Barbados National Commission For CNCDs

by HCC
BARBADOS NATIONAL COMMISSION FOR CNCDs
COMMISSION PROFILE
Status as at September 2023 Active
Country Barbados
Name National Commission on CNCDs
Status as at September 2023 Active
Date of establishment The National Chronic Non Communicable Diseases Commission was launched by the then-Minister of Health, Dr. The Honourable Jerome Walcott on 26 January 2007
Date of First Meeting March 2007
Date of Last Meeting 10 November 2016
Number of Meetings in the last 12 months 10
Chair Suleiman Bulbulia
Title -
Organisational affiliation -
Duration of tenure -
Summary of steps taken to establish the Commission Specifically <!----> <!---->
Was there a planning group, (e.g. Task Force, Committee or other “precursor body”) that worked to establish the Commission? Yes. Background documents: Strategy for the prevention and control of CNCD & Cabinet Note (2005) 26/MH.03, Ministry of Health, Barbados (2004); International Consultation on a Strategy for the Prevention and Control of CNCD for Barbados; Ministry of Health, Barbados (2005); “Healthy hearts for life”. Report of the Task Force on the development of cardiovascular services (Jan. 2007); Ministry of Health, Barbados
If so, does the group still exist? No
If it does, what is its relationship with the Commission? -
Are there recommended profiles or desired characteristics for Commission Chair and Commissioners? No
Were these applied in selecting the Chair and Commissioners? -
If yes, to what extent do the Chair and Commissioners satisfy them? Fully? To a large extent? To some extent? -
Legal authority/reference Cabinet of Barbados
Location(sector/entity) Ministry of Health
Mandate/Scope of work Advise Minister of Health on CNCD policies and legislation; broker involvement of all sectors in program implementation; assist in mobilisation of resources to facilitate implementation of programs; recommend relevant research; promote collaborations and partnerships; monitor regional and international trends; facilitate commissioning of audits/evaluation of CNCD programs; recommend to Minister of Health framework that encourages and promotes behaviour change to prevent CNCDs. There is no explicit mandate for hospital services review
Terms of reference Yes, as in mandate above
Conflict of interest policy No
Code of ethics No
Standard operating procedures Yes
NNCDC strategic plan/plan of action Yes. The Commission’s plan is the National NCD Plan of Action being implemented in conjunction with the Ministry of Health
Decision-making process (consensus, majority, other) Yes
Membership and Personnel 14 members and 4 ex-officio members
Government sector membership and level of representation Ministries of Health, Agriculture, and Education; Bureau of Standards
Civil society membership and level of representation University of the West Indies, faith-based organisations, trade union, health NGOs, sports groups, and retired persons’ groups
Private sector membership and level of representation Health insurers, manufacturers, food retailers, advertising, and the media
Ex officio members Chief Medical Officer, NCD Focal Point, Health Promotion Officer, and Project Manager
Secretariat exists? If so, please give date of establishment Yes, since 2007
Full-time human resources/functions No
Part-time human resources/functions Yes. Professional staff members of the Health Promotion Unit provide administrative and secretarial support
Main functions (advisory, accountability, strategic planning, project/programme implementation, other) Refer to ToR
Main areas of interventions for NCDs and NCD risk factors Unhealthy diet, exposure to tobacco, physical inactivity, hypertension, obesity, cancer, diabetes, heart disease,and stroke
Other health issues that the NCD/Wellness Commission addresses
  • Is there integration – structural or functional, with other health-related Commissions, such as HIV Commissions?
    Yes, Physical Activity Task Force
  • If so, to what extent? Fully? To a large extent? To some extent?
    To some extent
Framework(s) of reference (national policy, strategy or plan; international plans/strategies) Focus of interventions (legislation, taxation, policy development, project/programme development, project/programme implementation, capacity building, surveillance, monitoring and evaluation, other
Work groups/subcommittees/task forces and their functions None
Accountability mechanisms (periodicity of monitoring, evaluation, reporting, and to whom; financial accountability mechanisms) Official minutes of meetings provided to Minister of Health; annual reports developed
Main successes Contribution to enactment of legislation banning smoking in public places; heightened awareness about marketing and promotion of junk and unhealthy foods and beverages to children in schools; production of National NCD Strategic Plan; inclusion of NCDs in Protocol V1 of the Social Partnership; greater national awareness and conversation about NCDs; faith-based workshop on NCDs, including the Declaration of Bridgetown, gaining the commitment of over 25 faiths to prioritise NCDs in their communities; contribution to the establishment and subsequent funding of the Barbados National Registry; advocacy for the establishment of an Interministerial Commission for Health, which has a budget, chaired by the Minister of Health, and supported by meetings of Permanent Secretaries and Chief Technical Officers of several ministries; support for Caribbean Wellness Day
Success factors Active engagement and participation by members of the Commission over a sustained period of time; strong technical support from staff of the Health Promotion Unit of the Ministry of Health; commitment of leadership of Ministry of Health
Specifically
Were there any successes due mainly to the participation of non-health sectors in the Commission Edu-drama project in schools around NCD risk reduction in children, using ‘a play in a day’, supported by Sagicor Insurance
Main challenges Absence of specific funds to support Commission; disruptions in functioning with changes in Ministers of Health or end of period of appointment; difficulty in obtaining engagement of non-health sectors of government; monitoring curative services for NCDs; communicating with stakeholders; moving NCD prevention and control from knowledge to action
How were these challenges overcome? Project funds obtained from non-Ministry of Health source; meetings held despite not having the legal authority to do so but undertaken with agreement of Ministry of Health personnel
Specifically
Did changes in administration disrupt the Commission’s functioning? Yes, to a limited extent
If yes, what were these changes and their effects? Meetings were not held for a few months and/or they were held without having the specific legitimacy to do so
If no, how was continuity of function maintained? What steps were taken? Meetings were held with the agreement of Ministry of Health personnel
Main source(s) of funding and approximate percentage of funding from each source Ministry of Health, 100%
Technical support and project funds for the Commission are provided out of the funds allocated to the Health Promotion Unit of the Ministry of Health; Commissioners are paid a stipend
Mechanisms for sustainability No official mechanisms
Additional information/comments None

The NNCDC in Barbados is the oldest in the region, having held its first meeting in early 2007, pre-dating the Port of Spain NCD Summit and Declaration. Since its inception, there has been consistency of leadership. Its Chairperson, a well-known and internationally recognised academic and physician, has remained unchanged, despite changes in governing political parties and Ministers of Health. The strategic plan of the NNCDC and the Barbados Strategic Plan for the Prevention and Control of NCDs are one and the same, and was produced in collaboration with the Health Promotion Unit and the Senior Medical Officer (NCDs).

The Government of Barbados has shown strong and consistent commitment to NCDs through the funding of national risk factor surveys in 2007 and 2013; the Barbados National Registry (the region’s only active surveillance registry for heart attack, stroke and cancer); and a staff member dedicated to the Commission – the Senior Health Promotion Officer in the MoH is the Secretary of the Commission.

The Commission has had many successes, such as influencing product reformulation by a leading local bread manufacturer, with the result that the salt content of the products is lower than international targets, and contributing to enactment of legislation banning smoking in public places and prohibiting the sale of tobacco products to minors. It was also instrumental in securing inclusion of prevention and control of NCDs in Protocol V1 of the Social Partnership, which is a mechanism established at the highest level among government, private sector, and the trade union movement to determine and act on areas of major developmental concern in a collaborative and consensual manner.

NNCDC ADVOCACY WORK
Status as at December 2021 Inactive (no information available)
MENTAL HEALTH
Develop and implement a comprehensive mental health plan that complies with international human rights instruments,
includes allocated human and financial resources, and undergoes regular monitoring against indicators or targets for implementation
-
Decriminalize suicide, suicide attempts and other acts of self-harm -
Increase public awareness about mental health and how to stop discrimination through campaigns that involve
individuals living with mental disorders and psychosocial disabilities
-
Introduce brief interventions for hazardous substance use -
Advocate with other sectors such as housing, education, social welfare etc for the support of people with mental disorders
and psychosocial disabilities
-
YOUTH ENGAGEMENT
Does the NNCDC structure include a position for a youth representative? -
Is the NNCDC connected to other organizations that prioritize youth engagement? -
Has the NNCDC utilized social media campaigns to target youth? -
5 NCD RISK FACTORS

TOBACCO USE
Reduced affordability of tobacco products by increasing tobacco excise taxes and prices -
Protect people from tobacco smoke by creating, by law, implementing completely smoke-free environments in all indoor workplaces, public places, and public transport -
Warn individuals of the dangers of tobacco and tobacco smoke through effective health warnings and mass media campaigns -
Implement and enforce bans on all forms of tobacco advertising, promotion, and sponsorship -
Ban the sale of tobacco to minors -
Support plain packaging and pictorial health warnings on cigarette packages -
Implement measures to minimize illicit trade in tobacco products -
Assess the usage and impact of e-cigarettes, and develop appropriate control measures if indicated, including through legislation and regulations for tobacco control -
PHYSICAL INACTIVITY
Raise public awareness of physical inactivity through mass media public spaces and other programmes -
Develop population-based, age-specific guidelines on physical activity. -
Advocate for the design of public spaces that are supportive of physical activity. -
UNHEALTHY DIET
Reduce salt intake and salt content of food -
Replace trans fats with unsaturated fat -
Raise public awareness of unhealthy diet through mass media and other programmes -
Place taxes on sugar sweetened beverages -
Implement nutritional labelling policies which promote consumption of healthier foods and beverages -
Develop and implement school policies which restrict the availability of unhealthy foods and beverages within schools and their surroundings -
HARMFUL USE OF ALCOHOL
Raise excise taxes on alcoholic beverages -
Regulate commercial and public availability of alcohol -
Enforce restrictions or bans on alcohol promotion and advertising -
Collaborate with NGOs and Ministry of Transport to educate the public on the harmful use of alcohol -
Advocate for the introduction of breathalyser testing -
AIR POLLUTION
Improve housing conditions and ensure access to clean energy sources for indoor cooking, heating and lighting -
Create awareness and develop appropriate strategies to reduce exposure to second-hand tobacco smoke in households -
Phase out health-harmful subsidies for fossil fuels and polluting industries and introduce penalties for polluters and/or taxes on pollution -
Include air quality measures in urban, rural and transport planning at city, regional and national level, including measures to encourage modal shift and active mobility, noting the additional benefits to health, wellbeing, and reduction of health inequalities -
Adopt and strictly enforce emissions standards for all pollutants in all relevant sectors, including industry, energy, transport, waste, and agricultures -
Guyana National NCD Commission Study Tour to Barbados

In June 2018, with the support of the Guyana PAHO Country Office, the HCC hosted members of the Guyana National NCD Commission for a 2 day Study Tour aimed at learning more about the experiences of the Barbados National NCD Commission. The Guyana team consisted of: Dr. Shamdeo Persaud (CMO Ministry of Health Guyana), Dr. Kavita Singh (NCD focal point Guyana MOH); Delicia Haynes; and Dr. Karen Roberts (Specialist, Non-Communicable Diseases and Family Health, PAHO).

This is part of HCC’s larger effort to support the strengthening of the multisectoral response to NCDs in the region through support to these multisectoral platforms mandated through the 2007 Port of Spain Declaration. Both the St. Lucia and the Grenada NCD Commissions have undertaken similar exchanges to visit the Barbados National NCD Commission which has been chaired by Sir Trevor Hassell since its formation in 2007, and in this time has held 100+ meetings and enjoyed uninterrupted tenure.

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Guyana National NCD Commission Study Tour to Barbados

The Guyana team in a meeting with the Barbados National NCD Commission commissioners: David Neilands, Prof. Alafia Samuels and Gabby ‘Orlando’ Scott

Barbados National NCD Commission Hosts the National Chronic Non-Communicable Disease Commission of Grenada

The HCC and partners have been continuing their work in the region aimed at supporting the multisectoral response through the strengthening National NCD Commissions (NNCDCs) or their equivalents.  On January 11-12, 2018 Dr. Damian Greaves, Chair Grenada NNCDC and Dr. Sonia Nixon, Senior Medical Officer of Health for NCDs, Grenada and past interim NNCDC chair, visited Barbados for a 2 day site visit/observership with the Barbados National NCD Commission.

‘This session for us over the last 2 days has been totally engaging and eye opening. I am leaving very ‘buoyed up’ and highly motivated.’ Dr. Damian Greaves, Chair  of the Grenada NNCDC.

‘I am very grateful to HCC and the Barbados NNCDC.  This experience can only enhance the forward movement of the commission.’ Dr. Sonia Nixon, Senior Medical Officer of Health for NCDs.

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The Grenada NNCDC team

The Grenada NNCDC team meets with members of the Barbados NNCDC, including Denise Carter Taylor, Dr Arthur Phillips, Sheena Edwards and Donna Carter, whilst participating in the PAHO NCD update webinar, led by Dr Tomo Kanda, mental health and NCD advisor

Barbados National NCD Commission Hosts the St. Lucia National NCD Commission

On August 17-18, 2017, Ms. Lydia Atkins, Alternate NCD Focal Point for the St. Lucia Ministry of Health and Wellness and a member of the recently formed St. Lucia NCD Commission, and Dr. Owen Gabriel, Consultant Oncologist, and Chair of the St. Lucia NNCDC, visited Barbados to meet with the Barbados NNCDC. The St. Lucia NNCDC was initially established in 2013 and went into dormancy after serving a two-year term. In 2017 it was re-established with a new Chair and new membership and the mandate to enhance visibility of the National NCD Agenda in an effort to mobilise and strengthen public, private and civil society partnerships for reducing the NCD burden at the national level. The Commission has been given an agenda of accelerated NCD action that will place St. Lucia on a trajectory to bring the country closer to achieving the 2025 global NCD targets and the health related targets within the 2030 Agenda. To achieve these targets there is a need to ensure that the Commission is adequately equipped to advance the work on NCDs.

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St. Lucia National NCD Commission visit to HCC

Ms. Lydia Atkins, Alternate NCD Focal Point for the St. Lucia Ministry of Health and member of the St. Lucia National NCD Commission, Professor Sir Trevor Hassell President HCC, Dr. Owen Gabriel, Consultant Oncologist, and Chair of the St. Lucia National NCD Commission and Maisha Hutton, Executive Director HCC