Control and elimination of lymphatic filariasis in Oceania: Prevalence, geographical distribution, mass drug administration, and surveillance in Samoa, 1998-2017.

Lymphatic filariasis (LF) is a major public health problem globally and in the Pacific Region. The Global Programme to Eliminate LF has made great progress but LF is persistent and resurgent in some Pacific countries and territories. Samoa remains endemic for LF despite elimination efforts through multiple two-drug mass drug administrations (MDA) since 1965, including renewed elimination efforts started in 1999 under the Pacific Programme for Elimination of LF (PacELF). Despite eight rounds of national and two rounds of subnational MDA under PacELF, Samoa failed transmission assessment surveys (TAS) in all three evaluation units in 2017. In 2018, Samoa was the first to distribute countrywide triple-drug MDA using ivermectin, diethylcarbamazine (DEC), and albendazole. This paper provides a review of MDAs and historical survey results from 1998 to 2017 in Samoa and highlights lessons learnt from LF elimination efforts, including challenges and potential ways to overcome them to successfully achieve elimination.

Achieving UHC in Samoa through Revitalizing PHC and Reinvigorating the Role of Village Women Groups.

The increasing prevalence of NCDs such as cardio-vascular diseases, diabetes and kidney failure represents a threat to sustainable development in Samoa. The aim of this commentary is to describe the important role played by women in the community in relation to public health and to detail the lessons learnt and results of a community-based NCD prevention and management package that utilizes the strengths of community engagement at primary care level to accelerate progress towards UHC. The impetus of reforms in Samoa is to strengthen community-based care and rebuild its foundation-Primary Health Care (PHC). In doing so, the government is reinvigorating the role of women's village committees in identifying and referring people with high risks factors for non-communicable diseases. In 2015, an attempt to reinvigorate the role of Komiti Tumama in health was undertaken to address the high burden of non-communicable diseases. The government together with WHO launched a demonstration project, "NCD early detection and self-management through community participation (PEN Fa'a Samoa)", which aimed to address key issues on NCDs through an approach of contextualizing universal health coverage. Preliminary results of the program implementation are positive. PEN Fa'a Samoa achieved a high level of population screening coverage in the demonstration villages, in which the women's committee representatives played a key role. Samoa has shown in this example how such action can strengthen its health system, by utilizing critical human resources at a community level, which have proven to be essential to support the functioning of health services.