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Mr Chairman It is for me a great pleasure to welcome you to this Sixth Meeting of the Council for Human and Social Development (COHSOD). I am delighted to see so many of you here as you are aware of the exciting times we had last night as we attempted to come into Guyana. The focus of this meeting on Health and Human Development is very timely. It is very consistent also, with the integrating theme adopted by your Council, which is, Investing in Human Resources with Equity. Our Community has always placed very high priority on health. In the very early days of the integration process, for example, the Health Desk here at the Secretariat under Dr Boyd, played a vital role in helping to shape a regional response to the ravaging effects of structural adjustment programmes on social services. Indeed, as a result studies have demonstrated that during the late 1970s and early 1980s, health expenditure as a ratio of Gross Domestic Product [GDP] in most Caribbean countries remained stable and among the highest in the Americas. The Secretariat also collaborated with PAHO/WHO in the mid-1980s to establish the Caribbean Cooperation in Health (CCH) initiative in an effort to pinpoint the major health challenges and to deal with them in a collective way. In the mid-1990s the Caribbean Community was fully involved in another landmark policy study that gave direction to sharing of services as a way for the Region to confront the then emerging process of globalization. The Caribbean Health Study known as the Green Paper on Caribbean Health Issues, produced by PAHO in collaboration with the IDB and CARICOM, was presented to the CGCED Meeting at the World Bank in 1996 and is one of the most highly referenced documents on regional health policies. Most Ministers of Health and officials present today will have some sense of the rich history of the institutional role of health sector initiatives in the development of the region. Indeed, in the early days, we used to say that the CARIFTA Secretariat was a health Secretariat with a few trade and economic issues thrown in, so powerful and dynamic was Dr. Phillip Boyd and his staff. The most recent illustration of this regional leadership role by the Heath Sector is to be found in The Nassau Declaration: The Health of the Region is the Wealth of the Region, issued by the Conference of Heads of Government in The Bahamas in July 2001. The Nassau Declaration is in many ways a synthesis of the incremental policies in the preceding initiatives to which I have referred. In this regard, the mandates from our Heads of Government are clear. They require the Council for Human and Social Development (COHSOD) to establish clear guidelines for activities that would improve the health of the region and to implement them. The specific timelines established by the Heads are quite rigorous and they portray the urgency that they attach to implementation. We in the CARICOM Secretariat are totally committed to honouring them. So for example, the establishment of strategic plans and the implementation of programmes dealing with mental health and the non-chronic diseases by December 2003 and December 2004 respectively, are some of the tasks of the Caribbean Cooperation in Health Coordinating Mechanism, which is the joint responsibility of PAHO/WHO and the CARICOM Secretariat. The implementation of the HIV/AIDS Strategic Framework and the strengthening of the Pan Caribbean Partnership Mechanism coordinated by CARICOM have even more stringent target dates. However, even with the best “political will” and with the most constructive strategic plan, in the final analysis achieving these regional targets depends on what happens at the national level. We therefore implore you to incorporate National COHSODS into the normal processes of your work. At the Fifth Meeting of the COHSOD in October 2001, the Caucus of Ministers requested the CARICOM Secretariat to provide a concept paper dealing with the options by which the COHSOD system may function more effectively. This proposal developed by the Secretariat in consultation with Member States was circulated to all Social Sector Ministers at the end of October, two weeks after the Fifth Meeting of the COHSOD, and will again be on the Agenda of the Ministerial Caucus at this Meeting. We urge countries that have not yet done so, to find the formula to move forward the implementation without further delay. Ladies and Gentlemen, there are two issues that I believe to be relevant to your discussions at this Sixth Meeting of the COHSOD that I wish to stress. The firsthas to do with the central role of health in development, which I am happy to note is the subject of the Ministerial panel and is intended to set the framework for the more specific discussions to follow. I am sure that the panellists will deal with the transition in our Region that has shifted the burden of our policy concerns toward chronic diseases, like heart diseases and diabetes, as major causes of death compared with the communicable diseases. I am sure the panellists will also be concerned with the effects of HIV/AIDS as well as the re-emergence of malaria and TB in some countries and their effects on the labour force and on productivity. In your deliberations, I also urge that some attention be given to the importance of income inequality and poverty as determinants of health status. In this regard, the issue of food security on your Agenda must highlight the lessons learnt from those countries that have introduced effective policies to reduce malnutrition and diarrhea – diseases whose fatal outcomes, especially among young children, can be linked to poverty. In your deliberations you must also pay attention to the issue of the nutritional component of HIV/AIDS care and treatment programmes. In this way food security will not be seen as just a set of activities aimed at achieving efficiency in agricultural production, but it is a reinforcement of the overall investment in human resources with all the attendant beneficial effects. There is urgent need to search for interventions that produce most impact on health status in areas of poverty. This is not an academic matter. It is at the heart of the policy equation. A recent study conducted jointly by CARICOM and PAHO, Investing in Health to reduce the impact of poverty (2000), clearly shows that an increase in productivity through health investment is likely to be greatest among the poor and is one of the most important ways to reduce income inequality. But this also assumes that other factors to increase reproductive health among the poor are in place. Among these are programmes that ensure greater access to education at various levels and that provide more facilities for recreation and sports at the level of the Community. It assumes an environment whereby the youth in general, and particularly those who are poor, are involved in healthy life styles, rather than those that lead to the harmful effects of drugs and crime. It also means fostering gender equity and discouraging household and other forms of abuse especially against women and children. This brings me to the second issue that we tend to overlook. And it is this: increasing productivity through health investment requires an inter-sectoral approach if it is to be sustainable. An inter-sectoral approach is at the heart of the COHSOD system, which advocates greater linkages among the social sectors that make up COHSOD. How else can we scale up the response to HIV/AIDS and reduce its spread without collaboration among health practitioners, educationists, sports administrators, youth and community leaders? How can we hope to change behaviours toward healthier lifestyles without the active involvement of the media, the use of cultural activities which involves not only the messages by the performing artists through the reggae and calypso, the theatre but also through the curriculum and the churches? I am therefore very glad to note that your Agenda includes items such as: Strategic inter-sectoral alliances with gender, youth, and drug demand reduction and food security and, crime, security and human development Ladies and Gentlemen, If COHSOD VI exploits the opportunity provided by these items to forge the linkages among the social sectors that would lead toward collaborative policy making then it would go a long way toward achieving its mandate It is only left for me to wish you a successful meeting and to let you know that I will be attending sessions of this Council as much as possible as time permits and will definitely be joining you in paying Tribute to Sir George Alleyne at the closing session on Friday. I wish this Sixth Meeting of the COHSOD every success in achieving deliberations that truly advance policies and programmes on health and human development. |
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