In a region beset by serial disasters, effective recovery from hazardous events is not just a worthy goal it is an imperative. The Caribbean Resilience and Recovery Knowledge Network will support a transformational approach towards post-disaster recovery in the Caribbean,particularly as it responds to the impacts of the 2017 hurricane season that caused $130 billion of losses in the region. A community of researchers, practitioners and policymakers is emerging, but at the moment their response is ad hoc and driven by divergent research or short-term aid goals. This generates locally useful outcomes, that alleviate the worst symptoms from the disasters, however they are collectively less effective at encouraging long term resilience to future events, strengthening ecosystems or reducing long-term vulnerabilities in poor or remote communities. The Caribbean Knowledge Network seeks to remedy this by creating a new culture for responding to and preparing for hazardous events. This is our principle aim. We will do this by joining together diverse researchers, and engaging with practitioners and policymakers from the outset. These groups are all motivated to come together and transform how we approach post-disaster recovery. The researchers (in the Caribbean and the UK) work on wide-ranging topics relevant to long term hazard resilience, connected by their desire to improve recovery from disasters. The practitioners bear responsibility for ensuring the best possible outcomes for communities at risk and face increasing challenges associated with climate change and environmental degradation in the region. The attention of donors and policymakers has been focussed by the recent systemic destruction from the 2017 hurricanes. Thus, the Network is both timely and needed. We have structured a series of mutually beneficial activities to help us achieve our overall aim, and associated objectives. The first of these will be a forensic workshop where we will bring our multiple perspectives to bear to understand what drove and hindered recovery following three key events (the 2017 hurricanes, the Haiti earthquake and long-term recovery following Hurricane Ivan). To reflect the multiple perspectives were are calling these forensic analyses, and this will be a great vehicle for learning from each others expertise and perspectives. This will run in the same location and just before the Annual Caribbean Disaster Management conference, which will provide further immediate feed-in to our conclusions. After that we will create some scenarios to help test, design and evaluate existing response and recovery plans for multiple types of hazard. We will visit several Caribbean countries to do this, and they will be co-designed with different social groups to ensure relevancy. These will be used to create new principles and strategies in each setting. While we are doing this we will run a series of webinars to discuss challenges hilighted by these two activities. We will make these freely accessible to participants throughout the Caribbean and further afield. The outcomes from all of this work will create our new community who will co-create a manifesto for research to transform recovery and use that to secure further funding. Importantly, however along the way we will also have created some tangible benefits which will ensure the longevity of the grouping and maximise its benefit. These are: (1) forensic analyses on several important disaster events, identifying priority actions and sets of principles; (2) flexible, tailored scenario exercises for local disaster practitioners so they can develop their own new strategies in response to these on four islands (3) the time and momentum to consider how to 'join up' strategies across the islands, critically in collaboration with regional and international agencies.

Non communicable diseases (NCDs) such as diabetes, hypertension and heart disease are the leading causes of death in Low and Middle Income Countries (LMICs). Caribbean women, urban dwellers and the poor are more likely to have NCDs and a greater burden of NCD risk factors such as obesity, physical inactivity and unhealthy diet. The recent control measures to limit the spread of COVID-19 in many LMICs interfered with daily routines and food systems. While some control measures such as limiting sale of alcohol and closure of fast food restaurants might have potential benefits on NCDs, these may be counterbalanced by limited access to fresh fruits and vegetables and a tendency to consume unhealthy stored/preserved foods. Additionally, stress, working from home, increased screen time (computer and TV) and boredom also create a change in sleep, physical activity and other NCD related lifestyle practices. In this study we will examine how control measures used in 3 Caribbean islands affected the health and lifestyle practices of people living with NCDs, particularly women, the poor and those living in urban vs rural communities. By understanding the effects of COVID-19 control measures on NCD risk factors (lifestyle practices), mental health, metabolic health (blood sugar and cholesterol) and physical measurements (blood pressure and weight), LMIC governments can use their limited resources to better care for persons with NCDs during national crises and respond better to future COVID-19 and other infectious disease outbreaks.

Diabetes is a serious and growing problem globally. Evidence suggests diabetes disproportionately affects people in low- and middle-income countries, where 80% of people with diabetes live, both in terms of numbers of people affected as well as outcomes and deaths. Diabetes affects between 10 and 20% of the adult population in the Caribbean region with deaths due to diabetes estimated to be 35% higher than in the neighbouring United States. Not only are prevalence and mortality a large burden but also rates of complications such as lower-limb amputation are also high. Much of the high burden of diabetes can be attributed to major risk factors such as physical inactivity and obesity. Health systems with limited resources in these developing countries are struggling to meet the growing epidemic. There is a strong political will in the region to tackle diabetes and other non-communicable diseases (NCDs). In 2007, the Heads of Government of the Caribbean Community put forth the Port of Spain Declaration (POSD) on NCDs, definitively challenging the high burden of these diseases in the region and pledging action through policies to strengthen prevention and treatment. This laid the groundwork for a global political movement to recognise NCDs on the public health agenda culminating in the United Nations High Level (UNHLM) meeting on NCDs in September 2011. Both the POSD and UNHLM strongly emphasise the importance of policy measures for reducing NCD risk factors and put forth policies and targets. However, evidence on how to achieve a reduction in overweight/obesity and physical inactivity and subsequently reducing NCDs at the population level is scarce, particularly in developing countries. While the risk factors and determinants of NCDs like diabetes are well studied and established, research has not been able to conclusively demonstrate real-world interventions that can reduce their popburden or change the course of the epidemic. Systems science, which combines multiple factors and complex interrelationships, may offer a solution to evaluating and testing policies for diabetes reduction. It does this by explicitly taking into account system behaviour that is non-linear and complex, with feedback loops and time delays. Within systems science, system dynamics modelling is a methodology incorporating input from experts and stakeholders and combining that with quantitative research evidence to produce a map of a system with the ability to simulate outcomes by changing parameters. The approach has been used effectively in a wide variety of fields including engineering, agriculture, energy planning, business dynamics, and health including diabetes. However, few models have been developed for use in middle-income countries. This study will be the first to explicitly develop a model for diabetes in developing countries, drawing from work successfully conducted by the Centers for Disease Control in the United States and their model for diabetes. The study will apply the rigorous qualitative methods required by interviewing stakeholders, experts and policy makers in the region as well as gathering evidence from research published on risk factors, outcomes, and health system performance for diabetes in the Caribbean. The study will use the developed model to engage stakeholders and policy makers in time for the on going evaluation of the POSD as a tool for effective policy planning. It will also evaluate the utility of this method in the region in engaging policy makers to think in terms of systems and with long time horizons. The results of this development study will be used to build a larger model incorporating economics and costs, which can then be adapted and used in other low- and middle-income countries.

When Britain departed its colonies in the Caribbean it left in place political institutions and norms based on the Westminster model of government. Early analyses drew mainly positive conclusions about the effectiveness of the Westminster model in producing stable democratic states in the region, in contrast to other ex-colonial states in Africa and Asia. But in the last two decades, the Caribbean has experienced radical changes which bring into question the optimistic assessments of the early scholarship. Globalisation, the drugs trade, rising crime levels and the economic downturn are undermining the foundations of democracy in the Caribbean. The 'Westminster in the Caribbean: History, Legacies, Challenges' network brings together academics (from history, politics, development) and non-academics (NGOs, think tanks, policy-makers) to address the urgent need for new analysis of how the Westminster model has functioned in the post-independence Caribbean. The central aims of the research are: 1) To reassess how the political model inherited from Britain was adapted to the conditions of the Caribbean; its impact on Caribbean democracy; and the challenges the model has faced over the period of independence; 2) To advance earlier research by extending the time-frame under review, adopting a multi-disciplinary and comparative approach and examining the substantive as well as formal dimensions of democracy in the region; and 3) To reflect on and contribute to current critical debates on the evolution and perceived decline of democracy in the region as it prepares to mark 50 years of independence. Three major conferences will address different strands of research on adaptations, critiques and reformations of the Westminster model in the Caribbean. How have the different histories of colonisation, size, populations and ethnic demographics affected the nature and impact of the Westminster model in different countries? What role has the model played in distortions of democracy in the post-independence period? What alternative political systems have been developed within the Caribbean, in theory and in practice? Does the failure of radical alternatives (eg. the 1979 Grenada Revolution) testify to the legitimacy and robustness of the Westminster system in the Caribbean? Can the model withstand the "existential threats" of the present day? Given the small number and scattered location of scholars of the modern Caribbean in the UK, such research could only be achieved through collaboration with the larger community of scholars in the Caribbean and North America. The network will facilitate new interactions within the UK and abroad, new links across disciplines, and a forum for the exchange of ideas benefitting both academic and non-academic participants. The latter (NGOs, think tanks and policy-makers involved in governance in the region) will be involved in the network at all stages and will help shape the research agenda and outputs. The network forges new links with the University of the West Indies, the Commonwealth Democracy Network and the Caribbean Policy Development Centre. In advancing understanding of democracy in post-colonial states, the legacies of European imperialism and theories of small states, the network will both contribute to scholarship and feed into policy debates in the region today. The research will be disseminated widely via a range of outputs including a webpage, conference papers and reports, edited volumes and a special edition of a journal. A major output will be the development of an online Caribbean Democracy Bibliography, providing a lasting and valuable research tool for students, scholars and the public. The network will continue beyond the life of the grant and will lay the foundations for larger projects including applications to fund a doctorate in post-independence Caribbean political history and a post-doctorate to build a new digital resource base of primary sources on Westminster in the Caribbean.