The Emerging Disease Surveillance and Response (ESR) unit of the WHO South Pacific Office works with Member States and partners in building capacity for communicable disease surveillance and response in the Pacific Island countries. The recently revised International Health Regulations (IHR 2005) require WHO Member States to assess, develop, strengthen and maintain their country's capacity at a level to meet the minimum core capacity requirements for disease surveillance and response. WHO has identified an increasing need to develop and implement joint activities to strengthen national and regional capacity to detect and respond rapidly and effectively to emerging diseases and other health emergencies of national and international concern.
EPI focuses on seven vaccine preventable diseases (VPDs) including diphtheria, tetanus, pertussis (Whooping cough), poliomyelitis, TB, measles and hepatitis B in all countries while other life-saving vaccines including those against rubella and Haemophilus influenzae type B (Hib) have been integrated into the national Immunization Programmes in some Pacific island countries (PICs). Through EPI, over 3,000 child deaths are averted annually and more children can be saved through improving current routine immunization coverage and introducing new life-saving vaccines in the future. Furthermore by immunizing pregnant women and women of childbearing age, many women have been saved from maternal tetanus in addition to the benefit of protecting newborn infants from neonatal tetanus. Thus, immunization coverage across the Pacific has been generally high since the establishment of EPI, although VPDs continue to cause small outbreaks in some Pacific island countries.
Malaria is endemic in 2 PICTs, namely Vanuatu and the Solomon Islands. Dengue fever is a growing problem in the region. Dengue occurs in most of the PICTs, inflicting severe health and financial tolls on the populations affected. Lymphatic Filariasis is one of the world's leading causes of permanent and long-term disability and is currently endemic in 11 of the PICTs covered by WHO/SP. The disease can cause serious impact on the health and socioeconomic status of the people affected. Elimination of lymphatic filariasis can be achieved through annual mass drug administration of diethylcarbamazine (DEC) or ivermectin in combination with albendazole (ALB).
Although HIV prevalence remains low in most countries in the South Pacific, there are many significant risk factors, which raise concerns on the possible spread of HIV/AIDS in these countries. While HIV/AIDS programmes in most PICTs will need to continue to focus on prevention, and to strengthen the second generation surveillance, care and treatment including antiretroviral therapy need to be put in place.
Helminthiasis is the infestation of the body with parasitic worms. The public health burden of intestinal parasites, including soil-transmitted helminths (STH), is significant in most of the PICTs. School-aged children are most at risk. WHO is committed to helping Member States ensure access to essential antihelminthic drugs (albendazole or mebendazole). The goal is to regularly administer these drugs to at least 75% of school-aged children at risk of morbidity by 2010. Fiji, Kiribati, Tonga, Tuvalu, and Vanuatu have scaled up school-based deworming efforts.
The significant burden of TB, the emergence of multidrug resistant TB, and the increasing number of TB-HIV cases in several countries continue to make TB control a priority in the Pacific. Out of 33 countries that eliminated leprosy as a public health problem at the end of 2004, all of them have sustained the elimination status in 2005. However, leprosy has continued to be a public health problem in Federated States of Micronesia, Kiribati and Marshall Islands.