Focus on NCDs, climate at small island developing states health summit

Small island developing states, or SIDS, face unique health challenges associated with their remoteness. Noncommunicable diseases and malnutrition are on the rise, and climate change creates a very real risk of natural disasters, which can also destroy food, economies, and lives. Providing primary health care and mental health services is a challenge with local demand. And as leading economies race to vaccinate against COVID-19, SIDS are being left behind with vaccination rates lower than the global average.

“While we have made improvements and incremental progress in business as usual, it is not going to get us where we [need to] go,” Pohiva Tu'i'onetoa, prime minister of Tonga, said at the SIDS Summit for Health this week. “We are currently faced with the opportunity to make a sustainable change.”

Supporting the survival of SIDS

At the end of day two, an outcomes document highlighted the urgency facing SIDS from health and environmental challenges. Among the calls to action was fully addressing health in the climate change movement, a part of a whole-of-government and whole-of-society priority both among SIDS as well as internationally.

“The pandemic has shown us how delicate the balance is between people and the environment,” Taur Matan Ruak, prime minister of Timor-Leste, told the summit. “We need to work together and more closely so that we can ensure the health of our peoples, ecosystems, and our environmental sustainability. Our health depends upon it. Our lives depend upon it.” The 26th Climate Change Conference is set to be a forum where SIDS will make this call on a larger scale, urging a better balance in how humans interact with the world.

Generating global awareness of the rapid rise in NCDs facing SIDS is also a priority, as well as addressing malnutrition.

“Healthy, sustainable, and resilient food systems that focus on the preservation of biodiversity and deliver healthy diets are essential in SIDS,” the outcome document reads. And in tackling the economic and social determinants seeing the rise in NCDs, SIDS are seeking global support through advances in universal health coverage that are tailored to the specific needs and constraints for each of them.

A focus on mental health and psychosocial support is another growing priority, which SIDS leaders urged to “be viewed as a cross-cutting issue.”

“The COVID-19 pandemic has had a major impact on people’s mental health, including increases of harmful use of alcohol, substance abuse, mental health conditions and gender-based violence, which is expected to increase needs to access treatment, services and other forms of support and rehabilitation,” the document reads. SIDS leaders agreed that a reorganization of mental health services that expanded upon community-based mental health care and tackled an emerging health and social crisis was needed.

Access to better technology, data, and knowledge to support health advancements is also seen as critical to the future of SIDS, along with sustainable funding to support a resilient health sector that is responsive to the next global pandemic.

Working together and with partners

Achieving a healthier future for SIDS requires countries to have a uniform voice that can amplify their specific calls to action. But needs including climate action require global action, and international partners supporting them.

“This first ever SIDS summit for health has highlighted the complexities and interconnected nature of the health agenda, with so many other critical sectors,” said Fekitamoeloa Katoa ‘Utoikamanu, under-secretary-general and high representative at the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States. Responding would require coordinated action.

As part of outcomes, SIDS have committed to work more intensively together, within and across governments. “Being diminutive in size is no determinant of a country’s ability to excel in all spheres of activity,” said Amery Browne, the minister of social development for Trinidad and Tobago. “Collective action by SIDS in advancing health will multiply their individual capabilities exponentially.”

Access to finance, including concessional loans, grants, and development assistance is crucial in this engagement. But the reality for SIDS is that the response to COVID-19 has seen the rest of the world leaving them behind, the minister said.

“Disappointingly, a year into the pandemic there is still an urgent need for international cooperation by states and all other actors to tackle the pandemic in a spirit of global solidarity and shared responsibility,” Gaston Browne, prime minister of Antigua and Barbuda, told the summit.

What is certain, he said, is that it risks leading to permanent regression in SIDS, and risks creating greater inequalities. In supporting SIDS, and the world, in creating a healthy future beyond COVID, Browne said “more needs to be done.”