Health promotion is central to the establishment of an Australian Centre for Disease Control

Following a newly installed federal government and the ongoing COVID-19 pandemic, the Department of Health and Aged Care commenced planning for the establishment of an Australian Centre for Disease Control (CDC) with the release of a consultation paper about its role and functions, in tandem with a national roadshow.1 The Minister for Health and Aged Care and Chief Medical Officer invited public health experts to contribute thoughts and ideas about the establishment of an Australian CDC based on 28 guiding questions outlined in the consultation paper.1 Broadly, these encompassed the scope, functioning and monitoring of the proposed institution. The Australian Health Promotion Association (AHPA®) submitted a comprehensive response,2 as did multiple universities, peak bodies, health services and nongovernment organisations across Australia. A consistent theme of many submissions was a call for health promotion to be a prominent feature of the role and functions of the Australian CDC. This editorial extends on these responses, outlining why health promotion, and the evidence published in the Health Promotion Journal of Australia, needs to be central features of establishing the CDC in Australia for it to have optimal impact. The Australian CDC will be required to address the major causes of infectious and noncommunicable diseases in Australia.1 Health promotion will be central to this response. It is well recognised globally that health promotion is the process of enabling people to have control over their health at both an individual and community level, and includes actions directed towards changing behavioural, social, environmental, political, economic, commercial and cultural determinants of health.2-4 Importantly, principles that underpin contemporary health promotion emphasise actions that promote health and social equity.2-4 These characteristics are critical for understanding the role and function that the health promotion workforce will play during the establishment and subsequent operations of the CDC. At the start of the COVID-19 pandemic, health promotion experts quickly identified that its impacts would be experienced differently across the country. They noted the significant potential for COVID-19 to increase the health and social inequities experienced by communities already considered vulnerable, marginalised or at greater risk of disease.3 This susceptibility had been noted during past pandemics (eg, Swine Flu), particularly among Aboriginal and Torres Strait Islander people, where pre-existing health inequities exacerbated impacts.5, 6 Not surprisingly, this concern came to fruition relatively quickly during COVID-19, with issues promptly raised for, and by, Aboriginal and Torres Strait Islander people;5-8 people living in rural and remote Australia;8 people experiencing homelessness;9, 10 people with disabilities;11 people from culturally and linguistically diverse backgrounds including refugee and migrant communities;12, 13 the elderly, particularly those in aged care settings;14 and those living with mental health conditions, including those from low socio-economic backgrounds and young people.15 Understanding that the health promotion profession has worked long and hard to develop the requisite knowledge and expertise to address inequities experienced by individuals and groups within and across these populations is important. It meant that when COVID-19 emerged, the health promotion workforce was well-positioned to provide strategic advice and offer timely, pragmatic and innovative solutions to respond to the health needs of priority populations. The health promotion community has been influential during the COVID-19 response in many ways. For example, practitioners assisted in establishing consumer governance and advisory structures reflecting the authentic voices of people with lived experience of specific health concerns or with unique social and cultural needs;5, 6, 11, 16 developed health information in local languages for Aboriginal and Torres Strait Islander people7 and people from culturally and linguistically diverse backgrounds;17 and supported an increase in telehealth service availability and accessibility for people considered geographically isolated.13 These examples highlight the importance of ensuring the Australian CDC has mechanisms to rapidly and effectively engage consumers from marginalised and vulnerable backgrounds, and privilege their voices in decision-making. This will necessitate genuine participatory approaches—particularly during the planning, implementation and evaluation phases of programs and activities.4, 18 Such co-production practices are vital to address Australia's health and social inequities.4, 16 In tandem, the Australian CDC must prioritise the employment of health promotion practitioners with specialist skills and experience (operating within a multidisciplinary team) to work with consumer groups to appropriately tailor responses to meet the needs of their communities. Australia has seen significant variability in health promotion workforce investment (and disinvestment) by governments over the past four decades.19, 20 This has been cyclical and felt across all states and territories of Australia, albeit in some more than others.19 The establishment of the Australian CDC is a perfect opportunity to recognise and engage with the pivotal role that the health promotion workforce plays in improving the health and well-being of the Australian community. It provides a strategic juncture to acknowledge, embrace and bolster the application of health promotion competencies across Australia.2, 20 We agree with AHPA's® assertion that these core health promotion competencies should be mapped against the skills and capacities needed in emergency responses, where the Australian CDC will be expected to play a key leadership role.2 Such activity will help clarify and elevate the role that health promotion practitioners can play within the Australian CDC landscape. Meaningful functions could include advice about effective consumer engagement strategies;17, 18 efforts to build health literacy;12, 22 strategies to promote health and social equity;3-18 development and delivery of health education and health information, including mass media and social marketing campaigns;23 the development and reform of health policies and legislation, as well as social and broader policies to align with a Health-in-All-Policies approach;24 and the design and implementation of health-promotion-specific monitoring, evaluation and research activities. In addition, the strategic and effective use of evidence will be necessary for the Australian CDC functions. The Health Promotion Journal of Australia, the flagship peer-reviewed journal of AHPA®, should be used as an authoritative source of information to inform the work of the Australian CDC. Indeed, many of the references cited in this editorial reflect the role that the HPJA has played in publishing and disseminating timely commentary and evidence-based scholarship about COVID-19 and respective pandemic responses over the past few years. Consistent with the Global Charter for the Public's Health,25 the Australian CDC draft consultation paper has framed health promotion as one of its core public health functions, along with protection and prevention. Accordingly, health promotion as a discipline and profession must play a central role in its establishment and implementation. The health promotion community, and AHPA®, as the peak national health promotion professional body, welcome active involvement in the next iteration of the Australian CDC's planning. Health promotion expertise must be embedded into its architecture to ensure that it remains at the foreground of governance and operations. Key CDC actions should be appropriately aligned to the National Preventive Health Strategy 2021-2030,26 and the yet-to-be-finalised National Health Literacy Strategy, to leverage synergies and utilise relatively modest resources sensibly. The establishment of a CDC in Australia represents an exciting new chapter for Australia's health system, particularly in how we will respond to infectious and noncommunicable diseases in the future. The health promotion community looks forward to working with the Australian CDC to firmly embed health promotion concepts and a suitably skilled and experienced health promotion workforce within its purview. The authors declare no conflict of interest.