title: Health status and epidemiological capacity and prospects: WHO Western Pacific Region.
abstract: BACKGROUND
  This article on the state of epidemiology in the WHO Western Pacific Region (WPR) is the first in a series of eight articles commissioned by the International Epidemiological Association (IEA) to identify global opportunities to promote the development of epidemiology.
  
  
  METHODS
  Global mortality and disease data were used to summarize the burden of mortality, disease, risk factor and patterns of inequalities in the region. Medline bibliometrics were used to estimate epidemiological publication output by country. Key informant surveys, Internet and literature searches and author knowledge and networks were used to elicit perspectives on epidemiological training, research, funding and workforce. Findings The WPR has the lowest age-standardized disability-adjusted life-years (DALY) rate per 1000 of the six WHO regions, with non-communicable disease making the largest percentage contributions in both low- and middle-income countries (LMICs, 68%) and high-income countries (HICs, 84%) in the WPR. The number of Medline-indexed epidemiological research publications per year was greatest for Japan, Australia and China. However, the rate per head of population was greatest for Micronesia and New Zealand. The substantive focus of research roughly equated with burden of disease patterns. Research capacity (staff, funding, infrastructure) varies hugely between countries. Epidemiology training embedded within academic Masters of Public Health programmes is the dominant vehicle for training in most countries. Field epidemiology and in-service training are also common. The Pacific Island countries and territories, because of sparse populations over large distances and chronic workforce and funding capacity problems, rely on outside agencies (e.g. WHO, universities) for provision of training. Cross-national networks and collaborations are increasing.
  
  
  CONCLUSIONS
  Communicable disease surveillance and research need consolidation (especially in eastern Asian WPR countries), and non-communicable disease epidemiological capacity requires strengthening to match disease trends. Capacity and sustainability of both training and research within LMICs in WPR are ongoing priorities. China in particular is advancing quickly. One role for the IEA in building capacity is facilitating collaborative networks within WPR.
authors.affiliation: Health Inequalities Research Programme, University of Otago, Wellington, New Zealand. tony.blakely@otago.ac.nz
authors.forename: Tony
authors.initials: T
authors.lastname: Blakely
authors.forename: Frank
authors.initials: F
authors.lastname: Pega
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Robert
authors.initials: R
authors.lastname: Beaglehole
authors.forename: Liming
authors.initials: L
authors.lastname: Lee
authors.forename: Colin Fonotau
authors.initials: CF
authors.lastname: Tukuitonga
mesh_terms: D001208:Asia / Q000453:epidemiology; D044362:Australasia / Q000453:epidemiology; D015706:Bibliometrics; D057191:Capacity Building; D002908:Chronic Disease / Q000453:epidemiology; D003140:Communicable Disease Control; D003141:Communicable Diseases / Q000453:epidemiology; D003906:Developing Countries; D004813:Epidemiology / Q000193:education; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D011159:Population Surveillance; D015980:Public Health Practice; D012952:Societies; D012959:Socioeconomic Factors; D000078329:Workforce; D014944:World Health Organization