Water-Borne Budget Cuts


The Gillard Government is facing the challenge of returning the budget to surplus by 2013 with grim determination — and with little consideration of the impact budget cuts will have on Australia’s future beyond this election cycle. The cost of rebuilding the areas of Queensland and Victoria that were devastated by January’s floods has caused the Government to ominously describe its forthcoming Budget as "tough".

The Health Minister has made it clear that medical research is one area likely to take a hit. Rumours are circulating that 20 per cent will be cut from the National Health and Medical Research Council — which funds the bulk of Australia’s medical research — in order to bring the budget back to surplus and pay for flood recovery. There’s an irony here. The floodwaters that surged through Queensland and Victoria did not only inundate houses, submerge roads and waterlog possessions, they also carried serious threats to human health: microbes that would cause exotic diseases and conditions ideal for disease-carrying mosquitoes to breed.

Although it’s imperative that rebuilding "bricks and mortar" infrastructure be part of the flood recovery, responding to the impact of flood-associated health problems will, in the long term, be as important for Australia.

The Royal College of Pathologists of Australasia — representing the doctors who are often called upon to diagnose infections — has reported increases in waterborne infections in people who have been in contact with flood waters. In Queensland this has included the potentially fatal bacterial disease melioidosis. Patients can present with meliodiosis days, weeks or years after contact with contaminated water, with symptoms varying from bronchitis or pneumonia to ulcers, abscesses or blood poisoning. In Australia, 20 per cent of patients contracting melioidosis will die. We should therefore be very worried about likely increases in cases of melioidosis in the months and years to come following the Queensland floods.

What can be done to combat this? Australia already has several research groups studying melioidosis. Funding from the NHMRC and other funding bodies has enabled these groups to determine better ways to prevent, diagnose and treat melioidosis. If the government cuts medical research funding, it is possible that melioidosis research could be one of the research areas that is affected. We cannot predict how many Queenslanders will develop melioidosis in the coming years as a consequence of their contact with contaminated flood waters. Cutting medical research programs that may have improved the health — and even saved the lives — of these flood victims cannot be considered "flood recovery".

Mosquito-borne diseases have been the main health impact of Victoria’s floods. In the first three months of 2011 roughly 1000 cases of Ross River Virus were diagnosed in Victoria — more than the total number of notifications from the four year period from 2007 to 2010. Ross River Virus causes exhaustion and debilitating joint pain that can last for periods of weeks to months; one in 11 patients will still experience (pdf) chronic fatigue a year after infection. Especially in smaller regional communities, the lost workforce productivity which can stem from Ross River Virus infections will be a huge burden on the community. A loss of able workers in the aftermath of the floods has the potential to slow other aspects of the flood recovery.

There is currently no vaccination to prevent Ross River Virus, and no treatments other than symptomatic relief such as pain relief and anti-inflammatory medications. The development of vaccines and new treatments are obvious goals of medical research into these diseases. Indeed, in the past five years Australian researchers have identified that drugs that can suppress the inflammatory immune response may have value in improving recovery from Ross River Virus. 

In 2010 the Australian government, through the NHMRC, funded a mere $2 million of research into the Ross River Virus and related viruses, as part of its overall $101 million funding of research to improve the outcomes of infectious disease. The forecast 20 per cent NHMRC budget cut will likely reduce the amount of research that Australia conducts into Ross River Virus, thus slowing the development of new treatments or vaccines.

Both melioidosis and Ross River virus have limited global distribution, and are certainly not endemic in North America and Europe, which have the largest medical research capacity. Therefore we should not expect that other governments or large pharmaceutical companies will support research into these conditions. It is the responsibility of the Australian government to protect the health of Australians.

Cutting the funds that are available to researchers to improve the outcome of diseases such as melioidosis and Ross River Virus will only serve to prolong the health problems of many ordinary Australians living in flood affected regions. This, in turn, will increase the longterm costs of these diseases, both in medical costs and lost productivity. What the government may consider to be a short-term savings measure could, in the longterm, be likely to cost more money than it ever saved.

While the Queensland and Victorian floods were events of "once in a lifetime" magnitudes, there is no doubt that at some point in the future there will be more floods, and more surges in flood-associated illnesses. Just as levies, dams and flood management can protect homes and lives in flood-prone areas, the government can protect the health — and the lives — of Australians in these same areas by maintaining medical research funding.


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