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Cancer causes a fifth of deaths in the Caribbean region and its incidence is increasing. Incidence and mortality patterns of cancer in the Caribbean reflect globally widespread epidemiological transitions, and show cancer profiles that are unique to the region. Providing comprehensive and locally responsive cancer care is particularly challenging in the Caribbean because of the geographical spread of the islands, the frequently under-resourced health-care systems, and the absence of a cohesive approach to cancer control. In many Caribbean countries and territories, cancer surveillance systems are poorly developed, advanced disease presentations are commonplace, and access to cancer screening, diagnostics, and treatment is often suboptimal, with many patients with cancer seeking treatment abroad. Capacity building across the cancer-control continuum in the region is urgently needed and can be accomplished through collaborative efforts and increased investment in health care and cancer control. [ABSTRACT FROM AUTHOR]

Cancer is a leading cause of death in small island nations and is forecast to increase substantially over the coming years. Governments, regional agencies, and health services of these nations face daunting challenges, including small and fragile economies, unequal distribution of resources, weak or fragmented health services, small population sizes that make sustainable workforce and service development problematic, and the unavailability of specialised cancer services to large parts of the population. Action is required to prevent large human and economic costs relating to cancer. This final Series paper highlights the challenges and opportunities for small island nations, and identifies ways in which the international community can support efforts to improve cancer control in these settings. Our recommendations focus on funding and investment opportunities to strengthen cancer-related health systems to improve sharing of technical assistance for research, surveillance, workforce, and service development, and to support small island nations with policy changes to reduce the consumption of commodities (eg, tobacco and unhealthy food products) that increase cancer risk. [ABSTRACT FROM AUTHOR]

Improving basic capacities for regulation of medicines and health technologies through regulatory systems strengthening is particularly challenging in resource-constrained settings. "Regionalization"--an approach in which countries with common histories, cultural values, languages, and economic conditions work together to establish more efficient systems--may be one answer. This report describes the Caribbean Regulatory System (CRS), a regionalization initiative being implemented in the mostly small countries of the Caribbean Community and Common Market (CARICOM). This initiative is an innovative effort to strengthen regulatory systems in the Caribbean, where capacity is limited compared to other subregions of the Americas. The initiative's concept and design includes a number of features and steps intended to enhance sustainability in resource-constrained contexts. The latter include 1) leveraging existing platforms for centralized cooperation, governance, and infrastructure; 2) strengthening regulatory capacities with the largest potential public health impact; 3) incorporating policies that promote reliance on reference authorities; 4) changing the system to encourage industry to market their products in CARICOM (e.g., using a centralized portal of entry to reduce regulatory burdens); and 5) building human resource capacity. If implemented properly, the CRS will be self-sustaining through user fees. The experience and lessons learned thus far in implementing this initiative, described in this report, can serve as a case study for the development of similar regulatory strengthening initiatives in resource-constrained environments. [ABSTRACT FROM AUTHOR]

The article examines the efforts by member countries of the United Nations (UN) to meet the goal of reducing by 25% the premature mortality due to non-communicable diseases (NCD) by 2025. The major NCDs include cardiovascular disease, cancer and chronic obstructive pulmonary disease. It cites several steps that could be taken by all countries, especially for low-income and middle-income countries, including the planning and mobilisation of a multisectoral response.

Two cooperative public health initiatives involving representatives of civil society, academia, and the public and private sectors of the Americas are described and analyzed. One of them--the Multipartite Dialogue--promotes an intersectoral approach in its broadest sense, and the other--the Partners Forum--while it represents an institutional initiative, pays particular attention to chronic noncommunicable diseases. Both are a call to action for governments and offer alternatives to tackle regional health problems more effectively. [ABSTRACT FROM AUTHOR]

The article focuses on the identification of the risk factors for HIV infection and sexually transmitted infection (STI) service use among the female sex workers in Guyana. It mentions that program of screening and treatment of ulcerative STIs should be associated with the substance abuse services for the sex workers. Moreover, HIV stigma may prevent the sex workers from accessing the HIV test results.

This report describes a Department of Defense humanitarian assistance project to develop and build a regional computer-assisted laboratory-based electronic disease surveillance system in the Caribbean basin. From 1997 through 2000, the project donated 146 computer systems and trained more than 250 personnel from 14 ministries of health to operate this system. This humanitarian mission provided the region with a sustainable and locally maintained and operated surveillance system having a broad and long-term impact on public health. It has improved data gathering, analysis, and reporting at the local, national, and regional level. Benefits to the region include the dissemination through the Internet of increasingly timely and accurate information on the incidence and prevalence of endemic, epidemic, and newly emerging diseases. This serves the Caribbean residents, travelers, and U.S. national interests. The project is a model for cooperative Department of Defense capacity building and training programs in support of partner countries and international public health agencies. [ABSTRACT FROM AUTHOR]

Presents information on a study which examined the incidence of Salmonella enteritidis infection in Trinidad & Tobago. Methodology; Results of the study; Discussion.