Trevor Hassell | Time for paradigm shift in production and consumption of healthy food

As the Caribbean begins to look beyond the COVID-19 pandemic, there is much consideration being given to legacies of the pandemic that will contribute to the socio-economic development of Caribbean people.

Many of these legacies are expected to be in finance, how we do business, the use of technology, and the diversification of economies, leading to more resilient countries better able to respond to the ever-increasing shocks of climate change, natural disasters, and recurrent pandemics.

Of equal importance and need is a COVID-19 health legacy resulting in the greatest number of people receiving effective, affordable care in healthy national environments facilitated by pro-health policies and legislation.

Paramount among the health conditions to which attention should be paid are the chronic non-communicable diseases (NCDs). The coronavirus pandemic has highlighted the links between NCDs and infectious diseases, with people living with NCDs and obesity being more susceptible to severe complications and death from COVID-19.

The increased attention to NCDs has brought into sharp focus the large numbers of people living with NCDs (four out of 10 adults in many Caribbean countries ), with some eight out of 10 deaths being due to this group of diseases. Obesity and overweight are at critical levels in the Caribbean, with almost every country reporting that at least 50 per cent of all adults are overweight or obese and some countries reporting rates as high as 70 per cent.

UNHEALTHY DIETS

One of the main contributors to NCDs is the consumption of unhealthy diets, that is, diets that contain energy-dense, nutrient-poor, processed, and ultra-processed foods high in fats, salt, and sugars, – types of diets that either singly or collectively contribute to the diseases and conditions of heart disease, hypertension, diabetes, obesity, and cancers, which cause much sickness and death and are leading barriers to socio-economic development in the region.

A main contributor to the consumption of unhealthy diets is the high importation of unhealthy foods into the region, with many Caribbean countries importing more than 90 per cent of what they consume.

The issue of food nutrition and security is an important one inextricably linked to the high prevalence of NCDs in the region – with circumstances of the pandemic and its aftermath threatening to undermine the gains made in recent years in prevention and control of diet-related NCDs, as well as the maintenance of good health among people living with NCDs.

A legacy of the COVID-19 era, therefore, needs to be a fundamental tackling of the health challenges posed by NCDs at regional and national levels, with an important component of this being the development and employment of healthy, resilient, and sustainable regional food systems through increased domestic production and trade.

In a recent joint statement, ‘Strengthening food and nutrition security in the Caribbean: a legacy response to the COVID-19 pandemic’, issued by the Healthy Caribbean Coalition and the OECS Commission on the 15th of April, 2020, a call was made for food and nutrition security to be given priority at national and regional levels, guided by policy development and framed by supportive environments.

Several specific recommendations were made in the statement, including the inclusion by governments of consistent and coherent food and nutrition security measures in their national COVID-19 response plans, an expansion and improvement of emergency food assistance and social-protection programmes, and support for home or backyard gardening in the context of the broader regional and national food-security strategy.

The statement called on governments and the private sector to support smallholder farmers, fisherfolk, and fisheries to increase their productivity and market the food they produce; requested governments and the private sector to invest in healthy, resilient, sustainable regional food systems across the supply chain, including addressing intra-regional trade; reminded the international and regional health agencies of the need to continue their support and guidance on the implementation of policies and programmes that ensure access to healthy, nutritious foods and the strengthening of food security in the region; and highlighted the identification and management of conflicts of interest in interactions with the private sector as part of good governance.

The COVID-19 pandemic represents an opportunity for a paradigm shift in the Caribbean in the way we produce and consume healthy food. It presents an opportunity for a regional approach to achieving the goal of maximum food security, with support for sub-regional and national approaches for addressing the food self-security concerns.

- Sir Trevor Hassell is the founder and president of the Healthy Caribbean Coalition (HCC), chairman of the Barbados National Chronic Non-Communicable Diseases Commission, and Barbados special envoy for chronic diseases. He is a fellow of the American College of Cardiology and of the Royal College of Physicians of London, England. He has been engaged for many years in all aspects of the response to NCDs in the Caribbean. Email feedback to hcc@healthycaribbean.org.