Islands Business - WE SAY: Lifestyle diseases haunt islanders

October 2009 Issue

‘…are we doing enough to address the situation? As a former head of surveillance and prevention of chronic diseases at WHO and presently the chief executive of the Ministry of Pacific Islands Affairs in New Zealand, Dr Colin Tukuitonga candidly revealed not enough is being done to address the situation on a scale that it needs to be tackled with. And it was turning serious with each passing week. Despite several initiatives being put in place both regionally and by individual national governments, the outcomes have not been encouraging’

One of the more unfortunate consequences of globalisation and the increasingly unrestricted movement of goods, services, ideas and practices further fuelled by the proliferation of the global instant media is the spread of what can be loosely termed as the global culture including new and often unsuitable choices within a country’s milieu of food, clothing and other aspects of lifestyle.
Ever increasing choices of processed foods through supermarket shelves and relatively cheap and convenient fast food vended out through global chains, in most cases on a 24 x 7 basis, has exposed traditional communities not used to such high concentrations of salt, sugar, poly unsaturated fat and dozens of other chemical additives within a short period of time over the past few decades.
With the result, lifestyle diseases such as diabetes, hypertension, obesity, renal, respiratory and coronary heart disease, besides about a dozen others—hitherto largely considered “rich peoples’ ailments”—have now come to increasingly haunt ordinary folk all across the world including the Pacific Islands. All these are non-communicable diseases, NCDs for short, though some would definitely fall into the category of ailments that can be said to have genetic predispositions.
But by and large, most of these diseases have been proven to be lifestyle driven. Even those that have genetic predispositions could well be triggered or exacerbated by lifestyle changes as has been experienced to the utter dismay and costs of the public health systems in rich and poor countries alike in recent decades.
Adding on to the problems caused by low nutritive value processed food that more often than not come with a high glycemic index (GI), is the increasingly sedentary lifestyle people have begun to lead even in traditionally physically active societies because of the proliferation of instant personal and mass communication networks and devices such as mobile phones and the internet—not to mention the affordability of cheap personal transport options.
It is a small wonder therefore that even in countries that fare poorly on economic indices when compared to traditionally rich nations, they fare far on par as regards the incidence of lifestyle diseases.
But unlike the richer nations which can afford to put in place a range of mitigation factors across the board, beginning with dealing with the manifestations of the diseases themselves to education and even incentive programmes for adopting healthier lifestyle practices, the poorer nations have no comparable resources to fall back on.
Added to that the lack of infrastructure and trained personnel as well as relatively low awareness of the consequences of adopting unsuitable lifestyle changes has greatly accelerated health sector problems in the developing world of which the Pacific Islands region is a part.
Going by rate at which the incidence of lifestyle diseases is growing in the islands, it is going to be difficult for governments to catch up with mitigation and prevention programmes with the level of resources they are operating at present. The incidence of Type II diabetes, obesity, coronary heart disease and problems caused by high cholesterol are increasing by leaps and bounds throughout the islands—where not much more than a generation ago such ailments were almost never heard of.
According to a major gathering on non-communicable diseases specialists and development partners brought together in Nadi, Fiji, last month by the Secretariat of the Pacific Community (SPC) and World Health Organisation (WHO), as much as 75 percent of lives in the region are claimed by NCDs – including heart disease, stroke, cancer, diabetes and respiratory ailments.
It is a welcome development that these organisations have helped put in place a programme called the 2-1-22 regional initiative on NCDs (two organisations, one team, 22 countries) under the Pacific Framework for the Prevention and Control of Non-communicable Diseases.
But are we doing enough to address the situation? As a former head of surveillance and prevention of chronic diseases at WHO and presently chief executive of the Ministry of Pacific Islands Affairs in New Zealand, Dr Colin Tukuitonga candidly revealed not enough is being done to address the situation on a scale that it needs to be tackled with. And it was turning serious with each passing week.
Despite several initiatives being put in place both regionally and by individual national governments, the outcomes have not been encouraging. Every government, for instance, has programmes to curb the spread of smoking and awareness initiatives on diseases like diabetes. Some have gone on to encourage active lifestyles with a country like Tonga stipulating that every new road built in the country must have a footpath to encourage people to walk. Such bottom-up approaches like the one that the Tongan government has adopted are key to a multi-pronged approach in tackling the menace.
Other ideas, as suggested by speakers at the meeting, such as starting awareness programmes in schools so that children are taught about the dangers of falling into the lifestyle disease trap at a young age needed to be encouraged and funded.
Initiatives like more stringent food labelling, enactment of appropriate legislation to control and even help prevent cheap food imports by unscrupulous businesspeople particularly of the fat loaded, lamb flap variety which some dealers in rich nations where such products are banned are only too keen to dump on countries where either no regulations are in place or that can be bypassed or twisted by corrupt officials.
Countries also need to promote people who have achieved their goal of living a healthy disease-free lifestyle and employ their services as role models and even initiate a reward regime in the form of incentives for people who are known to be at risk and adopt a healthy diet and active lifestyle to mitigate their condition.
Innovative bottom-up initiatives are more than likely to help stem the rot much more affordably rather than for governments to ratchet up ever growing bills in putting in place infrastructure, personnel and ongoing care to deal with the effects of the diseases after they strike.
The old adage prevention is better than cure is as valid today as it ever was.