.Following the highly successfully hosting of the SIDS4 conference in St. John’s, Prime Minister the Hon. Gaston Browne, today joined forces with the Director General of the World Health Organization, Tedros Adhanom  Ghebreyesus in a Devex publication tagged “Let’s heal the health challenges faced by small island states.”

In the Op-Ed,  (in a Devex opinion piece) both Prime Minister Browne and DG Tedros wrote that “Climate Change and debt aren’t the only threats SIDS are grappling with.

“SIDS have disproportionately high rates of cardiovascular diseases, diabetes, cancer, and chronic respiratory conditions,” they write. “Pacific island countries account for nine out of the top 10 countries in the world with the highest prevalence of obesity among both women and men. …Tobacco use and mental health conditions such as depression and anxiety are also highly prevalent.”

DG Tedros and PM Browne outline four ways that leaders and donors can help, including more aid and debt relief, as well as adopting WHO’s “best buys,” such as taxes and regulation, “which are powerful tools for limiting the impact of health-harming products, such as foods high in sugar, unhealthy fats or salt, or highly processed foods.”

We reproduce the full text of the Op-Ed below and the link to the Devex publication: https://www.devex.com/news/opinion-let-s-heal-the-health-challenges-faced-by-small-island-states-107717

Opinion: Let’s heal the health challenges faced by small island states 

The hurdles small island developing states are facing in their health systems require urgent attention and investment.

By Gaston Alfonso Browne, Tedros Adhanom Ghebreyesus // 03 June 2024

We live in a world of overlapping crises – climate change, rising seas, food price hikes, long-running wars, growing disease burdens, and contracting economies, just to name a few. The 39 nations classified as Small Island Developing States (SIDS) by the United Nations are among the most affected by these challenges, and yet the least responsible for them. While many of these crises manifest themselves as economic and social threats, the impacts on the health of populations are an often-neglected issue.

In fact, SIDS are on the frontline of many health threats. This is particularly true in the areas of noncommunicable diseases and mental health, with consequences for premature mortality and threats to livelihoods and wellbeing.

SIDS have disproportionately high rates of cardiovascular diseases, diabetes, cancer, and chronic respiratory conditions. Pacific island countries account for 9 out of the top 10 countries in the world with the highest prevalence of obesity among both women and men. Commercial and trade-related forces create persistent barriers to access healthy, safe and sustainable diets. Tobacco use and mental health conditions such as depression and anxiety are also highly prevalent.

All of these issues are exacerbated by the climate crisis, which is an existential threat to in the very existence of SIDS. While they represent just 1% of the world’s population and economy and emit less than 1% of greenhouse gases, SIDS are disproportionately and severely affected by climate change, rising sea levels, and natural disasters.

Despite limited resources and geographical constraints, SIDS have shown remarkable global and national leadership and resilience in the face of adversity. But they also face significant domestic challenges that require attention. The health systems of most SIDS have decades of underinvestment, limited capacities, and persistent gaps in health-related data and statistical capacities. These health system hurdles require attention and investment.

We cannot afford to ignore the crippling impact of these colliding threats. It is our moral imperative to act swiftly and decisively, to forge a path forward based on equity, resilience, and sustainability. The challenges faced by SIDS are interconnected.

The landmark Bridgetown Declaration on NCDs and Mental Health, adopted by SIDS in June 2023, showcased the feasibility of SIDS-specific actions, evidence-based commitments and accountability mechanisms to overcome the multifaceted challenges that island nations face. That, along with the COP28 Declaration on Climate and Health, are important for countries to adopt and implement to help SIDS move forward.

Here are four priorities, for both national leaders and international actors and donors:

First, we call on the international community to support the SIDS in their efforts to strengthen their health systems, including through enhanced official development assistance and financial and technical support and support to research, development and innovation programmes. 

Second, we must enhance promotion, prevention, early detection measures, management and control and prioritize the integration of NCD and mental health into primary health care package of services.

This includes implementing WHO’s “best buys”, a set of cost-effective interventions to prevent and manage NCDs, including taxes and regulation, which are powerful tools for limiting the impact of health harming products, such as foods high in sugar, unhealthy fats or salt, or highly processed foods.

Many SIDS are already implementing these measures: Mauritius has taken decisive action on tobacco control; Fiji has vaccinated teenage girls to protect them from cervical cancer; Timor-Leste is putting 50,000 people with hypertension and diabetes on standard care by 2025; and Barbados has introduced a school nutrition policy, banning trans fats and reducing the consumption of salt and sugar.

SIDS are also taking action on mental health. For instance, Antigua and Barbuda is building the capacity of primary care providers to identify and manage priority mental health conditions, and Tuvalu aims to develop a comprehensive mental health action plan by 2025.

Third, meaningful action on health and climate means overhauling financing to unlock billions in joint investment in climate action, good health and wellbeing, while making it less punishing for developing countries to pay their debts.

Fourth, health workforce issues also pose significant challenges for SIDS, which struggle to sustainably produce, recruit, and retain an adequate number of health and care workers. This is exacerbated by historical underinvestment and the migration of health workers. The impact of these shortages on already strained health systems is substantial. Addressing this requires measures to educate, employ, protect and retain health workers, and to manage migration ethically in line with the WHO Global code of practice on international recruitment of health personnel.

The Fourth International Conference on SIDS, hosted by Antigua and Barbuda on 27-30 May 2024, will provide a historic opportunity to reaffirm commitment to addressing the complex development challenges faced by SIDS, and to recommit to delivering on the SIDS health agenda. We simply cannot afford to ignore the crises affecting SIDS anymore. The future of island nations depends upon our leadership and action.

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