PORT OF SPAIN, Trinidad, Mar 20 – The Second International Conference on Non-Communicable Diseases (NCDs) of Children and Adolescents began here Wednesday amid concerns for the wellbeing of the future generations in the Caribbean.
Trinidad and Tobago’s Health Minister Dr. Fuad Khan told his global audience that the issue of non-communicable diseases and its tragic consequences on society had become a matter of great importance.
Chancellor of the University of the West Indies, (UWI), Sir George Alleyne, said that the most important task ahead is to continue to elevate concerns for NCDs in the youth to the highest political levels and press for the application of the technical tools to give concrete expression to the political statements.
“And there must be concerted effort to ensure that the political and the technical are underpinned by an adequate social enterprise,” said Sir George, who is also Director Emeritus of the Pan American Health Organization (PAHO).
He said the nature and size of the problem in terms of morbidity and mortality in the group of interest that needs to be addressed “is almost a matter of vulgar record and is now impatient of any serious debate”.
But the prominent Caribbean health expert said it may not be enough for the voices to speak to the bald data on mortality and morbidity.
“ I believe that not enough importance in advocacy terms has been attached to the social and human aspects of NCDs in children-the consequences of diabetes on schooling, the social isolation and discrimination against the obese child and the ineffable tragedy of childhood cancer- a tragedy made starker by the inequities in terms of access to adequate treatment and palliative care when it is needed.
“Society tends to block out the images of the wheezing child who is prevented from taking part in the sports the young enjoy because of asthma.”
Sir George said that the declaration that came from the “NCD Child Oakland Conference” two years ago” is pellucidly clear as to the urgent concerns that needed to be dealt with.
He said one of the declaration had noted that children and adolescents often have no political voice and minimal influence in shaping health policies and programmes, especially as they relate to NCDs.
“NCD Child must continue to facilitate those voices being heard, act as a mouthpiece for them, but also use the institutional muscle that it possesses in their service,” he told the audience.
The two-day conference which is being held under the theme “Doing what needs to be done to fight chronic diseases in children” is being organised by the Geneva-based NCD Alliance in collaboration with the Trinidad and Tobago government.
There will be a number of presentations and discussions ranging from “Chronic non-communicable diseases in a group of primary school children in Barbados” to Australia’s commitment to legislation and action to protect young people from NCDs”. One of the highights of the two-day conference is the launch of the report entitled “Responses to NCDs in the Caribbean Community”.
In his address, Dr. Khan said the Global Health School survey completed in 2011 had shown that 30 per cent of teenagers between the ages of 13 and 15 were overweight, and that 17 [er cent of schoolchildren in Trinidad and Tobago are overweight, 15 per cent obese and more than 40 per cent have at least one risk factor for developing diabetes.
He said the results also showed that 45 per cent of students between the ages 13-15 had an alcoholic drink in the month preceding the survey with 80 per cent of them admitting to having the first alcoholic drink before the age of 14 years.
In addition 70 per cent of students drank one or more carbonated soft drinks daily, with Dr. Khan saying “this is dangerous as excessive amounts of sugar as empty calories are taken in the form of liquid that are not offset by a reduction of calories taken in as food.
“More importantly, not all calories are equal. Soft drinks and snacks that are processed and convenient tend to be high in sugars, including fructose, which have been described by some experts as poison with addictive qualities that is strongly associated with the development of obesity”.
The survey had also showed that 10 per cent of children had smoked and that 50 per cent reported that adults had smoked also in the presence.
Dr. Khan said despite efforts by health authorities and the governments to deal with the problems, there was also need for parents to play a significant role in the health of their children.
“It has been shown that the dietary habits of children are formed before the age of five. After 11 years old, it becomes hard for them to change their habits. So the onus is on us as parents and guardians to inculcate healthy lifestyle habits in our children from an early age.
“It is clear that addressing prevention and management of NCD children is paramount to securing the health and wellbeing of our future generations,” Khan said, noting that 40 years ago, a pioneer of medicine in Trinidad had warned that diabetes would be a problem and that 40 per cent of affected people were undiagnosed.
“At this time, diabetes was rare in those younger than 20 years old, but this trend has changed markedly in the past decade. These warnings have come to pass in Trinidad and Tobago with a diabetes prevalence of more than 12 per cent in those under 20 and growing numbers of young people being diagnosed with Type 2 diabetes and pre-diabetes”.
Sir George said that since the NCD Oakland Conference he had become more convinced that NCD Child and its partners have a powerful lever with which they can maintain the momentum to have policy makers deal adequately with the situation.
He said the right to health of children is enshrined in the Convention of the Rights of the Child which to date has 140 signatories including all Caribbean Community (CARICOM) countries. “Although I have conceptual difficulties with the strict interpretation of the right to health and prefer the notion of the rights to the measures needed to ensure health, I embrace Article 24 of the Convention which is a comprehensive statement of what the states parties have agreed as far as the health of children is concerned.”
Sir George said the Convention itself refers broadly to the need to combat disease and malnutrition, but last year the influential Committee on the Rights of the Child which publishes its interpretation of the content of human rights provisions, issued one on the Right to Health.
He said it made specific reference to the changing health priorities which had to be considered as part of the rights agenda and included NCDs to be addressed through a combination of biomedical, behavioral and structural interventions.
“The Comment went on to indicate that “preventing NCDs should start early in life through the promotion and support of healthy and non-violent lifestyles or pregnant women, their spouses/partners and young children”. Thus the Committee firmly embraced the life course approach to dealing with NCDs.”
Sir George said that the concern for NCDs in the young must also turn around the economics of the problem, “the catastrophic spending occasioned by the cost of lifelong treatment.
“But strangely enough, it is difficult to find good data on the economics of NCDs in children. There are data on the economic losses when adults die in their productive years but children are not often included in these calculations,” he said.
He told the audience that there are calculations on the extent to which NCDs can plunge a family into poverty, but this is usually related to adults and not the cost for children.
“However we do know a bit about one disease, as it is shown that the cost of treating a child with diabetes may be multiple times the cost of caring for a healthy child.”