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Item An Exploratory Study of Quality of Life and Its Relationship with Academic Performance among Students in Medical and other Health Professions(Medical Sciences, 2020) Chattu, Vijay Kumar; Sahu, Pradeep Kumar; Seedial, Neela; Seecharan, Gerlisa; Seepersad, Amanda; Seunarine, Melina; Sieunarine, Shivanna; Seymour, Kahamaron; Simboo, Samantha; Singh, ArissaQuality of life (QOL) is a broader concept which represents experiences, states, appraisals, behaviors, capacities and emotional reactions to circumstances. The study aimed to evaluate the di erences in various domains of QOL among the students of five schools (medicine, dentistry, veterinary medicine, pharmacy and nursing) and an optometry unit in the Faculty of Medical Sciences, Trinidad and Tobago. Further, the study evaluated the factors (sociodemographic variables and academic performance) predictive of physical, psychological, social and environment domains of quality of life. The research tool consisted of a validated questionnaire which had two sections; (1) sociodemographics inclusive of students’ cumulative grade point average and (2) the shorter version of WHO quality of life (WHOQOL-BREF). The data were transformed into a linear scale and exported into the IBM SPSS version 24 where t-tests, one-way ANOVA and stepwise regression were performed. Of the total 535 participants, most 383 (71.6%) were females. While comparing the di erences in the domains of QOL that existed based on the schools (professions) they were enrolled, significant di erences were recorded for physical (p < 0.05), psychological (p < 0.05) social (p < 0.05) and environmental domains (p < 0.05). Though the domains of physical health, psychological health and environment showed a significant association with the academic performance of students, the social domain had no such relationship. The overall quality of life has a positive connection with the academic performance of students in medical and health professions. Therefore, universities and all stakeholders involved in health professions need to play a critical role to ensure the students in health professions maintain a high QOL. At the same time, there is a great need for extra attention for students who showed poor academic performance in the previous semester to bring them on track.Item India’s Health Diplomacy as a Soft Power Tool towards Africa: Humanitarian and Geopolitical Analysis(Journal of Asian and African Studies, 2021) Mol, Rajani; Singh, Bawa; Chattu, Vijay Kumar; Kaur, Jaspal; Singh, BalinderIndia and Africa have been sharing a multidimensional relationship of cooperation and friendship since the ancient civilizations. The COVID-19 pandemic has brought new possibilities and opportunities for India to leverage its soft power diplomacy towards Africa. The paper’s main focus is to analyze how India has made soft power part of its foreign policy and examine India’s relationship with the African continent through health diplomacy. A literature search was done in major databases, such as Web of Science, Medicine/ PubMed, Scopus, OVID, and Google Scholar search engine to gather relevant information. Through humanitarian assistance and geopolitical influence, India had won the support and heart of Africans. Besides, India has become a global healthcare provider in the African continent through its global health diplomacy and vaccine diplomacy. India has achieved impressive gains through its soft power diplomacy and has become a compassionate and benevolent actor in the African continent.Item COVID-19 Vaccine, TRIPS, and Global Health Diplomacy: India’s Role at the WTO Platform(BioMed Research International, 2021) Chattu, Vijay Kumar; Singh, Bawa; Kaur, Jaspal; Jakovljevic, MihajloIn light of the devastation caused by COVID-19, the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and vaccine research and development (R&D) have been occupying a prominent position in the field of global health diplomacy (GHD). Most countries, international organizations, and charitable organizations have been engaged in the R&D of COVID-19 vaccines to ensure timely affordability and accessibility to all countries. Concomitantly, the World Trade Organization (WTO) provides some provisions and enforcements regarding copyrights, patents, trademarks, geographical indications, and industrial designs. Given these safeguards, it is considered that intellectual property rights (IPRs) have become major barriers to the affordability and accessibility of vaccines/medicines/technology, particularly to the developing/least developed countries. Realizing the gravity of the pandemic impact, as well as its huge population and size, India has elevated this issue in its global health diplomacy by submitting a joint proposal with South Africa to the World Trade Organization (WTO) for a temporary waiver of IPRs to ensure timely affordability and accessibility of COVID-19 medical products to all countries. However, the issue of the temporary waive off had become a geopolitical issue. Countries that used to claim per se as strong advocates of human rights, egalitarianism, and healthy democracy have opposed this proposal. In this contrasting milieu, this paper is aimed at examining how the TRIPS has become a barrier for developing countries’ development and distribution of vaccines/technology; secondly, how India strategizes its role in the WTO in pursuant of its global health diplomacy? We conclude that the IPRs regime should not become a barrier to the accessibility/affordability of essential drugs and vaccines. To ensure access, India needs to get more engaged in GHD with all the involved global stakeholders to get strong support for their joint proposal. The developed countries that rejected/resisted the proposal can rethink their full supportItem COVID-19 pandemic containment in the Caribbean Region: A review of case-management and public health strategies(AIMS Public Health, 2021) Umakanthan, Srikanth; Chauhan, Anuradha; Gupta, Madan Mohan; Sahu, Pradeep Kumar; Bukelo, Maryann M; Chattu, Vijay KumarCOVID-19 emerged initially from Wuhan, Hubei province, China, in late December 2019, and since then, it has spread globally to be declared a pandemic by the World Health Organization. The Caribbean region started reporting COVID-19 cases in early March 2020, triggering new regional public health crises. The initial suspects and confirmed cases across the Caribbean countries were mainly imported cases and from cruise ships. The clinical manifestations varied from fever, cough, and malaise in mild cases to acute respiratory distress syndrome (ARDS) and shock in severe cases. The Caribbean Public Health Agency has provided frequent updates on the preventive strategies and quarantine measures across the Caribbean member states. COVID-19 has had a serious impact on the Caribbean region’s health system, economy, and psychology. This review presents the Caribbean perspective of COVID-19, detailing the epidemiology, clinical manifestations, diagnosis, management, and preventive and surveillance measures. Vaccine hesitancy was found to be a major challenge that needs appropriate health education strategies to address the public. Strong leadership and regional collaboration among the Caribbean member states are necessary to provide optimal real-time data to the public and implement appropriate and effective guidelines in the island statesItem Global epidemiology, risk factors, and histological types of ovarian cancers in Trinidad(Journal of Family Medicine and Primary, 2019) Umakanthan, Srikanth; Chattu, Vijay Kumar; Kalloo, ShereneOvarian cancer is the seventh most common cancer in women in the world and Trinidad and Tobago is ranked 18th in the world with respect to the rate of occurrence. About 68% cases are diagnosed at a late stage, resulting in low survival rates. Since there is very scanty literature available on the epidemiology of ovarian cancer in the Caribbean region, this study was undertaken to assess the most common risk factors, presenting symptoms and common histological varieties in Trinidad. Methods: A hospital‑based, cross‑sectional study was designed, and all the 23 diagnosed ovarian cancer cases registered during 2015–2017 were considered. Information on sociodemographics, presenting symptoms, and histological type of cancers were collected after getting the ethical approval. Of the total 23 cases, 17 cases were included in this study after ensuring completeness of data as detailed analysis of patient data was done using Microsoft Excel. Results: The common risk factors identified were previous pregnancies, previous surgeries, and irregularities in the menstrual cycle. The commonest histological variety was granulosa tumors and the most common associated symptoms were irregular menses and abdominal pain in premenstrual women, and abdominal distention in postmenopausal women. Conclusions: It would greatly enhance the detection rate if screening and testing for the CA‑125 gene were a mandatory practice, for any patient found with more than three risk factors. The public health authorities should identify the modifiable risk factors and implement cancer reduction and health promotion activities to reduce the mortality related to ovarian cancersItem COVID-19 Pandemic as an Excellent Opportunity for Global Health Diplomacy(Frontiers in Public Health, 2021) Taghizade, Sanaz; Chattu, Vijay Kumar; Jaafaripooyan, Ebrahim; Kevany, SebastianUndoubtedly, the COVID-19 pandemic is not the first and most frightening global pandemic, and it may not be the last. At the very least, this phenomenon has though seriously challenged the health systems of the world; it has created a new perspective on the value of national, regional, and international cooperation during crises. The post-coronavirus world could be a world of intensified nationalist rivalries on the economic revival and political influence. However, strengthening cooperation among nations at different levels will lead to the growth of health, economy, and security. The current situation is a touchstone for international actors in coordinating the efforts in similar future crises. At present, this pandemic crisis cannot be resolved except through joint international cooperation, global cohesion, and multilateralism. This perspective concludes that the pandemic could be an excellent opportunity for the scope of global health diplomacy (GHD) and how it can be applied and practiced for strengthening five global arenas, namely (1) International Cooperation and Global Solidarity, (2) Global Economy, Trade and Development, (3) Global Health Security, (4) Strengthening health systems, and (5) Addressing inequities to achieve the global health targets. GHD proves to be very useful for negotiating better policies, stronger partnerships, and achieving international cooperation in this phase with many geopolitical shifts and nationalist mindset among many nations at this stage of COVID-19 vaccine roll-outItem Prioritizing ‘equity’ in COVID-19 vaccine distribution through Global Health Diplomacy(Health Promotion Perspective, 2021)With over 4 million deaths worldwide, the current coronavirus disease 2019 (COVID-19) pandemic is regarded as one of the worst pandemics in history. With its wider devastating consequences, even so-called affluent countries could not provide full coverage for COVID-19 vaccines and medications to all of their citizens. Against this backdrop, the main aim of this article is to examine how Global Health Diplomacy (GHD) can play a role in prioritizing vaccine equity in the global health agenda in the fight against COVID-19. The majority of developed countries’ healthcare systems have been exposed and have reached a tipping point. After the completion of eighteen months of the pandemic, only five countries were able to produce vaccines for the treatment of COVID-19. This pandemic has divided the world into two blocs: those with vaccines, such as the United States, the United Kingdom, Russia, China, and India; and those without, such as the rest of the world. The greatest challenges are vaccine inequalities, inequities and distribution, which undermine the global economic recovery. Many poor countries are still waiting for the initial doses to be delivered to their citizens, while some rich nations are planning for booster doses. GHD plays a critical role in establishing successful global collaborations, funding mechanisms and ensuring international cooperation through the combined efforts of all stakeholders. Besides, global solidarity is necessary to lessen the wider gaps between the vaccination status of rich and poor nations. Therefore, through GHD, the vaccine gaps and inequities can be addressed to strengthen global health security and accelerate global economic recoveryItem Equity in health care: is it achievable?(Elsevier Public Health Emergency Collection, 2020) Pooransingh, Shalini; Chattu, Vijay KumarItem Developing a community‑based breast cancer risk prediction tool for resource‑poor settings(Journal of Education and Health Promotion, 2019) Pillai, Divya; Shah Hossain, Shaikh; Chattu, Vijay KumarBACKGROUND: With an estimation of every two women newly diagnosed with breast cancer, one dies. It is accounted that 1 in 28 women is likely to develop breast cancer during her lifetime. Developing a risk prediction tool by assessing the prevalence of known risk factors in the community will help public health intervention. METHODOLOGY: A cross‑sectional study was conducted among 18–64‑year‑old women to gather the prevalence of known breast cancer risk factors, through a community survey (sample survey). In this multistage random number‑based cluster sampling study, the results were compiled, collated, and analyzed in rates and proportions. Statistical conclusions were made using spreadsheets (Microsoft) and the values were converted into ordinal values using modified Likert scale and median was used to estimate central values. The estimated prevalence of these known risk factors was re‑assorted for analysis and these re‑assorted data were categorized into range of values across the communities. The internal validity of the survey questionnaire was measured using Cronbach’s alpha (α). RESULTS: The analysis of 558 participants was performed for the known risk factors for breast cancer including participant’s age, age at menarche, marriage, first childbirth, menopause, family history of breast cancer and benign breast disease, history of abortion, and body mass index. Based on the estimated prevalence of these risk factors, a community‑based risk prediction tool was developed with Cronbach’s α score of medium internal validity. CONCLUSIONS: The risk assessment tool has collated most of the risk factors of breast cancer that are capable of being measured at community level. The survey findings concluded that the community under survey was bearing moderate risk for breast cancer for womenItem Strengthening the COVID-19 pandemic response, global leadership, and international cooperation through global health diplomacy(Health Promotion Perspective, 2020) Javed, Sumbal; Chattu, Vijay KumarThe coronavirus disease 2019 (COVID-19) pandemic continues to claim lives around the world and, to some extent, reflects the failure of international cooperation. Global health diplomacy (GHD) can be a bridge for international cooperation for tackling public health crises, strengthening health systems through emphasizing universal health coverage for sustainable and equitable development, and rebuilding multilateral organizations. It can be a catalyst for future global health initiatives. Health should not be used as a political tool at the cost of people’s lives, nor should it become a proxy for geopolitics but can be used to diffuse tensions and create a positive environment for political dialogue. Health diplomacy’s focus should be to mitigate inequality by making available diagnostics, therapeutics, and vaccines as a global public good. The implications for the lack of international cooperation will lead to increased global disparities and inequities as the countries that cannot procure vaccines will find their population more vulnerable to the pandemic’s repercussion. Though the international cooperation on trade has suffered the impact of geopolitical shifts and competition, through engaging in GHD, the governments can align the trade and health policies. Amid this global health crisis, the World Health Organization (WHO) has faced an increase in International Health Regulations violations, limiting its influence and response during this COVID-19 pandemic. Nations need to develop a sense of cooperation that serves as the basis for a mutual strategic trust for international development. The priorities of all the countries should be to find the areas of common interest, common operational overlap on development issues, and resource allocation for this global fight against COVID-19Item Higher Education as a Bridge between China and Nepal: Mapping Education as Soft Power in Chinese Foreign Policy(Societies, 2021) Gauttam, Priya; Singh, Bawa; Chattu, Vijay KumarIn this globalized world, education has become an important medium to enhance people-to-people contact. The Delores report of the International Commission on Education for the 21st century highlights the enormous potential of higher education to use globalization as a resource for bridging the knowledge gap and enriching cross-cultural dialogue. As a major contributor to soft power and an important field of public diplomacy, international education can have a wealth of advantages, including the ability to generate commercial value, promote a country’s foreign policy goals and interests, and contribute to economic growth and investment. The People’s Republic of China, well-known for being the world’s most populous nation and the global economic powerhouse, prioritizes the internationalization of the country’s higher education system. China is looking to expand its higher education program and carry out its diplomatic project in South Asia. In this sense, the South Asian zone, especially Nepal, is significant for China, where its educational diplomacy is playing as a “bridge between Sino- Nepal relations.” In this review, we describe the place and priority of “Education” in China’s foreign policy; explore China’s mediums of investment in Nepal’s education sector; and highlight the importance of educational aid in Sino-Nepal relations. Chinese educational aid to Nepal takes many forms, where Nepali students and officials engage with Chinese investment to enhance their career prospects and the education system in NepalItem Tuberculosis Skin Test Screening in the National Tuberculosis Program of Trinidad and Tobago(Healthcare, 2020) Chattu, Vijay Kumar; Sakhamuri, Sateesh; Motilal, Shastri; Pounder, Liam J.; Persad, Vasishma Kanita; Pierre, Neelmani; Persad, Shivannie; Pooran, Nikesha; Pottinger, Akua MosiGlobally, a quarter of the population is infected with tuberculosis (TB), caused by Mycobacterium tuberculosis. About 5–10% of latent TB infections (LTBI) progress to active disease during the lifetime. Prevention of TB and treating LTBI is a critical component of theWorld Health Organization’s (WHO) End TB Strategy. This study aims to examine the screening practices for prevention and treatment employed by the National Tuberculosis Program of Trinidad and Tobago in comparison to the WHO’s standard guidelines. A cross-sectional retrospective study was conducted from the TB registers (2018–2019) for persons aged 18 years and above with recorded tuberculin skin test reactions (TST). Bivariate comparisons for categorical variables were made using Chi-square or Fisher’s exact test. Binary logistic regression was used for exploring predictors of TST positivity with adjustment for demographic confounders in multivariable models. Of the total 1972 eligible entries studied, 384 (19.4%) individuals were tested positive with TST. TB contact screening (aOR 2.49; 95% CI 1.65, 3.75) and Bacillus Calmette–Guerin (BCG) vaccination status (aOR 1.66; 95% CI, 1.24 to 2.22) were associated with a positive TST reaction, whereas, preplacement screening failed to show such association when compared to those screened as suspect cases. The findings suggest that TB contact screening and positive BCG vaccination status are associated with TST positivity independent of age and genderItem Global health diplomacy at the intersection of trade and health in the COVID-19 era(Health Promotion Perspective, 2021) Chattu, Vijay Kumar; Pooransingh, Shalini; Allahverdipour, HamidGlobal health diplomacy has gained significant importance and undoubtedly remained high on the agendas of many nations, regional and global platforms amid the coronavirus disease 2019 (COVID-19) pandemic. Many countries have realized the importance of the health sector and the value of a healthy workforce. However, there is little control on issues related to trade that impact on human health due to the dominance of profit-oriented business lobbies. A balance, however, needs to be struck between economic profits and a healthy global population. This paper aimed to highlight the importance of building capacity in global health diplomacy, especially during the COVID-19 pandemic so that health personnel may effectively negotiate on the multisectoral stage to secure the resources they need. The recent proposal to waive off certain provisions of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement for the prevention, containment and treatment of COVID-19 by India and South Africa at the World Trade Organization (WTO) presents an important opportunity for all governments to unite and stand up for public health, global solidarity, and equitable access at the international level so that both developed and developing nations may enjoy improved health outcomes related to the COVID-19 pandemicItem Strengthening African health systems through global health diplomacy(Health Promotion Perspective, 2020) Chattu, Vijay Kumar; Pooransingh, ShaliniItem The Emerging Role of Blockchain Technology Applications in Routine Disease Surveillance Systems to Strengthen Global Health Security(Big Data and Cognitive Computing, 2019) Chattu, Vijay Kumar; Nanda, Anjali; Chattu, Soosanna Kumary; Manzoor Kadri, Syed; Knight, W. AndyBlockchain technology has an enormous scope to revamp the healthcare system in many ways as it improves the quality of healthcare by data sharing among all the participants, selective privacy and ensuring data safety. This paper explores the basics of blockchain, its applications, quality of experience and advantages in disease surveillance over the other widely used real-time and machine learning techniques. The other real-time surveillance systems lack scalability, security, interoperability, thus making blockchain as a choice for surveillance. Blockchain o ers the capability of enhancing global health security and also can ensure the anonymity of patient data thereby aiding in healthcare research. The recent epidemics of re-emerging infections such as Ebola and Zika have raised many concerns regarding health security which resulted in strengthening the surveillance systems. We also discuss how blockchains can help in identifying the threats early and reporting them to health authorities for taking early preventive measures. Since the Global Health Security Agenda addresses global public health threats (both infectious and NCDs); strengthen the workforce and the systems; detect and respond rapidly and e ectively to the disease threats; and elevate global health security as a priority. The blockchain has enormous potential to disrupt many current practices in traditional disease surveillance and health care researchItem Subjective Well-Being and Its Relation to Academic Performance among Students in Medicine, Dentistry, and Other Health Professions(Education Sciences, 2020) Chattu, Vijay Kumar; Sahu, Pradeep Kumar; Seedial, Neela; Seecharan, Gerlisa; Seepersad, Amanda; Seunarine, Melina; Sieunarine, Shivanna; Seymour, Kahamaron; Simboo, Samantha; Singh, ArissaSubjective well-being is defined as a person’s cognitive and a ective evaluations of his or her life. This study aims to investigate the di erences in the domains of subjective well-being based on gender, type of school, and academic performance. Additionally, the study aimed to determine the factors (socio-demographic variables, including the academic performance of the students) that are predictive of subjective well-being. Subjective well-being was assessed using a questionnaire which included the Satisfaction with Life Scale (SWLS), which measured the respondent’s life satisfaction, the Scale of Positive and Negative Experience (SPANE), which consisted of six positive and negative emotions, and, lastly, the Flourishing Scale (FS), which measured the respondents’ self-perceived success. Data were collected, transformed into a linear scale, and exported into SPSS version 24, where t-tests, one-way analysis of variance, Pearson correlation, and stepwise regression were performed. Of the total of 535 participants, the majority were females (383 = 71.6%) and studying in a school of medicine (31.8%). With respect to the SWLS and FS, a significant di erence was reported among students based on the type of school and their academic performance (p < 0.05). While comparing the di erences in the SPANE, a significant di erence was recorded based on academic performance. Among the domains of subjective well-being, only the SPANE showed a significant association with academic performance. Greater subjective well-being correlates with higher academic performance, indicating that subjective well-being is an important aspect of a student’s academic life; provisions can be made by paying more attention to those who showed poor academic performance during and at the end of each semesterItem Global Health Diplomacy Fingerprints on Human Security(International Journal of Preventive Medicine, 2019) Chattu, Vijay Kumar; Knight, W. Andy; Reddy, K. Srikanth; Aginam, ObijioforHuman security is a concept that challenges the traditional notion of national security by placing the ‘human’ as the central referent of security instead of the ‘state.’ It is a concept that encompasses health and well-being of people and prioritizes their fundamental freedoms and basic livelihoods by shielding them from acute socioeconomic threats, vulnerabilities and stress. The epicenter of “health security” is located at the intersection of several academic fields or disciplines which do not necessarily share a common theoretical approach. Diverse players in the “health security” domain include practitioners in such fields as security studies, foreign policy, international relations, development theory, environmental politics and the practices of the United Nations system and other multilateral bodies like the World Health Organization (WHO) and the Pan American Health Organization (PAHO). Improvements in health are not only dependent on continued commitments to enhance the availability of healthcare and to strengthen disease prevention systems; they are very much enhanced by that intersection between global security and global health. What is emerging is global health diplomacy paradigm that calls for strengthening of core capacities in the public health and foreign policy arenas aimed at advancing human security through the strengthening of global health diplomacy practices. Human security in its broadest sense embraces far more than the absence of violence and conflict. It encompasses human rights, good governance, access to education and health care, and ensuring that each individual has opportunities and devices to fulfill his or her potential. Every step in this direction is a step towards reducing poverty, achieving growth and preventing conflict. Freedom from want, freedom from fear and the freedom of future generations to inherit a natural environment – these are the interrelated building blocks of human‑ and therefore national securityItem Politics of disease control in Africa and the critical role of global health diplomacy: A systematic review(Health Promotion Perspective, 2021) Chattu, Vijay Kumar; Knight, W. Andy; Adisesh, Anil; Yaya, Sanni; Reddy, K. Srikanth; Di Ruggiero, Erica; Aginam, Obijiofor; Aslanyan, Garry; Clarke, Michael; Massoud, M. Rashad; Jha, AshishBackground: Africa is facing the triple burden of communicable diseases, non-communicable diseases (NCDs), and nutritional disorders. Multilateral institutions, bilateral arrangements, and philanthropies have historically privileged economic development over health concerns. That focus has resulted in weak health systems and inadequate preparedness when there are outbreaks of diseases. This review aims to understand the politics of disease control in Africa and global health diplomacy’s (GHD’s) critical role. Methods: A literature review was done in Medline/PubMed, Web of Science, Scopus, Embase, and Google scholar search engines. Keywords included MeSH and common terms related to the topics: “Politics,” “disease control,” “epidemics/ endemics,” and “global health diplomacy” in the “African” context. The resources also included reports of World Health Organization, United Nations and resolutions of the World Health Assembly (WHA). Results: African countries continue to struggle in their attempts to build health systems for disease control that are robust enough to tackle the frequent epidemics that plague the continent. The politics of disease control requires the crafting of cooperative partnerships to accommodate the divergent interests of multiple actors. Recent outbreaks of COVID-19 and Ebola had a significant impact on African economies. It is extremely important to prioritize health in the African development agendas. The African Union (AU) should leverage the momentum of the rise of GHD to (i) navigate the politics of global health governance in an interconnected world (ii) develop robust preparedness and disease response strategies to tackle emerging and reemerging disease epidemics in the region (iii) address the linkages between health and broader human security issues driven by climate change-induced food, water, and other insecurities (iv) mobilize resources and capacities to train health officials in the craft of diplomacy. Conclusion: The AU, Regional Economic Communities (RECs), and African Centres for Disease Control should harmonize their plans and strategies and align them towards a common goal that integrates health in African development agendas. The AU must innovatively harness the practice and tools of GHD towards developing the necessary partnerships with relevant actors in the global health arena to achieve the health targets of the Sustainable Development GoalsItem Port of Spain Summit Declaration as a successful outcome of global health diplomacy in the Caribbean region: a systematic review(Health Promotion Perspective, 2019) Chattu, Vijay Kumar; Knight, W. AndyBackground: The Caribbean region, with a population of around 17 million, has the highest burden of chronic noncommunicable diseases (NCDs) in the region of the Americas. It is estimated that diabetes and hypertension has an economic impact of around 5%-8% of the gross domestic product of the region. The purpose of this study was to explore and understand how global health diplomacy contributed to the evolution of a collective Caribbean regional summit declaration to address the epidemic of NCDs. Methods: A systematic review was conducted, and all the major databases such as MEDLINE, PubMed, EMBASE, Scopus, Web of Science, EBSCO, Global Health database and other available policy documents from various sources were screened. All articles available from 1910-2018 were extracted. From the total of 3223 titles, after filtering, the search narrowed down to 28 full texts that are included in this study. Policy documents and articles related to NCDs, global health diplomacy, and the Port of Spain Declaration (POSD) were the focused themes. Results: The Caribbean region showed significant commitment to the prevention and control of NCDs through its united voice and commitment since 2001. The successful rounds of negotiations for regional health have led to the formulation of the 15- point multisectoral POSD “Uniting to Stop the Epidemic of Chronic NCDs.” This was the first Summit in the world where the Heads of Government focused on prevention and control of NCDs with a clear road map for policy implementation, collaboration, and collective action. This regional summit declaration gained global attention and resulted in the United Nations Political Declaration on the Prevention and Control of NCDs and as WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020. Conclusion: There is enormous scope for this evolving area of Global Health Diplomacy in addressing the future challenges of health securityItem The need for health diplomacy in health security operations(Health Promotion Perspective, 2019) Chattu, Vijay Kumar; Kevany, SebastianThe concept of health security involves the intersection of several fields and disciplines and is an inherently political and sensitive area. It is also a relatively a new field of study and practice which lacks a precise definition - though numerous disciplines and areas like foreign policy, national interests, trade interests, health security, disaster relief, and human rights contribute to the concept. The purpose of this paper is to highlight the need for, health diplomacy in improving health security. For example, it is not unusual for developing country societies to build their health security measures by restricting travel and movement of those emanating from affected areas. When extreme health security measures threaten cordial and cooperative relations between nations, the issue of protection of one country’s population may lead to the risk of international conflict. As the World Health Organization (WHO) stated in 2007 that ‘functioning health systems are the bedrock of health security,’ it is crucial that partners with sound financial and technical capacities benefit developing countries through their assistance and sharing information. This paper explores how health diplomacy holds great promise to address the needs of global health security through binding or nonbinding instruments, enforced by global governance mechanisms