CARICOM Heads of Government Summit on Chronic Diseases - PowerPoint PPT Presentation

Loading...

PPT – CARICOM Heads of Government Summit on Chronic Diseases PowerPoint presentation | free to download - id: 5bd4f7-NjI3N



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

CARICOM Heads of Government Summit on Chronic Diseases

Description:

CARICOM Heads of Government Summit on Chronic Diseases Presentation of Prime Minister Denzil Douglas Overview of Presentation Global situation with Chronic NCDs ... – PowerPoint PPT presentation

Number of Views:87
Avg rating:3.0/5.0
Slides: 45
Provided by: PAHO79
Learn more at: http://www.caricom.org
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: CARICOM Heads of Government Summit on Chronic Diseases


1
CARICOM Heads of Government Summit on Chronic
Diseases
  • Presentation of Prime Minister Denzil Douglas

2
Overview of Presentation
  • Global situation with Chronic NCDs
  • Caribbean situation and costs
  • Caribbean Response
  • Exploding common myths
  • Review of effective interventions
  • The Way Forward
  • Addressing the risk factors
  • Globalisation and health

3
Globalisation and Health THE MALADIES OF
AFFLUENCE
The Economist, August 11th 2007
4
  • The poor world is getting the rich worlds
    diseases
  • Europeans have been exporting their maladies
    throughout history. They seem to be doing it
    again, but in a new way. In the past the problem
    was infection. Now illnesses associated with
    Western living standards are the fastest growing
    killers in poor and middle-income countries.
    Chronic disease has become the poor worlds
    greatest health problem.
  • The Economist, August 11, 2007

5
Chronic Diseases and their Causes
  • Chronic Diseases
  • Heart Disease, Stroke, Cancer, Diabetes, Chronic
    Respiratory Disease
  • ?
  • Biological Risk Factors
  • Modifiable overweight, high cholesterol, high
    blood sugar, high blood pressure
  • Non-modifiable Age, Sex, and Genetics
  • ?
  • Behavioral Risk Factors
  • Tobacco use, physical inactivity, unhealthy diet,
    alcohol abuse
  • ?
  • Social and Environmental Determinants
  • Social, economic and political conditions such as
    income, living and working conditions, physical
    infrastructure, environment, education,
    agriculture, and access to health services
  • ?
  • Global Influences
  • Globalization of food supply, urbanization,
    technology, migration

6
Distribution of Deaths by Major Cause in the World
7
Distribution of Deaths from Infectious and
Chronic Disease by Income Category, 2005
8
Source CAREC, based on mortality reports from
countries
9
Leading Causes of Death in CARICOM Countries by
Sex, 2004 (MINUS Jamaica)
MALES
FEMALES
  1. Heart Disease
  2. Cancers
  3. Diabetes
  4. Stroke
  5. Hypertension
  6. HIV/AIDS
  7. Influenza/pneumonia
  8. Injuries and violence
  • Heart Disease
  • Cancers
  • Injuries and violence
  • Stroke
  • Diabetes
  • HIV/AIDS
  • Hypertension
  • Influenza/pneumonia

Source CAREC, based on country mortality reports
10
(No Transcript)
11
Disability Adjusted Life Years (000) 2002
12
(No Transcript)
13
(No Transcript)
14
Prevalence () of diabetes among adults in the
Americas
Source Pan Am J Public Health 10(5), 2001
unpublished (CAMDI), Haiti (Diabetic Medicine)
USA (Cowie, Diabetes Care)
15
Caribbean trends in Diabetes mortality
16
A consequence of Diabetes
17
Amputations at the QEH 2002-2006
Diabetic Non diabetic
Male 308 116
Female 379 120
Total 995 236
Source A. Hennis, 2007
18
Age adjusted death rates/100,000 population from
Diabetes (2000)
19
  • From community surveys, the prevalence of
    hypertension in adults 25-64 years of age was
  • Barbados 27.2
  • Jamaica 24.0
  • St. Lucia 25.9
  • The Bahamas 37.5
  • Belize 37.3
  • Trinidad TBD
  • Control of blood pressure would reduce the death
    rates from Cardiovascular Disease by about
    15-20.

20
(No Transcript)
21
Age adjusted death rates/100,000 population from
Hypertension (2000)
22
Projected national income lost from NCDs (
2005-2015)
Projected
National
Income
Lost
from
NCDs


2005
-2015,
USBN
600
500
400
300
200
100
0
Bra
Can
Chi
Ind
Nig
Pak
Rus
UK
Tan
23
Possible economic burden (US Million, 2001)
BAH BAR JAM TRT
Diabetes 27.3 37.8 208.8 494.4
Hypertension 46.4 72.7 251.6 259.5
Total 76.7 110.5 460.4 753.9
24
Total cost of DM and H/T as percent of GDP
25
Exploding the Myths
  • Myth Chronic diseases are a problem of the rich
    countries
  • Fact Non-communicable disease account for more
    than half the burden of disease and 80 of the
    deaths in the poorer countries which carry a
    double burden of disease.

26
Developing countries carry a double disease
burden
Percentage of deaths by cause
Low- and Middle-income countries
High-income countries
27
Exploding the Myths
  • Myth NCDs are a problem only of the elderly
  • Fact Half of these diseases occur in adults less
    than 70 years of age and the problems often
    begin in the young e.g., obesity
  • Myth NCDs affect men more than women
  • Fact NCDs affect women and men almost equally
    and globally, heart disease is the largest cause
    of death in women.

28
Exploding the Myths
  • Myth NCDs cannot be prevented
  • Fact If the known risk factors are controlled,
    at least 80 of heart disease, stroke and
    diabetes and 40 of cancers are preventable, and
    in addition there are cost-effective
    interventions available for control.

29
Exploding the Myths
  • Myth people with NCDs are at fault and to be
    blamed because of their unhealthy lifestyles
  • Fact individual responsibility, while important,
    only has full effect where people have equal
    access to healthy choices. Governments have a
    crucial role to play by altering the social
    environment to help make the healthy choice the
    easy choice.

30
Exploding the myths
  • Myth my grandfather smoked and lived to 90
    years, and everyone has to die of something
  • Fact While some people who smoke will live a
    normal lifespan, the majority will have shorter,
    poorer quality lives. And yes, everyone has to
    die, but death does not need to be slow, painful
    or premature, as is so often the case with NCDs

31
What works?
  • A small shift in average population levels of
    several risk factors can lead to a large
    reduction in chronic diseases
  • Population wide approaches form the central
    strategy for preventing and controlling chronic
    disease epidemics, but should be combined with
    interventions for individuals
  • Many interventions are not only effective, but
    suitable for resource constrained settings

32
Finland Dramatic Declines in NCD Mortality
33
Relation of fitness to mortality TT, St. James
Cardiovascular Study
  • 1309 men had blood sugar, cholesterol, fitness
    measured at baseline and then followed up
    carefully for 7 years.
  • Unfit men compared with fit men were
  • - 3.6 times more likely to die
  • - 2.5 times more likely to have a heart
  • attack

34
Caribbean Responses
  • Since the 1960s, history of collective action in
    health, formalized in 1986 as the Caribbean
    Cooperation in Health (CCH) initiative.
  • Countries, CAREC, CFNI and CHRC, CARICOM
    secretariat, PAHO/WHO and partners have had
    successes e.g.,, malnutrition and
    gastroenteritis, vaccine preventable diseases,
    HIV/AIDS (p (PANCAP).
  • CCH now entering 3rd phase major thesis that
    Caribbean health can be improved through actions
    taken universally and collectively.
  • Current priorities for action under CCH include
    chronic diseases where the cited goals are to
    reduce deaths by 2 per year and to reduce
    serious, costly complications such as amputations
    or renal failure.

35
Caribbean Responses Summarised
Source PAHO Survey of NCD National Response
Capacity, 2005
36
Addressing the risk factors
  • Tobacco and alcohol
  • Increase taxes with proceeds to prevention and
    treatment
  • Ban smoking in public places
  • Ban smoking in all schools
  • Ban cigarette and tobacco advertising near to
    schools
  • Curtail promotion of alcohol products targeted to
    women and children
  • Establish target dates for passage of the legal
    provisions in the FCTC already ratified.

37
Addressing the risk factors
  • Physical activity
  • Have physical education compulsory in schools and
    provide the facilities
  • Provide healthy, secure exercise spaces
  • Provide wellness centers
  • Give tax relief for worksite exercise facilities

38
Addressing the risk factors
  • Improve dietary practices
  • Promote a standard of meals in public eating
    places eg. eliminating trans fats
  • Provide healthy school meals
  • Establish community based networks for training
    in preparation of health foods
  • Mandate RNM to investigate the trade issues which
    impact negatively on healthy food imports
  • Promote elimination of trans fats from Caribbean
    diets

39
Addressing the risk factors
  • In the case of cancer
  • Primary prevention
  • Eg screening and vaccination to prevent
  • cervical cancer
  • Promote screening for breast cancer

40
Secondary prevention
  • Screening programs for NCDs
  • Provide health services with resources to apply
    the established cost-effective interventions
  • Establish mechanisms to ensure availability of
    the medications necessary for the long term
    treatment of NCDs when they occur

41
Critical other recommendations
  • Establish national level Commissions on NCDs
  • Mandate CAREC to establish a system of behavior
    and risk factor surveillance
  • Insist on the updating of the Caribbean Regional
    Plan of Action for NCDs
  • The Caribbean should name a CARIBBEAN WELLNESS
    DAY

42
  • Involve Partners
  • PAHO/WHO
  • Financial institutions
  • Caribbean social partners private sector and
    civil society
  • Monitoring and evaluation
  • Designate CARICOM/PAHO as the joint Secretariat
    with responsibility for monitoring and reporting
    progress in the control of the NCDs.

43
The way forward
  • First We can utilize the policy instruments at
    our disposal
  • legislation
  • taxation
  • regulation
  • Second We should establish partnerships
  • Third We must take personal responsibility and
    lead by example

44
CONCLUSIONS
  • The Caribbean has a very serious problem -
    getting worse
  • Economically and socially, it is not sustainable
  • There are cost-effective interventions that work
    why not utilise them?
  • We must put into effect National and
    Caribbean-wide (CCH) plans
  • It is CRITICAL to strengthen health services to
    for management and control of chronic diseases
  • Deepened partnership with public and private
    sector, and civil society absolutely needed
About PowerShow.com