The 2007 Declaration of Port of Spain, “Uniting to stop the epidemic of chronic NCDs,” resulted from a historic and unprecedented effort by heads of state of the Caribbean subregion who recognized the devastating burden and consequences of noncommunicable diseases (NCDs) on their citizens and the need to respond at the highest political level. The Port of Spain Declaration (POSD) comprises 27 commitments to action in key areas including risk factor reduction and health promotion; improving quality of care; the development of appropriate legislative frameworks and the establishment of NCD commissions or similar entities to provide oversight of NCD prevention and control efforts.

This bold initiative by Caribbean leaders proved to be a critical catalyst, prompting countries in other regions to take stock and ultimately resulting in the 2011 United Nations High-level Meeting on the Prevention and Control of Non-communicable Diseases. This process continues with the evaluation of progress towards agreed targets at the global level and a third UN high-level meeting on NCDs, scheduled to take place in September 2018.

Within the Caribbean, efforts to evaluate the outcomes of the POSD have been ongoing since its adoption in 2007. One of these efforts was conducted between 2014 and 2017 by an international team of academics and public health practitioners led by the George Alleyne Chronic Disease Research Centre of the University of the West Indies (UWI), with funding from the Canadian International Development Research Centre (IDRC) and participation from the Pan American Health Organization/World Health Organization, the University of Toronto, the Caribbean Public Health Agency (CARPHA) and the Healthy Caribbean Coalition. Their report provided a comprehensive analysis of the extent to which the regional commitments had been implemented during the first seven years following the Declaration. The report highlighted the importance of intersectoral and multisectoral engagement on NCDs and emphasized the critical need for increasing the political priority accorded to NCDs, noting that larger nations with greater investments in NCDs had achieved more.

This thematic issue of the Pan American Journal of Public Health presents the results of more recent work by the same POSD evaluation group, this time looking at progress 10 years after the Declaration. The articles examine important topics such as specific implications for small island developing states (SIDS); successes and barriers to policy implementation; policy implications of disparities and social factors related to specific NCDs; and the use of taxes from alcohol and tobacco to fund NCD prevention and control in line with the Addis Ababa Action Agenda. Additionally, this work has fostered collaboration with colleagues in the South Pacific who share similar challenges related to NCDs and SIDS, producing joint reports on approaches to fighting obesity and to building sustainable food environments.

This thematic issue of the Pan American Journal of Public Health should be required reading for health authorities, academics, policymakers, governments and political leaders in the Caribbean subregion and beyond, who can apply these valuable lessons learned to strengthen their own countries’ public health and fiscal policies, regulation, legislation, and the intersectoral and multisectoral approaches needed to ensure policy coherence in tackling NCDs and their risk factors.

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