April 28, 2026 | Maggie Nilz
Strong collaboration between public health agencies and health care systems is essential to preparing for and responding to emerging health threats. From supply chain disruptions to large-scale public health emergencies, coordinated planning helps ensure health care facilities have the resources they need to continue serving their communities. ASTHO sat down with Jon Lujan, Public Health Emergency Preparedness Program Manager for Guam, to discuss how the jurisdiction’s Guarding the Pacific conference helped strengthen health care readiness and support response efforts across the unique challenges of the island jurisdictions.
Can you briefly describe your role and how it interfaces with health care partners in your jurisdiction?
As the Program Manager for the Guam Public Health Emergency Preparedness Program, my role centers on coordinating public health preparedness activities and strengthening operational links between public health, health care facilities, emergency medical services, emergency management, border health, laboratory systems, and federal partners. This includes organizing regional engagements like the Guarding the Pacific conference, where health care and public health teams jointly participated in surveillance discussions, legal preparedness sessions, modeling workshops, outbreak panels, and hands-on personal protective equipment (PPE) training.
What inspired the creation of the regional emerging infectious disease conference?
The increasing threat of avian influenza (H5N1) and other emerging diseases, combined with the unique vulnerabilities of the Pacific Islands, inspired the creation of a regional conference to strengthen preparedness, share experiences, and build cross-sector collaboration. Guam and the U.S.-Affiliated Pacific Islands face unique challenges: geographic isolation, limited surge capacity, complex supply chains, and the need for harmonized surveillance and response systems across small island jurisdictions. We convened the Guarding the Pacific conference to address these gaps through integrated training, legal preparedness, laboratory capacity building, and the sharing of lessons from remote island operations.
Who were the key partners involved, and how did you build buy-in across public health and health care sectors?
The conference convened over 124 participants representing Guam, American Samoa, Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, Palau, and Republic of the Marshall Islands, as well as CDC, Administration for Strategic Preparedness and Response, Cedars-Sinai Region 9 Special Pathogens Treatment Center, Council of State and Territorial Epidemiologists, Federal General Services Administration, and Johns Hopkins Center for Outbreak Response and Innovation. We built buy-in through leadership engagement, diverse sector participation, co-designed agenda content, and practical training such as PPE donning and doffing.
What governance or coordination structures were essential to making this effort successful?
Key structures included regional networks, federal coordination with CDC and Region 9 center, and a multi-day linked outbreak scenario that unified legal, clinical, lab, border, and surveillance considerations across all participants.
What challenges did you encounter and how did you address them?
Challenges included travel limitations for some jurisdictions, which we addressed by making our event hybrid with both virtual and in-person options; difficulty tracking virtual engagement, addressed by recommendations for a virtual lobby system; and limited Q&A in technical sessions, which will be improved by increasing interactive time and polling in future events, and incorporating breakout sessions.
What outcomes or improvements have you seen as a result of this work?
Based on participant feedback, outcomes included 96% overall satisfaction, 96% content relevance, 94% satisfaction with the hybrid format, and 83% of participants gained practical strategies they could apply within three months. Participants highlighted hands-on PPE training and daily scenario activities as the strongest contributors to learning and skill-building.
How did the conference strengthen relationships between public health and health care partners?
Our scenario-based activities and panel discussions fostered shared understanding, trust, and continuity across jurisdictions. The [conference] strengthened Guam’s preparedness by improving pre-event coordination, reinforcing surveillance and clinical frameworks, enhancing lab readiness, and expanding connections with CDC Port Health for border screening and quarantine coordination.
What lessons from the conference could be applied to other islands or mainland jurisdictions?
Transferable lessons include incorporating scenario continuity across multiple days, prioritizing hands-on training and interactive activities, ensuring multi-sector representation, and using evaluation feedback to refine Q&A structure and improve engagement.
What advice would you give to other states or territories interested in implementing a similar approach?
It was important that we had diverse voices from different disciplines when planning and coordinating the agenda. Building active learning into the agenda, ensuring diverse jurisdictional voices, expanding interactive features such as polling and Q&A, securing sustainable funding, and maintaining hybrid models to improve accessibility were all critical to the conference’s success.
