New Zealand-based companies are among the top offenders earning big from selling sugary drinks to the Pacific, where lifestyle diseases are rampant.
New research shows beverage exports to the islands have increased significantly to more than 39 million kilograms a year.
At the same time, New Zealand taxpayers are stumping up for the region's escalating healthcare costs exacerbated by that, the report said.
The biggest cause of death in the Pacific is diet-related chronic diseases, with the region having some of the highest rates of type two diabetes (47 percent) and obesity (75 percent) in the world.
Massey University's Research Centre for Hauora and Health associate professor Lisa Te Morenga said it was "incredibly disappointing" New Zealand was a world-leader in selling sweetened drinks to the islands
"It's not new to anybody that high consumption of sugary drinks is a contributor to the global epidemics of obesity and obesity related diseases," Te Morenga said.
"So the fact that the amount that we're exporting has increased substantially - it's kind of unbelievable that it's happened on our watch."
Exporters from New Zealand, the US and France have earned more than $1.5 billion dollars sending sugar-laden drinks to the Pacific, the report found.
University of Auckland faculty of medical and health sciences associate dean Dr Colin Tukuitonga said food and drink companies were taking advantage of the region.
"Some people would describe the Pacific as a soft touch in the regulatory environment, its legislation (and) level of awareness is not particularly strong," Tukuitonga said.
"And some companies, particularly the tobacco and food industries, dump their products in the islands."
Te Morenga urged the New Zealand government to take the global pandemic of non-communicable diseases as seriously as it took Covid-19.
Pacific neighbours attempting to control the quality of imported foods and drinks needed support from New Zealand, she said.
"If they want to consider putting levies or taxes or tariffs on imported unhealthy foods and drinks, we should stand behind them. Not to say, 'Oh, what about our own export businesses?'."
But Tukuitonga said finding a lasting solution would be messy and difficult.
"You know, people might say, well, why doesn't New Zealand stop exports of mutton flaps and soft drinks to the Pacific? Well, it's actually not that straightforward because there are World Trade rules that get in the way and make things difficult."
However, work on the issue was underway, with 14 out of 21 Pacific island countries imposing sugar taxes, he said.
The Ministry of Foreign Affairs and Trade said New Zealand had sent NZ$31.6 million in non-Covid-19 related health aid to the islands between 2019 and 2020.
New Zealand's trade and development agreement with the Pacific allowed it to take legitimate measures to protect human health, but it could not unreasonably or arbitrarily discriminate against imported goods, a ministry spokesperson said.