Caribbean health officials gathered for the 38th Caribbean Expanded Programme on Immunisation (EPI) Managers’ Meeting, held from 28-30 October, where renewed urgency for immunisation efforts and HPV vaccine promotion took centre stage. The regional meeting, hosted in St. Kitts and Nevis, spotlighted progress and ongoing challenges in the effort to raise vaccination coverage across CARICOM Member States following setbacks caused by the COVID-19 pandemic.

In her address, Dr Rhonda Sealy, Assistant Director of the Pan American Health Organisation (PAHO), commended Caribbean health leaders for reversing the decline in vaccination rates but emphasised the need for continued momentum, particularly around HPV vaccinations. With the Caribbean grappling with vaccine hesitancy and disruptions to healthcare access, Dr Sealy highlighted the importance of the HPV programme within the broader Cervical Cancer Elimination Initiative, as countries move towards a one-dose schedule in line with recommendations.

Dr Sealy outlined a strategic roadmap to sustain immunisation successes, calling for strengthened political and financial commitment. “Maintaining our targets for eliminating polio, measles, and rubella requires us to achieve and sustain a 95% coverage rate,” she urged. She advocated targeted strategies to improve vaccine accessibility for children under five and reiterated the importance of training healthcare workers to address vaccine hesitancy effectively.

Dr Daniel Salas, Executive Manager of PAHO’s Special Programme on Comprehensive Immunisation, echoed Dr Sealy’s commitment to strengthening HPV vaccination in the region. “The Caribbean is known as a leader in disease elimination,” he declared. “I urge you to be the first subregion to eliminate cervical cancer and reduce the toll of preventable disease.”

The meeting also celebrated regional achievements, with Jamaica receiving the esteemed Harry Smith Award for the most improved immunisation coverage in 2023. Grenada was honoured with the inaugural Beryl Irons Award for its excellence in surveillance and immunisation achievements. Additional surveillance awards went to Barbados, St. Kitts and Nevis, and Belize, acknowledging their strides in immunisation monitoring and public health commitment.

Curtis Martin, Permanent Secretary for the Ministry of Health in St. Kitts and Nevis, praised PAHO’s vital support, noting, “PAHO’s technical expertise in EPI is a global best practice. The transfer of skills and knowledge has had a measurable impact on our region’s health systems.” He emphasised that “health is too big to fail,” underscoring the need for PAHO’s ongoing involvement in the Caribbean’s public health endeavours.

Dr Solange Kobi-Jackson, speaking on behalf of PAHO/WHO Representative Dr Amalia Del Riego, acknowledged the progress made in 2023, crediting committed healthcare professionals, government investment, and public trust in vaccination. However, she cautioned that maintaining immunisation gains and reestablishing the Americas at the top of the global immunisation rankings remains critical.

The meeting concluded with a workshop focused on risk communication strategies for boosting vaccine uptake, where Caribbean EPI managers shared innovative approaches to address public concerns and overcome vaccine hesitancy. Presentations from health officials from Turks & Caicos, Grenada, and Suriname offered insight into managing measles outbreaks, preparing for new vaccine rollouts, and responding to adverse events.

Chaired by Professor Peter Figueroa, Chair of the Caribbean Immunisation Technical Working Group, the meeting left participants with a sense of urgency and collective resolve. “Vaccination has averted an estimated 154 million deaths globally, and we must remain vigilant to uphold this legacy,” Professor Figueroa urged, calling on Caribbean nations to reach and maintain 95% vaccination coverage.

Under the theme “Stronger Together: Advancing Immunisation, Eliminating Disease,” the 2024 EPI Managers’ Meeting underscored a regional commitment to collaborative health efforts, aiming to build a healthier, disease-free Caribbean.

 A Welcome Change, but with Mixed Reactions

The introduction of a visa-waiver for Guyanese travelling to the British Virgin Islands, aimed at deepening ties with the oil-rich nation, has prompted mixed reactions from both Guyanese residents in the territory and those at home.

Premier and Minister of Finance Dr. Natalio Wheatley confirmed that as of November 1, citizens of Guyana would no longer need a visa to visit the British Virgin Islands for up to six months, whether for tourism or business. 

This move eliminates the often lengthy and complicated visa application process that had previously been a barrier for many.

“This step strengthens the bond between our countries and the region, facilitating greater ease in travel, trade, tourism, and investment. It underscores our shared vision of regional cooperation and opens new opportunities for people-to-people exchange. Many of our Caribbean brothers and sisters already benefit from visa-free access to the BVI, and we are pleased to extend this offer to Guyana, a giant in our Caribbean community,” Premier. Wheatley said during a press conference on September 30.

For many Guyanese, particularly those who have lived and worked in the BVI for more than two decades, the visa process had been a source of frustration. 

Long-time resident Natasha, who has called the BVI home for more than twenty years, welcomed the change, describing it as long overdue.

“It really is about time that this was done,” Natasha smiled. “I’ve lived in the BVI for over twenty years and was very annoyed when I had to get a visa after being granted a work permit. Made no sense to me, but what can I say—when you’re in another man’s country, you adhere to their rules.”

The issue was first raised during a 2023 trade mission, when both the BVI government and private sector visited Guyana.

The British Virgin Islands is keen to position itself as a key player in Guyana’s burgeoning oil industry, offering specialised services in finance and other sectors. 

At the same time, the Guyanese government is keen to ensure its citizens have the freedom to travel internationally with ease. Reflecting this shift, the United Kingdom in 2022 has also eased visa restrictions for Guyanese nationals.

While some share Natasha’s relief, others in Guyana are less enthusiastic. For many, the BVI has not been a primary travel destination, particularly as Guyana has gained visa-free access to the United Kingdom and streamlined visa procedures for European Schengen countries. 

A Guyanese, who resides in Georgetown, added that, “After we’ve been given visa-free access to the UK and we can now get our Schengen visa right here in Guyana, the BVI is not really at the top of my bucket list of places to visit.”

Indeed, the perception that this new policy will lead to a surge of visitors from Guyana appears exaggerated. 

A Guyanese who previously visited the BVI voiced her appreciation for the Territory but downplayed the likelihood of a major influx. 

“I love the BVI, and yes, I would visit again,” she said, “but this notion that we are going to be passing through in the hundreds to take up permanent residence in the BVI is utter foolishness. I am quite happy being home.”

The exemption reflects a broader move by the BVI government to ease restrictions for Caribbean nationals, pushing for regional unity and enabling greater mobility across islands with historical and cultural links. Guyana, with its vibrant economy and close community ties across the Caribbean, is seen as an important partner in this vision. 

While some are ready to embrace the opportunity, others view it as an optional advantage in an increasingly accessible world.

As the BVI opens its doors, the hope is that this policy will facilitate more meaningful exchanges between the two countries. 

But whether it will lead to significant shifts in travel patterns remains to be seen. 

In the words of Premier Wheatley, “We are pleased to extend this offer to Guyana,” but for many Guyanese, the decision may simply be a convenience, not a game-changer.