President David Granger: Other senior government officials, members of the Presidential Commission, members of the media, ladies and gentlemen, I’m very happy to follow Pan American Health/World Health Organisation Representative to Guyana Dr. William Adu-Krow because my remarks are similarly folksy, granular, down to earth and I think persons of my age will understand what I say. I’m over fifty and I’m sure those of you who are over fifty or sixty or seventy, but I won’t go on, will understand.
Movie stars, social celebrities and business magnates a few years ago were often pictured smoking cigarettes and drinking alcohol. I don’t want to call names but those of us who are old enough to remember names like Humphrey Bogart or even James Bond, you know the smoking of tobacco and the drinking of alcohol were celebrated habits on the screen and these habits inevitably were imitated by their adoring fans, especially children- they wanted to be like the stars and they started puffing away early in life and drinking all kinds of substances.
It is my view that, particularly in poorer countries like ours, traditional lifestyles were quickly transformed as we sought to copy the glamorous habits of the rich and famous. We wanted to be like the stars. Food preparation similarly shifted from home to the street. I could remember the first time I had a soft drink or ate outside of my mother’s house but prior to that food was prepared at home, safe and healthy; now it’s gone to the street. I’m not criticising anyone; street food could be safe and healthy. Similarly you will remember, ladies and gentlemen, residents of the hinterland and rural regions who were accustomed to preparing food for themselves, reaping products from their own kitchen gardens, started to resort to restaurants selling sugary beverages, salty, oily, processed food in preference to fresh home-grown local produce.
As Dr. Adu-Krow pointed out, even at schools I sometimes get worried when a school doesn’t have a playground, a school doesn’t have physical education classes; a school doesn’t have annual sports. I wonder what these children are doing for fun. I think I prefer it to be done outdoors rather than indoors but these should be mandatory in any school. Annual sports, physical education classes should be mandatory. Any new schools being built in Guyana must have playgrounds. We can’t complain that we don’t have space. Dr. Adu-Krow has pointed out that countries with less space find room for playgrounds and sporting facilities. Every school should have one. Schools too, should be equipped with cafeterias but sometimes when we go to these cafeterias we see the consumption of cola. I wouldn’t go as far as Dr. Adu-Krow and say what type of cola. I am a Head of State, he isn’t. What I will say is that the consumption of cola and candy are more likely to be available in school cafeterias than coconut water.
Minibuses have started to replace or maybe in some places have completely replaced bicycles as the preferred means of going to school; while I was growing up even a trip to the cinema used to be something to look forward to if you wanted to see a movie. Now all you have to do is go to your living room. You don’t have to exert yourself to actually leave home to go to the cinema; so you could just stay home, get fat and watch a movie. And we need to think about these things. They seem to be comfortable but these are some of the factors which encourage obesity, inactivity and slothfulness. Perhaps one day we should have something like no minibus day when everybody must walk or ride a bicycle. What about that? Any minibus owners here?
Ladies and gentlemen, the consequences of such cultural carelessness are everywhere visible. More than half of Guyana’s adult population suffer from one of the main non-communicable diseases. Almost seven out of every premature deaths of Guyanese age 23-60 are caused by cancers, by chronic lung diseases, diabetes, heart disease and hypertension. Non-communicable diseases cause illnesses and may frequently result in premature death. They reduce human productivity and they exact a huge cost by individuals on the state. NCDs are a silent epidemic but an expensive epidemic nevertheless. Worldwide non-communicable diseases are responsible for 70% of the 56 million global deaths in 2015 and the majority of these are caused by cardiovascular diseases which accounted for 45% of deaths – cancers 22%, chronic respiratory diseases 10%, and diabetes 4% in that year 2015.
Ladies and gentlemen, these statistics should make it clear that the prevention and control of non-communicable diseases is essential to ensuring human health and by extension to bringing up healthier children and happier communities. As you’ve heard the Caribbean Community, CARICOM, was quick to recognise the dangers of non-communicable diseases. CARICOM Heads of Government convened a special regional summit on chronic NCDs on the 15th of September, 2007, a decade ago. So we were warned, we knew about the dangers and this is four years before the United Nations High Level Meeting of the General Assembly on the Prevention and Control of NCDs. So CARICOM was even ahead of the United Nations.
The Summit of CARICOM leaders issued a 15-point declaration known, and I am not saying this to be funny, known as the Declaration of Port-of-Spain, one of the two prominent countries. The Declaration of Port of Spain uniting to stop the epidemic of chronic NCDs. That declaration urged the establishment of National Commissions on NCDs or analogous bodies to plan and coordinate the comprehensive prevention and control of NCDs.
Guyana, in fulfilment of the declaration, did develop a Strategic Plan for the Integrated Prevention and Control of Chronic NCDs and their risk factors in 2013-2020. We acknowledge that but the Government of Guyana recognise the importance of combating NCDs and have established a commission, and today we witness the establishment of a presidential commission, but there was a commission before for the prevention and control of NCDs that was established three years ago. But it would be impossible to ensure satisfactory standards of public health unless the highest priority was accorded to the prevention and control of NCDs and that is why I have come here today to lend my name and my office so that children everywhere, schools, adults, the drinking classes, the smoking classes would know that it is at the level of the President himself that attention will be paid to NCDs and the elimination of NCDs.
President David Granger: Thank you for your applause. Unless you’re divinely inclined you can’t get higher than that. So today we assemble to celebrate the launch of a presidential commission and we recognise the need for increased public information, for fresh initiatives and for the implementation of programmes to promote a revised NCD strategy and to institute mechanisms. I would therefore like to propose to the Minister of Public Health, a three-pronged approach towards reducing the incidents of NCDs.
First is information. There must be countrywide public information if you are to prevent NCDs. We mustn’t assume that everybody knows that drinking sugary colas or eating oily fast foods could be harmful. Some people just don’t know. People buy the stuff because it’s cheap and convenient and they like how it tastes.
So we must have a campaign of public information to let every child know that he or she is indulging in self harm and of course we must make alternatives available to that sugary stuff. I know one place in Main Street where you can’t get aerated drinks. Someone was very surprised and they asked for a cola and they said we don’t sell colas here anymore.
So we have to get this information through to the public. The public must be better informed about the need for lifestyle changes and choices in order to reduce risk from the harmful use of alcohol and tobacco and from unhealthy diet and physical inactivity.
Second, there must be fresh initiatives and these initiatives must be led not only by the Government but by citizens, by celebrities. Get celebrities and encourage them to lend their popularity to get the message of not smoking tobacco, not drinking excessively, exercising frequently, to children. Get civil society on board and try to discourage them from purveying commodities which could be harmful to your health – (if you could) get NGOs on board.
Ladies and gentlemen, this is an emergency; we are in a state of emergency and if you ever had a relative who’s suffering from one of these four diseases and you had to dig into your pocket for every round of treatment you’d know that we are in a state of emergency. So these measures are not a sideshow, they are serious initiatives to make the whole country aware of the dangers of NCDs. Get the media on board, trade unions; together we can help to propel an intense programme of responding to the crisis and the threat of NCDs. This is a national effort. It is not a Governmental effort; it is not a ministerial effort.
Few of us go through life without having a loved one suffer from one of these NCDs and the best thing we could do is to launch these initiatives to make people more aware of the danger of NCDs and as I said, it may sound a little jokey now but even if it’s one day a month or one day a year, people walk to work, bicycle to work. You won’t die right away; and thirdly, implementation.
Once we have all these Declarations, once we have all these strategies, there must be implementation. There must be a comprehensive, multi-sectorial approach to implement measures for the prevention and control of NCDs. We have a plan, the Guyana Strategic Plan for the Integration and Control of Chronic Non-communicable Diseases and their Risk Factors, which expires I think in 2020; but this needs to be updated and it needs to be complemented by the implementation of an action plan, a plan that is aimed at preventing and controlling NCDs.
So ladies and gentlemen, we all have a role to play. I know we’ve gone to school and there’s a fat boy or a fat girl in the school; but obesity is not a joke. You know you go to the tuck shop or the cafeteria and everybody is quaffing away at some sugar water but there are alternatives. You see the big shots puffing away. I don’t know if any of you ever saw a picture of Winston Churchill without some little stick in his fingers. It was high fashion and of course there was a revolutionary leader somewhere in this hemisphere who popularised that product but those days are over. We know better now and we must realise that NCDs are not a joke, they’re not fashion, they are a serious threat to life and a leading cause of premature death.
Ladies and gentlemen, NCDs are a pressing problem and unfortunately the burden falls mainly on the poor. The burden falls mainly on the poor. Sometimes you’ll see some very rich people who don’t smoke that stuff anymore but when you go to ordinary workers you see them taking a break.
I remember as a young cadet you go on a route march, you were told to stop for a smoke break and even though there were some of us who didn’t smoke, we were told to go through the motions but smoking was almost second nature, but the fact is that the burden falls mainly on the poor and perhaps the less educated. Reducing risk factors therefore, will not only save lives but will save money. There will be more money to buy milk for baby instead of the other stuff.
I was at a recent Regional Agricultural Commercial Exhibition and I noticed that most of the vendors of honey and cassareep in that particular region – I can’t call the region of course because I have to go back there next week – most of the vendors were women and most of the bottles were vodka and rum bottles.
So I said, “This is a nice household, this is a cottage industry”. The men empty the bottles and the women fill them but I instructed my Minister of Business to start providing other bottles so we discourage the men from emptying bottles to give their wives to fill cassareep.
Ladies and gentlemen, the Presidential Commission has a lot of work to do, as I said, in these three areas and its work will be decisive in determining the extent to which we can enjoy the good life in Guyana. The public information programme, the public initiatives – and don’t be afraid if people may regard you as a crack because you are exercising or walking or you acquire a bicycle – of course we have to exercise some traffic controls. We don’t want exercising people to be hit down by any speeding cars or by angry minibus owners who think you should be going in the bus rather than riding a bicycle and of course there must for forceful implementation. At every Government ministry you must get rid of plastics. You know I just came from Nairobi you know, the United Nations Environment Programme there. You can’t get water in plastic bottles anymore. You have to use glass bottles so there is less plastic. I think the point is taken.
No, we must be serious about this and you go to some event organised by a state agency, none of this bottled sugar water anymore. There is a rich market for local juices; passion fruit and soursop drink and tamarind, mauby and so on; a rich market and people are prepared to produce those commodities by the litre, so let’s make sugar water history.
Ladies and gentlemen, this Presidential Commission for the Prevention and Control of Non-communicable Diseases in Guyana, I repeat, can succeed if it’s based on better information, more initiatives on the part of all of society and the implementation of campaigns aimed mainly at our children. I would like to see a nation of happier children and healthier communities. With these few words I am very happy and proud to declare the launch of the Presidential Commission on Non-communicable Diseases open.