1. Republic of Palau 52 nd PIHOA Meeting Guam, USA June 12, 2012

2. Planning in Palau Ministry of Health Plan 2008-2013 – Plan for Public Health Divisional Plans – Plan for Hospital and Clinical Medicine Divisional Plans – Human Resource for Health Strategic Plan

3. Implementation Activities Minimal Essential Program – Pharmaceuticals, Medical Supplies, Equipment and Personnel College of Health – Community, Classroom (MOE), Institutions of Higher Learning and Internal MOH – Reclassification and career path designs Declaration of State of Health Emergency on NCD- Using ICS – Health System Strengthening- Disease- MOH, manage NCD affected – Primary Health Care- Health- Community Groups, NEMO, manage NCD at risk – Communitizing health and institutionalizing Disease Elimination of Neglected Tropical Diseases – Using NCD created system: Elimination of intestinal helminths, yaws, elephantiasis and working on the Hansens and TB Moving to Earlier Indicators - Pediatric, Larva: Pop Index, Obesity, “would be” population

4. The primary reason why we have an NCD Crisis in Palau is because of: Passive Integrated Disorganization! We have over time adopted passive integrated disorganization. This applies to the way we handle traditional ways, policy decisions, funding mechanisms, planning, ownership (silo effects, territorialism), accountability, displacements of personal decision, disregard to data and information, importation of expatriate models or research without scrutiny. The solution to this PID is : Active Integrated Organization! Data driven decisions utilizing horizontal management mechanism to integrate stakeholders to appropriately and expediently manage resources in enabled environments. Just remove the: PASS DIS ! And insert: ACT ! Ions

5. Current Situation 33% Obesity Rate 4% Proteinuria 3% Glycosuria 52.9 % tobacco use AdultYouth/ChildrenUnborn Obesity Proteinuria Glycosuria Tobacco use If we act now! If we do nothing! Unborn generation are born into an unhealthy system! Affected with NCDs Trans-generational based Urgency NCD Risk Factors 1.Tobacco Use 2.Alcohol Abuse 3.Inappropriate diet 4.Inactivity Int journey

6. President Ministries Vice Pres NEMO Bureaus MOH BH&CSBPHAdmin NCD ICNCD IC Liaison PIO Safety Operations Intelligence Logistics Finance/Admin National Emergency Committee NCD Incident Command Structure is a horizontal management tool to Actively Integrate Coordination within the MOH (HSS) and the whole of society through NEMO (PHC). Iii IEA

7. NCDPROGRAMSTRATEGIESNCDPROGRAMSTRATEGIES NCDSTRUCTURENETWORKSNCDSTRUCTURENETWORKS NCD RESISTENT HOMES NCD RESISTENT SCHOOLS NCD RESISTENT HOSPITAL NCD RESISENT WORK- PLACE Health Promotion: health education (to reduce demand) Health Protection: healthy policies and laws (reduce supply ) NCD FREE PALAU Health Care Services Primary Health Care Concept Integration of the IEA Model to the Healthy Island Framework NTD Health Systems Strengthening Ottawa Charter 1976

8. Thank you very much