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Thow AM, Phulkerd S, Ngqangashe Y, Ravuvu A, Zaruba L, Huckel Schneider C, Collin J, Schram A, Friel S. Protecting children from unhealthy food marketing: a comparative policy analysis in Australia, Fiji and Thailand. Health Promot Int 2023; 38:daad136. [PMID: 38011397 PMCID: PMC10681351 DOI: 10.1093/heapro/daad136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Restrictions on marketing of unhealthy foods and beverages to children is a globally recommended policy measure to improve diets and health. The aim of the analysis was to identify opportunities to enable policy learning and shift beliefs of relevant actors, to engender policy progress on restrictions on marketing of unhealthy foods to children. We drew on the Advocacy Coalition Framework to thematically analyse data from qualitative policy interviews conducted Australia (n = 24), Fiji (n = 10) and Thailand (n = 20). In all three countries two clear and opposing advocacy coalitions were evident within the policy subsystem related to regulation of unhealthy food marketing, which we termed the 'strengthen regulation' and 'minimal/self regulation' coalitions. Contributors to policy stasis on this issue were identified as tensions between public health and economic objectives of government, and limited formal and informal spaces for productive dialogue. The analysis also identified opportunities for policy learning that could enable policy progress on restrictions on marketing of unhealthy foods to children as: taking an incremental approach to policy change, defining permitted (rather than restricted) foods, investing in new public health expertise related to emerging marketing approaches and scaling up of monitoring of impacts. The insights from this study are likely to be relevant to many countries seeking to strengthen regulation of marketing to children, in response to recent global recommendations.
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Affiliation(s)
- Anne Marie Thow
- Faculty of Medicine and Health, Sydney School of Public Health, Menzies Centre for Health Policy and Economics, Charles Perkins Centre (D17), The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Phutthamonthon, Nakhon Pathom, Thailand
| | - Yandisa Ngqangashe
- Australian Research Centre for Health Equity, School of Regulation and Global Governance, Fellows Road, Australian National University, Canberra, ACT, 2600, Australia
| | - Amerita Ravuvu
- Non-Communicable Disease (NCD) Prevention and Control Programme, Public Health Division, Pacific Community (SPC), Private Mail Bag, Suva, Fiji
| | | | - Carmen Huckel Schneider
- Faculty of Medicine and Health, Sydney School of Public Health, Menzies Centre for Health Policy and Economics, Charles Perkins Centre (D17), The University of Sydney, Sydney, NSW, 2006, Australia
| | - Jeff Collin
- Global Health Policy Unit, Social Policy, School of Social and Political Science, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Ashley Schram
- Australian Research Centre for Health Equity, School of Regulation and Global Governance, Fellows Road, Australian National University, Canberra, ACT, 2600, Australia
| | - Sharon Friel
- Australian Research Centre for Health Equity, School of Regulation and Global Governance, Fellows Road, Australian National University, Canberra, ACT, 2600, Australia
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Bertrand-Protat S, Chen J, Jonquoy A, Frayon S, Thu Win Tin S, Ravuvu A, Caillaud C, Galy O. Prevalence, causes and contexts of childhood overweight and obesity in the Pacific region: a scoping review. Open Res Eur 2023; 3:52. [PMID: 38031554 PMCID: PMC10685071 DOI: 10.12688/openreseurope.15361.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Abstract
Background Non-communicable diseases (NCDs) are a major threat to health and development and account for 75% of deaths in the Pacific Islands Countries and Territories (PICTs). Childhood obesity has been identified as a main risk factor for NCDs later in life. This review compiled overweight and obesity (OWOB) prevalence (anthropometric data) for children aged six to 12 years old living in the Pacific region and identified possible related causes. Methods We conducted a systematic search using PubMed, Google Scholar and ScienceDirect for articles published between January 1980 and August 2022. We also searched for technical reports from Ministries of Health. Guided by the eligibility criteria, two authors independently read the selected articles and reports to extract and summarise relevant information related to overweight and obesity. Results We selected 25 articles, two worldwide analyses of population-based studies and four national reports. Information revealed that childhood OWOB prevalence reached 55% in some PICTs. This review also indicated that age, gender and ethnicity were linked to children's weight status, while dietary practices, sleep time and level of physical activity played a role in OWOB development, as well as the living environment (socio-economic status and food availability), parenting practices and education level. Conclusion This review highlighted that anthropometric data are limited and that comparisons are difficult due to the paucity of surveys and non-standardized methodology. Main causes of overweight and obesity are attributed to individual characteristics of children and behavioural patterns, children's socio-economic environment, parenting practices and educational level. Reinforcement of surveillance with standardised tools and metrics adapted to the Pacific region is crucial and further research is warranted to better understand root causes of childhood OWOB in the Pacific islands. More robust and standardized anthropometric data would enable improvements in national strategies, multisectoral responses and innovative interventions to prevent and control NCDs.
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Affiliation(s)
- Solene Bertrand-Protat
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Juliana Chen
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Aurélie Jonquoy
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Stéphane Frayon
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Si Thu Win Tin
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Amerita Ravuvu
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Corinne Caillaud
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Olivier Galy
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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Hardin J, Enari D, Phillips T, Aiavao T, Boodoosingh R, Fulu Aiolupotea SM, Lua PM, Lees T, Lima UL, Samuelu Matthes SM, Maua F, Poltorak M, Ravuvu A, Taylor J, Taufa S, Waqa G. Developing Trust in Collaborative Research: Utilizing Indigenous Pacific Methodologies to Create Dialogue Within Research Teams. Asia Pac J Public Health 2023; 35:529-531. [PMID: 37864308 DOI: 10.1177/10105395231204809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
This article explores the processes involved in developing international, cross-cultural research teams. Scholarship on Indigenous and Pacific Methodologies demonstrate the importance of employing methodologies that center Indigenous approaches to research and relationships. This article explores using these methodologies within research teams as a preliminary step in developing sustainable and impactful international, cross-cultural research teams. Although this is not a formal study, the article reports that the importance of building trust within research teams as an essential step in addition to building trust with communities.
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Affiliation(s)
| | - Dion Enari
- Auckland University of Technology, Auckland, New Zealand
| | | | | | | | | | | | | | | | | | | | | | | | - John Taylor
- LaTrobe University, Melbourne, VIC, Australia
| | | | - Gade Waqa
- Fiji National University, Lautoka, Fiji
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Reeve E, Ravuvu A, Johnson E, Nasiga S, Brewer T, Mounsey S, Thow AM. Scaling up food pricing policies in the Pacific: a guide to action. BMJ Glob Health 2023; 8:e012041. [PMID: 37813442 PMCID: PMC10565307 DOI: 10.1136/bmjgh-2023-012041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/21/2023] [Indexed: 10/13/2023] Open
Abstract
There are calls for governments around the world to adopt pricing policies, including taxes, subsidies and price controls that ensure all people have access to, and can afford, healthy diets. Despite the strong potential of pricing policies to promote healthy diets and to support a post-COVID-19 recovery, there are gaps in evidence with regard to 'how' to design and apply effective food taxes in practice, and countries report challenges in navigating the different policy options.In this practice piece, we examine the global evidence for food taxes with a view to identifying practical lessons for policy design, adoption and implementation, using the Pacific Islands Region as a case study. We present a systematic resource that draws on locally generated evidence, and a Pacific conceptualisation of healthy diets, to address considerations in setting the tax base, rate and mechanisms, and to ensure tax targets are clearly identifiable within national tax and administrative systems. Health and Finance collaboration at the country level could ensure tax design addresses concerns for the impacts of food taxes on employment, economics and equity, as well as position food taxes as an opportunity to fund revenue shortfalls faced by governments following the COVID-19 pandemic. We demonstrate a need to review other policies for consistency with national health objectives to ensure that countries avoid inadvertently undermining health taxes, for example, by ensuring that foods with known non-communicable disease risk are not being price protected or promoted.
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Affiliation(s)
- Erica Reeve
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Amerita Ravuvu
- Non-Communicable Disease (NCD) Prevention and Control Programme, Public Health Division, Pacific Community, Suva, Fiji
| | - Ellen Johnson
- Sydney School of Public Health, The University of Sydney Menzies Centre for Health Policy, Sydney, New South Wales, Australia
| | - Selai Nasiga
- Independent consultant, Commonwealth Secretariat, London, UK
| | - Tom Brewer
- Australian National Centre for Ocean Resources and Security, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sarah Mounsey
- Sydney School of Public Health, The University of Sydney Menzies Centre for Health Policy, Sydney, New South Wales, Australia
| | - Anne Marie Thow
- Sydney School of Public Health, The University of Sydney Menzies Centre for Health Policy, Sydney, New South Wales, Australia
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Tin STW, Na'ati E, Kubuabola I, Bertrand S, Soakai S, Vivili P, Kafoa B, Nasiga S, Ravuvu A. A Framework that Strengthens Legislative Measures to Halt and Reverse the Pacific Non-Communicable Diseases Crisis. Hawaii J Health Soc Welf 2023; 82:219-221. [PMID: 37694218 PMCID: PMC10485767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
- Si Thu Win Tin
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Elisiva Na'ati
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Ilisapeci Kubuabola
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Solene Bertrand
- Public Health Division, Pacific Community (SPC), Noumea, New Caledonia (SB, BK)
| | - Sunia Soakai
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Paula Vivili
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Berlin Kafoa
- Public Health Division, Pacific Community (SPC), Noumea, New Caledonia (SB, BK)
| | - Selai Nasiga
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Amerita Ravuvu
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
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Tin STW, Bertrand S, Moreau M, Na'ati E, Kubuabola I, Ravuvu A. Scaling up Non-Communicable Diseases Prevention and Control Actions: The Need for Empowering Youth in the Pacific Region. Hawaii J Health Soc Welf 2022; 81:259-261. [PMID: 36118153 PMCID: PMC9460759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Si Thu Win Tin
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, AR)
- The University of Sydney, Sydney, Australia (STWT)
| | - Solene Bertrand
- Public Health Division, Pacific Community (SPC), Noumea, New Caledonia (SB)
| | - Maiwenn Moreau
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, AR)
- The University of Sydney, Sydney, Australia (STWT)
- Public Health Division, Pacific Community (SPC), Noumea, New Caledonia (SB)
| | - Elisiva Na'ati
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, AR)
| | - Ilisapeci Kubuabola
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, AR)
| | - Amerita Ravuvu
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, AR)
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Win Tin ST, Kubuabola I, Snowdon W, Cash HL, Na’ati E, Waqa GD, Moadsiri A, Bertrand S, Ravuvu A. Assessing the progress on the implementation of policy and legislation actions to address the Non-Communicable Diseases crisis in the Pacific. PLoS One 2022; 17:e0272424. [PMID: 35951506 PMCID: PMC9371336 DOI: 10.1371/journal.pone.0272424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 07/19/2022] [Indexed: 11/19/2022] Open
Abstract
Aim
To assess the progress on the implementation of Non-Communicable Diseases (NCD) related policies and legislations in the Pacific Island Countries and Territories (PICTs).
Materials and methods
The Pacific Monitoring Alliance for NCD Action (MANA) Dashboard was used to assess the progress on the implementation. The MANA Dashboard includes 31 indicators across four different domains such as leadership and governance; preventative policies and legislations; health system response programs; and monitoring This progress assessment was conducted between 2019 and 2020 for all 21 PICTs. The data were analyzed and compared with the baseline status (2018) report and presented across four different domains of the MANA dashboard.
Results
This progress assessment found that PICTs overall have made advancements in a number of areas, particularly the establishment of a national multi-sectoral NCD taskforce; implementation of referenced approaches to restrict trans-fat in the food supply in national documents; and fiscal measures to affect access and availability to less healthy foods and drinks. However, the strengths of actions varied across PICTs, and most are categorised as low strengths. Measures which had the most limited progress in implementation include policy and legislation that restrict alcohol advertising; tobacco industry interference; marketing of foods and non-alcoholic beverages to children; and marketing for breast milk substitutes.
Conclusions
This progress assessment further highlights that while PICTs continue to make progress, NCD policy and legislation gaps still exist, both in terms of weaknesses of existing measures and areas that have had little attention to-date. These require urgent actions to scale up NCD related policies and legislation at regional and national level.
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Affiliation(s)
- Si Thu Win Tin
- Public Health Division, Pacific Community (SPC), Suva, Fiji
- * E-mail: ,
| | | | - Wendy Snowdon
- Division of Pacific Technical Support, World Health Organisation (WHO), Suva, Fiji
| | - Haley L. Cash
- Pacific Islands Health Officers’ Association (PIHOA), Honolulu, Hawaii
| | - Elisiva Na’ati
- Public Health Division, Pacific Community (SPC), Suva, Fiji
| | - Gade D. Waqa
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), College of Medicine, Nursing & Health Sciences, Fiji National University, Suva, Fiji
| | - Ada Moadsiri
- Division of Pacific Technical Support, World Health Organisation (WHO), Suva, Fiji
| | - Solene Bertrand
- Public Health, Division, Pacific Community (SPC), Noumea, New Caledonia
| | - Amerita Ravuvu
- Public Health Division, Pacific Community (SPC), Suva, Fiji
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Ravuvu A, Lui JP, Bani A, Tavoa AW, Vuti R, Win Tin ST. Analysing the impact of trade agreements on national food environments: the case of Vanuatu. Global Health 2021; 17:107. [PMID: 34530860 PMCID: PMC8447725 DOI: 10.1186/s12992-021-00748-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/30/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND A large body of literature exists on trade liberalisation and the ways in which trade agreements can affect food systems. However, the systematic and objective monitoring of these and their impact on national food environments has been limited. Using a case study, this paper undertakes a systematic analysis of how Vanuatu's obligations under WTO agreements has impacted its food environment. RESULTS Data collection was guided by the INFORMAS trade monitoring framework's minimal approach and seven selected indicators outlined in three domains: trade in goods, trade in services and FDI, and policy space. Strong associations between trade liberalisation and imported foods, especially ultra-processed foods were evident in measured indicators as follows: (i) food trade with 32 WTO countries showing high levels of import volumes; (ii) a marked increase in 'less healthy' focus food imports namely fatty and other selected meat products, sugar, savoury snacks, ice-cream and edible ices and energy-dense beverages; (iii) actual and bound tariff rates impacting import trends of ice-cream and edible ices, bakery products and confectionary; and in other instances, a sharp increase in import of crisps, snacks and noodles despite tariff rates remaining unchanged from 2008 to 2019; (iv) policies regulating food marketing, composition, labelling and trade in the domestic space with relatively limited safeguard measures; (v) 49 foreign-owned food-related companies involved in food manufacturing and processing and the production of coffee, bakery products, confectionary, food preservatives, fish, local food products and meat, and the manufacturing, processing and packaging of palm oil, coconut oil, cooking oil, water, cordial juice, flavoured juices, soft drinks and alcoholic beverages. These were largely produced for local consumption; (vi) 32 domestic industries engaged in food and beverage production; and (vii) an assessment of WTO provisions relating to domestic policy space and governance showing that the current legal and regulatory environment for food in Vanuatu remains fragmented. CONCLUSIONS The analysis presented in this paper suggest that Vanuatu's commitments to WTO agreements do play an important role in shaping their food environment and the availability, nutritional quality, and accessibility of foods.
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Affiliation(s)
- Amerita Ravuvu
- Non-Communicable Disease Policy & Planning Adviser, Public Health Division, Pacific Community (SPC), Private Mail Bag, Suva, Fiji
| | - Joe Pakoa Lui
- Department of External Trade, Ministry of Foreign Affairs, International Cooperation and External Trade, Government of the Republic of Vanuatu, Port Vila, Vanuatu
| | - Adolphe Bani
- Department of External Trade, Trade Negotiation Division, Ministry of Foreign Affairs, International Cooperation and External Trade, Government of the Republic of Vanuatu, Port Vila, Vanuatu
| | - Anna Wells Tavoa
- International Trade Merchandise Statistics, Vanuatu Statistics Office, Ministry of Finance and Economic Management, Government of the Republic of Vanuatu, Port Vila, Vanuatu
| | - Raymond Vuti
- Vanuatu Investment Promotion Authority, Port Vila, Vanuatu
| | - Si Thu Win Tin
- Non-Communicable Diseases, Public Health Division, Pacific Community (SPC), Suva, Fiji
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Abstract
PURPOSE OF REVIEW Childhood obesity is increasing substantially in many Pacific island countries and poses an urgent and serious challenge. The Sustainable Development Goals set by the United Nations and the NCD Roadmap created at the request of the Pacific Finance and Economic Ministers identify prevention and control of noncommunicable diseases as core priorities. Among the various risk factors responsible for the development of noncommunicable diseases (NCDs), overweight and obesity are particularly of concern with the potential to negate many of the health benefits that have contributed to increased life expectancy. With the increase in childhood obesity across the region, it has become apparent that surveillance data remains a challenge; however, it is essential to inform the development of effective policies and strategies to tackle the challenge of childhood obesity in the Pacific region. RECENT FINDINGS The paper highlights the paucity of childhood obesity surveillance data available in the Pacific region and how the absence of a standardised tool to collect this data makes it difficult to do comparative analysis between countries. Drawing on a global protocol and identifying the gaps that currently exist in the region, the paper aims to highlight opportunities via which childhood obesity surveillance data can be improved to monitor better childhood obesity across the Pacific region.
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Affiliation(s)
- Amerita Ravuvu
- Non-Communicable Disease Policy & Planning Adviser, Public Health Division, Pacific Community (SPC), C/- Pacific Community (SPC), Private Mail Bag, Suva, Fiji.
| | - Gade Waqa
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), Fiji Institute of Pacific Health Research, College of Medicine, Nursing & Health Sciences, Fiji National University (FNU), Suva, Fiji
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Win Tin ST, Kubuabola I, Ravuvu A, Snowdon W, Durand AM, Vivili P, Passmore E. Baseline status of policy and legislation actions to address non communicable diseases crisis in the Pacific. BMC Public Health 2020; 20:660. [PMID: 32398159 PMCID: PMC7216373 DOI: 10.1186/s12889-020-08795-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-Communicable Diseases (NCD) are the leading cause of death in the Pacific Island Countries and Territories (PICTs) accounting for approximately 70% of mortalities. Pacific leaders committed to take action on the Pacific NCD Roadmap, which specifies NCD policy and legislation. To monitor progress against the NCD Roadmap, the Pacific Monitoring Alliance for NCD Action (MANA) was formed and the MANA dashboard was developed. This paper reports on the first status assessment for all 21 PICTs. METHODS The MANA Dashboard comprises 31 indicators across the domains of leadership and governance, preventive policies, health system response and monitoring processes, and uses a 'traffic light' rating scheme to track progress. The dashboard indicators draw on WHO's best-buy interventions and track highly cost-effective interventions for addressing NCDs. The MANA coordination team in collaboration with national NCD focal points completed Dashboards for all 21 PICTs between 2017 and 2018 in an agreed process. The data were analysed and presented within each area of the MANA dashboard. RESULTS This assessment found that PICTs are at varying stages of developing and implementing NCD policy and legislation. Some policy and legislation are in place in most PICTs e.g. smoke free environment (18 PICTs), alcohol licensing (19 PICTs), physical education in schools (14 PICTs), reduction of population salt consumption (14 PICTs) etc. However, no PICTs has policy or legislation on tobacco industry interference, controlling marketing of foods and drinks to children, and reducing trans-fats in the food supply, and only 7 PICTs have policies restricting alcohol advertising. Eighteen PICTs implement tobacco taxation measures, however only five were defined as having strong measures in place. Nineteen PICTs have alcohol taxation mechanisms and 13 PICTs have fiscal policies on foods to promote healthier diets. CONCLUSION This baseline assessment fills a knowledge gap on current strengths and areas where more action is needed to scale up NCD action in a sustained 'whole of government and whole of society approach' in PICTs. The findings of this assessment can be used to identify priority actions, and as a mutual accountability mechanism to track progress on implementation of NCD policy and legislation at both national and Pacific level.
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Affiliation(s)
- Si Thu Win Tin
- Public Health Division, Pacific Community (SPC), Suva, Fiji. .,The Boden Institute, the Sydney Medical School, The University of Sydney, Sydney, Australia.
| | | | - Amerita Ravuvu
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), College of Medicine, Nursing & Health Sciences, Fiji National University, Suva, Fiji
| | - Wendy Snowdon
- Division of Pacific Technical Support, World Health Organisation (WHO), Suva, Fiji
| | - A Mark Durand
- Pacific Islands Health Officials Association (PIHOA), Honolulu, HI, USA
| | - Paula Vivili
- Public Health, Division, Pacific Community (SPC), Noumea, New Caledonia
| | - Erin Passmore
- Public Health Division, Pacific Community (SPC), Suva, Fiji
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Phillips T, Ravuvu A, McMichael C, Thow AM, Browne J, Waqa G, Tutuo J, Gleeson D. Nutrition policy-making in Fiji: working in and around neoliberalisation in the Global South. Critical Public Health 2019. [DOI: 10.1080/09581596.2019.1680805] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Tarryn Phillips
- Department of Social Inquiry, College of Arts, Social Sciences and Commerce, La Trobe University, Melbourne, Australia
| | | | - Celia McMichael
- School of Geography, Faculty of Science, The University of Melbourne, Melbourne, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
| | - Jennifer Browne
- Global Obesity Centre, Deakin University, Melbourne, Australia
| | - Gade Waqa
- C-POND, Fiji National University, Suva, Fiji
| | | | - Deborah Gleeson
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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12
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Ravuvu A, Friel S, Thow AM, Snowdon W, Wate J. Protocol to monitor trade agreement food-related aspects: the Fiji case study. Health Promot Int 2019; 33:887-900. [PMID: 28453626 DOI: 10.1093/heapro/dax020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Despite the growing rates of obesity and diet-related non-communicable diseases, globally, public health attention has only relatively recently turned to the links between trade agreements and the nutritional risks associated with it. Specific trade agreements appear to have played an influential role in the volume and types of foods entering different countries, yet there is currently no systematic and objective monitoring of trade agreements for their impacts on food environments. Recently, INFORMAS was set up to monitor and benchmark food environments, government policies and private sector actions within countries and globally. One of its projects/modules focuses on trade policy and in particular the food-related aspects of trade agreements. This paper describes the INFORMAS trade protocol, an approach to collecting food-related information about four domains of trade: trade in goods; trade in services and foreign direct investment; domestic supports, and policy space. Specifically, the protocol is tested in Fiji. The development and testing of this protocol in Fiji represents the first effort to set out a framework and process for objectively monitoring trade agreements and their impacts on national food supply and the wider food environment. It has shown that entry into WTO trade agreements contributed to the nutrition transition in Fiji through the increased availability of imported foods with varying nutritional quality. We observed an increase in imports of both healthy and less healthy foods. The application of the monitoring protocol also highlights challenges for data collection associated with each trade domain that should be considered for future data collection and analysis in other low and middle income countries.
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Affiliation(s)
- Amerita Ravuvu
- School of Regulation and Global Governance, Australian National University, Australia
| | - Sharon Friel
- School of Regulation and Global Governance, Australian National University, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy, University of Sydney, Australia
| | - Wendy Snowdon
- Western Pacific Regional Office of the World Health Organisation, Fiji
| | - Jillian Wate
- Pacific Research Centre for Prevention of Obesity and Noncommunicable Diseases, Fiji National University, Fiji
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Ravuvu A, Friel S, Thow AM, Snowdon W, Wate J. Monitoring the impact of trade agreements on national food environments: trade imports and population nutrition risks in Fiji. Global Health 2017; 13:33. [PMID: 28610575 PMCID: PMC5470202 DOI: 10.1186/s12992-017-0257-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 06/07/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Trade agreements are increasingly recognised as playing an influential role in shaping national food environments and the availability and nutritional quality of the food supply. Global monitoring of food environments and trade policies can strengthen the evidence base for the impact of trade policy on nutrition, and support improved policy coherence. Using the INFORMAS trade monitoring protocol, we reviewed available food supply data to understand associations between Fiji's commitments under WTO trade agreements and food import volume trends. METHODS First, a desk review was conducted to map and record in one place Fiji's commitments to relevant existing trade agreements that have implications for Fiji's national food environment under the domains of the INFORMAS trade monitoring protocol. An excel database was developed to document the agreements and their provisions. The second aspect of the research focused on data extraction. We began with identifying food import volumes into Fiji by country of origin, with a particular focus on a select number of 'healthy and unhealthy' foods. We also developed a detailed listing of transnational food corporations currently operating in Fiji. RESULTS The study suggests that Fiji's WTO membership, in conjunction with associated economic and agricultural policy changes have contributed to increased availability of both healthy and less healthy imported foods. In systematically monitoring the import volume trends of these two categories of food, the study highlights an increase in healthy foods such as fresh fruits and vegetables and whole-grain refined cereals. The study also shows that there has been an increase in less healthy foods including fats and oils; meat; processed dairy products; energy-dense beverages; and processed and packaged foods. CONCLUSION By monitoring the trends of imported foods at country level from the perspective of trade agreements, we are able to develop appropriate and targeted interventions to improve diets and health. This would enable national health interventions to both identify areas of concern, and to ensure that interventions take into account the trade context.
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Affiliation(s)
- Amerita Ravuvu
- School of Regulation and Global Governance (RegNet), The Australian National University, H.C. Coombs Extension Building #8, Fellows Road ACT, Canberra, 0200 Australia
| | - Sharon Friel
- School of Regulation and Global Governance (RegNet), The Australian National University, H.C. Coombs Extension Building #8, Fellows Road ACT, Canberra, 0200 Australia
| | - Anne-Marie Thow
- Menzies Centre for Health Policy, School of Public Health, The University of Sydney, Sydney, Australia
| | - Wendy Snowdon
- Centre for Population Health Research, Deakin University, Burwood, Australia
| | - Jillian Wate
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
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