Is historical research relevent to infection prevention?

  • Dr Deborah Jowitt, Northland District Health Board, New Zealand

Can historical research contribute to the development of contemporary infection prevention policies? Using a case study of government policies for the prevention and control of hepatitis B in New Zealand from 1970-2005, this poster explores the impact of social, economic and political issues on policy decisions, and examines the influence of leading individuals on the direction that policy took. An effective vaccine for hepatitis B was available from the early 1980s, nevertheless, universal childhood immunisation was not introduced in New Zealand until 1988, and coverage among high risk children in Maori and Pacific communities remained low throughout the 1990s and early 2000s. Follow up of babies born to hepatitis B carriers proved particularly challenging. The thorny issue of hepatitis B infected health care workers remains problematic for policy makers, despite clear evidence of harm to patients in the medical literature. While the UK introduced mandatory hepatitis B screening for health care workers in the mid-1980s, with exclusion of higly infectious individuals from clinical practice, New Zealand, like the US, continued to recommend that health care workers know their infective status and respond according to appropriate ethical and professional standards. Contemporary historical research throws light on the sometimes haphazard nature of health policy making, and shows that evidence-based research is but one of a number of considerations in the policy making process.