Countries, agencies work together

Pacific Islands Countries and territories (PICTs), the Secretariat of the Pacific Community (SPC) and the World Health Organization (WHO) have joined forces to combat noncommunicable diseases in the region. Together they have developed the Pacific Framework for the Prevention and Control of NCDs which provides a combined 2-1-22 approach (2 organisations, 1 team, serving 22 countries). The main objectives of the programme are to:


  • strengthen development of multisectoral national NCD strategies
  • support countries to implement their NCD strategies
  • develop sustainable funding mechanisms to deliver the strategies
  • strengthen national health systems and capacity to address and prevent NCDs
  • strengthen regional and country M&E and surveillance systems Pacific Framework (1.25 Mb)

The programme’s focus is on reducing preventable NCD risk factors. High priority will be given to developing national strategies and supporting their implementation with capacity building and funding mechanisms. Over the medium term, the programme will include support for the promotion of healthy lifestyles, provision of clinical interventions where needed and workforce planning and capacity assessment.

As announced at the 2007 meeting of Pacific Islands Forum Leaders, AusAID is committing funding of AUD 20 million over four years for the programme, which will be implemented in a partnership between SPC and WHO and overseen by a management committee made up of representatives of Pacific Island countries and territories, SPC, WHO and development partners. NZAID will provide funding for the programme, and the AFD (Agence française de développement) has also expressed interest in supporting it. This additional support will ensure the programme can provide wider coverage over a longer period.





NCDs are the leading cause of death in the Pacific, accounting for approximately 75 per cent of deaths every year compared to 70 per cent worldwide.

Evidence from STEPwise Surveillance surveys carried out by WHO in some Pacific Island countries and territories (PICTs) shows very high rates of NCDs. For example, Figure 1 shows the prevalence of diabetes in adults in seven Pacific Islands. This rate is three to four times higher than in Australia and USA – an alarming statistic given the debilitating long-term effects of diabetes.

Fortunately, research has shown that lifestyle changes can have a significant effect on lessening the incidence of NCD, preventing as much as 80 per cent of heart disease, stroke and Type 2 diabetes, and 40 per cent of cancer.

The new programme will support action to combat NCDs in PICTs through a combination of individual or clinical approaches and population approaches that have been shown to work.

Individual approaches may include quit-smoking programmes and obesity clinics, while population approaches will involve reducing risk factors at a population level by combining lifestyle changes with policy and environmental approaches.

Examples of action include reducing tobacco smoking through continuing to exclude tobacco from the Pacific Island Countries
Trade Agreement and complying with the Framework Convention on Tobacco Control; increasing fruit and vegetable consumption by supporting production of local produce; and promoting physical activity through improving the built environment, such as providing safe walkways and cycling paths.

In other words, a combination of approaches is needed to make ‘healthy choices easy choices’.



Responding to PICT priorities


Under the motto ‘2 organisations, 1 team to serve 22 countries’, SPC and WHO have taken steps to ensure a harmonised approach to implementing the programme and have developed a joint implementation work plan, governance and management arrangements, and monitoring and evaluation procedures.

All of the strategies and activities included in the implementation plan respond to priorities identified at Pacific meetings, particularly Pacific Ministers of Health Meetings jointly convened by WHO and SPC, annual meetings of SPC’s governing body (CRGA), the Pacific Heads of Agriculture and Forestry Meeting (Nadi 2007), the Pacific Ministers of Education Meeting in collaboration with the Pacific Islands Forum Secretariat (Nadi 2007), the Pacific workshop on tobacco control (Oceania
Tobacco Control Conference 2007), the Pasifika Medical Association Conference (Samoa 2007), and the Pacific Islands Forum Leaders meeting (Tonga 2007). Consultations were also held during regional workshops and in country planning meetings in 2007 and 2008.



National action crucial


Under the current funding arrangement, the programme will be implemented over four years (2008–2011). However, given that NCDs are the single largest cause of death and morbidity in most PICTS, resources are needed to sustain activities over the long term. It is also crucial that PICTs acknowledge their role in the fight against NCDs and take advantage of the support provided by the 2-1-22 Programme to develop and resource their own national programmes because it is at the national level that the battle against NCDs will be won.

Annual progress reports on the programme will be submitted to Pacific Islands Forum Leaders.





For further information, please contact the NCD team:


SPC contact:
Dr Viliami Puloka, Section Head,
Healthy Pacific Lifestyle Section
Secretariat of the Pacific Community
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Ph. 687 26 20 00
687 26 09 52 (direct)
Fax: 687 26 38 18


WHO contact:
Dr Temo K. Waqanivalu
Nutrition & Physical Activity Officer
World Health Organization -
South Pacific Office
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Ph: 679-323 4100 / 323 4127 (direct)
Fax: 679-323 416