New Zealand called on to help Pacific improve health systems

A maiden study into health system preparedness has found the Pacific region wanting, with researchers hoping neighbouring New Zealand can help fill the blanks.

Against the 2019 Global Health Security Index (G.H.S.I.) rankings, New Zealand public health researchers said it is in the larger nation’s interest to help the region improve their scores and strengthen health security.

No country in the Pacific scored above 28 out of 100, and the lowest regional score was 19.2. New Zealand only scored 54, a number the paper’s authors consider accurate. The global average is 40.2.

“This relatively low score could be particularly problematic given that one recent analysis indicates that New Zealand is the second most optimal island nation refuge for humanity in the case of pandemics that threaten human extinction,” the authors state. 

The highest scoring island nation was Papua New Guinea with 27.8, and Samoa next with 26.4. The two rank 155 and 162 in the global list of 195 countries. 

Authors Dr. Matt Boyd, Professor Michael Baker, Dr. Cassidy Nelson and Associate Professor Nick Wilson said the key gaps in their scores largely stem from insufficient evidence of how the health system is performing. 

While New Zealand also scored poorly in some areas, the authors state it has been underspending on overseas development assistance (O.D.A.) and could do more to help the region anyway.

“Although the dollar value of this O.D.A. has increased since 2011, the ratio between O.D.A. and Gross National Income (G.N.I.) has fallen from 0.52 per cent in 1975 to 0.28 per cent in 2011 and to 0.23 per cent in 2017.”

Meanwhile, the United Nations O.D.A target is 0.7 per cent of gross national income. The authors argue that New Zealand is not doing enough, and that there is evidence enough to do more, from the low G.H.S.I. scores, the 2019 measles epidemic and the current global COVID-19 pandemic. 

 “New Zealand could target aid in ways that will allow Pacific nations to comply with the I.H.R. (International Health Regulations) and at the same time improve their G.H.S.I. 

“If New Zealand continues to give less and less O.D.A. while its own G.N.I. rises, then this neglect will likely further contribute to regional inequality and poor regional health security.”

In particular, the authors suggest New Zealand should invest in supporting Pacific countries to develop five-year- country roadmaps to develop their health systems, starting with countries like Tokelau, the Cook Islands, Niue and Samoa, and helping ensure common threats are vaccinated against fully.

They also call for data sharing agreements on public health surveillance data monitoring. 

Because the risk of another global catastrophic biological risk like the COVID-19 pandemic is almost inevitable, the researchers urge New Zealand to close their health index gaps and help the region close theirs. 

“Given that infectious diseases do not respect international borders, the New Zealand Government perspective of enlightened self-interest might lead to resources being allocated to help such nations improve their G.H.S.I. scores.

“The COVID-19 pandemic needs to be seen as a warning, a dress rehearsal for a future [risk], and policy needs to be proactive, not reactive. We must realise that in future extreme cases we may not be able to merely ‘scale up’ existing plans.”

The G.H.S.I., released in October 2019, is the first ever assessment of global health security capability in 195 countries, and its development was led by the John Hopkins Centre for Health Security and the Nuclear Threat Initiative. 

It is hoped to be a resource in the face of increasing major risks, for which there is increasingly limited international finance for. 

Samoa’s scores across the index:

Prevention of the emergence or release of pathogens: 20.2 (ranked 158)

Early detection and reporting for epidemics of potential international concern: 14.1 (ranked 173)

Rapid response to and mitigation of the spread of an epidemicL 28.9 (ranked 133)

Sufficient and robust health system to treat the sick and protect health workers: 9.2 (ranked 168)

Commitments to improving national capacity, financing and adherence to norms (30.7 (ranked 179)

Overall risk environment and country vulnerability to biological threats: 66.1 (ranked 52)

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