World Health Day 2014
Message from the Executive Director, CARPHA
Port-of-Spain, Trinidad and Tobago, April 4, 2014: The Caribbean Public Health Agency (CARPHA) joins the rest of the world in celebrating World Health Day. The theme for World Health Day 2014 – Small Bite, BIG THREAT - is very timely and of great importance to us in the Caribbean Region.
Vector-borne diseases are diseases which are spread by insects that transmit bacteria, parasites and viruses to humans. With our perennial tropical climate, we are always at risk for the transmission of vector-borne diseases such as malaria, yellow fever, dengue and more recently, chikungunya, which are all spread by mosquitoes. Yellow fever which was a problem in the past has been controlled through programmes of vaccination.
Malaria was eradicated from the Region in the 1960s and since then most CARPHA member states have been malaria-free. However, this does not mean that we can become complacent since malaria can be re-introduced into countries which have been declared malaria-free, as evidenced by the outbreak which occurred in Jamaica in 2006. With frequent air travel and migration of persons from areas which are known to have malaria transmission occurring, to areas where there is no malaria, coupled with the presence of the mosquito vectors, the likelihood of the emergence or re-emergence of vector-borne diseases is great. Strong systems of monitoring, prevention and control are therefore important.
Since the 1990s we have seen an increase in the frequency and intensity of dengue outbreaks in the Caribbean with a decrease in intervals between outbreaks and introduction of severe cases. All four types of dengue have been circulating in the Region with dengue types one-1 and type-2 being most prominent. This means that we still have susceptible populations to dengue since infection with one type does not protect from infection with the other types, and the circulation of all types increases the risk of severe cases. If not controlled, we could see more explosive and severe outbreaks in the years to come.
In December 2013, chikungunya entered the Caribbean Region with the report of the first case of local transmission on the island of St Martin. Since then, the disease has spread to other islands and to date, there are 3,112 confirmed cases of chikungunya in 11 Caribbean territories. The Aedes aegypti mosquito is the main vector which spreads dengue and chikungunya and each member state has high infestation levels of this mosquito. The main tool, therefore, for prevention and control of these outbreaks is through control of the mosquito vector.
The islands of the Caribbean rely heavily on tourism and these vector-borne diseases due to the potentially high levels of illness, can severely affect our tourism-dependent economies. Changes in the environment, unplanned and rapid urbanization, increased generation of solid waste, inadequate water supply and storage systems and poor infrastructure are some of the factors which have contributed to the proliferation of the mosquito vectors and the subsequent spread of these diseases. The good news is that these diseases are preventable and can be achieved through control of the vectors and the implementation of personal protective measures.
Everyone has a part to play in the fight to prevent and control vector-borne diseases. Individuals and communities are encouraged to work together to rid their premises and communities of containers which can contribute to mosquito breeding. Old tyres, bottles, cans and any containers which can collect water should be properly discarded, domestic water storage containers such as drums, barrels and buckets should be securely covered to prevent mosquito access. Persons can reduce exposure to mosquito bites by using mosquito repellants, sleeping under mosquito nets, wearing long sleeved shirt and long pants and screening windows and doors.
Governments also have a responsibility to make a political commitment to invest in strengthening existing vector control and education and surveillance programmes to make them more efficient at preventing and/or responding to outbreaks of vector-borne diseases.
Other sectors are also encouraged to join in the fight as it is not the responsibility of the Ministries of Health alone. Achievement of the control and/or eradication of vector-borne diseases can only be attained through the coordinated effort and collaboration of the various sectors.
CARPHA continues to work with its partners to provide support to its member states in promoting integrated vector management strategies aimed at ridding the Region of these vector-borne diseases, making our Caribbean region a healthier place for our citizens and visitors, alike.
Dr. C. James Hospedales
Executive Director, CARPHA