OBJECTIVES

Adiposity rebound (AR), the childhood period at which body mass index (BMI) rises from its lowest point, is linked to increased risk of later obesity. The study aims to determine the average age at AR, describe baseline characteristics and analyze the correlation between these characteristics and timing of AR in a population of Filipino pediatric outpatients.

Seven subjects born between 2016 and 2019 from a University Hospital Outpatient Department participated in this cross-sectional analytic study. Childhood anthropometrics were retrospectively collected to determine the age at AR by plot visual inspection. Sex, birth weight and gestational age were obtained from hospital records; breastfeeding duration, maternal BMI, parental obesity, maternal age, maternal smoking, education, parity and family income were gathered through a questionnaire completed by mothers or guardians. Associations were assessed using bootstrap univariate linear regression.

The mean age at AR was 3.2 years (SD = 1.2). Vaginal delivery was significantly associated with later age at AR compared to cesarean section (p = 0.035). Socioeconomic status at ages 2 to 5 showed positive association with delayed AR. Higher monthly family income (≥₱19,000) at ages 2 to 5 years was significantly associated with delayed age at AR. Other baseline childhood and parental factors showed no significant correlation with age at AR.

These results highlight the complex and context-dependent nature of AR, emphasizing the need for further studies to better understand and mitigate early obesity risk in Filipino children.

Problem: On 17 December 2024, a magnitude 7.3 earthquake struck the Pacific Island country of Vanuatu, affecting over 80 000 people and causing 14 deaths and 265 injuries. Facing limited specialist clinical capacity, increased patient load and strained facilities, Vanuatu’s Ministry of Health requested support from emergency medical teams. Context: Vanuatu, highly disaster-prone and geographically dispersed, has a health system constrained by limited human resources and recent cyclone-related damage. The country’s national emergency medical team, the Vanuatu Medical Assistance Team, was established in 2017 and plays a central role in health emergency response in the country. Action: Within 24 hours of the earthquake, the Vanuatu Medical Assistance Team was activated and established an Emergency Medical Team Coordination Cell within the national health emergency operations centre. National and international emergency medical teams from Australia, Fiji, Indonesia, Japan and New Zealand were deployed over the subsequent weeks and provided clinical, mental health and information management support. The World Health Organization’s emergency medical team Minimum Data Set was implemented to monitor health trends and inform response actions. Outcome: Eight national and international emergency medical teams deployed alongside local health services. Together, they reported more than 5500 consultations to the Emergency Medical Team Coordination Cell, and a specialized team provided mental health and psychosocial support to 521 people. Minimum Data Set analysis showed a rapid decline in trauma-related presentations and detected increases in influenza-like illness, guiding the transition from emergency to recovery. Discussion: This response underscored the value of emergency medical teams following disasters, the importance of national leadership and coordination, and the significance of regional solidarity and partnerships. It also highlighted the importance of information management during emergencies and demonstrated potential innovations in this space.

This manuscript details the process and outcomes of emergency medical team (EMT) reclassification in WHO’s Western Pacific Region. EMT reclassification is undertaken approximately 5 years after initial classification, ensuring adherence to published common EMT principles and standards. This report reflects on the first four EMTs reclassified in the Western Pacific Region, detailing the reclassification process and notable outcomes.

This report reflects on the Indo-Pacific Health Security Alliance Meeting held in Port Moresby, Papua New Guinea in May 2025. It considers the importance of civil–military coordination in health emergency preparedness and response in the Indo-Pacific Region, and highlights efforts to align resources and capabilities to better serve the needs of populations affected by health emergencies.

The International Health Regulations (2005; IHR) are a legally binding instrument for the 196 States Parties, including the 194 Member States of the World Health Organization (WHO), requiring them to build and maintain capacities across critical domains to prevent, detect and respond to public health threats. In an analysis of 15 IHR (2005) core capacity scores reported by States Parties in WHO’s Western Pacific Region from 2021 to 2023, average regional scores increased from 68% in 2021 to 72% in 2022, then declined to 66% in 2023. Seven States Parties maintained consistently strong scores (>=85%), whereas nine exhibited fluctuations of at least 10 percentage points. Categorizing States Parties into three groups based on geographical and economic characteristics highlighted that core capacities such as financing, food safety and the control of zoonotic diseases were areas requiring additional capacity-building, particularly among Pacific Island States Parties. Low- and middle-income States Parties also reported notable gaps in financing and infection prevention and control. These findings underscore the need to strengthen national coordination and accountability mechanisms. The strategic establishment or designation of a National IHR Authority – a key amendment introduced in the 2024 revision of the IHR – has the potential to enhance implementation by ensuring institutional leadership, fostering multisectoral collaboration and facilitating resource mobilization. However, national efforts alone may not be sufficient. Regional coordination will enhance political commitment and promote coordinated action, thereby strengthening preparedness and response capacities across diverse contexts and supporting more effective implementation of the IHR (2005).

This article describes the Western Pacific Region’s participation in the Emergency Medical Team Global Meeting held in November 2024 in Abu Dhabi, United Arab Emirates. Participants from the region actively contributed to various panels, discussions, working sessions and abstract presentations throughout the 3-day meeting, highlighting the increased strength of the Western Pacific to respond to health emergencies.

This article highlights the vital role of affordable satellite communications during health emergencies. Drawing on examples from Vanuatu and Tonga, it underscores the importance of integrating satellite technologies into disaster preparedness for effective communication and response.

Problem: While the COVID-19 pandemic threatened the entire world, the extremely remote Pitcairn Islands faced unique vulnerabilities. With only a physician and a nurse to care for an ageing population of fewer than 40 residents, and with very limited referral pathways, Pitcairn encountered distinct challenges in preparing for and responding to the COVID-19 pandemic. Context: The Pitcairn Islands is an overseas territory of the United Kingdom of Great Britain and Northern Ireland consisting of four islands in the South Pacific: Pitcairn, Henderson, Ducie and Oeno. Pitcairn is the only inhabited island with a local resident population of approximately 31 people, around half of whom were over 60 years old in 2023. The islands are only accessible by sea and are located more than 2000 km from the nearest referral hospital in French Polynesia. Actions: Pitcairn’s Island Council took aggressive action to delay the importation of SARS-CoV-2, vaccinate its small population and prepare for the potential arrival of the virus. Outcomes: As of May 2024, Pitcairn was one of the only jurisdictions in the world not to have had a single COVID-19 hospitalization or death. Nevertheless, the pandemic presented the islands’ population with many economic, social and health challenges. Discussion: Pitcairn’s population avoided COVID-19-related hospitalizations and deaths despite its elderly population’s vulnerability to COVID-19, a significant level of comorbidities, and limited clinical management capabilities and options for emergency referrals. The pandemic highlighted some of the population’s health vulnerabilities while also underscoring some of their innate strengths.

Objective: The Commonwealth of the Northern Mariana Islands (CNMI) is a remote Pacific island territory with a population of 47 329 that successfully prevented the significant introduction of coronavirus disease (COVID-19) until late 2021. This study documents how the response to the introduction of COVID-19 in CNMI in 2021 was conducted with limited resources without overwhelming local clinical capacity or compromising health service delivery for the population. Methods: Data from COVID-19 case investigations, contact tracing, the Commonwealth’s immunization registry and whole genome sequencing were collated and analysed as part of this study. Results: Between 26 March 2020 and 31 December 2021, 3281 cases and 14 deaths due to COVID-19 were reported in CNMI (case fatality rate, 0.4%). While notification rates were highest among younger age groups, hospitalization and mortality rates were disproportionately greater among those aged >50 years and among the unvaccinated. The first widespread community transmission in CNMI was detected in October 2021, with genomic epidemiology and contact tracing data indicating a single introduction event involving the AY.25 lineage and subsequent rapid community spread. Vaccination coverage was high before widespread transmission occurred in October 2021 and increased further over the study period. Discussion: Robust preparedness and strong leadership generated resilience within the public health sector such that COVID-19 did not overwhelm CNMI’s health system as it did in other jurisdictions and countries around the world. At no point was hospital capacity exceeded, and all patients received adequate care without the need for health-care rationing.

Problem: From April to September 2021, Fiji experienced a second wave of coronavirus disease (COVID-19) precipitated by the Delta variant of concern, prompting a need to strengthen existing data management of positive COVID-19 cases. Context: With COVID-19 cases peaking at 1405 a day and many hospital admissions, the need to develop a better way to visualize data became clear. Action: The Fiji Ministry of Health and Medical Services, the World Health Organization and the United Nations Office for the Coordination of Humanitarian Affairs collaborated to develop an online clinical dashboard to support better visualization of case management data. Outcome: The dashboard was used across Fiji at national, divisional and local levels for COVID-19 management. At the national level, it provided real-time reports describing the surge pattern, severity and management of COVID-19 cases across the country during daily incident management team meetings. At the divisional level, it gave the divisional directors access to timely information about hospital and community isolation of cases. At the hospital level, the dashboard allowed managers to monitor trends in isolated cases and use of oxygen resources. Discussion: The dashboard replaced previous paper-based reporting of statistics with delivery of trends and real-time data. The team that developed the tool were situated in different locations and did not meet physically, demonstrating the ease of implementing this online tool in a resource-constrained setting. The dashboard is easy to use and could be used in other Pacific island countries and areas.