SPC: Non-Communicable Diseases in the Pacific

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Suva, Fiji – “I do believe that if there is a problem there are bound to be solutions, as long as people recognise the ties that they have with one another as a world community.”

This is the opinion of Dr Yvan Souarès, manager and medical epidemiologist of the Secretariat of the South Pacific’s (SPC) Health Protection Programme, which makes up a part of the Public Health Division.

Dr Souarès has recently taken up this position, but has extensive experience of the region, having worked in Solomon Islands as Project manager for the European Union and then with SPC as an epidemiologist 1993 to 2002. He also has worked with Doctors Without Borders in Africa and the Middle East.

[Dr Yvan Souarès, manager and medical epidemiologist of the Secretariat of the South Pacific’s (SPC) Health Protection Program ]

In the past, the main concern of the Division was communicable diseases, but this has expanded into the area of non-communicable diseases (NCDs), and provides services in surveillance, operational research, control, and response to public health problems.

Dr Souarès also believes that humans are “made for living in societies. Therefore we need to organise our societies, we need to pre-empt some problems, and we need to propose some solutions. In doing so, we are losing a few battles, but we are also winning some others, and so I am always optimistic.”

The battles he refers to are those being fought in South Pacific countries against NCDs such as diabetes, and heart disease, cancer and chronic respiratory disease; diseases that, in September last year, Pacific Island Forum Leaders called a “human, social and economic crisis.”

Later that same month, the United Nations General Assembly adopted a declaration that includes measures to prevent and control NCDs, which contribute to 36 million of the world’s 57 million deaths each year.

“We start by being involved in the surveillance of the problem with partners, such as the Pacific Islands Health Officers Association and WHO, trying to find out innovative ways of assessing the depth and the dynamics of the problem. This helps us to better inform and assist the member country with drafting an action plan, for example, and if requested, we could also help in monitoring the impact.”

This applies to other diseases as well, explained Dr Souares. “We try to pre-empt the problem. For example, a mosquito-borne disease, where we would monitor some of the determinants of the disease, that is, the status of the mosquitoes responsible for transmitting that disease, as well as monitoring the actual cases of that disease.

“The aim, ultimately, is to try and be involved in a cross-sectional manner with some of our other partners in SPC.  For example, in July, the Solomon Islands are hosting the 11th Festival of Pacific Arts. Our Programme has been involved in prompting the setting up of the public health surveillance system around what will be a mass gathering.

“First, we have to assess what is needed to prevent problems, and so of course sectors like water are involved. Sanitation is involved. And also, the human transmission of diseases is involved. Hence, we now find ourselves working within the narrower issue of setting up the public health surveillance system, hand-in-hand with our colleagues from the SOPAC Division of SPC addressing water and sanitation, their part of the challenge.

Dr Souarès said as well as partnering with other SPC Divisions where practical, the Public Health Division also partners with the World Health Organisation (WHO).

“ WHO has been our number one partner in the region for a number of years, and together, in the last 15 years, we have set up the Pacific Public Health Surveillance Network (PPHSN). This brings together all the stakeholders, starting with the SPC member countries, but also all the other international agencies and expertise that is available in the region. The network has a governing body, and SPC acts as a focal point and facilitator for this body.

“The network is set up so that the Pacific Island Countries and Territories are core members, and expert regional and international agencies and academic institutions, from both the Pacific and the rim of the Pacific, are allied members.

Dr Souarès said that the sharing of information, through the PPHSN, whether through the specific surveillance network, called PacNet or else in meetings, was both essential and continuous.

“Humankind seems to keep repeating the same mistakes but, as Aristotle said, we are social animals so I do believe in communities. However I also believe real breakthroughs can happen at the world level. That keeps me optimistic.”