Canada's International Development Research Centre (IDRC) is committed to supporting the development of evidence, innovation, and policies to build healthier food systems, enable healthy and sustainable diets, and prevent noncommunicable diseases (NCDs). The need and opportunity to do so has been great in the small island nations and communities of the Caribbean where political commitment and leadership have enabled both local action and influence of high-level, global dialogue to address the NCD epidemic. The 2007 Caribbean Community's (CARICOM) Jagdeo Initiative and the Port of Spain Declaration on NCDs have been responses to complex and unique challenges stemming from the pressures of international trade, climate change, and limited public resources and capacity in the region. Multisectoral initiatives remain critical to addressing the interlinked challenges of obesity, food insecurity, and NCDs, all of which threaten human and economic development.

In 2014 − 2017, IDRC supported researchers from the University of the West Indies and their partners in taking stock and evaluating progress toward the commitments made by the Port of Spain Declaration. Their findings, captured in this special issue of the Pan American Journal of Public Health, celebrate the successes achieved, in addition to revealing policy domains where a continued focus on health-promoting policy is needed. For instance, the research underscores the macro-level drivers of diets in shaping food systems and population health in the Caribbean—particularly, how low levels of national food production combined with a reliance on food imports and other socioeconomic policies predispose the region to nutritionally poor diets. The evaluation also points to school food environments as contributing to NCD risk factors, while also being a great opportunity for positive change.

Indeed, a focus on the diets of youth and the influence of schools resonates in a region where 20% − 30% of this age group is overweight or obese. With research that has unpacked the complex and pervasive drivers of poor nutrition, Dr. Alafia Samuels at the University of the West Indies has helped to sound the alarm on childhood obesity, elevating this issue in the public discourse and providing policymakers with evidence-based ways to improve the diets of Caribbean youth.

Recognizing the need to continue improving food environments, particularly by ensuring the availability, affordability, and accessibility of healthy and local foods, IDRC is supporting a new Caribbean initiative that will leverage regional momentum and research leadership to integrate the food security and the public health agendas for greater policy action and regional health impact. The research, civil society, and policy communities in CARICOM are key partners in this effort. This partnership is imperative to undertaking rigorous national and regional studies to better characterize the public health, social, and economic burden of nutrition-related chronic diseases and to identifying and advocating for policy interventions to improve Caribbean food systems, which underpin the NCD epidemic.

Despite the challenges, the Caribbean can continue to set benchmarks for action to combat NCDs, a global problem that impacts populations around the world and individuals across the life-course. This special issue of the journal provides an important compilation of recent learnings and related efforts. The lessons garnered here will enable a renewed and stronger response to the NCD challenge and better priority-setting for health-promoting environments in the Caribbean.

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