ADMINISTRATION

Mission Statements: FIRST: To provide and facilitate effective management of the resources of the Centre to enable the organisation to achieve its mission.

FINAL: To provide efficient administrative support using high performance teams in the areas of finance, human resources, information technology, Fig. 2.1. Dr Patrick Hamilton Fig. 2.2. Dr Peter Diggory Fig. 2.3. Dr David Bassett procurement and general services to enable the organisation to achieve its mission in a safe and healthy working environment.

Directors Dr Patrick Hamilton (1975 – 1982) Dr Peter H. Diggory (1982 – 1988) Dr David C. J. Bassett (Acting) (1988 - 1989) Dr Franklin White (1989 – 1995) Dr Stephen Blount (1995 – 1997) Dr C James Hospedales (1998 - 2006) Dr Glenda Maynard (2006 - 2008) Dr Jose Campione-Piccardo (2008 - 2009) Fig. 2.4. Dr Franklin White Fig. 2.5. Dr Stephen Blount Fig. 2.6. Dr James Hospedales Dr Beryl Irons (2009 - 2012)

Administrators/Managers Mr Orlando Succhi (October - December 1974 and February-April 1975) Mr Arthur Maul (August 1975 - 1984) Mr Jean Pierre Scioville (1984 - 1985) Ms Ava Cameo (1986 - 1995) Ms Carol Gayle (1997 - 1999) Mr Stephen Glover (August-October, 2000) Dr Elton Bobb (2001) Mr Gilberto de Barros (July 2004 - 2009) Ms Anna Maria Frixone (2009-2012) Fig. 2.7. Dr Glenda Maynard Fig. 2.8. Dr Jose Campione-Piccardo Fig. 2.9. Dr Beryl Irons

the The Caribbean Centre: Contributions to 1975 - 2012 17 CAREC story ADMINISTRATION (continued)

On 1st October 1974 the buildings, equipment to Trinidad, the Rio Bravo virus. Another project and staff of the Trinidad Regional Virus Laboratory was the study on the taxonomy of two mosquito (TRVL) was transferred officially to PAHO/CAREC. species, Culex portesi and C. taeniopus. These Thus, TRVL moved from the administration of the two species were singled out for study, as University of the West Indies to a PAHO/WHO were commonly isolated from them. administration. Dr Miles C Williams, a PAHO/ Dr John B. Davies was the project leader. The WHO epidemiologist and Acting Director of third UK MRC project under Dr Christopher TRVL, became the Acting Director of CAREC. Everard was a study on rabies and the ecology of Ms Y Lumsden, the administrator of TRVL mongooses in Grenada. remained until the end of December 1974 and worked with Mr Orlando Succhi, a retired PAHO/ A study of post-streptococcal rheumatic fever was WHO administrator re-hired as a PAHO/WHO another project which was conducted at the time consultant to act as administrator for the period of transfer of TRVL to CAREC. Mr Hugo Reid October-December, 1974. (Fig. 2.13) was the investigator of the project Fig. 2.10. Mr Arthur Maul, Administrator (right) being congratulated by two staff which was funded by the Rockefeller University members at his retirement function. The transfer of TRVL to CAREC was completed by of New York. the end of December 1974 and CAREC became operational on 1st January 1975. Shortly after Dr There were two other projects that were being Elisha Tikasingh (Fig. 1.4.) acted as Director until conducted at TRVL which were concluded in the arrival of Dr Patrick Hamilton in late February 1975. One was a project on scorpion venom to take up duties as Director. Mr Arthur Maul and pancreatitis undertaken by Dr Courtenay (Fig.2.10) was appointed Administrator in August Bartholomew and Dr Barbara Hosein. TRVL/ 1975 and succeeding him was Jean-Pierre CAREC’s involvement was the provision of Scioville (Fig. 2.12) followed by Ava Camejo (Fig. space, maintenance of the scorpion colony, and 2.11). the ‘milking’ of the scorpions’ venom.

In addition to the buildings, equipment and staff, When Dr Hamilton arrived, he encouraged the CAREC also inherited a number of projects continuation of these projects and incorporated which were fully funded by external sources. The them in the new structure of the Centre. In the United Kingdom Medical Research Council (UK new Organogram of the Centre, there were MRC) funded three, one of which was a study on three basic units: Surveillance, Laboratory and arboviruses in bats. Dr J. C. Price led the project Training. Dr Peter Diggory (Fig. 2.2) headed the which ended in 1975. During the course of his surveillance Unit which had responsibility for data study, Dr Price discovered an new to collection, statistical analysis and the preparation Fig. 2.11. Ms Ava Camejo Administrator Fig. 2.12. Mr Jean Pierre Scioville, (1986-1995). Administrator (1984-1985). science, the Tamana bat virus and another, new of reports for the dissemination of information to

the CAREC story 18 The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 ADMINISTRATION (continued)

CAREC Member Countries (CMCs) and PAHO/WHO, with the bi-lateral agreement signed by PAHO/WHO and while Mr Ken Latimer (Fig. 2.14) was in charge of the the Government, the Director of Training Unit responsible for the planning of courses in TPHL, Dr W Swanston, was made Assistant Director of conjunction with the Surveillance and Laboratory Units, CAREC. The relationship of all these entities is shown in as well as provision of audio-visual services. Organogram I. (See page 14)

The Laboratory, which existed before the change to At its start in 1975 CAREC had a budget of US$348,171 CAREC, had to be reorganised as a support for the which was woefully inadequate. The budget was based Surveillance Unit. Virology - headed by Barbara Hull on 1973 prices and, added to that, there was rapid (Fig. 2.15) - remained, but the Entomology section had inflation. Staffing was inadequate as TRVL had cut parasitology added to it as a completely new section and its staff to an absolute minimum at the end of 1974. was headed by Dr Elisha Tikasingh. Bacteriology was Fig. 2.13. Dr Hugo Reid, Immunologist Some parts of the building had to be modified to meet expected to be developed. Dr Miles Williams was head training obligations and supplies and equipment were of the Laboratory Unit. also needed. The lecture hall, too, was greatly improved by the installation of new lighting, the purchase of new The Administration Unit had under its direction, finance, furniture and updating of visual aids. In order to meet personnel, library services, maintenance, supplies and these commitments, CAREC’s Council at its second transport. The CAREC Director reported to the PAHO/ meeting in 1976 recommended an increase in quota WHO Director through the newly- formed Division contributions of 20% by member countries. There was of Disease Control. It should be noted, that CAREC rapid expansion under Dr Hamilton’s leadership: from a was formed under the Department of Research and total staff of 38 in 1975, to a total of 101 in 1982 when he Development with Dr Mauricio Martins da Silva who had left. The administrative staff, too, increased from 12 in a large role in the creation of CAREC. CAREC’s Director 1975 to 22 in 1982. Fig. 2.14. Mr Ken Latimer, first Training Officer at CAREC was guided by a Scientific Advisory Committee (SAC) explaining a section of the exhibition to Mrs Fiona Hamilton, made up of eminent scientists and other observers (Annex wife of Dr Patrick Hamilton. As Director, Dr Hamilton laid a sound foundation for the 6.), and a CAREC Council looked after financial matters development of CAREC. His infectious enthusiasm was (Annex 5). There was also a close relationship between caught by staff members who were also excited and CAREC and PAHO/WHO’s Country Representatives in participated in this new adventure in raising the standard the various countries. of health in the Caribbean. Governments, too, were excited as requests from them for assistance in disease Located in the same building as CAREC, was the outbreaks saw CAREC staff leaving on first available Trinidad and Tobago Public Health Laboratory (TPHL) flights to the countries. Countries saw quality and value and both entities shared some common facilities and Fig. 2.15. Dr Barbara Hull, in this service and supported the work of the Centre. workload. However, the staff at TPHL were employees Virologist of the Trinidad and Tobago Government. In accordance

the The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 19 CAREC story ADMINISTRATION (continued)

In 1982 Dr Hamilton was succeeded by Dr Peter H Diggory who recognised Organogram II that CAREC should be a resource for HIV/AIDS surveillance, research, and the development of relevant programmes for member countries. Accordingly, a special programme on STD/HIV/AIDS was formalised in 1987. CAREC then became part of the Global Network of Information Centres on AIDS, which was developed to support national programmes. Sadly, Dr Diggory died suddenly in 1988. The Annual Report for 1988 noted that the “loss of a man with such a breadth of expert knowledge, selfless devotion to public health and long experience of work in the Caribbean was felt deeply, not only in CAREC, but throughout the sub-region and in many places further afield.”

Following Dr Diggory’s demise, Dr David Bassett, microbiologist at CAREC, acted as Director for the next nine months until the arrival of Dr Franklin White in 1989.

Some Directors altered CAREC’s basic structure over the years as they interpreted the role of CAREC and its mandate. In 1989-1990 Dr Franklin White made a major revision, the purpose of which was to emphasise both laboratory and epidemiology as broadly based foundations of the Centre. Sexually transmitted diseases, HIV/AIDS, the Expanded Programme on Immunisation (EPI) and Zoonoses/Mammalogy were viewed as focused programmes. Within epidemiology, there was to be greater visibility for chronic diseases, health situation and trend assessment (HST) – all with programme evaluations.

Dr White also introduced a committee structure to CAREC which gave more individuals the opportunity to participate in the management of the Centre. As a result, nine committees were formed: Executive; Administrative Coordination; Occupational Health and Safety; Information Management, Library and Archives; Research Ethics; Human Resource Development; Epidemiology Technical; Laboratory Technical; and the Special Programme on Sexually Transmitted Diseases (SPSTD). This structure is shown in the Organogram II. during this period; links were established with the Pasteur Institute and the French Institute of From its inception CAREC had a loose arrangement with the French Territories Health and Medical Research (INSERM) and CAREC staff attended meetings in Martinique in the Caribbean inviting the technical people to meetings and workshops from and Guadeloupe, setting the stage for future development of French Technical Cooperation time to time. However, this informal arrangement became more intensified activity at the Centre.

the CAREC story 20 The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 ADMINISTRATION (continued)

Five-Year Review of CAREC Transformation period of CAREC, The Multilateral Agreement signed by the CMCs and 1996-1997 PAHO recommended that CAREC should be established There was another major transformation when Dr Stephen for a period of 10 years with a review after five years. The Blount (Fig. 2.5) became Director in 1995. Dr Blount noted review started in 1979 with a self-audit by the Centre’s that the “goals of transformation were to improve service staff. In addition, a questionnaire was forwarded to to strengthen CAREC’s financial position by reducing participating countries followed by site visits. The Director costs and increasing income; to improve management of of PAHO also established a Review Team. At the Directing human and financial resources; and to improve the quality Council of PAHO in 1980 the Caribbean Countries gave Fig. 2.16. Dr P Hamilton, Director, explaining our programme on coronary heart diseases to high school students. of work life” (AR, 1996). Dr Blount further noted that the their overwhelming desire for CAREC to continue and decision to initiate the changes in the structure was due for PAHO to continue to support the Centre. In 1984, the to trends in the economic, political and technological Caribbean Health Ministers’ Conference again endorsed environment which showed a steady decline of financial the management of the Centre by PAHO until 1990. support from its major contributors: the PAHO regular budget, budgeted contributions from CMCs were not The fifth anniversary of CAREC was celebrated with an being met, and there was declining support from donor “Open House” mounting of an exhibition of its work at agencies. Throughout this transformation process, he was the Centre to which the public was invited. Among the informed by advice from PAHO/WHO’s leadership and the visitors to the Centre were His Excellency Sir , Institute of Business of the University of the West Indies. President of the Republic of Trinidad and Tobago as well as the Director-General of the World Health Organization. Core competences were required for CAREC to meet its Fig. 2.17 H.R.H. Princess Anne receiving an arrangement of Many high school students also attended and learnt of the vision and mission. In this process, post descriptions had work of the Centre. (Fig. 2.16). flowers from Jan Wilson, Office Services Coordinator at the conclusion of her visit at CAREC. Dr F White is centre. to be revised and had to include “values, attitudes, and behaviours in addition to technical skills”. All staff, except The exhibition was subsequently mounted at the Caribbean those in PAHO posts, were asked to resign and re-apply Health Ministers’ Conference and at the American Society for positions with new post descriptions under a new of Tropical Medicine and Hygiene’s annual meeting. management structure. There were many stakeholder meetings to explain and discuss the meaning of this Visit of Princess Anne transformation. (Fig. 2.18).

In 1990, CAREC welcomed a Royal Visitor, Princess Anne At the beginning of the transformation process in (Fig. 2.17) to its campus. The Royal Princess gave high 1996, there were 101 employees including eight PAHO praise for its work. professionals, plus one epidemiologist from German Fig. 2.18. Stakeholders in a discussion session on the Transformation process. (L to R). Yvette Holder (bio-statistician), Technical Cooperation Project (Dr Uli Wagner) and one from Victoria Glasgow (Laboratory Technician), Dr Wayne Labastide French Technical Cooperation (Dr Michel de Groulard). By (Research Fellow) and Valerie Wilson (Senior Laboratory Scientific Officer).

the The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 21 CAREC story ADMINISTRATION (continued)

the end of the transformation 23 staff members had accepted There were subsequent changes to the Laboratory Division. The Bacteriology, Parasitology and Entomology Units voluntary separation packages. There were five divisions in the were merged as the Department of Microbiology and Medical Entomology. Molecular Biology and Immunology new structure, each with a Manager as its Head: Epidemiology, became separate departments and there were new departments of Laboratory Administration, Support Services/ Human Resources, Administration, Laboratory and the Special Safety and Customer Services Information. The new organisation structure is shown in Organogram III. Programme on Sexually-transmitted Diseases.

Organogram III The Public Health Intelligence, Research and Development Unit L.C. The Transformation Process saw the development of a Unit in CAREC called the Public Health Intelligence, Research and Development Unit. The Mission Statement of this Unit was “To provide visionary leadership to CAREC and Member Countries into a healthier 21st century”. It was to work closely with and continue to provide technical oversight and consultancy services for each divisional programme. They were expected to “identify the strategic disease prevention and control issues facing the Caribbean, advise on opportunities and critical choices in public health practice and policy, assist in setting the strategic direction and research agenda for CAREC, and assist in the mobilisation of the resources to pursue that agenda; act as the major interface between CAREC and the external environment, including the scientific community, CMCs, and other stakeholders. The PAHO professionals at CAREC became the core of the Public Health Intelligence, Research and Development Unit. The first individuals in this grouping included the following:

Dr Jose Campione-Piccardo, Virologist, Ms Yvette Holder, Bio-statistician, Dr James Hospedales, Epidemiologist, Dr Samuel Rawlins, Entomologist/Parasitologist, and Dr Parimi Prabhakar, Microbiologist

the CAREC story 22 The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 ADMINISTRATION (continued)

o The organogram was modified by successive Directors The National Cancer Institute/Medical Research Fig. 2.19. The between 1997 and 2012. Although some of these Centre was removed from the organisational Honourable Basdeo modifications were temporary the major ones were: structure. Panday, Prime Minister of Trinidad and o A Non-communicable Disease (NCD), Injury and Tobago addressing • A change in the name of the Special Programme Substance Abuse Department was formed with the audience at a tree- on Sexually Transmitted Diseases (SPSTD) to three units, NCD Surveillance, Injury Surveillance planting ceremony. the Special Programme on Sexually Transmitted and Substance Abuse Epidemiology Infections (SPSTI) in 1999, in keeping with the Fig. 2.20. Prime consideration of asymptomatic infections and the 25th anniversary celebrations Minister Panday plants WHO recommendation for a change in terminology a tree on the campus to mark CAREC’s of sexually transmitted diseases to a more CAREC celebrated its 25th anniversary in 2000 with the 25th anniversary. Dr comprehensive one, that of sexually transmitted theme “Celebrate the Past and Imagine the Future”. A Hospedales (CAREC’s infections. Director) is at extreme monograph with the same theme giving the highlights of right and second from • In 1999 the Caribbean Tourism, Health, Safety the past 25 years was published as CAREC Monograph, extreme right is and Resource Conservation Project was officially Series 3 as part of the celebration. Many previous staff Sir George Alleyne (Director of PAHO). launched. This morphed into a Quality Tourism for members returned to participate in a Scientific Seminar the Caribbean (QTC) project, which was a unique and to share their experiences – both successes and public/private partnership between CAREC and the challenges – with current staff members. In addition, Caribbean Hotel Association/Caribbean Alliance. there was a flag-raising ceremony and monthly country Fig. 2.21. Sir George There were three units in this project: Standards, displays to educate staff on the situation and needs of Alleyne (left) greets Training and Marketing. member country. Prime Minister (Fig. former President • The introduction of a Foodborne Disease Programme of the Republic of 2.19) gave the feature address and planted a tree (Fig. Trinidad and Tobago, in 2003 to promote a multi-disciplinary, integrated, 2.20) to mark the occasion. Many dignitaries were in Mr Noor Hassanali farm to table approach to food safety. attendance, including Sir George Alleyne, Director of (right). Centre is Mr Kamaluddin • A European Union funded project for strengthening PAHO, the Former President of the Republic of Trinidad Mohammed. Medical Laboratories in the Caribbean started in and Tobago Mr Noor Hassanali and his wife Mrs Zalayhar 2001. Hassanali, and Mr Kamaluddin Mohammed, Minister of • In the late 1990s the following changes occurred: Health of Trinidad and Tobago in 1975 when CAREC was o Tuberculosis and Leprosy Programmes were established (Fig. 2.21). Fig. 2.22. Awardees added to Epidemiology for 25 years of loyal service to CAREC and o Materials Management and Human Resource The year ended with an awards ceremony where four its member countries. units were added to Administration persons who were with CAREC since its inception (l to r): o Kenneth Sheppard, A Surveillance and Research Unit was added to received 25-Year Awards bringing a fitting end to a year of Gemma Burroughs, the SPSTI celebrations. (Fig. 2.22) Shirley Smith and Edward Corbin.

the The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 23 CAREC story ADMINISTRATION (continued)

Budget The budget of CAREC grew from US$348,171 in 1975 to US$12,645,262 in 2007. Approximately half of the budget came from donor funds for special projects. The following Table 2.1 gives a yearly breakdown of the budget and graphically shown in Fig. 2.

Table 2.1. CAREC’s Budget expressed in USD 1975 - 2012

1975 348,171 1994 4,212,334 1976 586,623 1995 4161,011 1977 715,823 1996 3,659,214 1978 NA 1997 5,171,754 Fig. 2.23. The rapid increase in funds for the budget starting in the late 1980s was probably a response to the HIV/AIDS/ STI epidemic. 1979 675,231 1998 5,980,898 1980 1,081,779 1999 7,517,967 Funds for the running of CAREC initially started with quota contributions from member 1981 1,202, 385 2000 9,048,274 countries, PAHO and the Overseas Development Agency of the United Kingdom. However, as CAREC grew nearly half of its budget came from donor agencies such as 1982 1,356,509 2001 9,345,28 the International Development Research Centre (), the Agency for International 1983 1,507,760 2002 NA Development (USA), the National Institutes of Health (USA), the Global Programme on 1984 1,643,652 2003 8,444,945 AIDS (WHO), as well as others. In 1994 the German and French Technical Cooperation Agencies were approached for funding and this came in 1995 for the first time. Two 1985 1,827,542 2004 NA technical officers, one from Germany and the other from France were assigned to CAREC 1986 NA 2005 10,787,781 to assist in the technical work of the STD/HIVAIDS programme. These and other donors 1987 NA 2006 12,264,114 are listed in Table 2.2. 1988 NA 2007 12,645,262 1989 NA 2008 NA Physical Structure and Infrastructure 1990 NA 2009 NA When CAREC succeeded the TRVL the original buildings, that is, the main laboratory and 1991 4, 646,719 2010 NA administrative area, the residential flats and cottage were already at least 27 years old. 1992 4,012,900 2011 NA The New Office Block, Animal House and Inoculation Rooms were 14 years old. One new building was added in 1991. Earlier, in 1987-1988, Dr Peter Diggory had succeeded in 1993 4,171,600 2012 NA attracting funds from the WHO Global Programme on AIDS to fund the establishment of a NA: Data not available. Caribbean AIDS Education and Information Centre at CAREC. A portion of the grant was to fund the erection of a building which was eventually built and dedicated in 1991 and

the CAREC story 24 The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 ADMINISTRATION (continued)

appropriately named the “Peter Diggory Building.” (Figs 2.24 and 2.25)

Successive Directors of the TRVL and CAREC had made modifications and renovations to the existing plant to satisfy the programme of work as directed by the various Scientific Advisory Committees. In the 1960s, for example, the TRVL held meetings and lectures in the library as there was no lecture hall. As a result, two of the larger offices in the new office block had a common wall removed, Fig. 2.24. “The Peter Diggory Building” for the Caribbean AIDS Fig.2.27. The Reverend Clive Abdullah creating a larger room to be used as a lecture hall. In Education and Information Centre. at the dedication of the “Wilbur Downs Training Laboratory”. Rev. Abdullah 1975, to meet the new mandate of training, this lecture was also a member of CAREC’s hall was renovated with new equipment and, in 1989, was Ethics Committee. further enlarged and remodelled with funds provided by Fig.2.25. Present at the the Director of PAHO and named the “Elisha Tikasingh Dedication of the Peter Lecture Theatre.” (Fig. 2.26). Diggory Building” were (l to r): Dr F White, Mrs Mona Diggory There was also a need for a Training Laboratory so as (wife of Dr Diggory) to bring medical laboratory technicians from CMCs for and the Honourable Dr Emmanuel Hosein, training and updating of their techniques. This training Minister of Health, laboratory, to accommodate 20-30 students, was built by Trinidad and Tobago. modifying a part of the “Animal House” which was originally built to house the many thousands of mice which were needed for the arbovirus programme as well as ancillary Fig.2.28. Dr Wilbur Downs, first Director of the Trinidad Regional Virus Laboratory on a field trip to Chaguaramas during his last trip to services needed for the maintenance of mouse colonies. Trinidad in 1982. (Photo: Elisha Tikasingh). Wild small mammals needed for experimental purposes were also kept in the “Animal House”. Later, in 1991, the Training Laboratory was enlarged, renovated with funds donated by the UK Overseas Development Administration and named the “Wilbur Downs Training Laboratory” at a ceremony where the Reverend Clive Abdullah did the blessing. (Fig. 2.27). Dr Downs, (Fig. 2.28). a Rockefeller Fig. 2.29. Dr T H G Aitken at Foundation staff member, was the first Director of the the dedication of TRVL and had a special interest in the training of local Fig.2.26. Workshop session in the “Elisha Tikasingh Lecture “Thomas Aitken personnel. As a result of these modifications the Insectary Theatre”. Laboratory”.

the The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 25 CAREC story ADMINISTRATION (continued)

which was used to house live mosquito colonies for the state of electrical systems at CAREC. By 1993 a new area of CAREC the door of which carried the proud title experimental purposes was lost. However, by 1982 with switch-room/standby generator building was erected and “Computer Room”. The computer was used for improving a grant provided by the British Development Division a the installation of a new switchgear/standby generator the inventory list, accounting and management, and small building was erected on the north-eastern corner of began. reporting systems. 1987 saw the computerisation of the campus for this purpose. Later, a caravan which was the Centre with installations of all corporate hardware used to do field work in various parts of the country was In 1992, a master plan for the physical development of the and software. A series of training programmes for staff remodelled and added to the Insectary facilities to house Centre in accordance with the Building Fund Guidelines to be become computer literate was initiated with the the Toxorhynchites colonies. was proposed. Still, little was done and by 1999 the ageing Administrator as tutor. Persons involved in routine physical plant took a beating when there was considerable computer operations in their respective departments were The Entomology Laboratory which was in the main damage to the roof in the Administration and Laboratory trained in dBase III plus. In 1987 too, the General Ledger building was moved to the Animal House Building close blocks which hampered activities in these two Divisions of Accounting System compatible with the IBM XT was to the new Parasitology Laboratory in 1975, but had been the Centre for the entire year. Both the CAREC Scientific successfully installed. By installing a modem international re-configured and renovated in 1993 with funds from Advisory Committee and the CAREC Council concluded data connections were possible. By 1988 a computer the British Development Division of the Caribbean. The that a new facility was needed. audit was done by PAHO HQ with a recommendation parasitology and Entomology laboratories were dedicated made to hire a Programmer/Analyst. Such an individual, in November 1993 as the “Thomas H G Aitken Laboratory.” With the intensification of the HIV/AIDS programme there Ms Carolyn Attong, was indeed hired and she performed Dr Aitken (Fig. 2.29), also a was also a need to expand the laboratory facilities to an analysis design and programming of the Laboratory staff member, had been the Entomologist at the TRVL support the programme. Records Management database, the Personnel database from 1954 to 1966 and laid the foundation for studies in and also enhanced the Personnel and Payroll databases. medical entomology in Trinidad and Tobago. He was the The Government of Trinidad and Tobago who owned the A dedicated phone line was added to the system in 1994 senior author or co-author of 70 articles written while at lands and buildings gave permission in 2003 to construct for emails and in 1995 the Local Area Network (LAN) was the TRVL. Another laboratory next to the mouse colony a pre-fabricated Molecular Biology Laboratory North of launched. A major upgrade of the system occurred in 1997 was renovated and made into a high security laboratory the main compound. Funding for this project was provided with contributions of equipment by the Walter Reed Army and named the “Barbara Hull Laboratory”. Barbara Hull by the Centers for Disease Control, Atlanta, Georgia and Institute of Research which greatly aided information worked at the TRVL as technician, Senior Laboratory construction was completed in 2006. for disease prevention and control. Critical information Superintendent and Virologist. products in 1997 were the launching of the CAREC The European Union Medlabs project also needed website and the provision of an email system for all staff During the period of occupation of the buildings by the space for its quality assurance laboratory which was built members which increased accessibility to information TRVL and CAREC various Directors had made many adjacent to the Molecular Biology Laboratory. from the Centre. modifications to the electrical system to meet the ever- increasing addition of electrical equipment, both light and Equipment Other Equipment heavy, used in particular in the laboratories. By 1990, the Up to date communication devices were necessary power supply had become inconsistent and had a negative Computers when dealing with so many islands scattered around impact on many items of equipment. Accordingly, an In December 1980 CAREC received its first computer, an the Caribbean Sea. The Centre already had telephone independent electrical engineer was hired to investigate IBM PC which was placed in a room in the Administration and telex facilities and in 1980, a facsimile machine was

the CAREC story 26 The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 ADMINISTRATION (continued)

added which proved to be a simpler, less costly and more Council of Health and Social Development (COHSOD). of Health, Belize; The Honourable Julius Timothy, Minister user-friendly device than the telex machine. With the In turn, a report coming out of the COHSOD meeting of Health, Dominica; Dr Jean Dixon, Ministry of Health, installation of computers email services became available. encouraging the establishment of a public health agency Jamaica; Dr Sirving Keli, Director of Health, Ministry of In 2000, CAREC installed a Very Small Aperture Terminal was then forwarded to the Ministers of Health. Meanwhile, Health, Curacao; Ms Antonia Popplewell, Permanent (VSAT) Dish on its compound which made available to all CAREC’s Multilateral Agreement which was due to end in Secretary, Ministry of Health, Trinidad and Tobago its users and stakeholders up-to-date systems for online 2009, was given a two-year extension pending a decision and Dr Akenath Misir, Chief Medical Officer, Ministry of collaborative work, distance education, video conferences, by the Heads of the Governments of CARICOM. Health, Trinidad and Tobago; and Dr Shamdeo Persaud, intranets and high speed internet services. Chief Medical Officer, Guyana. Dr Rudolph Cummings, Through the fusion of these regional bodies the intention Programme Manager Health Sector Development, Transfer of CAREC to the Caribbean Public Health was to rationalise the public health institutions in the CARICOM Secretariat and Dr Jerome Walcott, Interim Agency Caribbean. An agreement to this effect was signed by Director CARPHA were also present at the meeting. In 2006, and perhaps before, the governance and structure Heads of the various CARICOM Governments in July of five Regional Health Institutions (RHIs) were being 2011 establishing the Caribbean Public Health Agency The Chairperson conveyed thanks to PAHO, congratulated scrutinised by CARICOM Ministers responsible for health. (CARPHA) in January 2013. Once the agreement came the CAREC Director for being a stalwart to the centre The group of RHIs consisted of the following organisations: into effect CAREC staff members devoted significant time, during the transition and thanked the CAREC staff for the Caribbean Epidemiology Centre (CAREC) situated in particularly in 2012, to the transition from PAHO/WHO to their hard work. The Honourable Dr Fuad Khan, Minister Trinidad and Tobago, the Caribbean Food and Nutrition the new CARICOM entity. of Health, Trinidad and Tobago delivered the feature Institute (CFNI) in Jamaica, the Caribbean Environmental address. In offering thanks to PAHO for giving Trinidad Health Institute (CEHI) in St Lucia, the Caribbean Health The 37th CAREC Directing Council was held in July 2012, and Tobago the opportunity over the years to partner and Research Council (CHRC) in Trinidad and Tobago and the chaired by Professor E Nigel Harris, Vice Chancellor, develop surveillance programmes with Regional Health Caribbean Regional Drug Testing Laboratory (CRDTL) in University of the West Indies (UWI), Mona, Jamaica. Institutions, Dr Khan reaffirmed that this was not the Jamaica. At the request of the Caribbean Governments, This was the last meeting of CAREC’s Council prior closing of an organisation but an opening of a new phase PAHO appointed a former Minister of Health from to its transition to CARPHA. The council members in in a new direction for the Caribbean. Jamaica, Mr John Junor, to review the function and attendance were: Dr Ernest Pate, Caribbean Program governance of these institutions and to make appropriate Coordinator, Pan American Health Organization (PAHO), The Caribbean Epidemiology Centre which was recommendations. Later in 2007, CAREC hosted a The Hon. Willmoth Daniel, Minister of Health and Mr Edson established in January, 1975 came to an end in December, meeting of all the RHI Directors, representatives from Joseph, Permanent Secretary, Antigua and Barbuda; The 2012 bringing to an end 37 years of distinguished service CARICOM and PAHO/WHO, where the Junor Report was Honourable Dr Fuad Khan, Minister of Health, Trinidad and in public health to Caribbean Governments. discussed. The report of that meeting was forwarded to the Tobago; Dr Peter Allen, Chief Executive Officer, Ministry

the The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 27 CAREC story ADMINISTRATION (continued)

Table 2.2. List of donors to CAREC’s budget Grantor Project BOSTID Control of Aedes aegypti with Toxorhynchites Canada CIDA Programme on AIDS or AIDS-related projects Canada IDRC Hospital-based injury surveillance Canada IDRC & TT Government Arbovirus studies Caribbean Development Bank Caribbean tourism Centers for Disease Control & Prevention Study of Salmonella enteritidis Emmaus Suisse Leprosy control in the LDC’s Emory School of Public Health/Fogarty Capacity building in epidemiology European Union 1. Drug abuse surveillance 2. HIV/AIDS 3. Strengthening of medical laboratories in CDCs Family Health International 1. Serum pooling for HIV screening (T&T) 2. Development of a strategy for cost recovery for blood transfusion services Intervention with STD clinic patients (T&T) Intervention with 4 high risk behaviour groups (St Lucia and Antigua) French Technical Cooperation Reduction of HIV/AIDS and STD’s in the Caribbean Gates Foundation (via PAHO) Cervical cancer German Agency for Technical Cooperation AIDS control in the Caribbean Japanese International Agency Laboratory infrastructure strengthening Mexican Health Foundation Modelling HIV/AIDS in the Caribbean National Cancer Institute (USA) Human T-cell leukaemia/lymphoma virus research National Institute of Occupational Safety Health and Safety projects Netherlands Leprosy Relief Assoc. Leprosy control Rockefeller Foundation Support for travel in the Caribbean (special assignment)

the CAREC story 28 The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 ADMINISTRATION (continued)

Grantor Project Government of Trinidad and Tobago Cervical cancer UNICEF To study antibody of seroprevalence in antenatal clinics UK Department for International Development Prevention and control of AIDS and STDs in the Caribbean and four territories; Institutional Strengthening UK ODA 1.Programme on AIDS or AIDS-related projects 2. Epidemiology training for health service personnel 3. Health economic appraisal 4. STD 5. Leptospirosis University of Maryland Training in public health USAID 1. Strengthening of surveillance training 2. Hospital infection control mainly with a training component 3. Traffic injury prevention - training 4. Programme on AIDS or AIDS-related projects World Bank Pan-Caribbean Partnership against HIV/AIDS World AIDS Foundation Programme on AIDS or AIDS-related projects WHO Chagas disease and its control in Trinidad and Guyana WHO Global Programme on AIDS 1. Establish AIDS education centre 2. Programme on AIDS/ AIDS-related projects

the The Caribbean Epidemiology Centre: Contributions to Public Health 1975 - 2012 29 CAREC story