|Status as at October 2017||Active|
|Name||National Commission on CNCDs|
|Status as at December 2016||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||Sir Trevor Hassell|
|Title||Professor of Medicine|
|Organisational affiliation||President, Heart & Stroke Foundation of Barbados|
|Duration of tenure||9 years, to date|
|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|
|Are there recommended profiles or desired characteristics for Commission Chair and Commissioners?||No|
|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|
|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|
|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|
|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|
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.
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.
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.
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.