Non-Communicable Diseases (NCDs) are now causing more damage than communicable diseases, globally killing approximately 40 million persons annually, three-quarters of which occur in low and middle-income countries. Cardiovascular disease, cancer, diabetes, chronic respiratory disease and mental disorders have now been confirmed as the leading causes of death worldwide.
Unfortunately, this reality is no different in the Caribbean. According to the Pan American Journal of Public Health, every year 16,000 persons prematurely succumb to Non-Communicable Diseases in the Caribbean region. In fact, over 70% of all deaths in the region can be traced back to an NCD. Such a record has lasting effects, significantly stunting economic growth and productivity, and has been brought to the alarming attention of health authorities. While the exact reasons for such high mortality rates still remain an ongoing point of research and discussion, risk factors, including tobacco smoking, harmful use of alcohol, poor diet and physical instability, have been found to significantly contribute to the mortality of NCDs in the Caribbean Region. Furthermore, the lack of improvement in the quality of available health care has also been identified as one of the leading causes of the rise in NCD prevalence, case-fatality rate and mortality burden in the Caribbean region.
Investment in Prevention and Control of NCDs
For a long time, regional leaders wrote off deaths associated with NCD as unavoidable. However, the impacts of the NCD epidemic in the region have been found to be much more far-reaching than just health and well-being. Moreover, the existing NCD epidemic has served as a catalyst for negative ripple effects on the economies, productivity and quality of life in the region. Investing in the prevention and control of NCDs is therefore needed to keep other indicators of economic growth and development in check.
Existing Policy Action to Address the NCD Epidemic
Caribbean leaders have put forward outstanding effort and measurements to curb the growing costs associated with NCDs. While sticking with the timeline has proven to be quite a challenge, the regional health authorities have set the following paths and goals toward slowing the progression of its NCD epidemic:
- The 2007 Mandates of the Port of Spain Declaration (POSD): This includes 27 commitments to action in the areas of reducing NCD risk factors, which include improving healthcare awareness and quality, increasing development of appropriate legislative frameworks and establishing NCD commissions to provide effective monitoring and evaluation of NCD prevention and control efforts.
- The World Health Organization’s Best Buys/Investments: WHO has designed a set of affordable, cost-effective and evidence-based interventions termed the “WHO Best Buys” to achieve the Sustainable Development Target of 30% reduction of premature NCD related deaths by 2030. Made up of six policy target areas: tobacco use, harmful alcohol use, poor diet, low physical activity, management of cardiovascular diseases and diabetes and cancer management, the regional health authorities have set out to generate a $7 yield in health care costs for every $1 invested in Caribbean health care reform by 2030. Additionally, with 16 areas of targeted intervention to guide the policy decisions of each country in the region, countries can design their health policy to address their specific NCD related challenges.
- Global WHO 25 x25 Strategy: After the 2007 mandate of the POSD in the Caribbean, the World Health Assembly set a global target of a 25% reduction in NCD related mortality by 2025. Set as a part of the WHO’s Global NCD Action Plan 2013-2020, the WHO detailed a total of nine voluntary national targets, with reduced mortality from NCDs and stopping the rise in diabetes and obesity being among the most urgent. This is set to be done through directed health and public policy, focusing on social, political and economic determinants of NCDs in the Caribbean Region.
With continued health policy effort and focus, both the Caribbean Region and the world at large will be able to successfully control this Non-Communicable Diseases epidemic.
– Rebecca Harris