11^th PAHO/Caribbean Awards for Excellence in Health Journalism

Feature Address

by Dr. Mirta Roses Periago - Director, PAHO

Dr. Mirta Roses Periago - Director,PAHO

The Millennium Goals and the Role of Caribbean Journalists

Acknowledgements:

I am delighted to be here in Barbados to be part of this ceremony to present the PAHO/Caribbean Awards for Excellence in Health Journalism. This is truly an evening of celebration - a celebration of the contribution Caribbean media workers are making and have made as advocates for health, consistent with our development goals.

This is also a special opportunity for me, personally.

For while I've been involved in PAHO’s work for nearly two decades, including a period at the Caribbean Epidemiology Centre in Trinidad and Tobago, I appreciate the chance to experience our Organization’s work in the field generally, and the English-speaking Caribbean particularly. And so it is a real pleasure to be here and to see a number of familiar faces, several of whom go back to my days at CAREC.  This visit, which closely follows one to Jamaica some three weeks ago, provides just that interaction in the field; interactions which allow me to better respond to the needs of this region, as a good Director should.

It also affords me the opportunity to participate in this special occasion – the PAHO/Caribbean 11^th Media awards. I wish to congratulate all tonight winners. I am very pleased to see the strong interest and enthusiasm generated by this annual activity. I especially want to thank the judges, and the various committees who administer the competition in each country; the two corporate sponsors, BWIA and Sagicor; also our colleagues at UNDP and UNICEF for partnering with PAHO to make this initiative possible and helping to sustain it over these 11 years.

I also want to say a big thanks to all of you for the wonderful program of celebration mounted in all your countries throughout last year in commemoration of our 100th milestone. As I like to say, a hundredth birthday doesn't come around every day, so it was a significant event for us. Although I understand that in this region PAHO is much younger than many of your senior citizens. Also in comparison to Bridgetown, which I understand is now 375 years old, PAHO is still a mere toddler. However, that having been said, ours is a history of which we in our organization were all proud to celebrate and were grateful that you chose to celebrate with us.

In this regard I am pleased to finally have the opportunity to see Mr. Bumba Payne in live and living color and to thank him for his contribution to our centennial activities last year. His photograph appeared in several publications which featured some of our centennial activities in Barbados, so it is good that I have this opportunity to meet and thank him in person for his contribution to our celebrations last year; also for entertaining us so magnificently tonight.

Tonight I want to use this forum to talk about a subject to which our Organization is deeply committed. That is the Millennium Development Goals, and to explore some of the ways in which Caribbean journalists can be involved in promoting these targets as a road map to the development of the countries of this region.

One of my early commitments as Director of PAHO, is to continue to promote the role and contribution of health in development and focus the attention of the Hemisphere on the MDGs, which highlight the contribution of health.

Accepted by member states of the United Nations in 2000, the eight Millennium Development Goals and targets are seen as a framework for measuring development progress. The eight are:

• Eradicate extreme poverty and hunger
• Achieve universal primary education
• Promote gender equality and empower w
• Reduce child mortality
• Improve maternal health
• Combat HIV/AIDS, malaria, and other diseases
• Ensure environmental sustainability
• Develop a global partnership for development

Four of these goals are directly related to health and there is a health dimension to all the others. The first seven are mutually reinforcing and are directed at reducing poverty in all its forms. The last goal, concerning a global partnership for development, is about the means to achieve the first seven.

The importance of the MDGs in health is, in one sense, self-evident.  Improving the health and quality of life of the poor is an end in itself, a fundamental goal of economic development. But it is also a means to achieving the other development goals relating to poverty reduction. The linkages of health to poverty reduction and to long-term economic growth are powerful, much stronger than is generally understood. The level of education, the quality of water, availability of housing and access to appropriate services, all have an impact on the health status of both individuals and the community. The poor and disadvantaged members of society, usually have less access to good education, housing, potable water etc, resulting in a less than favorable health status. Therefore, directly or indirectly the MDGs refer to the area of health or to determinants closely related to health and are convergent for the most part with the public health mandates of PAHO/WHO.

Health Goals and Targets

In addressing you this evening, I will focus my attention on the Goals which more directly relate to heath, Reduction in child mortality; improvement in maternal health; combating HIV/AID, malaria and other diseases and ensuring environmental protection.

The Caribbean has achieved considerable progress towards these indicators yet there are differences within and between countries. Undoubtedly, this region has led the way in several respects in terms of your achievements in health. Of immense significance are the strides you made through an aggressive immunization program which saw early success in the eradication of polio and now the virtual elimination of measles. Other successes include a reduction in the number of underweight children; infant, child and maternal mortality; increased numbers of births delivered by skilled personnel; and improved water source and sanitation, increasingly available essential drugs.

However, there are still significant health concerns. This Region is now one of the most affected by the HIV/AIDS pandemic.  There is also a resurgence of tuberculosis and a rise in obesity,  and the non communicable diseases, such as diabetes and hypertension.

Reduce Child Mortality

There is evidence that your countries are undergoing a demographic transition evidenced by a rise in life expectancy and a fall in infant mortality.

Life expectancy at birth for 1996-2002 is 73 years, an increase from 68.1 years for 1980-1985.

Infant Mortality rates (per 1000 live births) declined from 36.9 (1980-85) to 25.3 (1995-00).

The main causes of infant deaths are conditions originating in the perinatal period, that is the periods covering gestation, birth, and the first weeks of life. This accounts for 38% (198,500) of all under five deaths in the late 20^th century in Latin America and the Caribbean.

Available information shows that child health has improved in recent years throughout the Caribbean. Data from CAREC indicate that between 1980 and 1995, communicable disease mortality rates in children aged 1-14 years declined by 67% as a result of interventions such as preventive immunisations, and provision of safe, potable water.

Improve Maternal Health

Worldwide, more than 50 million women suffer from poor reproductive health and serious pregnancy-related illness and disability. And every year more than 500,000 women die from complications of pregnancy and childbirth.

High maternal mortality rates in many countries are the result of inadequate reproductive health care for women and inadequately spaced births. These are often cured by serious neglect of women’s reproductive health, particularly for the poorest women, as well as ineffective interventions.

Combat HIV/AIDS, Malaria, and Other Diseases:

HIV/AIDS, tuberculosis, and malaria are among the world’s biggest killers, and all have their greatest impact on poor countries and poor people. These diseases interact in ways that make their combined impact worse. Effective prevention and treatment programs will save lives, reduce poverty, and help economies develop.

Estimates suggest that tuberculosis costs the average patient three or four months of lost earnings, which can represent up to 30 percent of annual household income.

Although mortality due to communicable diseases has declined, tuberculosis cases increased to 949 in 2000 (from 882 in 1980)  due to a combination of factors such as poverty, malnutrition, diminished control efforts, the HIV/AIDS epidemic and the emergence of multiple-drug-resistant strains of the causative agent (Mycobacterium tuberculosis).

Reversing the spread

With your permission, I wish to elaborate a bit on the HIV/AIDS pandemic.  This pandemic represents a unique challenge of unprecedented urgency and intensity. This single epidemic can undermine development in the Caribbean over this and the next generation. The time is now ripe for aggressive action by all persons in the Caribbean. And media workers are especially welcomed as active partners in this response.

The vast reach of the media into the daily lives of our communities make them formidable allies in health promotion. Over the years, for public health communicators, collaboration with the media have provided many advantages. There is ample evidence of your effectiveness in advocating health causes such as tobacco control, breast cancer promotion, and environmental protection. I salute the contribution that you are making especially in recent months in highlighting the many and varied concerns pertaining to HIV/AIDS in this region.

I also wish to congratulate the Prime Minister and the Government of Barbados for taking a practical and comprehensive approach to this pandemic. The results of which are already demonstrating some success. I want to encourage you particularly in your efforts to promote prevention and eliminate stigma and discrimination against those affected with the virus.

I am also pleased to learn  of the  recent successes of several Caribbean countries in securing approval from the Global Fund for AIDS, Malaria and Tuberculosis, to support their efforts.

CAREC estimates that there were more than half a million people living with HIV/AIDS in the wider Caribbean at the end of 2000. Taking into account the HIV/AIDS prevalence rates, the conclusion is that at the end of 2000, for every single individual living with HIV/AIDS in Brazil, there were close to 5 individuals living with that same condition in the Caribbean. An analysis of AIDS cases between the period 1982-2000 in the Caribbean shows the highest incidence is in the 25-34 age group (35.3%), the male/female ratio stands at 2 to 1, and the highest category of transmission is through sexual encounters among heterosexuals (64%).

The Caribbean is faced with a major challenge to combat this disease. However, you are well on the way. Your senior government officials are signatories to the PAN Caribbean partnership against HIV/AIDS and now, with possibly one exception, all countries have drafted National Strategic Plans and are in the process of developing or implementing operational strategies. The costs are high both to do and not to do, but I would prefer that we err on the side of action.

Several international partners are providing direct technical assistance to CARICOM and CAREC for regional programs and to national governments for bilateral programs. PAHO for its part will continue to make contributions to improve the general health systems, negotiate and procure where necessary, cheaper antiretroviral drugs to reduce sexually transmitted infections, and provide technical guidance for prevention of transmission of HIV from mother-to-child.

Foremost in all these efforts, national governments must assign efficient managers to monitor and evaluate their programs, to ensure that returns on the significant investments for HIV/AIDS are being realized. It is not adequate just to provide drugs, we must use our best efforts to develop programs that address prevention, reduce stigma and discrimination. We must provide the means to interact with, and the services needed to people in prisons, also persons who, for whatever reason, are commercially engaged in sex. We must pay special attention to our young persons 15-24 year olds who are proving to be the more vulnerable members of our population.

Ensure Environmental Sustainability

Accessibility to safe drinking water continues to be of the highest priority in this region for several valid reasons. We all know that universal access to safe drinking water and proper sanitation services have a direct and beneficial effect on good health, and consequently to social stability and economic development. It is also true that this region, with its heavy reliance on tourism, is especially dependent on rational management of water resources and proper disposal of wastewater. Hence, commitment to the MDGs are especially significant in this region.

Journalists as Allies

The need for partnerships and external support is particularly pertinent to the English-speaking Caribbean; for although most of your countries fall in the middle income groupings, many are experiencing economic challenges, increase in social instability, demonstrated by the increase in violence which is now recognized as a public health challenge.

Tonight I use this forum to challenge all media practitioners in this country and region to commit yourselves to working through your channels of communication to ensure that the Caribbean remains on stream for achieving the MDGs.

The late American journalist Water Lipmann once wrote that “Mass media are like the beam of a searchlight that moves restlessly about, bringing one episode and then another out of darkness into vision.”

I encourage you, as gatekeepers of public information, to direct the media searchlight on the Millennium Development Goals.

As many of you already know, recognition of your gatekeeping potential is implicit in the Caribbean Charter for Health Promotion endorsed by the Ministers Responsible for Health in 1993. Despite patterning most of the strategies in the Ottawa Charter for Health Promotion, the Caribbean Charter is unique for the attention and importance it accords to the role of the media as an ally in health promotion, or as agents of change and development.

The MDGs provide an opportunity to see how effectively this alliance for health called for in the Caribbean Charter can be manifested in the interest of development in this region. It remains your challenge to ensure that these goals are illuminated and legitimized in the public information spotlight in the interest of the community you represent.

What resources are needed to achieve the MDGs_

If Caribbean media practitioners are serious about being a force for change, yours is a crucial role in positioning the MDGs as a road map for development.

Clearly, achieving the goals will require a seriousness of purpose and a political resolve  not only by government, civil society and the media, but also by an adequate flow of resources from high-income to low-income countries on a sustained and well-targeted basis.

We at PAHO are well aware that given existing rates of progress many countries will fall short of these goals. However, if developing countries take steps to improve their policies and increased financial resources are made available, significant additional progress towards the goals is possible. 

On September 22, 2003 the Pan American Health Organization (PAHO) and the Caribbean Community (CARICOM) announced the creation of the Caribbean Commission on Health and Development under the Chair of your own Sir George Alleyne.  This Commission offers a unique opportunity for the Caribbean.  Its goal is to give substance to the Nassau Declaration (2001) that the health of the region is the wealth of the region and respond effectively to the U.N.'s Millennium Development.  The Commission will provide guidelines for action to increase investment in health in the countries of the 15-member Caribbean Community (CARICOM). Once again, the Caribbean Community sets the example on how to improve the health of the people of the region. The establishment of this Commission is an example to be followed by other regions of the Americas.

We at PAHO are taking the Millennium Development Goals into account both in our current work and in preparing the Organization’s goals in the strategic program budget for 2004-2005.

Some of the specific activities undertaken by our organization to date, include ensuring relevance of indicators; quality of data; harmonization between the CARICOM Priority List, PAHO Core Data, and MDG indicators; also by strengthening and promoting inter-sectoral linkages on the part of the countries we serve. We look forward to seeing these goals and targets reflected in the many health plans now being drafted by countries in this region. 

The MDGs provide a fresh path to development. With political involvement and/or participation from the highest level, and with collaboration from all partners, we are convinced that real success will be realized and be a step forward towards not only ensuring but also sustaining the health and development of the Caribbean.

 Thank you and God bless!

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