Philipsburg — During his first year in office, Minister Richinel Brug and the Ministry of Public Health, Social Development and Labor (VSA) focused on strengthening Sint Maarten’s healthcare system through a combination of immediate improvements, long-term strategic planning, and expanded support services aimed at improving health outcomes for the population.
In accordance with the Governing Program 2024–2028, the Ministry’s main priorities for 2024–2025 included: the BIG healthcare-professionals registration legislation, reform of the “Krankzinnigen” legislation and related mental-health policy, the finalization of the General Health Insurance legislation (SAAHA), and mental health reform, with a particular focus on youth mental health.
Recognizing that the Ministry’s primary responsibility lies in developing and updating legislation and policy, as well as promoting public awareness on health matters, the Ministry focused on accelerating the creation of the legal and policy frameworks needed for a stronger healthcare system. While the Ministry does not provide medical services or manage day-to-day healthcare delivery, responsibilities that rest with our country’s health care institutions and medical professionals, it plays a critical role in establishing the conditions for quality care through effective legislation and policy development.
Registry (BIG)
The Ministry secured funding through the TWO initiative to execute the Health Care Registry project (BIG). Two (2) key project team members were selected via an open public bidding process, while confirmation by the Council of Ministers is pending.
General Health Insurance Legislation (SAAHA)
With the recently received advice from SER, the draft Ordinance has now finalized an important step in the legislative process. The next phase will be submission to COA, which is the final step before the legislation can be formally submitted to the house of Parliament.
Mental Health Reform
The Ministry secured funding for the implementation of national mental health reforms and finalized the multi-annual National Mental Health Strategic Plan (2025–2035). Implementation has officially begun. Additionally, the Kingdom Framework for Involuntary Care legislation was approved by all four Ministers of Health, with country-specific laws to be developed in 2026.
Key initiatives include:
1. Partnership with Trimbos Institute — The Ministry signed an agreement with the international mental-health research and advisory institute to support Sint Maarten’s mental-health reform, including technical expertise, professional training, strengthened referral systems, and sustainable community-centered services.
2. Youth Mental Health Awareness Campaign — Launched under the theme “It’s OK Not 2 B OK” in collaboration with local artist King James, with continuation planned in 2026.
3. 10-Year Mental Health Strategic Plan: “Stronger Minds, Stronger Communities (2025–2035)” — A comprehensive, person-centered, prevention- and recovery-oriented mental health system structured around four pillars: support networks, early intervention & prevention, mental health in all sectors, and robust monitoring & evaluation.
4. Planning for the Mental Health Facility — Minister Brug directed efforts to clarify service capacity and design needs, review financing options, secure additional funding, and align the facility with long-term policy goals.
Prevention
The Ministry published the WHO/PAHO STEPS Survey Report, providing critical data on non-communicable diseases and lifestyle-related risk factors. In collaboration with Social & Health Insurances (SZV), the Ministry launched prevention-focused pilot programs aimed at promoting sustainable lifestyle changes and improving overall health outcomes.
Community outreach activities — including health screenings, educational sessions, and public awareness campaigns — were organized across Sint Maarten to foster engagement and improve knowledge of healthy living.
Regional and Kingdom-Wide Cooperation
The Ministry strengthened Kingdom-wide cooperation through the Four-Country Conclusion Document, reinforcing commitments in public health, crisis preparedness, and mental-health collaboration. Technical partnerships with PAHO through the Country Cooperation Strategy (CCS) continue to support public-health system development, disease prevention, and capacity building in Sint Maarten.
Insurance coverage for sole proprietors and taxi drivers
Contrary to recent statements regarding the 1B legislation, which includes insurance coverage for sole proprietors and taxi drivers, Minister Brug instructed SZV and the Department of Public Health to revisit and finalize the draft amendment that previously received negative advice from the Council of Advice in 2023. This draft forms part of a broader effort to address structural issues in existing SZV legislation. The project resumed in July 2025 and is now being advanced alongside the development of the Ordinance regulating Access to Health Insurance for All, which will provide a comprehensive, updated framework to include sole proprietors and taxi drivers in a sustainable and legally sound manner.
SZV
As it relates to SZV, decisive steps were taken to strengthen SZV, ensuring its long-term financial sustainability and inclusiveness.
Key measures included reviewing and revising the 1B legislation in accordance with the advice of the Council of Advice to address structural issues, and advancing the Ordinance regulating Access to Health Insurance for All, which will provide sustainable coverage for sole proprietors, taxi drivers, and other currently uninsured groups.
The Ministry also instructed SZV to conduct a comprehensive financial assessment to identify gaps and improve operations, while implementing initiatives to increase employer compliance with mandatory contributions — boosting SZV’s funds. A stronger collaboration was also established with the CFT, ensuring joint efforts to safeguard SZV’s sustainability.
In addition, public awareness campaigns were enhanced to educate employers and residents about their obligations under the social-insurance system, reinforcing transparency and long-term financial stability.
Minister Brug stated:
“These steps lay a solid foundation for a sustainable and inclusive SZV, ensuring that the system remains financially strong and able to serve all residents effectively in the years ahead.”
Health in All Policies
During his first year, Minister Brug emphasized the integration of health considerations across all sectors of government, in particular within VSA, through the Health in All Policies (HiAP) approach. Recognizing that health outcomes are influenced not only by medical care but also by social, environmental, and economic factors, the Ministry worked to ensure that health would be systematically incorporated into decision-making across all VSA departments in 2026 and beyond.
One key milestone in 2025 to reinforce this approach is the allocation of XCG 1,000,000 in the draft 2026 budget toward food programs and nutrition-related initiatives, linking policy decisions directly to the promotion of health and well-being across the community.
Minister Brug stated: “In 2025, we laid the foundation for Health in All Policies. In 2026, our focus will be on ensuring that every policy and program considers health first, so that all residents of Sint Maarten can thrive in a healthier, more supportive environment.”
“While we are not yet where we need to be, this year we successfully expedited the creation and updating of key health legislation and policies, laying a strong foundation for the future. With additional staff joining next year, we will continue along this trajectory, ensuring that our legal and policy frameworks are fully aligned with the health needs of the people of Sint Maarten.”