Cayman’s new Chief Medical Officer, Dr. Hilary Wolf, has set out a focused agenda for her first 100 days, emphasising the need to map and align key health priorities, strengthen coordination across agencies, build strategic relationships and advance the government’s broader long-term health strategy.
She takes over from Dr. Nick Gent, who retired at the end of September after three years in the post.
Wolf, a paediatrician and global health specialist with more than two decades of experience at organisations such as the World Health Organization, Pan American Health Organization, UNAIDS and the US State Department, steps into the role as the Ministry of Health, Environment and Sustainability moves to finalise and implement its National Health Strategy – a process she will lead.
According to ministry officials, her appointment is expected to strengthen clinical governance, expand public health capacity, bolster infectious disease preparedness, align health, environmental and sustainability priorities and deepen global health partnerships.
“Her global experience will be instrumental in shaping policies that integrate public health with environmental sustainability and in fostering regional partnerships to address emerging health challenges,” said a health ministry spokesperson.
To advance those goals, Wolf said her initial focus will be on setting clear direction and laying the groundwork for “collaborative, sustainable progress,” starting with a country-wide “listening and learning tour”.
‘Listening and learning’
Wolf’s first steps will involve meeting frontline clinicians, public health teams, community leaders and partners across the system to understand their challenges, priorities and expectations of the CMO’s office, stressing that “relationship-building and trust” would be critical to her role.
She said the principles that guided her work on large global platforms would remain the same in Cayman. What differs, she noted, is the closeness of the community and the agility with which meaningful reforms can be put into practice.
“In large international programmes, success always came when we listened deeply, partnered locally and built solutions that truly fit the context,” she said. “That same principle applies, perhaps even more so, in a small island setting like the Cayman Islands.”
Aligning core health priorities
Another early priority will be mapping and aligning Cayman’s major health needs – from chronic disease and maternal–child health to emergency preparedness and mental health – to ensure that resources, data and partnerships are directed toward shared outcomes. This work will include reviewing current surveillance systems, quality-improvement initiatives and coordination mechanisms with regional partners such as the Pan American Health Organization and the Caribbean Public Health Agency.
The ministry has identified the National Health Strategy as a key outcome under the government’s Strategic Policy Statement. Wolf is expected to help refine remaining elements of the strategy and lead its implementation.
“Dr. Wolf’s appointment brings a critical layer of global expertise and technical insight to refine and operationalise its components,” said the ministry spokesperson, speaking of the National Health Strategy.
“Her responsibilities will include reviewing existing national health policies, aligning them with international best practices and ensuring that the strategy translates into actionable reforms that improve public health outcomes, strengthen clinical governance and enhance system-wide capacity.”
Improving coordination and communication
Wolf’s third priority is improving communication and coordination across the ministry, the Health Services Authority and the wider health community. She emphasised the importance of clear, trusted public health information and ensuring that clinicians feel supported by strong lines of communication and policy guidance.
Her arrival follows comments by Gent, who warned in a recent Forefront interview that poverty and financial barriers remain Cayman’s greatest health threat, contributing to widespread undiagnosed chronic conditions identified in the 2023 STEPS National Health Survey.
Wolf is expected to build on that work by helping shape new health-equity frameworks that account for social determinants of health and support more inclusive access to care.
Strengthening preparedness
As part of her statutory responsibilities, Wolf will lead public health preparedness and advise the government on its response capabilities for both communicable and non-communicable diseases.
Ministry officials say Wolf’s experience designing large-scale public health programmes, most notably overseeing HIV treatment for more than 20 million people under the US President’s Emergency Plan for AIDS Relief, maps directly onto these priorities.
Wolf said Cayman’s size offers a rare chance to apply global public-health lessons in a setting where change can happen quickly. “The Cayman Islands offer a unique opportunity to apply what I’ve learned about evidence-based public health, health systems strengthening and equitable access in a setting that’s both globally connected and locally nimble,” she said.
She added that she is motivated by the ability to directly shape programmes that improve local health outcomes while mentoring emerging health professionals. Her goal, she noted, is to bring experience in data-driven systems and integrated, collaborative service delivery, “working side by side with local clinicians, public health teams and communities to identify what works best here.”
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