Biomed Engineering Workshop 28th Sept, 2019

Sunil Chandra No Comments

Bula vinaka and a very good morning to you all!
 I am delighted to be here this morning to officiate in the opening of this Biomedical Engineering Workshop and I thank the organizing committee for the invitation.
 I also take this opportunity on behalf of the Government and the Ministry to welcome all participants that have travelled all the way from the Northern, Western & those from within the Central Division and I hope that you will enjoy the company of your fellow colleagues
 The timing of this workshop is just right considering the demanding need for improvement in our service delivery, patient care, and it is important for you to note that the Ministry is undergoing valuable structural adjustments with its processes as we aspire to inculcate the objectives of Universal Health Coverage as a strategy to improve the quality of life and increase longevity for all Fijians.
 Ladies and gentlemen, the Biomedical profession has evolved over the years since the initial set up in 1989 through the Australian Staffing Assistance Scheme. It started with 5 staff but now we have a total of 29 staff operating in the 3 major Hospitals in Suva, Lautoka and Labasa and I am here to tell you that the Government recognizes and values your contribution towards our health sector. This show of commitment by the Government has seen the creation of an additional 8 new positions in 2018.
 The Biomedical unit plays a pivotal role in patient care, by ensuring the availability of equipment’s and overseeing its proper maintenance. The inventory of the equipment for Fiji’s health care system has vastly increased over the years and now sits at 7,159 in 2019 and the Government of the day continues to commit and invest through the budgetary provisions such as the increase in the spare parts allocation from $500,000 in 2017 to $1.5million in 2019. In addition, there is also the budget provision of $5.5m provided for the purchasing of equipment.
 Moreover, there is a growing demand for new technology to improve patient care, and the Government is keen to audit and remove aging equipment and furnish our health care facilities with new state of the art equipment in the next 5 years. Examples are the MRI Scan at CWM hospital, the PAC system, Dialysis and Laboratory Equipment, etc.
 Most equipment nowadays are highly complex and technologies are ever evolving, therefore it demands a high level of knowledge and skills to provide precise designs, standards, and environmental condition for proper functioning, at the same time considering the intricate logistics and lowering overall cost.
 Having said that, I strongly believe that the Ministry though the Biomedical unit can pursue better outcomes to improve our service delivery if we work in a smart and effective manner. I am told that the Biomedical profession now has a very dynamic workforce and I believe in each and every one of you to raise the bar in terms of service delivery. The future of this profession is in your hands now and you must endure to maintain the professionalism and integrity of your profession and our Ministry.
 On that note, I wish to acknowledge and thank you all for your continuous effort and for taking extra steps in ensuring that equipment’s are repaired and service restored for the betterment in the delivering of our health care services.
 Ladies and gentlemen, the exchange of experiences and ideas in today’s workshop is very important in achieving the desired goals of this workshop. I trust that you will have healthy deliberations and that you will identify innovative ways to accelerate our aspirations of achieving the objectives of UHC.
 Once again, thank you for the invitation and may you all have a pleasant weekend.

Vinaka vakalevu

Chemical society of the South Pacific- Annual Awards Ceremony 2019

Sunil Chandra No Comments


 Secondary school students & teachers from around Fiji.
 USP Chemistry and Biology Staff members.
 Chemical Society of the South Pacific members and volunteers.
 Partners including Vodafone representative

 A very good afternoon to you all and I am absolutely delighted to be here with you not only as your chief guest but also as a former student in the field of sciences. I wish to thank the organizers of this event for the invitation and I must commend them for their efforts in organizing this competition.
 I understand that participants for this competition was selected after a series of preliminary rounds with over 4000 students throughout locations in Fiji and before me today are the very best OR shall I say, the best Chemistry students in Fiji! Congratulations for making it this far!
 The Chemical Society of the South Pacific has done a marvellous contribution to the region since 1985 and I applaud their continuing commitment in the general advancement of chemical science and its application to the South Pacific
Fellow students of science
 Chemistry is an ever growing science today! Understanding basic chemistry concepts is important for almost every profession. You will often hear your teachers say that Chemistry is part of everything in our lives! They are absolutely correct! Every material in existence is made up of matter — even our own bodies. Chemistry is involved in everything we do, from growing and cooking food to cleaning our homes and bodies to launching a space shuttle[1]. Chemistry is one of the physical sciences that help us to describe and explain our world.
 This competition has not only provided a competitive experience between the schools and students but you have made friends and you have broadened your horizons in the science of chemistry. What you have learnt and done over the past two and a half months will be an inspiration to aspiring science students. You have all come this far because you have put in a lot of time and effort in perfecting your understanding of the natural science that deals principally with the properties of substances, the changes they undergo, and the natural laws that describe these changes[2].
 And as the Minister of Health and Medical Services, I encourage you to maintain this competitive edge and pursuance of excellence throughout your life BUT best of all, be a lifelong learner in all the field of sciences.
 Our nation needs people who are exceptional in the fields of science such as chemistry. Advancements in the field of chemistry have brought about major improvements in our world. Improvements range from new medicines that cure disease, to new materials that make us safer and stronger, to new sources of energy that enable new activities.
 Let me remind you, that the ever changing world is throwing up challenges such as natural disasters, man-made disasters and the impacts of Climate Change. Bright minds like those of you here today will be needed to come up with innovative ideas and develop a future that is safe and sustainable for generations to come.
 That is one of the reasons why your Government of the day is investing a lot in your education through the Toppers and TELS scholarships. These scholarships are earmarked to support your transition from high school to tertiary education without putting a financial burden on your families. Importantly, the Toppers scholarship is intended to reward brilliant minds like you here today so that you can pursue your dream job and later on contribute to the development and advancement of our beloved nation.
 On that note, I must commend the teacher’s efforts and time invested in preparing Fiji’s future that is represented here today. Every successful person today can say that in their lifetime they were taught buy an awesome and wonderful teacher. Teachers, your commitment so that these schools and students can be represented today is acknowledged!
 To the sponsors and the Chemical Society of the South Pacific, please continue fostering and encouraging the growth and application of chemical science in Fiji and the South Pacific so that our region can also become a haven of knowledge in the field of sciences.
 To the participating schools and students! Winning or not does not define you or the school you represent, but the mere fact that you are here for the finals is testament of how hard you have prepared yourself. Whatever the outcome may be, please hold your head high and be proud of who you are and who you represent. Let this day be the beginning of your journey in seeking knowledge so that come next year you are better prepared for the competition.
 On that note I wish the students the very best in your exams for this final term of the year and I congratulate you again for making it to the finals!
Vinaka vakalevu

[1] Live Science, What is chemistry
[2] University of Idaho, What is Chemistry

KEYNOTE: Asia-Pacific Parliamentary Forum on Global Health Pullman Nadi Resort – Thursday 22 August 2019.

Sunil Chandra No Comments

BULA VINAKA and a warm welcome to this important side event on Tuberculosis.


Ladies and Gentlemen, the global burden and scourge of TB continues to prevail. The global data that WHO reports annually affirms that, TB remains among the top 10 causes of death worldwide and is the leading cause of death for all infectious disease categories. The report estimates that 3 people die from TB every minute worldwide which tallies to approximately 1.6 million deaths annually.

Just to reflect on information we already know about TB; it is caused by the Mycobacterium tuberculosis bacteria. TB is spread through air when a well person through suspended infectious droplets when a TB infected person coughs or sneezes it allows infectious droplets to be suspended in the air long enough to then be inhaled by an uninfected individual(s).

TB is diagnosed via an array of WHO-recommended laboratory tests and imaging techniques that are feasible and provide highly valid results. The disease is curable, and effective Directly Observed Treatment Supervision (DOTS) intervention is available which involves taking a number of antibiotics continuously and devotedly for a minimum of 6 months.

TB is not new to Fiji, it has been causing disease, claiming lives and exacerbating poverty amongst Fijians since it was identified earlier on during the colonial era.

Until the 1960’s, Fiji was a TB high-burden country. Following the second world war, in the late 1940’s, TB incidence and mortality in Fiji was at its peak so, in 1951, Fiji’s colonial government established the TB control program, with country-wide screening of individuals largely with the use of chest X-rays and the follow on (Twomey) hospital isolation and treatment of identified cases using effective anti-TB therapy.

The use of sputum positive lab diagnosis to confirm TB cases was minimal (approx. 19% TB cases were confirmed with sputum microscopy) at the start but improved tremendously from 1985 onwards and is now the mainstay for TB diagnosis in Fiji. Between 1951- 2010,      approximately 14,500 cases were registered at PJ Twomey Hospital. There was a substantial drop in TB caseloads in Fiji in the 1960’s       attributed to intensified campaigns of community-driven screening and treatment interventions of the disease. The DOTS strategy was adopted by the National TB Control Program (NTP) in 1997 and since then there have been sustained efforts to reduce the burden of TB in Fiji.

The TB case notification for Fiji underwent a cyclic trend from the year 2000, until 2009. In 2010, when Fiji became a recipient of the Global Fund for Control of TB, HIV/AIDS & Malaria (GFATM) until 2018, the TB case notification rate stabilized at around 49 per 100 000 population. The prevailing case detection and treatment success rates (TSR) for the country at 95% and 81% are above or close to the internationally recommended targets of 70% and 85%, respectively. With the current case notification rates, Fiji is currently categorized as a low burden country, which is an outstanding milestone achievement considering the country’s initial TB status in the 1950’s.

Key to the Ministry and its NTP’s progress over the years in achieving its annual objectives of identifying and successfully treating TB cases around the country includes the following:

  1. Increasing awareness on the TB management guidelines for primary health care and community health workers – this has resulted in substantial increases in outpatient numbers of presumptive TB cases
  2. Establishing microscopy diagnostic centers at 6 subdivisional hospitals located in TB high burden and/or hard to reach communities. This is supported by 3 Divisional laboratories that provide geneXpert molecular testing for TB and 1 Mycobacterium National Reference Laboratory that also provides gene Xpert molecular testing in addition to TB cultures, at national level.
  3. Improving the capacity of the Ministry’s workforce to do screening of high risk groups, early referrals, diagnose cases, support treatment in hospitalised and community settings and treating contacts of TB cases prophylactically. This was achieved through local in-service training to community health workers, doctors and nurses, and overseas workplace-based attachments and trainings abroad in TB Control for TB staff. This was supported by the Global Fund as well as Zero TB World Korea under a KOICA agreement for country support.
  4. Intensifying campaign on TB screening for PLHIV (People Living with HIV), Diabetics, Prisoners and Contacts and targeted LTBI (Latent TB Infection) screening for TBT (TB Prophylactic Treatment).
  5. Sustained supply of antituberculous drugs procured from the WHO-sanctioned Global Drug Facility allows for improved accessibility to recommended anti-TB drugs for Fijians. This supply is accessible at all Divisional Hospitals including the National TB Hospital in Tamavua. The Ministry’s investment in the FDC (fixed dose combination) formulary of antituberculous drugs has to an extent, minimized treatment interruption as a result of reduced pill burden during treatment.
  6. Operating a grant scheme that engaged CSOs (Civil Society Organizations), FBOs (Faith-Based Organizations), Youth, Women and Men’s Groups To support community DOTS programme for patients at the community level and also TB advocacy.
  7. Steering a governance structure that guides programme outputs, drive research and innovative strategies, and collaborate on TB drug surveillance and programmatic response to MDR TB (Multidrug Resistant Tuberculosis) has led the NTP to be able to meet the obligations of its commitment to the End TB Strategy, the TB Strategic Plan 2016-2020 and realign strategies to reduce the burden of TB based on disease trends, geographical burden, health seeking behaviour of the population ,and risk factors associated with poor outcomes of death and treatment interruption.

Future plans for the Fiji’s TB control program will focus on formulating and implementing an action plan to bridge the achievement of TB elimination in Fiji, to 10-20 incident cases per 100 000 population, within a 3-5year time frame. The plan will focus on intensive control interventions among high-risk cohorts (such as PLHIV, diabetics and the contacts of known TB cases) in high burden and hard to reach communities. In addition, screening and prophylactic treatment of LTBI will be prioritized. The intermediate and long-term strategic plans of the NTP are underpinned by the principles of UHC (Universal Health Coverage) and the “Healthy Islands” ideals.

As the Ministry drives toward supporting the End TB Strategy it endeavours to ensure all TB cases are well supported by community models of care as compared to hospitalised phases of treatment reflected in the low occupancy rates and bed states in mostly the Northern and Central Divisional DOTS centres in Labasa Hospital and Tamavua Twomey Hospital. This allows them to complete treatment at home at the earliest without facing treatment interruption, provide necessary social welfare benefits and develop the capacity for individuals to be TB control advocacy champions in the homes, schools, workplaces and communities rendering early referrals of presumptive cases, support other persons on treatment in the community and advocate for hygienic and social practices to prevent disease transmission.

With regards to TB surveillance, the establishment of the TB information system for use in all the Ministry’s divisions will enhance the notification and the public health response process. Upscaling of laboratory capacity is also earmarked to enable Whole Genome Sequencing to genotype TB strains and drug susceptibility profiles for Fiji and perhaps for the region as well. The possibility of establishing a training center for TB control for the region via WHO collaboration is also a possibility. In addition, there are also plans to undertake prioritized research initiatives on TB control so as to guide and inform the formulation of targeted policies and appropriately align strategic approaches for the control program.

With political commitment from Fiji’s government driving concerted and cohesive effort amongst all stakeholders to achieve its action plan, the Fiji TB control program intends to work hard in the coming 3 years to achieve its elimination targets. Fiji anticipates that perhaps the caucus can suggest an appropriate high-level governance and accountability framework to support and guide the fulfillment of such an endeavor at the regional level.

I wish to take this time to thank our local stakeholders, bilateral and multilateral partners for supporting the TB control work for Fiji thus far. I also wish to invite you all to journey with us in the next 3 years towards fast-tracking TB elimination in Fiji.


Thank you all for your attention.