rp21 situational analysis - Pacific Health Voices

Health and development
The main challenges facing Tokelau are environmental.
As a group of low-lying atolls, it
is susceptible to natural disasters. In addition,
limited land mass creates challenges for
waste management, which directly affects
reef quality and therefore the health of
Tokelauans, who consume locally available
seafood. 788 A full-time medical practitioner
is available on each of the three atolls and
WHO has been engaged to address some of
the health issues associated with increasing
pollution. 789 The increased pollution is partly
due to lifestyle changes and increasing reliance
on imported food and beverages, which
contribute to increases in non- communicable
diseases. 790 To date, Tokelau has not reported
on progress toward the Millennium Development
Goals. 791
14.2 Drug and alcohol
overview
Tokelau is not independently represented on
common regional forums such as: PIFS, PILON,
OCO and PICP. However, it is a member of
the SPC. Tokelau was not one of the countries
considered in the 2004–05 situational
analysis. 792 To date, Tokelau has not been represented
at the PDARN meetings and attendance
at regional meetings will continue to be a
challenge due to transport limitations. Almost
no information is available on drug and alcohol
use in Tokelau, but there is potential for
more information to be generated from WHO
activities in the area on non-communicable
disease prevention for 2008–09.
14.3 Illicit drug trends
A recent study into the global epidemiology
of injecting drug users does not include
any data for Tokelau. For the whole of the
Pacific region it was equally difficult for the
authors to provide any estimates of incidence
or prevalence. There are reportedly no illicit
drug problems in Tokelau. 793 HIV infections
have now been reported in every country
or territory in the Pacific island region, barring
two of the smallest countries, Niue and
Tokelau. 794 Lack of reports on HIV infection
may support the view that there is no injecting
drug use on the atolls. Alternatively it
may be a consequence of lack of surveillance
or of migration of affected people.
163
788 Above, fn.779.
789 Ibid.
790 Ibid.
791 Ibid.
792 Burnet Institute & Turning Point Drug and Alcohol Centre (2006), Situational Analysis of Illicit
Drug Issues and Responses in the Asia–Pacific Region. ANCD Research Paper 12. Canberra:
Australian National Council on Drugs.
793 See (accessed November 2008); and Exxun,
available at: (accessed November 2008).
794 UNAIDS country progress reports, available at: accessed November 2008.
Tokelau