Caribbean NCD death highest in the world

The Caribbean has the highest mortality rates from non-communicable diseases (NCDs) in the world as well as the highest premature mortality rate with three out of four people dying from NCDs.

Dr Edwin Bolastig, adviser on health systems and services at PAHO/WHO in TT, made the statement at the eighth Caribbean Association of Oncology and Haematology (CAHO) conference at Hyatt Regency, Port of Spain, yesterday.

Since cancer is a NCD, it has the same risk factors as other NCDs such as heart disease, stroke, and diabetes. He said one third of cancer cases could be avoided by reducing the key risk factors including tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol environment, and occupational health.

He noted that in 2012, 77 per cent of all deaths in the Caribbean (39,460) were from NCDs and 40 per cent of NCD deaths were premature. Among those deaths, 23 per cent were from malignant neoplasms (cancerous tumours).

He said globally in 2014, 14 million people, ages 30 to 69, died from NCDs and those deaths could have been prevented. “These are the premature deaths that really have an impact on countries and global development. That is why NCDs are such a major issue when it comes to the sustainable development goals.”

Bolastig added that cancer was the second leading cause of death in the Americas, responsible for 1.3 million deaths in 2012, of which 47 per cent occurred in Latin America and the Caribbean. “The number of cancer deaths in the Americas is expected to almost double by 2030 to 2.1 million deaths... That is why your oncology sector has a very big role to play when it comes to addressing NCD issues.”

“If we impact on the behaviour that is causing these lifestyle diseases, we are able to prevent these NCDs from becoming the burden that it is now and becoming much more so in the coming years.”

Since 2005, there have been several political commitments on NCDs and cancer from various international bodies including the UN’s Political Declaration on NCDs, the World Health Assembly’s Global Monitoring Framework on NCDs, and PAHO’s Regional NCD Plan of Action.

With the aim of a 25 per cent reduction in premature mortality from NCDs by 2025, the Global Monitoring Framework on NCDs outlined nine voluntary global targets.

These include a 25 per cent reduction in the overall mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory disease; a ten per cent reduction in the harmful use of alcohol; a ten per cent reduction of insufficient physical activity; a 30 per cent reduction in the intake of salt/sodium; a 30 per cent reduction in tobacco use; a 25 per cent reduction in raised blood pressure; to halt the rise in diabetes and obesity; 50 per cent of eligible people receiving drug therapy and counselling to prevent heart attacks and strokes; and an 80 per cent availability of the affordable basic technologies and essential medicines, including generics required to treat major NCDs in both public and private facilities.

Bolastig also made several suggestions to State and private agencies as he believed ongoing political will was needed to sustain NCD commitments and public health gains. To the State, Bolastig’s advice included securing, allocating and distributing financial and human resources within the health system; and strengthening the competencies and skills of health providers and public health professionals.

He advised the private sector to support national authorities in strengthening health care system and expanding quality service coverage, especially through primary health care, to improve NCD prevention and control; and contribute to the efforts to improve access to affordable, safe, effective and quality medicines and diagnostics for NCDs.