1. PARADOX IN PARADISE
Dr Viliami Puloka
Secretariat of the Pacific Community

2. PACIFIC ISLANDS - WHERE?

4. Pacific Islands in top ten globally
source:
Global country ranking
in 2011
International Diabetes Federation 2011
Prevalence of diabetes in Estimated Global
2011 (% total population) Country Ranking in
2030
Estimated prevalence of
diabetes in 2030 (% total
population
25.7
1.Kiribati
26.3
2.Marshall Islands
22.2
2.Marshall Islands
23.0
3.Kuwait
21.1
3.Kuwait
21.2
4.Nauru
20.7
4.Tuvalu
20.8
5.Lebanon
20.2
5.Nauru
20.7
6.Qatar
20.2
6. Saudi Arabia
20.6
7. Saudi Arabia
20
7. Lebanon
20.4
8. Bahrain
19.9
8. Qatar
20.4
9. Tuvalu
19.5
9. Bahrain
20.2
10. United Arab
Emirates
19.2
10. United Arab
Emirates
19.8
1. Kiribati

5. “PARADISE”

6. DOUBLE DISEASE BURDEN
DIABETES
INFANT
MORTALITY
TB
HEART
DISEASE
HIV/AIDS
and STI
Dengue
OBESITY
fever
Malaria
SMOKING
LUNG
DISEASES
Typhoid
NCD : TOO BIG TO IGNORE

7. NCD Burden in the Pacific
Age-Adjusted Mortality by Cause
of Death
% of COD
57
60
57
50
40
32
30
NCD
24
19
20
CD
Injury
10
10
0
PICTs
WPRO
Greatest Cause of Premature Mortality in the Pacific

8. High rates of premature (<60 years) NCD deaths
Source: WHO (2011) Noncommunicable Diseases Country Profiles
Proportion of male premature NCD deaths, 2008
Kiribati
Nauru
Marshall Islands
Niue
Fiji
Cook Islands
Vanuatu
Solomon Islands
Micronesia FS
Tuvalu
Samoa
Lower Middle Income Average Globally (both sexes)
Tonga
0
10
20
30
40
Proportion of premature NCD deaths
50
60
70

9. High rates of premature (<60 years) NCD deaths
Source: WHO (2011) Noncommunicable Diseases Country Profiles
Proportion of female premature NCD deaths, 2008
Nauru
Marshall Islands
Kiribati
Vanuatu
Solomon Islands
Fiji
Tuvalu
Micronesia FS
Tonga
Cook Islands
Lower Middle Income Average Globally (both sexes)
Samoa
Niue
0
10
20
30
40
50
Proportion of female premature NCD deaths
60
70

10. Multiple risk factors are feeding a large pipeline of future NCDs
in countries of Pacific (Source WHO 2012)
80
70
overweight
obesity
60
50
40
30
20
10
0
SMOKING ALCOHOL OVER EATING INACTIVITY

11. RISK FACTORS FEEDING FUTURE NCD PIPELINE…….
Per cent of students aged 13-15 years overweight, 2010 and 2011
Tonga
Cook Islands
Niue
Nauru
Solomon Islands
Fiji
0
10
20
30
40
50
Per cent of students
Overweight at young ages
Source: Global School Based Health Survey 2012
60
70

12. NCDs already significant and risk
factors are feeding the future
pipeline
(Main Non-Communicable Diseases= Cardiovascular disease; Cancer; Diabetes;
Chronic Respiratory Disease)

13. NCD PATHWAY

14. NCDs are serious threats to global
prosperity
(World Economic Forum, 2011)
• Around 30% NCD mortality in low- and middleincome countries occur during working age (below
the age of 60), compared to only 13% in high-income
countries
• NCDs reduce productivity and increase health-care
costs
• Health spending to control NCDs outpaces economic
growth
• NCDs lock millions of people into chronic poverty
every year due to impact on household income and
health care expenditure

15. Today is the Tomorrow you dream about
Yesterday!
Yourself,
is the only instrument you have
to deal with Life and
to contribute to Life

16. HEALTHY ISLANDS-HEALTHY PEOPLE