The Government of Barbados, the World Health Organization (WHO) and the Pan American Health Organization are holding a high-level technical meeting on noncommunicable diseases (NCDs) and mental health with Small Island Developing States (SIDS). The discussion focusses on progress, challenges, and opportunities to scale up multi-sector actions on NCDs and mental health and to set out recommendations to scale up actions that save and improve lives.

For this occasion, WHO has released a data portal on NCDs in SIDS highlighting some of the highest prevalence rates of NCD and mental health risks in the world. The data shows that over half of people in SIDS are dying prematurely from NCDs and the rate of hypertension is over 30% in almost all of the countries.

Ten of the countries with the highest rates of obesity worldwide are small island states. The highest prevalence of diabetes among adults in the world is also projected to be in SIDS. Rates of mental health conditions reach as high as 15% in the Caribbean and the Pacific.

“Countries are facing multiple overlapping crises. The climate crisis and the COVID-19 pandemic, combined with poverty, unemployment, inequality and the marginalization of minority communities are fuelling an increase in noncommunicable diseases and mental health conditions,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “To address these challenges, we need to hear from affected communities about the challenges they face and the solutions that work in diverse settings. We look forward to working with SIDS to achieve ambitious outcomes on NCDs and mental health.” 

SIDS countries are disproportionately exposed to the impact of the climate crisis on both physical and mental health. The high prevalence of risk factors for NCDs such as tobacco use, low physical activity, unhealthy diet and obesity, coupled with weak integration of NCDs and mental health services in Primary Health Care (PHC) and Universal Health Coverage (UHC), left populations vulnerable to becoming severely ill with COVID-19. This placed further pressure on already strained health systems. Progress and investment in NCD prevention and control, as well as mental health promotion and care, remain inadequate.

“SIDS have a history of dealing with outsized challenges, shaping solutions and influencing the world agenda to advance development,” said the Minister of Health and Wellness of Barbados, the Honourable Dr Jerome Walcott. “We have identified the issues and drivers, while committing to action, mobilizing resources, and collaborating with non-traditional partners. We must critically examine the initiatives that address NCDs and that have the potential to positively impact and improve the health and well-being of our citizens.”

At the high-level meeting, countries have identified key recommendations to scale up action on NCDs and mental health to achieve the SDG target of a one third reduction in premature mortality from NCDs and suicide before 2030.

The recommendations include concrete actions to accelerate collaboration for the early detection, prevention and management of NCDs and mental health conditions across SIDS; strengthening health systems in the face of the climate crisis and the COVID-19 pandemic; promoting health and preventing NCDs with a focus on tackling obesity; providing adequate, sustainable resources (financial and human) for NCDs and mental health; and strengthening information systems for health. These recommendations will also inform the outcome document to the Ministerial Meeting in June 2023. 

The meeting also heard that SIDS are at the forefront of rolling out low-cost, high-impact solutions to reduce the mostcommon risk factors of NCDs and mental health. Examples of successful prevention and treatment interventions in SIDS countries include the use of health taxation; including health into climate change adaptation and mitigation efforts; campaigns on physical and mental health and wellbeing; expanding treatment coverage for NCD and mental health as a part of the national UHC effort; and maintaining NCD and mental health services during health emergencies.

The meeting also provided a platform to address commercial drivers of NCDs. Trade agreements and policies, through their influences on price, availability and promotion of food products, cigarettes, and alcohol, have accelerated the transition away from traditional diets and nutrition. This process has contributed to the alarmingly high levels of obesity, food insecurity and NCDs in SIDS countries.

People living with NCDs and mental health conditions in several SIDS countries shared their experiences. Healthcare professionals, civil society representatives, academics and development partners also joined the meeting.

“Achieving UHC and building climate-resilient societies will be critical in tackling the risk factors of NCDs and mental health, as well as ensuring people living with these conditions can access the treatment and support they need,” said Dr Bente Mikkelsen. “Based on the outcomes of this meeting, the forthcoming Ministerial Meeting in June 2023 will set out an ambitious agenda to accelerate the capacity of SIDS countries to deliver life-saving NCD and mental health outcomes and to provide the global leadership for the NCDs and mental health agenda.”

This agenda will also inform and contribute to preparations for the High-Level Meeting of the UN General Assembly on UHC in 2023, the Fourth High-Level Meeting of the UN General Assembly on NCDs to be held in 2025 and future global health summits on mental health and climate change.