By Professor T. Alafia Samuels – Director of the George Alleyne Chronic Disease Research Centre, University of the West Indies
Small Island Developing States (SIDS), most of which are in the Caribbean and the Pacific, face unique NCD challenges. They are among the most obese nations in the world, resulting in some of the highest diabetes prevalence rates globally.
Much of this is due to lack of food sovereignty. The World Trade Organization rules require open trade, facilitating importation of calorie-dense, nutritionally poor foods with long shelf life. The capacity to produce a variety of local fruits and vegetables is hampered by economies of scale and high cost of inputs many of which need to be imported from long distances away (e.g. farm equipment).
Many of these island states are classified as upper middle income and high income countries thus are attractive targets for “Big Food” and “Big Soda” and their aggressive marketing. This often includes marketing within school compounds, in violation of the human rights of these children to grow up in a healthy promoting environment.
Vulnerability to climate change, extreme weather, hurricanes, typhoons, earthquakes, volcanic eruptions can compromise the management of chronic diseases.
When a small island is devastated by a major hurricane for example, both individuals and health facilities might loose all their medication and facilities for dialysis, and the island nation may be completely cut off, having lost its airport, sea ports and all external communications. Thus the assumptions of the abilities of countries labelled “high-income” is not applicable to small island developing states. In many scenarios, including post-disaster, there is little local capacity to respond.
It is appropriate to consider SIDS in their post-disaster situation as desperately in need of support to facilitate recovery.