such as the Australian Commission on Safety and Quality in Health Care and the Australian Institute for Health and Welfare, will need to be clarified.
We don’t yet have timelines of what the CDC plans to achieve, nor a strategic and implementation plan of how to get there. While infectious diseases are understandably a priority area, how soon will the CDC get into other important areas such as cancer, diabetes and heart disease?
We don’t know the CDC’s role in setting priority areas for research funding, how resources will be allocated within the CDC, and there is no mention of its role in training the future public health workforce.
But answers to these and other questions will come with time.
