A decade of development – a perspective from a distance
I recall vividly the air of expectancy as we gathered at the relatively new home of SPC in Noumea in December 1995. The meeting we were attending was ambitiously titled “Interagency Meeting on Health Information Requirements in the South Pacific”, but it did in fact succeed in its aims. It was the meeting that inaugurated PPHSN.
The meeting ended with a rather vague idea documented as “Recommendation 8e: The Pacific Public Health Surveillance Working Group … identify procedures and seek support for: communication links, training needs, technical and laboratory assistance needed for supporting coordinated routine public health surveillance, trend monitoring, early warning systems, and national and regional public health action”. We weren’t exactly sure how to do this, but a year later PPHSN was born. Ten years on, we can see how these threads of thought have been woven together into the fabric of the network and transformed into the four services: PacNet, LabNet, EpiNet and PICNet.
The early years had their fair share of teething problems as people from many countries and agencies debated the pathways that would enable regional coordination and nurture the network’s development. PPHSN’s true potential was put to the test in 2003 when SARS threatened to spread globally. The network collaboratively customised guidelines for preparedness and response through a model that laid the groundwork for preparing the region for the introduction of avian influenza and the looming threat of an influenza pandemic.
I have learned three important lessons along my journey with the network. Firstly, development – the natural and innate characteristic of communities – works best when it is phased (in this instance, progressively from PacNet to LabNet to EpiNet and ultimately to PICNet) and when it builds on the confidence and strengths of the new partnerships. This allows better responsiveness to the expressed needs of the membership, and helps the members to keep control of the pace, scope and direction of development.
Secondly, the contribution of allied members is optimal when they can facilitate development through good listening and supportive skills, without imposing predetermined pathways for development.
Finally, stormy encounters and other setbacks along the journey do not dampen development, but are essential and integral to moving forward.
Over the last decade, the network has been in a reactive phase to emerging infections, and has coupled national and regional social systems with technological advances to strengthen our defences against invasive microbes. At the same time, microbes have continued their practice of adapting and evolving. For all of us, living in harmony within the ecosystem, causing little or no harm to the environment and human hosts (as in the case of commensal microbes), is a safe strategy and offers the best prospects for the future.
It’s been a privilege and a pleasure to accompany members of PPHSN along the decade’s journey of strengthening our defences against communicable diseases. What will the network’s 2016 report highlight? Will it reveal an ongoing battle between people and microbes? Or will we have begun to develop ways to live in harmony with our microbial environment?
Mahomed Said Patel
National Centre for Epidemiology and Population Health
Australian National University