Guyana will be lobbying for support for trade policy changes in hopes of turning the tide against non-communicable diseases (NCDs) like diabetes, hypertension and heart disease, which are the leading cause of deaths both here and worldwide.
“We will not be a silent voice at the UN when it comes to addressing the issues. We are not necessarily asking for more money but will ask for policy changes, since unless we address them now the world can face a worse crisis,” Health Minister Dr Leslie Ramsammy said on Monday at a consultation in preparation for a UN High Level Meeting, set for September 19th and 20th at UN headquarters in New York, to chart the way forward in addressing NCDs.
Presenting the feature address on NCDs and the country’s agenda for the upcoming Summit, Ramsammy stated that although Guyana may be given just ten minutes to speak at the meeting he will be very vocal. He noted that for small countries like Guyana, putting certain precautionary food control mechanisms in place could have long term effects for the economy and if the country complains about excessive processed food imports it might be told to implement its own national policies. This, he said, would likely see resistance from the World Trade Organisation (WTO).
According to Ramsammy, should government put import regulations on saturated fatty and processed food products, the WTO would object and Guyana could be termed communists and anti-world trade, and being a small, developing country it would be unable to win such a battle.
Trade policies, he, however, said, “need urgent and emergency adjustment. Processed food enters our country freely and we would be labelled as communist if we tried to stop same,” he said. He added, “Everyday in each of our countries persons are being cremated… people are getting ready to say permanent goodbyes to fathers [and] sons…the number one cause being non-communicable diseases.”
Ramsammy further said NCDs used to be called the silent tsunami but the tsunami is no longer silent. He noted that not only do they have an individual impact; they also have far reaching impacts on the national development of countries. To illustrate the domino effect, he pointed out that when an individual is ill, his family will face certain pressures and ultimately his job and the economy of the country.
He also highlighted the challenges faced by the Ministry of Health when implementing healthy eating practices. For example, he said, when advocating breastfeeding, the ministry competes against marketing companies with limitless funding for advertisements which sway mothers’ decisions. Ads that depict “sexy looking” models advertising a variety of baby formulas changes women’s thinking, he said, while adding that the psyche of the mothers then is that by bottle feeding they save their bodies while giving their children formula loaded with preservatives and other chemicals.
Risk factors, he added, will not be eliminated by educating the masses alone and as a result health practitioners were given the mandate to reach “the heart and minds” of persons getting treatment in an attempt to change their thinking about NCDs and making positive lifestyle changes.
The upcoming summit was decided upon after global leaders recognised that non-communicable illnesses have reached epidemic levels and accounted for over 63% of deaths globally. It is only the second meeting of its kind in the history of the United Nations, where heads of state worldwide will meet and discuss emerging health issues and will be expected to “adopt a concise action-oriented outcome document that will shape the international agenda for years to come.” As such, the mandate was given to countries globally to host consultations on NCDs, to prepare country representatives to present problems faced with possible recommendations.
CARICOM well ahead
Dr. Rudolph Cummings, Programme Manager of Health Sector Development at CARICOM, presented a regional perspective on NCDs at Monday’s consultation. He stated that the consultation came at a time “when there is global recognition of the plight the world faces on account of the changing epidemiology of its disease profile. I mean the epidemic of Chronic Non Communicable diseases.”
While accepting that there is an increase in the years humans now live, primarily due to advances in preventative technologies such as vaccination and early detection of diseases and treatment, Cummings said that there is a major setback to these advancements. He noted that technological development was not limited to medicine, since with technology came the television, numerous labour saving devices, fast food outlets, increased motorised transport and urbanisation as well as others which have contributed significantly to “growing waistlines” of the global population.
He added that CARICOM member states have been well ahead of the developing world in terms of functional cooperation in the area of health and that meeting as a united Caribbean people had been implemented since the early 1950s.
In 1984, without empirical evidence, he said Caribbean governments recognised that NCDs were among the six identifiable health priorities and thus formed the Caribbean Cooperation Health Strategy. He added that in 1993, CARICOM embraced the “the health of the region is the wealth of the region” theme at a meeting in The Bahamas, realising NCDs as the leading health challenge to the region, far outweighing HIV. In 1995, another study affirmed that the expenditure on NCD treatment was not sustainable and it was “strangling the health sector.” These facts, he said, prompted the first world summit of heads of governments and the fifteen points formulated then served to direct the NDC policy in member nations.
Cummings, who complimented the ministry on the consultation, said that the challenge will be in convincing persons that NCDs have more to do with prevention and the advocacy role that non-governmental organisations play. He said, “Whilst the road to a comprehensive global response may yet be long and tedious, this High Level Meeting is a significant first step in the right direction, which, if we strategise well, will spawn other complementary initiatives as we continue to advocate for the necessary changes which can affect the global disease burden.”
Meanwhile, Dr Beverly Barnett, Pan American Health Organisation (PAHO) representative, gave the global perspective on NCDs and highlighted statistics which showed that globally over 57 million people die annually of NCDs. From that amount, 29% are below the age of 60 years old. She added that 80% of those deaths occur in developing countries and current losses in the national production amounts to hundreds of billions of dollars.
Dr Barnett echoed most of Dr. Cummings’ findings while stating that diseases such as diabetes, cancers and chronic respiratory diseases contribute greatly to mortality in most countries. She strongly advocated inter-sectoral action, stating that the region “must improve awareness of health and health equity consequences of policy decisions institutional practices at different sectors.” She said she firmly believed that with inclusion, the health sector will be better able to tackle NCDs. She noted that primary health care is critical for NCD prevention and care in reducing progression to severe and costly illnesses and complications. As a result, she said establishing cross sectoral action teams involving health and especially agriculture, education, finance, planning, social affairs and welfare, trade and transport is needed.
On behalf of PAHO, she congratulated the Ministry on the consultation and pledged to continue to work with it and other ministries, civil society, the private sector, international development partners and sister UN agencies to support outcomes of the UN summit.
The Ministry of Health has also made public a declaration to support the reduction of chronic NCDs in Guyana, with a commitment to advocate for policies and programmes to prevent and control NCDs while participating actively in partnerships between government and the private sector and civil society. (Marcelle Thomas)