Chief Medical Officer, Dr. Joy St. John??

A call has gone out for health strategies in the region to be tailored towards halting the rapidly increasing chronic non-communicable (CNCDs) diseases which are causing so many premature and unnecessary deaths.

Chief Medical Officer (CMO), Dr. Joy St. John made the appeal today as she addressed a workshop at the Amaryllis Beach Resort, to discuss the application of the "Integrated Chronic Care Model to Chronic Non-Communicable Disease Management" to Barbados – a model proposed by the World Health Organisation (WHO).

She explained that in Barbados and the rest of the Caribbean, the burden of non-communicable diseases in the region had escalated to the extent that it had now become a public health crisis, with, the four leading causes of death being heart disease, cancer, stroke and diabetes.

Adding that non-communicable diseases continued to account for approximately 51 per cent of deaths in the region, Dr. St. John argued such trends had clear and profound implications for planning and executing health programmes.

She also alluded to figures from WHO and noted that it was estimated that of the 35 million yearly deaths from non-communicable diseases, around 15.8 million, or 40 per cent were premature in nature, from preventable heart attacks, strokes, diabetes and asthma. "What is even more disconcerting is that the WHO expects this figure to increase to 73 per cent by 2020," the CMO added.????

The point was made that deaths were not the only factors under consideration. Dr. John stressed that diseases such as diabetes and asthma often required life-long care and could affect the quality of life of an individual. She explained too that the Health Ministry was concerned that CNCDs were increasingly having their onset in the young adult population and even in childhood.

She pointed out: ??"This is a world in which an estimated 43 million pre-school children are obese or overweight. Think of what that means in terms of life-long risks to their health and life-long costs of care. This could perhaps be the first generation of children, in a very long time that has a life expectancy shorter than that of their parents, if we do not effectively halt and reverse these disturbing trends."

Participants were, therefore, told that planning and implementation of health strategies had to be fashioned towards identifying gaps and priorities to advance the Integrated Chronic Care Model to Chronic Non-Communicable Disease Management. Also, that through technical partnership with PAHO/WHO, the Caribbean Epidemiology Centre and CARICOM, the model would be "applicable to our local situation" with CNCDs.

"Our objective would, therefore, be to stimulate both community and political impetus for its support by turning public health knowledge into public and political action," Dr. St. John concluded.??

Meanwhile, Chairman of the National Commission for Chronic Non-Communicable Disease, Professor Trevor Hassel, echoed similar sentiments, as he noted the need for a paradigm shift in managing chronic diseases at the level of the patient, physician, health care settings, and the application of policies and standards.??????????

Explaining how this could be applied to the physician, he said: ??"Perhaps on every occasion that a patient attends a doctor, the physician should, among other things, write an ideal weight attainment prescription, provide a physical activity prescription, advise on the dangers of exposure to tobacco smoke, and make information available on the dangers of salt intake." jgill@barbados.gov.bb

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