10 years of preventive health in Australia. Part 1 – lessons for policy and implementation

Given that the focus of this journal is the connection between public health research, policy and practice, our reflections at this 10-year point in the journal's history are upon lessons to be drawn from recent efforts to achieve effective, evidence-based prevention in Australia. The accompanying commentaries on progress in critical areas of public health action (refer to Part 2 - centring First Nations sovereignty; Part 3 - engaging the primary care sector; Part 4 - extending gains in tobacco control) highlight that there have been numerous commitments to prevention policies and programs alongside continued difficulties in achieving the required quality and continuity of implementation. In order to realise the aspirations that are held regarding these and other prevention priorities, it will be vital to strengthen the essential enablers of successful implementation, namely governance, organisation and investment. Fortunately, Australia is well placed in this regard, with the National Preventive Health Strategy (NPHS) and Australian Centre for Disease Control (ACDC) providing opportunities for leadership and coordination across sectors and agencies. Yet neither of these potential pillars for prevention policy and practice at a national level are being used in ways that have been hoped for. The blueprint for implementation promised in the NPHS has not been developed, while the ACDC has had its scope of responsibility constrained to communicable disease control, despite calls from leading health organisations for this to include Australia's large burden of chronic disease and injury. Although the progress being won in a number of areas of public health should be acknowledged, the continuation of sporadic and disjointed policy implementation will mean that the nation fails to achieve the lasting health, social and economic benefits that may be gained from sustained, evidence-based prevention. It is clear that the need for evidence gathering, critical analysis, advocacy and learning through practice in diverse arenas of prevention activity is as apparent now as when Public Health Research & Practice commenced publication 10years ago.