State Obligations under the Inter-American Human Rights System concerning Unhealthy Diets: An Opportunity to Advance NCD Prevention in the English-Speaking Caribbean?

• Author: Aura Guerrero and Nicole D. Foster
• Pages: 45-69

State Obligations under the Inter-American

Human Rights System concerning Unhealthy

Diets: An Opportunity to Advance NCD

Prevention in the English-Speaking Caribbean?

Aura Guerrero1 and Nicole D. Foster2

Abstract

The English-speaking Caribbean has one of the highest noncommunicable

disease burdens in the Americas. Although unhealthy diet is one of the principal

drivers of these countries’ noncommunicable disease epidemic, to date they have

not made meaningful progress on regulating their food environments. This paper

examines state obligations under the Inter-American Human Rights System related

to unhealthy diets and comments on their potential to support and accelerate action

on unhealthy diets in the English-speaking Caribbean. The authors argue that,

notwithstanding these countries’ limited participation in the Inter-American Human

Rights System and their dualist tradition, the Inter-American Human Rights System

can be a useful tool to encourage greater government action to regulate their national

food environments.

Keywords

Inter-American Human Rights System; Noncommunicable diseases; Unhealthy

diets; English-speaking Caribbean; Dualism.

Introduction

Noncommunicable diseases (NCDs), also known as chronic diseases, refer to

various conditions, including cardiovascular and chronic respiratory diseases, cancers,

and diabetes, which are not primarily caused by acute infection, but which result

1 Associate, Health and Human Rights Initiative, O’Neill Institute for National and Global Health

Law, Georgetown University Law Center. Email: aeg126@georgetown.edu.

2 Law Lecturer and Head, Law & Health Research Unit, Faculty of Law, University of the West

Indies, Cave Hill Campus, Barbados. Email: nicole.foster@cavehill.uwi.edu.

46

State Obligations under the Inter-American Human Rights System concerning Unhealthy Diets:

An Opportunity to Advance NCD Prevention in the English-Speaking Caribbean?

in long-term health and other consequences.3NCDs are arguably one of the most

pressing public health challenges globally. In 2022, NCDs accounted for 41 million

(74%) deaths globally, with 77% of these in low-and middle-income countries.4

According to the World Health Organization (WHO), each year 17 million people

die prematurely (i.e. between the ages of 30 and 69 years) from one of the four major

NCDs (cardiovascular disease, chronic respiratory disease, cancers, and diabetes)

and 86% of these deaths are in low-and middle-income countries.

5

In the Americas,

particularly in the Caribbean, NCDs carry some of the highest health-related burdens

and are the most common causes of death.6 NCDs account for 80% of deaths in

the English-speaking Caribbean7 with cardiovascular diseases (CVD), being the

leading cause of death.8 The English-speaking Caribbean also has some of the

highest NCD mortality rates and the highest diabetes death rate in the Americas,9

while Guyana has the highest rate of premature NCD mortality in the Americas.10

These gures are especially disturbing when one considers that NCDs are largely

preventable through action to address their ve modiable risk factors, namely,

tobacco use, alcohol consumption, unhealthy diet, insucient physical activity, and

air pollution.

11

Indeed, scaling up national NCD responses through the use of cost-

eective interventions to reduce NCD risk factors is at the heart of the Global Action

Plan for the Prevention and Control of Noncommunicable Diseases 2013 – 2030

(which includes the updated list of ‘Appendix 3’ measures also known as the WHO

3 WHO, ‘Fact Sheet on Noncommunicable diseases’ <https://www.who.int/news- room/fact-

sheets/detail/noncommunicable-diseases > accessed 10 May 2023.

4 Pascal Bovet, Colin Mathers, Nick Banatvala and Majid Ezzati, ‘Global burden of NCDs’ in

Nick Banatvala and Pascal Bovet (eds), Noncommunicable Diseases: A Compendium (Routledge 2023)

12. See also WHO, ‘Noncommunicable Diseases. Key Facts’ (16 September 2022) <https://

www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases>.

5 ibid.

6 PAHO, NCDs at a Glance: NCD Mortality and Risk Factor Prevalence in the Americas PAHO/NMH/19-

014 (2019) 4.

7 This concept includes what PAHO considers as Non-Latin Caribbean countries: Antigua &

Barbuda, The Bahamas, Barbados, Dominica, Grenada, Guyana, Jamaica, St. Kitts and Nevis,

St. Lucia, St. Vincent and the Grenadines, Suriname and Trinidad and Tobago.

8 PAHO, NCDs at a Glance: NCD Mortality and Risk Factor Prevalence in the Americas PAHO/NMH/19-

014 (2019) 9.

9 PAHO, NCDs at a Glance: NCD Mortality and Risk Factor Prevalence in the Americas PAHO/NMH/19-

014 (2019) 11.

10 PAHO, NCDs at a Glance: NCD Mortality and Risk Factor Prevalence in the Americas PAHO/NMH/19-

014 (2019) 6.

11WHO, ‘Noncommunicable Diseases’ <https://www.who.int/news-room/fact-sheets/detail/

noncommunicable-diseases>.