Policy 101
Health in All Policies

An Introduction to the NCD Toolkit

Dear Pacific Colleagues,

Iakwe kom, kaselehlie maing, len wo, mogethin, hafa adai, ran annim, talofa and alii!

I have the ultimate pleasure to present to you the USAPI NCD Policy Toolkit. It has been a long road to travel in achieving this significant milestone for the Pacific region since an NCD emergency was declared in May 2010. This toolkit has been made possible through the hard work, dedication, passion and commitment of many individuals and organizations over the last couple of years. Most especially, I wish to thank the University of Hawaii John A. Burns School of Medicine, Department of Family Medicine and Community Health team, for their tireless work in researching, developing, refining, editing and putting together in a cohesive and coherent manner, this very important tool and resource which will guide and inform critical work to address NCD risk factors through the adoption of appropriate policies and legislation in the USAPIs. Below is a summary background of when, where and how the USAPI NCD Response began, and the critical next steps in our continued response to reducing the impact of NCDs on our island communities and families.

We hope you will use this toolkit to its maximum potential!

Emi Chutaro
Executive Director

USAPI NCD Polciy Toolkit Background

In May 2010, the health officials of the US-affiliated Pacific Islands (USAPIs) joined together in a landmark decision to Declare a Regional State of NCD Emergency: Pacific Island Health Officers Association (PIHOA) Resolution #48-01. It was a critical decision that pulled together the USAPIs in responding to the NCD crisis in ways the region had never experienced, and triggered high-level USAPI responses and commitments across executive and legislative branches of government, and traditional leadership. Following the declaration, an ‘incident command’ response framework (USAPI NCD Strategic Roadmap) was developed to inform the regional response over three key phases:

  1. Sounding the Alert: raising awareness and advocacy amongst key decision-makers in the USAPIs and across the wider Pacific;
  2. Crafting the Response: developing NCD-related tools and resources and establishing effective partnerships, and
  3. Implementing the Response: adoption of an agreed package of NCD policies and legislation, convening a USAPI NCD law and policy summit, collection and analysis of NCD data and information to track NCD progress and risk factors.

USAPI NCD Strategic Roadmap

In June 2012, PIHOA assisted to establish the Health Leadership Council (HLC) as a regional coordination body to bring together a network of existing USAPI professional associations and strengthen partnerships and synergies to address NCDs. The HLC Terms of Reference was developed and endorsed by the USAPI health officials in June 2013, including the USAPI NCD Roadmap which informs and guides NCD work across the HLC members. This was to capitalize on existing NCD interventions and content-area expertise available through the regional professional associations, and to strengthen and enhance collaborative responses to NCDs in support of the USAP NCD emergency response as mandated by the USAPI health officials.

In early 2012, PIHOA also convened two regional technical working groups (TWGs) to discuss and develop a regional NCD surveillance framework and regional NCD policies. In 2013, the USAPI health leadership reviewed and endorsed the USAPI NCD Core Monitoring and Surveillance Framework (and Data Set), as well as the USAPI NCD Commitment Package addressing common NCD risk factors: alcohol and tobacco use, lack of physical activity and poor nutrition.

With wide endorsement and support of the USAPI NCD Commitment Package and a call to convene a USAPI NCD Law and Policy Summit, a USAPI NCD Toolkit needed to be developed to guide and inform NCD policy development appropriate to the USPAI context. In early 2014, PIHOA contracted the University of Hawaii John A. Burns School of Medicine, Department of Family Medicine and Community Health to develop an online NCD toolkit embedded within the PIHOA website. Drafts of the online toolkit were vetted and peer reviewed on several occasions across different regional meetings and forums throughout 2014. CD-ROMs of the toolkit will be made and distributed to the USAPIs in 2015.

Next steps will include convening the USAPI NCD Law and Policy Summit to move forward with the USAPI NCD Policy Commitment Package, as well continue to work with the USAPIs to utilize this important resource in advocating, promoting, developing, adopting,implementing and monitoring NCD policies and legislation. By having comprehensive, supportive and enabling NCD policies and legislation in place address key risk factors, significant strides will be made in reducing the negative impact of NCDs on our islands and communities.


This USAPI NCD Policy toolkit was made possible primarily with funding from PIHOA's United States Center for Disease Control (CDC) National Public Health Improvement Initiative (NPHII) Grant, as well as additional funding support from PIHOA's CDC Association of State and Territorial Health Officials (ASTHO) project funds. Technical support for the development and refinement of the toolkit was made possible by the generous support and expertise of the University of Hawaii John A. Burns School of Medicine (JABSOM), Department of Family Medicine and Community Health team and PIHOA Secretariat staff, the Health Leadership Council, Secretariat of the Pacific Community, CDC Chronic Disease, and the USAPI national and state NCD programs. In particular, PIHOA would like to thank:


  • Dr. Lee Buenconsejo-Lum
  • Dr. Neal Palafox
  • Mavis Nitta
  • Dioreme
  • Janos Baksa

PIHOA Secretariat Team

  • Michael Epp
  • Dr. Mark Durand
  • Dr. Gregory Dever
  • Jason Aubuchon
  • Billie Hiraishi

CDC Team

  • Roberta Erlwein
  • Suzanne White
  • Loren Cadena

Health Leadership Council

  • Va’a Tofaeono
  • Patrick Luces
  • George Cruz

Here are additional resources to help you get started:

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PIHOA's Calendar

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