Asia-Pacific Population Journal - Volume 22, Issue 3, 2007

The first case of human immunodeficiency virus (HIV) infection in Papua New Guinea was detected in the capital in 1987. After a relatively short period during which the epidemic was concentrated in certain “high-risk” groups, the disease spread throughout the country and by 2005 had become a “generalized epidemic” - with a 1 per cent HIV prevalence rate among adults aged 15-49. The most recent (2007) estimates suggest that the adult prevalence rate has risen to 1.6 per cent, confirming that the epidemic is continuing to grow rapidly (NACS, 2007).

The paradigm shift in population and development that occurred at the International Conference on Population and Development (ICPD) in Cairo, in 1994, from reduction in population growth for socio-economic progress to ensuring sexual and reproductive health and rights as a fundamental human right and as a means for improving the quality of life, has also become apparent in the Pacific. The Millennium Development Goals (MDGs) provide the current global framework for development efforts and were formally endorsed in 2000 by 189 countries, including Pacific island countries. The importance of sexual and reproductive health was not fully articulated during the formulation of the MDGs as an explicit goal. However, during the World Summit convened in 2005, world leaders endorsed the fundamental human right of “universal access to sexual and reproductive health services” - an additional target to the MDG 5, as a result of intense lobbying by sexual and reproductive health advocates, including the Prime Minister of Tuvalu. The full integration of the MDGs into national sustainable development strategies and plans outlining an allocation of a certain percentage of the national budgets to poverty reduction is requiring a lengthy internalization and implementation process for many Pacific island countries. Part of the challenge for many of those countries has been the relevance of the poverty definition and the prevailing perception by some country leaders that “poverty of opportunity” is the more fundamental issue.

Pacific island countries and territories are at different stages of demograhic transition, with some populations still experiencing relatively high mortality and fertility and others manifesting lower mortality and declining fertility. These countries are also passing through the epidemiological transition, with a progressive increase in proportionate mortality from chronic diseases and widening sex differentials in death rates (Taylor, Lewis and Sladden,1991; Taylor, Lewis and Levy, 1989).

The Governments and people of the Pacific are faced with what many perceive to be difficult choices between traditions and modernity, affecting customs and culture, lifestyles and the many facets of daily life. Inevitably development and progress mean change. Information, education and travel all introduce new concepts into society, and change threatens traditional values.

The Pacific region is comprised of 22 island countries and territories - featuring some 7,500 islands of which around 500 are inhabited-spread over an area of 30 million square kilometres and stretching from the Northern Marianas Islands in the north-west Pacific Ocean to Pitcairn in the south-east. Representing an enormous diversity in physical geography and culture, languages and socio-political organization, size and resources endowment, some countries and areas such as Nauru and Niue, consist just of one coral island, whereas others, like Papua New Guinea and the Federated States of Micronesia comprise literally of hundreds of islands. Melanesia comprise large, mountainous and mainly volcanic islands, endowed with natural resources, rich soil and an abundant marine life. Micronesia and Polynesia, by contrast, comprise of much smaller islands and their natural resources are limited to the ocean; they mostly comprise of small atolls with poor soil, with elevations usually between one and two metres (Kiribati, Marshall Islands, Tokelau and Tuvalu). There are also some islands of volcanic origin with more fertile lands (such as Samoa, Tonga, the Federated States of Micronesia and the Cook Islands).