Overview

Non-communicable diseases prevention and control

Declaration of Port-Of-Spain: Uniting to Stop the Epidemic Of Chronic NCDs

Declaration of Port-Of-Spain 15 September 2007.

We, the Heads of Government of the Caribbean Community (CARICOM), meeting at the Crowne Plaza Hotel, Port-of-Spain, Trinidad and Tobago on 15 September 2007 on the occasion of a special Regional Summit on Chronic Non-Communicable Diseases (NCDs);Conscious of the collective actions which have in the past fuelled regional integration, the goal of which is to enhance the well-being of the citizens of our countries;

Recalling the Nassau Declaration (2001), that “the health of the Region is the wealth of Region”, which underscored the importance of health to development;

Inspired by the successes of our joint and several efforts that resulted in the Caribbean being the first Region in the world to eradicate poliomyelitis and measles;

Affirming the main recommendations of the Caribbean Commission on Health and Development which included strategies to prevent and control heart disease, stroke, diabetes, hypertension, obesity and cancer in the Region by addressing their causal risk factors of unhealthy diets, physical inactivity, tobacco use and alcohol abuse and strengthening our health services;

Impelled by a determination to reduce the suffering and burdens caused by NCDs on the citizens of our Region which is the one worst affected in the Americas;

Fully convinced that the burdens of NCDs can be reduced by comprehensive and integrated preventive and control strategies at the individual, family, community, national and regional levels and through collaborative programmes, partnerships and policies supported by governments, private sectors, NGOs and our other social, regional and international partners;

Declare – that the burdens of NCDs can be reduced by comprehensive and integrated preventive and control strategies at the individual, family, community, national and regional levels and through collaborative programmes, partnerships and policies supported by governments, private sectors, NGOs and our other social, regional and international partners;

1. Our full support for the initiatives and mechanisms aimed at strengthening regional health institutions, to provide critical leadership required for implementing our agreed strategies for the reduction of the burden of Chronic, Non-Communicable Diseases as a central priority of the Caribbean Cooperation in Health Initiative Phase III (CCH III), being coordinated by the CARICOM Secretariat, with able support from the Pan American Health Organisation/World Health Organisation (PAHO/WHO) and other relevant partners;
2. That we strongly encourage the establishment of National Commissions on NCDs or analogous bodies to plan and coordinate the comprehensive prevention and control of chronic NCDs;
3. Our commitment to pursue immediately a legislative agenda for passage of the legal provisions related to the International Framework Convention on Tobacco Control; urge its immediate ratification in all States which have not already done so and support the immediate enactment of legislation to limit or eliminate smoking in public places, ban the sale, advertising and promotion of tobacco products to children, insist on effective warning labels and introduce such fiscal measures as will reduce accessibility of tobacco;
4. That public revenue derived from tobacco, alcohol or other such products should be employed, inter alia for preventing chronic NCDs, promoting health and supporting the work of the Commissions;
5. That our Ministries of Health, in collaboration with other sectors, will establish by mid-2008 comprehensive plans for the screening and management of chronic diseases and risk factors so that by 2012, 80% of people with NCDs would receive quality care and have access to preventive education based on regional guidelines;
6. That we will mandate the re-introduction of physical education in our schools where necessary, provide incentives and resources to effect this policy and ensure that our education sectors promote programmes aimed at providing healthy school meals and promoting healthy eating;
7. Our endorsement of the efforts of the Caribbean Food and Nutrition Institute (CFNI), Caribbean Agricultural Research and Development Institute (CARDI) and the regional inter-governmental agencies to enhance food security and our strong support for the elimination of trans-fats from the diet of our citizens, using the CFNI as a focal point for providing guidance and public education designed toward this end;
8. Our support for the efforts of the Caribbean Regional Negotiating Machinery (CRNM) to pursue fair trade policies in all international trade negotiations thereby promoting greater use of indigenous agricultural products and foods by our populations and reducing the negative effects of globalisation on our food supply;
9. Our support for mandating the labelling of foods or such measures as are necessary to indicate their nutritional content through the establishment of the appropriate regional capability;
10. That we will promote policies and actions aimed at increasing physical activity in the entire population, e.g. at work sites, through sport, especially mass activities, as vehicles for improving the health of the population and conflict resolution and in this context we commit to increasing adequate public facilities such as parks and other recreational spaces to encourage physical activity by the widest cross-section of our citizens;
11. Our commitment to take account of the gender dimension in all our programmes aimed at the prevention and control of NCDs;
12. That we will provide incentives for comprehensive public education programmes in support of wellness, healthy life-style changes, improved self-management of NCDs and embrace the role of the media as a responsible partner in all our efforts to prevent and control NCDs;
13. That we will establish, as a matter of urgency, the programmes necessary for research and surveillance of the risk factors for NCDs with the support of our Universities and the Caribbean Epidemiology Centre/Pan American Health Organisation (CAREC/PAHO);
14. Our continuing support for CARICOM and PAHO as the joint Secretariat for the Caribbean Cooperation in Health (CCH) Initiative to be the entity responsible for revision of the regional plan for the prevention and control of NCDs, and the monitoring and evaluation of this Declaration.

We hereby declare the second Saturday in September “Caribbean Wellness Day,” in commemoration of this landmark Summit.

Overview

Non-communicable Diseases (NCDs) or chronic diseases are a group of conditions that are not passed from person to person and are mainly of a long duration and progress slowly. NCDs include cardiovascular diseases, diabetes, cancers, chronic lower respiratory diseases, sickle cell disease, mental illness and injuries. They are mainly a result of a combination of genetic, environmental, behavioural and metabolic risk factors, such as, physical inactivity, unhealthy diet, harmful use of alcohol, air pollution, stress and overweight/obesity. The way people live, work and play are contributing to this public health problem.

In the Caribbean Region, NCDs are the leading cause of death and disability, 76.8% of the total deaths (non-Latin Caribbean, excluding Haiti) were due to NCDs in 2016. Cardiovascular diseases 30.8%, cancer 17.2% and diabetes 10.8% are the leading causes of death due to NCDs. Many of these persons die in the prime of their lives before the age of 70 years. The top four countries with the highest premature mortality in the Americas are CARPHA Member States (Guyana 57.9%, Haiti 52.5%, Belize 47.5%, Suriname 47.3%). ¹

In, September 2007, the CARICOM Heads of Government in recognition of the threat to health and socio-economic development posed by the burden of these diseases committed to the Port of Spain Declaration: “Uniting to stop the Epidemic of NCDs”. This was the first ever summit and regional declaration on NCDs worldwide, which subsequently created the catalyst for global action resulting in the United Nations (UN) Political Declaration and High-Level meeting on NCDs in 2011 and follow-up meetings and commitments in 2014, and 2018. In 2015, targets for NCD and their risk factors were included in the UN Sustainable Development Goals (SDGs).

Why It Matters

NCDs not only have health consequences but also a social and economic impact on individuals, communities and the society. However, NCDs is mostly preventable and there are cost-effective, evidence-based interventions (WHO best and good buys create link to document) that can prevent most of the death and disability associated with these diseases. A recent study in Jamaica found a minimum $2.10 JMD return for every dollar invested in implementing a package of interventions to treat diabetes, and cardiovascular disease; and alcohol and tobacco control, over the period 2017 to 2032. These interventions would also grow the GDP by an extra 0.11 percentage points by year five of the intervention.²

What We Do

The Chronic Diseases and Injury Department provides leadership, strategic direction, coordinates and implements technical cooperation activities directed towards the prevention and control of NCDs in CARPHA Member States. Global, Regional, and Sub-Regional commitments provide the framework for action, such as, the 2007 Port of Spain Declaration on NCDs, Caribbean Cooperation in Health Phase IV (CCH IV), United Nations (UN) Political Declarations on NCDs and UN SDGs.

References

1. Noncommunicable Disease Mortality and Risk Factor Prevalence in the Americas PAHO/NMH/19-014. Retrieved from website: http://iris.paho.org/xmlui/handle/123456789/51696
2. The Case for Investment in Prevention and Control of Noncommunicable Diseases in Jamaica: Evaluating the return on investment of selected tobacco, alcohol, diabetes, and cardiovascular disease interventions. Washington, D.C.: UNIAFT, UNDP, and PAHO; 2018.