March 2016


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While the explosive spread of the Zika virus through the Americas is getting noticed worldwide, the Caribbean should be equally concerned about non-communicable diseases. The threat of Zika, though formidable, is hardly singular. Heart attack, stroke, chronic respiratory diseases, cancers and diabetes cause high morbidity and drain regional governments’ health budgets.

It’s not hard to see why Zika has captured the world’s attention. It has been fodder for global news, prompting mass media hyperbole. Not since the West Africa Ebola outbreak has a disease so consistently generated such panicked headlines. The mosquito-borne virus quickly became a flashpoint for arguments over everything from climate change to reproductive rights, not to mention heated debates over what we can and cannot yet know about it.

The reality remains unknown, in part because a definitive link between the virus and other serious complications appears difficult to establish. Notably in Brazil, an observed but not yet confirmed link to a surge in microcephaly – babies born with abnormally small heads – is troubling; as is another unproved link to Guillain Barré Syndrome, a neurological illness that causes paralysis.

That uncertainty is fanning the flames of the worst health scare in recent history, in spite of assurances from World Health Organisation (WHO) Director General Margaret Chan that Brazil is doing a good job ensuring that the Olympic games it will host in August will be safe for athletes and visitors. The WHO declared the Zika outbreak, which has spread to more than 30 countries, an international health emergency on February 1.

If you had to put a number to the level of uncertainty surrounding Zika, it would probably be 1.8 billion. That’s roughly the figure that US President Barack Obama asked Congress to set aside for work on halting the spread of the virus. The bulk of the money would go to the Center for Disease Control and Prevention, which has dedicated hundreds of staffers to responding to the outbreak.

Some Caribbean leaders matched their US counterpart’s concern, although our national and regional public health agencies lack the equivalent operational capacity and access to finances. In Trinidad and Tobago, the Health Ministry’s declaration of a national emergency actually came days before the World Health Organisation declared the global health emergency. The UWI has set up a task force specifically to address it.

Zika fully deserves that level of attention, not just from regional leaders but all Caribbean citizens. Eradicating mosquito-borne disease is a responsibility we all share. And the only way to deal with the virus at present is to reduce the population of the Aedes Aegypti mosquito vector, which is an old friend to the Americas, having long facilitated the spread of yellow fever, dengue and Chikungunya. Health officials must now redouble perennial efforts to educate and motivate information-swamped publics to get rid of potential mosquito breeding sites.

At the same time, the region’s tourism industry – many states’ economic mainstay – has to stomach the prospect of vacationers rethinking their trips. The CDC has warned pregnant women and those planning to become pregnant against travel to several popular regional destinations. Some airlines are reportedly offering free postponements or full refunds to customers holding tickets to places identified by the CDC as affected.

If the threat of Zika is immediate, far-reaching and multi-layered, the region’s response must also be urgent, consultative and multi-sectoral. Regional leaders should follow the same playbook of urgent, aggressive, collaborative action to eliminate non-communicable diseases (NCDs). The Caribbean has both the highest prevalence of NCDs and the highest mortality from NCDs in the Americas. Four out of 10 deaths under the age of 70 are potentially preventable.

In Trinidad and Tobago, where NCDs are the leading cause of death, there have been some encouraging signs. NCD-reduction has been identified as a national priority development issue, and the government identified the development of the National NCD Strategic Plan as a priority.

Regionally, a 2007 CARICOM Heads of Government Summit on NCDs produced the Port of Spain Declaration, which helped to lead the way to the 2011 United Nations High Level Meeting. The process of evaluating the national and regional implementation of the Port of Spain Declaration is ongoing, and recommendations are to be presented to the World Health Assembly in May and to the CARICOM Heads of Government meeting in July 2016.

The highest risk factors for NCDs are being overweight and obese, and part of what feeds poor dietary choices is the vast amount of unhealthy foods being imported into the region and insinuating themselves into everyday consumption, according to a 2015 State of Food Insecurity in the CARICOM report released by the United Nations Food and Agriculture Organisation Subregional Office for the Caribbean based in Barbados.

The imported foods we eat are literally making us sick, contributing to the increased prevalence of chronic NCDs. Sedentary lifestyles and a predilection for food low in nutrients, energy-dense and high in fats, oils, sweeteners and sodium leave us vulnerable to diabetes and hypertension, stroke, heart disease and some forms of cancer.

Food imports are by far the largest source of food for CARICOM countries, which import more than US$4 billion in food annually. Processed foods, grains and livestock products are among the top five food import categories, accounting for over US$ 1 billion or approximately 25% of annual food imports regionally. Half of CARICOM countries import more than 80% of the food they consume.

In part, the Caribbean’s inherent vulnerability to natural and economic shocks is responsible for undermining efforts to advance regional food security. From 1990 to 2014, 182 major natural disasters occurred in the region. But improved public policy is critical to achieving improved food and nutrition security. Public policies are essential for the sustainable management of food systems such as school feeding programmes and early childhood nutrition programmes.
Strong leadership is needed to ensure beneficial health outcomes for our populations.

Even as we formulate our response to Zika and other infectious diseases, we would do well to apply any lessons learned to the fight against NCDs. We certainly cannot afford to allow Zika to simply become just the latest distraction from our more longstanding, widespread and intractable health issues.

—Gerard Best is a Communication Consultant and Journalist, with a focus on Caribbean Development and Open Data. Follow @gerardbest on Twitter.