Fiji: World Bank Report Calls for Investment in Health System to Combat NCDs Crisis

The report highlights the alarming health trends in Fiji, where NCDs have reached catastrophic levels, costing the country approximately US$260 million (FJD 591 million) annually.

Fiji is facing a critical health crisis, with non-communicable diseases (NCDs) responsible for 80% of deaths, especially affecting the working-age population. In response, a new World Bank report titled Fiji Health Sector Review, “Mo Bulabula, ka Bula Balavu” calls for urgent investment in a more robust, efficient health system to address the mounting health challenges and prevent further economic decline.

The report highlights the alarming health trends in Fiji, where NCDs have reached catastrophic levels, costing the country approximately US$260 million (FJD 591 million) annually. Over 64% of NCD-related deaths occur among people of working age, highlighting the widespread economic and social impact of this health crisis.

Despite significant progress in some areas, such as reducing child mortality by nearly 50% between 1975 and 2020 and keeping out-of-pocket expenses for patients low, Fiji's health system is struggling. With aging infrastructure, an under-resourced workforce, and a health system not structured to manage NCDs, the country's health system is under severe strain. Primary healthcare facilities are overwhelmed, and many health workers are responsible for large populations, making it difficult to provide adequate care. For example, in some areas, one public health nurse is tasked with managing a catchment area of 30,000 people. If current trends continue, the country's health expenditures could increase by more than 2.5 times by 2050.

Economic Impact of Fiji's Health Crisis

According to the report, the health crisis not only poses a threat to public health but also to the country's economic stability. Without intervention, more households will be forced to allocate larger portions of their income to healthcare, undermining economic development and social well-being. However, the World Bank report suggests that investing in a healthier Fiji could provide economic benefits, with transformative reforms potentially increasing the country's economic growth by 0.3 percentage points per year.

“The review shows that investing in a healthier Fiji is not just a health priority, it’s an economic imperative,” said Hon. Professor Biman Prasad, Deputy Prime Minister and Minister for Finance. “It is very timely to inform the implementation of our National Development Plan.”

Key Recommendations for Reform

The World Bank report outlines several actions to tackle the NCD crisis while ensuring long-term health improvements:

Redesign Primary Healthcare Services: Modernizing facilities and increasing resources to support effective prevention and treatment of NCDs.

Digital Health Initiatives: Accelerating the use of technology to enhance health services and create a more integrated hospital network.

Promote Healthier Lifestyles: Encouraging healthier diets and active lifestyles through policy reforms, including taxes on unhealthy foods.

Better NCD Screening: Expanding access to screening and digital health registries to identify and address NCDs early.

Empower Healthcare Workers: Retaining and upskilling the healthcare workforce to meet the growing demands of the population.

Strengthen Public-Private Partnerships: Enhancing collaboration between the public sector and private healthcare providers to improve service delivery.

Financial Management Reforms: Improving financial management within the health sector to maximize resource allocation and ensure sustainability.

World Bank's Commitment to Fiji’s Health Transformation

Stephen Ndegwa, Country Director for the World Bank in Papua New Guinea and the Pacific, emphasized the importance of immediate action: "By taking decisive action now, Fiji could not only add 10 years to life expectancy but also see significant economic gains. Transformative change is essential for inclusive economic growth, improved health, and a better quality of life for Fijians."

As the government of Fiji works towards implementing these recommendations, the report emphasizes that a coordinated effort with both local and international partners is necessary to transform the health sector and ensure a healthier, more prosperous future for the people of Fiji.