Pacific Island Countries and Territories (PICT) are experiencing a health crisis, with rates of non-communicable diseases (NCDs) soaring in recent decades. The major NCDs —cardiovascular disease, diabetes, cancers and chronic respiratory disease—account for more than 80 % of all deaths in the region. (WHO, 2013b)
Across the Pacific region, national governments and regional organisations have been working to combat rising rates of NCDs. A consistent message across these strategies and programmes has been the importance of a multisectoral approach to addressing the NCD crisis. For example, the Pacific NCD Roadmap noted that “relying on the health sector alone to reduce the NCD crisis is ineffectual. The social determinants of health need to be addressed” (World Bank, 2014, p. 9).
However, the various targets and objectives have proved difficult to meet. WHO (2018) has referred to “the lack of adequate global progress in combating noncommunicable diseases,” and noted the progress among WHO member states towards fulfilling the commitments made to combat NCDs was “disappointing” (WHO, 2018). Roberto et al. (2015) observed that no country has been successful so far in reversing its obesity epidemic, indicating that attempts to shift diets away from a reliance on energy-dense, nutrient-poor foods have been limited in their effectiveness.
In response to these shortcomings, this review seeks to apply a food systems approach to analysing NCD policy developments in the Pacific region. First, the meaning of a food systems approach and its significance and usefulness for analysing the complex problem of dietary change in the Pacific will be outlined. Then three domains of policy which impact upon diets in the Pacific will be examined: food production, climate change and sustainability, and trade.
By examining how these interlocking domains each contribute to the overall picture of diet in the Pacific, this review seeks to draw together research from a variety of different disciplines and sectors which are not always closely associated with public health. The intention is to bring a wider lens to the issue of food in the Pacific, which better meets the consistent demand for a multisectoral, multi-disciplinary approach in dealing with the NCD crisis.