Healthy Caribbean 2008

Colin Alert

Barbados

The title of an article in the Barbados Advocate of August 6th 2008 was “Healthy Caribbean 2008 – A Wellness Revolution:, and the article that followed focused on the upcomingHealthy Caribbean 2008 Conference, to be held here in Barbados between October 16-19th .
 
This follows, at a Caribbean level, the meeting by Caribbean Prime Ministers on September 15th 2007, in Port-of-Spain, Trinidad, and culminated in the “Declaration of Port-of-Spain: Uniting to stop the epidemic of Chronic Non Communicable Disease (CNCDs)”. This declaration marked the launch of Caribbean Cooperation in Health III (CCH III), signaling the will at the highest political level to promote policies that favor prevention and enhanced treatment of the CNCDs, a.k.a. preventable lifestyle diseases.
 
I congratulate the Healthy Caribbean Conference organizers, wishing them not only a successful conference, but more importantly the actual introduction of these policies as rapidly as possible.
 
I commented in a newspaper article last year on CCH I, introduced in 1986, with a projected 10 year action plan; and CCH II, in 1995, with a proposed 25 year life span. Both of these were agreed upon by our Caribbean Ministers Responsible for Health, yet there is little evidence on the ground that any of the proposals actually were implemented. Then last year the reigns were taken over by our Prime Ministers (as opposed to Ministers responsible for Health), presumably men with closer ties to the public purses, so the opportunity for some real action (as opposed to political speeches) presented itself. I applauded this as an excellent initiative.
 
One of the specific plans that the Heads of Government of the Caribbean Community (CARICOM) committed themselves to was to “ strongly encourage the establishment of National Commissions on NCDs or analogous bodies to plan and coordinate the comprehensive prevention and control of chronic NCDs”. Having established no less than four such commissions over the last decade, the Government of Barbados is well experienced in this area: the current Commission, announced by the Ministry of Health in January 2007 (before the Port-of-Spain conference), are in fact hosting the October Healthy Caribbean 2008 Conference.So we follow-up a September 2007 conference with an October 2008 conference – what next?
 
Another of the specific plans that the Heads of Government of the Caribbean Community (CARICOM) committed themselves to was “that our Ministries of Health, in collaboration with other sectors, will establish by mid-2008 comprehensive plans for the screening and management of chronic diseases and risk factors …”. Mid- 2008 has come and gone, and if our Ministry of Health has established such a plan then it is one of the better kept secrets in our community. If such a plan does exist we await its speedy implementation. We also hope that other declarations made by our Caricom Heads will be implemented in a timely manner.
 
In the last millennium, we had successful conferences that led to CCH I and CCH II, but little or no follow-up action. In this millennium we have had a successful conference that had led to CCH III, and now just over a year later we are planning yet another conference – one hopes we are not repeating the steps of the last millennium.
 
No less of a person than Sir George Alleyne, Chancellor of the University of the West Indies and former Director of the Pan American Health Organization (PAHO), pointed out in a lecture two years ago in Barbados that we (in the Caribbean) have death rates from the CNCDs that are many times higher than our neighbors to the north, and we need to take urgent stock of our lifestyles and environment. We may not be able to afford the approach to health that positions high-cost high-technology tertiary care at the centre of our health care (in spite of the fact that our single hospital the Queen Elizabeth Hospital seems to monopolizes the spotlight), as these same neighbors to the north sometimes do. Let’s hope that the implications of the word ‘urgent’ are not lost on our Health Decision makers. As Sir George Alleyne himself notes, success is 1% genius and 99% elbow grease: a lot of ‘elbow grease’ has to be put in to establish the ‘preventable’ component in these preventable lifestyle diseases. But there is little in the past that tells us we are actively approaching a Healthy Caribbean in 2008.