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      The impact of COVID-19 on public health systems in the Pacific Island Countries and Territories

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          Abstract

          The Pacific Island Countries and Territories (PICTs) have experienced the coronavirus disease (COVID-19) pandemic in different ways and with different timelines, with some experiencing large outbreaks leading to high levels of morbidity and mortality with significant strain on health systems, while others have had no local transmission or delayed transmission until after vaccine rollouts started. Regardless of COVID-19 trends, the pandemic has had a large impact on the social, political, and economic landscape in the Pacific, the effects of which are still being understood. However, the pandemic has also put renewed focus and investment into public health systems and provided an opportunity for the PICTs to build on existing systems and recent capacity strengthening to improve public health in the Region.

          Funding

          Leila Bell was supported by an Australian Government Research Training Program (RTP) Scholarship. Other funding sources had no role in paper design, data collection, data analysis, interpretation, or writing of the paper.

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          Potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria in low-income and middle-income countries: a modelling study

          Alexandra B. Hogan, Britta Jewell, Ellie Sherrard-Smith … (2020)
          Summary Background COVID-19 has the potential to cause substantial disruptions to health services, due to cases overburdening the health system or response measures limiting usual programmatic activities. We aimed to quantify the extent to which disruptions to services for HIV, tuberculosis, and malaria in low-income and middle-income countries with high burdens of these diseases could lead to additional loss of life over the next 5 years. Methods Assuming a basic reproduction number of 3·0, we constructed four scenarios for possible responses to the COVID-19 pandemic: no action, mitigation for 6 months, suppression for 2 months, or suppression for 1 year. We used established transmission models of HIV, tuberculosis, and malaria to estimate the additional impact on health that could be caused in selected settings, either due to COVID-19 interventions limiting activities, or due to the high demand on the health system due to the COVID-19 pandemic. Findings In high-burden settings, deaths due to HIV, tuberculosis, and malaria over 5 years could increase by up to 10%, 20%, and 36%, respectively, compared with if there was no COVID-19 pandemic. The greatest impact on HIV was estimated to be from interruption to antiretroviral therapy, which could occur during a period of high health system demand. For tuberculosis, the greatest impact would be from reductions in timely diagnosis and treatment of new cases, which could result from any prolonged period of COVID-19 suppression interventions. The greatest impact on malaria burden could be as a result of interruption of planned net campaigns. These disruptions could lead to a loss of life-years over 5 years that is of the same order of magnitude as the direct impact from COVID-19 in places with a high burden of malaria and large HIV and tuberculosis epidemics. Interpretation Maintaining the most critical prevention activities and health-care services for HIV, tuberculosis, and malaria could substantially reduce the overall impact of the COVID-19 pandemic. Funding Bill & Melinda Gates Foundation, Wellcome Trust, UK Department for International Development, and Medical Research Council.
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            Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage

            Arush Lal, Ngozi Erondu, David L. Heymann … (2020)
            The COVID-19 pandemic has placed enormous strain on countries around the world, exposing long-standing gaps in public health and exacerbating chronic inequities. Although research and analyses have attempted to draw important lessons on how to strengthen pandemic preparedness and response, few have examined the effect that fragmented governance for health has had on effectively mitigating the crisis. By assessing the ability of health systems to manage COVID-19 from the perspective of two key approaches to global health policy—global health security and universal health coverage—important lessons can be drawn for how to align varied priorities and objectives in strengthening health systems. This Health Policy paper compares three types of health systems (ie, with stronger investments in global health security, stronger investments in universal health coverage, and integrated investments in global health security and universal health coverage) in their response to the ongoing COVID-19 pandemic and synthesises four essential recommendations (ie, integration, financing, resilience, and equity) to reimagine governance, policies, and investments for better health towards a more sustainable future.
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              Is Open Access

              Transmission Dynamics of an Outbreak of the COVID-19 Delta Variant B.1.617.2 — Guangdong Province, China, May–June 2021

              Meng Zhang, Jianpeng Xiao, Aiping Deng … (2021)
              Article 0 comments Cited 110 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Lancet Reg Health West Pac
                Journal ID (iso-abbrev): Lancet Reg Health West Pac
                Title: The Lancet Regional Health: Western Pacific
                Publisher: The Author(s). Published by Elsevier Ltd.
                ISSN (Electronic): 2666-6065
                Publication date PMC-release: 24 June 2022
                Publication date (Print): August 2022
                Publication date (Electronic): 24 June 2022
                Volume: 25
                Page: 100498
                Affiliations
                [a ]Burnet Institute, Melbourne, Australia
                [b ]School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
                [c ]The University of Melbourne, Melbourne, Australia
                [d ]Vanuatu Health Program, Port Vila, Vanuatu
                [e ]The Pacific Community, Nouméa, New Caledonia
                [f ]Pacific Island Health Officers Association, Honolulu, HI, USA
                [g ]Department of Infectious Diseases, Alfred Health, Melbourne, Australia
                [h ]Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Australia
                Author notes
                [* ]Corresponding author.
                Article
                Publisher Item ID: S2666-6065(22)00113-4 Publisher ID: 100498
                DOI: 10.1016/j.lanwpc.2022.100498
                PMC ID: 9230438
                PubMed ID: 35785109
                SO-VID: bbd70138-d267-46d1-b410-912caefd7446
                Copyright © © 2022 The Author(s)
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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                Subject: Viewpoint

                Keywords: covid-19,pacific island countries and territories,public health,system strengthening
                Data availability:
                Keywords: covid-19, pacific island countries and territories, public health, system strengthening

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