Mark Butler, Minister for Health and Ageing, and Disability and the NDIS, has some serious heavy lifting ahead, and The Health Wrap identifies several key priorities for the Albanese Government’s attention.
Meanwhile, as turmoil continues in science and health spheres in the United States, an average of 350 people are dying there every week from COVID-19, and many countries are actively recruiting American scientists.
Dr Lesley Russell also brings news from hiking in the Atlas Mountains and Malta, as well as the Yoorrook Justice Commission’s Walk for Truth now underway across Victoria.
The quotable?
Will the Albanese Government have the courage and the vision to do more in health, after what was a pretty timid first term with lots of short-term, Band-Aid solutions?”
Lesley Russell writes:
After a brief hiatus while I was hiking in Morocco and Malta, and exploring Madrid, The Health Wrap is back.
My women’s only hike in the Atlas Mountains was a life-changing experience – dramatic scenery, and the chance to interact with local women and nomadic Amazigh (Berber) people and learn about their culture. I also enjoyed delicious food and some fairly challenging hiking. 
Malta was a special chance to return to a place that has fascinated me since I first visited in the early 1970s. There is so much history to explore, including the key role Malta played in WW2.
We enjoyed hiking on Gozo and Comino, and the chance to swim in the startlingly blue waters of the Mediterranean.
You can follow my #3MAdventure, with some of my many photos, on BlueSky. And I will write up my trips for The Hiking Wrap.
What’s ahead for the Albanese Government?
Labor’s unexpectedly large election win gives Prime Minister Albanese huge policy and political authority. And the fact that the Coalition has fallen apart seems to almost guarantee Labor two more terms in government.
A recent article in Crikey asks if Albanese, now with unprecedented authority and immense political capital, will face up to the pressure to be more ambitious?
Along with many other health policy wonks, I have been critical of the failure to tackle the big problems in health (like obesity and the impact of climate change) and healthcare (like improved coordinated management of chronic conditions, the better integration of mental health services, the need to ensure Medicare is truly universal) and to improve access to and affordability of dental care.
Will the Albanese Government have the courage and the vision to do more in health, after what was a pretty timid first term with lots of short-term, Band-Aid solutions?
Mark Butler, Minister for Health and Ageing, now has an expanded portfolio of health, disability and ageing that puts him in charge of about $220 billion in annual government spending – more than a quarter of the federal budget.
He has some major heavy lifting ahead. This includes tough negotiations with the States and Territories over the National Health Reform Agreements (NHRAs), which are now linked to negotiations over their roles in taking pressure off the ballooning National Disability Insurance Scheme.
The NHRAs were simply extended for a year (with one-time additional funding) in last year’s Federal Budget and the NDIS “foundational support” system was supposed to start last July, but agreements are yet to be reached.
There have been concerns about the lack of transparency around work on this new system, which is being developed by the secretaries of Prime Minister and Cabinet and Premiers and Cabinet. Butler’s office has said the Albanese Government is seeking to implement the new system “as soon as possible”.
Additionally, Butler must ensure he delivers on the promised expansion of the healthcare workforce, the implementation of aged care reforms is lagging, COVID-19 continues to damage and claim Australian lives, access to safe birthing facilities is declining around the nation, there is so much more that must be done to Close the Gap, and the private health insurance system/ private hospital system is faltering.
There is a raft of reports from government-convened expert advisory groups about what needs to be done and how to do it.
It’s time to be brave and take action.
Recent Croakey articles on these issues:
- Governments urged to prioritise high level action on the social determinants of health equity
- Calling for national leadership to address workforce shortages in community mental health services
- Five priorities for the Albanese Government to transform Australia’s mental health system
- Health Minister urged to prioritise investment and action on climate health
- Albanese Government told loud and clear: get your act together
- Seize the moment: and other calls to action on prevention.
Turmoil continues in the United States
These are the headlines from the US:
- New Scientist: US science faces existential crisis
- The Washington Post: NIH reels with fear, uncertainty about future of scientific research
- National Public Radio: Scientists reel as turmoil roils National Science Foundation
- Politico: RFK Jr. vowed to upend American health care. It’s happening faster than expected
- National Public Radio: RFK Jr. stands by deep cuts to health budget during contentious hearings
- Nature: Harvard researchers devastated as Trump team cuts nearly 1,000 grants
- The Economist: Trump’s attack on science is growing fiercer and more indiscriminate.
There has been so much budget cutting, abolition of agencies, slashing of staff and it’s very hard to see any rebuilding, reforms or revitalisation. The damage inflicted in just over 100 days will not easily be repaired.
One of the Trump Administration’s senior officials, the head of the Office of Management and Budget, has been quoted as saying: “We want the bureaucrats to be traumatically affected. When they wake up in the morning, we want them to not want to go to work, because they are increasingly viewed as the villains. We want their funding to be shut down … We want to put them in trauma.”
This approach is working all too well across the Administration, but especially in areas related to health, healthcare and science.
Even when agencies and divisions remain technically intact, their operations are stymied by a lack of funds.
For example, at the Environmental Protection Agency, research in the laboratories run by the Office of Research and Development has been crippled by a new requirement that Trump officials approve all new lab purchases, which has not been happening. As a result, ORD is effectively shutting down their laboratory activities.
Over at the Department of Health and Human Services (HHS), there has been a dramatic restructuring, promulgated as a “Transformation to Make America Healthy Again”.
This is proposed to:
- Save taxpayers US$1.8 billion per year through a reduction in workforce of 20,000 full-time employees (it’s interesting that this is seen as the key point!).
- Reduce the current 28 divisions into 15 new divisions, including a new Administration for a Healthy America. Regional offices will be reduced from ten to five.
- Implement the new HHS priority of ending America’s epidemic of chronic illness by “focusing on safe, wholesome food, clean water, and the elimination of environmental toxins”.
- Make HHS more responsive and efficient, while ensuring that Medicare, Medicaid, and other essential health services remain intact.
Drew Altman of KFF has provided a good analysis here of what all this will really mean.
He makes the point that it is currently unclear how simply consolidating agencies into a new Administration for a Healthy America will reduce chronic diseases, and their causes such as obesity and diabetes, without new initiatives and substantive redirection.
He also highlights that staff cuts of the magnitude proposed will have a profound effect on the scope and effectiveness of operations.
It’s important to note that the decisions (or lack thereof) of US agencies like the Food and Drug Administration have consequences for regulatory decisions around drugs and medical devices in Australia.
America’s science brain drain
In the wake of the draconian actions of the Trump Administration and the Department of Government Efficiency against research institutions and universities, American researchers are feeling devastated and hopeless, and many are looking to leave.
In an article in Nature, five US-Based researchers spoke about why they are exploring career opportunities overseas.
See also this article in The Washington Post: As Trump cuts science budgets, some researchers look abroad.
American scientists are being actively recruited by countries, including France, Spain, Germany and China, that are hoping to reverse the flow of expertise into the US that has been the norm for decades.
International research institutions such as the European Research Council have put out incentives to attract American talent and expertise.
See US brain drain: Nature’s guide to the initiatives drawing scientists abroad.
The American Civil Liberties Union and others have filed a lawsuit challenging the sweeping cancellation of grants by the National Institutes of Health.
As part of this lawsuit, the ACLU collected statements from affected scientists. You can read them in this article: ‘Devastated’ and ‘Hopeless.’ Researchers Speak Out on Funding Cuts.
A recent article in The New York Times highlights the extent of the cuts that have been made to research and education funded by the National Science Foundation, whose budget has been reduced by 51 percent.
There will inevitably be long-term consequences.
All this has direct impacts for Australian academics and researchers working in the US and for those here in Australia who have lost funding from US agencies like the NIH.
I haven’t seen any indication that the Albanese Government is looking to replace the US funding that Australia has lost (I have previously argued that there are excess funds in the Medical Research Future Fund that could be used here). Nor have I seen any efforts to attract those Americans who are part of the brain drain.
Australian students enrolled at Harvard University now also face an uncertain future as the Trump Administration has instructed the university that it can no longer enrol overseas students (although note that as I write this a federal judge has blocked this action).
The other international consequence of all this academic upheaval and the current efforts of the Trump Administration to detain and deport people – often for no justifiable reason – and to make it harder to get entry visas is that medical and scientific conferences are moving elsewhere in order to ensure good attendances.
“Conferences are an amazing barometer of international activity,” says Jessica Reinisch, an historian who studies international conferences at Birkbeck University of London, in an article in Nature on this issue.
“It’s almost like an external measure of just how engaged in the international world practitioners of science are. What is happening now is a reverse moment. It’s a closing down of borders, closing of spaces…a moment of deglobalisation.”
Kennedy is upending the US vaccine system
At the Senate hearing that considered his nomination to be the Secretary of Health and Human Services, Robert F Kennedy Jr clinched the political support needed by pledging to work within the established federal system for the approval and use of vaccines.
Those commitments have now been tossed out.
The Food and Drug Administration (FDA) will soon “unleash a massive framework” for how vaccines are tested and approved, according to the FDA Commissioner.
As yet there are no details of this plan, which is being overseen by the new FDA vaccine chief who has been an outspoken critic of the agency’s handling of COVID-19 boosters.
At the same time, the FDA has announced it will limit COVID vaccines to adults over 65 and those with certain medical conditions (until now, annual COVID boosters were recommended for everyone aged six months and older).
In an article published in The New England Journal of Medicine, the FDA Commissioner and the Vaccine Division Chief wrote that boosters offer “uncertain” benefits to many young and middle-aged people who have already been vaccinated or have had COVID.
“The FDA will approve vaccines for high-risk persons and, at the same time, demand robust, gold-standard data on persons at low risk,” the officials wrote.
Kennedy has repeatedly stated that vaccines are exempt from safety studies – but they undergo rigorous safety testing and are continuously monitored for adverse events.
He claims that no vaccines (other than COVID vaccines) have been tested against a placebo, and has vowed to “remedy” this in what HHS has described as “a radical departure from past practices.”
Many vaccines are, in fact, tested against placebos. For those that aren’t, there is always a specific ethical and scientific rationale. There are concerns that changing existing practice won’t make immunisations safer but will delay access.
There are also concerns about the fate of the Vaccine Safety Datalink (VSD), a database of 12 million Americans’ medical records managed by a partnership between the CDC and 11 healthcare organisations that has been used to monitor vaccine safety and conduct studies of rare side effects.
There’s a good article about the VSD here.
Although Kennedy has been critical of the VSD, he plans to use this for his vaccine-autism study (despite the fact that many studies using VSD data have already disproven this link).
Perhaps fearful that this new study won’t deliver the findings they want, some of his anti-vaccine allies are now claiming that the data base has been obliterated.
Two asides here:
- Addressing rising rates of autism is a top health priority for the Trump administration. Kennedy has pledged $50 million to help identify environmental causes of autism and announced plans to create a national “autism registry.” But to date that money has not gone out and in fact the NIH has reduced funding for autism-related research by an estimated $31 million.
- Kennedy is already walking back his commitment to have a report on the links between autism and vaccines completed by September.
For Kennedy and his allies, mRNA vaccine technology has long been a target and it appears that the National Institutes of Health (NIH) might be forced to abandon this promising field of medical research.
Earlier this month, the Trump Administration announced an investment of $500 million (funds previously allocated by the Biden Administration to COVID vaccine development) to a new “universal vaccine” project at NIH.
“This initiative represents a decisive shift toward transparency, effectiveness, and comprehensive preparedness,” said an HHS statement which dubbed the project Generation Gold Standard.
The project involves producing vaccines from chemically inactivated whole viruses, a throwback to how flu vaccines were made decades ago. The goal, one that scientists have chased unsuccessfully for decades, is to make “universal” vaccines that protect against multiple strains of a virus at once.
While some experts were pleased about any support for vaccine research, concerns have been raised about the focus on outdated science.
A media release from the American Association for the Advancement of Science was headed “Gold Standard or appalling? HHS’s $500 million vaccine bet on inactivated viruses puzzles field”. 
Gaps in the MAHA report
In February President Trump signed an Executive Order establishing the Make America Healthy Again (MAHA) Commission and tasking it with delivering a “Make Our Children Healthy Again Assessment” focused on chronic disease among children.
The MAHA Commission’s report was released last week.
Secretary of Health and Human Services, Robert F Kennedy Jr, called the report a “diagnosis” of the causes of Americans’ poor health, and said the “prescription” for the report’s findings would come in August, when new policies would be unveiled by the Trump Administration.
He refused to provide details about who authored the report.
The report describes American children as over-medicated and under-nourished and lists a range of contributing factors, including poor diets with too much over-processed foods, accumulation of environmental toxins, insufficient physical activity and too much screen time, and chronic stress.
It calls for increased scrutiny of the childhood vaccine schedule and a review of the pesticides sprayed on American crops.
I suspect that I am like many public health people – it’s hard not to agree with the broad principles of the report, but it is focused on Kennedy’s favourite topics while ignoring other key issues and the lack of scientific integrity is disturbing.
For example:
- The report fails to mention that the most common causes of death among children are car crashes and firearm accidents (I guess they can say these are not chronic illnesses?).
- It ignores behaviours that often start in adolescence and lead to chronic disease in adulthood, such as smoking and alcohol use.
- The report speaks about the (presumptive) adverse health effects of childhood vaccinations and fluoride in the water supply with no acknowledgement of the overwhelmingly positive benefits.
- The adverse effects of high levels of salt in ultra-processed foods is ignored.
The report does not address structural issues such as physician shortages or high healthcare costs.
And it is silent on the fact that many of the actions of the Trump Administration, DOGE and the Republican Congress will make it increasingly difficult to improve children’s health.
The Guardian: Key takeaways: RFK Jr’s ‘Maha’ report on chronic disease in children
The Washington Post: The findings – and scientific problems – in White House ‘MAHA Report’
The report is also contentious because it creates factions within the government agencies on the MAHA Commission and Trump Administration allies.
The focus on pesticides (Roundup is specifically mentioned) means that farmers are now upset about possible new regulations.
Agriculture Secretary Brooke Rollins has acknowledged the tight rope Trump officials are walking to keep farmers, many of them in Republican-leaning states, happy while also working to satisfy Kennedy’s MAHA following.
The report calls on the NIH to execute sweeping, nationwide studies of ultra-processed foods, even as the White House has called for $18 billion to be cut from the agency’s budget.
It also raises concerns about other environmental and chemical research results that are funded by corporations and industry and calls for more “neutral” research – even as billions of dollars for research studies, agency laboratories, scientific positions and environmental health-tracking programs have been slashed.
The report is described as “a pretty accurate depiction of the nutrition crisis facing our country”, said Dr Dariush Mozaffarian, an expert in nutrition and policy at Tufts University.
But Trump’s “big, beautiful” reconciliation bill just passed by the Republican House of Representatives cuts the Supplemental Nutrition Assistance Program, or SNAP, by about $300 billion, the largest cuts in the program’s history.
Meanwhile, over at the Centers for Medicare and Medicaid (an agency of HHS), headed by Dr Mehmet Oz (who nominally reports to Kennedy), plans are already underway to Make America Healthy Again:
- Making America Healthy Again: Innovation for Healthier Lives
- CMS Innovation Center Strategy to Make America Healthy Again
There’s a big focus on prevention and personal responsibility and cost savings.
It will be interesting to see where all this leads.
Trump’s remarks on the report at a meeting of the MAHA Commission was mostly a rant about prescription drug prices, and don’t give much hope for either his understanding of the issues or the implementation of the recommendations that will emerge.
Resurgence of COVID-19?
Tracking what’s happening with COVID-19 in Australia and internationally is difficult: reporting has ceased in many cases or is sporadic, and no-one is paying much attention.
Thank goodness then for people like Denis The COVID info Guy (@thecovidinfoguy.bsky.social).
His weekly Australia update for 23 May shows COVID-19 cases rising across Australia, especially in Western Australia, where a new subvariant NB.1.8.1 is driving an increase in infections and hospitalisations.
The only regular reporting of COVID-19 cases at the national level is for aged care (and even then not all the States and Territories provide data).
As of May 15, there were 583 active COVID-19 cases reported in 84 outbreaks in residential aged care homes across Australia.
Worryingly, there have been 49 new outbreaks, two new resident deaths and 585 combined new resident and staff cases reported since 8 May.
The new NB.1.8.1 subvariant is driving a surge in infections internationally, especially in Asia and Europe.
Airport screening in the United States (it’s a wonder that CDC is still doing this!) has detected the new variant in travellers arriving from Japan, South Korea, France, Thailand, the Netherlands, Spain, Vietnam, China and Taiwan.
The KFF Global COVID-19 Tracker shows where cases are increasing.
In the United States, despite government refusal to talk about it, an average of 350 people are dying every week from COVID-19.
This is due to low vaccination uptake, waning immunity and not enough people accessing treatments.
During the 2024-25 season, only 23 percent of adults aged 18 and older and just 13 percent of children received the updated COVID-19 vaccine.
In Australia vaccination levels are also dropping – not just for COVID-19 but also for flu, whooping cough and measles (Measles cases have reached the highest level in six years, with more than 50 cases reported so far in 2025, surpassing the total for all of 2024).
Australian Government data is concerning. As of May 7, only 2.1 percent of Australians aged 18 to 64 had received a COVID-19 booster in the past 12 months; 26.2 percent of people aged 75 and over and 50.5 percent of aged care residents had received a booster within this time frame.
As winter and a new variant arrives, this could mean problems ahead.
WHO approves historic Pandemic Agreement
On 20 May, the World Health Assembly approved the first international Pandemic Agreement.
Based on the difficult lessons learned from COVID-19, this lays the foundation for global collaboration to prevent, prepare for and respond to future pandemics.
I have written previously about the long and difficult road to this point.
The agreement has been described as: “A bit of a glimmer in the darkness. We should take hope from the fact that countries didn’t abandon this process when there were many opportunities for them to do so.”
While there is much to celebrate here, the promise of the agreement is limited by compromise and marred by the fact that the United States – withdrawn from the WHO by Trump – is not a party to it.
The joint media release of the Minister for Foreign Affairs, Penny Wong, and the Minister for Health and Ageing and Disability, Mark Butler, on the adoption of the Pandemic Agreement is here.
In case you missed it
AI Code of Conduct for Health and Medicine
A new publication from the US National Academy of Medicine provides a framework for the responsible, effective, equitable and human-centred use of artificial intelligence (AI) in health and medicine.
This is something Australia should look to develop.
Spiralling cases of dengue in Latin America
An article in the BMJ highlights the increasingly severe outbreaks of dengue in Latin America.
In 2024 there were 13 million reported cases and 8328 deaths, mainly in Brazil, Argentina, Mexico, and Colombia, up from 4.5 million cases in 2022.
This poses a persistent challenge to national health systems not only in Latin America but worldwide due to imported cases.
Polio outbreak raises alarm in Papua New Guinea
Papua New Guinea has raised the alarm over a polio outbreak in Port Moresby and Lae after samples of the virus were found in wastewater and cases confirmed in two healthy children.
Less than half of all children in PNG are vaccinated for polio, driving the risk of further outbreak.
The World Health Organization, United Nations Children’s Fund (UNICEF) and Australian government are assisting in rapid immunisation efforts aimed at at-risk children.
The re-emergence of polio in PNG highlights how global eradication remains elusive.
Report from NSW Special Commission of Inquiry into Healthcare Funding
Justice Beasley’s report has just been released and I have not had time to do anything other than skim the contents. It strikes me as well-written, wide-ranging and thought-provoking.
The report makes 41 recommendations across 12 key areas including workforce, education and training, funding and procurement processes.
Mental health needs of people with autism
A recent edition of The Lancet has a paper making the case that mental health care is an essential priority for healthcare equity for people with autism.
The risk of poor mental health is substantially elevated in people with autism. Estimates of lifetime prevalence in autistic adults are around 40 percent for both anxiety and depressive disorders and people with autism are three times more likely to die by suicide.
Mental health and climate change
An Australian study published in The Lancet Public Health finds that experiencing repeated disasters leads to severe and sustained effects on mental health.
As northern New South Wales struggles to recover from the most recent dreadful floods, it will be imperative that mental health services are provided to the local population.
Indigenous news
Some members of the Croakey team took part in the first two days of the Yoorrook Justice Commission’s Walk for Truth on Gunditjmara Country in Victoria this week.
You can learn some of the background to this historic walk here and here.
Croakey will publish more on the Walk for Truth on coming days; below you can link to interviews and recordings with some participants, including:
- Michelle Isles from the Climate and Health Alliance, on healing and truth-telling
- Lisa Briggs, Metropolitan Member for the First Peoples Assembly of Victoria, discusses preparations for Treaty.
The best of Croakey
As I outline above, and as several policy experts wrote for The Conversation, Labor has the chance to do something big in its second term. Mental health should be a focus of any big efforts.
In a recent Croakey article, experts from the Brain and Mind Institute at the University of Sydney pick up from there, and provide five recommendations for bold innovation to ensure a mental health system that is accessible, equitable and effective.
Other recent Croakey articles make the case for national leadership to address workforce shortages in community mental health; discuss how new research offers guidance for improving mental healthcare for Aboriginal and Torres Strait Islander people; and call for diverse models of care for young people.
The good news story
Under this heading I often take licence to stray from issues that are strictly about health and healthcare. This week is no exception.
I have two great Australian television shows to recommend to you, thanks to the ABC.
The first is a wonderful reality series, The Piano. You will be enchanted by the wonderful array of pianists of all ages and all genres, the excellent and sensitive hosting by Amanda Keller, and the great assessments and commentary from Harry Connick Jr (who knew he was so personable?) and Andrea Lam.
More information here.
And the second is a beautifully filmed series on the Kimberley. It is hosted by Indigenous actor Mark Coles Smith and explores a year in the unique environment of this very special area, with a special focus on how the changing seasons and the flora and fauna are viewed and valued by the local Indigenous communities.
More information here.
By the way: if watching this series has you persuaded that you must go visit (or revisit) the Kimberley, I wrote about my own trip in 2024 in this year’s edition of The Hiking Wrap. I can heartily recommend this way of seeing this magnificent country.
Croakey thanks and acknowledges Dr Lesley Russell for providing this column as a probono service to our readers. Follow her on Twitter at @LRussellWolpe.
Previous editions of The Health Wrap can be read here. And see The Hiking Wrap.
