rp21 situational analysis - Pacific Health Voices

determinant of drug and alcohol consumption
patterns, with a number of churches
providing leadership and influence on the
congregation. 140
Government
The Cook Islands Government has the right
at any time to move to full independence
by unilateral action. 141 In the 1990s a radical
structural adjustment program to reduce
significant government deficits was undertaken.
The program has had a significant
impact on employment opportunities and
migration from the Cook Islands. The adjustment
program with associated government
downsizing may provide some insight into
the lack of specific drug and alcohol policies
and services and needs further exploration.
Health and development
Internationally, the Cook Islands is a highranking,
middle-income country. 142 Compared
with residents of most developing countries,
the people of the Cook Islands have
a high standard of living, with a Human
Development Index of 0.789 in 2002,
among the highest-ranking in the Pacific
region. 143 The Asian Development Bank
reports that, among adults, the prevalence
of non- communicable diseases, especially
heart disease, diabetes and cancer, has risen
with increased use of alcohol as one of many
contributing factors. 144 The ADB notes that
most of the Millennium Development Goals
(MDGs) have been met or will be met by
2015. 145 The most recent MDG report available
is the 2005 report. 146
Similar to other PICTs, the Cook Islands has
relatively limited natural resources, remoteness
from major trade and industrial centres,
and a diminishing labour force. However, the
country does have a small, but successful,
tourism industry, with further development
afforded high priority by the government.
This is in addition to the development of
marine resources within the Exclusive Economic
Zone. 147 Trade deficits are offset by remittances
from emigrants and by foreign aid,
with the majority provided by New Zealand.
The impact of high levels of remittances on
disposable income and expenditure needs to
be considered further.
35
140 New Zealand Ministry of Health above, fn.127.
141 Above, fn.131.
142 Asian Development Bank & AusAID (2008), Cook Islands 2008 Social and Economic Report: equity
in development; Tango-tiama o te kimi puapinga. Manila: ADB, Ch. 3.
143 Ibid.
144 Ibid.
145 Ibid.
146 Cook Islands Statistics Office, Millennium Development Goals Report, available at:
(accessed April 2009).
147 Australian Government Department of Foreign Affairs and Trade, Cook Islands Country Brief,
available at: (accessed
May 2009).
Cook Islands