Evidence systems a “worrying gap” in Australia’s pandemic readiness, experts say

Australia urgently needs systems that support sophisticated data analysis as well as evidence synthesis and sharing to be prepared for the next pandemic, say leading epidemiologists.

Published in the latest issue of Public Health Research & Practice, a peer-reviewed journal of the Sax Institute, the paper examines the impact that limited data had on the response to the COVID-19 pandemic in Australia and internationally and calls for greater investment in analytic epidemiology.

The paper explains that during the COVID-19 pandemic, many countries did not have adequate data consistency or analytic capability and as a consequence policy was not always based on local evidence and important risk populations were overlooked. For Australia, this meant that the overseas-born population – which had a COVID-19 death rate 2.5 times higher than the rest of the Australian population by 2022 – was not recognised as an at-risk population until late in the vaccine rollout.

The paper’s authors, Professor Catherine Bennett from Deakin University and Associate Professor Meru Sheel from University of Sydney, argue for a better funded and coordinated approach to the generation, analysis and communication of evidence, which “remains a worrying gap in pandemic readiness”.

“Good-quality public health data that are reliable, consistent and sufficiently granular to inform nuanced decision-making and policies are central to a speedy and effective pandemic response,” the authors say.

Analytic epidemiology, which includes case-control studies, cohort studies and emulated target trials, can provide “higher-resolution identification” of at-risk subpopulation groups, the authors say.

The authors also argue that the world’s first Pandemic Agreement, which was approved for adoption in May, focuses only on the research areas of genomics and clinical trial readiness, and not on applied public health research.

“Failure to acknowledge the value of real-world evidence generation risks effective pandemic responses and trust in policymaking,” the authors say, calling for a “coordinated approach to applied public health research that also encapsulates, social and behavioural sciences, and risk assessment and communication.”

Professor Bennett, one of the public faces of epidemiology during the COVID-19 pandemic and one of the leaders of the COVID-19 Response Inquiry, says that she was motivated to write this paper to bring together insights from Australia as well as an international perspective. “This paper shows what we missed in the pandemic, but also what the possibilities are for the future.”

Australia has made improvements to its data quality but still does not have the capabilities to conduct sophisticated epidemiological studies in real time if another pandemic hit today, says Prof Bennett.

“We’ve done some of the technical work, but we’re still way off having a nationally coordinated system. We might have more consistent and available data, but data are not evidence – they are the building blocks.”

Associate Professor Sheel, who has extensive international field experience and is on WHO’s Immunization and Vaccines Related Implementation Research Advisory Committee, says that with the US having terminated funding for research and data collection, it’s even more important to have strong evidence.

“The Pandemic Agreement shows there is the desire to help each other and come together, but we need to be careful about protecting and strengthening our data systems.”

Both authors are optimistic about the long-term impact of the Australian Centre for Disease Control (CDC). The CDC is expected to shift from an interim to a permanent body on 1 January 2026.

“It will take time for the CDC to build those important relationships with the states and research institutions, to help build a coordinated and national system for evidence. But for now, it has made headway with detection and warning systems,” says Prof Bennett.

“I hope that the CDC can enable an ecosystem to support evidence-based decisions, bringing in the CDC, jurisdictions and academics for better evidence generation,” says A/Prof Sheel. “I don’t think traditionally we’ve seen this in Australia. If we can create an ecosystem that allows for this, we’ll do much better in a pandemic.”

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