Bleak outlook for Pacific on World Health Day
Today is World Health Day but by all accounts the Pacific is anything but healthy. Between 30 and 50 percent of the populations of all Pacific countries are either overweight or obese and the region has some of the highest non-communicable disease rates in the world.
Today is World Health Day but by all accounts the Pacific is anything but healthy.
Between 30 and 50 percent of the populations of all Pacific countries have diabetes and the region has some of the highest non-communicable disease rates in the world.
The focus of World Health Day this year is Beat Diabetes with emphasis on scaling up prevention, strengthening care and enhancing surveillance.
The Director-General of the Pacific Community Colin Tukuitonga says diabetes rates in the region continue to climb at an alarming rate and a multi-dimensional approach is needed if there is to be any hope of slowing let alone stopping the trend.
COLIN TUKUITONGA: We need to strengthen the whole spectrum from information and education for healthy people about better diet and physical activity and son. But also for early detection. The problem with type 2 diabetes which is the predominant type that our people suffer from. It's mostly hidden. A lot of people don't know they have diabetes until they have a cut on their legs that doesn't heal, for example. So the symptoms that people describe of you know severe thirst and weight loss and all that sort of thing is more to do with type 1 diabetes, which is different. But type 2, more often than not, people don't have any symptoms. So it's really important that they get checked, you know, to get the nurse to check their blood sugar (levels) and weight and so on. So that's the area that we're trying to encourage at this time. But also obviously once people have diabetes it's really important that it's managed properly, because the problem with diabetes is not so much in the short term, but it's in the long-term where complications set in such as blindness, heart disease, kidney failure... those sorts of really terrible long-term complications.
KOROI HAWKINS: I was giong to ask you about the types (of diabetes). There's three types, I understand, and the type 2 you mention that is the largest in the Pacific, that is actually preventable in terms of living a healthy lifestyle, is it?
CT: Yeah the big trials from around the world have shown that with an active lifestyle, a good diet - regular physical activity and a good diet - you can prevent or at least postpone a large proportion of type 2 diabetes, so people need to maintain a healthy weight, to keep an eye on what they eat. Consumption of fizzy drinks has become quite a major issue and of course sugar consumption, more broadly. So that's the sort of advice that we're trying to give to the people in the region. The problem we have in the Pacific is we don't have any hope of managing the complications of diabetes once they set in. For example, to put someone on dialysis, it costs about 40,000 US dollars a year. And generally the outcomes for people who have kidney failure from diabetes is pretty bad, most of them have died within two years. And so this is why our advice generally is in the prevention, education, early detection, better management at primary care community level, because once the complications set in it's pretty much unaffordable from a state health budget point of view. But clearly from a family and personal viewpoint as well.
KH: Right and is there any progress being made on any front in combating NCDs?
CT: Oh yeah, and the news is pretty bad on that front. I'm not aware of any of the islands making any progress on reducing the prevalence of diabetes. If anything the general trend continues to be an upward trend. There's a lot being done, obviously, but we're not making the impact that's needed.
KH: And what is needed to make that impact?
CT: Well I think firstly the improvements in diets and what people eat. Less consumption of imported, highly processed food like rice and processed flour, fizzy drinks, that kind of thing. And more consumption of locally-produced fresh fish, taro, cassava and kumara and so on. Improvements in diet. A reduction in the prevalence of obesity would be a good indication. But again, none of that is apparent. A reduction in prevalence of diabetes. Those sorts of indicators, none of which are apparent at the moment.
KH: So, basically you're saying we're our own worst enemy in terms of our choices and what's being brought into countries?
CT: Well I suppose that's one way of putting it. But it's really important that we don't apportion blame, or victim blaming as people would say, because often that is counter-productive. There's no doubt that there are aspects of diets for example which are individuals' choices. But our general recommendation and advice is yes by all means provide individual education, information and support. But there needs to be systemic policy interventions led by government. And the NGO sector needs to contribute, the private sector, particularly those involved in production and distribution of food and drinks, the advertising industry, everybody's got to play their part. But to simply attribute the blame to the individual is counter-productive. So for example just telling people not to drink too many soft drinks is not all that effective. whereas we do know from experience around the world that if you increase the tax on soft drinks, consumption goes down. So really what's needed is a combination of individual education and information support, but also systemic policy type interventions.
Colin Tukuitonga says surveillance and prevention are the best approach for the Pacific because the cost of caring for people with diabetes is prohibitive for struggling health systems in the country.
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