The blog this week is based on a report by Ms. Peggy DaSilva, Chair of the Caribbean Regional Nursing Body (RNB). It is a follow up in reference to her comment made in the April 9 Blog, Celebrating 2020 World Health Day - Supporting Nurses and Midwives - in a time of Crisis. In a report covering a range of issues, Ms. DaSilva has sourced data and responses from nursing bodies in the 15 CARICOM Member States and 5 Associate Members. It is evident that the RNB is a vibrant regional enterprise that represents a critical force on the frontline of the fight against COVID 19. GOFAD joins in the well-deserved commendations for the dedicated efforts of our nurses. The CARICOM COVID-19 Dashboard tracker, places in context the spread of novel coronavirus throughout the region. The tracker on April 30 shows that there are 1177 confirmed cases, 62 deaths and 337 recoveries. Jamaica has the highest rates including 396 confirmed cases, 8 deaths and 29 recoveries.
The CARICOM region has been plagued by a number of challenges that have serious negative effects on the functioning and sustainability of health systems in general, nursing, in particular. These are not limited to migration trends that have shown a significant brain drain related to the experienced and qualified nurses. They also have implications for the quality of leadership among the nursing profession in the region. The World Health Organization (WHO) State of the World’s Nursing 2020 Report has underscored the critical role of nurses towards the achievement of universal health coverage. Nurses have always been and will continue to be central to the health systems in spite of new and emerging technologies and other modalities in the management of client systems. The growth of new and emerging infections, exacerbated by the Chronic Non-Communicable Diseases (NCDs) as we have seen in the case of COVID 19, has intensified the prevention, care and essential services demanded of nurses.
WHO declared 2020 as the International Year of the Nurse and Midwife with a call for governments to invest more in Nursing. The advent of the COVID-19 pandemic has brought to the fore the critical importance of the need for such investment. The global economic challenges affecting countries, especially small and middle to low income ones like ours in the Caribbean, are projected by the CDB and IMF, as well as our local experts to have a serious and debilitating impact on the economy and workforce. The epidemiological data and trend analysis associated with the current pandemic predict a potential second and third wave. In these circumstances, the economic and human resource impact will be especially challenging for CARICOM member states, especially if the need for additional resources required for effective management of those who are critically ill becomes more pronounced.
The immediate challenges faced by the nursing profession in the Caribbean have persisted over a long period of time. COVID 19 has however brought them into sharp focus. Based on a sample of responses from a cross section of CARICOM States the following have emerged:
There are other dislocations confronting nurses that need to be urgently addressed. These include:
The Regional Nursing Body has developed a Strategic Plan for Nursing and Midwifery (2020-2024). It was finalized and presented to the Council of Human and Social Development (COHSOD) in September 2019. Many issues contained in that plan require urgent implementation. Among them is the need to increase the number of nursing graduates, ensuring that they find jobs, are adequately remunerated and retained in the health system. Specifically mentioned in the Plan are the needs for:
While COVID-19 has placed a strain on the healthcare system as more resources are funneled toward caring for coronavirus patients, nurses and other health professionals still need to pay attention to the essential services. Maybe, the Caribbean might wish to consider paying homage to our nurses and others on the frontline by dedicating a time and day when the entire region would collectively pause, toot their horns, wave , applaud, and symbolize in whatever way, the importance we ascribe to these valiant soldiers on the battle field to save lives and livelihoods of us all. This gesture would at least bring the countries on the Region -- physical distancing together -- in line with engendering a spirit of "CARICOM as a Community for All".
Eddie Greene and Peggy DaSilva
Among the takeaways in the global fight against the coronavirus is the need to come together to tackle thorny problems. We have learnt the benefits of sharing medical equipment and research, staff and scientific expertise, and data. We have also learned the necessity of setting aside our sense of entitlement, our pride, our egos, and hoarding our resources, for the greater good of others. This realization comes when we feel that our well-being depends upon being well too. One of the most interesting aspects of the way the world has been dealing with the novel coronavirus pandemic is for the most part, the pivot that policymakers who have previously been anti-science tacked back to respecting science around the pandemic. This is the stark reality in an appeal by Dr. Rick Wright , Coronavirus Virus Vaccine Research Chief at the US Health and Human Service (HHS), who has allegedly been removed from his post for objecting to making the available the drug hydroxycholroquine ---- over the counter due to its unproven value in protecting COVID -19 patents — “ I am speaking out because to combat this deadly virus, science — not politics or cronyism — has to lead the way,” he said.
Science trumps Politics
Most compelling and relevant is the view by Paul Arthur Berkman “As a common and apolitical language, in Scientific American in 2018 that “ science brings allies and adversaries together with technology and innovation to address cross-border challenges.” Those borders may can be political, state, cultural, religious, gender, ethnic , or international borders. Pandemics like COVID -19 obliterate them all. The evidence is clear. Viruses know no state or country boundaries, nor abide by any regulations,. The ubiquity of global travel coupled with the fact that one can unknowingly have the virus and be asymptomatic, thereby spreading it to innocent bystanders, family members and friends, adds to its frustrating illusiveness. That’s why science needs to come to the rescue to stop it too, with accurate, verifiable, safe and scalable testing for the virus, the disease, its antibodies and to determine immunity to it, as well as a safe, effective and scalable vaccine. None of which we have yet. What resonates is that Science matters, but Science takes time.
The same need to adhere to scientific evidence applies to approaches to climate Science. The same principles also apply to ensure that climate action is not put in eclipse. How to strengthen resilience? Why a whole of Government approach is necessary to cut emissions and stimulate behavioral changes? What are the elements of a recovery climate plan? How to prioritize protection of biodiversity, promote renewable energy, and afforestation, and prevent soil degradation.
Positive movements since the inaugural World Earth Day 1970
The onset of the deadly COVID-19 pandemic from the novel coronavirus has made more people value science. Flattening the curve has given proof to the fact that when lives are on the line, and as people understand that their daily decisions are connected to the lives of others, people everywhere will act in accordance with the scientific findings. Knowledge of the scientific information will provide the basis for communicating effectively and combating disinformation. When World Earth day was inaugurated in 1970, the configuration of the world economy, diplomacy and international relations were vastly different from they are today. John Kerry, former US Secretary of State, who along with Al Gore, former Vice President was among the pioneers of the 1970 Earth Day movement provided a poignant reflection. According to him, the advocates knew that the solutions on climate were actually good for our economy. But they didn’t have confirmed proof. Today, looking back at the scare tactics and false information by the big polluters were in 1970, science has proven them wrong. His vivid portrait :
“That’s the story of climate change. Progress has been halted by finger-pointing, denial, replacing real science with junk science, misinformation, and flat-out lies, elevating political hacks instead of scientists and experts, refusal to work with allies and even adversaries, and leaving states and cities to fend for themselves. Sound familiar? It’s no coincidence that the same president who called COVID- 19 a “Democratic hoax” referred to climate change as a “hoax from China.” Kerry said in an interview with Our Daily Planet. (April 21, 2020)
But there’s a story of hope in the climate crisis that is the opposite of what is required to stop the spread of COVID-19. Basically there is need to shut down much of the economy to stop this disease. On climate, it is not a choice between economic recovery and climate action. The science is explicit: solving the climate crisis is the engine of our economic future. We end up healthier and create more jobs. As the pandemic upends our world, it reminds us of what really matters is the health and safety of our families and our loved ones, our communities and countries. Climate science teaches us to connect the dots between our health and the health of our planet, and explains how burning fossil fuels and climate change threaten them both.
At the same time, an expected drop in greenhouse gas emissions linked to the global economic crisis caused by the COVID-19 pandemic has attracted some optimistic prospects. According to Gerhard Adrian, World Meteorological Organization (WMO) Secretary-General in reference to a 5.5 to 5.7 per cent fall in levels of carbon dioxide due to the pandemic, this trend is only “short-term good news". It is predicted that once the global economy begins to recover from the new coronavirus, emissions will return to normal. “There might even be a boost in emissions because some of the industries have been stopped”, he cautioned.
The last 50 years have seen the physical signs of climate change - and their impacts – gathering speed at a dangerous rate. Consequently, The UN Report on Climate Change (September 2019) has warned that unless the world can mitigate climate change, persistent health problems, especially hunger and inability to feed the growing population of the world, and there would be also more massive impact on economics. The report shows that since the first Earth Day in 1970, carbon dioxide levels have gone up 26 per cent, and the world’s average temperature has increased by 0.86 degrees Celsius (33.5 Fahrenheit). The planet is also 1.1C (nearly 34F) warmer than the pre-industrial era and this trend is expected to continue. In addition the last five years were the hottest on record. This warming has been uneven, with Europe seeing the highest change in the last decade (of around +0.5C, or 32.9F) and South America and the Caribbean experiencing the least change. Other key indicators showed an acceleration of climate change in the past five year including ocean heat and acidification, rising sea level (up 112 millimeters since 1970), glacier melt and Arctic and Antarctic sea ice shedding ice loss five times higher in last five years, compared to the 1970s.
Under these circumstances, the future choices revolve around two options. One is a path of global solidarity like we experienced in 2015 with the embrace of the UN 2030 Sustainable Development Goals and the Paris agreement signed by 192-198 countries . The other is to devolve into division, hate and nationalistic authoritarianism. GOFAD is optimistic in its belief that the enormous pain and suffering of responding to COVID-19 will actually increase the chances for Climate Action.
This blog is being written before the full report of a specially convened meeting of CARICOM Heads of Government on April 15 to discuss the Regional response to COVID 19, is available. A CARICOM Secretariat press release (March 16) highlights some of the major proposals that revolve around a common public health policy, food security, inter-regional transportation, threats to security, building a robust digital architecture to facilitate commerce and assist in the fight against the virus.
The Blog is inspired by the view of CARICOM Chair and convener of the special meeting, Barbados Prime Minister, Mia Mottley. It is that "the community is being confronted with a virtual reality beyond the physical boundaries of its sovereign states". Her implicit conceptualization of the solution brings into sharp focus the prospects of the Region's collectively planning to overcome the threat of COVID 19 to lives and livelihoods in the Caribbean. She sees this as a trigger for sharpening the reality of functional cooperation and acting as a spur to an accelerated quest toward a genuine single market and economy. The Special CARICOM conference coincided with a session of the IMF-World Bank Spring Meetings (March 15) on actions to save lives globally and protect livelihoods with targeted fiscal measures. Both conferences conducted virtually, provide an indication of the new normal for governance and decision making.
In her address to the opening press conference of the IMF-World Bank meeting, Kristalina Georgieva, IMF Managing Director reinforced the extraordinary uncertainty about the depth and duration of this crisis. Referring to the World Economic Outlook, she said that it is already clear that global growth will turn sharply negative in 2020, leading to the worst economic fallout since the Great Depression. In the previous quarter, January-March, per capita income growth was expected in over 160 of IMF member countries in 2020. “Today, that number has been turned on its head: we now project that over 170 countries will experience negative per capita income growth this year. The bleak outlook applies to advanced and developing economies alike. This crisis knows no boundaries. Everybody hurts.”
This is no doubt, the virtual reality to which PM Mottley refers. It is a realization that the health crisis will hit vulnerable people hardest and the economic crisis will have severest impact on vulnerable countries. And this means that CARICOM countries will be exposed to massive external pressure, dangerously exposed to the ongoing demand and supply shocks, drastic tightening in financial conditions and the reduction in remittances. Some may face unsustainable debt burdens.
It is the widely accepted view that the response to the coronavirus will be fully resolved only when enough people are immune to the disease to blunt transmission, either from a vaccine or direct exposure. Until then, it is evident that governments that want to restart their economies must have public-health systems that are strong enough to detect and respond to cases. A template by the World Health Organization (WHO) based on empirical observation illustrates the disease progression by phases and responses.
Listening to International Experts without neglecting regional expertise
Taking a different angle, the Brookings Institute (March 2, 2020) reveals the many channels through which an infectious disease outbreak influences the economy. Direct and indirect economic costs of illness are often the subject of the health economic studies on the burden of disease. The conventional approach uses information on deaths (mortality) and illness that prevents work (morbidity) to estimate the loss of future income due to death and disability. Losses of time and income by those infected and direct expenditure on medical care and supporting services are added to obtain the estimate of the economic costs associated with the disease. However, this conventional approach underestimates the true economic costs of infectious diseases like COVID 19 and before, SARS. and HIV. These are all of epidemic proportions which are highly transmissible and for which there is no vaccine.
In the Caribbean, a study by UWI (Trinidad and Tobago) Health Economics Unit in 2000 led by Prof Karl Theodore, sensitized CARICOM Heads of Government to the exceptional costs of HIV as a percentage of GDP that jolted the region into action. This included the establishment of the Pan Caribbean Partnership against HIV (PANCAP) on February 14, 2001.
The seminal Report of the CARICOM Commission on Health and Development 2005 , Chaired by Sir George Alleyne did the same for our understanding the macroeconomic implications of the Non Communicable Diseases (NCDs). It triggered the Port of Spain Declaration (2007), "Unite to Fight the NCDs" and a worldwide movement on the wellness revolution through advocacy at the levels of the Commonwealth Heads of Government and the United Nations General Assembly. Both HIV and NCDs reflect the principles of Test, Treat and Defeat a response actually coined by Professor Clive Landis one of the current researchers on the UWI COVID 19 Task Force. An emerging slogan in this contemporary fight is: Test, Trace and Treat.
The experience from the response to previous disease outbreaks includes success through collective action. The Caribbean region was the first in the Americas to eliminate poliomyelitis and the first to eliminate indigenous measles and rubella. This among others, must have provided useful lessons about mitigating and containing the coronavirus. It is heartening to note that CARICOM Heads from what we have so far learned, have placed emphasis on:
Equally important is the recommendation for a collective approach to the international institutions for addressing the financial challenges, placing emphasis on vulnerability over GDP. The allocation of an initial package of US$140 million by the Caribbean Development Bank which follows this principle is invaluable. It is intended to provide assistance to its borrowing member states coping with COVID-19. According to CDB President, Dr. Warren Smith, "this assistance is directed mainly towards the most vulnerable within our societies and giving the highest priority to strengthening social safety nets”.
Good practices and innovations within the region — Jamaica an Outlier
Most Caribbean countries have been responding with varying formulae to mitigate the economic fallout from the coronavirus. However, the most comprehensive that we have come across is the Jamaica government’s J$25-billion fiscal stimulus package announced by the Minister of Finance to cushion the impact on businesses, creative industries, workers and the vulnerable groups including the elderly. Heralded both nationally and internationally is Jamaica's robust health programme for prevention and mitigation; its sharing information and public awareness; strict enforcement of physical distance and protection for frontline workers; and making provision for quarantine facilities.
Innovations are also to be highlighted. University of Technology (UTech) student in Jamaica, Rayvon Stewart has produced XERMOSOL , an ultraviolet technology which field and laboratory tests have found to be efficient in killing about 99.9 per cent of deadly pathogens found on doorknobs, thereby reducing the spread of bacteria. This invention may prove to be as a possible key weapon in the fight against COVID-19. It is also worth noting the gumption of two Jamaica young inventors. With the assistance of UWI Engineering faculty and UWI Hospital in Jamaica, they have used their creative talents to build ventilators and develop 3D face shields https://www.youtube.com/watch?v=q9Au4TY8yG4
On Easter Sunday night, Jamaica again demonstrated to the world its creative talents. Undaunted by the challenges, and supported by the Government in partnership with the Private Sector, its producers master minded and its artists delivered a spectacular virtual mega concert. It was dubbed “Jamaica together we stand” and connected Diasporans in Europe, North America and throughout the Caribbean raising over US$10 million to support frontline workers in Jamaica.
It is increasingly clear that this new decade will be defined by an unprecedented new reality. We are enveloped by a new normal. It is most likely to usher forms of engagements that diverge from those which previously shaped our lives. Hopefully the contours of the regional discourse on COVID -19 convened by Prime Minister Mottley, will inspire CARICOM Leaders and citizens to let virtual reality trump national sovereignty.
2020 World Health Day on April 7 passed with a whimper, dwarfed as it were, by the continuing focus globally on the war against COVID-19. Its theme, supporting nurses and midwives is incorporated in the worldwide recognition given to health care workers and others on the frontline of the fight. The annual day, inaugurated in 1950, aims at raising awareness of important health issues, including mental health, maternal and child care, NCDs, food safety, climate change and most recently, in 2018 and 2019, “universal health coverage everyone everywhere”.
This year’s World Health Day should jolt us more than ever in celebrating the work of nurses and midwives among other health workers. We are reminded of the critical role they play in keeping the world healthy. Nurses and other health workers are at the forefront of COVID-19 response - providing high quality, respectful treatment and care, leading community dialogue to address fears and questions and, in some instances, collecting data for clinical studies. Quite simply, without nurses, there would be no response. Over these seventy years of celebrating World Health Day there has been no greater disruption to the health systems and no greater challenge to health workers globally.
All over the world, nurses are foremost among health workers fighting day and night not only to keep us safe from coronavirus, but also to provide the essential services we need to keep healthy in other ways. In his statement to mark this significant day, WHO Director General, Dr. Tedros Adhanom Ghebreyesus recognizes the vital role played by nurses and midwives. “These are the people who devote their lives to caring for mothers and children; giving lifesaving immunizations and health advice; looking after older people and generally meeting everyday essential health needs”. Indeed, they are often, the first and only point of care in their communities. And, more so, in these devastating times of death during social distance, they act as surrogate family to many, giving comfort and support to those who would otherwise expire in utter loneliness. At the same time, shortages of the most basic protective equipment leave doctors, nurses and other frontline workers dangerously vulnerable as they care for COVID-19 patients.
State of the World’s Nursing Report 2020
It is fitting that in commemoration of World Health Day, WHO launched the first ever report, The State of the World’s Nursing 2020. It provides an in-depth look at the largest component of the health workforce. It reflects a global picture of the nursing workforce and supports evidence-based planning to optimize their contributions to improve health and wellbeing for all. The report sets the agenda for data collection, policy dialogue, research and advocacy, and investment in the health workforce for generations to come.
Although the number of nurses globally increased by 4.7 million between 2013 and 2018, the world is facing a global shortfall of 5.9 million nurses, especially in Africa, South East Asia, the Eastern Mediterranean and some parts of Latin America. The report predicts that the current shortage of some 5.9 million nurses will increase, as 1 in 6 nurses worldwide is projected to retire within the next 10 years.
The State of the world’s nursing 2020 report provides the latest, most up-to-date evidence on and policy options for the global nursing workforce. It also presents a compelling case for considerable – yet feasible – investment in nursing education, jobs, and leadership. A similar report on the Midwifery workforce is to be launched in 2021.
Bridging the nursing gap in the Americas
The Report documents that the Region of the Americas is home to 30% of the world’s nurses, or some 8.4 million people, of whom 87% are female. On average, the Region has 83.4 nurses per 10,000 population, more than twice the global average of 36.9 per 10,000. The figure, however, masks extreme disparities in the availability of nurses in different countries. Fully 87% of all nurses in the Americas are concentrated in just three countries: Brazil, Canada, and the United States, which account for 57% of the Region’s total population. That translates into a density of 80 nurses per 10,000 population in those three countries but contrasts starkly with the less than 10 nurses per 10,000 population in Haiti, Bolivia, and the Dominican Republic.
In the Americas, some 30% of the nursing workforce is aged 55 or older, with nearly a quarter of nurses expected to retire over the next 10 years. While there are currently 1.2 young nurses available to replace each retiree, that replacement rate will be insufficient to keep pace with population growth. This is happening at a time when there continues to be a hemorrhaging of the nursing pool in the Caribbean due to migration and the proposals from CARICOM for managed migration have not yield beneficial results.
The Americas Region also has major disparities in the distribution of nurses within countries. In the 35 PAHO Member States that have reported data on distribution, only 36% of nurses are located in rural areas, even though 50% of the population resides there. The availability of nursing personnel is also complicated by the fact that a number of countries, especially in the Caribbean, are net exporters of nurses.
Commenting on the status of the situation in the Americas, Dr. Carissa Etienne, PAHO Director said in a press briefing on World Health Day that through April 6, 384,435 confirmed cases of COVID-19 were reported in the Americas, and 11,270 people have lost their lives. “In just seven days, we witnessed cases and deaths more than double in our region. The pandemic is accelerating rapidly, and I urge governments to prepare and respond at the same speed,” she said.
Cuba's Health Brigade must be Celebrated
COVID-19 has placed a strain on the healthcare system in various Caribbean countries as more resources are funneled toward caring for coronavirus patients. The mammoth effort by Cuba in sending aid in the form of doctors and nurses to Italy and other hard-hit territories cannot go unnoticed. Cuba has been exporting doctors and nurses throughout the Caribbean as COVID-19 cases began to pop up in the region and governments reached out for help. As of 2020 World Health Day, Cuban health professionals are being or have already been deployed to: St Kitts and Nevis (30); Barbados (101); Antigua and Barbuda (29); St Vincent and the Grenadines (16); Jamaica (140); St Lucia (120); Dominica (34); and Belize (58).
To bridge the nursing gap by 2030, the WHO report says countries will need to increase the number of nursing graduates by an average of 8% every year and ensure they can find jobs and be retained by health systems. This will require investments to expand educational and training opportunities, increase nurses’ remuneration and improve their working conditions to ensure better retention. Funding these measures would cost roughly US$10 per capita (overall population) per year, the report says.
Addressing Health Disparities
COVID -19 has demonstrated the worst-case scenario involved in the spread of an epidemic into the developing-world where huge numbers of people live, where health care facilities are poor and where millions lack the money to afford whatever care is available. There are also larger emerging-market countries that will take a huge economic hit as a result of lost tourism, and basic commercial and agricultural activity. But there are more specific and immediate areas to be addressed.
Speaking yesterday (March 8) to Ms. Peggy DaSilva, Coordinator of the CARICOM Regional Nursing Body from her base in St Vincent and the Grenadines, reinforced some concerns of that regional organization about the special plight of the differently abled that was brought to the attention CARICOM Heads of Government. Among them, the need for sign language accompanying health briefings to ensure this demographic has greater access to public education; statutory mandates for construction of ramps to facilitate access to public and other buildings; and special support to care givers and care giving institutions. At the same time a release from UNAIDS (March 7) draws attention to the particular hardships facing sex workers globally, and calls on countries to ensure the respect, protection and fulfilment of sex workers’ human rights. The case of prisoners in cramped cells has led to a rapid spiraling of the coronavirus in those institutions, in most cases without adequate plans for effective preventive and remedial action. In the USA, the Chicago jail for example has the highest concentration of deaths.
While all levels of society are being affected by COVID-19, the impact of this pandemic is particularly hurting schools and places of worship, and disproportionately impacting the underrepresented communities, the sick, the elderly and the lower income groups. In the USA, statistics reveal the enormity of the disparity afflicting the black and brown communities, with Black Americans at overwhelmingly higher risks of infection and deaths. As a result, it is vitally important that organizations delivering critical social services and meeting community needs remain viable, particularly during this economically challenging time. Consideration may be given to including places of worship as recipients of support in the category of small businesses.
During this weekend’s celebrations of Easter, Christians may wish to reflect on the fact that Jesus’ crucifixion and resurrection were indeed instigated by the betrayal of ‘Judas’. The Washington DC National Cathedral Lenten Medication by The Rev. Canon Leonard Hamlin (March 8) is a fitting preview of life beyond COVID -19. "Today, what does betrayal to His teachings look like when we see the hoarding and cleaning of shelves, communities disproportionately affected because of economic, environmental, political and racial factors? When we are able to reach a point of looking back, will anything be different because of what we have been through? Will the change be limited to our habits or will change truly be in our hearts? I am praying that the change begins with me and together, we will see a different world on the other side of this moment”
For believers as well as non-believers, this sacred pledge is a truly respectful tribute to those, the focus of our celebration of World Health Day.
The devastating trends of COVID 19 continue. Judging from the experiences in Italy, Spain, and in USA, especially in New York, California, Louisiana and the increasing impact on over 190 countries the world over, the war against this invisible enemy is deadly not delusional. The new reality as expressed in a recent tracking report shows the expected exponential rate of spread, excessive demands on health systems and the stress on health practitioners suffering from lack of personal protective equipment (PPE), helmets and ventilators. The projected number of deaths from COVID-19 in the USA is estimated to be approximately 93,500 by August. This is frightening. It is a reflection of the gravity of the situation likely to afflict other countries. http:covid19.healthdata.org/.
To stem the social and economic effects of this devastation, there are examples that there is need for policies and programmes to mitigate the effects on workers losing their jobs, renters and homeowners being evicted, bankruptcies of companies, avoided, and business and trade networks, preserved. These are all prerequisites for mitigation to ensure that recovery will occur sooner and more smoothly. The enormity of the challenge is visible in many of the developed countries. Yet an IMF Report illustrates how the challenge is even greater for low-income and emerging economies that face capital flight and will require grants and financing from the global community . Antonio Gutérres, UN Secretary General advocates a Global Humanitarian Fund.
“May your choices reflect your hopes, not your fears.” (Nelson Mandela)
Nelson Mandela's aspirations are reflected in the sustainable solutions to cope with this situation gleaned from lessons learned. China, South Korea and Singapore that have flattened and bent the curve downward provide templates charting the difficulties they faced, the measures that proved most successful in mitigating the human and business impacts of the virus, and how their operational emphasis shifted throughout the stages of the epidemic based on "hopes" rather than "fears".
SDGs: Reducing Inequalities and Increasing Inclusiveness
The 2030 Sustainable Development Goals (SDGs) provide a useful set of markers linking health and economic factors. Implicit in these lessons are the inequalities that are being compounded. Unlike other economic downturns, the fall of output in this crisis is not driven by demand. It is an unavoidable consequence of measures to limit the spread of the disease. The role of economic policy is hence not to stimulate aggregate demand, at least not right away. The main objectives according to the IMF include:
SDGs: Shared Responsibility and Global Solidarity
While we were in the midst of this blog, The UN Secretary General issued a UN report, Shared Responsibility, Global Solidarity: Responding to the Socio-Economic Impacts of COVID-19. It has led to an appropriate diversion in its amplification of his previous call for a global humanitarian response. Its message is made more forceful by empirically demonstrating the impact of COVID on the 17 sustainable development goals. https://www.kff.org/ce6c676/
Among the examples of increased inequalities are:
Dare and care.
This important refrain emerged out of the lessons from China. South Korea and Singapore.
Dare to take quick decisions by a crisis management team properly informed, trusted and empowered to preserve social cohesion, business continuity, and enforcement of sanctions.
Care, demonstrated by the management team, always putting people first in terms of health and financial security with emphasis on those first responders on the frontline of testing and treatment, the back office to guarantee service continuity and the marginalized to reduce inequalities. A statement in the UN report aptly captures the present reality.
"COVID-19 is menacing the whole of humanity and all humanity must fight back . An effective response needs to be multidimensional, coordinated, swift and decisive. It needs to be a result of strong political leadership and buy-in of the population. It needs to foster public trust; be focused on human values; and supported by solid institutions, technical skills and financial resources. Everyone needs to play their part. No individual country can do it alone"
So much has happened during the past week on the contagion of COVID 19. Among the most sensational are the slowing down of the spread in Northern Italy; the surge in the USA, especially in New York; the record US$ 2Trillion stimulus package in USA; and the decision to postpone the 2020 Tokyo Olympics to 2021. There are however signs of health emergencies in other areas of the world like in South Africa for example. In other smaller countries like those in the Caribbean, there are gradual increases in numbers especially the Dominican Republic, Jamaica and Trinidad and Tobago. What has emerged as a vital outcome is that the coronavirus is not only a health crisis of immense proportions, but also requires an imminent restructuring of the global economic order.
The Need for a Global Humanitarian Plan
Mr. Antonio Guterres, UN Secretary General in a statement issued on March 25 captures the enormity of the challenges. “COVID is menacing the whole of humanity and so the whole humanity must fight back. Individual country responses are not going to be enough. Wealthy countries with strong health systems are buckling under the pressure. Now, the virus is arriving in countries already in the midst of humanitarian crises caused by conflicts, natural disasters and climate change.” He called for a Global Humanitarian Response Plan for COVID 19.
Implicit in the UN Secretary General (UN SG)’s plea is that traditional metrics and assumptions are being rendered irrelevant. More starkly Christine Amanpour, Chief International Anchor for CNN, in the interview with the UN SG (BBC March 25), pronounced : “it’s our turn to answer a question that many of us once asked of our grandparents: What did you do during the war?”
Wall Street Journal editorial “Rethinking the Coronavirus Shutdown” (March 19) proclaimed that no country can safe guard public health for long at the cost of its economic health.“ if government shut down continues ... the human cost of job losses and bankruptcies will exceed what most imagine". What it advises for USA applies elsewhere: “unless federal and state officials start adjusting their antivirus strategy now to avoid an economic recession, [the outcome] will dwarf the harm from 2008-2009". In other words, the dilemma we may soon face is the terrible choice to either severely damage our livelihoods through extended lockdowns, or to sacrifice the lives of thousands, if not millions, to a fast-spreading virus. It is with this realization that the call for a global humanitarian response to militate against inequalities, is a feasible solution.
The Next Normal or What Next
Nowhere else have I seen more viable solutions than in an article by Mc Kinsey Analysis in collaboration with Oxford University (March 25) which poses 5 scenarios for the new normal that will emerge in the post-viral era: the “next normal.”
It is increasingly clear that this new Decade will be defined by an unprecedented new reality. Even before a solution to COVID 19 is conceivable, we are witnessing the beginning of discussion and debate about what the next normal could entail and how sharply its contours will diverge from those that previously shaped our lives. The question to be answered urgently is, how to begin navigating to what’s next ?
As we write, governments around the world are scrambling to deal with the spread of the coronavirus, which has sickened at least 176,500 people worldwide and contributed to more than 7,350 deaths. These figures are likely to increase exponentially without the enforcement of stringent and effective measures. Canada shut its borders to anyone who is not a citizen or permanent resident, while the European Union ordered a halt to all non-essential travel. The USA has declared a national emergency, restricted airline flights into the country, ordered restaurants, schools and businesses except grocery stores, pharmacies and banks closed and recommended limiting social gatherings to 10. In France, President Emmanuel Macron banned all social and family gatherings, placing the country in an unprecedented lockdown. A number of African countries —Kenya , Senegal , Nigeria, Benin, and Ethiopia have declared cases while others like Zimbabwe, Chad, Tanzania, Somalia , Ghana, Ivory Coast have instituted restrictions. South Africa has declared a state of disaster and so has The Philippines. These actions together with those in China, Italy, and Spain among others provide lessons learned and portray examples of epic struggles against an invisible enemy. All these jurisdictions have imposed restrictions of between 2-8 weeks duration. Cancellation of sports activities over the world, now threatens next Summer’s Tokyo Olympics.
COVID -19 and the Distinction between Global effects and Globalization
Prof Ian Goldin, at Oxford Centre of Globalization, likened the COVID-19 pandemic to a virulent form of globalization, even more so than the 2008 financial crisis that slowed down the world economy. In 2008, the world appeared much more unified, hence global models for stimulus packages were variably applied to reduce respective economies from total collapse. Yet it magnified the inequality among and within countries. While the financial crisis may have been due to globalization, the current pandemic is a global one. Deregulation was the source of the former crisis, mainly instigated in the developed countries, but with severe impact on developing countries, with least access to effective social safety nets. The slow down on the world economy in 2008 mostly affected the vulnerable and exacerbated inequality within and among countries. Persistent inequalities were fanned by the arteries of globalization. The projected effects of the coronavirus is much more devastating with domino effects across the globe.
The World Health Organization (WHO) has deemed COVID 19 a Pandemic. Its virulence as illustrated by the number of deaths and impending social and economic consequences, is compounded by the fact that it is both a public health and an economic emergency. It exposes the need for strengthening public health, better science, national unity, regional coordination, international solidarity and social support. These elements are required to ensure economic resilience during and after the passing of the Pandemic, whose timeline remains unpredictable.
Already England has announced a COVID Bill guaranteeing £300Bn of government assistance or 15% of GDP, to provide liquidity through support packages, business interruptions loan schemes and loan guarantees, especially for small businesses and the service sector including the airlines. It also includes mortgage holidays, employment support and cash grants to support the vulnerable groups. The USA has advocated US $850bn stimulus package to give relief to small businesses and affected industries like airlines and to support those in need.
"This enemy can be Deadly but not Unbeatable"
Prevalence of the infection is different in different states. The responses are in turn based on these differences. Enforcement of China’s draconian measures to quarantine whole cities for example, has resulted in a massive slowing down of the Coronavirus. Scientists around the world are proclaiming that from an epidemiological perspective, the earlier the action taken, the better the results. But the race to contain the virus is constrained by lack of a vaccine. While the Center for Disease Control (CDC) has initiated trials this week, indications are that it will take at least a year to produce an immunological safe vaccine. Hence preventing the spread will be dependent on information based on the science and building the bonds of trust to manage the risks and achieve mitigation and containment. There is need for coherent policies as a Nudge to slow the trajectory of the virus.
Acknowledging Cuba's Effort and the role of CARPHA
What has emerged is an illustration of the ill effects to human development caused by the ideological divide. According to reports, Cuba produces a drug known as Interferon Alpha 2B, that could save thousands of lives in the COVID-19 pandemic. The drug has been produced in China since January 25 and, according to data from China, has managed to effectively cure more than 1,500 patients from the coronavirus. It is one of 30 drugs chosen by the Chinese National Health Commission to combat the respiratory disease and is currently been prescribed in Italy. The drug was first developed in 1986 by a team of researchers from the Centre for Genetic Engineering and Biotechnology (CIGB) and has benefited thousands of Cuban patients since its introduction into the national health system. It has been used as a treatment for HIV-AIDS, Hepatitis B and C, Herpes zoster or Shingles, Dengue and different types of cancers. The medication is said to increase the natural production of interferon in the human body and strengthens the immune system of patients, thus, is effective in treating the coronavirus disease. https://www.telesurenglish.net/news/Cubas-Interferon-Alpha-2B-Successful-in-Treating-COVID-19-20200317-0015.html
Small island states in the Caribbean, most of which depend on tourism and other service industries, have commenced putting in place programs to prevent the spread of the virus. Chief among these are strengthening health systems, enacting policies based on scientific information, widespread public education and establishing mechanisms for enforcement. They are also considering sourcing supplies of Interferon Alpha 2B from Cuba as part of an overall strategy.
A regional approach is essential for identifying resources, sharing expertise, resisting the temptation for bilateral negotiations that distort regional efforts. It is to the benefit of CARICOM, that the Caribbean Public Health Agency (CARPHA) has become a lead institution in the implementation of the Caribbean Cooperation in Health. in collaboration with the Pan American Health Agency(PAHO). CARPHA has the capability to conduct the necessary tests on behalf of the entre Caribbean but in particular for those smaller islands without local laboratories and test kits. It therefore must be one of the priority institutions in which to invest as a cost effective measure for the Caribbean.
In fighting the contagion of COVID -19, the world is engaged in a war of a different kind. It is most likely to revolutionize the way we live, work and play. It may well be referred to as 'social distance-together'
2020 World Women’s Day Prompts Reflections and Recollections on Women and Development in the CaribbeanRead Now
I am Generation Equality: Realizing Women's Rights. This is the theme of International Women’s Day (March 8), 2020. It is a significant reminder that an equal world is an enabled world. It is one to which we must strive. Individuals and leaders of institutions around the globe have issued statements to this effect. Many countries and regions have identified the champions that have brought the struggles for women's rights and gender equity to the forefront of the global agenda. They ensured inclusion of measurable targets in the 2030 Sustainable Development Goals. GOFAD, reaching into its library, found an amazing contribution to this global movement emanating in the Caribbean that is worthy of highlighting. This Caribbean movement is portrayed in an informative book, The UWI Gender Journey: Recollections and Reflections coedited by three of the Caribbean's foremost scholars, Professors Jocelyn Massiah, Elsa Leo Rhynie and Barbara Bailey. It is a must read for scholars, students, advocates and all those interested in issues of social justice, equality and inclusion. .
The focus of this book is on the evolution and growth of gender studies at the University of the West Indies. It illustrates how the leaders of this enterprise forged ahead to open new areas of academic investigations; how they impressively disseminated results of their studies; and how these results laid the basis for formidable policies, advocacy and actions at community, national, regional and international levels. The three editors are of course among the original pioneers of this movement which began as a modest venture under the banner Woman and Development (WAND). But others include Peggy Antrobus, Dame Neita Barrow, Lucille Mair, Kathleen Drayton, Magna Pollard, Rhoda Reddock, Eudine Barriteau, Patricia Mohamed, Verene Sheppard and Lieth Dunn. Together and at different times, they and many others referenced in the book contributed to institutionalizing an internationally reputable Institute of Gender Studies with focal points at all three campuses (in Jamaica, Barbados and Trinidad and Tobago) of the University of the West Indies (UWI). As Sir Hilary Beckles, UWI’s Vice Chancellor so aptly describes in his testimonial, the Institute of Gender Studies which emerged out of WAND has blossomed into “a fastidious custodian of the commitment to gender liberalization, intellectual engagement --- and effective leadership in the interactive fields of teaching, research, policy formulation and institutional refashioning”
In setting the scene, Joycelin Massiah connected the mission of Women and Development with a colonial past and a developmental future. It referred to the identification of discrimination of women in the Caribbean by the Moyne Commission in 1946, the blue print for women’s rights established in the UN Declaration on Human Rights, 1948, and the stimuli of the first World Conference on Women in Mexico City, 1975. They all created a firm basis on which to move to the next level of women’s development. This dynamic triggered the establishment of the Caribbean Women’s Association (CARIWA) and the inauguration of the Woman and Development (WAND) Unit within UWI in 1978. They were, however, just “the first tentative steps toward the introduction of women and development studies into the regional academy.“
Among the highlights of this book that readers will find enlightening are:
The book goes on to illustrate how the period of Consolidation 1996-2010, following the landmark Beijing Platform for Action in 1995, witnessed the roll out of graduate programmes, accelerated capacity building in research, the establishment of a robust data base to sustain analysis and policy making, the emergence of new programme areas such as gender and sexuality, construction of masculinities, the making of feminisms, and the blossoming of outreach activities within and beyond the academy. Such outreaches include national-level initiatives on gender policies, gender awareness and training women in leadership. In addition, the visibility of WAND soared through the increasing number of its leadership serving in regional and international bodies. Joycelin Massiah assumed the position as Caribbean Regional Director of United Nations Development Fund for Women, (now UN Women). Eudine Barriteau, became Prinicpal , UWI Cave; Elsie Leo Rynie, Deputy Principal UWI Mona; and Rodda Reddock, Deputy Principal, UWI St Augustine. Others were engaged in leadership roles in the Committee on the Elimination of Discrimination (CEDAW) and Development Alternatives with Women in the New Era (DAWN]. Verne Shephard emerged as a highly respected spokesperson on reparations and gender equity at the UN and other international theatres. Barbara Bailey became a foremost advisor to the Caribbean Community on Gender and Education. Rosina Wiltshire served as Gender Justice Advocate to CARICOM. Yet there are so many others who gained professorships and have taken primary roles within the public and private sectors and in NGOs both nationally and regionally.
This book covers a journey of approximately 30 years. It is based on archival material and sturdy analysis. Reflections, recollections and spontaneous testimonials of the major players over the years formed an innovative methodology. It is a holistic assessment of the origins, evolution, challenges and triumphs of woman and development in the Caribbean.
In reflecting on the future, it is quite clear that the pioneers of the Caribbean women and development programme marshalled the intellectual fabric, ushered in an era that has placed women and gender as cross cutting elements of academic significance, and have given substance to the claims of ordinary women for greater attention to the social and economic challenges they face. It is to their credit that increasingly, policy, advocacy and militancy are backed by evidence; that there is a seismic shift in the understanding of women in the workplace, in entrepreneurial ventures, in politics , in the law and, in particular, in struggles to overcome the discrimination and disadvantages they encounter in the value chain, resistant to change. Increasingly this includes attention to issues such as sexual harrasment and violence against women and girls.
Let us therefore take the opportunity of 2020 World Women's Day to hail the contribution and inspiration of these Caribbean Champions that set the stage for Generation Equality- Realizing Women's Rights.
As we write this blog, the official results the 2020 Guyana general elections are still pending. All Observer Missions offered commendations to the Guyana Electoral Commission (GECOM) for the scrupulous manner in which it handled the process and to the people of Guyana for their participation in a peaceful democratic process. This Election has attracted attention worldwide and especially in this age of active social media has stimulated much discussion among the Guyanese people at home and abroad. It is the view of GOFAD that whatever the outcome, which ever group emerges as the Government, there will be a need to pay great attention to equality and inclusion. This blog draws of some eclectic remarks made at the University of Guyana’s Pre Conference on the Diaspora (February 28,2020). It was intended to launch an International Diaspora Engagement in late May, 2020 on the theme, "investing in Guyana's emerging business, indigenous women and youth leaders". It coincides with the celebration of its 54th anniversary of Guyana's Independence and provides an opportunity to examine the reality of the Diaspora in Guyana’s development.
The Diaspora at its Core
The word Diaspora comes from the Greek verb 'to sow' and by extension to disperse. More contemporary references illustrate examples of recent initiatives by governments around the world to reach out to “their” diasporas. The primary aims are to include those who have migrated in the national outreach or embrace; to establish new networks of commerce and culture; to tap into the enormous financial, technical and political resources that they can contribute to the national development; and in most cases, fly the national flag and achievements abroad. In this sense we can refer to the UG Diaspora over the past 57 years of its existence, as embracing those graduates and friends in and outside Guyana , amounting to over 40,000. The UG alumni, in particular, must have a vested interest in sustaining the credibility of their certification and therefore must be encouraged to contribute tangibly to this end. And I am glad to note that the University of Guyana’s Division of Philanthropy Alumni and Civic Engagement (PACE) has been at the forefront of coordinating and accelerating alumni affiliates in the England, Canada, and the USA. But the broader catchment of the Guyanese Diaspora that is the focus, is estimated to be over 1.8 Million, double the size of the Guyana population.at home. These are sources of goodwill whose encouraged commitment to the country’s development can make a difference.
The historical molding of our Diaspora
Recall, that one reason for the proliferation of the Guyana/Caribbean Diaspora was decolonization. As countries gained their independent status, it became necessary to forge transnational bonds of solidarity among their scattered populations, globally. For Guyana as for the rest of the Caribbean, many of its citizens, for example, migrated to Britain and have stood astride the colonial experience that produced Windrush, or the stigma of ‘’shit hole” countries rained on us by the current President of the USA.
Especially as Guyana is on the cusp of a new and rapidly developing economy, its good prospects as part of a Pan Caribbean integration movement is attracting worldwide attention. What a time of elevated pride and promise to foster an environment for a dialogue focused on the inter connection with a Diaspora of Guyana in CARICOM. This is indeed a vibrant context for a Diaspora conference that could inspire internationally respected advocates of global solidarity, equity and social justice.
What has Migration got to do with It
In May 2017 I was privileged to witness a memorable exhibition at The Caribbean Cultural Center African Diaspora Institute (CCCADI) in New York by 16 Guyanese artists living in the USA, including Stanley Greaves, former lecturer at UG. Under the theme, Liminal Space, the artists working in various medium illustrated vividly how decades of migration have defined Guyana’s space. The content of that masterful exhibition is relevant to this conversation. It pointed out the relationship between migration and the idea of the “liminal” — from the Latin, ‘limens’, which means “threshold,” a place of transition, waiting, and unknowing. Fully etched in my memory is how that exhibition of creative arts testifies ‘to what drives one from a homeland and simultaneously keeps one tethered to it’.
Nowhere is this better illustrated than in the massive scale of contemporary international migration estimated at 217 million which has led some commentators to proclaim the last decade as the ‘Age of Diaspora’. So much so, that the UN designated 18th of December as international Migrants Day is conflated with a new configuration of diaspora strands that have proliferated to an extraordinary extent.
The 2020 World Migration Report produced by the international Organization on Migration (IOM), provides concrete evidence showing how the application of the principles of humane and orderly migration benefits migrants and the societies from which they come and those in which they reside. For Guyana and the Caribbean this is a lived experience. The ‘barrels ‘and ‘remittances’ are only one side of the coin. The other more ‘heads up’ side, comprises the contribution of our teachers, nurses, doctors, artists and other distinguished professionals, many of whom were groomed at UG.
Our writers have provided the context
George Lamming, in his 1950’s book, In the Castle of my Skin vividly portrays the colonial entanglement that made for a complex relation between colony and metropole. It is a psychic entanglement that is often beyond the understanding of a third-generation of British citizens of West Indian ancestry. Their relation to England is experienced as a racial assault that allows little space for a dialogue that would humanize the conflicts arising from a perception of ‘the other's’ difference. In another book The Emigrants Lamming explores the alienation and displacement caused by colonialism. It is out of this displacement and alienation, that the late Edward Kamu Braithwaite in his magnificent trilogy, The Arrvants, helps us to understand the amazing reach of our plantation system and culture that enriched the civilizations of the metropole . This is not to mention our music, athletics and (used to be) cricket. But it also makes us aware of the strength of the case for reparation by The CARICOM Commission spearheaded by Sri Hilary Beckles, Chancellor of the University of the West Indies. These vestiges of slavery, colonization and imperialism that disadvantaged our Caribbean societies provide major items for the Diaspora engagement to address
The Diaspora in the future of our development
Our Guyanese or Caribbean Diaspora is connected to these experiences and streams of migration, that manifested themselves in both opportunities and exploitation . Therefore UG’s engagement of migrants and now the children and grandchildren of those who left to better their circumstances in the international communities, must be placed in this context. It is a context that must counter an unfortunate but emerging views of ‘Diaspora fools ‘ in reference to those perceived to have left their homeland in the bad times, now returning to exploit rather than to contribute’. More meaningfully, the context should be interpreted as an attempt to recognize the operational challenges of migration; advance the understanding of migration issues; and encourage social, cultural and economic integration of our migrants in the development of the country and the Region.
Guyana’s new opportunity with continued exploration and recently-started production and export of oil and gas must be seen as bringing a number of wonderful possibilities but also some risks. The dominant perspective in Guyana’s discourse with the Diaspora must be viewed as being one that calls for using its windfall gains to consolidate Guyana’s long-term development goals. The achievements are bountiful. They depend on ensuring good governance and management of all Guyana’s resources. It requires working to stave off the well-known perils of some oil economies. But most of all it means seeking to enhance local content and, equally important, tap the required expertise , investments and collaboration of the members of the Diaspora.
The reality of the Diaspora in Guyana’s development beckons. Let us grasp the opportunity of engagement.
Mr. Dereck Springer's tenure as Director of the Pan Caribbean Partnership against HIV (PANCAP) ends on February 28, while this blog is being distributed. This is a slightly modified tribute delivered at the 37th meeting of CARICOM's Council of Human and Social Development (COHSOD) in Washington DC on September 28, 2019 . I have been closely associated with PANCAP from its inception in 2001 and was Advisor to PANCAP during Dereck's tenure as Director. I feel obliged to share this tribute to a creative and outstanding leader.
When Dereck announced over one year ago that he would not renew his contract as Director of the Pan Caribbean Partnership against HIV AIDS (PANCAP) every level of the partnership persuaded him — indeed begged him — to reconsider . Some even engaged in soft diplomacy which went something like this “Dereck man! just give us one more year”. Faith leaders prayed that spiritual redemption will change his mind and the youth pleaded for his continued mentorship. Nothing worked. No power on earth or the Holy Spirit for that matter could change his mind. A Jamaican colleague in frustration confessed “Dat man Dereck, he like the rock of Gibraltar: ‘to raw-tin’- him stand firm”
But this should come as no surprise for those of us who came to know him professionally. The keywords from the many tributes attest to this:
These are not just platitudes nor lyrics They truly characterize Dereck as a man of the time, in the time and for the time
As a man of the time, he came to the leadership of PANCAP at a difficult period when sources of external funding for the AIDS response were drying up ; when making the case for the Caribbean deemed as middle and upper income countries could no longer easily yield concessional funding; when complacency for the AIDS response was increasing and political will declining in the face of so many competing demands; and when the PANCAP Coordinating Unit (PCU) Staff was being depleted as a result of these cumulative tendencies. Yet Dereck remained undaunted: ever seeking new ways to overcome the challenges and in the process, molding the PCU into one of the most efficient and effective units within CARICOM
He was man in the time. When faint hearts would have succumbed, He remained optimistic : reformulating the scope and substance of the partnership , repurposing its programmes and uplifting its morale toward greater inclusion. Among the innovations are webinars, knowledge for health , national and regional stakeholder consultations —all of which have contributed to collective leadership, a prerequisite for the sustainability of PANCAP after Dereck.
These together have also no doubt blunted the doom and gloom about the future of the partnership that prevailed when he assumed office
Dereck was a man of the time. Not only has he been aware of the need for PANCAP to change gear but also to find new expressions for galvanizing the various strands of the partnership weaving them into a cohesive web. Its inter interlocking creed was to become Justice for All for which he so passionately advocates. It is universal yet indigenous. It illustrates the essence of how with common cause AIDS can truly be ended.
Besides being of and in the time, Dereck is a man for the time. He came to the Directorship with training and experience in public health, counseling, social psychology, epidemiology and philanthropy. Small wonder he was able to establish the foundations for the changing times ahead: one in which PANCAP’s stakeholders —parliamentarians , faith leaders, civil society, youth advocates, key populations and donor partners ofttimes with varying methods could adhere and contribute to the core value and common goals and programmes so adequately outlined in the Caribbean Regional Strategic Framework (CRSF) 2019-2025 This is a portrayal of the true legacy of Dereck’s inspiring leadership.
When combined with his growing reputation in the international theaters, especially on the Board of the Global Fund, it is my hope that his resounding assets will be available to and utilized for the benefit of the regional and Global struggles to achieve the targets of SDG #3 Good health and well-being in this aspiration, ending AIDS is one component of the global integrated health agenda.
It has been my privilege to work with a colleague of Dereck’s ilk and to feel the vibrations of his sensibilities, sense of duty and concern for the vulnerable. Under his leadership we witnessed PANCAP’s maturity into the quintessential essence of functional cooperation. For these transcendent qualities of being in the time , of the time and for the time, Dereck has taken PANCAP to soaring heights of achievements, respectability and honour. For all these reasons we celebrate his contribution to the region. Those within and outside the Caribbean Community with whom he engaged over these nine years will no doubt join PANCAP in recording an ever inadequate appreciation to Dereck for his sterling service and also to his family for allowing us to consume so much of the time, talent and fortitude of this outstanding human being.
Edward and Auriol Greene Directors, GOFAD.