News 9 Aug 2018
As Keynote Speaker at the Pacific Wave Forum in Auckland on August 6-7, Dr Viliami Puloka, showed findings that surpassed common perceptions of the diabetes epidemic across the Pacific region.
The one that stunned many attendees was a table titled Prevalence Rates of Diabetes: Top 10 Countries of the World. Compiled by the IDF (International Diabetes Federation, 2015), the table revealed that six of the top 10 countries with high rates of diabetes are in the Pacific. Tokelau, an island country and dependent territory of New Zealand, tops the table with 30% of its population aged from 20-79 affected.
Following that in order are Nauru at 24.1%, Cook Islands 21.5%, Marshall Islands 21.3%, Palau 20.9% and New Caledonia 19.6%. The IDF report concluded that ‘The percent of people affected by NCDs will rise substantially in the Pacific in the coming decades’.
Among the Pacific nations not included is Papua New Guinea, despite a substantially bigger population which is growing faster than its Pacific neighbours with increasing NCD rates.
A key finding also reveals the NCD mortality burden is much greater in Pacific countries compared to global standings.
For Dr Puloka, a Research Fellow (University of Otago) and Senior Health Promotion Strategist for the Health Promotion Forum of New Zealand, it is not just a health issue.
“It is the only issue … because our health and wellbeing enables us to be able to contribute in a meaningful way,” he says.
“Our health is a resource that we do life with. But the statistics clearly show we in the Pacific are not doing it well.”
He admits it’s more challenging across the region because the island nations’ smaller economies do not have the health resources its bigger neighbours such as Australia and New Zealand operate on.
Therefore, Dr Puloka stresses education and lifestyle changes to diet and exercise are essential to reversing the rising and alarming projections.
A 2012 WHO (World Health Organisation) report noted that ‘tobacco is the leading behavioural risk factor causing substantially large numbers of potentially preventable deaths worldwide, leading to one death every six seconds’. Pacific island nations Kiribati and Papua New Guinea were shown as having the 3rd and 5th highest smoking rates in the world with prevalence rates of 67% and 55% respectively.
The share of public expenditure on health is also rising, said Dr Puloka, with nine of the 11 Pacific countries featured in a WDI (World Development Indicator) report increasing their share of public spending on health as a percentage of GDP (Growth Domestic Product) between 2000 and 2013, despite being increasingly vulnerable to global economic shocks.
Working closer with the private sector is one of the few ways Dr Puloka can see light flickering at the end of the tunnel.
“Preventing the rise of NCDs through education is the key for long-term sustainability,” he says.
"Working alongside the private sector to find solutions has the potential to provide a workable solution.”