The dust has now settled on what has been a historic moment that saw Samoa successfully hosting the Commonwealth Heads of Government Meeting (CHOGM) from 21 to 25 October 2024 – the first Pacific Island to host such a gathering.
Months of preparation by the CHOGM Task Force ensured the health and security of thousands of delegates from 56 Commonwealth member countries who attended this meeting.
Building upon the progress made in Rwanda at CHOGM 2022, leaders deliberated on issues pertinent to their countries, including global economic, environmental and security challenges. They also discussed how Commonwealth countries could work together to build resilience, boost trade, innovation, growth and empower its 1.5 billion young people to inherit and co-create a more peaceful and sustainable future. Also flagged during CHOGM was the critical issue of noncommunicable diseases and mental health and the need for planning to meet this ongoing challenge in the Pacific.
From a health perspective, enhanced disease surveillance was put in place and continues even after all participants have departed. This event was successful and unfolded without incident, thanks to the leadership, commitment, and tireless work of the CHOGM Health, Emergency and Security Services (HES) subcommittee members, chaired by the Director General of Health, Professor Aiono Dr Alec Ekeroma. The Ministry of Health (MOH), responsible for CHOGM’s medical and public health emergency response, embarked on extensive and meticulous preparations months in advance, building upon lessons learned from the 2019 measles outbreak and COVID-19 pandemic response. This resulted in an effective public health response before, during and after CHOGM, which secured the health of visiting delegates, Samoans, and other visitors.
Given the small size of the health workforce in Samoa, the MOH collaborated with and integrated the skills of key health partners into its operations throughout the planning and response process. Partners such as the New Zealand Medical Assistance Team (NZMAT), UNICEF, The Pacific Community (SPC), and the World Health Organization (WHO) helped to extend and strengthen the public health capacity needed for responding to a mass gathering like CHOGM, where the potential for diseases and other risks may be magnified.
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The Ministry of Health’s Samoa Emergency Medical Assistance Team (SEMAT) join forces with the New Zealand Medical Assistance Team (NZMAT) to provide ample clinical support during CHOGM. Photo: WHO/Lepaitai Blanche Hansell
The WHO supported the MOH surveillance team to assess and identify all potential local and imported risks and to develop a surveillance and response plan to mitigate them. WHO also trained the MOH’s surveillance, rapid response, clinical, public health and port health teams using virtual and in-person training modalities. Simulation exercises were also conducted to identify and respond to potential risks, particularly measles, dengue, COVID-19, mpox, food poisoning, and natural disasters.
The training sessions tested the robustness of the surveillance and response plan, the teams’ knowledge, their implementation of the plan’s protocols to detect and respond to disease outbreaks, and their general response and readiness for emergencies. The port health teams, for example, refreshed their knowledge, skills and practice by using the screening protocols developed to detect diseases at air and seaports. They also refreshed their knowledge and practice on rapid diagnostic testing gained during the COVID-19 response and for mpox. WHO provided mpox test kits as a preparatory measure although it was assessed as low risk for Samoa.
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The Ministry of Health Samoa and WHO conduct training sessions to refresh the skills of health workers on enhanced surveillance. Photo: WHO/Seona Cha
The Samoa Emergency Medical Assistance Team (SEMAT) was ready to respond to any medical emergencies or disasters, and to support the implementation of the mass evacuation and casualty incident plan if necessary. The team is fully equipped and has undergone several logistics and cache management training and simulation exercises since its establishment in 2021 with the support of NZMAT, Australian Medical Assistance Team (AUSMAT) and WHO.
Risk communication and community engagement (RCCE) mechanisms were also enhanced to ensure the public could access health and general information. The RCCE team, comprised of MOH staff from various departments, was sensitized on the risks identified for Samoa. They monitored social media to pick up any signs of identified health risks, disease outbreaks or disasters in communities. They also managed a hotline set up to receive and respond to queries from the public. Together, these activities augmented the work of the disease surveillance team. UNICEF and WHO also supplemented social listening activities, providing regional and local intelligence.
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MOH staff take in calls via the established hotlines. Photo: WHO/Kolisi Viki
In addition to refresher training for the various health teams, health facilities in Samoa were fully equipped to meet the potential increased demand for services. The CHOGM Ward set up at the Tupua Tamasese Meaole Hospital (TTM) in Apia was well prepared to provide healthcare services to visiting delegates who may have needed urgent care. Medical clinics were also set up to provide medical and First Aid services at 14 CHOGM meeting venues and 17 hotel/accommodation sites. These medical clinics comprised at least one doctor and nurse from the MOH and were supported by medical personnel from NZMAT and WHO.
The various health teams – including surveillance, rapid response, port health, environmental health, laboratory, and RCCE – worked in shifts around the clock. They reported their activities and status updates to the MOH Coordination Team daily for reporting, surveillance, and outbreak management. Daily reports were prepared every morning with up-to-date information and submitted to the Director General of Health for his reporting to the CHOGM HES Subcommittee Task Force every evening.
Thanks to these preparations, no health incidents occurred during CHOGM. Dr Kim Eva Dickson, WHO Representative to Samoa, American Samoa, Cook Islands, Niue and Tokelau, welcomed the collaborative efforts of the health sector, saying, “The months of behind-the-scenes work and seamless coordination between the Ministry of Health Samoa, WHO, and other partners were instrumental in ensuring the safety and well-being of everyone. The public health preparations for this event have set a benchmark for future large-scale gatherings in Samoa.”