Tom Kiedrzynski

Already 10 years – or only 10 years?

I ask the above question because, if we try and review PPHSN on its 10th anniversary, the answer lies between the two extremes – what has been achieved and what remains to be done like a half-full glass that is also half empty.

Leaving aside the debate about what still remains to be done, we should take a closer look at the development of PPHSN’s services over the past decade – in particular, the long-term development orientations against the background of the various changes and activities in the area of epidemic surveillance and response of all PPHSN members and partners.

PacNet: The service has put down strong roots in the region, with simplicity its main asset, despite some criticism over the lack of moderating (but moderating would require a more complex and less sustainable system) and, as usual but even more so, the problem of delays in posting some messages. Epidemics mean rapid detection, response and information circulation, which is something we need to do both for the sake of regional unity and transparency, and to satisfy the new International Health Regulations (IHR).

Some of PacNet’s functions will probably be taken over by the restricted list (PacNet-restricted), which will be more oriented towards key response personnel.

LabNet: The Level 2 laboratories are an important feature of this network, with four laboratories located in the Pacific Islands having assumed 1st Level reference laboratory functions for neighbouring countries. The goal is to develop and use the region’s skills and capacity. The New Caledonia Pasteur Institute (IPNC) has played a major role through a series of projects ranging from assessing laboratory testing to applying high-level techniques (in practice, equivalent to LabNet Level 3). Strengthening has been a feature in the Northern Pacific, in the US-affiliated Micronesian countries, through the technical assistance provided by the Pacific Island Health Officers Association (PIHOA) and then Mataika House with support from SPC and WHO. However, organisation and management are still priorities to be addressed. The role of the Malardé Institute remains limited despite its scope because of the lack of airline connections between Tahiti and the rest of the Pacific; this role therefore needs to be redefined.

EpiNet: Despite the fact that multidisciplinary teams are in place in all Pacific Island states and territories, functionality must be reinforced – either through training, or through reorganisation and redefinition. The principle of EpiNet is to identify field response teams, because public health is done in the community, particularly when dealing with epidemics, although in practice it is often restricted to a purely administrative and bureaucratic approach. A lot of work therefore remains to be done in this area, but Pacific Island states and territories must first clearly rally behind the new IHR and start to view action-oriented epidemiology, with rapid outbreak detection and response, as an essential public health function.

PICNet: The strengthening of hospital-borne or healthcare-related infection control began in a state of emergency with the SARS alert and continued with the establishment of this network in 2006. Work remains to be done, particularly in some countries and the network, to consolidate the service and give it more importance, on the grounds that its relevance has been clearly demonstrated. We place a lot of hope in PRIPPP and the specialist who will be working in this area to give this other essential health service function the impetus and visibility it requires.

Working in partnership is not always easy, but it is essential. This is because:
• it is the health worker who suffers from any incoherence and lack of coordination between the
various national and regional players and, at the end of the line, it is the patient and the community
who do not enjoy services appropriate to their needs; and
• it is by pooling our strengths that we will be able to make public health (the region’s poor cousin)
progress. There’s still a lot to do, so let’s do it together!

This is the very principle of PPHSN and I can see the glass slowly filling; even if it is only half full, I raise it to the health of Pacific Island communities, as enhanced by prevention work and other public health action. I also raise it to the health of PPHSN, a model of its kind. Neither handsome nor ugly, but still a model.

Happy new year and happy anniversary!

Tom Kiedrzynski
SPC Epidemiologist