The annual Pacific Basin Medical Association (PBMA) conference, held this year for the first time since the pandemic, brought together health professionals from across the region to confront a persistent and pressing issue: the high prevalence of obesity and other non-communicable diseases (NCDs) in the Pacific Islands.
Dr. Maddison, President of the Pacific Basin Medical Association, highlighted that the PBMA first convened in 1995 and has held regular meetings ever since, with the most recent in 2019, before the COVID-19 pandemic halted gatherings. “We were supposed to restart last year,” he explained, “but many participants were still fatigued from the pandemic. This year, we’re back, and the focus is on a pressing issue—NCDs.”
A major theme of this year’s conference, chosen by the local medical societies, was “One Health,” an approach that emphasizes the interconnectedness of human health, environmental health, and animal health. The conference also revisited a declaration from 2012, which recognized NCDs as a public health emergency in the region. Now, health leaders are reflecting on what went well in their responses, what failed, and how to improve outcomes moving forward.
Obesity as a Disease
One of the primary concerns discussed at the conference was the continued prevalence of obesity. Dr. Maddison pointed to recent surveys, including a 2023 report card from the Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), and Palau, which found little change in obesity rates.
“We were just discussing the prevalence of obesity and how it’s still widespread across the islands,” Dr. Maddison said. “One proposal was to view obesity as a disease, which would encourage more support for its management, including improving access to healthier foods.”
This proposal aligns with another key concept discussed at the conference: the idea of “food as medicine.” The conference participants explored ways to strengthen the Pacific Islands’ access to healthier foods, including through sustainable agricultural practices and food safety. “The conversation around food as medicine opened up a lot of discussion about how we can promote healthier diets in our communities,” she added.
Public Awareness and Capacity Building
Another challenge identified was the need for greater public awareness about healthy lifestyles, alongside the development of human resources to support these efforts. Dr. Maddison stressed the importance of investing in nutritionists and dietitians across the islands, where such professionals are in short supply.
“We lack nutritionists and dietitians in many of our health systems, which limits our ability to promote and support healthy eating habits,” he explained. “We also need to focus on improving primary care—taking services directly to the community rather than waiting for people to visit the hospital or dispensary.”
The conference also emphasized the importance of preventive measures, such as encouraging exercise, better nutrition, and addressing risk factors like tobacco and alcohol use. Dr. Maddison noted that while policies exist to address these issues, enforcement remains a challenge. “You can have all the policies in place, but if they aren’t enforced, they become useless, and we’re back to square one,” he said.
Looking to the Future
The PBMA conference is expected to conclude with a set of resolutions aimed at improving health outcomes in the Pacific Islands. Dr. Maddison and his colleagues are focused on creating actionable plans that can be presented to donor partners, including potential international support to combat NCDs.
“At the end of this meeting, we expect to have a set of recommendations and resolutions that will guide us moving forward,” he said. “We need to address this crisis, especially for the sake of the next generation. Early childhood interventions are crucial because lifestyle behaviors are formed early in life.”
As the conference moves toward its conclusion, it remains clear that the battle against obesity and other NCDs in the Pacific is ongoing, but with renewed efforts in public health policies, capacity building, and community-based interventions, health leaders are hopeful for a healthier future.
The Pacific Basin Medical Association (PBMA), a non-profit founded in Palau in 1995, represents medical associations from American-Pacific island groups, including Palau, FSM, the Marshall Islands, Guam, CNMI, and American Samoa. PBMA’s mission is to represent the medical profession in the Pacific, provide health-related information to members and the public, and establish guidelines for professional conduct and performance.