12th PPHSN Coordinating Body meeting

 The 12th meeting of the PPHSN Coordinating Body (CB) took place at the Research and Development Institute (IRD) in Noumea from Tuesday 4 to Friday 7 July 2006. Participants included representatives of CB core members from Cook Islands, Kiribati, New Caledonia, Samoa and Solomon Islands (French Polynesia and Papua New Guinea couldn’t make it) and representatives of CB-allied members from Institute of Environmental Science and Research, Fiji School of Medicine, Pasteur Institute of New Caledonia, WHO and SPC. A representative of Communicable Diseases Network Australia was also invited to the meeting.

 Summary of conclusions & recommendations

Highly pathogenic avian influenza and pandemic influenza preparedness

1.    SPC and WHO will work together to obtain information from evaluations of commercial kits that can be used to screen for avian influenza in humans and animals, and make appropriate recommendations to all PICTs.

2.    Stockpiling antivirals, including oseltamivir, was clearly not considered a priority at the WHO workshop on the International Health Regulations (2005) and pandemic influenza preparedness in the Pacific held in Nadi in November 2005. Nevertheless, if they wish so, PICTs’ decision to place orders for antivirals must depend on evidence-based information. SPC and WHO should consider this question in depth, further gather all the information available on these drugs and share it with PICTs, and also provide PICTs with advice or recommendations.

3.    Regarding pandemic vaccine availability, PPHSN should negotiate with manufacturers and providers in advance, with WHO helping to address equitable access for PICTs, knowing that PICTs had among the highest mortality rates in the 1918 pandemic.

4.    It was proposed that the composition of the Influenza Specialist Group (ISG) should be updated to include one person from SPC animal health, one animal health person from PICTs, the deputy director of the Australian Animal Health Laboratory (AAHL) in Geelong, and one functional person from PICTs who can report to others. The ISG should remain a technical group, but the Regional Pandemic Influenza Preparedness Task Force should include health professionals from the EpiNet teams of all PICTs.

5.    Pacific Regional Influenza Pandemic Preparedness Project (PRIPPP)

a.   PRIPPP should increase the proportion of its budget that would go to PICTs (e.g. for drug stockpiling, stockpiling of personal protective equipment, training/capacity building activities, etc.).
 

b.   PRIPPP should develop PICTs’ capacities in the long-term process (see also ‘Workforce development’ hereunder).

c.   The CB has the key role of monitoring the activities of the project, with technical input from the ISG. The ISG will report to the CB, which will validate the work of the ISG.

Other PPHSN target diseases

6.   Leptospirosis
SPC, through PPHSN, will continue to provide technical support and rapid test kits on request to PICTs. Leptospirosis surveillance should be part of normal routine surveillance activities.

7.   Dengue and vector control
Despite ongoing small-scale support to PICTs, more information from WHO is expected about the development of the regional dengue initiative. The next dengue epidemic might hit the Pacific soon.

Workforce development

8.   Resolution on the development of human resources in health (HRH)

That the CB:
> promote the implementation of inclusive regional mechanisms for HRH development; and
> task a newly established PPHSN HRH Working Group (HRH-WG) to:
    - provide advice to PICTs as requested on HRH development issues to complement country
      efforts and reform activities,
    - review key HRH development issues and current HRH status in PICTs, and
    - devise a draft proposal to develop a model regional education/service programme in support
      of capacity strengthening linked to core PPHSN services.

Information on PPHSN
9.   A standard presentation on PPHSN is now available on the website at http://www.spc.int/phs/PPHSN/Publications/PPHSN-presentation-2006.ppt and can be used as it is or adapted. The presentation will also be included on the CD-ROM of the Directory of PPHSN Resources that will be dispatched to all PICTs (refer to 10).

10. The Directory of PPHSN resources is a useful reference tool on the PPHSN website (now at http://www.spc.int/phs/PPHSN/Publications/directory/index.htm). CD-ROMs of the directory will also be dispatched to all PICTs.

 

PPHSN organisation

11.  Infection control experts should preferably be part of EpiNet (or equivalent) response teams, and PICNet will help to strengthen infection control capacities in the Pacific Islands region as per the PPHSN Strategic Framework. Nevertheless, PICNet’s place in PPHSN needs to be better determined by the CB (and proposed to PICTs).

 

12.  PacNet restricted role and membership
CB members agreed that the list should include all members of the EpiNet teams, IHR focal points and the CB – which includes WHO and SPC. The inclusion of PPHSN allied members must be further discussed with PICTs.

 

13.  Given that ‘sub-regional representation’ by individual PICTs in the CB has in practice not produced much sub-regional consultation, other options for PICT representation in the CB will be investigated by the CB and proposed to PICTs.

 

14.  Teleconferencing as an alternative mean of communication for PPHSN and the CB.
New Caledonia does not have proper facilities. Different options in place in NZ should be explored, as NZ facilities have already been used from Fiji. 

Other business

15.  Demographic and health surveys (DHS)

The consensus was that interesting DHS results should, if possible, be followed up with additional studies in order to get action-oriented information.

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More information on the CB and the meeting can be found on the PPHSN website at: http://www.spc.int/phs/PPHSN/Meetings/CB/12th_PPHSN-CB_meeting.htm.