Government leaders say NCDs are a "tsunami" that threatens health and development. They urge more cross-sector action and greater investments in NCD prevention and care.

Bridgetown, Barbados, 12 June 2015 (PAHO/WHO) — Representatives of CARICOM governments ended a high-level meeting in Barbados this week by declaring that noncommunicable diseases (NCDs)—such as heart disease, stroke, cancer and diabetes—are the greatest health and development threat facing the Caribbean.

They urged stepped-up efforts using all-of-government and all-of-society approaches to tackle NCDs and called for greater investments in health systems to reverse what they termed a "tsunami" that threatens economic and social development throughout the subregion.

"The truth is that our people are dying, our people are being disabled by chronic diseases," said Carissa F. Etienne, director of the Pan American Health Organization/World Health Organization (PAHO/WHO). "We are concerned that there is not enough being done to allow the Caribbean to reduce and prevent those deaths from chronic diseases. If we continue as we are now, we will not meet the targets we have set for ourselves."

In the Caribbean, NCDs are the cause of 75% of all deaths and 70% of premature deaths (in people 30-69 years old), and if action is not taken, that proportion will increase. Noncommunicable diseases place a heavy burden on individuals, families and societies due to suffering and deaths as well as high costs from treatment and care, lost productivity, and displaced resources from other sectors of the economy.

"We talk a lot about statistics, but there are faces behind them. We are talking about our mothers, fathers, sisters, brothers; we are talking about ourselves," said Etienne.

Participants said that NCDs are overwhelming Caribbean countries' health services and challenging their sustainability, and at the same time are impeding progress toward universal health coverage and universal access. They said needed actions include reorganization of health services and new models of care; strengthening of health sector governance and human resources for health; and the creation of physical and social environments that are conducive to healthy living.

Participants also discussed NCD "best buys," that is, highly cost-effective measures that reduce people's exposure to the top risk factors for NCDs. These measures include laws, regulations and taxation aimed at reducing consumption of tobacco, alcohol, sugar and salt. Because such measures can provoke resistance from the economic interests involved, adopting and implementing them requires active involvement and support from other sectors beyond health, including other areas of government and civil society.

"We need to empower civil society to be advocates, to help us get the political commitment that is necessary," said Etienne.

This week's meeting concluded with Caribbean leaders renewing their commitment to the principles set out in CARICOM's 2007 Port of Spain Declaration as well as in the 2011 political declaration of the United Nations' High-level Meeting on the Prevention and Control of NCDs and the formal 2014 U.N. review of progress on NCDs.

Participants called for particular focus on the following:

  • Strengthening of health systems
  • Prioritized investment in primary health care
  • Strengthening of surveillance and data collection systems, including through bilateral and regional cooperation
  • Support from and collaboration with international development partners and inter-governmental organizations
  • Ensuring that NCD prevention and control remain high on the Caribbean political agenda.

The "Forum of Key Stakeholders on NCDs: Advancing the NCD agenda in the Caribbean" was organized by PAHO/WHO in collaboration with the Ministry of Health of Barbados and took place on 8-9 June in Bridgetown, Barbados. Participants included ministers and other high-level delegates from ministries of health, social services, environment, population, and development; chief medical officers; and representatives of CARICOM, the Organization of Eastern Caribbean States (OECS), the Caribbean Public Health Agency (CARPHA), the Inter-American Development Bank (IDB), United Nations agencies, collaborating agencies from Canada and the United States, academia and civil society.


PAHO, founded in 1902, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of WHO.


Photographs, credit PAHO/WHO, Manuel Calvit

PAHO Forum of Key Stakeholders on NCDs: Advancing the NCD agenda in the Caribbean

PAHO program on noncommunicable diseases and mental health

Strategy for the Prevention and Control of Noncommunicable Diseases

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