Cook Islands promotes safe care for noncommunicable diseases

Amid the halls of Rarotonga Hospital, we meet Dr Koko Lwin, Chief Medical Officer at Te Marae Ora, Cook Islands Ministry of Health, to discuss one of the country’s greatest public health challenges, noncommunicable diseases (NCDs), which affect communities across the Cook Islands and the wider Pacific.

^{Te Marae Ora’s Chief Medical Officer, Dr Koko Lwin, at Rarotonga Hospital in Cook Islands. Photo © WHO / Nancy Wong}

As the world marks World Patient Safety Day 2026, the focus on safe care for NCDs shines a spotlight on an issue that resonates deeply in the Cook Islands. Safe care for NCDs means ensuring that people living with chronic conditions receive quality care throughout their lives, while reducing the risk of harm across the continuum of care. This is particularly important in the Cook Islands, where NCDs such as cardiovascular disease, diabetes, cancer, and chronic respiratory conditions continue to place a significant burden on Cook Islands’ communities and health systems alike.

The scale of the NCDs challenge is evident in the latest country health data. Survey results from the 2022 STEPwise approach to NCD risk factor surveillance (STEPS) in Cook Islands found that nearly half of adults had hypertension (44.3%), almost half were current alcohol users (49.8%), one-third were current smokers (34.5%), and just over one in five did not meet the World Health Organization (WHO) recommendations for physical activity (22.6%). WHO data also show that 68.9% of adults were living with obesity in 2022, while obesity affected 37.5% of children and adolescents aged 5-19 years. These risk factors continue to drive the burden of NCDs and reinforce the need for prevention, early detection, and safe care throughout life.

“NCDs are the main cause of death in the Pacific. The Cook Islands is one of the countries affected by NCDs,” said Dr Koko Lwin. “That’s why, as a country or as the Ministry of Health, we need to give priority to dealing with the patients living with NCDs.”

Across the Cook Islands, Te Marae Ora is working with communities to address these risk factors through health promotion and community outreach. These efforts encourage healthier lifestyles, including increased physical activity, healthier food choices, and reducing tobacco and alcohol use. They are complemented by stronger policies and programmes that support healthier environments and help reduce the risk of developing chronic diseases, including the tobacco tax increase last year.

For Dr Lwin, helping people understand how NCDs develop, recognize risk factors, and know when to seek care are critical to ensure people can make informed decisions about their health.

“When we talk about safe care, it starts with health promotion for people to understand what the risk factors are and then how to deal with them, how to prevent them, rather than treating the complications,” explained Dr Lwin.

Identifying conditions early before complications develop can improve health outcomes and reduce avoidable harm and is part of safe care.

“Early detection of particular diseases, like hypertension and diabetes, is important,” he said. “The health department needs to proactively go out to the community, do the screening to the community, to the work sites, and pick up early detection.”

^{Health workers taking the blood pressure of a patient in Tupapa Community Clinic. Photo © WHO / Yoshi Shimizu}

Across the Cook Islands, health services are also ensuring patient-centred approaches to care. This means understanding each person’s circumstances, ensuring they have the information they need, and supporting them to manage their own health confidently.

“Our approach has now changed to patient-centred care,” Dr Lwin emphasized. “We explore the understanding of the patient first. The aim is to empower patients and the public to understand and manage themselves.”

Informed and engaged patients are an important part of safe care. By understanding their conditions, asking questions, and sharing their experiences, patients can help health workers identify gaps, improve communication, and strengthen the quality of care provided.

“Patient feedback allows us, as a health system, to improve and to provide safe care,” Dr Lwin said.

WHO works closely with Te Marae Ora to provide technical support to prevent and manage NCDs and to strengthen the safety and quality of care.

“Safe care for people living with NCDs begins with prevention, early detection, and continued access to quality care throughout their lives,” said Dr Wendy Snowdon, WHO Representative to Samoa, American Samoa, Cook Islands, Niue and Tokelau. “We are encouraged by Cook Islands’ ongoing efforts to build healthier communities and the WHO remains committed to supporting Te Marae Ora in helping Cook Islanders lead healthier lives.”

 Across the islands and health facilities, the Cook Islands continues to advance safe care for NCDs by helping people and communities to understand their health, reduce their risks, and take an active role in their wellbeing.