CARICOM, partners forging a pathway to better health

(CARICOM Secretariat) – The Caribbean Community (CARICOM) is on course to better health as a project begins to bolster physical activity and healthy eating, to reduce the high rates of Non-Communicable Diseases (NCDs) like cancers, stroke, diabetes, and heart diseases in the Region.

Caribbean Moves initiative, launched recently in Jamaica under the theme Move as One for All to fight NCDs in the Caribbean is supported by a USD175,000 grant from the Caribbean Development Bank (CDB) to develop a framework for tackling the NCDs epidemic in the Region. A proposal for resource mobilisation for the implementation of the framework is expected to be a key feature of the framework.

The Caribbean Public Health Agency (CARPHA) is coordinating the development of the Caribbean Moves project which was endorsed by the Prime Minister of St Kitts and Nevis; the CARICOM Secretariat; the Ministry of Health and Wellness of Jamaica led by Dr. the Hon. Christopher Tufton; World Health Organisation (WHO)/Pan American Health Organisation (PAHO); the Healthy Caribbean Coalition (HCC); and the CARICOM Youth Ambassador Programme.

“Caribbean Moves will provide the gender-responsive and culturally appropriate and inclusive framework for promoting physical activity and healthy eating through innovating, exciting and innovative programmes where people live, work, study, and play. We view it as a complementing wider effort to strengthen health systems, and quality of life for citizens across the Region,” Mr. Isaac Solomon, Vice President, Operations at CDB said at the launch event.

Assistant Secretary-General (ASG) for the Directorate of Human and Social Development, Ms. Alison Drayton, said Caribbean Moves has its roots in Jamaica Moves, a health promotion programme introduced to Jamaica and the Caribbean by Jamaica’s Minister of Health and Wellness, Dr. the Hon. Christopher Tufton.

Jamaica Moves engages all sections of society at the individual, organisational, community, and national levels to encourage three bahaviours critical for the control and prevention of NCDs such as physical activity, eating healthy, and routine age-appropriate health checks for the general population.

Since its introduction, five CARICOM Member States have launched similar initiatives to encourage the practice of healthy lifestyles under the umbrella of Barbados Moves, Trinidad and Tobago (TT) Moves, St. Kitts and Nevis Moves, St. Vincent Moves, and Saint Lucia Moves.

Describing Caribbean Moves as a “flagship regional health programme,” ASG Drayton anticipated it will accelerate actions underway in Member States to achieve the unmet targets identified in the 2016 Evaluation of the Port-of-Spain Declaration.

The journey to the development of the Caribbean Moves initiative has a long history punctuated by the 2007 CARICOM Heads of Govern Summit on NCDs. Heads of Government united around the goal to enhance the health and well-being of CARICOM citizens, articulated in the Port-of-Spain Declaration (POSD): Uniting to Fight the Epidemic of Chronic Non-Communicable Diseases. In the POSD, Heads reflected on a forerunner agreement, the 2001 Nassau Declaration of Health that asserted the Health of the Region is the Wealth of the Region.

Caribbean Moves was endorsed by CARICOM Heads of Government in September 2018 when they met on the sidelines of the United Nations General Assembly in New York, to mark the 11th anniversary of the signing of the 2007 Port-of-Spain Declaration (POSD) on NCDs. In assessing the Region’s progress in implementing the POSD, CARICOM leaders recommitted to adopting innovative approaches such as Jamaica Moves. The national health campaign was adopted earlier in the year by CARICOM Ministers of Health as a regional best practice.

The Caribbean Moves trademark was conferred to CARICOM by Market Me, the original creators of the name and concept. In signaling its intention to gift the trademark to CARICOM in April 2021, Market Me lauded the CARPHA-CDB collaboration to support in the fight against NCDs in the Region.

“As the developers of the concept, we believe that a unified and united voice would assist in spreading awareness across the Region regarding the high incidence of premature mortality, and increased morbidity associated with NCDs,” Market Me developers stated.

ASG Drayton told the launch event in Jamaica that Caribbean Moves is “undoubtedly a timely and relevant regional response” that could reach a wide cross-section of Caribbean citizens, reenergizing them to adopt healthy lifestyles.

Over the past three years, the mortality data in the Region, Ms. Drayton said, highlighted the “bleak reality” that approximately three out of four deaths in the Caribbean are associated with Cardiovascular Disease, Diabetes, Cancer, and Chronic Respiratory Diseases, among people ages 30-69.

Most of these deaths could have been prevented by healthy diets, routine exercise and physical activity, and the non-consumption of alcohol and other harmful substances.

She said the Secretariat will promote Caribbean Moves, and lauded CARPHA’s efforts to improve data for health by promoting health through research and evidence-based decisions on NCDs. The CDB also came in for high commendations by Ms. Drayton who said Caribbean Moves comes at a cost which the CDB willingly absorbed, to support to goal to reduce the burden of NCDs.

“The partnership truly demonstrates the responsiveness and commitment of our sole development bank to invest resources in priority areas for development and we commend them for the continued support to the community’s agenda,” Ms. Drayton stated.

Jamaica’s Minister of Health and Wellness, Dr. the Hon. Christopher Tufton noted that the “intoxicating” nature of Caribbean culture is both a driver of NCD and a tool in the response.

“We in the Caribbean have a lot of fun, but sometimes we forget about the little exercise and to cut back on the salts, sugars, and the fats. We carnival, and we reggae dance, and we consume the spirits. That is part of the culture, but the challenge is over time, it leads to diabetes and heart diseases. We have to come to terms with the realization that we love our culture, we love our food, we love our socialization, but if we overindulge, it will lead to health challenges,” Dr. Tufton stated.

Explaining how culture can bolster the NCD response he related the success of a Jamaica Moves activity.

“… people were dancing up a storm for more than six hours and the only beverage served was water. They were just intoxicated by the music. The culture is intoxicating; you don’t need the help of alcohol to get intoxicated. The culture can do it, whether it is calypso or soca, or reggae.”

He added, “Caribbean Moves is about having fun, enjoying your culture, enjoying your history, enjoying your identity, whether it is roti and curry or ackee and saltfish, but do it in moderation and remember to move. Remember to get your health checks…”

Executive Director of CARPHA, Dr. Joy St. John, said the Caribbean Moves project will be guided by a steering committee involving representatives from CARPHA, PAHO, HCC, University of the West Indies, and the CARICOM Secretariat. The expected outcome is the enhanced capacity of CDB’s Member Countries to effectively implement a whole-of-society, socially inclusive, and gender-responsive NCD control and Caribbean Wellness initiative.

The primary target groups include Ministries of Health, Social Development and Wellness, NCD Commission, Healthy Caribbean Coalition, Regional Health Communications Network, PAHO, the CARICOM Secretariat, the private sector, Non-Governmental Organisations (NGOs) for children, youth, and persons with disabilities, women, youth, men’s affairs, and indigenous groups.

Dr. Terrance Drew, Prime Minister of St Kitts and Nevis and Lead Head in CARICOM on Health said,

“I am pleased that CARICOM recognised that an appropriate response must consist of a two-part strategy aimed at policy-making and continuing motivation aimed at Caribbean people to engage in a more active and healthier lifestyle encompassing decreased tobacco and alcohol use, increased physical activity, and healthy nutritional intake to mitigate against the risk of dying from NCDs.”

Dean of the CARICOM Youth Ambassadors (CYAs), Ms. Renee Atwell endorsed Caribbean Moves noting that the project is well-needed in a region where NCDs have been identified as the leading causes of death and disability.

“Over the past decade, we have all lost family members, friends, and colleagues to diseases such as stroke, cancer, and diabetes. We must therefore ensure collective action is taken at the regional level to promote preventative and control measures for NCDs.”

Ms. Atwell said young persons are no strangers to NCDs with lifestyle choices such as smoking, drinking, use of drugs, poor diet, and lack of exercise prevalent among young people.

Against that backdrop, she said youth engagement in the regional NCD response “is of utmost importance,” since data shows that 60% of the Region’s population is under the age of 30.

She added that young people agreed at the CARICOM Youth Forum held in June 2022, that the Region must adopt a coordinated approach to healthy eating through the schools, for early adaption.

President of the Healthy Caribbean Coalition (HCC), Sir Trevor Hassell, said that the HCC takes pleasure in being a co-sponsor of Caribbean Moves.
Highlighting the actions CARICOM has taken to address NCD policy weakness, he identified the target for a smoke-free Caribbean by 2022, the joint Council for Trade and Economic Development (COTED)/Council for Human and Social Development (COHSOD) six-point policy plan for improving the food environment in CARICOM, the development of technical policy briefs to address foods high in sugar, salts, and fats; the introduction of taxes on sugar-sweetened beverages, healthy school policies as well as policies to prevent the advertising of ultra-processed foods to children.

“Caribbean Moves now provides an opportunity for a meaningful, multi-sectoral, whole-of-society approach to NCD prevention and control. At the same time, it provides an enabling environment for implementation of requisite legislation, policies, and strategically targeted programmes to prevent NCDs and risk factors,” Sir Trevor stated.

PAHO/WHO’s Subregional Programme Director, Mr. Dean Chambliss, endorsed Caribbean Moves as “an innovative and emblematic initiative.” He said WHO recommends 150 minutes of moderate-intensity physical activity per week to reduce the risk of NCDs, but unfortunately, it is estimated that most adolescents and adults in the Americas fall short of this benchmark.

“We have several challenges in reducing NCD rates in our region, including the promotion of healthy behaviours. I am, however, certain that the Caribbean Moves campaign will have a direct positive campaign on people’s active lifestyles,” Mr. Chambliss said.

According to PAHO/WHO, the Caribbean has the highest NCD mortality rates in the Americas, with 40% of those deaths occurring in the most productive years: 30-69.

The scourge of NCDs is not only viewed as a major health concern, but also an economic one. Data predictions in Jamaica estimate a J$77.1 billion direct and indirect cost of cardiovascular disease and diabetes alone between 2017 to 2032. In Barbados, the same analysis done in 2015 estimated a cost of US$105 million per annum.

CARICOM’s 15 actionable commitments for reducing NCDs risk factors are outlined in the 2007 Port-of-Spain Declaration (POSD) on NCDs. A 2016 evaluation of the POSD revealed that the weakest areas of implementation were around unhealthy diets and inadequate physical activity, particularly where actions were required outside the health sector and through legislation. Those actions include increasing recreational spaces to encourage exercise by the widest cross section of the population; reintroducing physical education, promoting healthy meals and healthy eating in schools; eliminating trans-fat from foods; and labelling foods to clearly communicate their nutritional content.

Despite the uneven progress in the implementation of the POSD, CARICOM Member States have begun to take meaningful actions to address policy weaknesses identified during the POSD evaluation. These actions include the pursuit of intersecting trade and health agenda; and the establishment of a Task Force to design regional instruments for the implementation of CARICOM’s six-point policy package for a healthier food environment.