1. Broadening Pacific Collaboration and Networking in Responding to Health Priorities in the USAPIs

2. Presentation  USAPI NCD Strategic Response Timeline 2010-15  Pacific NCD Roadmap  20 th MCES Resolution 20-2  Heads of Health Meeting, Fiji, February 2015  Health Islands Healthy People Review – 2014  Monitoring Alliance for NCD Action (MANA)  Opportunities for wider regional collaboration

3. PIHOA Regional NCD Response Timeline, 2010-15 WHO and SPC assist jurisdictions on planning NCD Response (2-1-22) PIHOA declares NCD Emergency PI Health Ministers declare NCD Emergency MCES endorses NCD Emergency Declaration Health, Ed, Ag, Legis, Trad, Faith Leaders convene in Palau to develop Roadmap APIL endorses NCD Emergency Declaration 9-11 PIHOA and affiliates convene in HI to refine NCD Road Map + PIHOA proposes NCD Policy Summit PI Forum Leaders Declare NCD Emergency 4-10 6-11 1-11 7-11 8-11 PITLC endorses NCD Emergency Declaration Surveillance TWG develops Framework USAPI policy & surveillance TWGs formed 1-12 11-11 5-12 6-12 4-12 PIHOA affiliates organize Health Leadership Council (HLC) PIHOA endorses Surveillance TWG Recs APIL endorses NCD Policy Summit MCES endorses NCD Policy Summit 2-13 PIHOA endorses Policy TWG recs & HLC ratifies NCD Roadmap recs Policy TWG develops NCD Commitment Pkg 6-13 1-14 ?-15 Core Indicators review shows little progress in USAPI except tobacco MCES, APIL, PIHOA NCD Policy Summit 8-14 NCD Policy Toolkit completed Policy Summit National & state NCD Surv Plans developed at DDM 5-14 DDM joint effort with SPC, WHO, RAPID, SPC, FNU and University of Guam

4. Pacific NCD Roadmap  Proposed to the region by the Secretariat of the Pacific Community (SPC) in 2014; presented at SIDS in Samoa and other regional forums  Countries should finalise own Country-specific NCD Roadmaps that would include the following four key strategies common to all Pacific islands:  Strengthen tobacco control (including raising the excise duty on tobacco products to at least 70% of their retail price);  Policies on reducing consumption of food and drink products directly linked to obesity, heart disease and diabetes in the Pacific, especially salt and sugary drinks;

5.  Improve efficiency and impact from the existing health dollar by reallocating resources to targeted primary and secondary prevention of NCDs including scaling up of PEN and better drug prices;  Strengthen the evidence base for better investment planning and program effectiveness, including estimating productivity losses to the economy from premature NCD disability and death.  Strengthen multi-sectoral and multi-partner agencies Pacific NCD Roadmap continued…

6. Micronesian Chief Executive Summit  PIHOA is the secretariat for the MCES Regional Health Committee (RHC)  In June 2014, Yap, FSM hosted the 20 th MCES  RHC presented resolution with regards to wider Pacific partnership in responding to NCDs  MCES endorsed Resolution 20-2

8. Heads of Health Meeting Suva, Fiji February 2015

9. Yanuca Island Declaration on Health in the Pacific in the 21 st Century – Healthy Islands Healthy People Declared in 1995 and endorsed by the Pacific Health Ministers  Children are nurtured in body and mind  Environments invite learning and leisure  People work and age with dignity  Ecological balance is a source of pride  The ocean that protects us is sustained

10. Objectives of the WHO-commissioned review  Assess the overall achievement of the Healthy Islands vision and the Yanuca Declaration in the Pacific Islands including identifying success stories and lessons learnt  Identify both remaining challenges and opportunities in realizing the Healthy Islands Vision in the Pacific  To propose renewed Health Islands Vision for consideration at PHMM April 2015, include scaling up action and introducing new areas while considering the deliberation on post 2015 development agenda and universal health coverage Healthy Islands, Healthy People Review 2014

11. Healthy Islands Vision was great but implementation was inadequate. Governance  Leadership continuity only in some countries  Weak connection with WHO’s RCM and the Pacific Island Forum  Development Partners and lobbyists set the agenda rather than Pacific countries Management  No one body responsible for carrying out the PHMM recommendations and provide continuity  Infrequent prioritization and loss of continuity between meetings Information and Indicators  Not used to focus the activity, and lack of monitoring and evaluation  Weak HIS in many countries The Healthy Islands Vision and the Yanuca Declaration: Lessons Learnt

12. Healthy Islands Review Conclusion  Healthy Islands is a strong vision but implementation has fallen short  “Business as usual” for health development in the Pacific is insufficient to meet the increasing gap between it and the rest of the world  The 20 th Anniversary should re-commit to the Vision, at the same time address the implementation challenges that have weakened progress to date  Ministers, officials, donors, technical agencies all need to come to Yanuca prepared for a fresh approach for the decades ahead.

13. Healthy Island Review Recommendations  Develop an approach for the provision of technical support to Pacific countries with populations less than 100,000 that recognizes their ongoing need for national level policy support.  Establish the actual cost of realizing the right to health for Pacific Peoples, and develop novel funding options for consideration by Ministers for the period 2015–2035 and to 2100.  Support the process of the Heads of Health meetings and the PHMM. This is primarily a facilitation role, and should be distinct from the role of providing particular technical agendas.  Produce a combined program of work and present it to the PHMM (via the HOH meeting) for their approval.  Invite PIHOA as a third agency to directly support the PHMM and the HoH meetings.

14. Heads of Health Endorsements to Pacific Ministers of Health Meeting, April 2015  Endorsement of Healthy Island Review recommendations  Sub-Committee of the Heads of Health to be the governing body of the Monitoring Alliance for NCD Action (MANA)  WHO representative to MANA Coordination Team requested inclusion of PIHOA within MANA Coordination Team  Endorsement of Data-for-Decision Making/Strengthening Health Interventions in the Pacific (DDM/SHIP) – lead by SPC in partnership with PIHOA, RAPID, FNU, CDC and University of Guam

15. Linkages and Opportunities: Food for Thought  USAPI professional associations and agencies  PIHOA and MCES  US federal agencies  Links into PIFS, HoH, PHMM and WHPRO RCM  Feedback loop

16. Kalahngan Kommol tata Si yu’us ma’ase Mesulang Kinisou chapur Kamgar Fa’afetai tele Kula malulap Mahalo Thank you