Transcript Slide 1

The Chronic Disease problem in the Caribbean
– civil society perspective
Twelfth OECS Health Ministers Meeting, 11th September 2009
Prof. Trevor A. Hassell
Chairman of the Healthy Caribbean Coalition,
Chairman of the National Commission for Chronic
Non Communicable disease, Barbados
“Three primary risk factors (tobacco, poor
diet and physical inactivity) and three
intermediate risk factors (hypertension,
obesity and diabetes) lead to three diseases
(heart disease, lung disease and cancer)
resulting in 50% of all deaths”
Crude Mortality Rates (per 100,000 population)
for Select Diseases: (2000-2004)
CARICOM Member States
140
Rates per 100,000 population
120
100
Heart
Disease
80
Cancers
Diabetes
Stroke
60
Injuries
40
Hypertensive
Diseases
HIV/AIDS
20
0
2000
2001
2002
2003
2004
Year
Source: CAREC, based on mortality reports from countries
Leading Causes of Death in CARICOM Countries
by Sex, 2004 (excluding Jamaica)
MALES
1.
2.
3.
4.
5.
6.
7.
8.
Heart Disease
Cancers
Injuries and violence
Stroke
Diabetes
HIV/AIDS
Hypertension
Influenza/pneumonia
FEMALES
1.
2.
3.
4.
5.
6.
7.
8.
Heart Disease
Cancers
Diabetes
Stroke
Hypertension
HIV/AIDS
Influenza/pneumonia
Injuries and violence
Source: CAREC, based on country mortality reports
Potential Years of Life Lost <65years by Main Causes, 2000
& 2004, CARICOM Countries (minus Jamaica)
Injuries
Y2004
HIV/AIDS
Y2000
Chronic Disease
0
10000 20000 30000 40000 50000 60000 70000
Source: CAREC, based on country mortality reports
Note: Chronic Disease includes heart disease, stroke, cancer, diabetes, hypertension,
chronic respiratory disease
‘Injuries’ includes traffic fatalities, homicide, suicide, drowning, falls, poisoning
Disability Adjusted Life Years (000) 2002
Mortality Attributable to Select Risk Factors (Latin America &
from DCP2
Caribbean)
High BP
Obesity
Alcohol
Tobacco
High cholesterol
Low fruits & veg
Physical inactivity
Unsafe sex
0
100
200
300
Attributable Deaths (thousands)
400
500
Prevalence (%) of diabetes among adults in the Americas
Source: Pan Am J Public Health 10(5), 2001; unpublished (CAMDI),
Haiti (Diabetic Medicine); USA (Cowie, Diabetes Care)
Caribbean Trends in Diabetes Mortality
80
Rate/100,000
70
60
Male
Female
50
40
30
20
1985
1990
1995
2000
CARICOM
From community surveys, the prevalence
of hypertension in adults 25-64 years of age
was:
Barbados
27.2 %
Jamaica
24.0 %
St. Lucia
25.9 %
The Bahamas 37.5%
Belize
37.3%
Control of blood pressure would reduce the
death rates from Cardiovascular Disease by
about 15-20%.
Hypertension
 Uncontrolled hypertension contributes to 45%
of all ill health from CVD
 Hypertension uncontrolled in 80% of
hypertensive Barbadians
 49 anti-hypertensive drugs available in
Barbados National Formulary
Estimated Economic Burden
($US Million, 2001)
BAH
BAR
JAM
TRT
27.3
37.8
208.8
494.4
Hypertension 46.4
72.7
251.6
259.5
Total
110.5
460.4
753.9
Diabetes
76.7
Estimated Cost of Diabetes and Hypertension
as percent (%) of GDP
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
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
Recent initiatives






Ratification of the FCTC
Establishment of NCD Commissions
Recognition of Annual Caribbean Wellness Day
National Chronic Disease Registry, Barbados
Risk Factor Surveillance
Healthy Caribbean Coalition public education
campaign
 National Nutrition improvement and salt reduction
Recent initiatives
 CNCD National Summits held in Dominica and St. Lucia
 Blood Pressure Monitoring initiative in barber shops and
hairdressing salons developed in St. Kitts
 Completion of STEPS survey for CNCDs and risk factors in
Barbados, Dominica, BVI and St. Kitts and Nevis
 Grenada completed a Workplace Wellness Summit (Part 1)
 Expert consultations on Cancer Registries in Barbados,
Antigua and Barbuda and Grenada
Complementary
approaches to
chronic disease
prevention
Individual responsibility
Changes to the
"toxic" environment
HEALTH CARE
AND
DOCTOR
POLICY ENACTMENT
COMMUNITY AND CIVIL SOCIETY
21
Areas of support and
recommendations for further action
 Establishment of NCD Commissions in all OECS
countries
 Ratification and full implementation of FCTC
by all OECS countries
 Implementation of a population salt
reduction programmes in OECS countries
 Support by OECS Governments for HCC led
public education campaign on NCDs
Areas of support and
recommendations for further action
 Support for Annual Caribbean Wellness Day
 Acceptance of Caribbean Civil Society
Declaration and Action Plan for tackling NCDs
 Official recognition of the Healthy Caribbean
Coalition by OECS Ministers of Health
www.healthycaribbean.org