Finance and Trade
Poor nutrition and reduced physical activity are leading causes of the current Non- Communicable Disease (NCD) crisis in the Pacific Islands as we move swiftly away from traditional lifestyles towards a market and services economy. In the Pacific Islands, diet and the economy are intrinsically linked in relation to the causes, consequences and solutions of the NCD problem.
In July 2014, Economic and Health Ministers from around the Pacific held a joint forum to discuss this relationship. During the forum the Pacific NCD Roadmap was presented to the ministers which outlines the current economic costs of NCDs and how their prevalence already undermines social and economic development in the Islands.
The report identified that in many Pacific Island countries and territories, the costs of treating NCDs take up more than 50% of the total health budget. In one Pacific Island country, treating one diabetic patient is equal to the average cost of treating 76 other people. Only 1.3% of the population can be treated with insulin before the total annual drug budget is exhausted. In another country, dialysis to treat kidney failure cost just under USD 40,000 per patient per year in 2010–2011, or more than 12 times the Gross National Income (GNI) per capita. Disability resulting from NCDs, including amputation and blindness, affects the productive members of Pacific communities, contributes to poverty and strains national budgets, taking a toll on individuals, families and economies.
Regional data on trade and consumption patterns highlights the association between imported foods high in unhealthy fat, sugar and salt and obesity. Yet countries are repeatedly compelled by various trade agreements to further reduce import barriers which make processed foods which are even more accessible. In fact, trade agreements have already made imported food cheaper than locally grown food in many countries.
The good news is the burden of NCDs can be reduced with immediate and urgent action by governments and communities and the much needed support of development partners. As a result of the forum the Economic and Health ministers committed to these 5 actions to develop country-specific roadmaps to address NCDs:
- Strengthening tobacco control by an incremental increase in excise duties to 70% of the retail price of cigarettes over the medium term;
- Consider an increase in taxation of alcohol products as a way of reducing harmful alcohol consumption
- Considering policies that reduce consumption of local and imported food and drink products that are high in sugar, salt and fat content and directly linked to obesity, diabetes, heart disease and other NCDs in the Pacific through targeted preventative measures, taxes and better regulation
- Improving the efficiency and impact of the existing health budget by reallocating scarce health resources to targeted primary and secondary prevention of cardiovascular disease and diabetes, including through the Package of Essential Non Communicable Disease Interventions of ‘best buys’
- Strengthening the evidence base for better investment planning and programme effectiveness to ensure interventions work as intended and provide value for money
The Economic and Health Ministers also commit to facilitate other multi-sectoral strategies, as described in the NCD Roadmap, as appropriate. This included a joint strategy to urge exporting countries to introduce policies and regulations that promote healthy food and drink products and restricting export and ‘dumping’ of such sub-standard and unhealthy food and drink products in the Pacific.
Moving forward Ministries of Finance and Economic Planning have a particularly strategic role to play by ensuring that scarce resources from Government, development partners, and other stakeholders are allocated to best use and can be sustained. Most Pacific Islands are caught in a pincer movement: rapidly rising NCD related health costs but only modest prospects for overall economic growth and revenue generation. They also have the important role of setting tax policy to discourage consumption of unhealthy products such as tobacco, alcohol and sugar sweetened beverages.
To see more on the Pacific NCD Roadmap and the new Pacific NCD Partnership click here.
“Addressing NCDs is critical for global public health, but it will also be good for the economy; for the environment; for the global public good in the broadest sense. If we come together to tackle NCDs, we can do more than heal individuals – we can safeguard our very future.”
Secretary-General Ban Ki-moon, United Nations General Assembly, 19 September 2011
WHOs Best Buys for NCD prevention. See the full break down here
- Pacific Trade and Human Rights: Released in 2014 by UNDP this report examines the current state of trade policy and agreements in the Pacific. Contains a case study exploring the links between trade liberalisation, nutrition and public health, specially the potential of sugar and fatty meat taxes. Includes recommendations to governments and policy makers in the Pacific.
- Pacific Trade and the Right to Health: This information sheet, developed by UNDP explains how trade in the Pacific is relevant to all people by highlighting the link between trade and the human right to health. One of the core minimum obligations in ensuring people’s right to health includes access to the minimum essential food which is nutritionally adequate and safe.
- Trade, trade agreements and non-communicable diseases in the Pacific Islands: Intersections, lessons learned, challenges and way forward: This report summarises the proceedings of the Sub-Regional Workshop “Trade, Trade Agreements and Non-Communicable Diseases held in Nadi, Fiji in 2013. The event was sponsored by SPC, UNDP Pacific Centre and WHO.
- Processed foods available in the Pacific Islands: A research paper led by Wendy Snowden that examines the impact of globalization of the food supply has on the Pacific Islands. The paper identified that from the sample of 6041 foods, 54 countries of origin were identified and the main provider of food for each country was the country with the strongest political links. Poor nutrient labelling and interpretation were also found to be an issue for consumers.
- Health implications of PACER-Plus for Pacific Island Countries: This article by Adam Wolfenden explores the potential impact of the free trade agreement PACER-Plus on Pacific Island countries ability to provide health care and respond to health problems
- Trade Agreements and Non-Communicable Disease in the Pacific Islands: Published in 2013 this report looks into existing trade agreements and negotiations and there potential impact on NCD’s in the Pacific. Prepared for the NCD Forum in 2011.
- Trade and the Nutrition Transition: Strengthening policy for health in the Pacific: This study describes pathways through which trade policy in two Pacific Island countries has contributed to changes in food supply and thereby the nutrition transition. It suggests that promoting healthier imports and increasing production of healthier traditional foods, both of which trade policy has an important impact on, has the potential to improve diets and health.
- Trade as a structural driver of dietary risk factors for non-communicable diseases in the Pacific: an analysis of household income and expenditure survey data: This study focuses on Kiribati, Solomon Islands, Tonga, Vanuatu and Samoa using data collected from the Household Consumption and Expenditure Surveys (HCES) and analyses the link between trade, diets and NCD risk factors such as obesity. It confirms that trade is a structural driver of NCD risk and highlights the need for health-sensitive trade policy and viable options such as sugar taxes to curb the NCD crisis.
- Trading health for wealth? Obesity in the South Pacific: An article by Douglas Webb for UNDP examining the impact of trade on health in the south Pacific.
- Trade and transfat in the Pacific: An article written for IRIN about the Pacifics struggeling agriculture, reliance on imported food and potential policy options ahead of the International Nutrition Conference in 2014.
- Cheap Meat: Flap Food Nations in the Pacific Islands: A fantastic book written by anthropologists Deborah Gewrtz and Frederick Errington that explores the controversial trade of inexpensive, fatty cuts of lamb and mutton from the farms of Australia and New Zealand to the Pacific Islands