Understanding the Situation

Regional health security describes the capacities required for CARPHA Member States to prepare for and respond to public health threats, issues and concerns that transcend national boundaries and potentially impact on economic and political stability, trade, tourism, and access to goods and services. Infectious diseases, whether they be endemic, emerging or re-emerging, naturally occurring or a manmade threat, continue to cause illness and death globally. In the Caribbean, infectious diseases such as human immunodeficiency virus, cholera, dengue fever, foodborne diseases, antimicrobial resistant organisms, severe acute respiratory syndrome (SARS), and the pandemic causing influenza A(H1N1)pdm09 virus, have all been major causes of epidemics, multiple local, regional and global outbreaks and severe diseases, at times leading to death. The epidemic of Zika (2016), Chikungunya (2014), the Hurricanes of 2017-18 and other threats show the need to have good systems of regional health security, especially given the region's tourism dependent economies. Communicable diseases are also linked to chronic diseases. Infectious agents can cause cancer and other long term debilitating illnesses. For example, following an acute episode of chikungunya a high percentage of patients can develop a chronic phase defined by persistent arthritis for months or even years. Therefore, in addition to imposing enormous financial burdens on societies and stretching local and regional health and public health systems in low and middle income countries, these and other public health threats have highlighted the importance of strong national public health systems that can contribute to health security in the region, and globally. Infectious diseases continue to present significant health, social, economic and development challenges.

Globally the revised International Health Regulations (IHR 2005) entered into force in 2007 and have been a key driver in international efforts to strengthen global health security. However, the success of the IHR (2005) relies upon the capacity and performance of national and regional public health systems to address public health threats before they become potential global health emergencies. In the Caribbean region, all CARPHA Member States (CMS) requested and received an extension for implementation of the IHR (2005) core capacities. While the region has made some progress, significant gaps remain and there is an urgent need to provide dedicated resources to effectively implement the IHR (2005) core capacities in order to overcome technical, financial, governance, legal, and political obstacles. There is also a need to facilitate greater communication, coordination and collaboration between health and non-health sectors, and between sub-national, national, regional and international public health authorities which is consistent with the Global Health Security Agenda.

Regional Health Security has also received the attention of the CARICOM Heads of Government at its 17th (2014) and 19th (2016) Special Meetings through its declared plans of action in relation to Ebola, Chikungunya and, more recently, Zika.

The Need for Regional Health Security

The Caribbean faces health threats which occur as a result of infectious disease outbreaks, natural disasters or man-made events. These are all potential threats to health security, and are amplified by the tourism-dependent nature of the region with over 45 million visitors annually, increasing the risk for importation, and export, of diseases of international concern. Whilst it is impossible to predict what, where, when and how a new threat to public health will appear, it is clear that emerging infectious diseases and public health emergencies will continue to occur.

Globalisation has served to change our world, it has also provided increased opportunities for the emergence and spread of infectious diseases. Factors contributing to disease emergence include: diversity and number of microorganisms; microbial adaptation and evolution; increased international travel and trade; population growth; rapid urbanisation; changes in human demographics and behaviour; climate change; degradation of ecosystems; breakdown of public health measures, and; deficiencies in public health infrastructure. Today’s infectious disease challenges are therefore more complex than previously encountered and require broad, sustained and coordinated efforts from multiple sectors, individuals, groups, public health agencies and other key stakeholders in order to accelerate progress towards regional and global health security.

Weak health systems in many countries in the Caribbean makes responding effectively to the challenges posed difficult. Despite the middle income country status of the majority of CARPHA Member States, the public health systems are characterised by a: shortage of human resources: deficient information systems; under-resourced laboratories; weak institutional and organizational capacity; inadequate health technologies, and; insufficient financial resources for IHR (2005) core capacities implementation. In addition there is lack of real-time surveillance and epidemiological systems, as well as ineffective and fragmented communications networks, and inconsistent collaboration with non-health actors. All of these have a negative impact on the performance of health systems and make the region vulnerable to infectious disease threats, and threaten regional and global health security.

A number of initiatives have been established to strengthen and build Regional Health Security. These include the formation of the Regional Coordinating Mechanism on Health Security (RCMHS), chaired by CARPHA, and the development of the Caribbean Region Global Health Security Agenda Roadmap 2017-2021 in a participatory manner.

Members of the RCMHS at meeting held in May 2017

Where will your money go:

Funds donated to the CARPHA Foundation, will assist in the implementation of the Global Health Security Agenda Roadmap and the functioning of the RCMHS.