{"id":7075,"date":"2020-03-27T13:00:00","date_gmt":"2020-03-27T03:00:00","guid":{"rendered":"https:\/\/testblogs.griffith.edu.au\/asiainsights\/?p=7075"},"modified":"2023-03-29T14:56:23","modified_gmt":"2023-03-29T04:56:23","slug":"emerging-disease-and-emerging-economies-the-capacity-of-pacific-health-systems-in-the-face-of-covid-19","status":"publish","type":"post","link":"https:\/\/testblogs.griffith.edu.au\/asiainsights\/emerging-disease-and-emerging-economies-the-capacity-of-pacific-health-systems-in-the-face-of-covid-19\/","title":{"rendered":"Emerging disease and emerging economies: The capacity of Pacific health systems in the face of COVID-19"},"content":{"rendered":"\n

Annually health\nsystems across Pacific Island Countries and Territories (PICTs) demonstrate\ntheir resilience to acute external shocks. Generally presenting as natural\ndisasters including cyclones, tsunamis and earthquakes, the region\u2019s disaster-prone\nlocale means that PICTs\u2019 health systems unfortunately have an extensive history\nof responding in the wake of crises. Yet, while tried and tested in response to\nnatural disasters, alongside the rest of the world\u2019s health systems, it remains\ntoo early to fully conceptualise how these systems may respond to the global\npandemic COVID-19. However, as Pacific-based\ncases escalate<\/a>, it is important to mitigate panic (and its causal relationship with\nmistakes) by alleviating blind spots and taking stock of the current strengths\nand weaknesses of PICTs\u2019 health systems.<\/p>\n\n\n\n

While often discussed\ncollectively, it is important to acknowledge that \u2018the Pacific\u2019 is a diverse\nregion. Although home to nations which share similar geographic, cultural and\nhistoric communalities, there are also distinct differences between countries\nand territories in the region.<\/p>\n\n\n\n

Such differences are\nevident when analysing World Bank data<\/a> to assess regional\nhealth and economic standings. With gross domestic product (GDP) per capita\nvarying from 1,625USD in Kiribati to 35,712USD in Guam, the economic position\nof nations dictate the available funds to spend on health. Analysing\nhealth-specific expenditure, regional variance is again apparent. Many PICTs\nspend less than 6% of GDP on health, whereas data from the Federated States of\nMicronesia and Marshall Islands indicates expenditure as great as 12.6% and\n23.3% respectively. While not linear, there is a relationship between health\nexpenditure, system responsiveness and metrics such as life expectancy. This is\napparent than when making regional comparisons, where projections currently exhibit\na 15-year life expectancy gap between the region\u2019s highest and lowest\nperforming states. This stark diversity is apparent before we have even begun\nto consider how health systems across the region are structured, function or\nare financed. <\/p>\n\n\n\n

So, given such\ndiversity, is it helpful or even feasible to consider how the region may be\naffected by or respond to COVID-19? In my opinion, yes. Despite their diversity,\nthere are also a number of regionally unique factors which both exacerbate risk\nand afford protection to PICTs in response to COVID-19. Highlighting these\nfactors may support regional and state policy makers in ensuring responses are contextually\ntailored and evidence informed.<\/p>\n\n\n\n

Regional\ngeography offers PICTs both protection and risk in responding to COVID-19. The\nisland nature of states means few land borders for transmission of disease. With\nthe majority of PICTs\nrestricting marine and air arrivals<\/a>, nations yet to receive the virus or that have\ntightly controlled cases may be able to prevent transmission long enough to\nlearn valuable lessons from the global community, flatten the curve or even wait\nout a vaccine. However, difficult terrain and population dispersal are ongoing challenges\nto health care provision. Severely limiting economies of scale, in responding\nto COVID-19, this dispersal may exacerbate the deficiencies in such a thin\nspread of health resources. Further, while oceanic borders may limit the spread\nbetween islands, it is also important to note that rapid and unplanned urbanisation\nmay place urban centres and, in particular, those in cramped or informal\nsettlements at greater risk. <\/p>\n\n\n\n

As highlighted\nabove, when nations have more money, typically, more is spent on health. Unfortunately,\nmany low- and middle-income PICTs experience constrained access to global\nmarkets and are particularly reliant on tourism; an industry\ncurrently scrambling to remain afloat<\/a>. With potentially less money in national\neconomies, this raises concerns that fewer funds may be available to forge\nsufficient responses to the pandemic. Further, with several nations and their\nhealth systems reliant on foreign aid, the current downward trajectory of\nWestern economies could constrain donor partners\u2019 generosity into the future. <\/p>\n\n\n\n

The\nsocio-political structures and cultures of PICTs look to provide some\nprotection in response to COVID-19. The complex political histories of many\nPICTs has typically meant there is lower reliance on centralised government\nmechanisms. Coupled with greater power afforded to local decision makers and\nthose in the chiefly system, distribution of authority is likely to support\nproactivity and community ownership in prevention and response.  <\/p>\n\n\n\n

Finally, the\nintersection of epidemiology and demography also presents risk and protection in\nthe face of COVID-19. Populations of PICTs are typically young by comparison to\nglobal average. With evidence indicating older persons to be at greater risk,\nthe relatively young makeup of PICTs may afford some protection from COVID-19.\nBy contrast however, evidence also indicates COVID-19 adversely impacts those\nwith underlying health conditions. In this respect, unfortunately, the non communicable\ndisease crisis<\/a> faced by the region may undo some age-afforded concessions. Further,\nwith the double burden of communicable and non-communicable diseases\nexperienced by many PICTs placing a significant strain on health systems, this\nmay weaken responses to COVID-19. With greater exposure to communicable diseases\nhowever, it may be argued that PICTs\u2019 communities are more aware of and conscious\nof implementing hygiene and infection control practices; behaviours that appear\npoorly instigated in nations experiencing escalating disease transmission. <\/p>\n\n\n\n

COVID-19 presents\nan opportunity to reflect on the importance of health, health systems and\nhealth workers in this increasingly interconnected world. While we face this\nweek more uncertain than before, in considering how PICTs may respond to this\nchallenge, one may draw comfort in reflecting on the resilience these systems\nhave shown in the past. Whether we consider Samoa\u2019s response\nto measles<\/a>, responses to landslides in\nPNG<\/a>, cyclones in Fiji<\/a>, Vanuatu<\/a> and Tuvalu<\/a> or the region-wide\nresponse to climate change<\/a>, PICTs health systems and populations have\nproven themselves incredibly resilient. I\u2019m not saying our current situation isn\u2019t\nincredibly challenging but, in being pragmatic, I don\u2019t believe that panic is helpful.\nPICTs\u2019 health systems and their regional agencies have grown immensely and are\nled nationally and driven locally by dedicated health workers and public\nservants. Drawing on these personnel in forming and executing evidence-informed\nresponses will give PICTs the best chance to proactively prepare for, recognise\nand respond to the diverse impacts COVID-19 may have on populations and their\nhealth now and into the future. <\/p>\n\n\n\n

AUTHOR<\/p>\n\n\n\n

Lana Elliott<\/strong> is a lecturer in health policy at Queensland University of Technology<\/a> (QUT) and doctoral student at James Cook University.<\/a> Her work focus on health policy and systems research in the Pacific. <\/p>\n\n\n

<\/p>","protected":false},"excerpt":{"rendered":"

How will Pacific Island and Territories respond to the global pandemic, Covid19.<\/p>\n","protected":false},"author":14,"featured_media":7078,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_newsletter_tier_id":0,"footnotes":""},"categories":[1105,233,1427,1755,1021,248,1055,1056,1057],"tags":[1093,1092,969,1050],"class_list":["post-7075","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-coronavirus-in-the-pacific","category-feature-series","category-pacific-forum","category-governance-democracy","category-pacific-outlook","category-png-and-the-pacific","category-economies-and-development","category-politics","category-security","tag-covid19","tag-lana-elliot","tag-pacific-islands","tag-pacific-outlook"],"acf":[],"modified_by":"Jill Moriarty","yoast_head":"\nEmerging 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