CHOGM Greetings from
Asiata Professor Satupaitea (Satu) Viali,
BHB, MBChB (Auck), MPH (UNSW), FRACP, FCSANZ, FESC, FACC
Vice Chancellor, Oceania University of Medicine

We are so proud that Samoa is hosting the Commonwealth Heads of Government Meeting this week. The Commonwealth is as committed as we are here in Samoa and at Oceania University of Medicine (OUM) to improving the health of residents in its 56 countries.

As the Vice Chancellor of OUM and a long time public health researcher focused on non-communicable diseases (NCDs), I am proud that the Commonwealth Secretariat’s Health Section is also committed to managing these conditions which are so prominent here in Samoa and worldwide.

The Commonwealth’s Health Section has been covering four key areas of work as part of its strategic plan for 2021-2025, and one of them is NCD Policy and Legislative Efforts.

Noncommunicable diseases (NCDs), are the leading cause of death globally, with more than 36 million deaths annually, primarily from cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases. Commonwealth countries share a high burden of NCDs, with nearly 400 million individuals currently diagnosed with at least one NCD, according to the Commonwealth’s Health section’s website.

A personal and national crusade

Most of my career as a researcher, clinician, and academic has emphasized NCDs — understandable, as Samoa’s population is known to have some of the highest rates of diabetes and other obesity-related illnesses in the world. 

The Samoan Ministry of Health’s National Noncommunicable Disease Control Policy 2018-2023 included key information from the World Health Organization’s (WHO) NCD fact sheet which noted that globally:

• 80 percent of all premature deaths are caused by cardiovascular diseases, cancers, respiratory diseases, and diabetes.
• 70 percent of deaths around the world are caused by NCDs – an equivalent of 40 million people each year.
• 15 million people between 30-39 years of age each year die from a NCD.
• 17.7 million people annually die from cardiovascular diseases — 8.8 million die from cancers — 3.9 million die from respiratory diseases — 1.6 million die from diabetes.

With limited fiscal resources and staffing, it has been imperative that our Ministry of Health focus its efforts on diseases/NCDs that have the highest morbidity levels in Samoa and those that

incur a large societal cost. A focus has been placed on addressing the social determinants of health and conducting a multifactorial and interdisciplinary approach to reduce the prevalence of these NCDs in Samoa:

• Diabetes Mellitus
• Hypertension
• Cardiovascular Disease
• Cancer
• Mental Health Conditions (see OUM’s efforts to address Samoa’s mental health issues in our September blog post)

In addition to these, my current research involvement centers on the clinical management of rheumatic fever, rheumatic heart disease and screening, salt reduction/hypertension, and ischemic heart disease. My Master of Public Health thesis from the University of South Wales was on noncommunicable diseases and the prevalence of their associated risk factors over a 24 year period in Samoa. 

These strong and longstanding research ties led to the establishment of The Yale University/Samoa Ministry of Health Collaborative Research Center which provides training opportunities in perinatal epidemiology and noncommunicable diseases. The training opportunities are directed by myself and long-time colleague Nicola Hawley, Ph.D., Associate Professor of Epidemiology at Yale’s School of Public Health. 

The Center’s original collaboration involved a study of the genetic origins of adult noncommunicable diseases which has since extended across the lifespan, studying noncommunicable and infectious diseases in adulthood, adolescence, and childhood, while also exploring how obesity, diabetes, and hypertension impact maternal pregnancy health and offspring health outcomes. The site is currently supported by three major grants from the US National Institutes of Health.

The University is very pleased to have Commonwealth countries, the WHO, Samoa’s Ministry of Health, America’s leading public health institutions, and other global organizations aligning their health concerns and priorities with those most concerning to our brothers and sisters here in Samoa. Many thanks for your presence here during CHOGM 2024.