Caribbean Leaders Endorse Health Recommendations

Caribbean leaders meeting at a CARICOM summit in July embraced the recommendations of the "blue ribbon" Commission on Health and Development, headed by former Pan American Health Organization (PAHO) director Sir George Alleyne.

Officials agreed on the need to increase health budgets and resolved to disseminate the report widely to generate public support for stepped-up efforts in health.

Addressing the changing health needs of citizens of the Caribbean will require higher national spending on health, according to a report by the Commission on Health and Development. © Armando Waak/PAHO

Denzil Douglas, prime minister of St. Kitts and Nevis and the CARICOM leader responsible for health issues, said that after analyzing the commission's report his colleagues agreed that governments needed to boost health spending above the current average of 5 percent of national budgets.

The report notes that Caribbean countries have made significant gains in recent decades in areas including infant mortality and life expectancy. However, as a result of population aging, lifestyle changes, and the adoption of risky behaviors, chronic noncommunicable diseases have increased.

"Heart disease, cancer, cerebro-vascular disease, and diabetes mellitus have continued to be the four major leading causes of death for the past two decades," the report notes. "Deaths from stroke, heart disease, and hypertension, at least in Barbados and Trinidad and Tobago, are three to four times more common than in North America. Death from coronary artery disease is particularly prevalent in Trinidad and Tobago, with rates double those found in North America. Diabetes has emerged as a major problem and must now be regarded as an epidemic in the region."

The report cites high rates of overweight and obesity in every country studied.The trend is particularly alarming among children, the report says. It concludes: "This epidemic must be addressed with urgency."

The report also notes that a lack of epidemiological data made it difficult to draw conclusions about needs in some areas, such as mental health.

Regarding the issue of health financing, the report rejects calls for the introduction of user fees, which it says would be "regressive and likely to be particularly damaging to the very poor and others who need the services most." The report notes that many of the region's poor people have been made poorer by having to shoulder higher health care costs.

Citing the impending increased movement of people in the region as a result of the implementation of the Caribbean Single Market and Economy (CSME), the commission also calls for the introduction of a regional health insurance scheme.