Good afternoon ladies and gentlemen,

This press conference has been organized to again outline the Ministry’s response in combatting the spread of Men-C in Fiji and provide an update on the procurement of the vaccinations for Men-C Infection.

Situational Report on the meningococcal C outbreak, Fiji

The Ministry of Health and Medical Services confirms that there are a total of 58 cases reported from January 1st to April 22nd, 2018. Of these, 24 are laboratory confirmed, and 34 are either suspected or probable cases based on clinical diagnosis by a doctor.

Of the total 58 cases, 38 have been from the Central Division, 17 from the West, 2 from the North, and 1 from the Eastern Division. Males account for 66.7% of cases, and females 33.3%. As of April 22nd, all confirmed cases were below 19 years old.

There have been four confirmed deaths from meningococcal disease this year. All these deaths have been in the age group less  than  5  years.  There  have  been  no  deaths  from meningococcal disease reported in the last five weeks, since the outbreak was declared. And we thank the general public for adhering to the preventatives messages that the Ministry has been putting out through mass media advertising and awareness campaigns. Indeed with no deaths recorded within last 5 weeks, it shows that the general public has been responsive to the awareness messages conveyed through various communication channels.

On that note, I would like to express my sincere gratitude and appreciation to the National Meningococcal Taskforce, whose membership includes: paediatric, internal medicine, intensive care unit, pathology, and emergency medicine consultants and heads of departments, and infection prevention control officers, and medical superintendents of the Divisional Hospitals; the Deputy Secretary Public Health, Divisional Medical Officers, Suva Subdivisional Medical Officer, National Advisor Family Health, Director Epidemiology, National Advisor Environmental Health, National Advisor Communicable Disease; A/Director Fiji Pharmaceutical and Biomedical Services; representatives from the School of Public Health at the Fiji National University College of Medicine Nursing and Health Sciences (CMNHS); the Pacific Community (SPC); the Fiji Program Support Facility; and the World Health Organisation (WHO). The Fiji General College of Practitioners has also sent representatives to Taskforce meetings.

In addition to the Taskforce, the Vaccine Preventable Disease Committee, led by the National Advisor Family Health, and including the National Expanded Program on Immunisations Coordinator, and the Divisional Directors of Nursing, has also spearheaded planning and procurement of the vaccine through consultations with UNICEF.

Furthermore, the World Health Organisation’s Office in the South Pacific (WHO- SP), based in Suva, has been a key member of the Taskforce from the very beginning. And through WHO-SP we have also had the opportunity to consult, via teleconference, with health authorities in other countries that have been through similar outbreaks, as well as other international health organisations. We would also like to thank DFAT  for their tremendous assistance given during the consultation process during this outbreak.

The Ministry continues to intensify its public health awareness and closely monitor the reported cases. We have also captilised on the targeted awareness opportunities through last week’s Coca Cola Games, during which our team was also involved in the promotion of public health measures and awareness, zone nurses and health inspectors were also available at the game site providing education and information materials to participants. An informational video was also played on the big screen at the Games. Similarly, this week, we have teams at the divisional youth and sports conference held at the Lelean Memorial High School to raise awareness on combatting the spread of Men.C.

The appropriate antibiotics are available in all divisions and subdivisions, and all suspected cases have been referred to Divisional Hospitals.

Rollout of  national mass  immunisation campaign for ages 1 to 19 years

In terms of the further progress plans, the Ministry of Health and Medical Services has committed to the rollout of National Mass Immunisation Campaign for 333,876 within the ages 1 to 19 years. The vaccination program will target meningococcal C because this is the type of bacteria that is causing this outbreak.

The decision by the Ministry of Health and Medical Services to rollout the Mass vaccination for 1-19 year olds has been based on  the  consultations, extensive  review  of  the  evidence  on international best practice for response to outbreaks of meningococcal disease.    This  vaccination  program  has  the following objectives:

  1. Protecting those most at risk of disease (children under the age of 5, and teenagers).
  2. Protecting those most at risk of dying from the disease (children under the age of 5).
  3. Reducing spread of the disease by lowering the amount of people in the community that carry the bacteria, causing what is known as ‘herd immunity’.

The latest case information shows that the vast majority of cases recorded this year have been in the under 19 age group, with close to 40 percent under age 5. All the deaths this year have been in the under 5 age group. Thus, individuals under 19 years old are the most at-risk for getting the disease and they need to be protected. They are also known to be the biggest age group that spread the bacteria, likely for behavioural reasons.

Vaccinating the 1-19 age group against meningococcal C has been shown in other countries (e.g. Australia) to greatly reduce the cases of meningococcal C in all age groups, and most importantly in babies <1 year of age (who will not get the vaccine because of reduced effectiveness with immature immune systems).

Vaccine Rollout

Since the outbreak declaration on March 20th  2018, Taskforce has been working tirelessly to secure the procurement of the

Men. C Vaccine. Within a month through its prompt response, the Ministry was able to secure confirmation from International Coordinating Group for Vaccine Provision for Epidemic Meningitis Control (ICG) that we would have access to the vaccines required to vaccinate everyone from the ages of 1-19 years during this outbreak.

Upon confirmation received on the April 20th  2018, we are expecting the first batch of vaccines to arrive on the 4th  May 2018. This has been an intensive process, complicated by the fact that access  to  this  stockpile  is  usually  prioritised  for outbreaks of meningococcal disease in the African Meningitis Belt, and for low income countries (based on Gross National Income per Capita- GNI) – which Fiji is not. However, the Ministry made every effort in its power to ensure this application was successful.

The Government made the promise to vaccinate everyone from the age of 1 to 19years.   There has been “NO DELAYS” since the rollout of the immunisation campaign is planned to begin on the 14th of May 2018.

In addition to this procurement process, supplies of Men C vaccine are limited on the world market, and it would have been extremely difficult, and much costlier, to procure this massive amount of vaccine by any other means.

Vaccination campaign rollout

The conjugate monovalent Men C vaccine is safe and effective, it has been licensed for use in countries like Canada, United Kingdom and Australia since the late 1990s. The rollout of the immunisation campaign will commence within days of the arrival of the vaccines. Initial rollout will be in the Central and Ra subdivision in west. It will continue until all the individuals within the target age group across Fiji have received their vaccination.

Children attending schools will be vaccinated at their primary/secondary schools and kindergartens. Those children who might miss the vaccination at schools are required to go to their nearest healthy facility which will be having a dedicated teams to provide the vaccination. So we are encouraging every parent, guardian and community at large to make good use of this opportunity.

While for individuals at tertiary level, working or staying home and are within the targeted age group can get vaccinated at their nearest health facility. The Ministry will continue to provide more information on the vaccination rollout through media advertisements and awareness.

Meanwhile, we have emphasised earlier that vaccination is just one part of the strategy to combat this outbreak. The other components of the prevention strategies have continued throughout the outbreak i.e. enhanced surveillance and early case detection, early treatment, contact tracing, and prevention (public awareness).

We continued to reiterate that the public continues to play an important role through recognising possible early symptoms and going early to a health facility to be checked, and employing basic hygiene (washing hands with soap and water, coughing into a handkerchief/tissue, not sharing drinking cups/glasses/bottles) to prevent the spread of the bacteria.

Dengue Update

Just on the dengue update, we have so far 3197 confirmed dengue cases recorded so far this year. There is a downward trend in all the divisions. The breakdown of cases by divisions as follows: Northern is 1443, Western is 908, central 825 and eastern is 21.  As such we thank the general public for their continued support in our efforts to combat dengue and we would like to encourage them to continue to practice the preventative measures to prevent themselves and their families from Communicable Diseases.

Media Responsibility on Fair/Accurate Reporting

So, ladies and gentlemen, those are the facts of the situation. We are dealing with this issue responsibly and effectively, in consultation with international experts who have helped us craft the most effective response strategy possible. And, as of tomorrow, we are going to have the vaccines in hand to begin the nationwide vaccinations to combat the spread of Men-C in Fiji.

It has been unfortunate to see various political parties attempt to seize on this issue for their own political purposes, by making deeply irresponsible and unsubstantiated commentary. They’ve caused public confusion and they’ve created misplaced anxiety and fear among our people on a very important issue that pertains to public health and wellbeing.

At every stage of our management of this issue, the Ministry has been clear and transparent, and we’ve provided critical information that has helped protect our people from the spread of this disease. That is what we are focussed on, and I suggest that members of the other political parties focus on the same. We all owe it to our people to only speak the truth, because when it comes to public health, the truth saves lives.

The Ministry has reached out to media organisations and sought their support in  protecting the  people of  Fiji,  by  providing truthful, accurate and scientifically valid information on vaccines and vaccination. It is essential that communities maintain their confidence and trust in the vaccination programme as a whole, because it is safe, and it will be very effective in combatting the spread of Men-C.

Instead of spending time enabling the spread of false information from certain political parties, we ask that members of the media practice professional and responsible reporting to raise awareness of the importance and the safety of vaccines. Every minute you spend enabling false information that you fail to make sure is true or accurate is a minute spent playing with Fijian lives. This is not the time for politics, lies or for sensationalising. The Fijian people deserve much better.

Here in this Ministry, we are going to keep doing our jobs to help protect the Fijian people from the spread of diseases like Men- C. We aren’t deterred by political attacks that attempt to undermine our work, because we are here to serve the best interests of all Fijians at all times. That is always our mission.

Thank you.