A.  H1N1 Influenza

On Wednesday August 10th 2010, the Director General of the WHO, Dr Margaret Chang, issued a statement to the effect that the world is no longer in phase 6 of the H1N1 influenza pandemic alert.  The world has entered a post-pandemic period meaning that the H1N1 virus, commonly referred to as “swine flu”, has run its course as a new influenza virus and is now one of several seasonal influenza viruses.  

The general public will recall that the Federation experienced two waves of H1N1 influenza.  Overall, the people of St. Kitts and Nevis fared well during the pandemic phases.   

Appreciation is extended to all health providers for their outstanding performance in responding to the H1N1 pandemic and in caring for affected persons.  Special thanks to the various media outlets for helping to disseminate locally relevant guidance.   

The Ministries of Health of both islands will continue their surveillance of influenza viruses and other infections in conjunction with CAREC and the Pan American Health Organization.  


B.  Dengue

In a statement to Parliament, the Hon. Marcella Liburd, Minister of Health reported that there were five (5) suspect cases of Dengue Fever but no outbreak situation.  An outbreak means that the number of confirmed new cases exceeds the number normally expected. 

Every year, there are several cases of Dengue Fever in the Federation usually less than ten (10).  So far for 2010, one (1) confirmed case has been reported in the month of January. 

Surveillance reports do not show an increase in suspect cases at this time however conditions exist for an outbreak because of the unhealthy practice of littering, excessive rainfall and the presence of an increased number of confirmed cases in the neighboring countries.

Reports out of Trinidad and Tobago indicated that the outbreak there started in rural communities where people store potable water.  In St. Kitts and Nevis, the need to store water for drinking, cooking and washing has been eliminated because water is piped directly into homes. 

Nevertheless, with the continuing heavy rainfall, it is possible for water to collect in containers such as flower pots, cans, tires, shells etc. allowing the dengue spreading mosquitoes to breed.  The Minister of Health appealed to all persons in the community to search out and destroy all mosquito breeding sites in their homes, yards and adjacent lots.  She concluded that community action will go a long way to prevent an outbreak of dengue in the Federation.

C.  Value Added Tax

In her presentation on the VAT legislation, the Hon. Marcella Liburd pointed out a number of issues that were of importance to the health of the population. 

1. In light of the Federation’s high rates of obesity, high blood pressure and diabetes, and the resulting premature loss of life, kidney function, eyesight and limbs, there is need for tax policy to make healthier food and beverage items more affordable and accessible to the public.

2. Several items that are either vital or essential to promoting health and maintaining health are exempt from VAT.  They include:
a. Water
b. Food produced by local farmers and fishers.
c. Certain imported food items particularly those made of whole grain, low in fat, salt and refined sugar.
d. Essential medicines i.e. those prescribed for the control of diabetes, high blood pressure, HIV/AIDS, asthma, cancer etc.
e. Medical products used by disabled persons.

3. VAT is a measure to provide government revenue to 
a. Keep government health facilities open and operational.  Health centers are totally free.  Senior citizen homes are also totally free.  Hospital services are free to most residents.  The cost to the government (Federal and NIA) is EC $52 million or EC$ 1000 for every person.

b. Maintain social services such as the home care program for the elderly, food voucher program for persons with HIV/AIDS, school meals, uniform assistance, foster care, etc.  The cost of social programs in the Federation is EC $ 20 million. 

……………………
Patrick Martin
Chief Medical Officer