Public Health Activities

Communicable Diseases

CARPHA is equipped to investigate and manage communicable diseases through its security laboratories, a variety of specialized units such as an experimental mosquito colony, several epidemiological databases that are maintained within a LAN infrastructure and an active preventive maintenance unit.

The diseases which are investigated are:

• Vaccine preventable diseases (EPI)
• HIV/AIDS and sexually transmitted disease
• Vector borne diseases (Dengue fever, Malaria, Leptospirosis, Plague, Rabies and Yellow Fever)
• Food and water borne diseases (Gastroenteritis, diseases caused by almonella, Norovirus, Ciguatera, Campylobacter, Shigella and E. Coli)
• Air borne diseases (Influenza-like illnesses, fever and respiratory symptoms and tuberculosis)
• Other diseases and syndromes of interest (Leprosy, Viral Hepatitis A and B, Meningococcal infection, Viral Encephalitis/Meningitis, Fever and Neurological Symptoms

This grouping includes the re-emerging diseases like tuberculosis in association with HIV/AIDS, and new communicable diseases that are now endemic in the region.

CARPHA’s role is in:

• The surveillance of communicable diseases.
• Conducting research on the determinants of communicable disease and on approaches to prevention and control, including cost-benefit studies and providing relevant training and capacity building
• Preparing and disseminating information in response to outbreaks as well as information on the prevention of communicable diseases.
• Working with national and regional institutions and organizations to coordinate the health response to epidemics and activities on prevention, including immunization.
• Providing specialized diagnostic and reference laboratory services and works towards strengthening national laboratories.
• Providing support on the World Health Organization immunization, food, water and vector borne disease programme and other programmes. It also assists countries in working towards the requirements of the International Health Regulations (2005).

Non-Communicable Diseases

As a public health agency, CARPHA is involved in addressing the prevalence of non-communicable (NCD) or chronic diseases, which account for the majority of deaths and illnesses in the Region. The NCD epidemic causes enormous human suffering and also impacts negatively on human development in both social and economic realms. Diseases of concern are hypertension, diabetes, obesity—especially childhood obesity, cardiovascular disease and cancers such as cervical carcinoma. The Agency focuses on:

• Surveillance of chronic disease and its determinants. This includes behavioural surveillance of risk activities and surveys of such factors as alcohol, drug and tobacco consumption, diet, adolescent pregnancy and use of condoms;
• Conducting research on the causation of chronic diseases and preventive strategies;
• Health promotion and developing options for preventive action based on scientific evidence, including cost-benefit analyses.

CARPHA’s efforts to improve the quality of life in the Caribbean focus on household food and nutrition security with the aim of achieving optimal nutritional status for all the people of the Region. It is mindful of the importance of reviewing the food and nutrition security situation in the Caribbean and planning for averting future occurrences of food insecurity. The Agency is therefore contributing to the identification of pockets of malnutrition that exist in vulnerable groups, as a consequence of inequities associated with poverty.

CARPHA gives high priority to the prevention of diseases associated with obesity, for example, diabetes, hypertension and cardiovascular disease. It acknowledges that a multi-sectoral approach is required and will contribute to the effort through:

• Surveillance and research on food and nutrition through the life course, including measuring and monitoring the nutritional status in Caribbean populations
• Contributing to the development of Member States’ plans and policies on food and nutrition including food standards and safety
• Promoting inter-sectoral food and nutrition strategies
• Promoting multi-disciplinary, multi-sectorial coordinating mechanisms
• Building alliances with both the public and private sectors and collaboration with other regional institutions, NGOs, international agencies and the mass communication media entities for the prevention of NCDs
• Strengthening institutional dietetics services within countries with emphasis on schools
• Education, training and capacity building
• Promotion, protection and support for infant and young child nutrition (including breastfeeding and baby-friendly hospital initiatives)
• Producing and disseminating information on food and nutrition issues

As a public health institution, CARPHA’s mandate extends beyond the surveillance and management of disease to the improvement of well-being at all stages of human development, from infancy to old age. This involves attention to immunization and vaccines, reproductive and sexual health and the increasing occurrence of injuries and violence.

Immunization and Vaccines

The Expanded Programme on Immunization (EPI) at CARPHA aims to reduce morbidity and mortality due to common vaccine preventable diseases by developing and expanding permanent immunization services within primary health care in the Region.

The EPI office at CARPHA has made a significant contribution to making EPI in the Caribbean one of the leading programmes in the world. Poliomyelitis has been eliminated from the Caribbean since 1982 and eradicated from our region of the Americas since 1994. Indigenous measles was last confirmed in 1991, congenital rubella syndrome (CRS) in 1999 and rubella in 2001. Tuberculosis, diphtheria, pertussis, and tetanus are virtually unknown in the CARPHA-served Caribbean.

Most countries in the Region are now providing protection against at least ten diseases in their National Immunization Programmes. These diseases are: tuberculosis, diphtheria, pertussis, tetanus, polio, measles, rubella, mumps, CRS, hepatitis B and more such as haemophilus influenza b, etc. Bermuda is providing protection against more than 15 diseases.

Injuries and Violence

Injuries and violence are among of the top three causes of mortality and morbidity in the Caribbean. CARPHA is:

• Conducting surveillance of the patterns, distribution and impact of violence and injuries
• Evaluating preventive actions, including cost-benefit analyses
• Developing policy options based on sound scientific evidence from surveillance and research

The abuse of alcohol and recreational drugs generates significant secondary morbidity. Excessive alcohol use can lead to auto accidents, spousal and child abuse, and other injuries while recreational drug use may result in physical violence, wounding or even death.

Accurate surveillance data for substance abuse as well as the legitimate use of psychotropic drugs for minor and serious mental illness are important in the formulation of mental health policies.

CARPHA is:

• Developing regional standards and networks related to laboratory practice and other public health and IT systems.
• Producing food and nutrition standards and guidelines.
• Conducting evaluations of the quality of medicines used in the region through its surveillance programme and contributing to the development of a regional medicines regulatory framework.
• Providing support to countries in the monitoring and evaluation of national health programmes. This will assess progress, to inform programme improvement and improve results.
• Conducting analysis of training outcomes and conduct of tracer studies with workshop recipients to assess training effectiveness using a customized version of the TRAINSmart software.
• Building health research capacity in the Caribbean through the Research Grants Programme.

Environmental health is the interrelationship between people and their environment that promotes human health and well-being and fosters a safe and healthy environment. Problems arise from biological and chemical contaminants in water, food, air and soil, and physical hazards in the home, workplace and general surroundings. CARPHA takes a multi-faceted and multi-disciplinary approach to the management of environmental health in the Caribbean.

The role of CARPHA in environmental health is focused on:

• Environmental quality monitoring, and the surveillance and detection of environmentally-related illness
• The conduct of field and laboratory research and recommendation of intervention measures
• The provision of technical and advisory services
• Environmental health information including guidelines and promotion of best practices
• Training of environmental health officers and other public health practitioners

More specifically, technical and advisory services in environmental health involve:

• Water, land and coastal areas management
• Waste management: solid, liquid, hazardous, biomedical and electronic waste
• Chemical and pesticide management
• Indoor air quality, chemical safety and occupational health and safety
• Sustainable consumption and production, eco-efficiency and renewable energy
• Prevention and control of vector borne diseases
• Environmental and social impact assessments
• Environmental management training