Here we are again, staring at the same elephant in the room that has been mentioned again and again but nobody seems to be doing anything about it.

That elephant in the room is called non-communicable diseases or lifestyle diseases. The name tells us all that we do not catch these diseases from someone else but instead we get them through the choices we make.

The type of food we eat, how much we eat, smoking, alcohol consumption and lack of exercise all leads to NCDs. And this is what the majority of the Ministry of Health budget is wasted on.

According to the National Kidney Foundation, that is the major reason why there are so many people on dialysis. Even when people are told that they have high blood pressure or diabetes, we in Samoa tend to continue on the path that has led us to the situation we are in.

The main types of NCDs encountered in Samoa are cardiovascular diseases (like heart attacks, high blood pressure and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.

The World Health Organisation reports that NCDs disproportionately affect people in low- and middle-income countries where more than three quarters of global NCD deaths – 32 million – occur.

Many more millions are disabled. These conditions are often associated with older age groups, but evidence shows that 15 million of all deaths attributed to NCDs occur between the ages of 30 and 69 years. Of these “premature” deaths, over 85 per cent are estimated to occur in low- and middle-income countries such as Samoa.

Children, adults and the elderly are all vulnerable to the risk factors contributing to NCDs, whether from unhealthy diets, physical inactivity, exposure to tobacco smoke or the harmful use of alcohol, many of which result from or are made worse by modifiable behaviors.

According to WHO, tobacco accounts for over 7.2 million deaths every year (including from the effects of exposure to second-hand smoke), and is projected to increase markedly over the coming years.

One million annual deaths have been attributed to excess salt/sodium intake and more than half of the 3.3 million annual deaths attributable to alcohol use are from NCDs, including cancer. Six million deaths annually can be attributed to insufficient physical activity.

Recognising and reducing these risk factors is an important way to control NCDs. Low-cost solutions do exist for governments and other stakeholders.

Investment in better management of NCDs is also critical, including detection, screening and treatment, and providing access to palliative care, all of which can be delivered as primary health care. Evidence shows such interventions are sound investments that when provided early can reduce the need for more expensive treatment.

Last year Samoa spent $11 million tala to take people for overseas treatment and the biggest budget allocation is for the Ministry of Health. We can be smart about NCDs even through government policies and there is a serious need for government intervention.

Physical education in schools needs to be made compulsory. Children need to get into sports. As it is, the current generation are spending most of their time being glued to the phone. Scenes where five or six children are surrounding one with a mobile phone playing PUBG or Call of Duty is becoming a common sight in most villages.

Village councils need to bring back gardening and farming so people stop relying on imported food and have open spaces for people to enjoy afternoon sports. Churches can also do this and seriously consider the fact that a ‘body is a temple’ and ‘you are what you eat’.

The government can play the most vital role by increasing taxes on sugary drinks, snacks with monosodium glutamate and fatty foods. The import of fatty meats should also be stopped and allow all vegetable imports to be tax free.

The Ministry of Agriculture seriously needs to pull up its socks. There are so many vegetables which can be grown locally and incentives should be provided to farmers so more people with land pick up on this. Boats should be provided to all villages near the sea so fishing can be done for consumption instead of buying ‘elegi’.

There are so many things that can be done but the first step to fighting NCDs should come from an individual. Samoans have to realise that we are eating, smoking and drinking ourselves to death. The sugar shortage some weeks back caused more panic than water shortage.

Wake up and realise that the current lifestyle most Samoans are living is leading them to early graves and before that, to becoming a burden not only on our families but to every Samoan because it is the taxpayer footing the bill for the habits which we can break away from.