Diets high in salt and sugar could become a thing of the past in Fiji, thanks to a collaboration involving Institute for Health Transformation researchers in the Pacific Islands.

Poor diets are a major contributor to a crisis of noncommunicable diseases, such as cardiovascular disease and diabetes.

Now a research team from Deakin University’s Institute for Health Transformation is working with locals, academics and policymakers in Fiji and Samoa to test the feasibility and effectiveness of food policy measures, as well as exploring the factors that sustain the implementation of these policies in the long run.

The five-year collaborative project is part of a long-standing relationship between Deakin University and Fiji National University. Other partners include the George Institute for Global Health, Menzies Centre for Health Policy, Johns Hopkins University, the Fijian Ministry of Health and Medical Services, the Samoan Ministry of Health and international development agencies such as the World Health Organization.

The noncommunicable diseases crisis has been driven in part by the introduction of imported foods, refined oils, sugar and processed meats to the Pacific Islands, said Professor Colin Bell, project lead and Institute member.

‘One major challenge for Pacific countries is that a lot of foods are imported from countries around the world, so they don’t necessarily have much control over what food products come in, what ingredients they contain, or how they’re how they’re labelled,’ he said.

‘Pacific countries need to be part of free trade agreements so they can export products to countries like Australia. But because countries like Australia are so much bigger, they have many more products to export so the flow of goods is mostly to Pacific countries not from, potentially swamping small countries with unhealthy food products.’

There is evidence that policy measures, such as those addressing unhealthy foods, can be an effective means of preventing noncommunicable diseases. In recent years, the Fijian Government has introduced a reduction in tax on imported fruit and vegetables and both Samoa and Fiji have national school nutrition standards in place.

‘The Pacific is a standout region internationally for the number of policies it has on products like sugar sweetened beverages or palm oils. The next stage, though, is getting policies implemented and monitoring whether they’re effective or not,’ Prof. Bell said.

‘Pacific countries are really keen to use policy as a tool for strengthening population health. But they’ve had some challenges with getting those policies in place.

‘And that’s exactly what this project is focused on in Fiji and Samoa: supporting policymakers to get real traction with policies and policymaking processes.’

One of the challenges of policy is keeping food environment policy on the political agenda, said Ms Erica Reeve, a collaborator on the project and Institute member.

‘Nutrition is quite invisible. It’s a slow burn issue,’ she said. ’It can be hard to demonstrate the need for these policies in comparison to other development challenges that are easier to quantify, such as economic or educational outcomes.’

Co-creation plays an important role in the project, according to project collaborator and director of the Institute’s Global Obesity Centre, Professor Steven Allender. By using a co-creation approach, the people who work and live in the region help to create the response to the problem.

‘What we’re trying to do is build capacity to think in a different way,’ Prof. Allender said.

‘We’ve seen that when we’ve worked with communities and used co-creation techniques in the past; the communities fundamentally change the way they solve problems.

‘One of the ideas behind this project is to build enough capacity that the problem-solving approaches go to a whole new level, and we see improvements in health and food policies. But we’ll also see changes in the way that people work together to solve problems as well.’

Co-creation and capacity building regarding policy implementation have become especially important considering the impacts the COVID-19 pandemic has had on the Pacific, said Prof. Bell.

‘It’s really important that we [Australians] are good neighbours and support Pacific countries in the ways that we can’ but not in an us-and-them kind of way,’ he said

‘Co-creating these policy measures and implementation means that the ideas and solutions are coming from Fiji and Samoa and we’re supporting that process rather than us coming in with our bells and whistles.’