In Sint Maarten, the Department of Health monitored the growing burden of cardiovascular disease risk factors and took decisive action to protect residents’ health. It developed a national protocol to tackle type 2 diabetes, adapted from the regional HEARTS-D initiative – a model of care for cardiovascular risk management. The journey began with national hypertension protocols inspired by the HEARTS in the Americas initiative. General practitioners, pharmacists, diabetes educators, physiotherapists, and national health insurance representatives collaborated to establish a synergistic approach underpinned by the principles of Better Care for NCDs. 

By institutionalizing evidence-based protocols within primary care, this achievement strengthens service quality, supports early detection and effective management, and reduces avoidable complications. Over time, these system-level improvements are expected to lower the burden of cardiovascular disease and diabetes, improve quality of life, and enhance the resilience and sustainability of Sint Maarten’s health system.