Why James Hospedales, the Chair of the Defeat-NCD Partnership, is passionate about NCDs

I am the Executive Director of the Caribbean Public Health Agency and I have the privilege to be the Chair of the Governing Board of the Defeat-NCD Partnership.

Let me tell you a little bit about myself, why I’m in this position, and allow me to share a few details about the Partnership’s recent visit to Haiti with Dr Mukesh Kapila, the Chief Executive.

In 1988 I had a real wakeup call when some of the most important men in my life – one being my boss, my step-father, my uncle – all died from some form of NCD. At that time they were all between 50 and 55 years of age. For me, this was a call telling me to be much more attentive to my lifestyle moving forward. Dr Kapila reminds me that when we were trainees in Cambridge together, a long time ago, I used to go on talking about NCDs. And that would have been around 1988 when I had that shock in my life.

I served as one of the Commissioners for the Caribbean Commission on Health and Development (CCHD) and have done since 2002. With the CCHD, we reported to the heads of governments of this region. At that time, we told them that there were three super-priorities in health: one was non-communicable diseases; the other was HIV/AIDS, which has been more widely addressed; and the last was the health effects of violence and injuries. Fast-forward to 2006/2007, where I was the head of the Pan American Health Organization (PAHO) programme for prevention and control of chronic non-communicable diseases, and there I helped to organise the summit of the Caribbean Community heads of government on non-communicable diseases. That was the first time heads of government anywhere in the world had met on that subject, hoping to secure global momentum and recognition of NCDs and the placement of non-communicable diseases as a target in the Sustainable Development Goals (SDGs) in the global framework.

I was very happy when Dr Kapila asked me to Chair the Governing Board. I really see that this Partnership is needed. When I dealt with NCDs at the Pan American Health Organization, I worked to set up a Pan American forum for action on NCDs. This forum was a big tent with governments, civil society and even companies that would come together to look at what the problem is and what can be done. That still exists, and I hope that the Defeat-NCD Partnership can build on the work that has already commenced.

The Defeat-NCD Partnership and I made a recent visit to Haiti, where we saw first hand the challenges of NCDs in very poor countries. Haiti is the poorest country in the Western Hemisphere. During our recent visit, we realised that there is a huge need for attention on non-communicable diseases. Perhaps two million people have hypertension. Half of them have not been diagnosed and are not on treatment, along with three hundred thousand people with diabetes, and people with cancer. The cost in terms of people’s lives – strokes, amputations, kidney failure, and premature loss of life – is huge. There is cost to government, cost to the families, but also cost to employers. We met with the Haitian Association of Industries and they acknowledged and understood that this was a severe issue. They even offered to create programmes of education and screening. This is an indication of the kind of partnership framework that is needed where private sector, government and people have to work together in new ways. Funding agencies are also needed. We absolutely need funding for this scale of problem, and we need new delivery models, so that we can care for NCD sufferers from hospitals and health centres, in the family home, and in their communities.

NCDs are a symptom of the failure of our development paradigm in this world. It took us time to get into this mess and it will take us time to get out of it, working together. The work of the Defeat-NCD Partnership is required to bring all the partners together under one big tent. All of the different actors need to be together at the country level, especially in the poorest countries where we see first hand how pressing this problem is. And how much carnage there is – that is not an exaggeration – it is preventable carnage. In the case of the Caribbean countries, we are able to do further studies that show the preventable impediments to economic growth, the level of NCDs we have, and the costs of this.

Because today, the cost is far too high.