Abstract
The two gravest and most immediate threats to equitable and sustainable development in the Pacific Island countries (PICs) are global warming and non-communicable diseases. Regional vulnerabilities to these threats are greater than anywhere else in the world. In some important respects, the threats are interdependent, feeding off each other in ways that are multiplicative rather than additive. This fateful synergy could shrink national economies by more than 20% per annum for decades and cause untold social harm. To date, the threats have been treated largely in isolation by governments, usually by line ministries. However, their magnitude, immediacy and interdependence demand that their effects and associated costs on economy and society be assessed at the same time, that such assessments be accorded the highest priority by PIC governments and that national responses be led from the centre of government, by offices of the prime minister, ministries of finance and national security bodies. The production by national governments of valid evidence on the fiscal risks associated with these threats and their interdependencies will make the profound public policy changes that are called for much harder to resist politically and provide solid grounds for much-needed international assistance.
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