What’s the picture a decade after signing Declaration on NCDs?

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Diet and nutrition are key to preventing NCDs
Diet and nutrition are key to preventing NCDs

This year marks the 10th anniversary of the signing of the landmark CARICOM Heads of Government Port-of-Spain Declaration on non-communicable diseases (NCDs). The Thirty-Eighth CARICOM Heads of Government Meeting in St. George’s, Grenada, July 4-6, is expected to celebrate this momentous achievement. In 2007, the Caribbean led the world in convening the very first conference of Heads of Government on NCDs which in turn paved the way for the United Nations High-level Meeting on NCDs in 2011.

A ten-year anniversary is a good time to take stock, to look at how far we have come and how far we need to go. In terms of progress made in the NCD response, the picture appears to be a decidedly mixed one. Awareness of NCDs and their devastating effect on the health and development of the region has grown enormously. The dangers of childhood obesity are much better known. Barbados and Dominica have introduced taxes on sugary drinks and more countries are set to follow.

According to Executive Director of the Caribbean Public Health Agency (CARPHA) Dr. James Hospedales, “while several governments have made policy and financial provision for free medications, oftentimes people don’t take their medicines consistently and therefore don’t get the benefit.”

Regarding some of the other challenges Dr. Hospedales said “there are gains in some areas however some, like diet/nutrition/obesity just keep getting worse, and that drives diabetes, cancer, heart disease.’

CARICOM Heads of Government at the Port-of-Spain Summit
CARICOM Heads of Government at the Port-of-Spain Summit

He noted that “the food environment is not healthy. Obesity in children is the red flag. And, economically, we cannot afford to carry those preventable costs, when we are struggling to grow.”

The Caribbean has also become a world leader in chronic diseases in quite the wrong way.

“The statistics are quite shocking. Our soda consumption is the highest in the world. In some countries more than 30% of young people are overweight or obese. Our diabetes rates are double global rates and in some populations up to 50% of us are living with high blood pressure. It is clear that we need to accelerate our response,” said Dr. Alafia Samuels, Director of the George Alleyne Chronic Disease Research Centre, University of the West Indies, and head of a wide-ranging evaluation of the Port-of-Spain Declaration.

The Heads of Government Conference provides an opportunity to really make a difference in the challenge to chronic diseases. The leaders will be asked to consolidate pledges made at the 2016 meeting where they  promised to address such issues as banning smoking in public places; banning the advertising of unhealthy foods to children and raising taxes on foods high in sugar, salts and trans fats.

“We will continue to push for concrete commitments. We want to see more action on getting a tobacco-free Caribbean and on childhood obesity. The will is there from the leadership and we hope to get these commitments that put the region back at the heart of the global NCD response. We need to have another push at this 10 year anniversary,” said Dr. Samuels, who is attending the meeting.

In order to bring home the importance of the role leaders can play in influencing behaviour, the Port-of-Spain evaluation project will present the heads of government with blood pressure monitors. There will also be a vivid display highlighting key aspects of the NCD epidemic and recommendations for the way forward. These recommendations emerge from the evaluation which was commissioned by PAHO/WHO and CARICOM, working with regional research partners CARICOM, the CARPHA and the Healthy Caribbean Coalition, and led by the University of the West Indies.

Programme Manager, Health Sector Development at the CARICOM Secretariat, Dr. Rudolph Cummings has said that  “the 2007 Declaration of Port-of-Spain on Non-Communicable Diseases will remain one of the most visionary public policy coups scored by the CARICOM political leadership since the Treaty of Chaguaramas itself. It was pregnant with real possibilities for influencing the welfare of Caribbean peoples.”

“It fell victim to an aspect of our true democratic traditions, as its true potential has not been largely realised owing to the shifting political priorities of our constantly changing leadership. Ten years on, the threats to our health and well-being remain undaunted, providing an opportunity for our current leaders to make a renewed commitment to meaningfully influence the future of our peoples by joining the global movement against tobacco smoke and unhealthy diets with a firm timetable to eliminate these risks,” he added.

Michael Bloomberg, the World Health Organisation’s Global Ambassador for Non-communicable Diseases is expected to address the heads through a video message.

Dr. Samuels is optimistic. “I really think we can make progress at this Heads of Government Conference as we intensify our efforts to tackle chronic diseases. Let’s make the next ten years really count.” Dr. Hospedales also shares that vision, stating “if we could get the messages across and attain high levels of preventive care, we would save thousands of lives and save lots of money.”

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