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The overall goal of the project is to build a shared understanding amongst stakeholders of the complex adaptive systems driving local food production and consumption in English-speaking CARICOM states; and implement coordinated packages of interventions within national food systems that promote sustainable livelihoods of vulnerable groups, and combat obesity and diet-related NCDs.

The researchers, major collaborators and stakeholders of FaN who attended the Inception Workshop

The Port of Spain evaluation on NCDs contains a wealth of detail and recommendations on the way forward in the multisectoral challenge to the epidemic of chronic diseases in the Caribbean. Here is a wide-ranging but easily digestible look at the situation in a number of critical areas and what can and should be done next.

In 2007 CARICOM Heads of State signed a landmark Declaration to tackle the epidemic of NCDs

The Port of Spain Declaration promotes policies and behaviours that encourage the pursuit of better health on an individual, community, national and regional level

© PAHO-WHO/David Spitz

In July 2016 CARICOM Heads of Government pledged to address:
banning of smoking in public places;
banning advertisement of potentially harmful foods which specifically target children;
raising taxes on foods high in sugar, salt and trans fats

NCDs pose a major threat to both the health and future of the region and could seriously effect hard-won development gains

© PAHO-WHO/David Spitz

Childhood obesity exceeds 10% in most countries,
driven by consuming high-fat, high sugar food and drink,
Less than 1/3 of school children, 13-15, get the recommended level of physical activity

© fotolia/rubberball/igp

NCD mortality in the Caribbean is the highest in the Americas.
40% of NCD deaths occur in those under 70 and are potentially preventable

Photo Credit: Shari John

Heart attacks, stroke, diabetes and cancers are the leading causes of premature death in the region. Hypertension is the leading risk factor for death

© PAHO-WHO/David Spitz

Diabetes prevalence is double global rates. Up to 25% of adults in some countries have diabetes

© PAHO-WHO/David Spitz



Improving Household Nutrition Security and Public Health in the CARICOM (FaN- Food and Nutrition):

The project builds on the lessons and outcomes from the “Farm to Fork” project and the findings and recommendations of the Evaluation of the POS Declaration, and seeks to determine how previous and proposed research can best be scaled up and incorporated into more nutrition-sensitive, gender-responsive food systems for CARICOM.”

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The Port of Spain Declaration Evaluation (POSDEVAL)

The Port of Spain Declaration on Non-communicable Diseases: the path to a healthier Caribbean

In 2007, CARICOM leaders signed the ground-breaking Port of Spain Declaration aimed at uniting to stop the epidemic of NCDs. Now this Declaration is being evaluated by a team of top experts.

Are these ambitious commitments being met? What are the successes and challenges?

The evaluation answers these critical questions.

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Public perceptions of non-communicable diseases (NCDs)

What does the public understand about NCDs? Have they heard of them? What are their experiences of them and how do they feel they touch their lives?

This was the question that Dr Anique Atherley, a Junior Research Fellow at the University of the West Indies and a group of researchers set out to answer in a quick research project focusing on short street interviews with Barbadian men and women. They captured a variety of opinions in a variety of settings around the island.

Here is a selection of their voices.

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Living with cancer: Michelle’s story

Michelle O'Kieffe

Michelle O’Kieffe was diagnosed with an aggressive form of breast cancer at the age of 32. Having been in remission for many years, she is determined to improve support for women living with cancer in Trinidad and Tobago. Here is her story.

My name is Michelle O’Kieffe and I live in Trinidad. I was diagnosed with breast cancer in February 2000 at the age of 32.

I discovered a small lump just below my right breast. When I went to get it checked out the doctors were more panicked than I was. I didn’t have a clue that it could be cancer. There was no history of it in my family and I was young, 121 pounds, I didn’t smoke, I was vegetarian, really active.

But when I got the diagnosis, that the cancer had already spread, I took it in my stride. I saw it as another challenge, another hurdle to get over. If anything it was harder on my mum who was alive at the time. She took all the worry, all the emotion, asked all the questions that I didn’t want to ask.

It was hard on my husband and kids as well. I had two sons Christopher aged 12 and Christian 6. I started preparing them for what might happen.

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"We need to urgently tackle NCDs in our region and the 2007 Port of Spain Declaration helps us rise to the challenge. We are now evaluating the Declaration to find out where we have succeeded and where we can do better as we strive for a healthier Caribbean"
Dr Rudolph Cummings, Caribbean Community (CARICOM)

"The epidemic of non-communicable diseases is the pre-eminent public health challenge in the Caribbean. But the response goes far beyond health. That’s why we need a multisectoral approach that involves the whole-of-government and the whole-of-society. The Port of Spain Declaration evaluation helps guide us in what each sector should be doing to respond more effectively"
Dr C. James Hospedales, Executive Director, Caribbean Public Health Agency (CARPHA)

"There are those who can make lifestyle adjustments to challenge NCDs but there are other people who can’t do this on their own. We need government policy to address the realities of the typical man and woman in the Caribbean who has real difficulty making healthy choices because of the environment they live in"
Dr Patrick Martin, Chief Medical Officer, St Kitts and Nevis

"I often speak about the connection between spirituality and health, drawing attention to the theological notion that God Almighty cares about the whole person; about our immortal souls and our bodies. So we need to take care of them. We need to eat better, be active and reduce stress"
Canon Noel Burke, Rector of St David’s Church, Barbados

"The emotional impact of Trevor’s Illness is very profound, for example, the moments of sadness… especially when I think of the many things he was capable of and the many plans he had for the future. I miss our conversations too"
Beverley Redhead, commenting on life after husband Trevor’s stroke

"As a church elder, I preach that God wants us to look after ourselves not only spiritually but physically too. Our health is important to Him and it should be to us as well"
Priscilla Prevost, Health Coordinator for the East Caribbean Conference of Seventh - day Adventists

"As we approach the 10th anniversary of the Port of Spain Declaration in 2017, its evaluation allows us the opportunity to review the state of implementation of the 27 commitments and to reflect on the lessons learned, as we scale up our efforts to tackle the epidemic of non-communicable diseases in the Caribbean"
Dr. Carissa F. Etienne, Director, Pan American Health Organization (PAHO)