EDITORIAL: Taking the lead in global health initiatives

JUST late last year, reports suggested that a pilot project started at two local polyclinics had been so successful, that the results informed a global health initiative.

A senior official of the United States Centres for Disease Control and Prevention (CDC) was quoted as saying that the pilot project, which was aimed at improving blood pressure control in primary health care, had been so successful that the results informed a global initiative to reduce ill health and premature death due to heart disease and stroke.

Deputy Chief of the Global Non-Communicable Disease branch of the CDC, Dr. Lorna English, reportedly said that based on the positive results from the Barbados pilot, the evidence-based tools and practices that were promoted and demonstrated by the project, had been integrated into technical packages of a programme called the ‘Global Hearts Initiative’. She added that the tools developed for the technical packages reflected lessons learned in Barbados and that key elements included standardised, evidence-based treatment protocols; team-based care; registries for patient monitoring; and evaluation.

It was noted that the Ministry of Health here collaborated with the CDC, the Pan American Health Organisation (PAHO), the University of the West Indies and the Healthy Caribbean Coalition to execute the Barbados Global Standardised Hypertension Treatment Project, at the Winston Scott and Edgar Cochrane Polyclinics.

This all proves that Barbados can be a leader when it comes to global health initiatives. A fact noted by that same senior CDC official, who with reference to the project remarked, “Barbados and the PAHO region are global leaders in moving this work forward.”

Now this particular project focused on hypertension, since it was described as the most common non-communicable disease (NCD) in Barbados, with more than 40 000 adults affected and of these, an average of between 18 000 and 20 000 attend polyclinics for management of the disease. The project, according to reports, also involved the use of quality hypertension pharmaceuticals, training of health care professionals in hypertension management, the integrated use of health information systems, clinical audits and “an empowered patient”.

We would however like to see additional projects that focus on other NCDs such as strokes, cardiovascular disease and diabetes. Indeed, we could see some positive changes in patients’ lives if we could use a similar model to address these other NCDs and who knows, perhaps regional and international countries will want to follow our lead as well.

It has long been said that our small country punches far above its weight, and it would be good to see us continually standing out as a global leader in the area of health care. We should also make greater use of the Barbados National Registry for Chronic Non-Communicable Disease (BNR), which is a national surveillance system being conducted by the Chronic Disease Research Centre on behalf of the Ministry of Health. The BNR is made up of three registries – BNR-Stroke, BNR-Heart and BNR-Cancer; and each registry collects data about new cases of cancer, stroke, and acute myocardial infarction (also known as a heart attack or cardiac arrest) and produces statistics concerning incidence, mortality and survival.

It is said that information from the BNR is used to inform public health policy and clinical practice and is an important resource for Caribbean researchers investigating the problems of chronic disease. Armed with such an informative tool, we can begin to take the whole business of Chronic Non-Communicable Diseases seriously, and take action to ensure that we do not add to the statistics collected, but better inform policies and programmes, locally and abroad.