At least 18 Pacific island countries and territories (PICTS) have costed national noncommunicable disease action plans. The following summarises NCD related activities in PICTS in 2009 under the 2-1-22 programme managed by SPC and the World Health Organization (WHO).
American Samoa is ranked highest in the world for obesity and one of the highest in the world for diabetes among its adult population, according to the 2004 STEPS survey results published in 2007. Of most concern has been the increase in these risk factors among people under the age of 25 years. Despite the many challenges, including limited human resource capacity, American Samoa has initiated several NCD prevention programmes. Their focus has been on diabetes prevention activities, in line with funding arrangements. The Cancer Coalition is also very active and has developed a comprehensive American Samoa Cancer Prevention Plan 2007–2012.
American Samoa health workers attended the Pacific NCD Forum in mid 2010 and reported they were conducting outreach activities in villages. They had offered a one-stop-shop of free screening, tobacco counselling, checks by a doctor and advice from a nutritionist. The focal point in this initiative was the health of the heart. Villagers were encouraged to do exercise, make the family the core of their whole being and live happy and free of smoking. SPC posters educating about the composition of food were particularly useful, they said.
Latest: 2004, published in 2007
Risk factor prevalence (%): Daily tobacco use 29.9; Alcohol use 63.5; Low fruit and vegetables 86.7; Low physical activity 62.2; Obesity 74.6. No second survey is available for comparative analysis and trends.
American Samoa focal persons: Dr Faise Roby and Ms Dottie Aga-Sivavii; SPC: Ms Karen Nemaia-Fukofuka; and WHO Dr Temo Waqanivalu.
American Samoa is due to receive a large country grant under the 2-1-22 programme once it finalises its national NCD plan mid way through 2011. Earlier in April 2009 an adviser from SPC’s Healthy Pacific Lifestyles section visited American Samoa as part of an SPC joint country strategy mission. The 2–1–22 country grant support was discussed with key staff in the Department of Health and a workshop to develop American Samoa’s national NCD plan was arranged. The tsunami in September 2009 delayed negotiations and planning. Physical Activity Resources were provided under 2-1-22. No applications for small grant funding have been received from American Samoa.
A WHO technical officer subsequently visited Pago Pago to build on that work, develop an NCD planning framework and meet other stakeholders. In 2010 WHO conducted training on cancer registration and a mini-STEPS baseline survey for Fagaalu and BPH. They held discussions of repeating the last STEPS published in 2007.
Efforts to tackle the growing NCD epidemic in the Cook Islands continued in 2010 with the Ministry of Health strengthening its partnership with other organizations, private sector and government departments and to carry out or
support Healthy Lifestyle promotions.
The Cook Islands’ Ministry of Health estimates half of annual deaths in the country are due to NCDs. Diabetes and hypertension are increasing and there are high levels of obesity and low levels of physical activity. Under the 2–1–22 programme, in 2009 Cook Islands received a number of small country grants, and SPC and WHO provided technical assistance with developing and implementing its national NCD plan. On 1 July 2009 a large country grant agreement was signed with SPC supporting implementation of the plan and funding an NCD coordinator position. Three participants from Cook Islands (one each from the ministries of health and education and the private sector) attended a diet, nutrition and lifestyle subregional workshop in Nadi, Fiji Islands, in February supported by SPC, WHO, the Food and Agriculture Organization (FAO), the United Nations Children’s Fund (UNICEF) and the Japan International Cooperation Agency (JICA). Two Cook Islands representatives also attended the NCD Forum in Nadi. With assistance from WHO, the Cook Islands Ministry of Health has developed a Live smart-Be active-Eat wisely logo. Eat wisely was preferred to Eat less for the campaign to promote healthy eating. SPC assisted the ministry in its development of a 5+ a day logo. The 2–1–22 funding also supported the 5+ a day fruit and vegetable campaign, Kai Raurau/Ua Rakau no te Oraanga Meitaki, and the provision
of smoke-free resources for the Mini South Pacific Games in October. The Cook Islands Tobacco Control Working Group, in collaboration with the Ministry of Health, launched a smoke-free initiative in 2006, with young people doing hip hop dancing around the theme of Respect y’self before you wreck y’self. The Smokefree Challenge is held every two years. The Ministry of Health also has a number of other initiatives under its Live smart banner. To promote physical activity, the Vaevae team challenge is open to workplaces and the community. WHO sent a consultant to Cook Islands in 2009 to assist in planning and initiating a physical activity campaign. An SPC adviser also talked about nutrition and food security at a national food summit in Rarotonga.
Highlights in 2010 were: World Health Day—This was commemorated on 9th April in collaboration with relevant stakeholders. The main event was held in the main town of Avarua where the main street was closed off an various sporting activities such as cricket, tennis, basketball, zumba, aerobics/fight do etc were held to motivate people to keep active and healthy. Free health checks were offered to the public for early detection of diabetes and hypertension. Vaevae Challenge—This eight week walking challenge took place May 10th – July 2nd. The Cook Islands Sports and Olympic
Committee Women in Sport Program was a major partner with CITC and TopShape Health and Fitness Centre being partners in all our bonus points events. The Island of Mangaiia organized their own version of the Vaevae challenge and had great success and look forward to holding another event this year. The Outer Island of Penhryn organized an walking event and Atiu organised a weight loss competition. 5+ a day Awareness—This was carried out in October and mainly involved media awareness and participation in Agriculture Market Day on October 15th 2010. Posters promoting fruit and vegetables were developed for pretesting with positive feedback. Alteration will be made before final printing. The posters will be used in supermarkets, market stall, schools etc. Women’s Conference—The National Council of Women Conference featured a day focusing on health and Healthy Lifestyles was a major topic. Women representatives from Rarotonga and most of the Outer Islands attended this week long conference. Ministry of Health took this opportunity to organize a pedometer challenge for all participants with daily prizes awarded and major prize awarded to the participant who clocked up the most steps during the week. Diabetes Awareness—World Diabetes day was commerated in November with media awareness and free blood sugar testing and advice provided in the main town of Avarua. Tereora College Health Day—Prior to end of school break for Christmas holidays, a health day was organized for Year 9 and 10 students. The theme was “Stayin’ Alive”. Interactive health information booths were set up by Ministry of Health and Red Cross at the school covering healthy eating, alcohol, tobacco and sexual health. A one hour physical activity zumba session followed, finishing off with a hose down compliments of the local fire service. Global School Health Survey—Collection of data commenced in July and was completed in November. A total of 23 schools were involved from Rarotonga (10 schools), 5 Southern group Islands (5 schools) and 6 Northern group islands (8 schools). Final touches are being sought for answer sheets before dispersal to Center for Disease Control, USA for data analysis. NCD Guidelines—The Guide to the Prevention and Management of Hypertension, Diabetes and Obesity (2001)has been reviewed and updated. Training materials for outer islands is being developed. Atiu Healthy Lifestyle Awareness—A team of Health Promotion Staff and NGO members travelled to the outer island of Atiu to carry out Health lifestyle promotion. During this visit they also held early morning physical activity aerobic/zumba fusion activity the main road in one of the villages.
Commonwealth of the Northern Mariana Islands (CNMI)
The Chamorros and Carolinian people of CNMI have one of the highest rates of type II diabetes in the world. Health professionals in CNMI report that cancer and cardiovascular disease are next on their hit list of non-communicable diseases. They have decided the best way to address NCD risk factors is through multisectoral collaboration and an emphasis on policies of prevention. This conclusion was reaffirmed for CNMI representatives at an SPC–WHO NCD risk factor meeting in Suva in 2006. CNMI has therefore developed a comprehensive national NCD plan to address diet, physical activity, alcohol abuse and tobacco control. It aims to decrease overlap in programmes and to make the best use of the limited resources available in the islands. At a three-day workshop in 2008 SPC and WHO helped CNMI write its NCD strategy with 20 stakeholders from a broad spectrum of government agencies, the private sector and the community. Then in 2009 SPC supported CNMI’s Healthy Living in the Pacific Islands initiative, a United States federal government programme for all US affiliated countries in the Pacific. WHO contributed to CNMI’s diabetes and cancer programme and provided financial and technical assistance on policy advocacy, the NCD STEPS survey, diabetes control and legislation on tobacco. Following up on an earlier joint SPC–WHO mission and advocacy on NCDs with legislators, SPC sent a joint country strategy mission to CNMI in early 2009 to further develop the national NCD plan and a 2–1–22 large country grant work plan. CNMI health officers then visited SPC headquarters in Noumea, New Caledonia, in November to finalise the agreement, which funds a coordinator position and NCDrelated activities in 2010.
Federated States of Micronesia (FSM)
Technical assistance from SPC’s Healthy Pacific Lifestyle section led to the drafting of a national NCD plan for FSM and to the signing of a 2–1–22 funding agreement in December 2009. FSM submitted several proposals for the second round of 2–1–22 small grants in 2009. Grants approved will fund the Chuuk Healthy Lifestyle through the Diabetes Education and the Prevention Awareness project, and Physical Exercise through a Beauty project and Tobacco Policy Summit. Support was also provided for the Seafood Handling Safety and Security project designed to prevent spread of diseases and food spoilage, a project in the Dolon community to achieve lifestyle behaviour changes through home gardening and food preparation and consumption, the YWA Local market/Eatery project, and the Go Local project promoting planting and growing of more local fruit and vegetables. A WHO technical officer completed a visit to provide training for and initiate the mini-STEPS survey in the workplace in 2009. A WHO consultant assisted in the finalization of the FSM food-based dietary guidelines. The 2–1–22 programme supported FSM’s participation in the NCD Forum at Nadi, Fiji Islands.
Fiji’s Ministry of Health (MOH) reports NCDs have replaced infectious diseases as the principal causes of mortality and morbidity. The magnitude of NCD risk factors in Fiji was earlier highlighted in 2002 surveys which showed over half of the adult population was overweight. By 2009 MOH singled out anaemia as a major problem for Fiji and estimated half of the population rely on supermarkets for their food. MOH now aims to make health ‘everybody’s business’ and is improving clinical services and health promotion settings. Fiji’s national NCD strategic plan expired in 2008 and was reviewed and redrafted in 2009. The new version will form the basis of a 2–1–22 country grant in 2010. In 2009 SPC provided technical assistance for the drafting of a large country grant work plan. WHO supported the Bula 5:30 campaign, designed to raise awareness of diet and physical activity, and a national workshop on Health Promoting Schools, a programme being piloted in 16 schools. Small grants of the 2–1–22 programme supported the hospital food gardens project, the Friends’ Art and Cultural Enterprises (FACE) theatre project, the Promoting Healthy Lifestyle through Agriculture project, a diet, nutrition and lifestyle workshop, participation in the NCD Forum in Nadi and the Oceania food training course. WHO provided financial and technical support for training on STEPS surveys, review of the NCD plan, a rheumatic heart disease project, diabetes and tobacco control. MOH accesses technical assistance from WHO’s office in Suva. In 2009 WHO and SPC also provided MOH strategic health communications training.
In 2009 the 2–1–22 programme supported French Polynesia’s efforts to address NCD risk factors. Among these initiatives were regulations banning smoking in restaurants, bars and public places-which were to be introduced at the end of 2009. SPC and WHO supported a cooperative effort by health, education and agriculture services in the territory to promote local fruits and vegetables in school restaurants. In 2009 the 2–1–22 programme funded French Polynesia’s attendance at the NCD Forum in Nadi and a second round of small grants for three school-based initiatives focusing on promoting healthy eating habits and good nutrition among children. Following discussions on the development of a 2–1–22 agreement, an SPC adviser participated in an SPC joint country strategy visit to French Polynesia in November 2009. WHO provided financial and technical assistance for training on tobacco control and surveys. It also assisted the territory to prepare for a national STEPS survey in 2010.
Guam health officials report a high prevalence of smoking than the United States. A campaign of antismoking commercials for television has been introduced to combat this. The prevalence of diabetes is increasing in Guam. In particular, Chamorro people are reported to be at higher risk from NCDs with a 50 per cent level of diabetes. Although Guam does not have a national NCD plan, in 2009 it was undertaking a number of healthy lifestyle initiatives through the Wellness Center and the Cancer Control Coalition. The Healthy Guam initiative has increased physical activity on the island, especially among young adults. A fitness fiesta has promoted healthy lifestyles and cooking demonstrations. Childhood anti-obesity and new-start physical activity campaigns are reducing levels of obesity and fasting insulin. In 2009 the 2–1–22 programme supported Guam’s participation in the NCD Forum in Nadi. In addition, a small grant funded the development of an activity booklet LINK (Lifestyle and Innovative Nutrition for Kids) to Healthy Children. Using this booklet, children will investigate family risk factors for chronic diseases and advocate for health-promoting changes. Discussions on an agreement with SPC for a large country grant under 2-1-22 commenced in 2009.
The NCD Forum at Nadi in August 2009 heard that NCDs including diabetes, cardiovascular diseases and cancer-have become a major burden for Kiribati. The prevalence of diabetes is rising, resulting in more amputations. The representative of Kiribati at the forum said an estimated 80 per cent of the population was overweight and half were obese. Excessive alcohol consumption in Kiribati caused many road acidents and a new law has been brought in to control speeding. The Kiribati Ministry of Health reports that cervical cancer is the most common type of cancer. It is addressing this through screening, treatment, prevention and control initiatives. In 2009 the 2–1–22 programme supported WHO and Kiribati to finish and publish a STEPS survey report that showed 28 per cent of the population of aged 25–64 years was diabetic. Kiribati has meanwhile revised its national NCD plan for 2010–2011. The aim of the revised plan is to reduce the four main risk factors for NCDs (tobacco, physical inactivity, poor diet and alcohol) through activities in workplaces, schools and community maneabas. In 2009 SPC provided funds to support the implementation of Kiribati’s national NCD plan. Technical assistance was provided by an SPC Healthy Pacific Lifestyles adviser who helped the Ministry of Health develop its work plan for a large country grant of AUD$150,000. SPC also supported Kiribati’s tuberculosis–diabetes study and its participation in the inaugural Pacific NCD Forum. A WHO technical officer visited Kiribati to review the 2008 NCD plan, help draft the 2009 work plan, and assist in conducting mini-STEPS surveys in workplaces.
Nauru is working hard to reduce the impact of lifestyle changes associated with massive levels of disposable income from phosphate mining, which reached its peak in the 1970s. With these changes came one of the highest rates of diabetes in the world in 1975-an overall prevalence of 34.4 per cent among people over the age of 15. According to the Nauru STEPS survey report published in 2007, the overall diabetes prevalence for 25–64-year-olds was 22.7 per cent and prevalence rates for hypertension, overweight, obesity and NCD risk factors in Nauru were also high. To address this the Government of Nauru has a national NCD plan (2007–2012) in operation. Under the 2–1–22 initiative, SPC has provided AUD$300,000 for three years to 2012 to support the implementation of this multisectoral plan. In 2009 SPC contributed technical assistance for its implementation and for developing the monitoring and evaluation framework. SPC also supported nutrition training for district primary health care workers. Support was provided for a Nauru representative to participate in the NCD Forum in Nadi, and advice was given on the wording of the tobacco control bill to strengthen its provisions. The Nauru NCD plan invests heavily in health promotion and disease prevention initiatives to more effectively prevent and control diabetes and other noncommunicable diseases. These health strategies target risk factors such as physical inactivity, poor nutrition, smoking and alcohol. Physical activity programmes designed to promote a healthy diet and to control smoking and alcohol. These include the Stomp the Fat national weight reduction campaign, the New Nauruan eat healthy-live healthy programme and the Workers’ Walk on Wednesday initiative.
New Caledonia has long-standing programmes on alcohol, tobacco and marijuana control. In 2009, SPC supported New Caledonia’s efforts to address these key NCD risk factors. It hosted two community consultation workshops for the northern province on addictologie—addiction to alcohol and marijuana—in Noumea in November and December. SPC also provided advocacy support for legislation to ban smoking in public places. This followed earlier SPCbacked research showing relatively high incidence of smoking in bars and restaurants. The much-anticipated laws are expected to be introduced in 2010. New Caledonia has a diabetes programme and an obesity prevention campaign targeting school-age children. A resource tool for teachers was distributed for this campaign. Through technical assistance and a small grant, in 2009 SPC’s Healthy Pacific Lifestyle section supported the Breast Feeding for Healthy Life project. The 2–1–22 programme also funded the participation of a New Caledonia representative in the NCD Forum.
Data from patient records and surveys on national nutrition, health, general population characteristics and diabetes in Niue over the past decade show a steady increase in diabetes, hypertension and alcohol use and, for some groups, in tobacco use. However, according to 2008 patient and smoking cessation services records, the number of women smoking may have decreased. To address the overall trends, Niue came up with its Niue Moui Olaola national NCD plan developed with support from SPC and WHO in 2007. The action priorities of this plan were based on the 1995 Yanuca Island Declaration by Pacific health ministers, which incorporates themes of health education, promotion and protection. Guiding the Niue plan is a council with representatives of different sectors-government, health, community affairs, education, business, sport, and non-governmental organizations (NGOs). To support implementation of the plan, Niue signed a letter of agreement in August 2009 to receive country grant funding from SPC. The 2–1–22 programme supported Niue’s participation in the Pacific NCD Forum 2009 in Nadi. Niue is also being assisted to implement two community-based projects through the first round of SPC’s small grants scheme: a healthy village initiative and the Atuhau Moui Olaola youth health campaign. SPC worked with Niue to develop a lung health advocacy campaign to encourage more people on the island to use tobacco cessation services. The project was due to start in late 2009.
In addition to rising NCD risk factors, Palau has had to deal with the impact of betel-nut chewing, which causes oral cancers. Responding to these challenges, Palau’s health authorities revised their NCD plan early in 2009 during an SPC-WHO consultation workshop. Under 2–1–22 a representative of Palau attended the NCD Forum. A small country grant supported intensive multi-media programmes on NCDs and enabled an NCD officer to visit SPC in New Caledonia to develop Palau’s 2–1–22 agreement. It is expected that a large country grant agreement will be signed between Palau and SPC in 2010. A third stream of funding under 2-1-22 meanwhile supported a healthy workplace initiative, diabetes control, tobacco legislation, tobacco cessation and rheumatic heart disease prevention. An SPC Healthy Pacific Lifestyles adviser participated in an SPC joint country strategy visit to Palau in 2009 to initiate the planning process for a national strategy. This adviser and a WHO technical officer visited Palau in a joint mission with the University of Hawaii to support the review and redrafting of the NCD plan. The SPC officer met with two senators on the health and education committee to discuss upcoming tobacco legislation. A WHO medical officer also visited Palau in 2009 to conduct tobacco cessation training.
Papua New Guinea (PNG)
With more than 80 per cent of the population living outside of urban areas and less reliant on processed foods, Papua New Guinea has less problems with obesity than other Pacific Island countries and territories. However, widespread betel-nut chewing in PNG has led to a relatively high incidence of oral cancers. And a new cluster survey on NCDs has identified chronic diseases as an increasing burden to be addressed. In 2009 PNG was planning its NCD strategy and allocation for these diseases was sought in the Ministry of Health 2010 budget. PNG has expressed interest in the 2–1–22 programme and discussion has commenced on the development of a multisectoral NCD plan in 2010 and on PNG’s eligibility to access a large country grant. A WHO officer visited PNG in 2009 to assess their status, identify areas of possible support and open discussion on planning. The 2–1–22 programme provided some support for the Healthy Workplace initiative in 2009 and an NCD officer from PNG attended a diet, nutrition and lifestyle workshop. PNG participated in the Pacific NCD Forum and WHO supported in-country communication training. SPC and WHO were also planning an alcohol intervention study in PNG with Massey University of New Zealand.
Pitcairn does not have an NCD plan. Following the visit of a Pitcairn representative to SPC in Noumea, the Healthy Pacific Lifestyles section offered assistance for the development of the social welfare portfolio on the remote island territory.
Republic of the Marshall Islands (RMI)
An important theme in the campaign to address NCDs in the Marshall Islands is Fun—go local. Reports from RMI indicate that an increasing number of community groups are adopting this and other healthy lifestyle principles. The Diabetes Wellness Centre in RMI promotes healthy food and is a champion for healthy lifestyles. It operates without government funding but advocates at the political level on eating healthy food. The centre also promotes healthy cooking and sharing resources with the community. The Marshall Islands published its WHO STEPS report in 2008 and has an NCD and nutrition plan in operation. The Health Promoting Schools initiative was launched in 2008 through in-country training by WHO and a memorandum of understanding was signed between the Ministries of Health and Education for the implementation of the programme. The programme was piloted in a number of schools as part of the implementation of the NCD plan. The Healthy Workplace approach was introduced in 2009, commencing with the Ministry of Health. Under the 2–1–22 programme, an SPC Healthy Pacific Lifestyle adviser visited RMI to finalise a large country grant agreement signed in October. WHO conducted an in-country strategic health communication training course. A physical activity campaign, Kalimo 30+, was planned and initiated with support from 2–1–22 and national physical activity guidelines were developed as one of the tools for its implementation. RMI received a small grant to support healthy lifestyles at the Women United Together Marshall Islands (WUTMI) executive board meeting and a representative of RMI attended the NCD Forum in Nadi.
Samoa’s Ministry of Health conducted a health situational analysis in 2006 that identified NCDs as a major issue and challenge. In response, and in consultation with all health sector partners and the community, the ministry developed its Health Sector Plan 2008–2018. The plan provides a strategic framework that guides the planning and implementation of all health programmes and activities. The 2–1–22 programme made it possible for a participant from Samoa to attend the Oceania food training course at the University of New South Wales, Sydney in 2009. An SPC adviser visited Samoa and an NCD officer attended the NCD Forum. With its NCD policy and strategy under review in 2009, Samoa asked SPC to delay the large country grant process until 2010 while it worked through its other NCD activities. One key activity supported by the Samoa Health Sector Wide Approach programme (funded by the Government of Samoa, and the pool partners-NZAID, AusAID and the World Bank) was a WST 500,000 small grant for communities to improve and promote healthy living. A committee made up of representatives from the Ministries of Health, Finance and Women and Community Development approved 90 proposals for physical activity programmes and 61 for vegetable gardens. Samoa also has a community physical activity programme and a television programme on the Prime Minister’s 30-minute challenge. Samoa was to receive assistance from a WHO 2-1-22 Healthy Workplace programme in 2009. This was put on hold after the tsunami hit Samoa on 30 September.
The high prevalence of oral cancer due to betelnut chewing is a major NCD issue for Solomon Islands. It addresses this and other NCDs risk factors in national policies and legislation, by creating supportive environments for healthy lifestyles, implementing advocacy and social marketing campaigns in schools, workplaces and communities. Solomon Islands has a 10-year National Nutrition and Healthy Lifestyle Plan (2007–2017). This multisectoral plan addresses nutrition, other NCD risk factors and the prevention and control of lifestyle diseases. SPC conducted a strategic health communication workshop in Solomon Islands in 2009. Information, education and communication (IEC) materials have been developed by the government to address betel-nut chewing and other NCD risk factors such as lack of physical activity, poor nutrition, tobacco and alcohol use. In 2009 SPC provided funding to support the development and implementation of Solomon Islands’ national NCD plan. Technical assistance was provided through the visit of an SPC adviser to develop a large country grant and the visit of an NCD coordinator to Noumea to finalise the agreement. The 2-1-22 programme also supported the attendance of a Solomon Islands NCD officer at the Oceania food training course. The Health Promoting Schools framework was reviewed and piloted in schools. A 2-1-22 small grant backed the Go Local –Kastom garden project and the Makira Ulawa indigenous food compilation project. Solomon Islands is also considering an evidence-based intervention in alcohol prevention. A Solomon Islands’ representative participated in the inaugural NCD Forum in Nadi in August. 2009. In 2010 Solomon Islands health officers will work with SPC and specialists from Massey University’s Centre for Social and Health Outcomes Research and Evaluation (SHORE) on an alcohol intervention study
The 2–1–22 programme enabled an NCD officer from Tokelau to attend the diet, nutrition and lifestyle workshop in Nadi in early 2009. Tokelau received a 2–1–22 small grant in 2009 for its project promoting fruit and vegetables for better health. A delegate from Tokelau attended the NCD Forum and support was provided for a healthy lifestyle promotion in the three atolls. Health officers were revising Tokelau’s national health plan in late 2009.
Tonga has an NCD plan in operation and is the recipient of a large country grant under the 2–1–22 programme. This grant helped fund the establishment of the Health Promotion Foundation which introduced the Advocate for a Healthy Public policy. Every new road being built in Tonga must now include a footpath for safe walking. Legislation to reduce tobacco use has been passed and there are now bans on smoking in public places and the selling of single cigarettes to minors. In 2009, Tonga strengthened its partnerships with key stakeholders to ensure health promotion activities are implemented. Adapting SPC’s regional food guidelines, Tonga developed a school food policy. A Health Promoting Church programme was piloted in one village with six churches. Since then the programme has been rolled out to other villages. The 2–1–22 programme funded a Tongan NCD officer’s attendance at a diet, nutrition and lifestyle workshop. The WHO-led Healthy Workplace initiative—beginning at the Ministry of Health with a mini-STEPS survey—was also supported. Part of this initiative was to promote regular sporting activity among staff of government ministries and agencies. The Health Promoting Schools programme under a third funding stream of 2-1-22 continued and some assistance was directed to the rheumatic heart disease (RHD) programme. Tonga received technical assistance and guidance on taxation from cigarettes and alcohol. Two representatives of the Health Promotion Foundation attended the NCD Forum in Nadi. An SPC Healthy Pacific Lifestyle adviser visited Tonga in 2009 in connection with SPC’s joint country strategy, and a WHO NCD medical officer visited Nuku’alofa in October. An SPC monitoring and evaluation officer helped the Health Promotion Foundation develop a monitoring and evaluation framework and assisted the Ministry of Health on extracting information for monitoring Tonga’s NCD plan.
Tuvalu has completed the field work for a STEPS survey and is developing a nutrition and NCD plan. It is finalising the Food Based Dietary Guideline and has initiated the Health Promoting Schools programme. In 2009, technical assistance was provided in Tuvalu for negotiation of a large country grant from SPC. It is expected a representative of Tuvalu will visit Noumea in 2010 to finalise the grant agreement. A strategic health communications training workshop was conducted and two NCD officers from Tuvalu attended the NCD Forum in Nadi in August. Through a small 2-1-22 grant, support was provided for Tuvalu’s projects on healthy food and lifestyles and for the implementation of tobacco legislation. Discussions on a project focusing specifically on enforcement of alcohol legislation were initiated in 2009.
Health authorities in Vanuatu have identified nutritional deficiencies and anaemia among children and mothers as a major public health problem. To address these and other NCD risk factors, Vanuatu has a large country grant in place under the 2–1–22 programme and an NCD national plan. Following a national consultation workshop on the 2010–2014 NCD plan in Port Vila at the end of 2008, in 2009 SPC staff provided technical assistance to finalise the plan and to secure the grant. NCD officers from Vanuatu participated in the NCD Forum in Nadi in August. The Walk for Life policy in government workplaces continued in 2009. A formative assessment of the policy showed positive results as well as leading to recommendations regarding areas for improvement. The 2-1-22 programme also helped two participants from the Health and CODEX Committee to attend the Oceania foods training course, an NCD plan consultation meeting with stakeholders, and a meeting with a local AusAID official to share information on the programme. A WHO technical officer and an SPC adviser visited in 2009 to provide NCD risk factor training.
Wallis and Futuna
Diabetes is a major disease in Wallis and Futuna and efforts in 2009 to combat it drew on a prevention project funded by France’s aid agency AFD. The project uses the Diabetic Prevention in the Pacific (DPIP) design. An SPC Healthy Pacific Lifestyle adviser visited in April and SPC funded the printing of diabetes survey forms and the purchase of display stands for information, education and communications materials in villages. These activities promoted home gardening and chicken farming for women and community groups. A chronic diseases risk factor survey was completed by SPC in the French territory in early 2009. The data provides a baseline for Wallis and Futuna’s NCD plan to be developed and implemented in 2010. Under 2–1–22, in 2009 SPC also developed and published diabetes booklets for patients, and Wallis and Futuna participated in the first Pacific NCD Forum in Fiji.