The theme of the 3rd Conference of the Pacific Community convened 10-11 November 2003, was “The Pacific Islands Response to Infectious Disease”.
The Conference noted, with respect to infectious diseases in the region that:
- Infectious diseases continue to result in significant ill health and death.
- Diseases such as cholera, typhoid, malaria, dengue fever, influenza, tuberculosis, leptospirosis and HIV/AIDS occur across the region.
- New infectious diseases continue to emerge, such as the recent outbreak of SARS.
- Infectious diseases will continue to result in a significant disease burden for the foreseeable future.
- Increases in noncommunicable diseases will also increase the vulnerability of Pacific Island people to a number of infectious diseases.
The Conference acknowledged, with respect to effective action against infectious diseases that:
- Preparedness and planning; public health surveillance; outbreak and case investigation; response and prevention through activities such as health promotion, environmental health and immunisation programmes are essential.
- Strong partnerships between Pacific Island countries and territories (PICTs), regional organisations and donors, and between PICT governments, NGOs, the private sector and communities are especially important.
- The Pacific Public Health Surveillance Network (PPHSN) and the regional Global Fund project are excellent examples of such partnerships.
The Conference noted, with particular reference to HIV/AIDS that:
- HIV/AIDS is on the increase in many PICTs, and has already reached epidemic proportions in Papua New Guinea.
- Political will, commitment and leadership are key to addressing the HIV/AIDS challenge in PICTs, to prevent it becoming a regional epidemic.
- The Pacific region is probably the only region in the world today where there may be a realistic chance of achieving a target of halting and ultimately reversing the increasing trend of HIV infections.
The Conference acknowledged that central to achieving this goal are:
- The existence of high level political will and commitment at national and regional levels to lead the fight against HIV/AIDS.
- The recognition of HIV/AIDS as a broader issue than just a health problem (as it has obvious social, cultural, economic and political dimensions).
- The development and implementation of a broad-based and integrated “Regional Strategy on HIV/AIDS and STIs” that demonstrates a coordinated approach by all stakeholders addressing the HIV/AIDS challenge in the region”.
- The mobilisation of financial and other resources through donor partnership initiatives such as the France/Australia and France/New Zealand initiatives in HIV/AIDS and disease surveillance.
In responding to the challenge of infectious diseases in Pacific Island countries and territories into the 21st century, the Conference agreed on the following outcomes:
- With respect to the role of the Secretariat of the Pacific Community in infectious disease surveillance and control, the Conference agreed that:
- Infectious disease surveillance and control is core business for SPC’s Public Health Programme. SPC must provide active support to PICTs in areas such as surveillance and prevention of HIV/AIDS and other sexually transmissible infections (STIs); coordinating the development and implementation of a new regional HIV/AIDS/STI strategy; tuberculosis control; and surveillance and control of key epidemic and other infectious diseases, principally through PPHSN. SPC should continue to seek opportunities to strengthen the support it is able to provide to PICTs in this area.
- SPC needs to continue to actively support PPHSN, in particular through its ongoing role as Coordinating Body Focal Point.
- SPC should work with PPHSN members to progressively increase the range of diseases covered by the network. Specifically, SPC should integrate surveillance of HIV and other STIs into the network.
- SPC needs to assist member countries and territories where required through training staff in infectious disease surveillance and control.
- SPC should strengthen technical support available to PICTs in relation to the prevention of infectious diseases through activities such as environmental health and health promotion.
- SPC should seek to integrate awareness of health issues and potential health impacts into its range of programmes.
- SPC should ensure that the regional strategy for HIV/AIDS/STI is reviewed and redeveloped in time for consideration by the Pacific Islands Forum in August 2004.
- Acknowledged that a range of regional organisations are actively involved in this area, in particular in relation to HIV/AIDS.
- Noted that the HIV/AIDS Regional Coordination Meeting organised by SPC in October 2003 recommended that there was a need for improved coordination of HIV/AIDS activities and that this coordination should principally be undertaken by SPC (for PICTs, NGOs, donors and non-UN regional organisations) and UNAIDS (for UN organisations).
- Agreed that SPC should take on this coordination role for HIV/AIDS activities.
- Recommended that for other infectious diseases, activities should continue to be discussed and informally coordinated as necessary through the PPHSN and regional tuberculosis programmes.
- Noted that most of the responsibility for infectious disease surveillance and control rests with individual governments and administrations.
- Agreed that ensuring these activities are effective at the national level is essential if the health of Pacific people is to be adequately protected.
- Agreed that sharing public health information within and between PICTs, through PPHSN from the very early stages of possible outbreaks, is fundamental to effective outbreak control.
- Recommended that PICTs continue to actively participate as partners in PPHSN.
- Recommended that PICTs seek to strengthen multi-sectoral approaches to public health issues, including infectious disease control and prevention.
- Further recommended that PICTs, with the support of donors and regional organisations, seek to develop a dedicated and stable workforce with appropriate career paths.
- Further recommended that PICTs actively address HIV/AIDS prevention, including the development and/or implementation of national plans, and utilising the opportunities provided by new regional initiatives.
- Further recommended that PICTs explore and utilise opportunities to prevent other priority infectious diseases, such as through environmental health, health promotion and immunisation programmes.
- Noted with appreciation the role played by the WHO Western Pacific Regional Office and SPC in helping facilitate the successful submission from 11 Pacific Island countries for funding in round 2 of the GFATM.
- Endorsed the decision by the Pacific Island Regional Multi-Country Coordinating Mechanism (PIRMCCM), the coordinating body for the regional GFATM project, for the Pacific to contend for round 4 funding from the GFATM.
- Also endorsed the decision by the PIRMCCM to include in this new bid other interested PICTs that meet GFATM eligibility criteria.
- Requested further assistance from SPC and WHO to facilitate the regional submission to round 4 of the GFATM.
- Noted the strong emphasis in the UNGASS Declaration on the need for political leadership and commitment at the highest level, to lead the national fight against HIV/AIDS.
- Also noted that in practically all African countries for example, heads of government and heads of state are now at the forefront of this fight in their respective countries.
- Further noted that political commitment to and leadership in this fight is only just beginning in some PICTs.
- Acknowledged that the current rapid increase in HIV/AIDS in a number of PICTs makes the urgent attention and involvement of political leaders in this issue essential.
- Agreed to advocate for stronger political commitment and leadership at national levels, to ensure that Pacific Islands’ most valuable resource, their people, are better informed about HIV/AIDS, and better protected.
- Agreed that being prepared for possible future outbreaks is essential for prompt and effective public health responses.
- Recommended that PICTs pay more attention to preparedness, including: the development and adoption of national plans to guide future responses to outbreaks of priority communicable diseases, the regular updating of these plans informed by periodic exercises, and the identification of necessary resources that could be accessed quickly.
- Also recommended that SPC should provide additional technical support to PICTs to strengthen their activities in this area, and through PPHSN should organise occasional regional exercises to test preparedness.
- Further recommended that SPC should work with donors and PICTs to identify a flexible funding mechanism such as a revolving fund, to support rapid response to major disease outbreaks.
- Acknowledged that modern and flexible public health legislation, with supportive policy frameworks, greatly assists national public health action, including the control of priority and emerging infectious diseases.
- Recommended that PICTs review and, where necessary, seek to update their relevant legislative and policy frameworks, and that the legislation should be implemented.
- Also recommended that SPC should provide technical support to PICTs on request to assist them with this process.
- Acknowledged the important contributions from a number of donors under their bilateral, regional or multilateral programmes to support these activities in PICTs.
- Noted with appreciation the new France-New Zealand project in infectious disease surveillance, and the new France-Australia project in HIV/AIDS/STI.
- Agreed donor support for infectious disease surveillance and control needs to continue into the foreseeable future.