Africa: WHO Director-General’s Opening Remarks At the Small Island Developing States (Sids) Ministerial Conference On NCDs and Mental Health – 14 June 2023

Your Excellency Minister Jerome Walcott,

Honourable Minister Sonia Browne,

Honourable Ministers from Small Island Developing States far and near;

Professor Alafia Samuels;

My good friend George Alleyne;

My brother, PAHO Regional Director Dr Jarbas Barbosa;

Distinguished guests, dear colleagues, and friends,

I am honoured to welcome representatives from Small Island Developing States, along with associated Member States, people with lived experiences of health conditions, youth representatives, civil society groups, and other partners and supporters.

WHO and PAHO have come together with the Government of Barbados to convene SIDS and other stakeholders to help shape effective and equitable policies to address the pressing health challenges faced by island states.

Her Excellency Prime Minister Mia Mottley has been an unwavering advocate, both in her own country and globally, for taking a holistic approach to addressing non-communicable diseases and mental health.

Her vision and dedication make her a beacon of hope and progress.

The challenges facing SIDS in the areas of NCDs and mental health are pressing, with premature mortality and threats to livelihoods and wellbeing.

SIDS are disproportionately represented among the countries with the highest estimated risk of dying prematurely from cardiovascular diseases, diabetes, cancer, and chronic respiratory conditions.

Some SIDS have the highest rates of childhood and adult obesity worldwide, with commercial and trade-related forces shaping persistent bottlenecks to healthy diets.

Mental health conditions such as depression and anxiety, which were already highly prevalent in SIDS, continue to rise.

All of these are exacerbated by the climate crisis, which is an existential threat to health and development in SIDS.

SIDS represent 1% of the world’s population and economy and emit less than 1% of greenhouse gases, and yet they are disproportionately and severely affected by climate change and natural disasters.

We cannot afford to ignore the crippling impact of these colliding threats.

It is our moral imperative to act swiftly and decisively, to forge a path forward based on equity, resilience, and sustainability.

SIDS have long been a global leader in NCDs and mental health. This SIDS Conference will help to shape the 4th UN high level meeting on NCDs in 2025.

To support this process, Barbados and WHO convened the collective voices of SIDS in January this year for the SIDS high-level Technical Meeting on NCDs and mental health.

This led to SIDS-specific recommendations on how to address NCDs and mental health conditions as an integral part of climate change resiliency and pandemic preparedness and response.

Let me briefly cite some examples of the progress SIDS have committed to making in the next few years.

Belize, to launching a National Nutrition Policy;

Cabo Verde, to ensuring that 90% of primary health care facilities have trained health professionals in mental health and substance abuse;

Mauritius, to prescribing physical activity for patients with chronic illnesses;

The Cook Islands, to implementing tobacco control actions;

Saint Vincent and the Grenadines, to adopting evidence-based guidelines for the management of hypertension;

Kiribati, to setting up a system for NCD surveillance and monitoring of NCD cases;

Timor-Leste, to putting 50,000 people with hypertension and diabetes on standard care;

Montserrat, to implementing the Strategy for Mental Health to reduce stigma and discrimination and increase access to mental health services;

Grenada, Dominica, and St Kitts and Nevis are working on tobacco control legislation, and seventeen countries have adopted the HEARTS package.

As you can see, there are already many reasons to be encouraged.

Tomorrow, Ministers will meet to launch the 2023 Bridgetown Declaration on NCDs and Mental Health.

This landmark statement will showcase the feasibility of SIDS-specific actions, evidence-based commitments and accountability mechanisms to overcome the multifaceted challenges that island nations face.

I want to personally recognize the vision and commitment from the two Co-chairs of the process, His Excellency Ambassador Matthew Wilson of Barbados and His Excellency Ambassador Luke Daunivalu of Fiji.

And as Her Excellency Prime Minister Mottley pointed out so eloquently yesterday, medical interventions alone are not enough. We cannot tackle NCDs without a clear understanding of people’s health-related behaviours.

She said all that policy makers, politicians, clinicians are doing are necessary but insufficient without the wider behaviour change in communities and individuals. And she’s right.

That is why I am so pleased that at this year’s World Health Assembly, countries adopted a resolution on Behavioural Science for Better Health, committing to use behavioural science to refine health interventions, increase equity, and put communities at the centre of their work.

In closing, let me highlight three priority areas for action:

First, we must strengthen health systems, enhance promotion, prevention and early detection measures, and prioritize the integration of NCD and mental health services into primary health care.

Second, countries must make use of WHO’s best buys, a set of cost-effective interventions to prevent and manage NCDs.