Problem
While the ACT has built nation-leading responses to reduce drug-related health and social harms in the community, these are still relatively new, and not strongly embedded in the jurisdictions’ health and legal systems. Retaining and building on this harm reduction approach is an ongoing advocacy exercise, requiring a healthy awareness of the political ecosystem within which our current successes have been achieved.
What we did
Strong advocacy and community coalitions, within the social milieu of a progressive community, have resulted in successful implementation of Australia-first illicit drug harm reduction responses—in particular decriminalising personal use amounts of drugs, and implementing fixed-site drug checking. While these responses have been embedded in legislation or received committed resourcing, a long-term commitment is not guaranteed—legislation can be easily overturned and funding withdrawn.
Results
Of primary advocacy concern is how to maintain effective harm reduction policy and practice in the face of political change. Internationally, conservatism is sweeping through governments, exacerbating policy responses driven by moral panic, and threatening effective harm reduction systems. Policy reversals—for example with regards to decriminalisation of illicit drugs in British Columbia and Oregon—show that evidence-based reasoning or evaluation evidence is not always primary in decision-making. Policy decisions are also influenced by public opinion and pressure.
Lessons
The threat in the ACT is that the delicate balance can be easily undermined. This paper will discuss the future threats to effective harm reduction, how to keep the gains that we have made, and build further upon them. It will highlight how it is critical to not become complacent, but to keep advocating and engaging with potential harm reduction opponents. While strong evaluation, and an evidence-base is important, clear messaging, community engagement, understanding motivations, and working toward consensus will help to mitigate against the dismantling of this fragile system.

We are no closer to hitting recommended dietary targets in Australian households in four years (2020-2023), according to supermarket purchasing data. This is a concern with children born in the decade of 2023 predicted to live a shorter life expectancy than their parents in particular due to an unhealthy diet and the perception that a healthy diet is more expensive. Something has to change, our environments need to better support a healthy diet and our community needs support in purchasing a healthy affordable food shop.

Our unique data shows the number of serves of each of the five food groups and discretionary foods Australians are purchasing using 935 million+ Woolworths Supermarket aggregated transactions, ABS household composition, market share and Food Tracker database (coded to ADG food group serves). This shows the number of each of the core food groups and discretionary foods Australians are purchasing on average, and clearly where we need to improve.

The average cost per serve of each food group was calculated using pricing from October 2022- November 2023 and compared to the average per serve cost of discretionary foods. This shows the affordability of Vegetables, Grain/cereals and Dairy/alternatives groups compared to discretionary foods and where opportunities for Fruit and Meat/alternatives groups occur. This enables promotion of cost savings for eating healthy with data to dispel the myths. The largest contributors per serve to each food group are revealed, giving us insight to what Australians are purchasing.

The cost of a healthy diet that aligns with Dietary Guidelines was cheaper than the average habitual/unhealthy diet, particularly important data during the cost of living 'crisis'. Creating environments to improve the Australian diet, reduce spend and dispel the myth of a healthy diet being more expensive are critical.

Cost of living and purchasing an affordable food shop is topical right now. We need to breakdown the barriers to accessing a healthy diet or Australians are likely to continue along this same trajectory as the previous 4 years of data show.

Medical devices play an important role in health care, in the diagnosis, prevention, monitoring, prediction, prognosis and treatment of disease. Innovative technologies, including medical devices, are transforming how Australians manage their health and mitigate the burden of disease.
A core legislative mandate of medical device regulation is the prevention of harm, and the Therapeutic Goods Administration (TGA) achieves this through a risk-based approach across the entirety of the device life-cycle. This includes Device Surveillance, which provides evidence-based post-market scrutiny informed by peer reviewed literature, international safety signals, post market data, device incident reports and other real world evidence.
However, one key function of a regulator is to balance safety with access, and overregulation, in the pursuit of perfect prevention, could result in stifling innovation and impeding timely access, ironically causing the harm regulation is intended to prevent. Current medical device regulatory reforms aim to strike that delicate balance between the ideal and the real, through patient-centric stakeholder collaboration. This engagement will, inevitably, introduce political and sectoral interests.
Challenges of prevention include the ability for regulators to respond to public exposures/reports involving negative outcomes of medical devices, and to embrace innovative, complex technology such as AI.
The TGA is evolving to balance these priorities through a system of principles-based regulation incorporating Essential Principles. These are objectives, standards and values informing what action will best support government, agencies and organisations to improve outcomes for the population by preventing harm and disease.
The TGA is actively involved in navigating the political and stakeholder environment in regulation, with the goal of improving the governance and regulatory environment resulting in improved access to and safe use of medical devices.

Social media is often framed as a source of information for members of the general public. Health information on social media holds a tension between truthful inputs from researchers and health professionals and misunderstanding and misinformation from misinformed or malicious actors. It is important to understand the current content available on social media in order to detect and counter misleading or harmful information. We frame social media discourse on health topics as a source of information for researchers and healthcare organisations, much like the historical tradition of ministers listening to popular radio stations to keep track of the information and values of the wider populous. The challenge within this framing is the high volume and constant generation of possibly relevant discourse on social media. In this rapid-fire presentation we discuss the ethics of AI-driven analysis of social media discourse on preventative health, presenting a case study of an AI characterisation of YouTube shorts search results for “preventative health”.

Preventing the Liver Health Crisis: Symposium on Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD)

MASLD affects an estimated one in three Australians. Untreated it can lead to serious liver disease and liver cancer, one of the fastest growing causes of cancer death in Australia. With few symptoms, patients are often only diagnosed when significant damage has been caused to the liver, leaving limited options for treatment such as transplant.

MASLD is both treatable and preventable, but low levels of awareness amongst the general public and low levels of diagnosis by health practitioners means that Australians are dying preventable deaths.

Australia is not alone in facing this crisis with rates of MASLD globally reflecting similar levels and projected to increase, including rising rates in children.

In response to the escalating health, social and economic impacts of MASLD international research from over 90 countries established consensus around a Global Action Agenda with six key priorities to address MASLD. Recognising the urgent need for similar action in Australia, LiverWELL convened Australia’s inaugural national symposium on making MASLD a national public health priority, marking a critical step toward prioritising liver health within Australia’s public health agenda.

With a keynote presentation from Professor Jeffrey Lazarus, lead author of the Global Action Agenda research, the Symposium gathered over 60 stakeholders including healthcare professionals, clinicians, metabolic disease experts, researchers, policy experts, and consumers in interactive multi-sectoral exploration of the priorities in the Australian context.

Participants identified significant gaps in MASLD diagnosis and management, the need for non-invasive diagnostic tools and enhanced primary care support. Strong support for better integrating MASLD education into professional training and for a national awareness campaign .

Aligned with the conference theme, “Prevention is Political,” this symposium underscores that MASLD prevention requires coordinated policy action, political commitment and strategic collaboration across sectors.