Facing up to hardship in the Pacific

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Extreme weather events and cruel ironies of life and death in Australia’s Pacific neighbour countries are far from going away. Dr Lee Duffield reports.

RECENT BRAINSTORMING at a key institution in the Pacific region has updated alarming information on health and survival in the South Pacific islands, together with an outline of practical remedies.

Dr Colin Tukuitonga, Director General of the Pacific Community organisation, prepared the brief for a regional health forum at Brisbane in February, citing work by a team of researchers drawing on sources worldwide.


Tukuitonga told the gathering the South Pacific countries, through climate change alone, had been taking massive losses to annual gross domestic product (GDP) – 20-30% or more -- due to the effects of extreme weather events, especially cyclones.

While they are among some of the world’s poorest in dollar terms, for a bad year like 2009-10, those countries would be losing overall some $10 billion.

More figures reeled off by Dr Tukuitonga set out the pattern of relentless bad news, against which he offered some patches of light in terms of actions being taken, or which might be taken, by governments and other interests.


Life expectancy, although increasing, continues to lag behind the rest of the world — the gap hasn’t changed. In Papua New Guinea it is in the late 50s age group, in Fiji late 60s — against a country like Australia, for example, at 82.4 years of age. The premature death rate – those under 60 – exceeds the world average.

Infant mortality rates are high, particularly in Melanesian countries, with malnutrition among children under five reaching 50% in PNG and 30% in the Solomon Islands and Vanuatu.

Only half the regional population of ten million people have regular access to clean water and in competition with many other demands on resources, the provision of better water supplies has been “very slow to improve”.

While health financing is an obvious "major issue” the burden of non-communicable diseases (NCDs) connected to living conditions and economics -- like diabetes, heart or kidney disease, cataracts, cancers or stroke – continues to intensify. Three-quarters of deaths are now being attributed to those diseases, which most often affect people in their economically more productive years — worsening the chances for society to do anything about it. One third to half the population of several islands have diabetes. The economic cost of NCDs is expected to take away 9-15% of GDP by 2040.

Likewise, a continued lag in the number of years spent at school, against world averages, now adds to economic losses through the impact of joblessness.


Pacific Islanders have been actively taking on causes of these problems, assaults on the state of the ocean itself, as world climate changes: 

  • ocean acidification, especially in the Eastern Equatorial region, affecting healthy corals essential for the life of the sea;
  • rising sea levels and displacement of peoples — a Fiji Government program is already moving 63 villages;
  • drought;
  • cyclones: and
  • tsunamis.

Dr Tukuitonga said:

“Pacific Islanders are very careful about the ocean. Their livelihood depends on it. They take good care.”

Their delegations had a “terrific impact” on the outcome of the 2015 Paris climate change agreement, signed by 195 countries for dealing with greenhouse gas emissions, where they demonstrated the impacts of climate change in their region and demanded urgent action.

The list of the causes of the crisis in the Pacific is well-known without containing easy answers:

  • political instability and unclear accountability;
  • stagnant economies with educational under-achievement and skills losses;
  • “loss of focus” and ignoring of basics, like supplying fresh clean water;
  • globalisation, with lopsided free trade and imported goods having harmful impacts;
  • inadequate investment in health services, like employing health care workers; and
  • inadequate action against causes of ill health.

The main answer on the health front is to pinpoint and take action on major causes, like the devastating impacts of a changing diet in most of the Pacific states and also the impacts of smoking.

A study of 12 of the island countries or territories showed 70% of people smoking in 2017; smoking levels up to 80% are heaviest among men and fast catching on among females and the young.

Processed foods like breakfast cereals, canned fish, noodles and soft drinks have displaced nourishing products from village gardens and local fishing, which is blamed for a scourge of bad eating with heavy sugar content explaining the prevalence of diabetes.

“It is nothing new but this is the epicentre of obesity,” Dr Tukuitonga said, making the case for targeted attacks on “health determinants” and their linkage to problems in ailing local economies.

The strongest response had been the movement to impose restrictive taxes on tobacco products and soft drinks, with so far new taxes being imposed in, among others Fiji, Niue, Tonga, Vanuatu and Wallis and Futuna. 

The Pacific Commission, itself, had set up a seed bank to encourage planting of village gardens with new varieties of staple crops, such as taro and bananas, resistant to salty environments — where islands were facing encroachment from the sea.

For more focus, the strategic case for dependable supplies of good water had to be taken up.

Dr Tukuitonga said:

“We need to put more attention on clean water. We can target a basic thing like water. It is really important and if I had funding I would put more money into water.”

A coming aid would be better communication using new technologies, the example being safety messages broadcast in Tonga ahead of the 2017 cyclone. Despite the large-scale destruction, no lives were lost.


The Pacific Community is an inter-governmental agency with 26 members, embracing virtually all of the South Pacific, formed in Canberra in 1947, to be the  principal scientific and technical organisation for the region. Led by research, it works on getting “a deep understanding of Pacific islands contests and  cultures”, with specific interests in fields such as climate change, disaster risk management, food security, gender equality, human rights, non-communicable diseases and youth employment. Initially called the South Pacific Commission, it has an annual operating budget of approximately $140 million and 600 staff.

The member states are:

  • American Samoa 
  • Australia, Cook Islands 
  • Federated States of Micronesia
  • Fiji 
  • France
  • French Polynesia 
  • Guam 
  • Kiribati
  • Marshall Islands 
  • Nauru 
  • New Caledonia 
  • New Zealand 
  • Niue 
  • Northern Mariana Islands 
  • Palau
  • Papua New Guinea 
  • Pitcairn Islands 
  • Samoa 
  • Solomon Islands 
  • Tokelau
  • Tonga 
  • Tuvalu 
  • United States of America 
  • Vanuatu 
  • Wallis and Futuna

Dr Colin Tukuitonga, from Niue, is a former head of Pacific Island Affairs in the New Zealand Government; Director of Public Health in the New Zealand Ministry of Health; and Head of Surveillance and Prevention of Chronic Non-Communicable Diseases at the World Health Organisation. He was addressing the Pacific Health Governance Workshop at the University of Queensland, 15-16 February 2108.

Dr Lee Duffield is a former ABC foreign correspondent, political journalist and academic.

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