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The Experience of Building Momentum in GHD on Chronic Disease Prevention and Control: From the Caribbean toward the UN Summit 2011 C. James Hospedales, Senior Advisor & Coordinator, NCD Prevention & Control PAHO/WHO. Overview . Background CARICOM Summit on Chronic Disease

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The experience of building momentum in ghd on chronic disease prevention and control

The Experience of Building Momentum in GHD on

Chronic Disease Prevention and Control:

From the Caribbean toward the UN Summit 2011

C. James Hospedales,

Senior Advisor & Coordinator,

NCD Prevention & Control

PAHO/WHO


Overview
Overview

  • Background

  • CARICOM Summit on Chronic Disease

  • Lessons learned in GHD

  • Next Steps towards the UN Summit


The experience of building momentum in ghd on chronic disease prevention and control

CARMEN Network

MembersArgent, Anguilla, Ant&Barb, Aruba,

Barbados , Bahamas, Brazil, Can,

Colombia, Costa Rica, Cuba,

Curacao, Chile, Dominica,

Ecuador, El Salvador, Grenada,

Guatemala, Guyana, Jamaica

Mexico, Nicaragua, Panama,

Paraguay, Peru, Puerto Rico,

St Kitts & Nevis, St Lucia,

Trin. & Tobago, Uruguay

32

Prospective Members

Honduras, Venezuela, Bolivia

CARMEN SCHOOL

Collaborating membersSLU,USF,NHLBI,CDC, PHAC

AMNET, RAFA,ILSI,F&V

  • Special

  • USA-Mexico (border)

  • Caribbean CARMEN




Un high level meeting summit on chronic diseases september 2011
UN High Level Meeting /Summit on Chronic Diseases, September 2011

  • Many things have contributed: What was the role of the Caribbean in leading to this major opportunity for health?


What has led the un general assembly to convene the un summit in 2011
What has led the UN General Assembly 2011to convene the UN Summit in 2011?

May 2000

World Health Assembly endorses the 'Global strategy on the prevention and control of NCDs

September 2002

World Summit on Sustainable Development (Jo’burg) adopts 'Plan for Implementation‘ on NCDs

May 2003

World Health Assembly endorses the 'WHO Framework Convention on Tobacco Control'.

May 2004

World Health Assembly endorses the 'Global strategy on diet, physical activity and health'.

December2006

UN General Assembly adopts resolution A/RES/61/225 (develop national policies for diabetes)

September2007

Caribbean Community (CARICOM) Heads of Government adopt declaration on NCDs

May 2008

WHA endorses WHO 'Action Plan for the Global Strategy for the Prevention and Control of NCDs'.

April 2009

Summit of the Americas Conclusion includes Articles 28 and 29 on NCDs

November 2009

Commonwealth Heads Government issued a statement to combat NCDs.

January 2010

Drafting group led by the Caribbean Community convenes to develop a resolution on NCDs.

May 2010

A/RES/64/265 adopted unanimously by the UN GA; co-sponsored by 78 countries, including Canada and USA


The caricom heads summit on ncds sept 15 2007 trinidad tobago
The CARICOM Heads Summit on NCDs, Sept 15, 2007, Trinidad & Tobago

  • “We, the Heads of State of the Caribbean Community….”

  • 15-point “Port of Spain Declaration”; multi-sectoral

  • Tobacco – Ratify and implement the WHO Framework Convention on Tobacco Control: taxation, packaging, earmark some revenue for health promotion & disease prevention, ban smoking in public places

  • Healthy Diet - Trade policies on food imports, agriculture policies, Healthy school meals, Food labeling, reduce or eliminate trans fats

  • Physical activity-physical education in schools; physical activity in work places; improve public facilities for physical activity

  • Health services - screening and management of NCDs to achieve 80% coverage by 2012; primary and secondary prevention, comprehensive health education

  • Monitoring - Surveillance of risk factors; monitoring of the actions agreed upon in Declaration (CARICOM Secretariat, CAREC, UWI & PAHO/WHO)

  • Mobilizing Society - National Commissions on NCDs; including public, private sector and civil society, media and communications industry

  • Caribbean Wellness Day – Second Saturdays in September

WWW.CARICOM.ORG



Lessons learned from case study and from reflection
Lessons Learned – from case study and from reflection the CARICOM?

  • Progression and confluence of factors; not one single effort

  • Absolute need for evidence / data

  • Making the case: Speaking to head, heart and pocket

  • Political structure, and history of Caribbean cooperation in health

  • Importance of Champions: Political, technical, public health

  • “Pre-selling” by visiting countries/ Cabinets

  • PAHO-CARICOM collaboration

  • Country involvement in planning and preparation

  • Media and NGO involvement

  • International partners; especially Canada


1 progression and confluence of factors not one single effort
1. Progression and confluence of factors; not one single effort

  • Nassau Declaration of 2001: “The Health of the Region is the Wealth of the Region”, CARICOM Heads Conference

  • Caribbean Commission on Health and Development, 2003-05: identified Chronic Diseases, HIV/AIDS, and injuries and violence as “super priorities” for health

  • National level events, T&T, Barbados, Jamaica

  • Global /hemispheric awareness emerging


2 absolute need for evidence data
2. Absolute need for evidence / data effort

  • Caribbean Epidemiology Centre (CAREC) – mortality and risk factor trends

  • Caribbean Food and Nutrition Institute – dietary trends, obesity trends

  • University West Indies – economic impact data

  • U of Toronto, W Bank, CARICOM Trade desk – tobacco, financing issues, trade policy options, respectively


2 absolute need for evidence data1
2. Absolute need for evidence / data effort

  • Caribbean Epidemiology Centre (CAREC) – mortality and risk factor trends

  • Caribbean Food and Nutrition Institute – dietary trends, obesity trends

  • University West Indies – economic impact data

  • U of Toronto, W Bank, CARICOM Trade desk – tobacco, financing issues, trade policy options, respectively

Data are necessary but not sufficient!


3 speaking to head heart and pocket
3. Speaking to Head, Heart and Pocket effort

NCDs: Biggest cause premature death in the Caribbean


Speaking to head heart and pocket
Speaking to Head, Heart and Pocket effort

NCDs: Biggest cause

premature death

45-yr old man with

diabetes and amputation


Speaking to head heart and pocket1
Speaking to Head, Heart and Pocket effort

NCDs: Biggest cause

premature death

45-yr old man with

diabetes and amputation

3-5% GDP loss due to

diabetes, hypertension in

T&T, Jamaica, Barbados


Speaking to head heart and pocket2
Speaking to Head, Heart and Pocket effort

NCDs: Biggest cause

premature death

45-yr old man with

diabetes and amputation

3-5% GDP loss due to

diabetes, hypertension in

T&T, Jamaica, Barbados

Tobacco control could save lives

and raise $150M revenue in CARICOM


4 political structure and history of caribbean cooperation in health
4. Political Structure, and History of Caribbean Cooperation in Health

  • A political structure that facilitated regional appreciation of the problem and could mandate regional action, complementary to national action.

  • The Caribbean Community (CARICOM) is a formal political structure supported by the Treaty of Chaguaramas and a Secretariat

  • Council of Human & Social Development; Ministers of Health & others

  • Conference of Heads of Government – twice yearly

  • Caribbean Cooperation in Health – since 1986; polio, measles, rubella elimination; regional health institutions


5 importance of champions political technical public health
5. Importance of Champions: Political, Technical, Public Health

Dr Eddie Greene,

Asst Sec General

Human & Social Development

CARICOM

Sir George Alleyne

Chancellor UWI

Former D/PAHO

Dr Mirta Roses

D/PAHO


6 pre selling by visiting countries cabinets
6. Pre-selling by visiting countries/ Cabinets Health

  • Chairman or members of Commission on Health and Development visited all CARICOM Countries and spoke to Cabinet, PM, Parliament between 2004-2007

  • Allowed individual persuasion and consideration of situation of country



8 country involvement in planning and preparation
8. Country involvement in Healthplanning and preparation

  • Planning team included 4 CARICOM Chief Medical Officers

  • Survey of national NCD capacity and policies

  • Standard template for posters of national situation to be presented at the Summit

  • Progress reported regularly to Health Ministers


9 media and ngo involvement
9. Media and NGO Involvement Health

  • Not as intensive as planned

  • “One Caribbean Media” conglomerate printed free Summit supplements and distributed in Sunday newspapers in most territories prior to the Summit

  • Media articles, interviews

  • Healthy Caribbean Coalition born; a civil society alliance to combat chronic disease and risk factors


10 importance of international partners special role of canada
10. Importance of International Partners: Special Role of Canada

  • Public Health Agency of Canada provided a grant to PAHO support the Summit implementation and preliminary steps after

  • WHO Collaborating Centre on NCD Policy in PHAC provided technical assistance with case study of 26 key informants on perceptions of the Summit

  • CIDA provided a grant to the CARICOM Secretariat to support conduct of the Summit


Lessons learned from case study and from reflection1
Lessons Learned – from case study and from reflection Canada

  • Progression and confluence of factors; not one single effort

  • Absolute need for evidence / data

  • Making the case: Speaking to head, heart and pocket

  • Political structure, and history of Caribbean cooperation in health

  • Importance of Champions: Political, technical, public health

  • “Pre-selling” by visiting countries/ Cabinets

  • PAHO-CARICOM collaboration

  • Country involvement in planning and preparation

  • Media and NGO involvement

  • International partners; especially Canada


Next steps
Next Steps Canada

  • So you had the Summit; so what?

  • Implementation is key and in countries lags behind political statements

  • Twice-yearly monitoring mechanism helps greatly

  • Caribbean Wellness Day – amazing mobilization

  • Application of lessons learned to South and Central America

  • Healthy Caribbean Coalition – civil society alliance to combat NCDs and risk factors – beginning a texting campaign to create the “global demonstration”

  • UN Summit


The experience of building momentum in ghd on chronic disease prevention and control
NCD Progress Indicator Status / Capacity by Country in Implementing NCD Summit Declaration - September 2010


Un summit on ncds 2011
UN Summit on NCDs 2011 Implementing NCD Summit Declaration - September 2010

  • Unique policy window opening; think big

  • Need to Unite forces in NCDs, Risk Factors, H. Prom

  • Need roadmap/battle plan: before, during, after

  • Country by country advocacy campaign

  • Evidence - packaged to speak to head, heart & pocket

  • How do we create a “Global Demonstration”?

  • Champions, going viral, media advocacy

  • Be clear on “the ask”


The experience of building momentum in ghd on chronic disease prevention and control

SICA Presidential summit Implementing NCD Summit Declaration - September 2010

LAC Civil Soc

G-8 France

Obesity Forum


Running through the tape of the un summit
“Running through the tape”… of the UN Summit Implementing NCD Summit Declaration - September 2010


The experience of building momentum in ghd on chronic disease prevention and control

THANK YOU Implementing NCD Summit Declaration - September 2010

OBRIGADA

MUCHAS GRACIAS