Non-communicable diseases (NCDs) now account
for more than 36 million deaths each year; many of which are
premature. Pacific Islanders are some of the worst afflicted by
obesity and diabetes with prevalence of both diseases rising
disproportionately faster in the Pacific region over the past
three decades than in the rest of the world. A high burden of
disease is also found among enclaves of Pacifican migrants in
the USA, Australia, and New Zealand. Urgent action is needed
to alleviate the high economic and personal costs now
associated with NCDs in Pacific Islanders. In this article, we
describe contributors to the temporal trends in obesity and
diabetes, discuss the current burden of disease in the Pacific
Islands and among migrant communities, and suggest priorities
for future research in this area. Finally, we discuss challenges
unique to intervention among Pacific Islanders and
highlight promising opportunities to reduce the NCD burden.