Address by the Honourable Jahnel Nisbett

Minister of Health Gender Affairs & Social Empowerment in the Nevis Island Administration

in observance of World Kidney Day 2024

Greetings,

The Cabinet of the Nevis Island Administration and its Ministry of Health, Gender Affairs & Social Empowerment are pleased to celebrate with the Nevis Renal Society, kidney patients and health professionals the world over this 19th observance of World Kidney Day.

World Kidney Day is a joint initiative of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations – World Kidney Alliance (IFKF-WKA).

World Kidney Day is observed annually on the second Thursday of March. It started in 2006 and has not stopped growing ever since. Every year, the campaign highlights a particular theme. Under the Banner “ Kidney Health for All” the theme for this year is “Advancing equitable access to care and optimal medication practice”.

Why is this important to us as an Administration and to you the people we serve?

Short answer, it is all about the efficient use of scarce resources to achieve optimal health benefits. Prevention is still the best cure!

Please permit me to repeat and amplify this theme- advancing equitable access to care and optimal medication practice.

Chronic kidney disease (CKD) is estimated to affect more than 850 million people worldwide and resulted in over 3.1 million deaths in 2019. Presently, kidney disease ranks as the 8th leading cause of death, and if left unaddressed, it is projected to be the 5th leading cause of years of life lost by 2040.

Over the last three decades, CKD treatment efforts have centered on preparing for and delivering kidney replacement therapies. However, recent therapeutic breakthroughs offer unprecedented opportunities to prevent or delay disease and mitigate complications such as cardiovascular disease and kidney failure, ultimately prolonging the quality and quantity of life for people living with CKD.

While these new therapies should be universally accessible to all patients, in every country and environment, barriers such as lack of CKD awareness, insufficient knowledge or confidence with newer therapeutic strategies, shortages of kidney specialists, and treatment costs contribute to profound disparities in accessing treatments, particularly in low-and-middle-income countries, but also in some high-income settings. These inequities emphasize the need to shift focus towards CKD awareness and capacity building of the healthcare workforce.

Achieving optimal kidney care requires overcoming barriers at multiple levels while considering contextual differences across world regions. These include gaps in early diagnosis, lack of universal healthcare or insurance coverage, low awareness among healthcare workers, and challenges to medication cost and accessibility. A multi-pronged strategy is required to save kidneys, hearts, and lives:

• Health policies – Primary and secondary prevention of CKD require targeted health policies that holistically integrate kidney care into existing health programs, secure funding for kidney care, and disseminate kidney health knowledge to the public and the healthcare workforce. Equitable access to kidney disease screening, tools for early diagnosis, and sustainable access to quality treatment should be implemented to prevent CKD or its progression.
• Healthcare delivery – Suboptimal kidney care results from limited policy focus, inadequate patient and provider education, lack of resources for high-quality care, and limited access to affordable medication. To enact strategies successfully, it is essential to adopt a comprehensive, patient-centered, and locally oriented approach to identify and remedy barriers to high-quality kidney care.
• Healthcare professionals – Addressing the shortage of primary care professionals and kidney specialists requires enhancing training, minimizing loss of healthcare providers, and building capacity among healthcare workers, including primary care physicians, nurses, and community health workers. Education on appropriate CKD screening and adherence to clinical practice guideline recommendations are key to successful implementation of effective and safe treatment strategies. Embracing scientific innovation and utilizing pharmacologic and non-pharmacologic tools for CKD treatment, as well as fostering effective communication and empathy among professionals would greatly impact patient well-being.
• Empowering patients and communities – Globally, patients struggle to access care and medication due to high costs and misinformation, which impact their health behaviors and adherence. Raising awareness about CKD risk factors such as diabetes, hypertension, and obesity, enhancing health literacy about healthy lifestyle choices, self-care, and promoting long-term adherence to treatment strategies can bring large benefits especially when initiated early and consistently maintained. Involving patients in advocacy organizations and local communities will empower them to make informed decisions and improve their health outcomes.

The Nevis Renal Society was founded in 1999 in response to the growing awareness and increasing numbers of patients in Nevis coming down with End Stage Renal Failure and accessing Dialysis Services abroad.

Your persistent campaigns have borne fruit. Presently there are eight patients from Nevis receiving Treatment at the Dialysis Center in St. Kitts. As an Administration we are mindful of the issues and are working assiduously to make suitable accommodations here on Nevis.

We welcome this opportunity to partner with the Nevis Renal Society and wish them every success in their ongoing campaign to domesticate the full range of services here on Nevis. This week of activities in observance of World Kidney Day 2024 is a clarion call to us as a community to renew our efforts.

As your Minister of Health, I appeal to EVERYONE hearing this message to take stock and engage with the Nevis Renal Society, health professionals and your Administration to help us build the supportive community response that is so necessary to combat Kidney Failure and its root causes or risk factors.

I hereby declare the week of activities officially open.