Port of Spain, Trinidad. 01 December, 2023: It is with profound sadness and shock that I extend my deepest condolences to the family and friends, people of Dominica, the Caribbean Community and the Pan American Health Organization (PAHO), on the untimely passing of PAHO Director Emeritus, Dr. Carissa Etienne.

Dr. Etienne’s contributions to public health in the Americas were not only significant, but also transformative.  Her leadership and unwavering commitment to our Caribbean Community’s collective pursuit of healthier people, healthier spaces and a healthier Caribbean were a source of inspiration to many.  Dr. Etienne was a tireless advocate for The Americas’ regional solidarity, for she knew that was the only way to address the glaring inequalities that exist here.

She was the Director at PAHO for most of the life of the Caribbean Public Health Agency (CARPHA), and under her leadership, CARPHA graduated from the PAHO Biennial Work Programme (BWP) arrangement to having framework agreements.

PAHO funded many of the programmes that are difficult to attract support, like the Caribbean Regulatory System (CRS) and the Medicines Quality Control and Surveillance Department (MQCSD), which are important services for the Region to ensure the quality of medicines.  Under Dr. Etienne’s leadership, PAHO also funded non-communicable disease interventions, another area that does not attract large pots of funding, although the number one cause of deaths in the Caribbean region. 

During the Pandemic, CARPHA worked with PAHO to fund the downpayments to give 12 Member States access to COVID-19 vaccines through COVAX to the tune of US$2.6 million.

Dr. Etienne will be remembered as a true Caribbean lady who worked with great dedication and focus throughout the horrible COVID-19 period and right up to her last working day at PAHO.

During this challenging time, we pray that God will give strength to Dr. Etienne’s family, friends, and colleagues.  CARPHA cherishes the memories of her remarkable contributions to the well-being of individuals and communities throughout the Americas, but especially the Caribbean.

The CARPHA Executive Management and staff stand in solidarity with our Caribbean Community as we mourn the loss of a visionary leader. 

Dr. Joy St. John

Executive Director, CARPHA

Port of Spain, Trinidad and Tobago.  24 November 2023.  The Caribbean Public Health Agency (CARPHA) has noted the continued increase, over the past six months, in reports of suspected and confirmed cases of Dengue in the Caribbean region, especially in CARPHA Member States that have seen increased rainfall. The associated risks and ripple effects must not be underestimated as outbreaks of Dengue and other mosquito-borne diseases like Zika and Chikungunya pose a significant threat to health, tourism, as well as social and economic development.

“Regional Health Security remains at the fore of CARPHA’s focus. In this regard, any public health threat, such as Dengue, that imperils the integrity of our regional response systems must be dealt with in a timely and effective manner and as such demands, that as the Caribbean community, we mobilize efforts to maximise efficiencies. Member States are encouraged to remain vigilant and flexible with their national work plans and available resources to maximise chances of successful responses. In 2023, four CARPHA Member States have reported Dengue outbreaks and trends are being monitored in others with subsets of all four Dengue serotypes circulating across the region,” stated Dr. Joy St. John, Executive Director at CARPHA

Dengue is known to cause outbreaks every three to five years. In the recent past, the seasonality of Dengue transmission in the Americas and the Caribbean has added to the record highs of total case numbers and complications. While 2019 was distinct for being the year with the highest number of reported Dengue cases in the Americas, it is very likely that 2023 will surpass that historic high. In 2023, up to epi-week 40, the Caribbean has noted a 15 percent increase in confirmed Dengue cases in CMS compared to a similar period in 2022.

Dr Horace Cox, Assistant Director of Surveillance, Disease Prevention and Control, and Head Vector Borne Diseases at CARPHA stated that: “The Aedes aegypti mosquito, which spreads the virus, is present in all Caribbean territories.  Vulnerable populations in small island developing states, like the Caribbean, and continental states with low lying coastal regions, need to be better prepared and resilient in addressing the prevention and control of Dengue and other arboviral diseases”.

“Around our homes and communities, we need to ensure our surroundings are clean and free of materials or containers that can accumulate water. We often overlook plant pot bases, vases, buckets and used vehicle tyres. These are typical breeding sites and should be checked frequently.  Water storage drums and tanks must be properly covered and inspected periodically to ensure that there is no breeding. Roof gutters should also be cleaned. Wire-mesh/screens on doors and windows also help in reducing the entry of mosquitoes into homes,” stated Mr. Rajesh Ragoo, Senior Technical Officer for Vector-Borne Diseases at CARPHA.

The mosquitoes that spread Dengue are active during the day. Personal preventative measures to minimise mosquito bites are also extremely important. Vulnerable groups such as infants, young children, older adults, and women who are pregnant, or trying to get pregnant, must be extra cautious. Long-sleeved clothing and repellents containing DEET, IR3535 or lemon eucalyptus, should be used to protect exposed skin or clothing, and must be used in accordance with the instructions on the product label. Confirmed cases should rest under mosquito nets.

To counter the increase in mosquitoes and potential disease transmission, greater effort should be placed on mosquito control activities in communities, and these should be intensified.  CARPHA urges its Member States to review their preparedness and response plans, as well as to continue surveillance, early diagnosis, and timely care of dengue and other arbovirus cases, to prevent severe cases and deaths associated with these diseases. CARPHA Member States (CMS) are encouraged to use available data, tools, and technologies to improve forecasting capacities, including the use of Geographical Information Systems (GIS).

CMS should also prioritise proper clinical management of suspected dengue cases by strengthening detection and management capacities at the primary health care level, thus preventing the progression of the disease to its severe forms.

CARPHA remains committed to supporting CMS in their vector control efforts, including capacity building in integrated vector control strategies.  CMS must continue to strengthen prevention and control measures such as surveillance, diagnosis, as well as timely and adequate treatment of cases, while ensuring that health care services are prepared to facilitate access and proper management of patients with these diseases.

CARPHA has launched a social media campaign to raise awareness and promote effective prevention and control measures for Dengue, a recurring threat to public health in the Caribbean region.  The campaign is a “whole of society” call to the public, healthcare practitioners and vector control officers, about their roles in this effort, and the critical need for proactive measures to reduce the spread of Dengue.

More information about Dengue and other mosquito borne diseases here:

• Facebook at carpha1
• Mission Mosquito: https://missionmosquito.carpha.org/
• Caribbean Mosquito Awareness: http://caribbeanmosquitoweek.carpha.org/

Dana Malcolm

Staff Writer 

November 24, 2023 – An inquiry has been opened into the UK’s handling of the COVID-19 Pandemic and testimony regarding the government so far is damning.

“Arguably the most fundamental misstep in the UK response was the presentation that COVID-19 would be an unstoppable flu like wave” said David Halpern, Professor on the Behavioral Insights Team, in an assessment of the COVID strategy which was read out during the hearing.

Halpern added that overconfidence and an unwillingness to learn from other countries was a downfall in the UK as well.

The inquiry is made up of five modules to investigate Resilience and preparedness (Module 1), Core UK decision-making and political governance (Module 2),  Impact of the Covid-19 pandemic on healthcare (Module 3), Vaccines and therapeutics (Module 4)and most recently Procurement (Module 5)

Right now, Module two: Core UK decision-making and political governance which called Halpern is ongoing.

Halpern says in addition the public was confused about the UKs tiered system.

“The public didn’t really understand the roles and this in some ways got worse and worse.”

Several other government aides have been called to the stand including Helen MacNamara, Former Deputy Cabinet Secretary, who painted a picture of laissez faire approach to COVID-19 rules by Boris Johnson, the then-Prime Minister asks his aides with not enough consideration given to the health of children, and perspectives of women

She recalled what she told coworkers in 2020,  during the hearing which was broadcast live: “I think we are going to kill thousands of people”.

The inquiry is ongoing, it’s a learning exercise to better prepare the country for future outbreak response and to answer taxpayers questions. No one will be charged in this inquiry.