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

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

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

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 hypertension are present in a very high % of the population and are not being effectively tackled

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

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

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

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

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 monitor implementation of the POS Summit Declaration Consider resource mobilization

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

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

Participants Anguilla Antigua Aruba Bahamas Barbados Belize BVI 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 Anguilla Antigua Aruba Bahamas Barbados Belize BVI Cayman islands Dominica Grenada Guyana Jamaica Montserrat St. Lucia Trinidad and Tobago St. Kitts

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

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

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

Visits to www.healthycaribbean.org. Year Month Page view Unique visits 2008 November 428 215 December 253 150 2009 January 289 193 February 813 553 March 935 603 TOTAL 2,718 1,714

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

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

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

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

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

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

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

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

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

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

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

Thank You

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