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MINISTRY OF HEALTH, WELLNESS & THE ENVIRONMENT ST. VINCENT & THE GRENADINES NATIONAL ACTION PLAN for the PREVENTION AND CONTROL OF NON - COMMUNICABLE DISEASES 2017 – 2025 TABLE OF CONTENTS TABLE OF CONTENTS……………………………………………………………………… ... 2 ACKNOWLEDGEMENTS ........................................................................................................... 3 ACRONYMS ................................................................................................................................. 5 FOREWORD ................................................................................................................................. 6 EXECUTIVE SUMMARY ............................................................................................................ 7 DEVELOPMENT OF THE ACTION PLAN ................................................................................ 8 Introduction ........................................................................................................................... 8 Rationale ............................................................................................................................... 9 Scope ................................................................................................................................... 10 Situational Analysis ............................................................................................................ 10 The Mandate ....................................................................................................................... 16 Guiding Principles .............................................................................................................. 18 RESULTS FRAMEWORK .......................................................................................................... 21 ACTIVITY PLAN ....................................................................................................................... 26 SUMMARY BUDGET ................................................................................................................ 39 ANNEXES/ APPENDICES ......................................................................................................... 40 Annex 1: Chronic Care Model ............................................................................................ 40 Annex 2: Policy link for NCDs with various sectors .......................................................... 41 Annex 3: Summary of responsible organizations ............................................................... 43 Annex 4: Summary of stakeholders’ analysis ..................................................................... 44 Annex 5: Glossary of terms ................................................................................................ 47 REFERENCES ............................................................................................................................ 49 2 ACKNOWLEDGEMENTS The Ministry of Health, Wellness and the Environment is grateful to individuals who have contributed to the development of this National Action Plan for the Prevention and Control of NCDs which was produced under the direction of Mr. Luis de Shong, former Permanent Secretary, Mr. Cuthbert Knights, present Permanent Secretary and Dr. Simone Keizer-Beache, Chief Medical Officer, Ministry of Health, Wellness and the Environment. Thanks also to Pan American Health Organization/World Health Organization (PAHO/WHO) for providing technical assistance in the persons of Dr. Tomo Kanda, Advisor on Chronic Diseases and Mental Health and Ms. Anneke Wilson, the Country Program Specialist. Special thanks are extended to Sr. Beverly Liverpool, NCD Co-ordinator, for spearheading the entire process of completing the National NCD Action Plan. Other Contributors: Dr. Roger Duncan Medical Officer of Health Dr. Del Hamilton Consultant, Preventative Medicine/Public Health Mrs. Andrea Robin Chief Nutritionist Ms. Patsy Wyllie Chief Health Promotion Officer Sister Peggy Da Silva Chief Nursing Officer Sister Cecile James-Samuel Senior Nursing Officer, Community Health Service Mr. Levi Walker Chief Pharmacist Mr. Neri James Chief Environmental Health Officer Mr. Elliot Samuel Chief Laboratory Technologist Mr. Harold Lewis Debt Analyst II, Ministry of Finance & Economic Planning Mrs. Rosita King Retired Senior Nursing Officer MCMH, President-Diabetes and Hypertension Association 3 Ms. Tamara Bobb Epidemiologist Mr. David Latchman Health Planner Sister Arlene James Health Nursing Supervisor Sister Viola Richardson Senior Nursing Officer (Ag.), MCMH Ms. Grace Walters Hospital Administrator, MCMH Mrs. Azonya Vanloo-Morris Administrative Officer, HIV/AIDS Secretariat Ms. Nicole Samuel Secretary, HIV/AIDS Secretariat Acknowledgement is also extended to other unnamed contributors who have given their support in the preparation of this document. 4 ACRONYMS CARICOM Caribbean Community CCM Chronic Care Management CCH Caribbean Co-operation in Health FCTC Framework Convention on Tobacco Control GSHS Global School-Based Health Survey GYTS Global Youth Tobacco Survey MCMH Milton Cato Memorial Hospital MoE Ministry of Education, Reconciliation & Ecclesiastical Affairs MoHWE Ministry of Health, Wellness & the Environment MoA Ministry of Agriculture, Rural Transformation, Forestry, Fisheries & Industry MoFA & T Ministry of Foreign Affairs, Trade, Commerce & Regional Integration MoNM & SD Ministry of National Mobilization, Social Development, Gender Affairs, Persons with Disabilities and Youth MoNS Ministry of National Security, Air & Sea Port Development MoEP Ministry of Economic Planning, Sustainability Development, Industry, Information & Labour MoTS & C Ministry of Tourism, Sports & Culture MoTW Ministry of Transport Works & Urban Development NCDs Non-Communicable Diseases NHSSP National Health Sector Strategic Plan PAHO/WHO Pan American Health Organization/World Health Organization POSD Port of Spain Declaration 5 FOREWORD Non Communicable Diseases (NCDs) are the main causes of mortality and morbidity in St. Vincent and the Grenadines, as is the case in most of the countries in the world. At the UN High level Meeting in September 2011, St. Vincent and the Grenadines endorsed the UN resolution on NCDs; also at the Heads of Government of Caribbean Community (CARICOM) meeting in September 2007, St. Vincent and the Grenadines signed the Port of Spain Declaration (POSD), aimed at uniting to stop the epidemic of NCDs. This illustrates the government’s commitment in the fight against the epidemic of NCDs. One of the first priorities has been the development of this National Action Plan for the Prevention and Control of NCDs which provides a framework for a coordinated and integrated approach during the coming years in the fight against NCDs in our country. The elements of the NCD plan focus on strengthening coordination and management of NCD prevention and control programmes, building healthy and active communities through multi- sectoral policies and partnership, health systems strengthening for NCDs and risk factors at all levels and all sectors, healthy lifestyle promotion to reduce NCD risk factors and strengthen protective factors and the strengthening of surveillance, research and information. For the coming years the priority NCDs namely cancer, cardiovascular disease and diabetes which account for 64% of mortality nationwide will be targeted. The fight against NCDs cannot be successful without strong intersectoral collaboration which is crucial for healthy lifestyle promotion and risk factor reduction. This plan calls for a collective effort through the establishment of structured intersectoral cooperation with other ministries, private sector and civil society. Periodic evaluations are essential part of the fight of all diseases and specifically of NCDs which require more complex interventions than the communicable diseases. This NCD plan is a dynamic document which will be periodically revised in order to enable us to keep on track towards the set goals. As a health sector and as a nation we have to join hands, to be accountable and share responsibility to be able to really tackle the burden of NCDs. We owe it to the next generation. Hon. Robert T. L.V. Browne ______________________________________ Minister of Health, Wellness and the Environment St. Vincent and the Grenadines 6 EXECUTIVE SUMMARY Non-communicable diseases (NCDs) are the leading causes of death globally as well as in St. Vincent and the Grenadines. These chronic diseases, especially malignant neoplasms, cardiovascular diseases, diabetes and respiratory diseases were the cause of 64% of deaths in St. Vincent and the Grenadines in 2013. NCDs place a high burden on St. Vincent and the Grenadines health care system and prevention and control of these diseases has become a public health priority. Feasible and cost-effective interventions exist to modify risk factors such as tobacco use, harmful alcohol use, unhealthy diet and physical inactivity, which are the underlying causes for the onset and progression of NCDs. Applying best cost effective interventions and policy options to reduce risk factors and create a protective and enabling environment, will requires all government effort. The Ministry of Health, Wellness & the Environment in collaboration with partners from within and outside the health sector, has developed a plan, which outlines the course of action for St. Vincent and the Grenadines to combat the NCD epidemic that is profoundly affecting the population.