Hong Kong Special Administrative Region, China, faced unprecedented challenges during the COVID-19 pandemic. The Government implemented a range of strategies, including compulsory quarantine, physical distancing measures and vaccination programmes. Building on its contingency framework, it remains committed to enhancing preparedness, strengthening surveillance and ensuring coordinated responses to effectively manage future emerging communicable diseases.
This report describes how the Philippines used the World Health Organization’s intra-action review methodology to assess progress in the country’s response to the mpox public health emergency of international concern. It describes the methodology used, the focus areas of the review, and recommendations resulting from the intra-action review.
Problem: Natural disasters increase the risk of communicable disease transmission while disrupting routine disease surveillance systems, leading to delayed detection of outbreaks and weakened public health decision-making during emergency responses. Context: Indonesia is vulnerable to natural hazards, and Aceh Province has experienced recurrent disasters with significant public health impacts. In late 2025, major flooding and landslides affected Aceh Tamiang District, disrupting health services. Field epidemiology support was deployed to strengthen post-disaster disease surveillance during the emergency response. Action: A field epidemiologist strengthened case detection and registration at health posts, standardized disease recording, verified suspected clusters, and established centralized data compilation, analysis and situation reporting via the Health Emergency Operations Centre. Activities were aligned with World Health Organization functions and were adapted to emergency conditions. Outcome: There was substantial disruption to routine health services, with severe damage to 12 of 15 primary health-care centres and the district health office, and moderate damage to two hospitals. Nevertheless, core surveillance functions were maintained during the emergency response, facilitating the reporting and documentation of multiple outbreak-prone diseases, including typhoid, measles and varicella. Surveillance outputs were used to inform timely risk assessment and response actions, including mobilizing laboratory surge capacity to support diagnostic activities. Discussion: Concrete actions translate field data into timely, structured public health responses. Field epidemiologists can help maintain system functionality in resource-constrained emergencies by adapting to paper and mobile tools, synthesizing fragmented data and coordinating directly with laboratory personnel for case confirmation.
Problem: Antiviral therapy for chronic hepatitis B (CHB) reduces morbidity and mortality and improves quality of life. Achieving high levels of adherence is challenging due to multiple barriers, including medication fatigue, stigma, transportation and limited health literacy. Context: Suboptimal adherence to antiviral therapy for CHB is problematic in Kiribati, particularly among high-risk groups including pregnant women and individuals with cirrhosis. Action: During January–August 2025, a community volunteer intervention was initiated on Kiritimati, a remote island of Kiribati, to address adherence to CHB antiviral therapy. Community volunteers were assigned to patients positive for hepatitis B surface antigen who were commencing antiviral therapy and were pregnant or had cirrhosis. During home visits, volunteers provided education and encouraged medication adherence and clinic follow-up. Adherence in the intervention group was compared with adherence in positive patients being treated on other remote islands without the intervention. Outcome: Adherence was measured by medication bottle counts. Outcomes were assessed by overall group adherence and individual adherence >80%. Group adherence was 77.4% (240.5/310.75) in the volunteer intervention group compared with 52.5% (700/1333) in the group without it (P < 0.001). Overall adherence among pregnant women in the intervention group was 89.7% (52/58). Individual adherence >80% was met in 58.8% (30/51) of the intervention group and 34.1% (70/205) in the control group (P = 0.0012). Discussion: Although findings are preliminary and the intervention and control groups were not matched, this pilot suggests community volunteers are a promising intervention to improve CHB treatment adherence in a high-prevalence Pacific island setting. This strategy could also be explored for other chronic conditions where adherence is important.
Objective: This study presents the findings of a joint cholera risk assessment conducted in Eastern Visayas, the region in the Philippines with the highest incidence of the disease in 2022–2023. The study aimed to identify key risk factors, review progress since a 2016 assessment, and highlight persistent gaps in prevention, preparedness and response. Methods: In July 2024, the World Health Organization, the United Nations Children’s Fund and the Philippine Department of Health conducted a joint assessment using a standardized checklist for focus group discussions and interviews across four technical areas: partnership and coordination; epidemiology and surveillance; water, sanitation and hygiene (WASH); and risk communication and community engagement. Epidemiological trends between 2022 and 2024 were analysed, and water samples from wells and refilling stations were tested for Escherichia coli and total coliforms. Results: From 2022 to 2024, 12 284 cholera cases were reported in Eastern Visayas (case fatality rate: 0.5%). Testing showed 100% contamination in Level I and II sources, while 33% of Level III samples tested positive for total coliforms despite no E. coli detection. Partial progress has been made in implementing the 2016 assessment’s recommendations, with good practices in surveillance, water sampling and community awareness, although gaps remain in outbreak response, coordination and WASH access. Discussion: This assessment identified both progress and persistent challenges across the four technical areas. Key limitations were found in the qualitative design and the limited geographical coverage. Conclusions focused on prioritizing the strengthening of national cholera strategies by embedding them within the broader Food and Waterborne Diseases Prevention and Control Program alongside local ownership and equity-focused WASH investments.
