The Coordinating Body (CB) of the PPHSN met on 24–26 July in Noumea, New Caledonia, immediately after the first LabNet TWB meeting. The development of LabNet was thus one of the main items discussed.
Participants were representatives of the 10 CB members — the five core member countriesFederated States of Micronesia, Fiji Islands, New Caledonia, Samoa, Solomon Islands and the five allied members Fiji School of Medicine, NCEPH, SPC, UNICEF, and WHO — and also representatives of the Institut Pasteur de Nouvelle-Calédonie, as a TWB member.
Dr Dennie Iniakwala, Undersecretary of Health, Solomon Islands, chaired the proceedings of the meeting.
The issues discussed are detailed below.
Several CB members commented on the 2002 Pacific Regional Public Health Conference held at the initiative of the Hawaii Public Health Association in June 2002. They agreed that it was a good meeting with a good number of PICTs representatives and that a similar conference should be organised for the PICTs in the next couple of years.
The Wellcome Trust health research initiative for the Asia-Pacific, which focuses on research development in the region, was also discussed. CB members agreed to put in a request for training projects (LabNet and EpiNet) and for strengthening of applied research, for example regarding the dengue diagnostic test kits.
PPHSN Plan of Action
The CB members developed a plan of action for 12 months, which has been posted on the PPHSN website (URL: http://www.spc.int/phs/PPHSN/Activities/PPHSN-CB8-POA.doc)
The PPHSN Outbreak Surveillance and Response Guidelines
Dr Clement Malau gave a presentation on his work in the development of the guidelines. Following his presentation, the process for the further development of the guidelines was discussed. It was agreed that the PPHSN should concentrate its efforts on the regional aspect and level of application of the guidelines. PICTs will then adjust them to their national situation as appropriate.
It was agreed that the guidelines needed to be circulated widely to all the EpiNet members to give everyone a chance to comment — as already committed to during the EpiNet sub-regional workshops. A small group EpiNet members needs to be identified to collate feedback and prepare the next draft version, to be finalised at a regional EpiNet Meeting to be held early in 2003. A final version of the guidelines (hopefully in press at the time) should be ready to be tabled at the next WHO/SPC PICTs Ministers and Directors of Health Meeting, due to take place in Tonga in March 2003.
After initial field piloting, the guidelines will also be used for training purposes.
How should PPHSN Plan of action fit in the Health Reform agenda? (see following paper)
Dr M Nuualofa Tuuau Potoi’s presentation and paper were very well received and commended by CB members. The group recognised that the experience of Samoa in this area is remarkable and would like to invite other PPHSN countries exposed to the Health Reform process to produce such papers to advocate for PPHSN advantages at national level.
Where are we at regarding the PPHSN Field Epidemiology Training Programme (FETP)?
Fiji School of Medicine (FSM) progress: The arrival, last year, of a new Head in the School of Public Health (Dr Sitaleki Finau) boosted the development of a new academic framework for epidemiology education, including undergraduate and postgraduate qualifications comprising certificates, diplomas and degrees. Provided this framework is approved by the Academic Board, FSM should start implementing it as from next academic year. PPHSN training could well fit into the new framework, especially regarding the master’s (and undergraduate diploma and certificate) in applied epidemiology. Field supervision of the students should not, ultimately, be an impossible matter to solve.
The issue of cross-crediting was discussed in regard to the two training modules already developed at SPC and the third one ready to be implemented. As already agreed by both PPHSN partners, defining specific learning objectives and assessment methods would allow for cross-crediting.
The accreditation issue (of a PPHSN FETP) was also discussed. TEPHINET intends to define minimum standards for FETPs. It was noted that these should be considered and that FSM and the PPHSN should join TEPHINET in the future.
PPHSN-CB members acknowledge the development of the higher levels of education in epidemiology but would like to stress that, nevertheless, the PPHSN (SPC and others) must also continue to provide basic courses across the public health workforce.
The CB members are in favour of organising a regional meeting soon of key providers and institutional partners on public health surveillance training as part of the PPHSN training development strategy.
The use of Pacific-based case studies as training instruments should be encouraged.
PPHSN and NCDs
As has always been envisaged in principle,non-communicable diseases (NCDs) surveillance should be included into the PPHSN framework in the near future. CB members would need to look carefully, though, at the resources issues that such an expansion of the PPHSN’s scope of activities would trigger.
An NCDs initiative by AusAID together with the Fiji School of Medicine and WHO (STEPS) was launched last year. So far, it has included four PICTs: Fiji Islands, Samoa, Federated States of Micronesia and Marshall Islands.
The CB members agree to consider the inclusion of NCDs in the PPHSN framework and requested that WHO and the Fiji School of Medicine draft a discussion paper on the pros and cons and the options for widening PPHSN activities, and circulate it to all CB members for further consideration.
Overview of the SPC regional database project
Following Mr Garth Parry’s presentation, the CB members agreed, in principle, to work in close collaboration with the PRISM project (Pacific Regional Information SysteM). Further details on this issue will be considered and circulated by a database committee.
International health regulations (IHR)
The WHO IHR revision and the Global Outbreak Alert and Response Network, GOARN
Dr Mike O’Leary gave a summary presentation emphasising the links between the various components of the broader work — that is, the GOARN, outbreak verification, revision of the IHR and national capacity building.
PPHSN development and the IHR
CB members agreed that the PPHSN-CB Focal Point will contact the WHO Headquarters, through the CSR (communicable disease surveillance and response)Focal Point in WHO’s Western Pacific regional headquarters, to inform the relevant people of PPHSN’s interest in pre-testing the new IHR instruments and framework in PPHSN countries. Further operational details should be worked out later on, in consultation with PPHSN core members. These preliminary discussions should encompass the main financial implications of implementing such a trial and the need for appropriate support.
The bioterrorism project was first discussed at the last Pacific Island Health Officers Association (PIHOA) meeting, which took place in Majuro, Marshall Islands, in March 2002. The idea was to submit to the US government a joint proposal by the U.S. Affiliated Countries and Territories and regional organisations/institutions, focusing on the regional level of surveillance and response in relation to potential bioterrorism activities. Within the PPHSN proposal, Dr Mike O’Leary prepared the part dealing with LabNet development and Dr Tom Kiedrzynski prepared the sections on surveillance and response enhancing in general, plus training.
PPHSN-CB Focal Point’s role: resources adequacy at stake
WHO’s support and input into the PPHSN-CB especially may be reduced for a while with Mike’s departure to Guam on assignment to CDC/PIHOA.
The current downsizing of SPC Public Health Surveillance and Communicable Disease Control section resources — budget reduced by 50% compared to two years ago and staffing reduced from five to three in the next six months — will obviously impact on the CB Focal Point work capacity.
After discussing these issues, the CB members expressed their unanimous concern regarding the sustainability of the work achieved so far and agreed on a series of urgent measures to be considered, such as:
- The CB Focal Point workload should be shared between the CB members more than has been the case in the past, or
- A proper strategic plan should be developed in order to seek funding from all possible sources.
Extending PPHSN allied membership
Apparently some institutions, such as the Pacific Island Health Officers Association, the Institute of Environmental Science and Research, the Pacific Health Research Council and James Cook University, have expressed interest in becoming allied members of the PPHSN. The CB members considered this issue and it was agreed that the PPHSN-CB Focal Point (SPC) should send letters inviting these institutions to join the PPHSN.
Renewal of the PPHSN-CB membership
The PPHSN-CB has selected at random who among the four sub-regional (SR) and three at-large (AL) members will remain CB members for two years (2 SR and 1 AL) and three years (2 SR and 2 AL), respectively, for the next round only. Here is the result:
French speaking countries
At large #1
At large #2
At large #3
Subsequently, all members will serve a three-year term.