Six-year strategy addresses common health challenges facing the islands

Washington, D.C., 29 July 2016 (PAHO/WHO) — Ministers of Health from the U.K. Overseas Territories (UKOTs) in the Caribbean ended a two-day meeting at the Pan American Health Organization/World Health Organization (PAHO/WHO) this week by agreeing on new priorities for technical cooperation to improve the health of their populations.

The top health authorities from Anguilla, Bermuda, the British Virgin Islands, Cayman Islands, Montserrat, and Turks and Caicos, along with PAHO Director Carissa F. Etienne, signed a "strategic note" outlining a new cooperation strategy that seeks to create synergies among the territories to address social and environmental conditions that impact health, to mobilize resources, and to facilitate the development of a unified position and a stronger voice on health matters in the Caribbean.

"We are proud of this accomplishment," said Etienne, noting that the agreement marked the first time the territories have set a multi-country agenda for PAHO/WHO technical cooperation in health. "We believe this strategy will facilitate pooling and mobilization of joint resources, joint action, and increased efficiencies."

 

The document sets out three lines of health action that will be supported with PAHO/WHO technical cooperation over the next six years: (1) promoting physical and mental health throughout the life course, (2) building safe and resilient environments to facilitate effective responses to health emergencies and hazards, and (3) strengthening the governance, organization, and management of health systems to achieve access to health and universal health coverage.

The goal of achieving universal health was adopted by all PAHO Member States in 2014 as part of the regional Strategy for Universal Access to Health and Universal Health Coverage.

The UKOTs—whose populations range from about 5,000 (in Montserrat) to 70,000 (in Bermuda)—face a number of common health challenges. In all six territories, noncommunicable diseases (NCDs), especially cardiovascular disease, diabetes, and cancer, are the leading causes of death, and the prevalence of these diseases is expected to rise given the growing rates of overweight and obesity, and because of the territories' aging populations. The UKOTs face various levels of difficulty delivering primary care to smaller islands in their jurisdictions.

All six territories have recently had to cope with the emergence of new diseases such as chikungunya and Zika. In addition to these disease threats, all are highly vulnerable to natural disasters such as tropical storms, hurricanes, and volcanic eruptions. Climate change is a growing concern that is already having adverse impacts on production activities, the health status and well-being of the population, infrastructure, and ecosystems. Moreover, the islands are highly dependent on a few types of economic activity, especially tourism and agriculture, that are particularly sensitive to weather factors. 

Under the new strategy, PAHO/WHO will assist health authorities in tackling these common health challenges by implementing comprehensive strategies that seek to:

  • Expand equitable access to comprehensive, quality, people- and community-centered health services.
  • Strengthen stewardship and governance for universal health in the context of health sector reform.
  • Integrate mental health services into primary health care, while strengthening those services at the secondary and tertiary levels.
  • Address NCD risk factors, especially poor diet and tobacco use, through regulatory frameworks that help make the healthy choice the easier for people to make.
  • Increase and improve health systems financing and advance toward the elimination of direct payments that are a barrier to access at the point of service.
  • Strengthen integrated vector management to control Zika, chikungunya and other arboviruses.
  • Promote safe and resilient health facilities while reducing their carbon footprint using the PAHO/WHO "SMART hospitals" approach.
  • Strengthen capacity to prepare for and respond to "all-hazards" emergencies.
  • Develop and implement cross-territory health information systems.

"This milestone is the cumulative result of much effort, consultation, collaboration and consensus," said Dr. Merle Lewis, PAHO/WHO's Chief of Staff. "On behalf of the Director, I would like to re-confirm PAHO's continued commitment to working alongside the UKOTs to implement this strategy. This is critical since it will not only address the public health needs of the UKOTs but also contribute to improved reporting on the goals and targets of the PAHO Strategic Plan as well as the Sustainable Development Goals."

UKOT participants in the meeting included Anguilla's Minister of Health and Social Development, Evans McNeil Rogers; Bermuda's Minister of Health, Seniors and Environment, Jeanne Atherden; the British Virgin Islands' Permanent Secretary of the Ministry of Health and Social Development, Petrona Davies; Councillor Roy McTaggart of the Ministry of Finance and Economic Development and Chief Officer Jennifer Ahearn of the Cayman Islands; Montserrat's Deputy Premier and Minister of Education, Health and Social Services, Delmaude Ryan; Turks and Caicos's Premier and Minister of Health, Agriculture and Human Services, Rufus Ewing; and Jenny Harries, Director of Public Health England's South of England Regional Office. Also participating were technical and managerial staff from PAHO/WHO's headquarters and country offices in the Caribbean.