Prevention and control of non-communicable diseases in Pacific Island nations. Prospects and constraints.

The non-communicable diseases, which include hypertension, diabetes (adult onset type), coronary heart disease, chronic bronchitis and certain cancers (especially those of the lung and bowel) are major public health problems in the adult populations of many Pacific nations undergoing "modernization" of their way of life. Programmes for the prevention and control of these conditions have become more feasible in the Pacific in recent years because of increased awareness of the magnitude and the nature of the problem, and because of important conceptual breakthroughs. Primary prevention will play a cardinal role in such programmes. Secondary prevention, using a conventional therapeutic approach through the primary care system, will also be used, especially for hypertension. Prevention and control programmes against these diseases in the Pacific are in the process of development, and the prospects and constraints in each country will have to be individually and carefully assessed.