Universal Health 2030 Solving Complex Health System Problems
April 2013 UNDP; The islands of the South Pacific have some of the highest rates of obesity and diabetes in the world, with obesity rates as high as 75 percent and diabetes rates as high as 47 percent. The islanders are raising the most obese generation of humans in history.
A deeper look at the international trade regimes of these countries indicates that many of them have, in effect, traded health for wealth.
The epidemic levels of non-communicable diseases (NCDs) like diabetes, cardiovascular disease and cancers in the Pacific region are closely linked to the progressive substitution of traditional foods with cheap, energy-dense and nutrient-poor imported foods — i.e., processed “junk.”
These countries are being compelled by various trade agreements to further reduce import barriers, making over-processed foods like tinned meats even cheaper and more accessible — and limiting the policy space to respond to the problem on public health grounds.
The correlation between imported food and unhealthy diets is exemplified by Kiribati, which is estimated to import a whopping 72 percent of its food and has the highest rates of unhealthy food consumption. Sugar alone accounts for more than 30 percent of the total daily caloric intake and 65 percent of the total intake of unhealthy foods in Kiribati.
Regional data on trade and consumption reveals an association between both imported and unhealthy foods as well as imported foods and obesity prevalence across the islands.
Several trade agreements currently being negotiated by the Pacific Island countries are likely to have a big – and negative — impact on future ability to address NCDs.
For example, reductions in tariffs on unhealthy products such as fatty meats, tobacco and alcohol could lower the prices of these products, contributing to further obesity, diabetes and heart disease. Trade agreements can also restrict governments from banning certain unhealthy products or imposing restrictions on food labeling.
In a historic move, UNDP, WHO and the Secretariat of the Pacific Community convened a meeting in February in Fiji to bring together representatives of health and trade ministries in nine Pacific Island countries to assess how to respond to this growing problem.
The main outcome of the consultation was an establishment of a platform for interaction between trade officials and health officials across the nine countries. Many of them noted that it was the first time they had ever worked together
This may be novel now, but this mode of cross-sectoral dialogue must become routine if we want to stop this problem from becoming even more obese.
