Inform’ACTION # 20 + Supplement

May 2005

Printed version (PDF, 3MB) + Supplement (PDF, 321 KB)


Emergency health


  • Tuberculosis control in the Pacific: update and future hopes
    Mark Lambert (PDF, 74 KB)


  • Dengue fever Type 1 outbreak in Yap
    Dr Martin Bel (PDF, 12 KB)
  • Dengue entomological surveillance
    Laurent Guillaumot


  • Guidelines for HIV & STI surveillance in the Pacific Islands
    Tim Sladden [PDF, 30 KB]


  • Developing LabNet in the US Pacific – Vasiti Uluiviti (PDF, 16 KB)
  • LabNet 2004 annual activity report from New Caledonia Pasteur Institute – Dr Alain Berlioz-Arthaud (PDF, 22 KB)
  • Meeting of Ministers of Health for PICs, Samoa – Dr Narendra Singh (PDF, 17 KB)

In Brief

  • WHO/UNICEF PIPS Workshop
    Second Pacific Health Summit for Sustainable Disaster Risk Management (HTML, 7 KB)


  • Selection of articles published in the first 20 issues of Inform’ACTION (HTML, 13 KB)


Just one life

Each day dawns anew. Life goes on, in spite of everything that has happened, everything that has tried to destroy it. People die every day, others take their places. The sea is calm but we know that sooner or later a storm will arrive.

Participants in the Health Ministers Meeting in Apia, Samoa, in March might have been wondering what was going to happen this time. Two years earlier during the meeting of the same ministers in Nuku’alofa, while they were discussing the growing scourge of non-communicable diseases in the Pacific, the SARS alert was issued by WHO and the end of the meeting was marked by two tropical cyclones. Fortunately, this time, the sea stayed calm.

This present period of calm is a time when we can prepare ourselves to be better able to deal with future threats, to take into account the knowledge that humanity has gained about controlling such threats and the tools we have developed to prevent them or to limit their damage.

One of these threats, which we have heard a lot of talk about over the past year or so[1], is the influenza pandemic. But, despite the Regional EpiNet Workshop in June 2004, the publication of guidelines on how to prepare for the arrival of an influenza pandemic by the PPHSN, PacNet messages and country visits to encourage planning in this area, work still needs to be done in many countries and territories. Greater awareness and political commitment are absolutely vital. Governments need to implement and support multisector planning efforts. Such efforts must take into account existing emergency response plans for situations that can result in a large surge in the number of patients over a fairly short period of time — in the case of influenza, just a few weeks. They need to take into account the reduction in the number of health staff available, as they will be in the front line and will be rapidly affected themselves by this new type of influenza; they may even have to turn away from their public roles to take care of their nearest and dearest — their parents, wives and children, etc. — who will naturally take priority, particularly if they are seriously ill.

The recommendation on influenza pandemic preparedness formulated during the Health Ministers Meeting in Apia is one step in the development of public commitment. WHO and SPC, as well as PPHSN’s other partners, must continue to support national efforts and organise to provide practical and realistic support as part of their work to serve the region’s countries and territories. But the first step towards greater awareness, for countries to begin and gain ownership of this process, must come from national decision-makers.

These planning efforts will be useful not only for preparing for an influenza pandemic but for any outbreak. An influenza pandemic may present new epidemiological characteristics, for example, that will have to be taken into consideration. More generally, they can contribute to updating and testing existing disaster plans. Most importantly, “practical exercises” to test such plans should be encouraged. This is the best way to improve them, by identifying and resolving their weaknesses in practice, while at the same time ensuring that all the participants are thoroughly familiar with their roles.

Recently, on 26 December 2004 to be exact, a catastrophe on a scale that we had hoped never to see took place at the doorstep of the Pacific, with nearly 200,000 deaths and entire towns and villages destroyed in countries around the perimeter of the Indian Ocean. This event came some six and a half years after the tsunami that destroyed Aitape on the north coast of Papua New Guinea. In this issue, we share the experiences of Dr Tony Stewart, who discusses the priority response needs after the 26 December tsunami and the lessons learnt.

More recently, there have been other earthquakes and more deaths. Colossal forces are awakening: the tectonic plates are beginning to move, letting loose a chain of earthshaking events.

In another recognition of how vulnerable the Pacific Islands are to a variety of natural threats, the Second Summit for Sustainable Disaster Risk Management, organised by the Pacific Emergency Health Initiative (PEHI) of the US Centers for Disease Control and Prevention (CDC), will take place in Fiji in June 2005. This meeting will specifically address the issue of environmental disasters, and will work on proposals to put to funding agencies concerning the most important aspects of preparing the region for catastrophes.

Prevention, wherever possible, is always the best strategy against attacks on human health. The Pacific Immunization Programme Strengthening (PIPS) Workshop held in Noumea from 9 to 13 May injected new energy into the area of immunisation. We know that when you don’t see people around you affected by a certain disease you have the impression of battling phantoms by vaccinating them against this unseen disease. But we have seen how quickly a disease can re-emerge if there is any halt or negligence in such efforts. We have to keep up the pressure.

Another hollow-eyed spectre has returned more menacing than ever since it has been neglected. This is tuberculosis (this issue page 7). The current realistic DOTS strategy takes the disease very seriously and combats it more successfully than those recommended in the past. This strategy must be able to adapt to the disease’s tenacious and opportunistic nature: tuberculosis takes advantage of weakness due to HIV infection; it develops resistance to antituberculosis agents. We should not forget that tuberculosis is also an indicator of the poverty in which certain communities live, particularly those deprived of access to health care. For this reason tuberculosis prevalence is an important health indicator in the Millennium Development Goals (MDGs).

Dr Tom Kiedrzynski