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L e a d e r s h i p , r e s o u r c i n g a n d g o v e r n a n c e they could consider strategies aimed at retaining younger doctors, those concerned about quality of life and training opportunities, and, perhaps very importantly, pay attention to workforce stress. Acknowledgements The authors are grateful to the Medical Council of New Zealand for assisting with the survey research and to the interviewees. The material in this article was presented in a series of lectures in the UK in late-2014 given by Robin Gauld when he was the NZ-UK Link Foundation visiting professor at the School of Advanced Study, University of London. He is enormously grateful to the Foundation for supporting this work. Endnotes 1 In 2014 we invited all UK-trained doctors registered with the Medical Council of New Zealand, who had arrived within the previous ten years, currently practicing and with an active email address, to complete an online survey (n=1354). Fortyseven per cent (n=632) responded; 97 per cent of these completed the survey in full. Respondent characteristics were similar to those of non-respondents. We also interviewed 16 doctors – GPs and public hospital specialists from different locations – selected from around 200 survey respondents who offered to participate in this way. Interviews were recorded, transcribed and analysed for key themes (Rice and Ezzy, 1999). The NZ-UK Link lectures 2015: Professor Michael Baker NZ-UK Link’s 2015 lectures will be given by Michael Baker on the following topics: 1. The 1918 influenza pandemic: lessons for controlling emerging diseases in the modern era. The 1918 influenza pandemic remains the single most lethal natural disaster in recorded human history, with mortality exceeding 50 million people worldwide. In New Zealand (NZ) this pandemic killed more than 8,000 people in two months, which was almost one per cent of the population. This presentation will draw heavily on original research our group has carried out to understand factors that affected influenza mortality in the NZ armed forces. The lecture will also look at the experience of Pacific countries with both successful maritime quarantine (American Samoa) and unsuccessful exclusion (Western Samoa, where more than 20 per cent of the population died during the pandemic). Not surprisingly, these events have left lasting societal memories that are still evident today 2. Why are infectious diseases linked to poverty: Implications for controlling pandemics. Infectious diseases cause a far higher disease burden for those living in relative poverty, and for indigenous peoples and ethnic minorities. These disease gradients apply to both endemic disease and to pandemics. NZ has probably described these gradients better than any country, and begun to investigate the causes and implications for prevention and control of severe infectious diseases. The findings from this work have wide-ranging implications for managing emerging infectious diseases, particularly in a world where more people are living in crowded urban settings than ever before. 3. Stopping pandemic diseases at the border: can it be done? New Zealand’s pandemic plan includes an emphasis on preventing importation of emerging infectious diseases. Professor Baker has led a research programme funded by the US Centers for Disease Control and Prevention (CDC) to investigate the potential for identifying influenza in arriving airline passengers. He was also very actively involved in efforts to improve control measures at the borders in NZ 126 Commonwealth Health Partnerships 2015 during the 2009 influenza pandemic. This work has given NZ some of the best evidence available internationally about what works and what doesn’t in this setting. New Zealand’s focus on border control of infectious diseases is unusual, so this work is likely to be of interest to those involved in international infectious disease control. 4. Early detection of emerging diseases: Surveillance for severe respiratory infections in NZ. Experience and logic suggest that new pandemics will almost certainly be caused by respiratory pathogens (with influenza and SARS being the best examples). Professor Baker developed New Zealand’s infectious disease surveillance systems in his previous work at ESR and is working on implementation of the International Health Regulations (IHR) for the World Health Organization. More recently he has been co-leading a large US CDC-funded programme, the Southern Hemisphere Influenza Vaccine Effectiveness Research and Surveillance (SHIVERS) project, which has established the first site in the Southern Hemisphere to monitor severe acute respiratory infections (SARI). A major reason for such surveillance is to support early detection of emerging pandemics. This lecture would draw on this research to describe the potential for early rapid detection of emerging infectious diseases and the dissemination of these findings. For more information on the NZ-UK Link Foundation, visit www.nzuklinkfoundation.org MICHAEL BAKER is the professor of public health at the University of Otago in Wellington, New Zealand, and co-director of the He Kainga Oranga/Housing and Health Research Programme. He is also the director of continuing professional development for the New Zealand College of Public Health Medicine (NZCPHM) and co-director of the Public Health Summer School.


Commonwealth Health Partnerships 2015
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