Table 6.

Active NCD-relevant policies in Fiji

	Policy (years active)	Summary of policy objectives relevant to NCDs	Key policy relevant actions for diet-related NCD prevention
Economy	National Development Plan (2017+)	The plan indicates Fiji will be placing more emphasis on preventative health care by promoting physical activity and other lifestyle changes to reduce NCDs. The plan also includes a strategic action to ‘establish a framework for a multisectoral approach to address agriculture and NCDs in Fiji.’ Strategies include more food laws and regulations, a school nutrition policy, health promotion and improved rehabilitation services. Priority: Promote population health and reduce premature morbidity and mortality due to NCDs as part of a whole-of-society approach to wellness and well-being. Strategy: Expand investment approaches to address NCDs, including nutrition and mental health, within and beyond the health sector.	Examples of outcomes expected/target for 2019/2020: • Food Law and additional food regulations and school nutrition policy. • Health promotion for reduced premature mortality due to NCDs. • Rehabilitation services for NCD-related disability and injuries (including through diabetes hubs). • Fiji plan of action for nutrition for exclusive breastfeeding; a 10-year costed survey plan for STEPS, National Nutrition Survey, oral health, prepared and updated annually. Key indicator: • Premature mortality due to NCDs to reduce from 68.2% (2015) to 49.7% (2021).
	Fiscal Policy (Budget address/tax schedule) (2019)	This policy provides an overview of Fiji’s current macroeconomic and fiscal position and projections for the next three years (August 2019–July 2022). It also outlines the overall fiscal strategy and direction for the medium term, which is geared towards achieving inclusive economic growth and fiscal sustainability. The tax schedule notes the removal of import duties of fruit and vegetables is to ensure affordability of healthy foods and to promote combating NCDs.	• The 2012 tax schedule (amended 2016) indicated the following items have excise duties (in addition to various fiscal duties): ice cream, powders and preparations for making beverages other than those with the basis of milk, sugar syrups, flavoured waters containing added sugar or sweetening agents (15%); biscuits and sweet biscuits, wafers, toasted bread/crackers (15%); chocolate and chocolate-coated products and cocoa-containing products - and sugar confectionery (15%). • In 2018/2019, the import duty was reduced from 5 to 0% on apples, carrots, grapes, oranges, pears, mixed Vegetables, celery, capsicum, mushrooms, kiwi fruit, asparagus, strawberries, leeks, spinach, apricots, peaches, plum, grapefruit, raspberries, cranberries, pomegranate, cauliflower, broccoli and Brussel sprouts. In 2019/2020 a higher specific rate of duty of 32% or $2 per litre was be applied to imported SSBs. • In 2019/2020, an import excise tax on imported chicken was increased from 0 to 10%.
Health and Medical Services	National Strategic Health Plan (2020–2025)	This policy provides the overall strategic direction for Fiji’s health sector. Specific objectives relating to diet-related NCDs are to reduce lifestyle risk factors among the population; the early detection, risk assessment, behaviour change counselling, clinical management, and rehabilitation for targeted NCDs.	Key indicators: • No key indicators for the current Health Plan. The previous Plan had outlined the following key indicators: • Reduce premature mortality due to NCDs from 40.7% (2014) to 37% (2020). • Reduce population prevalence of diabetes from 31% (2014) to < 22% (2020). • Reduce prevalence of overweight/obesity in primary school children from 15.7% (2014) to < 10% (2020).
	Non-communicable Diseases Strategic Plan (2015–2019)	Reduction or no increases in all NCDs and their risk factors including mental health, violence, alcohol, physical activity, tobacco. Increased resource allocation as appropriate	Key Indicators for diet-related NCD indicators: • Reduced intake of salt per person aged 18+ years by 20% by 2019. • Increased daily average serves of fruit and vegetables among adolescents and adults by 10% by 2019. • No increase in obesity prevalence in adults or adolescents. • No increase in diabetes prevalence in adults.
	DRAFT Fiji Policy on Food and Nutrition Security (2018–2022) (At the time of publication, this policy was not endorsed)	Extensive list of policy objectives encompassing multi-sector leadership, ownership and coordination of national food security actions for sustainable food and nutrition security enhanced maternal and child health, social protection programmes, and supporting healthier school environments, better food standards and nutrition-sensitive food chains	Key actions for diet-related NCDs: • Incorporate the Food and Health Guidelines for Fiji into all nutrition and health programs to promote healthy eating and dietary practices for all Fijians. • Create safe and supportive environments for nutrition at all ages. • Promote healthy weight and reduce underweight, overweight and obesity among the population. • Strengthen coordination to implement best practices on fat, sugar, salt reduction strategies in consultation with partners’ e.g., health star rating with food industries, for adoption and submission to Cabinet. • Strengthen implementation and monitoring of community nutrition advocacy campaigns to promote fat, sugar and salt reduction strategies on meals at home and those purchased outside the home, to promote consumption of recommended number of daily serves of fruit and vegetables, healthy foods and increased physical activity, to reduce SSB consumption. • Support the development of healthy recipe books for easily grown, accessible and low-cost local root crops, fish and other local foods to help create interest that would result in increased consumption of these foods by households. • Strengthen multi-sectoral collaboration and advocacy to promote healthy diets and lifestyles within consumer groups, faith-based organisations, non-governmental and civil society organisations. • Strengthen multi-sectoral support, engagement and collaboration on the inclusion of healthy diet and lifestyle information into in-service training programmes to create more enabling institutional environments for improved nutrition outcomes.
	Wellness Policy (2015 )	The Wellness Policy reframes the findings of the NCD STEPS Surveys (in adults) and indicates that although the proportion of the healthy population is decreasing, there is still significant opportunity to encourage healthy lifestyles. The policy is based on a multisectoral, holistic approach to the concept of ‘wellness’ of the entire Fijian population. Its primary objective is to lay out the development of the National Wellness Strategic Plan (2015–2019).	No key indicators noted for diet-related NCDs.
Trade	Fijian Trade Policy Framework	In addition to global concerns over health issues surrounding tobacco products, this policy raises concerns over trade in products that are seen as potentially increasing susceptibility to NCDs.	• No key indicators noted for diet-related NCDs.
Agriculture	Fiji 2020 Agriculture Sector Policy Agenda (2014)	This policy is aimed at exporting agricultural products to international markets although currently, Fiji’s primary market is domestic. The objective of the strategic plan is that through improved infrastructure and processes, high quality goods can be exported overseas, and Fiji will become an internationally competitive central hub for exported agricultural produce.	• No key indicators noted for diet-related NCDs.
Women and Youth	Fiji National Gender Policy (date unidentified)	Generic health access to services diseases causing morbidity and mortality, recognising the need for holistic approaches to health and acknowledging the physical and psychological differences between men and women.	• No key indicators noted for diet-related NCDs.
Education	Fiji School Health Policy (2016 – to be reviewed every two years)	This policy provides generic ‘health and wellness’ activities to be supported and implemented in all schools through inclusion in the school curriculum by Ministry of Education, Heritage and Arts (MoEHA). Also, it implies an integrated approach to School Health Programs (SHPs) within the Ministry of Health & Medical Services’ (MoHMS) public health programs. Finally, it aims for strengthened multi-sectoral collaboration and coordination of wellness activities targeting the health of children in school and coordination of wellness activities	• No key indicators noted for diet-related NCDs.
	Policy on Food and School Canteens (2017 +)	This policy gives clear procedures and expectations by the Ministry of Education, Heritage and Arts (MoEHA) for canteens and where operators or School Heads and teachers are to engage collaboratively towards the provision of healthy food and beverages in the school canteen and to promote health food environments in the school. Supports the principles taught in various year levels which aim to promote healthy eating practices, healthy living, well-being and the safety of all students in school.	• No key indicators noted for diet-related NCDs.