1. The Experience of the Caribbean in the Lead up to Rio+20 and the Involvement of Health Looking Back and Looking Forward H. Elizabeth Thompson Assistant Secretary General - United Nations & Executive Coordinator-UN Conference on Sustainable Development (Rio+20)

2. Rio+20 conference On Sustainable Development The objectives Conference  to secure renewed political commitment for sustainable development  assess the progress to date and the remaining gaps in the implementation of the outcomes of the major summits on sustainable development  address new and emerging challenges

3. Conference Themes  Green economy in the context of sustainable development and poverty eradication  The institutional framework for sustainable development

4. Setting the Historical Context: The Rio Platform “Agenda 21,” the Outcome Document of the iconic Earth Conference of 1992 contained a chapter on health. “Protecting and Promoting Human Health,”  Meeting Primary Health Care Needs Particularly In Rural Areas  Control of Communicable Diseases  Protecting Vulnerable Groups  Meeting the Urban Health Challenge  Reducing Health Risks from Environmental Pollution and Hazards

5. Millennium Development Goals (MDGs)  End poverty and hunger  Gender Equity  Child Health  Maternal Health  Environmental Sustainability  Combat HIV/AIDS  Universal Education  Global Partnership

6. Where We Are Now: Health Challenges in the Caribbean  Aging population – diseases of old age and impacts on social care systems (national insurance etc.) against a narrow band of population defined as young  Chronic non-communicable diseases – morbidity, mortality, family and social costs  Diseases related to climate/pollution – allergies, asthma, dengue fever, post hurricane/flood problems

7. Where We Are Now: Health Challenges in the Caribbean C’td  HIV/AIDS  Maternal and child health - % of live births per 100,000  The cost of health care – especially in the context of shrinking national budgets and government expenditure

8. Expected Outcomes of Rio+20  Document for universal sustainable development  Sustainable Development Goals (SDGs)  Urgency re water, oceans, food security/sovereignty, energy  Enlarged understanding of planetary boundaries/critical thresholds  Principles for development of a green economy (within national policy and constraints)  Consideration of financial issues and GDP+

9. Identifying Priorities for the Caribbean  Defining the green economy – investments in human, social and natural capital including health and education and health education  Dealing with elderly and youth  Investing in primary health care – prevention and early intervention  Effecting behavioural change – NCDs and HIV

10. Identifying Priorities for the Caribbean c’td  Food and nutrition challenge of both under- nutrition and over nutrition  Water – water stress and scarcity in the Caribbean, access to potable water and water for development  Energy – fuel for life  Oceans – as they relate to Caribbean health statistics, protein consumption, jobs and oceans as critical maritime territory

11. Identifying Priorities for the Caribbean c’td  Consider and review the National Regional and International mechanisms and institutions for delivering on the agenda  Getting appropriate language included in the text  Ensuring that health is one of the SDGs  Compendium of Commitments

12. Central to the successful management of health issues  Empowering Caribbean people to make decisions about their own health  Strengthening national policy formulation and delivery  Collaborating on cross-regional approaches  The regional approach should be Rio++ so that the region has its own approach irrespective of the Rio outcome

13. The Divide

17. Barbados

18. St. Lucia Petit Piton

19. Boat Building in Guadeloupe

20. St Martin (French side) at twilight