Strengthening our health system
FROM working in some of the world’s most impoverished communities to inspiring the next generation of health practitioners, Stephanie Topp knows what it takes to build a resilient community.
The James Cook University Associate Professor in Global Health and Development is passionate about ensuring our region’s health system can continue to support the population, forged from years of experiences working in locations such as Zambia, South Africa and PNG.
Stephanie said she is particularly committed to strengthening public health services, the preventive and promotive functions of a health system.
“Public health is a central but sometimes overlooked function of any health system and without it, you would see services like GPS and specialist tertiary care overwhelmed,” she said.
“If you don’t have public health functions ensuring high rates of vaccination, food safety or vector control for mosquito-borne disease, you would have overwhelmed hospitals.
“And overwhelmed hospitals inevitably cost more than investment in upfront prevention.”
After graduating with a degree in modern political history, a year spent travelling around the world convinced Stephanie to shift her interest to public health, where she completed a Masters of International Public Health at the University of Sydney.
“I then went over to Oxford University in the UK where I did a Masters of Development Studies,” she said.
“The focus of my thesis was HIV policy in Papua New Guinea, which at the time was very influenced by Australia’s public health direction and I was exploring the way that policy had played out.”
Returning to Australia for 18 months, Stephanie enjoyed a stint working with the Cape York Institute in the mid-2000s before another opportunity arose to take up a role with a non-government organisation in Zambia that was helping to design and scale up HIV services.
“I happened to be entering the public health force at a
time when HIV prevalence was peaking globally. It was recognised as a humanitarian emergency, and being resourced accordingly,” she said.
“One of the things I most liked about my role, and which morphed into my PHD, was the opportunity to consider how these resources for HIV could be leveraged to strengthen what was a very under-resourced primary health sector.
“Something I was most proud of was helping my Zambian colleagues find their voice and take more of a leading role so their expertise and knowledge was better recognised as the centrepiece for the rollout of HIV services.”
Accepting a position with JCU as a Senior Lecturer in Global Health and Development in 2015, Stephanie soon immersed herself in regional public health.
“One of my main motivations to apply for this position was a desire to better understand and contribute to health system strengthening in Australia,” she said.
“I was aware from my earlier work with the Cape York Institute that in Northern Australia, our population health outcomes are not as strong as they are down south and I was interested in better understanding the drivers for that.”
In what would be a timely move, Stephanie began work on a National Health and Medical Research Council Investigator-funded project examining the strengths and weaknesses of communicable disease governance in the region and around the state in early 2020 – just prior to the COVID-19 outbreak.
“As aspects of the Covid experience have shown, we’ve seen a long term underinvestment in the preventive and promotive components of our health system,” she said.
“In Australia, there’s been a trend towards our health system being increasingly hospital and specialist focused and in that is no different in Queensland.
“It’s a challenge to protect, let alone increase, funding and workforce for basic public health functions like disease surveillance and response, in the context of the perceived urgency of hospital bed shortages or ramping.”
Stephanie hopes the pandemic has helped shine a spotlight on the need for wellfunded and resourced public health units, which would avoid placing additional strain on hospitals in the event of a future disease outbreak.
But it is in the classroom where Stephanie also finds fulfilment as she shares her knowledge and experience with Masters students in areas such as tropical public health, global health and development, and emerging public health threats.
“With teaching, you have direct access to a cohort of people who are potentially the next decision makers and you’re helping them to develop strategies needed to solve challenges in the health system,” she said.
“For example, it might be considering the implications of investing more in public health so that your tertiary healthcare isn’t overwhelmed in the instance of an epidemic, or helping them engage with the ways that health system and service providers can be advocates for policy reform that improve people’s health before they get sick.
“When you teach, you have the opportunity to help people make connections that they might not otherwise have seen.”
Having called Townsville home now for almost eight years, Stephanie said she feels “completely settled” in the region and is as enthusiastic as ever about her work.
“I have two wonderful girls at school and a partner who loves living here,” she said.
“Being based in North Queensland allows me to engage and collaborate on meeting the challenges faced by our health service system.”