Can you guess how much governments spent on public health activities on each of us in 2023-24? Hint: it’s triple figures, starting with a 2.
Government spending on public health activities in Australia has fallen by 30% in the past year, according to new data from the Australian Institute of Health and Welfare.
The figures showed spending had returned to pre-pandemic funding levels after the unprecedented surge driven by covid, the agency said.
“This report is a new and important resource for tracking how governments respond financially to emerging public health threats and how that spending evolves over time,” said AIHW spokesperson Geoff Callaghan.
The report, Government expenditure on public health activities in Australia 2023–24, revealed that total government expenditure on public health reached $5.4 billion in 2023-24, down $2.3 billion from 2022-23.
This equates to just $201 per person, as both federal and state budgets continue to shift away from pandemic-era spending. In real terms, this was $91 (31.2%) less per person than in 2022-23.
The report also presented a new decade-long view of funding by the Australian government and state and territory governments between 2013-14 and 2023-24.
Public health expenditure was reported against categories including communicable disease control; selected health promotion; organised immunisation; environmental health; food standards and hygiene; screening programs; prevention of hazardous and harmful drug use; public health research.
The spending represented 2.9% of total government health expenditure in 2023-24, a level consistent with the years before covid but still well below the 5% target set by the National Preventive Health Strategy.
Of the $5.4 billion spent in 2023-24, the Australian government contributed $3.4 billion, while state and territory governments provided $2 billion. The largest areas of spending were organised immunisation ($2.4 billion) and communicable disease control ($0.9 billion).
Government expenditure across various public health activities experienced modest growth during the pre-pandemic period, with an average annual growth rate of 2.5%.
However, over the covid pandemic (2019-20 to 2022-23), spending surged in several public health activities. Total estimated government expenditure on public health activities on the response to covid was $18.6 billion during that period. The largest increases in real terms were observed in communicable disease control and organised immunisation between 2019-20 and 2021-22.
The fastest growth rate occurred in communicable disease control in 2020-21 which rose by about 280% in real terms from 2019-20, mainly driven by government spending on the covid response.
The most significant increase in expenditure was in 2021-22 for organised immunisation, where there was an increase of $4.4 billion in real terms compared to 2020-21. This largely reflected spending associated with the covid vaccine, including logistics and distribution.
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At the state and territory level, government expenditure on public health activities remained relatively stable across all states and territories prior to the covid pandemic. Between 2013-14 and 2018-19, the average annual growth rates across jurisdictions ranged from a low of −11.0% in the Northern Territory to a high of 5.2% in Victoria.
During the pandemic, government spending on public health activities in most jurisdictions increased significantly. In 2020-21, the highest annual real increase in estimated government public health spending was in Victoria (173.6%) and Western Australia (164.5%). In 2021-22, the highest annual real increase in spending was in Tasmania (124.9%) and in NSW (123.2%), the report showed.
“Since 2022-23, public health spending has shown a downward trend,” the report noted.
“While the expenditure has declined from its pandemic peak, in 2023-24 most states maintained higher levels of government public health spending compared to pre-pandemic levels, except for the Northern Territory.
“Of the total government public health spending in 2023-24, more than half (54.2%) was spent in NSW ($1.7 billion) and Victoria ($1.3 billion) combined. These states also represented more than half (around 57%) of the Australian population.”
When it came to government public health spending per person, in 2023-24, the results were similar across all states and territories.
The highest average expenditure per person occurred in the Northern Territory, with expenditure of $474 compared with the national average of $201 per person. South Australia had the next highest average expenditure per person of $269 followed by the Australian Capital Territory ($221), Western Australia ($214), NSW ($198), Queensland ($186), Victoria ($185), and Tasmania ($186).
The report noted that the ACT per person figures “need to be treated cautiously, since a large volume of ACT spending is for NSW residents; the ACT population is therefore not an appropriate denominator”.
The release of the AIHW report coincided with a united call from leading Australian economic and health experts for more government investment in preventive health to boost the economy, reduce healthcare costs and improve national wellbeing.
The call comes as a new peer-reviewed commentary from researchers at Deakin Health Economics, Cancer Council Victoria, and The George Institute for Global Health is published in the Australian and New Zealand Journal of Public Health.
In the commentary, to be published in the Australian and New Zealand Journal of Public Health today, the authors welcomed the Australian Government’s current Productivity Commission Inquiry into “delivering care more efficiently” and support the Inquiry’s interim report that recommends a new prevention investment framework.
Lead author Associate Professor Jaithri Ananthapavan from Deakin Health Economics says Australia faced a tsunami of preventable diseases, and the cost to treat them was staggering.
“Nearly 60% of Australians already live with chronic disease, yet over one-third of this is preventable,” she said.
“As well as direct healthcare costs, these diseases cost the economy because people with chronic illness have more days off from work, have reduced productivity while at work and also leave the workforce prematurely.
“Despite strong evidence that prevention saves money and improves lives, only around 2% of health funding in Australia goes to prevention.”
Deakin Health Economics director Professor Suzanne Robinson said the rising cost of treating diabetes was just one example.
“We continue to spend billions managing avoidable complications rather than investing upstream in prevention and early intervention,” she said.
“Our research shows that diabetes cost the Australian healthcare system over $14 billion in 2024, with more than $7 billion in additional, preventable costs. These costs will only continue to rise unless we invest more in prevention.”
Cancer Council Victoria’s CEO Todd Harper said that healthcare spending and infrastructure like the Pharmaceutical Benefits Scheme (PBS) used rigorous methods to ensure medicines that work and were good value for money are funded, ensuring that Australia has a world class healthcare system that is affordable to the government.
“We need a similar approach to preventing diseases such as cancer and ensure we sustain investments in good value prevention programs proven to reduce illness in our community,” he said.
The authors outlined three steps needed to develop a robust national prevention investment framework, including priority-setting tools to navigate competing goals to make smarter investments; robust evaluation systems to track outcomes over time; and learning from previous efforts and other countries that have sustained long-term prevention efforts.
Public Health Association of Australia CEO Adjunct Professor Terry Slevin said Australia’s current health budget was unsustainable.
“We want more Australians to live long, healthy and productive lives,” he said.
“Lifting investment in prevention would be good for the economy, good for communities, and good for our overstretched healthcare system.
“By being healthier for longer, we can make more Australian lives better, Australian families stronger and achieve more of what is important to us all. All by spending public money more wisely. Surely that should be a key government priority.”