The flow of drug through the Pacific is being described as a drug superhighway. The thousands of kilometres of coastline and the hundreds of islands in each Pacific country makes it an ideal pathway for drug trafficking and in particular the drug methamphetamine. However, the impact on the local populations is devastating with easy access to drugs across the community. Alongside this is the availability and increased use of alcohol and with high alcohol content drinks easily accessible and cheap.
Responding to the harm caused is multifaceted with border control, policing, justice and AOD treatment all required. The Salvation Army currently provides AOD services in Tonga and Samoa and is in the process of expanding this to a regional service to include Fiji. This paper explores the process of designing a regional service across three different nations and cultures and identifies the themes that were important:

Do not assume anything.
Keep all stakeholders informed and involved.
Listen to the voices of the people and work in genuine partnership.
Ask for advice specifically about what works for health and resilience within that culture.
Start with an evidence based approach but hold this lightly as a framework.
Allow the local wisdom to inform the design.
Check and evaluate the design in a continuous quality cycle. Is it working?
Adjust rapidly where the approach is not effective.
Convene advisory groups to provide input and work through tensions or cultural misalignments.