Cholera is an acute infectious disease caused by Vibrio cholerae . The disease occurs in a variety of forms ranging from sporadic cases to outbreaks that may transition to endemic disease. While cholera case management focuses on early, rapid rehydration, antimicrobial therapy can reduce the volume of diarrhoea, duration of carriage and symptoms and is frequently recommended for patients with severe dehydration.

Problem: Fellows of the Papua New Guinea Field Epidemiology Training Programme (FETP) were part of the national coronavirus disease (COVID-19) response. However, the specific activities and challenges experienced by fellows in the field were unknown. Context: The advanced FETP cohort commenced just prior to the COVID-19 pandemic and all fellows were involved in the response. The advanced fellows participating in this review represented a cross-section of the country’s public health workforce. Action: A review was conducted to better understand the scope of activities undertaken by FETP fellows, identify the challenges experienced and assess how well the programme prepared fellows for their COVID-19 response roles. A facilitated discussion based on the World Health Organization COVID-19 intra-action review methodology and an online survey was conducted with advanced FETP fellows. Outcome: The fellows made important contributions to the national COVID-19 response by assuming leadership positions at all levels of government, leading training activities and applying core field epidemiology competencies in surveillance and response activities. The programme had prepared them well for the response, giving them the confidence and skills to undertake a diverse range of response roles. Discussion: The FETP review of the COVID-19 response in Papua New Guinea highlighted the role and influence of the fellows during the pandemic response. Fellows were able to apply core field epidemiology competencies across a range of roles. The recommendations derived from this review will be instructive for the FETP specifically and the COVID-19 response generally.

Problem: Rapid response teams (RRTs) are critical for effective responses to acute public health events. While validated training packages and guidance on rolling out training for RRTs are available, they lack country-specific adaptations. Documentation is limited on RRT programming experiences in various contexts. Context: In Papua New Guinea, there remain gaps in implementing standardized, rapid mobilization of multidisciplinary RRTs at the national, provincial and district levels to investigate public health alerts. Action: The human resources needed to respond to the coronavirus disease (COVID-19) pandemic forced a review of the RRT training programme and its delivery. The training model was contextualized and adapted for implementation using a staged approach, with the initiation training phase designed to ensure RRT readiness to deploy immediately to respond to COVID-19 and other public health events. Lessons learned: Selecting appropriate trainees and using a phased training approach, incorporating after-training reviews and between-phase support from the national programme team were found to be important for programme design in Papua New Guinea. Using participatory training methods based on principles of adult learning, in which trainees draw on their own experiences, was integral to building confidence among team members in conducting outbreak investigations. Discussion: The RRT training experience in Papua New Guinea has highlighted the importance of codeveloping and delivering a context-specific training programme to meet a country’s unique needs. A staged training approach that builds on knowledge and skills over time used together with ongoing follow-up and support in the provinces has been critical in operationalizing ready-to-respond RRTs.

Problem: Over the past two decades, there has been increased recognition of the importance of a more holistic approach to preventing, predicting, detecting and responding to public health threats. The COVID-19 pandemic highlighted the need to bring together environmental, human and animal health sectors in addressing public health threats and the need to develop skilled front-line workers to act as surge capacity during health emergencies. Context: Papua New Guinea is a high-risk country for emerging and re-emerging pathogens. The effects of climate change, human-mediated encroachment on natural habitats and destructive land-use practices have threatened ecosystems and caused environmental damage. The movement of goods, animals and people over porous borders provides opportunities for the introduction and spread of new pathogens. Action: In recognition of the importance of multisectoral responses to health threats in Papua New Guinea, and the need to train front-line workers, we designed and piloted a 3-month One Health in-service training programme for front-line workers from across all sectors. Lessons learned: The co-creation of curricula was essential in ensuring the relevance of the programme to front-line workers from multiple sectors, and the development of provincial training teams was key to ensuring mentorship and programme sustainability. Bringing front-line workers together in joint trainings facilitated the building of relationships, the understanding of the roles and responsibilities of the various sectors, the identification of sectoral focal points and the development of informal networks. Discussion: Papua New Guinea’s One Health front-line Field Epidemiology Training Program demonstrated that investment in cross-sectoral training programmes can be a catalyst for the implementation of One Health approaches on the front line.