ABSTRACT
<p> In the Pacific island states, in addition to the traditional health issues common in developing countries, such as maternal and child health and communicable diseases, the increase in noncommunicable diseases (NCDs), e.g., obesity and diabetes, has become a serious problem. NCDs account for 80% of all deaths in this region, and the increase in early deaths of people younger than 70 years old is of particular concern. It has also been pointed out that the cost of countermeasures against NCDs are constricting government finances, and enhancing a health system that supports such countermeasures is also an urgent challenge. However, with respect to international health cooperation in Japan, the present status of NCDs and the associated statistical data in the Pacific island states are not likely to be addressed. Therefore, in this report, we comprehensively explain the present status of and approaches to NCDs around the world based on the World Health Organization (WHO), including those in the Pacific island states. By taking advantage of health indicators, we confirm the disease structure present in the 10 Pacific island states that cooperate bilaterally with Japan and then discuss the approaches in these states. As a result, although countermeasures against NCDs have been actively implemented in the Pacific island states in accordance with the WHO strategies, no tendency for the prevalence of NCDs to improve has been seen. To promote countermeasures against NCDs in the Pacific island states in the future, it will be necessary to engage in analysis and discussion of the present situation, to develop human resources, taking into consideration the region-specific characteristics of the islands, and to accumulate sufficient numbers of successful local stories consistent with the local strategies.</p>
ABSTRACT
<b>Objectives </b><BR> Recently, there has been an increasing focus on nutrition in international health cooperation. However, little attention has been paid on global nutrition issues and their methodologies in Japan. One of the possible reasons is that the whole picture cannot be clearly grasped, because nutrition issues and actions have been considered separately at international organizations such as WHO, FAO, and UNICEF. Therefore, the aim of this study was to examine the trends in food and nutrition policy framework, dietary recommendations and nutritional requirements formulated by international organizations through a review of published nutrition policy guidelines and standards since the 1990s.<BR><b>Method</b><BR> Policy guidelines, technical reports, annual reports, and other relevant materials published between 1990 and 2015, available on the WHO, FAO and UNICEF websites, were reviewed. Then, we extracted the study focused on nutrition problems and their solutions. The purpose and contents of each document and guidelines were identified and categorized in a summary table, so as to investigate their feasures and time trend.<BR><b>Results</b><BR> This study identified 22 statements on food and nutrition policy frameworks, 14 dietary recommendations and nutritional requirements, and 5 information systems. It was revealed that, in the 1990s, the focus was to develop and standardize the methods for nutritional assessment of children. The goal during this period was to achieve food-based security through improvement in energy and nutrient intakes such as proteins and vitamin A, so as to reduce severe child malnutrition and maternal mortality. Later, various recommendations were formulated on double burden of malnutrition, the importance of breastfeeding and the context of the food system and nutrition in the 2000s, and on noncommunicable disease prevention and control policies and practical methodologies to reduce nutrition disparities after 2010. Several information systems were established, which have been utilized as the evidence database to develop policy frameworks.