Reflecting on the NCD crisis

On this date back in 2022, a Nadi-based private medical clinician urged health professionals and institutions alike to become more politically astute to bring about change and end the healthcare nightmare of noncommunicable diseases.

It was a powerful reminder by Dr Kris Naidu in the wake of statements at the time by the Health Ministry that NCDs were the number one killer in Fiji.

The “shocking data”, he said at the time, was “undoubtedly a consequence of an ailing healthcare system along with poor lifestyle choices and lack of health consciousness”.

We had one of the highest death rates from diabetes in the world, he pointed out, and our life expectancy world rankings show that.

Fiji, he said, needed comprehensive action plans that combined taxation, restriction of marketing of sugary products to children and education to reduce over-consumption of sugars and halt the epidemic of diabetes.

Today, as we have our children heading back to school for another new school year, perhaps we should reflect once more on this issue.

Given that we are at the start of a new year, perhaps we should be considering improving our diets and relook at the kinds of food we feed ourselves.

The Government and Ministry of Health, the good doctor said, had taken action to improve availability and access to healthy foods and comprehensive programs aimed at reducing consumption of sugars, but to no avail.

“Just as taxing tobacco helps to reduce tobacco use, taxing sugary drinks may help reduce consumption of sugars,” he was quoted saying.

We said this then, and say it again, processed foods are often high in calories, added sugars, trans-fats and sodium and they are heavily marketed products, such as soft drinks, instant noodles and biscuits. This isn’t something we can simply shrug aside and pretend will just go away. For many Fijians, it is a fact of life. They survive on food that are not good for a healthy lifestyle.

While the reality of NCDs being the nation’s leading killer cannot be ignored, attributing it solely to personal choices risks oversimplifying a complex issue with deep societal and systemic roots. Dr Naidu’s call for political astuteness from health professionals and institutions is a critical starting point. It was apt then as it is today!

Maybe the healthcare system itself deserves scrutiny. Is it adequately equipped to address the specific realities of Fijian communities?

Focusing solely on “poor lifestyle choices” ignores the powerful influence of structural factors shaping those choices. We are talking about heavily marketed processed foods. Our challenge goes beyond individual responsibility. While self-management and healthy choices are important, placing the burden on individuals is not only unfair but also ineffective. We need a multi-pronged approach that tackles the issue at various levels, from the individual level, social level to the economic and political levels. We should be building health literacy to empower communities to make informed choices.

We should be fostering supportive environments to support healthy lifestyle adjustments.

Once again we are reminded that perhaps we should be looking at policies that promote responsible marketing practices.

Perhaps we should also be relooking at health policies and putting in place measures that ensure access to top health services around the country.

In saying that, perhaps we also need the political will to make a difference.