Issue：By 15 June 2012, States Parties to the International Health Regulations (2005), or IHR (2005), were required to have established the core capacities required to implement Annex 1 of IHR (2005).Context：The Pacific is home to 10 million people spread over 21 Pacific island countries and territories. Seven of those have populations of less than 25 000 people; 14 of the 21 Pacific island countries and territories are States Parties to the IHR (2005).Action：The World Health Organization Division of the South Pacific embarked on an initiative to support Pacific Island States Parties meet their 15 June 2012 IHR obligations. We adapted the 2012 IHR Monitoring Questionnaire (IHRMQ) to assist Pacific island countries and territories determine if they had met the capacities required to implement Annex 1 of the IHR (2005). If a Pacific island country or territory determined that it had not yet met the requirements, it could use the assessment outcome to develop a plan to address identified gaps.Outcome：Direct support was provided to 19 of 21 (91%) Pacific island countries and territories including 13 of 14 (93%) States Parties. Twelve of 14 (86%) fulfilled their requirements by 15 June 2012; those that had not yet met the requirements requested extensions and submitted plans describing how the IHR core capacities would be met.Discussion：Adapting the 2012 IHRMQ for this purpose provided an efficient tool for assessing national capacity to implement Annex 1 of IHR (2005) and provided clear indication of what capacities required strengthening.

PROBLEM/CONTEXT: The Pacific island nation of Fiji Islands has high rates of endemic typhoid fever which is difficult to diagnose and often underreported. However, the majority of cases are preventable through use of safe water; adequate sanitation; vaccination; and, most sustainable of all, simple hygienic behaviour, such as hand washing with soap (HWWS). Despite many attempts by public health authorities, little progress has been made in the area of environmental adaptation and behaviour change. ACTION: To explore perceptions of typhoid fever risk among urban squatters and behavioural determinants surrounding HWWS, indigenous Fijians living in informal settlements with high typhoid fever incidence were invited to participate in focus group discussions. In-depth interviews were conducted with community leaders. OUTCOME: Perceptions of typhoid fever suggest confusion about risk factors, symptoms and communicability. Environmental barriers for hand washing were related to water and soap access. Standard social marketing approaches have been trialled with little clear evidence of impact. Despite this, we continue to advocate for the social and cultural determinants of typhoid prevention to remain central to future public health strategies. DISCUSSION: Despite behaviour change being notoriously difficult, we argue that community-driven behaviour adaptation initiatives based on sound epidemiological evidence and health communication theory are likely to have significant impact and greater likelihood of sustainability.