Hurricane Melissa has exposed critical gaps in Jamaica’s ability to respond swiftly to health emergencies, prompting renewed calls from the country’s top medical officials for urgent changes to the Public Health Act.

Speaking at a Jamaica Observer Press Club last week Monday, both Minister of Health and Wellness Dr Christopher Tufton and Jamaica’s Chief Medical Officer Dr Jacquiline Bisasor-McKenzie said the experience of managing both COVID-19 and a Category 5 hurricane revealed that existing public health laws are too rigid for fast-moving disasters, limiting the speed of quarantine measures, inter-agency coordination, and front-line response when lives are at risk.

Dr Tufton said that, while Jamaica’s health system had performed creditably under extraordinary pressure, the back-to-back crises provided an opportunity to reassess whether the country’s legal framework is fit for modern emergencies.

“When you have experienced the real-life examples of a pandemic and, of course, a Category 5 hurricane, it gives you an excellent vantage point on which to assess, from a policy perspective and from a legal framework perspective, how you respond to these disasters and, despite our best efforts, I do believe that the Public Health Act needs to be reviewed in terms of how we deal with emergencies,” he said.

The Public Health Act, which forms the backbone of Jamaica’s disease control and sanitation framework, grants the minister powers to order quarantines, restrict movement, close public spaces, and direct local health boards during outbreaks. However, Tufton suggested that many of those powers were designed for slower-moving public health threats and do not adequately reflect the speed, scale, and complexity of modern disasters.

“Coming out of COVID, we really need to look to see if there are any amendments that are necessary. Maybe there are only a few, maybe there are many, but there are also other pieces of legislation I think we need to look at… Emergency measures around security and safety are very central, but I think there is also a role for the Public Health Act in terms of some of the responses and some other pieces of legislation, some of which are outdated because they have been around for a long time. So there is a policy assessment around it that I think requires a revision,” he said.

One of the most pressing challenges noted was the difficulty in triggering emergency measures quickly enough under the existing law. While the Act allows for quarantine, isolation, and restrictions, the procedures for activating those powers can be cumbersome during a rapidly unfolding crisis such as a major hurricane.

Dr Bisasor-McKenzie told the Press Club that the Emergency Disaster Act often allowed for faster operational decisions than the Public Health Act, creating gaps during critical early stages of response.

She also pointed to weaknesses in how isolation and quarantine are supported by the Act.

“There are various issues in terms of how the different groups of staff are managed within the Public Health Act and the Quarantine Act. We need to look at that to ensure that, for example, the law that supports isolation and quarantine needs to be strengthened, and the reporting responsibilities of different agencies into one so there will be one approach,” she said.

Bisasor-McKenzie also suggested that the Act does not sufficiently address social and family-based interventions that become critical after disasters, such as relocating at-risk individuals or coordinating care for displaced households.

“You speak about social cases, and that is a good point to see how it is that we, from the Public Health Act, are able to move persons into different areas or to get families to respond. I think when we think about disasters and emergencies, what we would want, chiefly in terms of changing the Public Health Act, is to ensure that in terms of the support that is needed for health does not just come from within health, but also all the other things that support health,” she suggested.

Tufton echoed that view, arguing that future reforms must recognise the interconnected nature of modern health threats — from infectious diseases to climate-driven disasters that do not respect national borders.

“The approach to responding to emergencies, and indeed even under normal circumstances, needs to involve a kind of ‘one health’ theme where we either rise together or fall together. Diseases, as is the case with disasters, are not confined to any specific geographic space and, indeed, are normally linked. So the storm left us and went to Cuba, so even in the case of a natural disaster, we have to also prepare to help others,” Tufton said.

He said Hurricane Melissa also demonstrated the importance of legal flexibility to support international medical assistance, including the rapid credentialing of foreign doctors and nurses who arrived to staff field hospitals in the weeks after the storm.

“We had to turn around the credentials of nurses and doctors coming in, which was absolutely essential to the first three weeks, and in the past I have been critical to say it is taking too long and that some of those rules need to be re-examined,” said Tufton.

In the aftermath of Melissa, Jamaica hosted multiple health professionals, some of whom set up field hospitals operated by international partners, including military-supported units and humanitarian organisations — an experience Tufton said should shape future legal reforms.

“That support was nothing short of phenomenal, but it also shows the extent to which we have accommodated them. A lot of times people want help and can’t get it because there are obstacles,” said Tufton.