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Jim Bishop: The Chief Medical Officer of Australia
Perspectives
Profile Jim Bishop: The Chief Medical Officer of Australia Hitting the ground running does not even begin to describe it. Australia’s Chief Medical Officer (CMO) Jim Bishop had been in the post just 4 days when WHO declared the H1N1 influenza pandemic. Bishop knew that the country would be one of the first western nations, along with New Zealand, to face a winter season of H1N1. The eyes of the world were on these two countries. Working with Australia’s National Incident Room in Canberra, the Minister for Health and Ageing Nicola Roxon, and the health department team, Bishop helped roll out Australia’s well-rehearsed pandemic plan. Both Bishop and Roxon found themselves in front of the media on an almost daily basis. Bishop relied heavily on his 35 years as a practising oncologist in those media briefings. “I approached it like diagnoses for cancer patients”, Bishop told The Lancet. “I thought I should talk to the population like a patient—tell them everything they need to know. I wanted to talk as if I was in their home explaining things.” A 7-week window from the H1N1 outbreak in Mexico before cases reached Australia was vital in the country’s handling of H1N1. Bishop visited the US Centers for Disease Control and Prevention and the UK Health Protection Agency and determined that Australia should learn, and share, as much as possible. Canada also provided valuable insights: “Canada’s Indigenous population was hit badly. This gave us time to get antivirals to Australia’s Indigenous communities.” Bishop adds that Australia’s extra-corporeal membrane oxygenation (ECMO) machine capacity helped mitigate the number of H1N1 deaths to 191; around two-thirds of about 70 patients put on ECMO as a last resort survived. Bishop is also spearheading a media campaign to ensure more Australians are vaccinated against H1N1 as the country enters its second winter with the virus—more than 90% of all influenza cases are expected to be H1N1. Latest seropositivity data suggest 20–25% of Australians have immunity, but Bishop says this needs to be 33–50% to interrupt the virus spreading through the population. The pandemic placed a strain on Australia’s health system, with 700 influenza-related intensive-care admissions versus the usual 57 in a normal season. But Bishop thinks this influenza season could be one of Australia’s best, since there will be less seasonal influenza affecting elderly people and more people vaccinated against the dominating H1N1 strain. If this happens, Bishop says Australians could be forgiven for wondering what all the fuss was about. “I’d be pleased to be criticised for us having a very mild flu season”, he says. “The Australian Government was very fortunate to have Jim in the role of Australia’s Chief Medical Officer”, says Roxon. “While he was very new to the position of CMO, and although a cancer specialist by profession, Jim quickly became an infectious diseases expert. His calm demeanour, www.thelancet.com Vol 375 May 1, 2010
wise advice, and media liaison skills assisted the Australian Government to respond appropriately to the H1N1 pandemic.” Anne Kelso, Director of WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, was similarly impressed: “Jim communicated very clearly why the national response was modified as the pandemic evolved and new information came to hand, why the focus shifted to those most vulnerable to severe infection, and why people should take advantage of the pandemic vaccine once it became available. One of the outcomes is that vaccine uptake has been good despite the absence of much influenza in Australia for many months, so that we can expect a reasonable proportion of the community to be protected if, as we expect, the virus spreads again this winter.” The demands of managing H1N1 reminded Bishop of his time at the intensive care unit of the Royal Melbourne Hospital in the 1970s. His long career has also seen spells at the US National Cancer Institute, Melbourne’s Peter MacCallum Cancer Institute, and Sydney’s Royal Prince Alfred Hospital. For 6 years before becoming CMO, he ran the New South Wales Government’s Cancer Programme. And being Australia’s CMO is not just about managing a pandemic. Like many western nations, Australia is attempting to shift health focus from cure to prevention. “It’s time for that message—Australians are ready for it”, says Bishop. But he adds that people want more evidence on the health effects of obesity and inactivity before fully embracing prevention: “The lowest socioeconomic groups have the worst diets and screening rates. We have to get the prevention message to where it’s hardest to deliver. We need new ways to communicate and to consider that different types of intervention might work better in different socioeconomic groups.” Bishop is also a staunch antismoking advocate, having had key roles in many state and national antismoking campaigns. He supports programmes such as those that prevent federal health employees smoking at work, and he is assisting with the government’s antismoking strategy after the recommendations of the National Preventative Health Taskforce during 2009. Asked why he became CMO, Bishop says: “I got a lot of satisfaction being a high-level treating cancer specialist. But in this position, I see myself as a custodian of health institutions established so that we can all work to improve health for the largest possible number of people. That is the great opportunity that being CMO represents, and the advantage of having medical people in the middle of bureaucracy.”
To listen to an audio interview with Jim Bishop see http://www. thelancet.com/audio
Tony Kirby [email protected]
1517
Profile Jim Bishop: The Chief Medical Officer of Australia Hitting the ground running does not even begin to describe it. Australia’s Chief Medical Officer (CMO) Jim Bishop had been in the post just 4 days when WHO declared the H1N1 influenza pandemic. Bishop knew that the country would be one of the first western nations, along with New Zealand, to face a winter season of H1N1. The eyes of the world were on these two countries. Working with Australia’s National Incident Room in Canberra, the Minister for Health and Ageing Nicola Roxon, and the health department team, Bishop helped roll out Australia’s well-rehearsed pandemic plan. Both Bishop and Roxon found themselves in front of the media on an almost daily basis. Bishop relied heavily on his 35 years as a practising oncologist in those media briefings. “I approached it like diagnoses for cancer patients”, Bishop told The Lancet. “I thought I should talk to the population like a patient—tell them everything they need to know. I wanted to talk as if I was in their home explaining things.” A 7-week window from the H1N1 outbreak in Mexico before cases reached Australia was vital in the country’s handling of H1N1. Bishop visited the US Centers for Disease Control and Prevention and the UK Health Protection Agency and determined that Australia should learn, and share, as much as possible. Canada also provided valuable insights: “Canada’s Indigenous population was hit badly. This gave us time to get antivirals to Australia’s Indigenous communities.” Bishop adds that Australia’s extra-corporeal membrane oxygenation (ECMO) machine capacity helped mitigate the number of H1N1 deaths to 191; around two-thirds of about 70 patients put on ECMO as a last resort survived. Bishop is also spearheading a media campaign to ensure more Australians are vaccinated against H1N1 as the country enters its second winter with the virus—more than 90% of all influenza cases are expected to be H1N1. Latest seropositivity data suggest 20–25% of Australians have immunity, but Bishop says this needs to be 33–50% to interrupt the virus spreading through the population. The pandemic placed a strain on Australia’s health system, with 700 influenza-related intensive-care admissions versus the usual 57 in a normal season. But Bishop thinks this influenza season could be one of Australia’s best, since there will be less seasonal influenza affecting elderly people and more people vaccinated against the dominating H1N1 strain. If this happens, Bishop says Australians could be forgiven for wondering what all the fuss was about. “I’d be pleased to be criticised for us having a very mild flu season”, he says. “The Australian Government was very fortunate to have Jim in the role of Australia’s Chief Medical Officer”, says Roxon. “While he was very new to the position of CMO, and although a cancer specialist by profession, Jim quickly became an infectious diseases expert. His calm demeanour, www.thelancet.com Vol 375 May 1, 2010
wise advice, and media liaison skills assisted the Australian Government to respond appropriately to the H1N1 pandemic.” Anne Kelso, Director of WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, was similarly impressed: “Jim communicated very clearly why the national response was modified as the pandemic evolved and new information came to hand, why the focus shifted to those most vulnerable to severe infection, and why people should take advantage of the pandemic vaccine once it became available. One of the outcomes is that vaccine uptake has been good despite the absence of much influenza in Australia for many months, so that we can expect a reasonable proportion of the community to be protected if, as we expect, the virus spreads again this winter.” The demands of managing H1N1 reminded Bishop of his time at the intensive care unit of the Royal Melbourne Hospital in the 1970s. His long career has also seen spells at the US National Cancer Institute, Melbourne’s Peter MacCallum Cancer Institute, and Sydney’s Royal Prince Alfred Hospital. For 6 years before becoming CMO, he ran the New South Wales Government’s Cancer Programme. And being Australia’s CMO is not just about managing a pandemic. Like many western nations, Australia is attempting to shift health focus from cure to prevention. “It’s time for that message—Australians are ready for it”, says Bishop. But he adds that people want more evidence on the health effects of obesity and inactivity before fully embracing prevention: “The lowest socioeconomic groups have the worst diets and screening rates. We have to get the prevention message to where it’s hardest to deliver. We need new ways to communicate and to consider that different types of intervention might work better in different socioeconomic groups.” Bishop is also a staunch antismoking advocate, having had key roles in many state and national antismoking campaigns. He supports programmes such as those that prevent federal health employees smoking at work, and he is assisting with the government’s antismoking strategy after the recommendations of the National Preventative Health Taskforce during 2009. Asked why he became CMO, Bishop says: “I got a lot of satisfaction being a high-level treating cancer specialist. But in this position, I see myself as a custodian of health institutions established so that we can all work to improve health for the largest possible number of people. That is the great opportunity that being CMO represents, and the advantage of having medical people in the middle of bureaucracy.”
To listen to an audio interview with Jim Bishop see http://www. thelancet.com/audio
Tony Kirby [email protected]
1517