This editorial introduces the Special Edition on the Global Outbreak Alert and Response Network (GOARN) published by Western Pacific Surveillance and Response. The articles in this Special Edition reflect on insights from expert deployments through GOARN and the experiences of GOARN partner institutions across the Western Pacific Region since the network's formation in 2000. The Special Edition also serves as a call for continued strengthening of and investment in the people, systems and partnerships that facilitate effective emergency response.

Problem: The Global Outbreak Alert and Response Network (GOARN) has responded to more than 100 outbreaks during the past 23 years. The coronavirus disease (COVID-19) pandemic presented unprecedented operational constraints that challenged GOARN’s core mission to rapidly deploy technical experts from its partners to support national in-country responses to public health emergencies. This paper describes the type and duration of GOARN deployments to and within the World Health Organization’s (WHO’s) Western Pacific Region during the COVID-19 pandemic. Context: Despite strict border closures and ever-changing vaccination and quarantine requirements, GOARN continued to deploy international technical assistance to strengthen COVID-19 response operations within the Region, as requested. Action: Data were analysed from the GOARN Knowledge Platform about deployments to and within the Region for responses to the COVID-19 pandemic between 1 January 2020 and 5 May 2023. Data were available about deployment duration, technical role requested, country or area, partner organization and deployed expert’s demographics. Feedback from postdeployment briefings with the experts was collected and thematically analysed to determine ongoing needs and gaps to help improve deployment operations. Outcome: There were 72 experts deployed on 89 missions through GOARN to 12 countries and areas in the Region, for a total of 4558 field days, to support the response to the COVID-19 pandemic. Discussion: The volume of requests for assistance from countries and areas in the Region to respond to the COVID-19 pandemic uncovered a deficit in human resources available for domestic response to outbreaks and the reliance on international assistance. Strengthening the in-country capacity of ready-to-respond public health emergency staff is critical to meet the needs for outbreak response. The ongoing demand for technical experts to support national responses means that these lessons may have immediate implications.

Problem: In January 2022, Kiribati experienced widespread community transmission of COVID-19, leading to high rates of infection among health-care workers (HCWs), which reduced essential HCWs during a period of increased hospital admissions. Context: Kiribati, a Pacific island country made up of a remote group of 33 low-lying atolls in the Pacific Ocean, experienced its first surge of COVID-19 cases beginning on 24 January 2022. Action: Reports of increasing numbers of COVID-19 cases in South Tarawa prompted the Kiribati Ministry of Health and Medical Services to request assistance from the international community, including the World Health Organization’s Global Outbreak Alert and Response Network (GOARN), to support national COVID-19 response operations. Specialists in infection prevention and control (IPC) were deployed to Kiribati in February 2022 to assist the Ministry’s National COVID-19 Taskforce in collaboration with national partners. These specialists helped review and strengthen IPC capacities to accommodate a potential patient surge and consequent demands for medical consumables in health-care facilities in South Tarawa. Outcome: Strengthened knowledge about and processes for IPC among HCWs prevented health care-associated infections and reduced community disease transmission during the first surge of COVID-19 cases in Kiribati. Discussion: GOARN has the capacity and ability to rapidly deploy experts to support requests for assistance. Outbreak response activities can be enhanced and sustained by using GOARN’s resources and collaborating with all partners, as necessary.

This report documents the first national GOARN partner focal point engagement meeting held in Japan. It shares the objective, meeting format and outcomes. The meeting facilitated information exchange and encouraged the formation of national-led partner forums to foster collaboration between partners to enhance preparedness and response to international infectious disease outbreaks.

This report summarizes the purpose, content and outcomes of the first meeting of Global Outbreak Alert and Response Network (GOARN) partners in Australia in November 2023.

The inaugural hybrid virtual and in-person meeting of the Global Outbreak Alert and Response Network partners in the WHO Western Pacific Region convened on 20–21 November 2024 in Tokyo, Japan. Hosted by the National Centre for Global Health and Medicine and Japan's Ministry of Health, Labour and Welfare, the meeting aimed to enhance regional preparedness and response capabilities for emerging health threats, aligning with the Asia Pacific Health Security Action Framework. The meeting concluded with a consensus on the necessity for sustained engagement, expanded training programs, and strengthened research initiatives to fortify health security across the Western Pacific Region.

Objective: The COVID-19 pandemic challenged the Global Outbreak Alert and Response Network’s (GOARN) mechanism used to rapidly deploy technical support for international responses and highlighted areas that require strengthened capacity within the Network. GOARN’s partners in the World Health Organization’s (WHO) South-East Asia and Western Pacific regions were engaged to explore their levels of preparedness, readiness and ability to respond to international public health emergencies. Methods: Consultative discussions were held and a survey was conducted with GOARN’s partners from the two WHO regions. Discussion topics included partners’ capacity to support and participate in a GOARN deployment, training, research and collaboration. Descriptive and content analyses were conducted. Results: Barriers to engaging in GOARN’s international outbreak response efforts included limited numbers of personnel trained to respond to outbreaks; institutional, financial and administrative hurdles; and limited collaboration opportunities. Partners identified innovative solutions that could strengthen their engagement with deployment, such as financial subsidies, mentorship for less experienced staff, and the ability to provide remote support. Discussion: GOARN plays an important role in enabling WHO to fulfil its international alert and response duties during disease outbreaks and humanitarian crises that have the potential to spark disease outbreaks. Yet without systematic improvement to strengthen national outbreak capacity and regional connectedness, support for international outbreak responses may remain limited. Thus, it is necessary to integrate novel approaches to support international deployments, as identified in this study.

Objective: We explored the experiences of women in senior or leadership roles in navigating and leading during acute public health emergencies. Methods: Women leaders in the World Health Organization Western Pacific Region attending the Global Outbreak Alert and Response Network’s Outbreak Response Leadership Training (11–18 September 2024) were invited to participate in this phenomenological study. Eleven interviews were conducted with training attendees and observational data were gathered. Inductive thematic analysis was conducted to identify key themes. Results: Four themes associated with women-centric experiences in public health emergency response were identified: disproportionate expectations in the workplace; the use of authoritarian decision-making during planning and implementation; encompassing different perspectives and leadership styles compared to men; and requesting additional opportunities and equitable prospects for career growth. Four themes that reflect non-gender-exclusive challenges experienced during emergency responses were also detailed. Themes observed were related to: barriers to efficiency; consequences of working within this field; and needs and necessities during emergency response. Discussion: This study highlights both gender-specific and systemic challenges experienced by women leaders in public health emergency responses, revealing how sociocultural norms and operational barriers intersect during times of crisis. We identified opportunities to assist women leaders through the recognition and promotion of different leadership styles, establishing a support network for women, and addressing systemic and organizational barriers that impact women.

Australia’s Indo-Pacific Centre for Health Security joined the Global Outbreak Alert and Response Network (GOARN) to contribute to global operations to enhance health security, preparedness and response to infectious disease outbreaks and other health emergencies. This perspective provides as an example for current and potential GOARN partners.

This Perspective is written by participants and a training faculty member in the GOARN Tier 2 outbreak scenario training held in New Delhi, India, in 2022, hosted by WHO’s Regional Offices for South-East Asia and the Western Pacific. It provides a general overview of the GOARN outbreak scenario training programme, participants' perspectives and suggestions for future programmes.