The COVID-19 pandemic has reiterated the interdependence of health security and health systems, and the need for resilient health systems to prevent large-scale impacts of infectious disease outbreaks and other acute public health events.

This report was designed to identify and prioritise health system strengthening initiatives that prevent impacts of health security threats and strengthen the ability to respond to these threats in the Pacific region. We focus on Timor Leste, Papua New Guinea and Pacific Island Countries and Areas, which include the 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.

The authors examined the literature and explored the perceptions of experts with field experience in the Pacific region to identify and prioritise areas for future health system investments that strengthen health security. Guided in part by lessons learned from the COVID-19 experience and response, we conducted focus group discussions with health sector stakeholders with field experience in the Pacific region and expertise in either health systems or health security. Focus groups included 24 participants, representing 15 research and academic institutions, non-government agencies, the World Health Organization, and national governments, as well as independent consultants.

Key recommendations:

  • Localisation should be considered as a universal model for practice and apply to all activities, programs and initiatives. Success of any initiative will be limited without it.
  • Integrate health data systems to drive decision-making. Invest in strategies that promote data for decision-making, with a focus on using surveillance data, closing feedback loops, and using local data to guide responses.
  • Ensure ongoing support to expand laboratory services, including ongoing costs infrastructure, equipment, reagents and new staff.
  • Prioritise and support catch-up vaccination programs to minimise outbreaks of vaccine-preventable diseases.
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