The joint mission of the Pacific Regional UN Thematic Group on NCDs1 and the United Nations Interagency Task Force on the Prevention and Control of Noncommunicable Diseases (UNIATF) took place in Tonga between 9-13 March 2015. FAO, UNDP, UNESCAP, UNPFA, UN Women and WHO joined the mission.
NCDs account for around 70-75% of all deaths in the Western Pacific. Of these 50% are premature and the vast majority are preventable. Ministers of Health have committed themselves to action. In 2013 a WHO Western Pacific Regional action plan, fully aligned to the WHO Global NCD Action Plan, 2013-2020, was endorsed in 2013 and provides a clear way forward for countries to stem the tide of NCDs. In 2014, Pacific Health Ministers adopted the nine voluntary global targets for NCDs for the region, with an additional ambitious goal of a Tobacco Free Tonga is a middle-income country with a population of 103,300.
The Tonga Strategic Development Framework II, 2015-2025 includes as an outcome, “Stronger integrated approaches to address both communicable and non-communicable diseases”. Tonga has also utilized the MDG acceleration framework to identify and address key bottlenecks in its multisectoral response to NCDs.
The Joint Mission found that life expectancies for men and women are low and have shown no improvements since the early 1990s (low 60s for males and high 60s for females). This is a reflection of the premature adult mortality from NCDs as Tonga has relatively low infant and child mortality. The Joint Mission found extremely highprevalence of diabetes (34% in 2012).
The mission reviewed two national NCD STEPS surveys that were carried out in 2004 and 2012. They demonstrated enormous levels of NCD risk factors but considerable improvement in the numbers of people physically active and eating adequate amounts of fruit and vegetable.
As with other Pacific Island States, diet-related chronic diseases appeared to constitute the greatest single cause of death in Tonga with large proportions of household food expenditure spent on unhealthy imported foods.
The Joint Mission reviewed the draft multisectoral NCD action plan and governance arrangements for its implementation. The Joint mission also reviewed action to prevent and control NCDs across the Government of Tonga as well as support being
provided by the UN Country team and the activities of civil society and other development partners. A stakeholder workshop was conducted during the mission, where the Joint Mission heard from those involved in the prevention and control of NCDs. The mission also held meetings with Parliamentarians.
The Joint Mission’s report has been submitted to the government. It includes recommendations in the following five areas: (i) strengthening coordination and accountability at different levels; (ii) Developing a costed national multisectoral NCD plan, that prioritises the most cost effective actions, with national targets with clear mechanisms for accountability in place; (iii) financing the NCD response; (iv) developing and implementing a powerful and effective national NCD communication strategy; and (v) follow up.