Tackling health burdens

Yves Corbel
“Public health is undeniably a daunting challenge for Pacific political leaders and health officials. Both communicable and non-communicable diseases impact on the health of our populations and significantly affect the broader social and economic development of our region.
“In order to overcome the challenges of limited human and financial resources, the region needs stronger partnerships among key stakeholders, greater pooling of resources and effective mobilising of resources from multiple partners. But more importantly, a fundamental requirement for sustained positive health outcomes in the region is political commitment.” - Lourdes Pangelinan, SPC Director-General.


Last March, Pacific Ministers of Health met in Apia, Samoa, to discuss ways of strengthening collaboration between Pacific countries on regional health issues. Co-organised by the World Health Organisation (WHO) and the Secretariat of the Pacific Community (SPC), the meeting considered progress made in the last decade towards the attainment of the vision of “Healthy Islands”, as well as the much-needed urgent and continued actions to tackle health burdens of the Pacific.

In her keynote address, Pangelinan recalled that “a decade has passed since the first Healthy Islands meeting in 1995. As the year gets underway, we are finding ourselves at a critical crossroads to achieve our goal of a healthy Pacific Islands region.

Pacific Islands countries and territories today are at various stages of a 'health transition' period, in which communicable diseases like tuberculosis, malaria, epidemic diseases and HIV/AIDS, and STIs (sexually transmitted infections) remain major causes of ill health and deaths, while the prevalence of non-communicable diseases is quite substantial.


One vision, a double burden, three challenges

Infectious diseases threaten health in two ways in the Pacific islands. First, existing significant health problems (HIV/AIDS, dengue and others) are on the increase. Second, there is the ever-present threat of new and emerging infections (such as pandemic influenza) which, if imported into the islands, could devastate the health of our populations. Here, we have to fight on two fronts: we need to prevent or eliminate existing infectious diseases, while remaining vigilant for new threats and be prepared for a rapid response.

Health statistics show non-communicable disease is increasing in the region. Pacific Islands countries consistently have high rates of death due to heart disease, stroke and diabetes in the Western Pacific region of WHO.

Our third challenge, facing all Pacific Islands, is to develop health workers to a level where they can provide high-quality health services in the context of effective and efficient health systems. One innovative solution, distance education through the Pacific Open Learning Health Net, was reviewed at the ministers meeting.


Global Fund steps in

SPC plays a lead role in coordinating regional efforts in the Pacific to tackle these challenges and in helping channel support from the international community. In 2003, with the help of SPC, UNAIDS and WHO, 11 Pacific Islands countries were successful in obtaining funding from the Global Fund to Fight AIDS, TB and Malaria (GFATM) for three multi-country projects.

GFATM, an unprecedented effort by the international community to reduce suffering and death from these major causes, does not actually implement projects; it relies upon local organisations with the knowledge and experience to implement the projects it funds. As a financing mechanism, GFATM is able to encourage various partners, such as international and regional organisations, governments, NGOs and the private sector, to mobilise their resources in the fight against HIV/AIDS, TB and malaria.

The Global Fund commitment to the Pacific Islands to fight these three diseases is US$14 million over five years. The HIV/AIDS component includes 11 Pacific Islands countries: Cook Islands, Fiji Islands, Kiribati, Federated States of Micronesia, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu; the TB component includes all except Fiji; while the malaria component involves only the Solomon Islands and Vanuatu.

Eighteen months after the GFATM project inception, initial results for malaria and TB have already reached or exceeded the targets. The number of trained personnel working in the fight against TB, for example, has substantially increased with 49,000 more people receiving treatment. Public information programmes are increasing public awareness of the three diseases.

The March ministers meeting in Apia tasked SPC, UNAIDS and WHO to again assist Pacific Islands countries with a new submission for GFATM funding.

The inclusion of American Samoa, Nauru, Marshall Islands and the Commonwealth of the Northern Mariana Islands (CNMI) in the next submission will expand the number of Pacific Islands countries and territories involved with the GFATM to 15. Such strong partnerships among key stakeholders, including regional governments, NGOs, regional and international agencies and development partners, are the key to achieving the vision of a healthier region. SPC will continue its work in support of a harmonised regional approach to meet all three challenges-infectious diseases, non-communicable diseases and health training and education in the Pacific.



Yves Corbel is SPC Deputy Director-General and the Director of Social Resources Division.