CARPHA serves 26 Member States (MS), with a total population of approximately 17 million. The region is undergoing a demographic shift, with an aging population and decrease in the average rate of population change (Graph 1).
An epidemiological shift has also been occurring, as non-communicable diseases (NCDs) have surpassed communicable diseases (CDs) to become the leading causes of mortality (Graph 2). Cardiovascular diseases, diabetes and malignant neoplasms are currently the top three causes of death. As chronic conditions, they are burdens on the economy, and have a serious impact on both the wellness and life expectancy of people. A key factor in NCD morality is the worsening obesity epidemic (Graph 3), propagated by low levels of physical activity and the high consumption of energy dense, sugar-rich food.
Violence and injury is a further significant cause of mortality in the Caribbean. The potential years of life lost as a result, is estimated to be higher than that of CDs. For example, violence and injury were responsible for 10% of deaths in Trinidad, of which 5% was due to interpersonal violence in 2016. Road traffic incidents also remain the leading cause of death in 5-16 year olds.
In terms of CDs, while the proportion of deaths they account for has been reduced, they still remain a source of concern and pose an epidemic potential. The conditions of the Caribbean region, namely the warm climate, large degree of travel, and abundance of mosquitoes, make it suitable for a vector-borne disease outbreak. Surveillance, and programs such as those tackling mosquito breeding, are necessary to prevent epidemics of Dengue and Malaria. The situation with food-borne diseases is similar: food and safety standards from farm to table and ongoing surveillance can help prevent outbreaks of norovirus and salmonella in their inception.
Tuberculosis remains an issue, with 6 MS considered mid or high-incidence countries (Graph 4). Issues contributing to the propagation include lack of detection and the spread of multidrug resistance due to unregulated healthcare. Finally, in regard to HIV/AIDS, the situation has improved remarkably since the early 2000’s (Graph 5), with UNAIDS estimating that the number of HIV related deaths fell by 28% in the Caribbean region between 2000 and 2016. However, the Caribbean region also has the second highest prevalence of HIV in the world. It is estimated that in 2016, 2% of the population in the Bahamas is living with HIV, and the topic remains engulfed in stigma.