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Commonwealth Health Ministers Meet To Strategise Universal Health Coverage

The Commonwealth Health Ministers Meeting (CHMM) is the annual meeting of health ministers from across the (British) Commonwealth countries. The meeting reviews activity and events from the previous year and provides a platform for countries to bring issues of health relevance to the attention of their Commonwealth partners and peers. Each CHMM provides a ministerial statement summarising the discussion and priorities for the coming year including setting the theme for the next meeting.

The Commonwealth is committed to actively pursuing the attainment of health-related UN Sustainable Development Goals 2030. These reflect and affirm the Commonwealth Charter values and principles of promoting access to affordable health and removing wide disparities and unequal living standards as guided by internationally-agreed development goals. This includes accelerating universal health coverage (UHC), strengthening health systems and addressing communicable and non-communicable diseases (NCDs), as a means of securing a more sustainable future for Commonwealth citizens.  Key issues to be discussed at the meeting on Sunday include: mental health, violence and sexual and reproductive health, UHC for women and girls, building resilience to communicable diseases and climate change, and strategies to finance UHC such as national health insurance systems.

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PAHO: Nurses Critical for Making Universal Health a Success

The migration of nurses originating from the Caribbean to more lucrative opportunities in North America and other destinations has long been a chronic problem for governments in the region and now the Pan American Health Organisation (PAHO)  has released a new report with guidelines which advises countries to invest in nurses specifically to improve their availability, distribution and roles in order to advance universal health for all.

Nurses represent the largest health workforce, accounting for more than 50% of health workers. Despite this, however, the lack of nurses in most countries in the region compromises the global goal of achieving health for all by 2030.   The report noted that there is a current deficit of 800,000 health workers in the region, including nursing staff.   Contributing to this crisis include migration, poor distribution, lack of regulation, insufficient incentives and professional advancement, lack of higher education, and inadequate working environments all exacerbate the problems related to the deficit of health human resources in the region.

The report recommends the expansion of  the role of licensed nurses in the first level of care to improve access and care in areas with a limited number of physicians. The report also advocates for the better distribution of personnel in remote and rural areas; an increase in incentives for interprofessional practice, and an increase in the number of accredited training programs, particularly given that in most countries, there are few nursing schools and graduate programs.  [Read more…]

Jamaica Moves Closer to Providing Universal Health Coverage

The government of Jamaica took another step closer to providing universal health coverage to the population by the next fiscal year by unveiling a green paper on the proposal for a National Health Insurance Plan (NHIP). The Minister of Health, Dr. Christopher Tufton, made the announcement to the House of Representatives saying that feedback will be done on a national basis involving key stakeholders including the insurance industry and medical fraternities and others. In 2018, it was estimated that only 20 percent of the population had health insurance through their employers and the remaining 80 percent of Jamaicans were without health insurance.

Financing for the initiative would be sourced from a combination of employee contributions or premiums and industry taxes. Among the revenue sources the Ministry of Health has proposed are taxes on sugar and cannabis, raising billions to supplement healthcare costs. An excise tax focusing on cancer caused by tobacco and alcohol and a gaming and lottery levy supporting programmes for mental illness and substance abuse are also on the cards.

The Executive Director of the Caribbean Policy Research Institute (CAPRI) Dr Damien King contends that it is “feasible for Jamaica to have a national health insurance scheme given the emerging public health crisis on the horizon precipitated by the high level of chronic diseases affecting the population.”  Echoing this potential public health crisis was Chris Zacca, president of Sagicor, a major player in the local insurance sector, said that his company’s actuaries have warned that the cost for healthcare in the near future “is going to overwhelm the country if something is not done”.

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Taiwan Universal Health Coverage – A Role Model For the Caribbean

The entire Caribbean region is in the process of developing some form of universal health insurance for its citizens within the next ten years.  Caribbean nations include: Antigua, Aruba, Bahamas, Barbados, Bermuda, Bonaire, Cayman, Grenada , Jamaica, St. Lucia and Trinidad & Tobago just to name a few.

However, Taiwan has frequently been the model that many countries have looked up to as a successful role model for developing  universal coverage for its citizens. Taiwan launched the National Health Insurance (NHI) initiative in 1995 by integrating medical programs from existing insurance systems for laborers, farmers, and government employees, which covered only half the population. This has since been expanded to provide equal coverage to all citizens from birth, regardless of age, financial status or employment status. Furthermore, all foreigners who legally work or reside in Taiwan are also afforded the same coverage. Oddly enough for whatever reason Taiwan is currently not a member of the World Health Organisation despite having ranked very high in the world for giving its citizens access to high quality affordable healthcare.

Keys to Taiwan’s success included, the adoption of a single-payer model with contributions from individuals, employers and the government. A supplementary premium is also charged based on payers’ income levels. Second, to control medical expenses, a budget payment system was adopted to set caps on health care costs paid by the government. It is hoped that the consultants and other experts that Caribbean governments have retained to assist will take note of Taiwan’s experience and therefore not reinvent the wheel.   [Read more…]

Mercury Pollution and the Impact on Health in the Caribbean

According to the World Health Organization, mercury exists in various forms: elemental (or metallic) and inorganic (to which people may be exposed through their occupation); and organic (e.g., methylmercury, to which people may be exposed through their diet). These forms of mercury differ in their degree of toxicity and in their effects on the nervous, digestive and immune systems, and on lungs, kidneys, skin and eyes. People may be exposed to mercury in any of its forms under different circumstances. However, exposure mainly occurs through consumption of fish and shellfish contaminated with methylmercury and through worker inhalation of elemental mercury vapours during industrial processes. Cooking does not eliminate mercury.

In the Caribbean, people are exposed to mercury primarily through:

  • Consumption of seafood and shellfish,
  • Dental amalgams
  • Cosmetic and pharmaceutical products
  • Industrial sources, like aluminum refining in Jamaica.

The continued release of mercury into the environment from human activity, the presence of mercury in the food chain, and the demonstrated adverse effects on humans are of such concern that in 2013 governments agreed to the Minamata Convention on Mercury. The Convention obliges participating governments  to take a range of actions, including reduction of mercury emissions to air and to phase-out certain mercury-containing products.  Both Jamaica and St. Kitts and Nevis became parties to the Convention in 2017.

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