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PARADOX IN PARADISE
Dr Viliami Puloka
Secretariat of the Pacific Community
PACIFIC ISLANDS - WHERE?
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
“PARADISE”
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
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
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
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
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
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
NCDs already significant and risk
factors are feeding the future
pipeline
(Main Non-Communicable Diseases= Cardiovascular disease; Cancer; Diabetes;
Chronic Respiratory Disease)
NCD PATHWAY
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
Today is the Tomorrow you dream about
Yesterday!

Yourself,
is the only instrument you have
to deal with Life and
to contribute to Life
HEALTHY ISLANDS-HEALTHY PEOPLE

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Next Step 2014 presentation by Dr. Viliami Puloka from Secretariat of the Pacific Community (SPC)

  • 1. PARADOX IN PARADISE Dr Viliami Puloka Secretariat of the Pacific Community
  • 3.
  • 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
  • 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)
  • 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

Editor's Notes

  1. Looking at the three most common NCD conditions, Diabetes, High blood Pressure and Obesity , the prevalence are among the highest in the world. Hypertension is the most common condition leading up to cardiac arrest which is the leading cause of death in the Pacific. This is the deadly three and they are pretty even for all the countries of the Pacific. We only present the data that has been published but all the countries have very high prevalence including Smoking, alcohol consumption. Level of physical activity and consumption of fruits and vegetables are very low. “The perfect recipe for NCD.”