8 Oketopa / October 2020

Aotearoa NZ may be leading the world in eliminating COVID-19, but that is sadly not the case for other infectious conditions, says the Royal Australasian College of Physicians (RACP).

“It is completely unacceptable that as a country we continue to tolerate the incidence of rheumatic fever, congenital syphilis and bronchiectasis” said Dr George Laking (Te Whakatōhea), a medical oncologist and the RACP’s Aotearoa NZ President.

“These conditions are rare in other OECD countries – doctors come to work in Aotearoa and suddenly they are seeing diseases they have only read about in textbooks.”

“We have united as a team of five million to eliminate COVID-19. Our college is calling for Aotearoa to unite to also eliminate rheumatic fever, bronchiectasis and congenital syphilis.”

“These preventable infectious diseases are associated with cold, damp and overcrowded housing, and inequitable access to health and maternity care”.

High rates of congenital syphilis, rheumatic fever, and bronchiectasis in an OECD country like Aotearoa NZ will be shocking to many people, Dr Laking said.

“Cuba and Malaysia have eliminated congenital syphilis. Aotearoa NZ can as well, if we all work together”. Rheumatic fever and bronchiectasis predominantly affect children and have life-long impacts, often cutting lives short, as hearts and lungs are damaged beyond recovery. 130 people will die every year due to the lasting impacts of rheumatic fever.

Babies infected with syphilis during pregnancy may be stillborn. Since 2016, Aotearoa NZ has had 14 confirmed cases of congenital syphilis, including 6 stillbirths.

Dr Laking says elimination of all three complications of infectious diseases is achievable through action on the social determinants of health.

“Our College’s prescription for health is straightforward”, he said. “Healthy housing, good work, whānau wellbeing and health equity. There have been gaps in health outcomes for too long. Action to improve our housing, working conditions, and lifting incomes will mean gains in health and wellbeing – especially in preventable conditions like rheumatic fever, congenital syphilis and bronchiectasis.”

These are actions that will mean New Zealanders live longer, healthier lives, and good health is the norm”.

The RACP’s advocacy campaign #MakeItTheNorm launched in September 2020. Our recommendations include:

Make healthy housing the norm because a healthy home is a human right

• End prompt payment discounts for energy bills.
• Introduce a mandatory Warrant of Fitness under the Healthy Homes Guarantee Act 2018 to verify compliance under the legislation.
• Build all new public housing to universal design principles.

Make Good Work the norm because incomes must enable whānau to live with dignity

• Double minimum sick leave allowances in the Holidays Act 2003 to 10 days per year.
• The Living Wage is implemented, with the same rate applied to contractors and employees.
• Legislation is amended to improve conditions for contractors and gig workers.

Make whānau wellbeing the norm by ensuring our environments support health

• End food insecurity and take a life-course approach to nutrition from pre-conception through childhood, adolescence and adulthood to older age.
• Revisit the Law Commission’s recommendations for alcohol legislation reform, with a view to implementation.
• Mental health and wellbeing initiatives announced in the 2019 Budget are implemented as a priority to support people and whānau through COVID-19.

Make health equity the norm to support just and equitable health outcomes

• Health resources are prioritised according to equity and need, delivered by a culturally-safe and pro-equity workforce.
• A Public Health Commission is re-established with oversight of all core public health functions including management of public health units; regulation of products like tobacco and alcohol; and contract tracing capacity for all notifiable infectious diseases.

Visit racp.edu.au/MakeItTheNorm

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