MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. Estimated mortality (when mortality data excludes cases comorbid with HIV) from TB has decreased slightly in the period 1998–2012. Estimated incidences of TB have more than doubled since 1990. Antigua and Barbuda is non-endemic for malaria. There is not enough information from international agencies to confirm the country’s progress on this goal with regard to HIV/AIDS. For definitions, sources and explanations on the MDGs see page 314. Universal health coverage Only a quarter of health care in Antigua and Barbuda (25 per cent) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 5.2 per cent of GDP in 2012 and of this 75 per cent was covered by the government. This expenditure by government amounts to US$514 per capita. Public health care is financed mainly through allocations from the Ministry of Finance. The country’s public health system has a National Drug Formulary that provides a total of 360 different drugs, guaranteeing availability of medication to all people suffering from chronic conditions. In June 2014 the government released the Report on the Draft Strategy for Universal Health Coverage. The report identified four strategic lines for guiding the transformation of health systems on the islands, namely: expanding equitable access to comprehensive, quality and people-and-community-centred health services; strengthening stewardship and governance; increasing and improving financing, without out-of-pocket expenditures, with equity and efficiency; and taking inter-sectoral action on the social determinants of health. Antigua and Barbuda is not a signatory to the International Covenant on Economic, Social and Cultural Rights, the covenant that commits signees to ensuring ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. Care of the elderly: Approximately 6,000 people in Antigua and Barbuda are over the age of 65 – seven per cent of the total population (2013). At the age of 60, a person living in Antigua and Barbuda can be expected to live for an additional 21 years, on average (2013). Pensions were first introduced in Antigua and Barbuda in 1993. Today, the monthly Old Age Assistance Programme is paid by the state at a rate of US$94 per person (2007–12) on a means-tested basis. Overall, public pension spending is equivalent to 2.5 per cent of the country’s total economic output (2006). The Ministry of Health, Social Transformation and Consumer Affairs is the government agency responsible for the care and social protection of the elderly in Antigua and Barbuda. The Ministry of Health established the Fiennes Institute, which provides holistic, free long-stay residential care services for impoverished elderly persons and those elderly people whose family cannot provide for them. A programme, Government Residential Assistance Care for Population over 65 7% the Elderly and Eligible, is also in place to provide home care services and recreational activities to elderly people. The programme is managed by the Citizens Welfare Division of the Ministry of Social Transformation. In 2011 Antigua and Barbuda received support from the Pan American Health Organization (PAHO) to develop a National Policy on Ageing, which was finalised in 2013. The policy addresses issues relating to the care of the elderly in Antigua and Barbuda. Further information Ministry of Health, Social Transformation and Consumer Affairs: www.ab.gov.ag Commonwealth Health Online: www.commonwealthhealth.org/health/americas/antigua_an d_barbuda C ommo nwe a l t h memb e r c o u n t r i e s 134 Commonwealth Health Partnerships 2015
Commonwealth Health Partnerships 2015
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