Guam is dedicated to the attainment of health for all by the year 2010. The Guam Health Planning and Development Agency, in 1992, identified 13 health service priority areas to be strengthened:
- human resources development;
- health planning;
- wellness promotion;
- health information systems;
- communicable disease control;
- disposal of hazardous and toxic materials;
- availability and accessibility of health services;
- environmental protection;
- drug and alcohol abuse;
- chronic disease prevention and control;
- injury prevention;
- maternal and child health; and
- vector control.
Though some improvement has been made in the area of health information systems, wellness promotion, and communicable disease control, the remaining areas continue to be top priorities.
All public health services depend on having a basic infrastructure, especially in terms of personnel. Unfortunately, Guam is experiencing health workforce shortages due to the early retirement of its most experienced professionals.
Human resources for health in critical areas are still lacking and must be developed locally to the greatest extent possible. The following training needs are the priorities: environmental studies with an emphasis in environmental law, policy, management, and planning and analysis; and short-term training in retail hazard analysis critical control point (HACCP), and in drug, medical devices and controlled substances.
The Guam Environmental Protection Agency (GEPA) relies heavily on its professional staff to provide technical expertise in all areas of environmental resource protection, management and policy.
In addition, technical expertise in the areas of environmental protection, management and policy is seriously needed for the young professionals within GEPA, as the fields of environmental protection and science are constantly changing.
However, with the early retirement and voluntary separation recently offered by the Government, all personnel with over 10 years of professional and technical experience have left GEPA. This leaves half (two out of four) of the remaining division personnel with less than four years of professional GEPA experience. Combined with the local hiring freeze that was put into effect by the Government, it is anticipated that no new professionals will be hired within the next two to three years. This lack of well-educated and technically trained personnel severely undermines the professional credibility of GEPA.
To further complicate matters, GEPA also serves as the primary regulatory agency for all environmental issues and policies on Guam and takes the lead for most other islands in Micronesia. Personnel deficiencies will therefore not only affect Guam, but also elsewhere.
The Division of Environmental Health of the Department of Public Health and Social Services (DPHSS) is also greatly understaffed. Over half of the Division's staff have fewer than five years of experience, and staff generally lack specialized training.
Training in retail HACCP is lacking. The Federal Drug Administration is urging all locales, states and territories to explore HACCP as a requirement in retail and food service establishments, and to develop a model food code that incorporates HACCP principles.
All health care products from toothbrushes to prescription medications are regulated and enforced by the Drug and Medical Device Programme. Because of Guam's geographical location and the ethnic diversity of its people, various drugs and medical devices of foreign origin are imported, distributed and marketed. This includes many poorly labelled, misbranded and adulterated drugs, as well as hazardous medical devices. Training in the area of drug and medical devices is therefore necessary for the Division of Environmental Health staff.
Forged prescriptions, lack of accountability of controlled substances by businesses, and illegal dispensing of controlled substances are estimated to be significant problems. However, because of a lack of human resources, only urgent cases are pursued and investigated.