Epidemiologists Justine Marshall and Jonathan King were unsure of what to expect for their debut deployment through WHO’s Global Outbreak Alert and Response Network (GOARN). When they landed in Fiji, the gravity of the mission dawned on them: reinforce national surveillance and diagnostic capacity in the face of an HIV outbreak.
Amid the urgency to amplify response efforts, Fiji’s Ministry of Health and Medical Services (MHMS) tapped into GOARN’s global roster for rapid technical surge support.
Justine and Jonathan had been aware of GOARN for many years and admired the mechanism of sourcing and deploying experts globally at short notice. So, when they saw this request for assistance, they did not hesitate to step up to the challenge.
GOARN deployment in action – from observation to collaboration
In their first week, they embedded themselves with the national HIV program to understand how case data was being collected and verified across facilities.
During their deployment they travelled to 3 divisions to visit health centres, hospitals, sexual and reproductive health clinics, labs, and a prison to assess and identify bottlenecks to co-design solutions together with frontline workers.
They quickly discovered that the greatest impact wasn’t just unlocking potential and capacity building, but it was helping to build something far deeper – trust.
Being on the ground helped to build dynamic partnerships. Jonathan said, “things can change by the hour. [Being in country means] you can be agile, adjust and adapt to these changes with partners close at hand.”
Justine revealed that “you have to be patient, good at listening – to what is spoken and what is unspoken – and ready to adjust your approach. The relationships with local counterparts are genuine two-way exchanges, you learn as much from them as they learn from you.”
Data driving change – a legacy of learning
One of the most memorable moments for Justine was leaving behind skills to unlock the power of data. “I spent one morning with a frontline clinician to share some practical skills that would allow her to rapidly analyze data she had meticulously collected and stored.
“This was not only critical to see what the data could tell her about the outbreak and inform real-time decisions, but also that these skills could be shared with her colleagues in the future.”
Justine expressed that “data collection can feel like a black hole when you don’t get meaningful outputs. The sheer volume of data can be overwhelming, and it can be hard to know where to start with any analysis.” She hopes that people who collect data can see the value and impact of their efforts.
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Capacity building with frontline health workers at Savusavu Hospital. Credit: WHO/Matthew Shortus
Toward timely, dignified HIV care to meet people where they are
People need timely and convenient access to HIV services – for both diagnosis and treatment – to safeguard against losing people along that care pathway and to reduce transmission.
For this to happen, decentralizing HIV testing, care and treatment so that services are accessible and community focused is vital due to the stigma and discrimination associated with testing positive for HIV.
But decentralization comes with its drawbacks. It calls for comprehensive coordination and a standardized approach so that data can be swiftly interpreted to produce meaningful information.
With Justine’s and Jonathan's help the National HIV Program is working hard to standardize data collection tools and systems across Fiji, which reduces the burden on frontline staff.
In doing so, ensuring high quality data can be easily turned into actionable insights, like tracing people living with HIV quickly so that they receive care and treatment. This also frees up frontline workers to provide quality care services without delay.
Global solidarity meets local readiness, shared investment and strength
No single institution has all the capacity to respond to an outbreak. Through GOARN, experts are available when international surge capacity is requested.
The Pacific and GOARN have a symbiotic relationship – learning from one another through deployments spanning outbreaks of cholera, dengue and zika to measles and polio, as well as after disasters like Cyclone Winston. The robust surveillance and epidemiological capacity developed by Justine and Jonathan will leave a legacy for the Region’s HIV response
“When neighbouring partners stand with us, we’re better equipped to lead sustainable responses rooted in local expertise,” said Dr Jason Mitchell, Chairperson for the National HIV Outbreak and Cluster Response Taskforce.
“What matters the most is the partnership. GOARN experts didn’t come to take over – they listened, learned, and strengthened systems alongside our teams. Justine and Jonathan have made a lasting footprint in the HIV response, and we’re grateful to GOARN and WHO for making this possible."
Such deployments not only help fill urgent gaps but also elevate institutions’ roles in the global health ecosystem, deepening their own readiness while contributing to shared preparedness and response goals.
Professor Anthony Kelleher, the Kirby Institute Director recognizes the need for and the value of global collaboration. “Supporting GOARN deployments allows our team to gain invaluable experience whilst contributing to outbreak response; this is all the more meaningful when this support is in our Pacific neighbourhood.”
Professor Kelleher continues, “As an institution, I’m proud to be part of GOARN – not to be perceived as a band-aid solution during emergencies – but one that leaves the silhouette of stronger systems and relationships.”
For experts, this wasn’t a solo mission, and they highly recommend others to follow in their footsteps and to leap at the opportunity. Justine adds, “I would 100% deploy again. The support from WHO and the GOARN team to coordinate the deployment, get us in country quickly and set up with the contacts required to get the work underway has been brilliant.”
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GOARN experts, Justine and Jonathan, at Twomey Hospital in Tamavua, Fiji. Credit: Ministry of Health and Medical Services.
The HIV response is a health priority for WHO, working in close collaboration with the be Government of Fiji and key partners, including Australia’s Department of Foreign Affairs and Trade, UNAIDs, and United Nation’s Development Programme.