Case Studies, Pacific
Tonga prioritises NCDs
HPF’s Senior Health Promotion Strategist in charge of the Pacific portfolio, Dr Viliami Puloka, reports that non-communicable diseases (NCDs) – many of which are preventable – are the overwhelming cause of death in Tonga. The good news is that Tonga recognises the problem and is prioritising it at a government level. Dr Puloka believes the situation there is reflected across the Pacific and that we should keep a close eye on the results of the work being done in Tonga to address the problem.
Babies in Tonga have an excellent survival rate, with just 15 out of 1,000 dying before they reach the age of five – a mortality rate of 1.5%. However this picture changes dramatically once Tongans reach 15, where 25.6 % of males and 35.1% of females die before they reach 60 years of age. [i] Much of this dramatic increase in mortality is accounted-for by NCDs, of which diabetes and cardiovascular disease are the main culprits.
Tonga top of the obesity league table
According to an article in British newspaper The Guardian in August 2006, more than 90% of Tongans are overweight; making it the world’s fattest nation .[ii] In 2012 a league table from the London School of Hygiene and Tropical Medicine, supported this figure; putting Micronesia and Tonga at the top of the obesity league table, just ahead of the United States.[iii]
Non-communicable diseases account for approximately 74% of all deaths in the Pacific nation. Of these the vast majority are preventable diseases such as diabetes and cardiovascular disease. [iv]
It’s not hard to see why NCDs are so prevalent here. Two research papers, summarised in Risk Factors: Results of the Kingdom of Tonga NCD Risk Factors STEPS report (2004) found that overall 60.7% of the Tongan population was at high risk of NCDs, with three to five risk factors from the following list:
- Smoking (46.2% of males and 16.3% of females aged 15-64 years)
- Alcohol consumption (22.2% of males and 4.8% of females aged 15-64 years)
- Low fruit and vegetable intake (approximately 92.8% of Tongans aged 15-64 reported they eat less than the require five servings of fruit and vegetables a day)
- Low physical activity (54.8% of females and 32.4% of males aged 15-64)
- Obesity (76.3% of females and 60.7% of males aged 25-64)
- High blood sugar (16.4% of Tongans aged 25-64 had elevated blood glucose levels)
- High blood cholesterol (66.1% of men and 34.2% of women aged 25-64 had blood cholesterol levels of more than 5.00 mmol/L)