17 th Meeting of Chief Medical Officers of Health

1. 17th Meeting of Chief Medical Officers of Health Castries, St. Lucia 20th – 21st April 2009 Prof. Trevor A. Hassell Chair of HCC, Chair of NCN CDC

2. Summary – Caribbean civil society encounter on CNCDs • Background and context • “the encounter”/Conference • Outcomes • Achievements post conference • The way forward • Public Health Sector and Civil Society

3. The Extent of the Chronic Disease (CVD, Diabetes, Cancer and Lung Disease) Problem • 35 million chronic disease deaths occurred in 2005 out of a total 58 million deaths worldwide • 4 Caribbean countries have the highest prevalence of diabetes in the Americas (12 – 16%) • HBP contributes to 45 % of all heart and blood vessel diseases. Approximately 20% of adult Barbadians have HBP and fewer than 20% of these are well controlled • More than half of all adult Barbadian females, and more than quarter of males, are obese or overweight • Diabetes and HBP : 8% of GDP in T & T

4. The Situation • Chronic diseases occur in epidemic proportions world-wide, including in the Caribbean, and produce significant premature death and disability and impose a heavy economic burden • Risk factors (unhealthy diet, physical inactivity & tobacco exposure) and risk conditions of obesity and hypertensionare present in a very high % of the population and are not being effectively tackled

5. Caribbean Initiatives and Reports • Caribbean Commission on Health and Development Report • Nassau Declaration, CARICOM Heads of Government, 2001 • Caribbean Charter for Health Promotion • Caribbean Cooperation in Health initiative 1,11, 111 • Caribbean Regional Plan for Prevention and Control of NCDs and Injuries, 2008-2012, PAHO • Heads of Government of CARICOM Summit and Declaration against CNCDs, 2007

6. Complementary approaches to chronic disease prevention Individual responsibility Changes to the "toxic" environment HEALTH CARE AND DOCTOR POLICY ENACTMENT COMMUNITY AND CIVIL SOCIETY

7. The Conference • Healthy Caribbean 2008 – A Wellness Revolution Conference • 16 -18 October, 2008 • Accra Beach Hotel & Resort, Barbados

8. Purpose • To bring together a wide spectrum of partners from throughout the CARICOM countries – civil society, the business community, educators and researchers, policy makers to plan civil society’s response to the CNCD pandemic

9. Objectives • Provide a forum for cross section of representatives from various sectors of society to learn about CNCDs and consider how best to tackle them • Build capacity in important elements of civil society • Identify and promote evidence based best practices for addressing the CNCD epidemic in the Caribbean • Strengthen capacity of civil society to monitorimplementation of the POS Summit Declaration • Consider resource mobilization

10. Agenda • Introduction • Civil society and the tools or instruments used by civil society • Risk Factors • Disease prevention and management • Celebrating Caribbean initiatives • Reflections and the way forward..the ACTION…the REVOLUTION

11. Highlights • Opening of conference and feature address by the Hon. David Thompson, M.P., Prime Minister • InterAmerican Heart Foundation Award and Science of Peace lecture, Sir George Alleyne • Presentation of the 5th InterAmerican Journalism Contest Awards on Tobacco Control

12. Participants Anguilla Antigua Aruba Bahamas Barbados Belize BVI Cayman islands Dominica Grenada Guyana Jamaica Montserrat St. Lucia Trinidad and Tobago St. Kitts • Agriculture 3 • Business 5 • Education 3 • Faith Based 4 • Finance 7 • Food Industry 2 • Gov./Policy 13 • H C Providers 11 • Health Finance 3 • Labour 5 • Legal 1 • Media 9 • NGO/CNCD 35 • Pharma 3 • Reg./Pol 6 • Service Clubs 3 • Sports/PA 3 • Urban Dev. 3 • Youth 3

13. Faculty • USA 9 • Brazil 1 • Canada 1 • United Kingdom 1 • Guyana 1 • Jamaica 3 • Trinidad & Tobago 4 • Mexico 1 • Barbados 6

16. Achievements post conference • Decision taken to establish a Caribbean civil Society CNCD coalition • Decision taken to establish an Organizing Task Force to set up the Coalition • Declaration • Action Plan • Technical conference report by CDRC

17. Achievements post conference • Website established www.healthycaribbean.org. • Organising Task Force set up and functioning • Healthy Caribbean coalition in embryonic form • Enewsletter • Active Caribbean Workshop

18. Visits to www.healthycaribbean.org.

21. Active Caribbean Workshop • March 6 – 7, 2009 • Hosted by Faculty of Medical Sciences, UWI, Cave Hill • Partnering with CNCD Commission/Ministry of Health, CDB, PAHO • 90 participants, CARICOM wide, multi-sectoral • Output: physical activity proposals being submitted to the CDB for funding

22. Action Plan – Action Lines • Establishment of a Caribbean civil society CNCD Coalition/Network • Advocacy • Development of a communication strategy for and among Healthy Caribbean CNCD coalition • Healthy Caribbean CNCD public education programme • Support for Caribbean Wellness day

23. Action Plan – Action Lines • Advocacy and support for CNCD risk factor reduction • Tobacco control and implementation of FCTC • Increased physical activity • Improved dietary intake including reduction of transfats and salt • Enhanced identification and management of CNCDs • Support of initiatives, plans and programmes at country and organization level

24. Establishment of A Caribbean Civil Society CNCD Coalition • Undertaken by the Organising Task Force • Emphasis on advocacy and coalition building, public education and media campaigns, monitoring and evaluation, support for existing country level networks. • Many governance, finance, administrative decisions need to be taken including establishment of a small secretariat with seed funding

25. Advocacy • Recommendations made to PAHO for the HCC to assist with establishment of CNCD Commissions • Recommendation now made that the HCC be invited at take part in Caribbean meetings on CNCDs

26. Communication strategy • Production and dissemination of Declaration and Action Plan to Caribbean opinion leaders • Distribution of Conference report to conference attendees, invitees and others • Further development of HCC Website • Enewsletter • Regular email postings by Chair of the OTF

27. Public education • Posting of presentations given at HCC co-sponsored conference /workshops on the HCC unrestricted website • Development of an CNCD educational series on CMC TV

28. Support for Caribbean Wellness Day • Co-sponsorship of CWD in countries as appropriate • Promotion of CWD on website and in enewsletter • Encourage members of the coalition to actively support CWD • Encourage private sector to contribute to CWD

29. Support for countries and organisations • Respond to requests from members of the coalition • Chronic care model – Montserrat, MOH • Source of funding for setting up OECS Health Desk • Assistance with banning of carbonated drinks in schools, St. Vincent

30. Advocacy and support for CNCD risk factor reduction • Caribbean FCTC implementation report card • Support for a national population salt reduction and dietary improvement programme in Barbados • Support for Diabetes and Tobacco Conference due to be held in Jamaica 2010

31. Public Health Sector and Caribbean Civil Society • Propose forums within the Caribbean at which the HCC should be represented • Lobby for HCC to be represented on chronic disease Commissions • Funding for “web manager and communications officer” for the HCC –US$700.00/month • Production and distribution of Declaration and Action Plan to opinion leaders • Co-sponsor Caribbean wide radio/TV public education CNCD programme • Take action within respective ministries to ensure that CNCD Commissions receive revenue from increased taxes on tobacco products as recommended by the Heads of Government of CARICOM • Build capacity and enhance training to improve the health NGOs

32. Thank You

33. We are convinced that we can reduce the burden on CNCDs through the promotion comprehensive and integrated preventive and control strategies at the family