Many Small Island Developing States (SIDS) face a ‘triple burden’ of malnutrition where undernutrition and micronutrient deficiencies coexist with a growing burden of obesity and related NCDs. The new paper prepared by the Sustainable Development Solutions Network (SDSN) and the UN Resident Coordinators in SIDS suggests that countries with a higher degree of vulnerability, as measured by the pilot Multidimensional Vulnerability Index (MVI) , face more difficulties to achieve the SDG 2 – Zero Hunger and have a greater share of obese adult population. The spread of obesity contributes to the emergence of noncommunicable diseases (NCDs) which represent a significant financial and economic burden in SIDS and affect disproportionally vulnerable groups, including women and girls.
On 23 September 2021, world’s leaders will convene at the UN’s Food Systems Summit. This blog post explores the relationship between the pilot MVI and performance on SDG 2 – Zero Hunger as measured in the Sustainable Development Report 2021. It sheds light on some of the challenges faced by SIDS in achieving SDG 2 – Zero Hunger and aims to contribute to the reflections on pathways towards sustainable food systems and financing in SIDS.
The impact of vulnerability on the Zero Hunger Goal
Achieving food security and improving nutrition are crucial to reach the Sustainable Development Goals (SDGs) and 2030 Agenda for Sustainable Development adopted by all UN member states in 2015. Not only they are essential to reach SDG2 – Zero Hunger, but they are also linked to many other SDGs including SDG3 – Good Health and Well-Being, SDG12 – Responsible Consumption and Production, SDG14 – Life Below Water, and SDG15 – Life on Land, among others.
The new paper prepared by the SDSN and the UN Resident Coordinators in SIDS shows that countries with a higher degree of vulnerability as measured by the pilot MVI face more difficulties to end hunger and achieve food security and improved nutrition.
Moreover, across the different types of vulnerability captured by the pilot MVI, economic vulnerabilities and structural development limitations appear to have the greatest negative impact on the achievement of the SDG 2 – Zero Hunger.
SIDS face a ‘triple burden’ of
high undernutrition rates coupled with micronutrient deficiencies and high
obesity rates. Undernutrition and poor dietary diversity resulting in stunting,
wasting and micronutrient deficiencies (e.g. anemia especially among women of reproductive
age and children under five) are significant concerns in many island states. At
the same time, obesity is a major issue in Pacific Islands and to a lower
extent in the Caribbean SIDS. These countries are characterized by the highest
prevalence rates of obesity in the world.
The obesity challenge in SIDS
There are two main factors that lead to the current and increasingly high obesity rates in SIDS: declining domestic food production and changes in dietary preferences ( FAO 2017 ). One other factor is the use of highly harmful fertilizers that are known to be linked to endocrine disorder and obesity.
In many SIDS, local food production is challenged by the small size, the lack of arable land, the limited freshwater resources, the high vulnerability to natural disasters, and the fragile natural environment which is exposed more and more to the impacts of overexploitation of oceanic resources, marine pollution, and climate change. Consequently, several SIDS tend to increase their reliance on imported highly processed food and drink products which are low in nutritional value but high in fat, salt, and sugar, and therefore lead to overweight and obesity in the population.
The paper prepared by the SDSN and the UN Resident Coordinators in SIDS highlights that in more vulnerable SIDS there is a greater share of obese adult population (Figure 2). The highest obesity rates are in the Pacif SIDS, followed by the Caribbean SIDS. Obesity is significantly lower in the Atlantic and Indian SIDS.
The paper also suggests that SIDS
with a high degree of economic and environmental vulnerability are more at risk
from obesity.
The NCDs crisis in SIDS
The spread of obesity in SIDS contributes to the emergence of noncommunicable diseases (NCDs) such as diabetes and cardiovascular diseases ( World Food Programme and The Pacific Community 2018 ). Figure 3 shows that there exists a positive relationship between the prevalence of obesity and diabetes prevalence in SIDS.
Although there are important variations across and within SIDS regions on how obesity affects diabetes probably due to differences in behavioral factors such as physical activity, among others, there is evidence that the challenge of NCDs is particularly severe in the Pacific SIDS. Seven out of the ten countries with the highest diabetes prevalence in the world are Pacific Islands ( International Diabetes Federation 2019 ), and over 75% of deaths in the Pacific SIDS are caused by NCDs ( FAO 2019 ).
NCDs represent a significant financial and economic burden in SIDS, especially in the Pacific Islands. First, they add pressure to national budgets by increasing health costs. In the Pacific SIDS, for example, public expenditure on health as a share of GDP is much higher than the global average for lower-middle income countries ( Hou et al. 2016 ), and in many countries the costs for treating and managing NCDs represent more than half of the public expenditure on health ( Secretariat of the Pacific Community 2011 ). Second, NCDs lead to output losses by reducing the labor force because of people premature death. Recent estimates suggest that by 2040, mortalities due to NCDs will reduce labor force by 9-30% in twelve Pacific SIDS ( Hou et al. 2016 ).
In addition, the increased prevalence of NCDs has a disproportionate impact on advancing gender equality for women and girls. In most Pacific countries, women and girls traditionally are caregivers for the elderly and sick, including those with NCDs-related disabilities, and therefore they cannot participate in economic activities and activities to advance their learning and future prospects.
The way forward
Food security in SIDS is a policy priority which requires coordinated efforts from different stakeholders at both the local and international level. We try to identify below general priorities to promote more sustainable food systems and financing in SIDS.
At the local level, it is important:
At the international level, it is crucial:
At both the local and international level, it is essential:
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