Judith Gafa is the first Samoan to participate in the World Health Organization’s (WHO’s) Field Epidemiology Fellowship Programme (FEFP) in the Western Pacific Region. Through the programme, epidemiologists like Judith strengthen their skills in collecting, analyzing and interpreting surveillance data in response to infectious disease outbreaks. FEFP fellows introduce new tools and standardized approaches to disease surveillance and response within their respective country contexts, underpinning efforts to contain and eliminate outbreaks before they become epidemics.
Since 2006, this Programme has worked to strengthen countries’ capacities for surveillance and risk assessment by building a workforce to tackle public health emergencies. The Programme upskills national epidemiologists in critical data gathering for action. Given that alumni from the Programme are embedded within national health security systems, they’re able to directly and sustainably contribute to managing national health emergencies.
WHO's Field Epidemiology Fellowship Programme is supported by the Government of Japan. Speaking to the value of the Programme, Gina Samaan, Regional Emergencies Director, WHO Regional Office for the Western Pacific said: “The Field Epidemiology Fellowship Programme is a shining example of capacity-building, shared learning and networking. I am grateful to the Government of Japan for their support for this important work. It supports our Region to strengthen health security by building resilience and solidarity.”
Judith, like most fellows in the Programme, has seen her share of national emergency responses. “I was part of the team that identified the first community case of measles, during an outbreak in 2019. It is an experience I’ll always remember,” she said. Yet, despite previous hands-on experience, Judith notes key take-aways from her emersion in the programme that will enable her to further strengthen Samoa’s surveillance and response capacities. These include the importance of employing a systematic approach to risk assessment during an emergency.
Systematically assessing risk to public health
WHO advocates for a structured approach to assessing risk by looking at available health data, the local context, and asking a series of key questions. This helps decision makers to make quick and informed decisions on the interventions needed to protect people’s health. The COVID-19 pandemic and severe acute respiratory syndrome (SARS) epidemic underscored the critical role of surveillance during an emergency response. Countries were able to detect, monitor and assess the transmissibility, severity and impact (TSI) of variants and tailor their response efforts accordingly.
WHO works to train national public health professionals across the Region on TSI assessment—advancing national and sub-national surveillance capacities as prioritized under WHO’s Asia Pacific Health Security Action Framework (APHSAF). Judith benefitted from a Training of Trainers workshop that WHO conducted for fellows with the Western Pacific Epidemiology Fellowship Programme. During this training, Judith was introduced to WHO’s initial risk assessment tool that promotes a standardized way of assessing a risk prior to an event.
Reflecting on the value of this systematic approach to assessing risk she shares: “This approach could have supported our response during to the measles outbreak in Samoa. We could have improved the synthesis of surveillance data into actionable evidence to better align with public health messages that were developed and disseminated through the media.” Judith plans to introduce the Risk Assessment tool in Samoa and initiate a standardized way of reporting on events in the country. “The right kind of data can prompt the right public health actions,” she adds.
Strengthening national surveillance teams
In 2023, Samoa completed its first Joint External Evaluation (JEE) of the national capacities required by the International Health Regulations 2005 (IHR). JEEs help countries assess their national capacities to prevent, detect and respond quickly and well to public health risks. Findings from the JEE in Samoa noted the need for more robust surveillance capacities through recruiting and training national epidemiologists.
“I’m grateful for this experience and the opportunity to build skills in surveillance that I can take back to Samoa. I hope other epidemiologists in Samoa can have access to this training and exposure, so that we continually build our capacities,” Judith shares.
The WHO Samoa Country Office works closely with the Ministry of Health Samoa’s surveillance team supporting its surveillance activities including as a member of the Health Emergency Operating Committee (HEOC) during the Measles outbreak and COVID-19 pandemic. ‘We are pleased that Ms Gafa has been afforded this opportunity to enhance her skills in this area, which will strengthen her contribution to, and the capacity of, Samoa’s small surveillance team’, noted Dr Kim Eva Dickson, WHO Representative for Samoa.
Enabling the transfer of insights and learning across the Western Pacific
As a result of WHO’s Field Epidemiology Fellowship Programme (FEFP) in the Western Pacific Region, not only do national epidemiologists learn from the programme—they also learn from each other, and they contribute to strengthening the work of WHO. Over time, FEFP has established a network of trained epidemiologists across the Region and enabled pathways for cross-learning.
Emphasizing the value of this cross-learning, Judith shares: “It was incredible to hear how epidemiologists from other Pacific islands were able to overcome similar challenges and create pathways for better surveillance. I was so inspired by a fellow from Vanuatu who with the support of her Ministry of Health and over time has built a very strong national surveillance team. I look forward to implementing the tools and practicing the skills I’ve learned and thereby contribute to strengthening our approach to surveillance. Hearing the stories of other fellows, I can see how we will also get to where we need to be in the future. The future is bright.”