Caribbean leaders to tackle chronic diseases
Health leaders from throughout the Caribbean met this week with representatives of United Nations agencies, collaborating agencies from Canada and the United States, development banks, academia and civil society to discuss actions that can be taken to reduce the impact in the Caribbean of noncommunicable diseases (NCDs) such as heart disease, stroke, cancer and diabetes, and their associated risk factors.
The forum of key stakeholders on NCDs: Advancing the NCD agenda in the Caribbean was organised by the Pan American Health Organization/World Health Organization (PAHO/WHO) in collaboration with the Ministry of Health of Barbados, and wrapped up in St Michael, Barbados yesterday.
Compared with other subregions of the Americas, the Caribbean has the highest rates of premature death (among people ages 30 to 69) from the four major NCDs: cardiovascular disease, cancer, diabetes, and chronic respiratory diseases.
In addition, NCDs are a major cause of suffering and disability, which, combined with direct and indirect economic costs, places a heavy economic and social burden on families, communities, health systems and economies.
The discussions focused on how to reduce the impact of NCDs by addressing their main risk factors, by strengthening health systems and improving care for NCDs, and by engaging sectors beyond health to support and participate in efforts to tackle NCDs.
In 2007, CARICOM leaders committed to the Port of Spain Declaration, a series of 27 commitments to guide action against NCDs. In 2012, Caribbean countries joined other PAHO/WHO Member States in endorsing the goal of reducing NCD deaths by 25 per cent by 2025. Since then, Caribbean governments have been implementing measures addressing NCDs, and premature mortality from NCDs has begun to decline, though not fast enough to be on target to reach the 2025 goal.
"We need to intensify the public policy and health service response if we want to reduce the burden of NCDs and their risk factors on individuals, families and societies and prevent an even greater burden in the future," said Anselm Hennis, director of PAHO/WHO's department of chronic diseases and mental health.
"Current trends clearly show that the Caribbean countries will not achieve the 25 per cent relative reduction in premature mortality due to NCDs by 2025 if we continue the business-as-usual model."
REDUCING RISK FACTORS
A large proportion of NCDs can be prevented by tackling the four related principle risk factors: tobacco use, harmful use of alcohol, unhealthy diet, and physical inactivity. Prevention is the key cornerstone of an effective response. Cost-effective measures, such as stronger regulations, including taxation, are needed to protect the population from these risks. Robust public policies are needed in other sectors such as finance, trade and agriculture.
"Healthier lifestyle choices are not simply a matter of individual choice," said Hennis. "We really must impact the social, economic, cultural and living conditions through whole-of-government and whole-of-society actions to make the healthy choice the easier choice."
Among specific areas discussed at the meeting are:
- The role of legislation and regulations in modifying unhealthy environments and reducing exposure to tobacco, harmful use of alcohol, unhealthy diet and physical inactivity (the top four NCD risk factors).
- Multisectoral action, with whole-of-government and whole-of-society approaches that place health as an economic asset, required for economic development, and to create supportive environments for health and well-being.
- A comprehensive health-system response to NCDs that includes prevention and affordable access to health care, in the context of universal access and universal health coverage.
- Stronger surveillance and improved monitoring systems to measure countries' progress in tackling NCDs and risk factors.
- Innovative ways to efficiently and sustainably finance health systems and especially their response to NCDs and related risk factors, given the rising costs of care.
- Strategies for ensuring that NCDs remain a high priority on the Caribbean political agenda.