A health educator in Palau says the loss of federal funds for training health workers will be a huge set back for Micronesia's fight against lifestyle diseases.
Washington's budget shortfalls mean the United States' Area Health Education Centre programme is under threat.
Director of the Palau Centre Dr Gregory Dever says hundreds of Micronesian health workers have been trained at community colleges around the region thanks to the programme.
He says Palau has focused on training a local public healthcare workforce to deal with Micronesia's declared crisis of lifestyle diseases.
"The carnage that's going on. It's like a slow moving train wreck because of diabetes, heart disease, alcoholism and the problems with tobacco."
Dr Dever says the programme's been transformative for the region and axeing it will set things back three to five years.