AUSTRALIA'S fight to contain HIV, hepatitis C and other serious infections has been hobbled by a lack of leadership, and poor communication from the agencies nominally in charge.

An official independent review of the national strategies set up to combat HIV, hepatitisC and sexually transmitted infections has pointed the finger at a high-ranking federal committee, which it concludes failed to set goals or attempt to measure what impact its initiatives were having.

The review, the final reports of which have been obtained by The Australian following a Freedom of Information request, also uncovered concerns that the committee failed to engage with relevant organisations, did not listen to their advice and did not even deal effectively with recommendations from its own subcommittees.

Neither the committee nor the federal Health Department "exhibited the leadership expected in promoting the strategies and encouraging a national response" from 2005 to 2008, it found.

The findings have been welcomed by sexual health experts, who agree that Australia's response to HIV and other serious diseases needs a shake-up.

While the committee criticised in the review has since been abolished, a replacement body has been set up and new strategies in the four areas are still to be written. Experts say it will be essential to apply the lessons of the review to the new approach, to ensure the same mistakes are not made again.

Latest figures released last month showed rates of HIV infections had plateaued at nearly 1000 new cases a year in Australia, a similar level to 15years ago, causing consternation that too little was being done to combat complacency among younger gay men.

The review, conducted for the federal Health Department by the consultancy firm Urbis in 2008 and 2009, was set up to examine the strategies to tackle HIV, hepatitis C, sexually transmitted infections, and blood-borne viruses and STIs affecting Aboriginal people.

The review found broad support for the strategies but much more criticism of the way they were overseen by the Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis and its three subcommittees.

The review interviewed more than 80 people and found widespread concerns with the committee's failure to form strong partnerships with relevant bodies or to champion the causes nationally.

"Monitoring of performance is essential for ensuring that resources have been expended effectively," the report said.

"The review has found no evidence that this type of ongoing monitoring took place ... it appears that there has been no collective national reporting against the implementation plans to indicate progress against the national strategies."

In addition, it pointed out that a 2002 review had identified various concerns, such as the need to raise the profile of hepatitis C and STIs as serious national health problems. The report noted that "these concerns remain current" and should be addressed by the replacement committee.

"The governance structure has continued to suffer from a lack of role clarity, lack of administrative support, and a lack of co-ordination at a national level," the report said.

Sexual health expert Jonathan Anderson, immediate past president of the Australasian Society for HIV Medicine, who has been advising on the creation of the new strategies due for completion by the end of this year, said the Urbis report was "spot on".

http://www.theaustralian.news.com.au/story/0,25197,26171010-5013404,00.html