The Port of Spain Declaration on noncommunicable diseases (NCDs) stands out as an exemplar of considerable magnitude, not only to the Caribbean Community (CARICOM), but to the world. It was first time that the Conference of Heads of Government dedicated an entire meeting to a health theme, giving NCDs the pre-eminence that fostered the organization of the United Nations High Level Meeting on NCDs and its associated political declaration. This served as the platform for establishing NCDs as a problem requiring a multisectoral, whole-society approach.

The CARICOM Heads of Government had the foresight to include in the Declaration, an evaluation of its progress at the 5-year mark. The Pan American Health Organization (PAHO) and CARICOM were requested to put in place the modalities for such an evaluation and approached the International Development Research Centre of Canada for its support. The research was conducted by the University of the West Indies’ (UWI) Cave Hill Chronic Disease Research Centre (now named after Sir George Alleyne), with oversight provided by a steering committee comprising CARICOM, the Caribbean Public Health Agency (CARPHA), and PAHO, among others. After 18 months of work, the results were shared with a multisector group of professionals.

It was clear from the evaluation that the enthusiasm observed in the thoughtful targets of the Declaration were not matched by its implementation. The concept of a multisector/multistakeholder approach to problem solving has proven challenging to Member States of CARICOM, in particular the smaller ones. While tobacco legislation has been the most achievable action in the larger Member States, implementation of the regional standard for tobacco labeling has been a challenge for all.

Fortunately, the Conference of Heads of Government responded favourably to the research findings by reaffirming their commitment to the NCD goals and targets in 2016 and 2017. In 2016, they mandated the formation of a regional taskforce to address the epidemic of childhood obesity. In 2017, they affirmed the regional goal of being “tobacco-free” by 2022. In addition, at the national level, there has been recent progress; for instance, Trinidad and Tobago has stopped the sale of sugar sweetened beverages in public schools, and Barbados has imposed a fiscal tax on these beverages. There are other efforts underway, such as reducing the amount of salt in bread.

The team at UWI, led by Alafia Samuels, is deserving of the highest recognition for a job well done. We need to applaud their commitment to this work as they continue to evolve new avenues of inquiry in Member States. As such, the team has been able to interest the International Development Research Center (IDRC) in supporting appropriate NCD research interventions in our region. It is my sincere hope that we will find the will to translate their findings into useful policy.

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