World Scabies Program – Fiji

Status: Active

Health Systems Strengthening for scabies awareness and advocacy in Fiji

The World Scabies Program (WSP) in Fiji supports national efforts to reduce the burden of scabies through surveillance, mass drug administration (MDA), and strengthened health systems. Working in close partnership with the Fiji Ministry of Health and Medical Services (MHMS), the program has supported a transition from large-scale treatment campaigns to sustained, system-level control and scabies control.

Background and Key Milestones

 2021–2022: A national prevalence survey, led by the Fiji MHMS with support from WSP, identified the need for mass drug administration for scabies control.

2022–2023: The first national scabies MDA was implemented through a partnership between the Fiji MHMS and WSP, with funding from the Macquarie Group Foundation.

Early 2024: A post-MDA prevalence survey showed a reduction in national scabies prevalence to from 6% down to 3%, demonstrating significant population-level impact.

Current Focus: Health Systems Strengthening (HSS)

The program has now transitioned to a HSS approach. HSS refers to activities, policies, and strategies that improve how health systems function and deliver better health outcomes.

In Fiji, this means strengthening coordinated action across all levels of the health system to ensure sustained scabies control measures.

Following consultations with the Fiji MHMS, priority HSS areas focus on the following building blocks:

• Health service delivery
• Health information systems and surveillance
• Access to essential medicines
• Leadership and governance

Governance and Transition

WSP and the Fiji MHMS held a Scabies Program Transition Workshop in October 2024 to define responsibilities for long-term program management.

This led to the establishment of a Scabies Joint Transition Committee (SJTC), a multisectoral body including representatives from:

• Pacific Dermatology Training Centre
• Policy and Planning
• Family Health
• Fiji Pharmaceutical and Biomedical Services
• Nursing and Divisional Medical Officers
• Dermatology Department

The SJTC meets monthly and guides the transition of the scabies control program from the responsibility of WSP into the MHMS.

As part of the ReALiSE initiative, the following activities are being implemented in Fiji:

Health Service Delivery

• Training Community Health Workers on scabies identification and referral pathways 
• Supporting updates to national scabies treatment guidelines and reference materials
• Developing a train-the-trainer program based on clinical treatment guidelines
• Supporting awareness campaigns through World Health Day events including World Skin Health Day and World Neglected Tropical Diseases Day, radio, and television 

Health Surveillance and Information Systems

• Supporting the MHMS to include crusted scabies case in the National Notifiable Disease Surveillance System
• Determining the outbreak definition for scabies and the outbreak response

 Access to Essential Medicines

• Ivermectin included on the essential medicines list
• Supporting the Fiji Pharmaceutical and Biomedical Services to improve medicine quantification
• Donating scabies medications

 Leadership & Governance

• Monthly Scabies Joint Transition Committee meetings
• Development of a job description for a National Neglected Tropical Diseases Coordinator to be imbedded into the Ministries staffing allocations.
• Producing transition documentation for MHMS program ownership

This project is led by Dr Susanna Lake and World Scabies Program in collaboration with Fiji Ministry of Health and Medical Services, Fiji Pharmaceutical and Biomedical Services, Live & Learn Fiji, Pacific Dermatology Training Centre, Tamavua Twomey Hospital