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  • By Bernadette H. Carreon

NCD crisis in the Pacific

Tourism, fisheries and labor mobility present opportunities to the development-hungry Pacific, but they’ve got to be balanced off against serious threats, the two worst being climate change and non-communicable diseases.

The bad news is delivered by a World Bank report which contends NCDs are the worst and most immediate threat.

“This crisis already tragically impacts the lives of many Pacific Islanders,” the report states. “It results in severe human suffering and slows advances in standards of living,”

The World Bank report in turn cited a World Health Organization report that NCDs are now the leading cause of death in most countries in the Pacific, ranging from an estimated 60 percent of deaths in the Solomon Islands to 80 percent of deaths in Fiji.

Meanwhile in Palau, an NCD and Risk Factor Surveillance report stated that NCDs are the leading cause of morbidity and mortality in the United States Affiliated Pacific Islands (American Samoa, Guam, the Commonwealth of the Northern

Mariana Islands, the Federated States of Micronesia, Palau, and the Republic of Marshall Islands.

The Palau report said that the NCDs of concern in the USAPIs include diabetes,heart disease, stroke, cancer, and chronic obstructive pulmonary disease and that the five leading risk factors attributable to NCDs globally include unhealthy diets, insufficient physical activity, excessive consumption of alcohol, obesity and tobacco use

Betel nut chewing with or without tobacco is also identified as a significant health problem.

But why is the number one killer in the Pacific—NCDs—getting so little attention compared to climate change?

The main reason is funding and efforts to fight climate change have won huge funding—governmental or non-governmental—on all levels. Climate change funding is driven by concerns such as food security, loss of culture, economic challenges and health.

NCDs are the quiet crisis. Some view them as a personal issue resulting from foolish behavior. The immediate and tangible benefits promised by averting climate change are more inspiring.

But to many Pacific Islanders, the issue of NCDs is as important as climate change.

“Our oceans are dying, our people are dying, and we have the highest rates of NCDs in the world,” Taimalelagi Kasarina Salesa told Pacific reporters during the recent Pacific Islands Forum in Samoa.

“Up to 75 percent of us die from non-communicable diseases prematurely. Eight of our Pacific nations are ranked in the top 10 of the world with the highest prevalence of diabetes which has an extreme impact on our women and girls,” said Taimalelagi.

PIF Secretary General Dame Meg Taylor underlined this concern.

“NCD is of regional importance,” Taylor told reporters. “Just because it was on the agenda of the 2014 PIF meeting doesn't mean it’s disappeared.” She said encouraging the consumption of home grown and locally produced food is an important way to combat these diseases on a national level.

The Pacific Possible report roadmap from 2014 recommended strengthening tobacco control by an increase in excise duties to at least 70 percent of the retail price of cigarettes over the medium term or before 2020.

It also called for a tax increase on alcohol products to cut harmful consumption and policies such as targeted preventive measures, taxes and better regulation to reduce consumption of local and imported food and drink products that are high in sugar, salt, and fat content. All of these are directly linked to obesity, diabetes, heart disease and other NCDs.

Palau President Tommy Remengesau Jr. on February 2016, signed a law that sets aside 10 percent of the revenues raised annually from alcohol and tobacco taxes to finance NCD prevention through the country’s National Coordinating Mechanism.

Palau was touted as the first country in the world to channel such taxes to an NCD mechanism. Other countries dedicate tobacco taxes to various health care needs.

However, since the law’s passage, the implementation of the tobacco tax has been subject of controversy in Palau.

Instead of the money going to NCD related activities, the money has been appropriated to fund a medical referral house in the Philippines and a purchase of a hyperbaric chamber early this year.

Palau Senator Rukebai Inabo said that there was nothing illegal with the Congress or the government tapping into the NCD fund to finance activities unrelated to NCDs, but “it is improper when the law have not removed the restriction placed on the 10 percent of the tobacco and alcohol tax to specifically fund prevention of NCD as an NCD fund. The NCD National Coordinating Mechanism Committee’s right to commit the $500,000 on prevention of NCD programs has not been removed while the right to spend the same money on Philippines House and the hyperbaric chamber is being authorized.”

Another issue is that the government is not enforcing the law properly when it provides waivers to businesses which do not pay taxes on time. The result is lost revenues that could have been spent on NCD prevention.

“Because tobacco products are lethal, the tobacco industry should not be granted incentives or waivers to sustain their marketing of tobacco. The issues with our tobacco tax policy confirm the need for our government to adopt policies to implement its obligation under Article 5.3 of the Framework Convention on Tobacco Control,” a Palau official stated anonymously.

Regardless, the Palau Congress is still supporting efforts to prevent NCDs in Palau. This year, state governments, through an amendment in the were given the authority to approve projects and fund NCD prevention programs.

“Governors are now the ones to implement NCD’s program to each of the states. Make the NCD programs closer to the people, “ Inabo urged.


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