By IPS Correspondents
SUVA, Mar 28 2007 (IPS)

Pacific Island Countries (PIC) have made no real effort to deal with a public health crisis arising from overweight populations because it is “silent” and the effects are not immediate say experts.

Commenting on a World Health Organisation (WHO) report, released late February, that identified lifestyle diseases as the number one killer in the region, associate professor in economics at the University of South Pacific, Mahendra Reddy, said the findings were alarming but not surprising.

Reddy told IPS that the problems have been mounting because of delays in dealing with them and that many governments in the region are now finding that they lack the capacity to cope.

‘’As is the case in most developing countries, Pacific Island governments are facing many competing demands. With lifestyle diseases, the problems are not visible or immediate so they do not figure on the government’s top 10 or 20 list of priorities,” said Reddy.

In the WHO report, released last month, eight of the 10 “fattest” countries in the world were from the Pacific, with over 80 percent of the population in most of these countries deemed to be seriously tipping the scales on the wrong side.

Nauru weighed in with an alarming 94.5 percent of its adult population overweight and, together with the Federated States of Micronesia, Cook Islands, Niue and Tonga, filled out the top five slots. All have 90 percent of their populations overweight.

Reddy said that the loss in human capital was significant, adding it was having a crippling effect on the economies and the societies of the countries concerned. Money spent on treatments and doling out welfare payments could instead have gone towards building capacity in the economy, he said.

Delegates at a WHO-sponsored conference on obesity held in Istanbul, last year, said nutrition-related diseases could slice two- three percent off the GDP of affected countries. Meera Shekar, senior nutrition specialist with the World Bank, said at a WHO-sponsored conference on obesity the conference malnutrition sliced 2 to 3 per cent off gross domestic product in the hardest-hit countries, and obesity could cost the same.

“If you’re obese you’re more likely to be sick, to be absent from work … the opportunity cost of not working, these are indirect costs,” Shekar was quoted as saying at the conference according to the records of the Geneva-based health body. Citing available estimates, Shekar said that in 1992 obesity cost France 12 billion US dollars in direct costs alone.

“People with lifestyle diseases can linger on. They require long-term care which puts pressure on health facilities,” said Reddy who is also an associate dean of research and postgraduate affairs at the Suva-based university’s faculty of business and economic studies.

Another problem faced by the PIC, when it came to dealing with the health crisis identified by the WHO report, was a paucity of private health facilities.

Reddy said in most PIC, a majority of the people were employed in the informal sector, earned low wages and could not afford private medical care.

The lack of demand restricted the development of private health care facilities, forcing governments to take over the bulk of the responsibility.

“When health care is passed on to the private sector, a significant burden is removed from the government.” But this is not the case in most PIC where the government is the primary provider of health services. ‘’They are now unable to cope with the requirements and are forever short of human resources, equipment and medicine.”

Reddy added that the impact of high mortality rates or debilitation due to lifestyle diseases is also serious at the micro level. “If a breadwinner is dead or sick, and there is difficulty meeting the daily needs, families will cut back on activities that cost money.

“One result is children dropping out of school and going to work. The effect is intergenerational as research shows that uneducated children from poor backgrounds become entrapped in the poverty cycle.”

The WHO report blames the health problems on the dependence on imported, processed foods rather than eating fresh, local, nutritious foods. It has called for and is involved in an awareness and education programme starting from the grassroots.

Lax rules and regulations in the import of poor quality processed foods have also been blamed and calls are now being heard to ban the import of cheap, fatty meats such as lamb flaps from New Zealand.

The regional news magazine, Pacific Islands Business, in highlighting the problem in an editorial this month, said growing economies had made imported foods cheaper and more accessible.

It pointed out that tinned fish was now cheaper than fresh fish in the islands, and blamed poor public awareness and lack of government regulations for making the islands a “happy dumping ground” for unhealthy products from developed countries, particularly Australia and New Zealand.

Reddy said educating and legislating would be merely dealing with the “supply” side of the problem and would be insufficient.

He said people’s consumption habits were determined by price and income, and as such, the “demand” side of the problem, which is rooted in poverty, has to be considered if a meaningful, lasting solution is to be found.

Why do people in the Pacific islands engage in this type consumption? The answer, according to Reddy is that it is cheaper than buying food that is healthy. ‘’Over 70 percent of people in most island countries are earning poverty-line wages. You cannot expect them to engage in costly consumption habits.”

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