(CARICOM Secretariat, Turkeyen, Greater Georgetown,
Guyana) A major regional assault is about to be
launched against chronic non-communicable life-style
diseases. The historic first step will be made on 15
September when the Heads of Government of the
Caribbean Community (CARICOM) meet in Port -of
-Spain to start a campaign to galvanise the Region
against the scourge of such disorders as obesity,
high blood pressure, diabetes, stroke, heart attack
and some kinds of cancer.
Life-style diseases have emerged as the principal
public-health challenge in recent decades since
great inroads were made in tackling infectious
diseases that plagued the region. The chronic
diseases result largely from bad food choices and
low levels of physical activity. They come at a high
cost to individuals and to the region’s nation
states in terms of human suffering, expensive
treatment and loss of production.
Economic burden
Statistics on the cost of specific diseases in
the CARICOM region are not always readily available,
but it is reckoned that in 2001, the combined
economic burden of diabetes and high blood pressure,
in US dollar terms - if the diseases were properly
treated - would be $89.4 million in Barbados, $419.3
million in Jamaica, and $496.7 million in Trinidad &
Tobago, while the corresponding burden to the
Bahamas in 2002 would be $58.4 million."
These figures are very significant when compared
with the health budgets and gross domestic product
of the respective countries, and the economic burden
of diabetes and high blood pressure is relatively
high on the list of factors retarding the
development of the countries of the region. Even
more agonising is the realisation that most cases of
chronic non-communicable diseases are avoidable,
resulting as they do from poor lifestyle choices.
At the same time, there is an increasing
awareness in the region that while individual
responsibility and choice are crucial factors
affecting the incidence of chronic diseases, public
policy, public education, qualitative regulation of
food imports, licensing laws to protect consumers
and gearing the environment to support prevention of
chronic diseases are also pre-requisites for
combating this 21st century epidemic.
In its 2005 report, the Caribbean Commission on
Health and Development (CCHD), under its mandate
from the CARICOM Heads of Government, identified
chronic non-communicable diseases as the major
contributors to overall death and sickness in the
Caribbean in the closing years of the 20th century.
According to the report, cardiovascular diseases
(high blood pressure, coronary heart diseases and
stroke), diabetes and cancer accounted for 51 per
cent of the deaths in the region in the latter part
of the 1990s.
Focus on obesity
In the spirit of the consistent affirmation of
the Heads of Government that “the health of the
region is the wealth of the region” and that health
must be seen as an input of development as well as
an output, the Commissioners called on the
Governments of the region to move swiftly to meet
the challenge of chronic diseases. They zeroed in on
obesity – extreme fatness – which they identified as
a leading cause of chronic non-communicable
diseases. This results from such factors as the
consumption of too much food, the consumption of too
much of the wrong kinds of food, bad timing of food
intake, and too little physical activity. Obese
women – about 25 per cent of the adult female
population – are almost twice as prevalent as their
male counterparts.
Although obesity is generally associated with
ageing, when the body has slowed down and stores
more calories as fat than in younger days, there is
an alarming trend in the region in a high incidence
of obesity among young children and adolescents.
Data compiled by the Caribbean Food & Nutrition
Institute (CFNI) show that fat and obese children
account for as much as 15 per cent of their
population group in various Caribbean countries.
Research has linked the rising obesity rates to
corresponding increases in consumption of fatty
foods, snacks, soft drinks and high-energy foods and
drinks. Sugar and fat are implicated in this
worrying trend.
Obesity has been identified as a risk factor or
an “aggravating agent” for more than thirty medical
conditions. It tops the risk factors for the chronic
non-communicable diseases (NCDs) that accounted for
more than half the deaths in the region in the late
1990s. Other factors were physical inactivity,
itself a major cause of obesity; high cholesterol
and tobacco use. The Caribbean Commission on Health
and Development urged that obesity must be tackled
seriously on all fronts, with emphasis on the twin
pillars of weight control – eating right, or
balanced eating – and exercise and that policies
must be put in place to increase physical activity
for all age groups.
Public policy issues
At the same time, the Commission advocated
modulation of the environment to support policies
that facilitate weight reduction or ideal weight
maintenance at individual and group levels. In
particular, it cited the need for closer regulation
of foods, especially of the steadily increasing
importation of foods with high fat content. It
called for licensing laws to ensure that consumers
know the content of the foods they eat and for
agricultural policies that ensure that food security
is pursued in the context of incentives or subsidies
for local production of the fruits, vegetables and
whole grains required for a healthy diet.
The CCHD also contended that weight reduction
must begin in schools, focusing on nutrition and
“the absolute necessity” to include physical
education as a critical aspect of the curriculum,
and to recognise it as important as the “academic”
subjects.
Caribbean Governments have already shown
considerable harmony and success in tackling some of
the health challenges facing the region.
Breast-feeding, seat-belt legislation and
regulations designed to reduce tobacco use are good
examples.
A watershed initiative - the campaign against
chronic diseases and their major causes - which will
be launched in Port-of-Spain on September 15, will
see decision-makers, opinion-leaders, health
professionals, educators, workers, managers, leisure
industry leaders and the general publics of the
region declaring actions to curtail Chronic
Non-Communicable diseases.
For further information, contact:
1. Clare Forrester, Communication
Consultant,
antoye@yahoo.com
Tel: (876) 970-4250; (876) 318-992
2. Dorrett Campbell, Communications
Officer, CARICOM Secretariat,
dcampbell@caricom.org
Tel: (592) 222-0010 Ext 2423
