10 years on from the Port of Spain Dec­la­ra­tion on chronic dis­ease: what’s the score?

The Star (St. Lucia) - - LOCAL -

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.

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