The Chronic Disease problem in the Caribbean civil society perspective,Twelfth OECS Health Ministers Meeting, 11th September 2009Prof. Trevor A. HassellChairman 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”,Source: CAREC, based on mortality reports from countries,CARICOM Member States,Year,Leading Causes of Death in CARICOM Countries by Sex, 2004 (excluding Jamaica),Heart Disease Cancers Injuries and violence Stroke Diabetes HIV/AIDS Hypertension Influenza/pneumonia,Heart Disease Cancers Diabetes Stroke Hypertension HIV/AIDS Influenza/pneumonia Injuries and violence,MALES,FEMALES,Source: CAREC, based on country mortality reports,Potential Years of Life Lost 65years by Main Causes, 2000,& 2004, CARICOM Countries (minus Jamaica),Note: Chronic Disease includes heart disease, stroke, cancer, diabetes, hypertension, chronic respiratory disease,Injuries includes traffic fatalities, homicide, suicide, drowning, falls, poisoning,Source: CAREC, based on country mortality reports,Disability Adjusted Life Years (000) 2002,Mortality Attributable to Select Risk Factors (Latin America & Caribbean),from DCP2,0,100,200,300,400,500,Attributable Deaths (thousands),Prevalence (%) of diabetes among adults in the Americas,Source: Pan Am J Public Health 10(5), 2001; unpublished (CAMDI), Haiti (Diabetic Medicine); USA (Cowie, Diabetes Care),Caribbean Trends in Diabetes Mortality,From community surveys, the prevalence of hypertension in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%,CARICOM,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),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 societys 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,21,Individual responsibility,Changes to the “toxic“ environment,COMMUNITY AND CIVIL SOCIETY,Complementary approaches to chronic disease prevention,POLICY ENACTMENT,HEALTH CAREAND DOCTOR,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,Thank You,www.healthycaribbean.org,