The Pacific Island Health The Pacific Island Health Officers AssociationOfficers Association

5151stst PIHOA Meeting Status Report PIHOA Meeting Status ReportNovember 14, 2011November 14, 2011

MissionMission

Improve the health and well-Improve the health and well-being of USAPI communities being of USAPI communities

by providing, through by providing, through consensus, a consensus, a unified unified

credible voice credible voice on health on health issues of regional issues of regional

significance.significance.

Governance - Governance - Directors & Directors & AssociatesAssociates

Board of DirectorsBoard of DirectorsVOTINGVOTING

Chief Health Ministers, Secretaries, Chief Health Ministers, Secretaries, DirectorsDirectors

► ROPROP PresidentPresident► FSMFSM VPVP► RMIRMI SecSec► TreasurerTreasurer► CNMI CNMI ► FSMFSM► GuamGuam

Associate MembersAssociate MembersNON-VOTINGNON-VOTING

Advisory, provides continuity, activeAdvisory, provides continuity, active

► Four state Health Four state Health Departments in FSMDepartments in FSM

► Heads of hospitals in Heads of hospitals in Guam and ASGuam and AS

► Senior health deputies Senior health deputies in RMI, Palau and Guamin RMI, Palau and Guam

Governance Governance -- Affiliates -- Affiliates

Affiliate MembersAffiliate MembersProfessional associations Professional associations

for:for:► MedicineMedicine► DentistryDentistry► NursingNursing► Behavioral HealthBehavioral Health► Cancer ControlCancer Control► Primary CarePrimary Care► EducationEducation► Health CareHealth Care

PIHOA commitment to PIHOA commitment to Pacific GovernancePacific Governance

Must be:Must be:► Pacific-Governed Pacific-Governed ► CharitableCharitable► Impact on health policyImpact on health policy

Where a lot of work happens. Where a lot of work happens. PIHOA . . . PIHOA . . . ► . . . advocates for. . . advocates for► . . . builds capacity of. . . builds capacity of► . . . contracts with members for. . . contracts with members for

Professional licensingProfessional licensingContinuing educationContinuing educationProgram planningProgram planningMoreMore

Governance Governance – Regional Associations– Regional Associations

Health ProfessionsHealth Professions► Pacific Basin Medical Association Pacific Basin Medical Association ► Pacific Basin Dental AssociationPacific Basin Dental Association► American Pacific Nursing Leaders CouncilAmerican Pacific Nursing Leaders Council► Pacific Behavioral Health Collaborating CouncilPacific Behavioral Health Collaborating Council► Northern Pacific Environmental Health Northern Pacific Environmental Health

AssociationAssociation► Association of USAPI LaboratoriesAssociation of USAPI Laboratories► Association of USAPI PharmaciesAssociation of USAPI Pharmacies

Governance Governance – Regional Associations– Regional Associations

Disease SpecificDisease Specific►Cancer Council of the Pacific IslandsCancer Council of the Pacific Islands►Pacific Chronic Disease CoalitionPacific Chronic Disease Coalition►Pacific Partners for Tobacco Free IslandsPacific Partners for Tobacco Free Islands

Policy / LeadershipPolicy / Leadership►Pacific Resources for Education and LearningPacific Resources for Education and Learning►Pacific Post-Secondary Education CouncilPacific Post-Secondary Education Council►Pacific Island Health Officers AssociationPacific Island Health Officers Association►Association of Pacific Island LegislaturesAssociation of Pacific Island Legislatures►Micronesian Chief Executives SummitMicronesian Chief Executives Summit

Governance Governance – Regional Associations– Regional Associations

Health Systems SpecificHealth Systems Specific► Pacific Islands Primary Care AssociationPacific Islands Primary Care Association

Other Groups – Less FormalOther Groups – Less Formal► Quality Assurance Officers/Performance Quality Assurance Officers/Performance

Improvement ManagersImprovement Managers► Health Information Systems Swat TeamHealth Information Systems Swat Team► Human Resources for Health ManagersHuman Resources for Health Managers► Public Health, Nursing and Nutrition EducatorsPublic Health, Nursing and Nutrition Educators

Vasiti UluivitiHuman Resources for Health (HRH) Coordinator

Greg Dever,MDRegional Laboratory Coordinator

Alicia SitanFiscal Officer

Michael EppExecutive Director

Mark Durand, MDQA/QI and Health

Information Systems Specialist

Regie TolentinoAdministrative Officer

Current PIHOA SecretariatAngie Techur-Pedro

Data Specialist

Regional Health Priorities

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Figure 1: NCD platform for practicalizing PIHOA’s regional health priorities

New Strategic Period

PIHOA Resolution 48-01PIHOA Resolution 48-01passed May 2010passed May 2010

“Declaring a Regional State of Health Emergency to the Epidemic of Non-Communicable Diseases in the United States-Affiliated Pacific Islands”

The NCD BurdenThe NCD Burden

►Biggest health problem in USAPIBiggest health problem in USAPI►Among worst NCD disease and risk Among worst NCD disease and risk

factor statistics factor statistics in the worldin the world►Current disease burden unsustainableCurrent disease burden unsustainable

Endangering small, fragile culturesEndangering small, fragile cultures

►Current economic burden unsustainableCurrent economic burden unsustainable Largest part of health budgetsLargest part of health budgets Worker health/productivityWorker health/productivity

Earthquake has hit,Earthquake has hit,Waiting for the TsunamiWaiting for the Tsunami

►Future burden will be catastrophicFuture burden will be catastrophic High % of youth in USAPIHigh % of youth in USAPI Alarming increase in risk factors among Alarming increase in risk factors among

youthyouth

► Impact on all sectors of society, Impact on all sectors of society, especially health, labor, trade.especially health, labor, trade.

Current approach not Current approach not adequateadequate

►Heroic efforts underway, not nearly Heroic efforts underway, not nearly enoughenough

►Fragmentation and lack of coordination Fragmentation and lack of coordination at local, regional, donor levelsat local, regional, donor levels

►Too health sector focused. Whole of Too health sector focused. Whole of society mobilization neededsociety mobilization needed Agriculture, Trade, Education, Fisheries, Agriculture, Trade, Education, Fisheries,

etc…etc…

►Lack of UrgencyLack of Urgency

What’s happened What’s happened since the declaration?since the declaration?

Phase 1: EvangelismPhase 1: EvangelismMay 2010 to Oct 2011May 2010 to Oct 2011

““Do you know there’sDo you know there’s

a problem? Do you know a problem? Do you know

how big it is?”how big it is?”

SocializationSocialization

AlignmentAlignment

Political WillPolitical Will

Why? So leaders will listen to you. Why? So leaders will listen to you.

Resolutions & EndorsementsResolutions & Endorsementshttphttp://pihoa.org/initiatives/ncds/policy.php://pihoa.org/initiatives/ncds/policy.php

► NCD Emergency Communique, 10th Micronesian Presidents' Summit NCD Emergency Communique, 10th Micronesian Presidents' Summit Communique, July 2010Communique, July 2010

► NCD Emergency Declaration by the 5th Micronesian Traditional Leaders Conference, November 2010, Koror, Palau;

► Resolution endorsing the NCD Emergency Declaration by the 14th Micronesian Chief Executives' Summit, December, 2010;

► NCD Emergency Declaration by the Association of Pacific Island Legislatures (APIL), December 2010.

► Adoption of Pacific-wide declaration of NCD crisis, modeled after PIHOA resolution 48-1, by the 9th Pacific Health Ministers Meeting, Honiara, June, 2011.

► Back again: NCD “Policy” Communique, 15th MCES, Pohnpei, July 2011► Back again: Request by Association of Pacific Island Legislatures, 30th

General Assembly, for PIHOA to serve as NCD Policy Advisor, Palau, August 2011 (PIHOA given two hours on the APIL agenda)

Resolutions & EndorsementsResolutions & Endorsementshttphttp://pihoa.org/initiatives/ncds/policy.php://pihoa.org/initiatives/ncds/policy.php

► Pacific Steering Group on Revitalizing Healthy Islands (Focusing on NCDs), Organzied by the World Health Organization in Nadi, Fiji, February, 2011,

► Western Pacific Regional Ministerial Conference, Seoul, Korea, March, 2011,

► First Global Ministerial Conference on Healthy Lifestyles and Non-communicable Disease Control, Organized by WHO, Moscow, 28-29 April 2011,

► 64th World Health Assembly, May, 2011 (via representation through WHO Western Pacific Region),

► Endorsement of 9th PMM Communique, Pacific Island Forums Meeting, Fiji, September 2011

► High-level Meeting on the Prevention and Control of Non-communicable Diseases at the United Nations, New York, NY, September 2011.

Formal Emergency Formal Emergency DeclarationsDeclarations

! ! ! Palau ! ! !

! ! ! Chuuk State ! ! !

Socialization Among AffiliatesSocialization Among Affiliates

Evangelizing at the following MEETINGS:►American Pacific Nursing Leaders Council (twice)►Pacific Basin Medical Association►Cancer Council of the Pacific Islands (twice)►Pacific Behavioral Health Collaborating Council►Pacific Resources for Education and Learning►Pacific Islands Primary Care Association►Guam NCD Coalition Meeting►SPC/WHO meeting on Nutrition Diet and Lifestyle (Guam)►2-1-22 NCD Forum, Tonga (WHO/SPC)►Association of USAPI Laboratories►Association of USAPI Pharmacies►QA/QI/Performance Improvement Managers►Human Resource Managers Meeting

Socialization Among AffiliatesSocialization Among Affiliates

Underwrote / Helped Coordinate the following CONFERENCE CALLS:►Affiliate “Council” – 3 calls►Pacific Basin Dental Association►American Pacific Nursing Leaders Council►Pacific Behavioral Health Collaborating Council►Pacific Basin Medical Association►Association of USAPI Laboratories (2 calls)►Association of USAPI Pharmacists►Education Committee

5050thth PIHOA Meeting: Emerging PIHOA Meeting: Emerging ConsensusConsensus

Policy►Create healthy public policies throughout all sectors, in keeping with the Healthy Island Vision. ►NCD prevalence constitutes an emergency throughout the region, requiring urgent and coordinated response. NCDs are an emergency, and should be treated as such. ►Advocate for NCDs to be placed on the US national emergency management agenda. Prioritization / Resource Allocation►Direct resources and activities to protect children and future generations, empowering them to live healthy lifestyles by addressing the priority risk factors, including diet, physical activity, tobacco, and alcohol.►Transform our health systems to protect and empower the current generation by addressing the “Big Four” NCDs – cardiovascular disease, diabetes, cancer, and chronic respiratory disease.

5050thth PIHOA Meeting: Emerging PIHOA Meeting: Emerging ConsensusConsensus

Systems Strengthening ►Engage the government leadership to address the NCD crisis, using a whole-of-society response.►Build the capacity of the health system to address the NCD crisis. ►Strengthen NCD-related information systems.►Develop human resources to prevent and control the NCD emergency.  Mobilization ►Mobilize sufficient resources to address the NCD emergency, and ensure sustainable resources to prevent its recurrence. ►Increase engagement of the full community – all of society, involving all sectors and jurisdictions, from local to regional.►Build & strengthen mechanisms for regional sharing and collaboration across all groups involved regionally with addressing NCDs.

5151stst PIHOA Meeting: Emerging PIHOA Meeting: Emerging ConsensusConsensus

Strategic Objectives for Affiliate Organizations►Association of Pacific Island Legislatures (Senators Scaliem & Won Pat)►American Pacific Nursing Leaders Council►Pacific Basin Medical Association►Pacific Behavioral Health Collaborating Council►Association of USAPI Laboratories►Pacific Chronic Disease Coalition►Cancer Council of the Pacific Islands►Pacific Partners for Tobacco Free Islands►Pacific Islands Primary Care Association►Northern Pacific Environmental Health Association►Pacific Resources for Education and Learning►Pacific Post-Secondary Education Council

5050thth PIHOA Meeting: Emerging PIHOA Meeting: Emerging ConsensusConsensus

Strategic Objectives for Education Partners►Chuuk State Government, Ministry of Education ►The Fiji School of Medicine►The University of Guam, School of Nursing and Health Sciences►College of the Marshall Islands, Administration and School of Nursing►Guam Community College, School of Nursing►Palau Community College, Public Health Program and School of Nursing►College of Micronesia-FSM, School of Nursing►The University of Hawaii John A. Burns School of Medicine ►The University of Hawaii School of Agriculture►The University of Hawaii Department of Nursing of ►Island Food Community of Pohnpei►Pacific Partners In Nursing

5050thth PIHOA Meeting: Emerging PIHOA Meeting: Emerging ConsensusConsensus

Strategic Objectives for Development Partners►The World Health Organization►The Secretariat of the Pacific Community►US Health Resources and Services Administration ►US Centers for Disease Control and Prevention, Office of State, Tribal, Local, and Territorial Support ►US Health and Human Services, Region IX►US Department of Interior►Framework Convention Alliance►Association of State and Territorial Health Officials►National Association of Chronic Disease Directors►Asian Pacific Islander American Health Forum

Phase 2: Regional Phase 2: Regional MobilizationMobilizationNov 2011 to . . . Nov 2011 to . . .

““From Consensus to Action”From Consensus to Action”

OperationalizingOperationalizing

the NCD Crisis Responsethe NCD Crisis Response

Sample Mobilization Activities Sample Mobilization Activities at PIHOAat PIHOA

►Captured five year $1.7/year CDC National Captured five year $1.7/year CDC National Public Health Improvement Initiative with Public Health Improvement Initiative with significant NCD component:significant NCD component: Supporting NCD Policy/Law developmentSupporting NCD Policy/Law development

►““NCD Leadership Summit” early 2012NCD Leadership Summit” early 2012

Development of NCD profilesDevelopment of NCD profiles Development of standardsDevelopment of standards

►All health systems strengthening priorities to All health systems strengthening priorities to include NCD focus (QA/QI, HRH, lab, include NCD focus (QA/QI, HRH, lab, planning, HIMS, planning, etc..)planning, HIMS, planning, etc..)

Sample Mobilization Activities Sample Mobilization Activities at PIHOAat PIHOA

►Recruited Presidential Management Recruited Presidential Management Fellow for six month rotation beginning Fellow for six month rotation beginning Jan 2012. Primary focus: NCD Policy Jan 2012. Primary focus: NCD Policy and Lawand Law

►Variety of health systems Variety of health systems strengthening activities (see PIHOA strengthening activities (see PIHOA Annual Report)Annual Report)

Thank you very much!Thank you very much!Michael EppMichael Epp

Pacific Island Health Officers AssociationPacific Island Health Officers Associationmichaele@pihoa.org

(808) 382-1231(808) 382-1231