10 years on from the Port of Spain Declaration on chronic disease: what’s the score?
The year 2017 marks the tenth anniversary of the signing of the landmark CARICOM Heads of Government Port of Spain Declaration on non-communicable diseases (NCDs). This year’s thirty-eighth CARICOM Conference of Heads held on July 4-6 celebrated this momentous achievement. In 2007 the Caribbean led the world in convening the very first conference of Heads of Government on NCDs which in turn paved the way for the United Nations High-level Meeting on NCDs in 2011.
A ten-year anniversary is a good time to take stock, to look at how far the region has come and how far it still needs to go. In terms of progress made in the NCD response, the picture is a decidedly mixed one. Awareness of NCDs and their devastating effect on the health and development of the region has grown enormously. The dangers of childhood obesity are much better known. Barbados and Dominica have introduced taxes on sugary drinks and more countries are set to follow.
However, the Caribbean has also become a world leader in chronic diseases in quite the wrong way. According to Dr Alafia Samuels, Director of the George Alleyne Chronic Disease Research Centre, University of the West Indies, and head of a wide-ranging evaluation of the Port of Spain Declaration, “The statistics are quite shocking. Our soda consumption is the highest in the world. In some countries more than 30% of young people are overweight or obese. Our diabetes rates are double global rates and in some populations up to 50% of us are living with high blood pressure. It is clear that we need to accelerate our response.”
The Executive Director of the Caribbean Public Health Agency (CARPHA), Dr James Hospedales, agrees. “There are gains in some areas. However, some, like diet/nutrition/obesity just keep getting worse, and that drives diabetes, cancer, heart disease,” he said. He added, “The food environment is not healthy. Obesity in children is the red flag. And, economically, we cannot afford to carry those preventable costs, when we are struggling to grow.”
The Heads of Government Conference provided an opportunity for more discourse. The leaders were asked to consolidate pledges made at the 2016 meeting where they promised to address such issues as banning smoking in public places, banning the advertising of unhealthy foods to children, and raising taxes on food high in sugar, salts and trans fats.
According to the Programme Manager, Health Sector Development at the CARICOM Secretariat Dr Rudolph Cummings, the importance of the Port of Spain Declaration cannot be underestimated. “The 2007 Declaration will remain one of the most visionary public policy coups scored by the CARICOM political leadership since the Treaty of Chaguaramas itself,” he said. “Ten years on, the threats to our health and well-being remain undaunted, providing an opportunity for our current leaders to make a renewed commitment to meaningfully influence the future of our peoples by joining the global movement against tobacco smoke and unhealthy diets with a firm timetable to eliminate these risks.”
In order to bring home the importance of the role leaders can play in influencing behaviour, the Port of Spain evaluation project presented the heads of government with blood pressure monitors. There was also a vivid display highlighting key aspects of the NCD epidemic and recommendations for the way forward.