America is dismantling prevention, with deadly results
by Peter Breadon
A measles outbreak is spreading across America. Hundreds of children have been infected, almost 100 have been hospitalised, and three have died. Yet just when the country needs it most, America’s public health system is being kneecapped.
Health Secretary Robert F. Kennedy Jr – a vocal vaccine sceptic – has downplayed the outbreak, promoted unproven treatments, and overseen deep cuts to the Centres for Disease Control.
The CDC lacks independence and can’t fight back. During the COVID-19 pandemic, the White House repeatedly interfered with its advice and public messaging. In recent weeks, a senior vaccine official resigned, warning that Secretary Kennedy prefers misinformation over evidence. A rushed review into the causes of autism only reinforces that warning.
Australia doesn’t have the same system or politics as the US, so it’s easy to think it couldn’t happen here. But strong institutions and strong guardrails for prevention policy are important here too.
That’s because public health policy – the rules, regulations, services, and taxes designed to keep us healthy – is always fighting an uphill battle.
Public health policies save lives – but quietly. You don’t know about the heart attack you didn’t have, or the illness your child didn’t get. These benefits are diffuse, delayed, and politically thankless. The payoff rarely lands before the next election. Meanwhile, the pushback is immediate and well-funded.
Vested interests constantly counter public health policies, and governments often cave in to the pressure. In 2023-24, alcohol, gambling, and tobacco companies made $1.5 million of political donations, along with public advocacy and private meetings to sway government policy.
All these political pitfalls mean we’re sleepwalking into health crises of our own.
The toll of preventable chronic disease is rising fast. More than two-thirds of Australian adults are overweight or obese, putting them at increased risk of heart disease, diabetes, and cancer. Yet despite commitments to prevention – including plans to tackle obesity and chronic disease – governments haven’t followed through.
Australia’s prevention spending remains well below the average among wealthy nations. Countries such as Canada and the UK allocate a much bigger share of their health budgets to prevention, recognising that long-term investment in public health saves lives and money.
As well as spending more, other countries have adopted taxes and regulations to promote healthy choices. These include taxes on sugary drinks (adopted in more than 100 countries), stricter limits on salt in manufactured foods, and bans on junk food advertising to children.
Not only are we failing to introduce policies embraced by our peers, but policies we’ve had for decades are starting to fail us.
Each year since 2020, vaccination rates for children in Australia have fallen. Too many older people are missing out on vital vaccines as well. Last winter, one in five aged care homes vaccinated less than half their residents against the flu.
And now, new threats to public health are on the horizon.
The ongoing bird flu outbreak across North America highlights the risk of another pandemic. The virus has been detected in many wild bird species, has spread to livestock, and has infected 70 people, resulting in one death.
And as the climate gets hotter, new risks will follow from bushfires, heatwaves, and tropical diseases moving south into more populated parts of Australia.
Despite longstanding and emerging threats, complacency reigns. Even the loudest wake-up call imaginable didn’t work. A once-in-a-century pandemic that upended the country, killed tens of thousands, and left many more with ongoing symptoms. It has resulted in disappointingly little change.
Some new pandemic preparedness measures have been announced, and we’ve seen progress on problems like vaping. But Australia’s promised Centre for Disease Control hasn’t been legislated or fully established, and there is no sign that governments are shifting their focus towards keeping Australians healthy.
That slide back into complacency after a crisis is a well-known problem in public health, called the “panic-neglect cycle”.
When political incentives, vested interests, and short-termism block policies that are in the national interest, independent institutions can help break the panic-neglect cycle. Election season is a great time to see them in action.
As the campaign heats up, Australia’s independent bodies are beavering away. The Australian Electoral Commission, the nation’s most trusted public service body, is making sure the rules are followed and the election runs smoothly. The Parliamentary Budget Office will publish an independent costing of every election commitment, free from political spin.
The next parliament will have a golden opportunity to establish a similarly independent, capable, and well-resourced Centre for Disease Control. The Coalition doesn’t think we need one at all. But independent MPs – who could be an influential force in the next parliament – might advocate for this reform.
The last time Australia had a minority government, independents fought for the creation of the Parliamentary Budget Office. In the current term, they were crucial in pushing for an independent National Anti-Corruption Commission.
The chance to establish a truly independent Centre for Disease Control doesn’t come often. Done right, it could safeguard Australians’ health for generations – and finally break the panic-neglect cycle for good.