Vol. 18, No. 1	March 1997

The XXI meeting of the Scientific Advisory Committee (SAC) of the Caribbean Epidemiology Centre (CAREC) took place 20-21 March 1997 at CAREC, in Port-of-Spain, Trinidad. SAC members and observers from universities, national health agencies, international and national medical and research organizations, and PAHO, participated in the meetings, well as members of the CAREC staff.

In addition to the Center Director's report, which reviewed the work of the preceding year, there were individual presentations on subjects such us: Health Situation Analysis, the Laboratory Division, Chronic Diseases and Injury, vector borne diseases, and tourism and health.

In her presentation to SAC, the laboratory manager described the plan of action for the laboratory. She highlighted the procedures underway to establish guidelines for the submission of the specimens to CAREC and the focus on improved service in the reporting of results to countries. As well, there will be special emphasis on Quality Assurance in the laboratories of the subregion. The laboratory is also introducing a laboratory information system (LABIS) to ensure prompt, accurate and effective management of laboratory data.

The regional epidemiologist introduced the topic of tourism, health and development. A new partnership with the hotel association has been formed with a view to insuring healthy stays for their guests. It was noted that 10 to 15% of hotel guest days are for citizens of Caribbean countries and that the health of the hotel employees is affected by poor health practices in hotel. This project will focus on "back of house" issues, such us food safety and vector control. In the future, a consultant inspection service may be established.

The five working groups were established, which discussed: surveillance, vital and health statistics, laboratory policies and operations, HIV/STD/TB, and tourism health and development.

The principal elements of the SAC Recommendations in these five areas are summarized below.

1. Concerning surveillance priorities, SAC recommended that CAREC:
   • prepare a manual of surveillance procedures, including case definitions and response algorithms, and offer guidance in linking epidemiologic and laboratory databases to strengthen public health surveillance and that CAREC provide surveillance information to its member countries on a frequent and regular bases;

   • initiate in-country follow-up activities in order to ensure sustainability and more effective impact of training efforts;

   • work with other interested partners, e.g., the University of the West Indies, to develop a strategy for surveillance of chronic, non-communicable disease, taking into account the objectives to be met and existing sources of data;

2. Concerning vital and health statistics, SAC recommended that CAREC:
   • continue to support the strengthening of mortality data collection and the development and utilization of MORTBASE, including its updating to allow the use of ICD10 codes;

   • collaborate with the PAHO Information System Program to assist countries in accessing, processing and using hospital discharge data with identification of appropriate core variables;

   • explore and strengthen collaboration with subregional health economists with a view to assessing the burden of diseases of public health importance and cost-effectiveness interventions.

3. Concerning the laboratory policies and operations SAC recognized that CAREC's primary roles as original public health reference and referral laboratory are to promote Quality Assurance Programs in laboratories in member countries; develop and evaluate new technologies; transfer technology and training; apply research into diseases of public health importance in the Caribbean; and to analyze sufficient specimens to confirm etiology and to monitor trends of public health importance in outbreak investigations.

   SAC recommended that:

   • continue its development of the LABIS module of the CARISURV system, and that CAREC gather data on the impact of the implementation of CARISURV in the CAREC laboratory;

   • recommission a minimal facility for arbovirology in compliance with international safety standards;

     SAC endorsed CAREC's proposal to the EEC for "Strengthening of Medical Laboratory Services in the Caribbean."

4. Concerning HIV/STD/TB, SAC recommended that CAREC:
   • continue to strengthen the surveillance capability of CAREC member countries by addressing weaknesses identified relative to the quality, accuracy, completeness, confidentiality and utility of HIV/AIDS.TB surveillance data generated in countries;

   • foster collaboration between epidemiologists and the behavioral team at CAREC to undertake the design, testing and implementation of an HIV/AIDS behavioral surveillance tool for the collection of reliable risk category information;

   • support member countries' efforts to eliminate congenital syphilis;

   • continue to strengthen the links between the tuberculosis and AIDS/STD control and prevention programs at CAREC and in member countries.

5. Concerning tourism, health and development, SAC endorsed the initiative and foresight of CAREC's work in the area of tourism, health and development.

   SAC recommends that CAREC:

   • forge partnerships with relevant Ministers in member countries, the Caribbean Hotel Association, and the Caribbean Tourism Organization to improve the standards, surveillance and human resource development within the context of PAHO's overall plan in this area in pursuit of the vision for the Caribbean to be the safest, happiest and healthiest of comparable destinations in the world.

Source: Division of Disease Prevention and Control (HCT), OPS

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