RESUMEN
Barbados, like its Caribbean neighbours, has high death rates from chronic non-communicable diseases (NCDs), and corresponding high rates of NCD risk factors unhealthy diets, physical inactivity, alcohol abuse and tobacco use. In 2007, the Heads of Government of the Caribbean Community (CARICOM) held a summit of leaders of Government on NCDs, the i rst anywhere in the world, and issued the historic Declaration of Port of Spain (POS) "Uniting to Stop the Epidemic of Chronic Non-Communicable Diseases". h rough CARICOM advocacy, this approach was adopted globally, resulting in the United Nations High Level Meeting (UNHLM) on NCDs in September 2011 and the WHO NCD Plan, targets and indicators adopted in May 2013. Barbados has the most developed NCD response in the Caribbean, facilitated by political will and ef ective leadership, and steady progress has been made over the past i ve years. h is country has already adopted several of the NCD approaches recommended by the World Health Organization NCD plan: for example, the policy of access to health care as a fundamental human right and universal health coverage for Barbadian citizens and permanent residents have been largely achieved. h e National NCD Commission leads and coordinates the NCD response and continues to be ef ective despite economic constraints. To date, the national response to NCDs has been commendable, with political and i nancial support from the Government, support from health non-governmental organizations (NGOs) and some support from the private sector, especially the media. In the health sector, surveillance through surveys and the Barbados National Registry have been notable, and the Barbados Drug Service continues to provide high quality pharmaceuticals for all Barbadians. Legislation has made Barbados "smoke-free" and tobacco taxes have been increased, which reduce tobacco consumption, ill health and deaths. Anecdotal evidence suggests that more persons are exercising. However, gaps remain, particularly with respect to reporting on morbidity and mortality, adoption of a comprehensive health information system and less than adequate utilization of quality of care guidelines and audits. Alcohol focussed control measures need strengthening and ef orts to engage children in control and prevention activities need improvement. h is plan is the successor to the NCD Commission Plan 2009-2012, and it recognizes the vital role of other Ministries of Government, civil society and the private sector to reduce the risk factors for NCDs, since most of these risk factors lie outside of the reach of the Ministry of Health. It is therefore proposed to develop a National NCD Plan in the future, with full partnership and input from all-of-Government and all-of-society to guide us towards "health in all policies". h e Strategic Plan and log frame have four areas Strengthening Strategic Management, Surveillance and Research, Risk Factor Reduction and Integrated Disease Management including Patient Education. Health promotion is the strategy used for all areas of the plan and is integrated throughout. h e plan includes targets from the POS Declaration and the United Nations High level Meeting on NCDs September 2011.
