The Burden of Noncommunicable Diseases and the Current State of Noncommunicable Disease Prevention Regulation in the Caribbean

• Author: Tamu Davidson
• Pages: 1-28

The Burden of Noncommunicable Diseases and

the Current State of Noncommunicable Disease

Prevention Regulation in the Caribbean

Tamu Davidson

[Former Head Chronic Disease and Injury Prevention Department,

Caribbean Public Health Agency, tamkdav@gmail.com]

Abstract

Noncommunicable diseases are the leading cause of premature death in the

Caribbean. Governments in the region have pledged to address noncommunicable

diseases in several global, regional and sub-regional mandates. However, the

implementation of legal measures to address these diseases and their risk factors

has been slow and inconsistent, exacerbated by the COVID-19 pandemic. Key

challenges include inconsistent political will, limited legal system capacity, and industry

interference. Nevertheless, growing political determination, increased domestic and

international support and the Caribbean Public Health Law Forum oer hope for

progress. This paper assesses the status of noncommunicable disease prevention

regulations in line with the World Health Organization’s ‘Best Buys’.

Keywords

Noncommunicable Diseases, Caribbean, Small Island Developing States,

Prevention Regulation, Public Health.

Introduction

The noncommunicable disease (NCD) epidemic, which has most recently been

referred to as a pandemic, is a major challenge to health and development, including

global health security.1 NCDs, or chronic diseases, are a group of conditions that “tend

1 See e.g., World Health Organization [WHO], ‘Non-communicable Diseases – Overview’

www.who.int/health-topics/noncommunicable-diseases#tab=tab_1> accessed 12 December 2023;

N Unwin, F Mugusi, T Aspray, D Whiting, R Edwards, JC Mbanya, E Sobgnwi, S Rashid, KGMM

Alberti, ‘Tackling the emerging pandemic of non-communicable diseases in sub-Saharan Africa:

The essential NCD health intervention project’, Public Health, Volume 113, Issue 3, 1999, https://

doi.org/10.1038/sj.ph.1900549; Swarnakar R, Yadav SL. Communicable to Non-communicable

Disease Pandemic in the Making: An Urgent Call for Post-COVID-19 Preparedness. Cureus.

2022 Jul 29;14(7):e27453. doi: 10.7759/cureus.27453. PMID: 36051716; PMCID: PMC9420455.

2

The Burden of Noncommunicable Diseases and the Current State of Noncommunicable

Disease Prevention Regulation in the Caribbean

to be of long duration, and are the result of a combination of genetic, physiological,

environmental and behavioural factors.”

2

The main NCDs that cause most of the

death and disability globally include cardiovascular diseases (e.g., hypertension, heart

disease, heart attack, stroke), cancers, chronic respiratory diseases (e.g., asthma and

chronic obstructive airways diseases) and diabetes.3 These diseases share common

modiable risk factors, namely tobacco use, harmful use of alcohol, unhealthy diet

and physical inactivity.

4

These risk factors lead to metabolic changes including raised

blood glucose, raised blood pressure, overweight and obesity, and dyslipidaemia that

result in the development of NCDs.5 NCDs are mostly preventable by addressing

the risk factors, and legal interventions play a major role in this area of prevention.

6

According to Frieden, creating a supportive environment through the use of legal

interventions to make individuals’ default decisions the healthier, easier choice has

the greatest health impact.7

Caribbean governments have made several global, regional, and sub-regional

commitments to prevent and control NCDs. These include legally binding obligations,

such as the World Health Organisation (WHO) Framework Convention on Tobacco

Control (FCTC),8 to political instruments such as the 2007 Declaration of Port of

Spain “Uniting to stop the epidemic of chronic NCDs”,9 the various interations of

the Caribbean Cooperation on Health, the United Nations (UN) 2030 Agenda for

Sustainable Development, including the Sustainable Development Goals (SDGs),

10

2 World Health Organization, ‘Non-communicable Diseases Key Facts’ (16 September 2022)

<https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases > accessed 1

November 2023.

3 WHO, ‘Non-communicable Diseases Key Facts’ (16 September 2022) <https://www.who.int/

news-room/fact-sheets/detail/noncommunicable-diseases > accessed 1 November 2023.

4 WHO, ‘Non-communicable Diseases Key Facts’ (16 September 2022) <https://www.who.int/

news-room/fact-sheets/detail/noncommunicable-diseases > accessed 1 November 2023.

5 WHO, ‘Noncommunicable Diseases: NCD risk factors’ < https://www.emro.who.int/

noncommunicable-diseases/causes/index.html> accessed 1 November 2023.

6 Roger S Magnusson, Benn McGrady, Lawrence Gostin, David Patterson, and Hala Abou Taleb,

‘Legal capacities required for prevention and control of noncommunicable diseases’ (2019) Bull

World Health Organ 1;97(2):108-117. doi: 10.2471/BLT.18.213777, Epub 2018 Nov 20. PMID:

30728617; PMCID: PMC6357565.

7 Thomas Frieden, ‘A Framework for Public Health Action: The Health Impact Pyramid’ (2010)

American journal of public health, 100. 590-5. 10.2105/AJPH.2009.185652.

8 WHO. WHO Framework Convention on Tobacco Control (2003)

handle/10665/42811/9241591013.pdf?sequence=1> .

9 Caribbean Community [CARICOM]. Declaration of Port-of-Spain: Uniting to Stop the Epidemic

of Chronic Noncommunicable Diseases. 15 September 2007.

10 United Nations [UN]. Transforming our world: the 2030 Agenda for Sustainable Development.

A/Res/70/1. https://sdgs.un.org/sites/default/les/publications/21252030%20Agenda%20for%20