While the Cook Islands population is fewer than 15 000, it has still managed to take significant strides in expanding priority actions to control noncommunicable diseases (NCDs). They raised tobacco taxes for the past three consecutive years and recently launched a tobacco cessation programme. In 2013, they introduced an import levy on sugar-sweetened beverages, with annual subsequent increases to ensure ongoing cost increases.
First, measure the problem
From 2003 to 2004, the first national NCD STEPS survey of chronic disease risk factors was conducted in the Cook Islands. Results from that survey revealed that almost half of all adults, both men and women, smoked tobacco with around half starting by age 20. Furthermore, 3 out of 4 respondents engaged in insufficient physical activity while almost 2 out of 3 were obese. The survey was conducted among adults aged 25 to 64 years old. The second national NCD STEPS survey is ongoing and now includes population salt intake assessment.
Then plan and implement priority interventions
The first Cook Islands national NCD strategy was from 2009 to 2014. The second strategy will be rolled-out this year and will extend until 2019. The WHO PEN (Package of essential NCD interventions) has been adopted and rolled-out nationally. Cook Islands are working to prevent cervical cancer through screening and HPV vaccination, which was introduced three years ago. Currently they are finalising an evaluation system which builds on their existing health information system.
The Cook Islands have shown with national commitment it is possible to address NCDs in a sustained manner.
New report from WHO on NCD targets
A new report from WHO provides the baseline for monitoring implementation of the Global action plan for NCDs 2013-2020, aimed at reducing the number of premature deaths from NCDs by 25% by 2025. Outlined in the action plan are nine voluntary global targets that address key NCD risk.
Nearly five years into the global effort to reduce premature deaths from NCDs by 25% by 2025, the report provides a fresh perspective on key lessons learned. The report provides “best buy” or cost-effective, high-impact interventions recommended by WHO, including banning all forms of tobacco and alcohol advertising, replacing trans fats with polyunsaturated fats, promoting and protecting breastfeeding, and preventing cervical cancer through screening.
Cook Islands is just one of the Pacific island countries that is successfully implementing these interventions to meet global targets.