PAHO Director’s Opening Remarks at the CARICOM-COHSOD on Health Meeting

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Washington, DC

23 September 2023

Chair of COHSOD, Hon. Minister Kevin Bernard;
Honorable Ministers of Health of the Caribbean Community;
Assistant Secretary General of CARICOM, Ms Alison Drayton;
Permanent Secretaries; Chief Medical Officers; other Officials of the Ministries of Health; CARICOM officials;
Executive Director of CARPHA, Dr. Joy St. John;
Representatives of other organizations;
Distinguished Colleagues, friends, Ladies and Gentlemen;
PAHO Colleagues;

Good morning and welcome.

In the wake of the global health crisis of the COVID- 19 pandemic, as I look around this room today, I see the custodians of hope for the future, and the guardians of health for Caribbean citizens.  You carry the responsibility of ensuring that every man, woman, and child in the Caribbean has access to the healthcare they deserve, both in emergencies and during “peacetime”.

At the same time, the challenges we face are too great for any one nation to bear alone. 

The pandemic made this glaringly apparent: only through unity and collective action can we overcome the public health trials of our times.

CARICOM was founded with this understanding.

It channels the collective capacities of its Member States and provides a productive forum to discuss international and joint technical cooperation. 

I would like to highlight some priority topics that you already know that require a joint action such as: the successful implementation of evidence-based standards for Front of Package Warning Labels; agreement on communicable disease cross-border control measures; and improving the collective availability of health care workers across the Caribbean.

This region has faced its fair share of health crises.  But every cloud has a silver lining.  One optimistic spin-off of the pandemic is the aspiration of some small island states to produce their own medicines and medical supplies. 

Relying solely on imports for these essential health goods can leave Small Island Developing States highly vulnerable during health emergencies, like pandemics or natural disasters.  Ensuring regional and domestic production reduces dependency on external suppliers, mitigating the risk of shortages.  Producing medicines and medical supplies locally can also stimulate economic development, create jobs, and lead to cost savings.

While it is a challenging task - requiring major financial investment over long periods - establishing pharmaceutical and related industries, is well worth the investment. However, it’s clear that also identifying even the participation in a part of the chain of process is important.  

Key regional and international partners are ready to invest in well-developed projects that leverage existing resources.  PAHO stands ready to support you in approaching these partners and prioritizing technical cooperation on the regulatory aspects, demand planning and other relevant topics.

As you know, PAHO has several mechanisms to facilitate access to affordable medicines, vaccines, and health technologies, such your PAHO’s Revolving Funds, I hope that you use them extensively. These funds can also be used to leverage regional production in LAC.

Caribbean unity is also about building resilient health systems that can withstand the challenges of the future. It is about ensuring that every person in our region has access to quality healthcare, regardless of their socioeconomic status or where they live.  It is about building systems that prevent diseases, promote wellbeing, and address the social determinants of health.

I am well aware of the concerns of this region, including such priorities as:

  • Recapturing the immunization gains of the past,
  • Addressing the emigration of health workers out of the Caribbean that leads to a lack of well-trained human resources for health,
  • Reversing the growing epidemic of non-communicable diseases with its devastating effects on health and economies, and
  • Mitigating the effects of the changing climate, including both health and economic consequences.

Our technical experts are working hand in hand with your local authorities to develop and deploy evidence-based interventions to address these concerns, and to build health systems that are strong, resilient, and ready to handle the next crisis, whenever it comes. Actually, our Technical Directors are here with you to listen your deliberations on priority matters, please feel free to recur to them at any time.  

Earlier this year, you committed to the Declaration of Nassau  during Vaccination Week of the Americas.  Getting back on track in routine vaccination coverage is of paramount importance if we are to ensure that our children are not left susceptible to diseases such as polio, tetanus, measles, and diphtheria.  PAHO is working relentlessly to support you to reinvigorate your national immunization programs and rebuild trust in routine vaccines across the Caribbean.  

We are operationalizing the Declaration of Nassau through provision of specific recommendations for each country and territory of the Caribbean, based on their current epidemiological situation, vaccination coverage rates and performance of the epidemiological surveillance system.  We are working on a Regional Plan of Action, country-specific mitigation plans for polio eradication and in-country capacity development for all components of the national immunization program.  We are also conducting research to inform the development and production of effective communication products that address vaccine hesitancy and increase vaccine demand.

Speaking about other big issue, we may all have heard this statistic, but it is worth repeating.  An estimated 80% of NCDs are preventable by reducing exposure to the associated major risk factors.  Now, we have proven public policy measures and legislative strategies that can not only benefit population health but also your economies.  Recently in your region you have seen increased use of health-related laws, specifically related to NCD risk factors. 

But we acknowledge that change is difficult.  We face entrenched commercial and financial interests that hinder progress.    Through measures like front of package warning labels, the banning of trans fats and the creation of a smoke-free Caribbean, we can reverse the rates of NCDs.

As we continue to advocate for the implementation of the Octagonal Warning labels, we are joined by the University of the West Indies, CARICOM, CARPHA, the Healthy Caribbean Coalition, UNICEF, the Food and Agriculture Organization, the Organization of Eastern Caribbean States, and many others who believe that Caribbean people deserve to have the facts about what they are eating.  We will persist, with our partners, to confront the main drivers of non-communicable diseases - tobacco use, unhealthy diets, alcohol use and lack of physical activity. 

We are also developing and implementing innovative strategies and investment plans to tackle climate change and its impact on health.  PAHO has been supporting countries in the implementation of the Caribbean Action Plan on Health and Climate Change through partnerships under PAHO/EU/CARIFORUM Strengthening Resilient Health Systems in the Caribbean and Green Climate Fund Caribbean Readiness Projects.  Both projects have the expected outcome of reducing the negative health consequences associated with climate change. 

Several achievements have already been made in the creation of Health National Adaptation Plans (HNAPs) for climate change, capacity building for the preparation of concept notes and surveillance and the strengthening of climate change leadership. 

We are also supporting the work of the regional Human Resources for Health Commission to ensure that Caribbean countries have the health personnel they need and can retain them.  I know that this is a vexing issue for most countries.  We now have accurate and up-to-date data for monitoring and evaluating the status of HRH in the Caribbean.  This is critical if we are to advise on policy actions at the national and regional levels, improve planning, and remedy the specific health workforce issues that affect this region.

The Caribbean is poised to advance with the elimination of key communicable diseases and conditions.  This year, eight Caribbean countries and territories (Anguilla, Antigua and Barbuda, Bermuda, Cayman Islands, Cuba, Dominica, Montserrat, and St. Kitts and Nevis) were revalidated as achieving the mother-to-child transmission of HIV and syphilis.  Belize has now joined this list of countries as it was certified by WHO as having eliminated EMTCT earlier this year.  

I am pleased to announce that in partnership with the UN Office for South-South Cooperation, and through the India-UN Partnership Development Fund, PAHO has secured funds to support CARICOM Countries in their efforts to achieve and sustain the elimination of mother-to-child transmission (EMTCT Plus) of HIV, syphilis, and hepatitis B. In the coming weeks we will be conducting consultations to build the path forward together.

With respect to malaria, Belize was certified by WHO as having eliminated malaria in June this year. I congratulate these countries on these very important public health achievements.

PAHO remains committed to increasing our capacity to support Member States.  But we must stand together, working collaboratively to strengthen our healthcare systems.  We must adopt sustainable practices that protect our environment and promote healthy living.  We must prioritize equity in healthcare delivery, ensuring that the most vulnerable among us receive the care and attention they need.

In closing, I urge each of you, distinguished Health Ministers, to continue to embrace this spirit of unity, to commit to the well-being of our people, and to lead with unwavering determination in the face of adversity.  The challenges are great, but so is our collective strength. 

I wish you a successful meeting aiming to continue moving forward towards the construction of resilient national health systems based on renewed and strengthened primary care.

Thank you.

Dr. Jarbas Barbosa