a civil society alliance for combatting chronic disease in the caribbean

Healthy Caribbean Coalition - Address by Minister of Health the Hon. Jerry Narace at the opening ceremony of 55th annual Caribbean Health Research Council meeting on Thursday April 22, 2010 at 7 pm

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First Published; Trinidad and Tobago Government News - www.news.gov.tt/

SALUTATIONS

  •  Mrs. Sandra Jones, Permanent Secretary, Ministry of Health - Trinidad and Tobago
  • Ms. Gemma Marcus, Permanent Secretary, Ministry of Health - Trinidad and Tobago
  • Ms. Cheryll Hay, Deputy Permanent Secretary, Ministry of Health - Trinidad and Tobago
  • Mr. Waltrude Diaz, Deputy Permanent Secretary, Ministry of Health - Trinidad and Tobago
  • Sir Keith Hunte, Chairman Caribbean Health Research Council
  • Dr. Donald Simeon, Director Caribbean Health Research Council
  • Chief Medical Officers of CARICOM
  • Members of the Caribbean Health Research Council
  • Distinguished guests
  • Members of the media
  • Ladies and Gentlemen

Introduction

It is my pleasure this evening to address this distinguished body of stakeholders in healthcare at the ceremonial opening of the fifty-fifth (55th) Annual Council and Scientific Meetings of the Caribbean Health Research Council being held here at the Hyatt Regency Hotel in Port of Spain. We, in Trinidad and Tobago, are most eager hosts and we are pleased and honoured to have you.

I know that workshops and meetings for the CHRC began yesterday and continued in full speed today, on the heels of the meeting of the Caribbean Chief Medical Officers on Monday and Tuesday; I trust that deliberations have thus far been successful.

This week’s meeting follows a very successful hosting of the Commonwealth Heads of Government Conference in November 2009 here in Port of Spain. We were also pleased to host the meeting of the Bureau of CARICOM Ministers and the Steering Committee on the Caribbean Public Health Agency in early December and then the special meeting of the Council for Human and Social Development (COHSOD) in February.

All of these meetings of leaders in public health, science, research and Government are crucial to addressing the issues that affect the health of the Caribbean.

CNCDs-General

A major concern for our region that forms a part of the discourse at this meeting is chronic non communicable diseases (CNCDs). I am sure you are aware that the Caribbean is one of the regions most affected by the plague of CNCDs. Heart disease, cancer, diabetes, stroke and cancer are the leading causes of illness and premature death in the Caribbean today. In Trinidad and Tobago alone, over the last two decades, these diseases have represented four of the five leading causes of death, and have accounted for sixty per cent of all deaths.

These statistics do invoke my consternation and I am sure yours, as well. We know that CNCDs are caused by lifestyle behaviours including tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol, and are thus modifiable. Linked to unhealthy diets and physical inactivity are obesity, being overweight, high blood pressure, high cholesterol and high blood sugar.

If we control these risk factors, incidents of heart attacks, strokes and type 2 diabetes could be slashed by as much as eighty per cent and incidents of cancer could be reduced by as much as forty per cent [1]. And control them, we must, as CNCDs significantly reduce life expectancy, quality of life and productivity, placing both our health systems and our economies under significant pressure and presenting a threat to the sustainable growth and development of our region.

CNCDs-Declaration of Port of Spain

The united CARICOM response to this imposing threat was the signing of the Declaration of Port of Spain in 2007 when the CARICOM Heads of Government held an historic summit on CNCDs here in Port of Spain, spearheaded by our Prime Minister, the Honourable Patrick Manning, who is deeply committed to reducing the prevalence of CDCDs both in our country and of course in the Region.

The Declaration of Port of Spain, adopted by the Heads of CARICOM, comprised fifteen (15) resolutions which outlined the key strategies to be implemented in different sectors and settings, to prevent, control and reduce the burden of CNCDs and included:

  • The support of the elimination of trans fats from the diets of our citizens.
  • The provision of incentives and resources to promote healthy school meals and healthy eating.
  • The support of compulsory labelling of foods or such measures as are necessary to indicate their nutritional content; and
  • The pursuit of a legislative agenda on tobacco control.

CNCDs-CHOGM

In addition, at the Commonwealth Heads of Government Meeting (CHOGM) last November, Trinidad and Tobago also encouraged the adoption of a statement on CNCDs, which called for:

  • The integration of Non Communicable Diseases progress indicators in the 2010 Millennium Development Goals (DMG) review.
  • The support for the availability of essential medicines for people living with NCDs.
  • A UN Summit on CNCDs in September 2011; and the
  • Integration of NCD prevention into national health systems and the global development agenda.

Public policy-Tobacco Control

Ladies and gentlemen, I am a strong proponent of the use and implementation of public policy in the achievement of our desired public health outcomes.

To this end, Trinidad and Tobago, fully committed to the Declaration of Port of Spain, proceeded with Tobacco Control Legislation. We are very proud of our Tobacco Control Act, because, in addition to being pioneers in the Region in terms of passing such legislation, we have achieved a significant milestone in the fight against CNCDs through its passing.

Since the proclamation of the clauses of the law that prohibit, inter alia, smoking in public places, we have seen a clearly positive response from nongovernmental organisations and both private and corporate citizens. The general indication has been that people, including smokers themselves, are understanding and appreciative of smoke free environments. In fact, we are very encouraged by the response and grateful to civic society for their immediate observance and implementation of smoke free enclosed public spaces.

In our view, the intention of the law is for society to regulate itself. Although law enforcement officers are authorised to press charges, the spirit of the tobacco control laws, both here in Trinidad and Tobago and also internationally where similar laws have been enforced, calls for interpersonal and social interventions rather than police and legal interventions.

We recognise that tobacco control does in fact represent a cultural shift for our society. To encourage and support this much needed cultural shift, we are implementing a public education and communication plan, which encompasses the sensitisation of all stakeholders and the public at large. We are also developing a smoking cessation programme for the public, which will support and assist smokers who want to quit the habit. To say the least, public response and interest in the programme have been overwhelming.

Public policy-salt, sugar and trans fats

Also in our arsenal to fend against CNCDs, is the development of a new public policy on limiting the salt, sugar and trans fats from the national food supply.

Epidemiological trends have shown that childhood obesity in Trinidad and Tobago is on the rise, leading to the onset of diabetes and other chronic diseases much earlier in life. It is clear that these new epidemiological trends are a result of a shift in dietary patterns. There has been a decrease in the consumption of fibres along with the simultaneous increase in the consumption of foods rich in saturated fats, trans fats, salt, processed foods, sugar rich soft drinks and physical inactivity.

Further, a link has been made between salty foods and adolescents, as foods with a high salt content cause thirst and children are more likely to reach for high calorie soft drinks than for water.

The World Health Organisation has produced conclusive evidence showing that the consumption of trans fatty acids increase the risk of coronary heart disease and possibly raises the risk of sudden cardiac death and diabetes. The WHO also states that increasing blood pressure worldwide is the leading risk factor for death and the second leading risk factor for disability by causing heart disease, stroke and kidney failure. Additionally, there is strong evidence indicating that salt added to food is a major factor increasing the blood pressure in persons with otherwise normal blood pressure readings and those with hypertension, regardless of age. Diets high in salt also increase the risk of kidney damage and heart problems, and are linked to gastric cancer, osteoporosis, calcium containing kidney stones and asthma.

Using a collaborative approach, we have invited other government ministries, the private sector, NGOs and civil society organisations to join us in developing an action plan in our efforts to eliminate trans fats and reduce the excess salt and sugars from the population’s food supply. In fact, just last month we hosted a Partners Forum for Action on Chronic Disease, in collaboration with PAHO/WHO, to raise awareness and invite participation in a Steering Committee on the elimination of trans fats and the reduction of salt. Eleven (11) organizations have already signed up to participate in this Committee, while the Ministry of Health is finalizing its terms of reference.

Climate Change and health effects

Moreover, ladies and gentlemen, one of the key topics that has transcended all of the meetings held over the months has been climate change. Concerns about climate change have captured international attention and were even discussed at the Copenhagen Climate Conference immediately following last year’s meeting of Commonwealth Heads.

Climate change can cause death and disease through natural disasters including floods, heat waves and droughts. This year, many Caribbean nations are feeling the effects of a meteorological drought that is causing our reservoir levels to fall well beneath comfortable levels, resulting in much anxiety of the population. As a matter of fact, I don’t think anyone in Trinidad and Tobago was happier to witness rainfall than when the rains began to pour again approximately two weeks ago.

A number of diseases, including vector borne diseases, such as malaria and dengue, are highly sensitive to changing temperatures and precipitation. A relationship has also been established between climate change and an increase in cancers, mental disorders, the exacerbation of asthma and other respiratory conditions.

Socio-economic impact is bound to follow and is likely to have negative effects on the agricultural industry with a decrease in exports, disruptions of trade and tourism and increased cost of production of goods and services. These factors can lead to increased urbanisation. Having recently commemorated World Health Day on April 7th, under the theme, “Urbanisation and Health”, I am sure you are well aware of the negative impact unplanned urbanisation can have on our society - overpopulation and increased poverty, less access to fresh fruit and vegetables and decreased physical activity. All of these will take a toll on health, causing increased pressure on our health systems, as the basic health challenges associated with food security, disasters, water and infectious diseases will increase, both in frequency and severity.

Closing My dear friends, in closing I must underscore how important continued collaboration and research are to the advancement of healthcare in the Region. Especially with regards to CNCDs, we must not let up in our battle. In fact, we should not aim only to defend; we must take a position of offence and be proactive in our fight against this dreaded group of diseases. To do so, continued research, collaboration and deliberations are essential. And for this, I must congratulate the Caribbean Health Research Council, for their ongoing efforts in this area and for their development of a Health Research Agenda for the Caribbean. This Agenda is a crucial document, which will guide the conduct of research, thus filling gaps in the availability of locally relevant research evidence. It will assist in informing decision makers, as it relates to policy development, programme management and the provision of health care. Ladies and gentlemen, even though you have been here for a couple of days now, I would like to once again warmly welcome you to the city of Port of Spain in our twin island Republic of Trinidad and Tobago and I wish you all continued success as your meetings continue throughout the rest of the week. I thank you and may God richly bless you all.

Closing

My dear friends, in closing I must underscore how important continued collaboration and research are to the advancement of healthcare in the Region.

Especially with regards to CNCDs, we must not let up in our battle. In fact, we should not aim only to defend; we must take a position of offence and be proactive in our fight against this dreaded group of diseases. To do so, continued research, collaboration and deliberations are essential. And for this, I must congratulate the Caribbean Health Research Council, for their ongoing efforts in this area and for their development of a Health Research Agenda for the Caribbean.

This Agenda is a crucial document, which will guide the conduct of research, thus filling gaps in the availability of locally relevant research evidence. It will assist in informing decision makers, as it relates to policy development, programme management and the provision of health care.

Ladies and gentlemen, even though you have been here for a couple of days now, I would like to once again warmly welcome you to the city of Port of Spain in our twin island Republic of Trinidad and Tobago and I wish you all continued success as your meetings continue throughout the rest of the week.

I thank you and may God richly bless you all.

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