This report addresses several critical questions regarding Caribbean nations. Does size matter for economic growth and volatility? To what degree has Caribbean economic growth been inferior to that of ROSE? What could account for the Caribbean growth gap and what economic policies might decision-makers adopt to promote higher and sustainable growth? The answers to these questions will support the overarching hypothesis that the Caribbean suffers sclerosis. The almost-exclusive focus on economic growth in this report does not imply that it should be the sole criterion to judge economic performance. Nevertheless, economic growth is the central concern of Caribbean policymakers, who recognize that it is critical to improve broad economic development, and hence to improve the welfare of Caribbean citizens. The central focus here is on six countries in the region, which will be referred to as the C6: The Bahamas, Barbados, Guyana, Jamaica, Suriname, and Trinidad and Tobago. However, the analysis will sometimes include, most often in the aggregate, the countries of the Organisation of Eastern Caribbean States (OECS). The six members of the OECS used in this report are Antigua and Barbuda, the Commonwealth of Dominica, Grenada, St. Kitts and Nevis, St. Lucia, and St. Vincent and the Grenadines.