New reports inform future of health in our region

COVID-19 and other emergencies have highlighted the interdependence of health security and health systems; with an opportunity to build back better. Two new reports provide a roadmap for stronger post-pandemic health systems in the Indo-Pacific.

Two evidence-based reports launched today outline how we can reduce the risk of acute public health events like outbreaks and build resilient health systems in the Indo-Pacific – contributing to a healthier world.

The reports, led by the University of Sydney and UNSW Sydney, focus on the Pacific and Asia and were commissioned by the Australian Council for International Development (ACFID) and The Fred Hollows Foundation respectively.

The reports also present data on opportunities for Australia to demonstrate leadership in global health and development in the region, noting the strong cultural, economic and trade ties to neighbouring countries, as well as the benefits to Australia of strengthening neighboring health systems.

They also suggest that investments in health workforce and health data information systems would improve the population’s health.

Associate Professor Meru Sheel

Lead author of the report on health security, Associate Professor Meru Sheel from The University of Sydney Institute for Infectious Diseases and School of Public Health, Faculty of Medicine and Health, said it was imperative to ramp up investments in the health systems of our neighbours.

“We need to be better prepared to reduce the impact of future outbreaks, not just rely on border control as a quick fix. For example, improving surveillance of diseases in the region is a huge task and one we should be jointly planning now,” said Associate Professor Sheel.

“We also need to closely look at how we can help countries prioritise routine health services such as immunisation programs, maternal health or TB treatment to minimise the impact of preventable disease outbreaks.”

The report, “Health security in the Pacific: Expert perspectives to guide health system strengthening“, brought together 24 experts from Australia and the Pacific region, who have expertise in health security, health systems and have lived experience of working in the Pacific.

Data from focus group discussions informed the findings on major needs and gaps in preparedness which should be improved upon, taking into account the lessons learnt from COVID-19.

Importantly, the report provides nuanced recommendations on strengthening health systems in a manner that also prevents acute public health events such as outbreaks, particularly after significant weather events like cyclones.

We need to be better prepared to reduce the impact of future outbreaks, not just rely on border control as a quick fix.

Associate Professor Meru Sheel

Marc Purcell, CEO of ACFID, which commissioned the report, said a key take-out was the importance of supporting self-determination for our neighbours regarding their health security.

Mr Purcell said: “The findings of this report reinforce that our role is to support them as best we can in strengthening their health systems to ensure their own needs are met.”

Lead author of the second report, Dr Christine Linhart from the School of Population Health, UNSW Sydney, said it is imperative that we focus on building strong and resilient health systems in the Indo-Pacific region, capable of responding to health emergencies such as COVID-19, whilst maintaining continuous access to essential health services and addressing ongoing population health needs.

The report, “Investing in our future: Building strong and resilient health systems in the Indo-Pacific region”, provides recommendations for health system investment in seven countries.

“We found that efforts to strengthen health systems across the region need to focus on increasing equity in access, quality of care and resource optimisation, and that without locally relevant initiatives that fit the context, such efforts are likely to fail,” Dr Linhart said.

International development organisation The Fred Hollows Foundation commissioned the report and Deputy CEO Nick Martin said investing in primary care services must be prioritised.

“We recognise that our call for greater investment in health and development must be based on evidence. This report shows the inextricable nature of Australia’s relationship with the Indo-Pacific, and that without resilient health systems in the region, our security and prosperity is at stake,” he said.

Report recommendations

Combined recommendations from the two reports include:

  • Prioritise catch-up vaccination programs to minimise outbreaks of vaccine-preventable diseases.
  • Expand and integrate lab surveillance from diseases currently monitored to other diseases such as TB, malaria and emerging infectious diseases.
  • Understand the health workforce to document how it is utilised and what roles are performed by different people. It is particularly important to look at public health and primary care workforces.
  • Invest in country-led approaches, rather than the one-size-fits-all approach that is often applied.
  • Support publicly funded media channels to dispel misinformation.
  • Improve surveillance systems that improve data quality and allows public health action such as being able to find unvaccinated adults or infected persons for contact tracing.

The two reports focused variously on the Pacific (​​Timor Leste, Papua New Guinea and Pacific Island countries and areas​: Cook Islands, Fiji, Kiribati, the Republic of the Marshall Islands, the Federated States of Micronesia, Nauru, Niue, Palau, Samoa, Solomon Islands, the Kingdom of Tonga, Tuvalu and Vanuatu); and the Indo-Pacific region (specifically Cambodia, Fiji, Indonesia, Lao PDR, Papua New Guinea, Solomon Islands, Vietnam).

Declaration: Associate Professor Meru Sheel received funding from ACFID while at ANU for the research, which she completed after moving to the University of Sydney. ACFID did not play any role in study design and analyses. The report is yet to under-go peer-review. UNSW received funding from The Fred Hollows Foundation.

Image credit: Associate Professor Meru Sheel.

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