As noted in Chapter II, the recommendations of the Working Group on PAHO in the 21st Century prompted changes in PAHO’s collaboration with Member States and other stakeholders as well as in its program structure, resource allocation, and human resources management. These changes were implemented as part of a major reorganization aimed at making PAHO more efficient, more effective, and fully accountable to its stakeholders. They included new policies, strategies, models, and modalities as well as new procedures, instruments, technologies, and infrastructure. This chapter highlights the major components of the Organization’s institutional development over the past decade.

Budget Policy and Results-based Management

One of most far-reaching contributors to PAHO’s transformation during the decade was the development and implementation of the new PAHO Regional Program Budget Policy. The Organization’s first such policy and one of the first in the U.N. System, the Regional Program Budget Policy was developed through a Member State-driven process aimed at ensuring a more equitable distribution of resources.

The overall goal of the budget policy is to support countries in achieving programmatic targets agreed upon collectively by Member States as part of the PAHO Strategic Plan, in a way that also ensures equitable resource distribution. The policy allocates funds to three levels—regional, subregional, and country—and uses needs-based criteria to rank countries according to their relative health status and levels of inequality. These new allocation criteria have resulted in a significant shift of budgetary resources toward lower-income countries and from PAHO Headquarters to the country and subregional levels.

The first Regional Program Budget Policy was approved by the 45th Directing Council in 2004 for the 2006-2007 biennium, with revisions made at the request of Member States in subsequent biennia. The latest revision of the policy, for the 2014-2015 biennium, was led by a working group composed of Brazil, Chile, Grenada, Peru, the United States of America, and Venezuela (Bolivarian Republic of), with Argentina as an observer, and is being presented to the 28th Pan American Sanitary Conference in September 2012.

An equally important change during the decade was PAHO’s decisive shift to results-based management and programming, aimed at improving the Organization’s performance in pursuit of the goals defined by its Member States. Though a focus on results was not entirely new, PAHO’s adoption of a formal Results-based Management (RBM) Framework paralleled similar developments at WHO and other agencies of the U.N. system.

The RBM Framework defines clear objectives, selects indicators to measure progress toward those objectives, sets targets for each indicator, and provides for the collection, analysis, and reporting of results, allowing for objective assessment of the Organization’s performance. The RBM Framework has significantly changed the way the Organization operates, making results and performance the central orientation of all work.

The implementation of the RBM Framework has been a participatory process, particularly through the Performance Assessment System, and has been supported by a mandatory RBM e-learning course for all staff. A recent externally conducted gap analysis confirmed that PAHO has become a leader in RBM within the U.N. system. Nevertheless, as a process, RBM inherently requires continued implementation as well as adaption to ensure it continues to enhance the Organization’s work.

The new RBM Framework was incorporated into the Organization’s highest-level planning instrument, the PAHO Strategic Plan 2008-2012. The plan defines the Organization’s contributions to the fulfillment of the Health Agenda for the Americas 2008-2017 and the MDGs, and is aligned with WHO’s 11th General Programme of Work and Medium-Term Strategic Plan. It contains 16 Strategic Objectives that are directly aligned with those of WHO and defines Region-wide Expected Results (RERs) and indicators based on the Region’s current priority public health concerns while also allowing for the emergence of new issues and threats. PAHO’s RERs contribute to WHO’s Organization-wide Expected Results (OWERs), and their indicators aggregate to the global level.

Decentralization

In addition to the RBM Framework, one of the most far-reaching changes in the decade was the adoption of a Decentralized Technical Cooperation model. In conjunction with the new Regional Program Budget Policy, this new model progressively transferred the Organization’s competencies, functions, and resources from Headquarters to the subregional, national, and subnational levels. The goals were to increase efficiency in the use of human, technical, and financial resources; foster closer collaboration with country and subnational counterparts; and strengthen decision-making at the local level as part of the ongoing decentralization taking place in the countries.

The implementation of the Decentralized Technical Cooperation model advanced significantly during the decade. A number of regional technical programs formerly based at Headquarters were transferred to the countries, including programs on dengue (Costa Rica), Chagas disease (Uruguay), disabilities (Argentina), leprosy and leishmaniasis (Brazil), ocular health (Colombia), and indigenous health (Panama), among others. In addition, the Area of Family and Community Health (FCH) decentralized its technical team on women and reproductive health to the Latin American Center for Perinatology and Human Development (CLAP) in Uruguay, and the Area of Health Surveillance and Disease Prevention and Control (HSD) transferred its veterinary public health activities to the Pan American Foot-and-Mouth Disease Center (PANAFTOSA) in Rio de Janeiro, Brazil.

The Area on Emergency Preparedness and Disaster Relief (PED) has established three offices that cover different geographical areas: Ecuador/Colombia for South America, Barbados for the Caribbean, and Panama for Central America. In addition, Canada, Cuba, Mexico, and the United States are covered from the Regional Office in Washington, D.C. Each office has an Emergency Preparedness Advisor and support staff. The office in Barbados also has a Disaster Risk Reduction Specialist. This decentralization ensures not only technical cooperation that is close to the actual needs, facilitating interaction and diminishing costs, but also a quicker response in case of a disaster. In addition, PAHO has decentralized the Senior Regional Response Advisor to Barbados. There is also PED staff in Colombia and in Haiti.

In addition, as mentioned in Chapter II, new subregional technical cooperation programs, mandated by the Governing Bodies and in compliance with the recommendations of the PAHO in the 21st Century Working Group, were established to respond to the health priorities of the subregional integration systems. The following programs were established: for Central America, vis-à-vis the Council of Ministers of Health (COMISCA) and the Health Sector Meeting of Central America and the Dominican Republic (RESSCAD); for the Caribbean, vis-à-vis CARICOM’s Council for Human and Social Development (COHSOD) and the Caribbean Ministers of Health Caucus; for the Andean region, vis-à-vis the Andean Health Agency/Hipólito Unanue Agreement (ORAS/CONHU) and the Andean Community of Nations (and in accordance with the resolutions of the Meeting of Ministers of Health of the Andean Region, REMSAA); and for the Southern Cone, vis-à-vis MERCOSUR (Working Subgroup #11) and intergovernmental health commissions. The technical cooperation program for the U.S.-Mexico border continues to be carried out from the office in El Paso, Texas, which celebrated its 70th anniversary in 2012.

Various country offices underwent a further decentralization of their technical cooperation programs, in response to priorities established in the PAHO Strategic Plan and in agreement with national and subnational counterparts. For example, the country offices in Bolivia, Brazil, Colombia, Mexico, and Nicaragua established decentralized technical cooperation at the subnational level, in some cases with the permanent presence of PAHO staff. In the case of Ecuador, technical cooperation on communicable diseases is provided from a sub-office in Guayaquil, due to the fact that the main counterpart is in the coastal zone. In the case of the Eastern Caribbean countries, a decision was made to establish PAHO’s permanent presence in the islands via country program specialists who interact with their national counterparts on a daily basis while program teams located in Barbados provide specialized technical cooperation.

Paralleling the decentralization of PAHO’s technical cooperation programs were changes in the administration of several of its specialized Pan American Centers. Since the 1950s, PAHO had created or managed 13 such Centers responsible for carrying out research, providing technical cooperation, and building capacity in areas of priority to the Member States. During this time, PAHO’s Governing Bodies urged PASB to reexamine the Centers periodically and consider alternatives in cases where national institutions are capable of providing ongoing technical cooperation services in the Centers’ areas of specialization for their countries and for other PAHO Member States.

In response, PASB undertook a review in the early 2000s examining each Center’s operations, financing, and alignment with PAHO regional and subregional policies, while also exploring alternative structures, agreements, and funding sources that might be more efficient and effective for addressing the issues within each Center’s area of specialization.

As a result, in 2005, the Pan American Institute for Food Protection and Zoonoses (INPPAZ), based in Argentina, was closed, and a specialized food safety technical team was established at the Pan American Foot-and-Mouth Disease Center (PANAFTOSA) in Brazil. Subsequently, in 2010, the Institute of Nutrition of Central America and Panama (INCAP) was transferred to its Directing Council, with PAHO remaining as a member along with the institute’s eight Member States. The same year, the Pan American Center for Sanitary Engineering and Environmental Sciences (CEPIS) in Peru was closed, its laboratories were transferred to the Peruvian government, and a Regional Technical Team on Water and Sanitation (ETRAS) was established through an agreement with Peru to provide continuing technical cooperation in water and sanitation.

In the Caribbean, the two Pan American Centers, the Caribbean Epidemiology Center (CAREC) and the Caribbean Food and Nutrition Institute (CFNI), are in the process of transitioning to the Caribbean Public Health Agency (CARPHA). CFNI will be decommissioned at the end of 2012, and functions carried out by CAREC will be transitioned to CARPHA. Work over the past 10 years has focused on consolidating and strengthening the operations of these two centers to facilitate a smooth transition.

CARPHA became a legal entity on 4 July 2011, when Heads of Government of the Caribbean signed an intergovernmental agreement for its establishment. The agency is scheduled to become fully operational in January 2013. An Executive Board has been established, and an interim team has been developing a resource mobilization strategy and sustainability plan, a social marketing and communications plan, and a work plan focused on laboratory services, surveillance, and health analysis.

PAHO/WHO Collaborating Centers (CCs) continued to play an important role in the Organization’s work by carrying out research that supports its technical programs, helping to expand the Organization’s networks, and contributing to national and regional capacity-building in the areas of information, services, research, and training.

During the decade, PAHO significantly increased its involvement in the designation of new CCs. While traditionally most centers in the Americas were initiated by WHO Headquarters, from 2002 to 2012, this trend was reversed: 60 new CCs were initiated by PAHO/AMRO and 32 by WHO Headquarters. Thirty-seven of the 92 new CCs in the Region are in Latin America and the Caribbean, including the first-ever CCs in Bolivia and Uruguay. For the first time since the 1980s, three new centers were designated in Costa Rica.

In addition, a new category of relationship was created for National Institutions Associated with PAHO in Technical Cooperation, with procedures for identifying, designating, and monitoring such institutions. The process is aimed at strengthening in-country technical cooperation while also building national capacity, ensuring intersectoral collaboration, and promoting public-private initiatives and collaboration with civil society institutions.

New Models and Entities

To support the RBM Framework, PASB created a number of new entities during the decade. In addition to the Decentralized Technical Cooperation model, a new horizontal team-oriented organizational model was approved that uses teams, standardized collaborative groups, and networks rather than traditional organizational units. The goal is to bring people from different backgrounds and competencies together working toward a common purpose in a results-based culture. The model allows for organizational adjustments in each new planning cycle in response to Member States’ changing needs. It also defines a process for delegation of authority that helps clarify roles and responsibilities for results defined in the PAHO Strategic Plan.

To support the implementation of the RBM Framework and culture, PAHO also created a new project team for Organizational Effectiveness and Development (IDU) in 2010 within the Area of Planning, Budget, and Resource Coordination (PBR). Its mandate is to strengthen PAHO’s capacity to make innovative, efficient, and effective use of its resources in fulfilling its vision and mission. The team is staffed with experts on institutional effectiveness and development with both regional and global experience.

Among IDU’s contributions to PAHO’s transformation in the 2000s have been ensuring approval by the Governing Bodies of the new RBM Framework, facilitating the transition of the Pan American Centers, supporting the new PAHO Management Information System (PMIS), overseeing the development of PAHO operations and management manuals, and ensuring the systematic use of online dashboards for programming and budgeting.

The most senior new entity formed to support the RBM Framework was the Executive Management Team (EXM), made up of the Director, the Deputy Director, the Assistant Director, and the Director of Administration, with a Chief of Staff who serves as liaison, coordinator, and secretary. Established in 2003 to enhance PAHO’s management practices, EXM improved transparency in decision-making at all levels of the Organization.

EXM is responsible for developing PAHO’s strategic direction, priorities, and policies and for coordinating planning and implementation of Organization-wide initiatives, including cross-cutting priorities and policies. The team is also responsible for defining the Organization’s resource requirements and overseeing resource mobilization. In addition, EXM fosters information-sharing, communication, collaboration, and accountability at all levels of the Organization with the overarching goal of improving effectiveness and transparency.

As part of the participatory management model, a Permanent Managers’ Forum was created with a view to achieving effectiveness, efficiency, and synergy in the work of the Organization. It allows EXM and PASB Managers to exchange information and discuss topics of importance, enhancing and facilitating open dialogue, teamwork, and consensus-building. The forum includes a bi-annual face-to-face meeting.

Workplace Policies and Processes

The PAHO Strategic Plan 2008-2012 established six cross-cutting priorities—gender, ethnicity, human rights, primary health care, health promotion, and social protection in health—and called for prioritizing and mainstreaming these in all of PAHO’s technical cooperation programs.

One of these priorities, gender, led to the development and implementation of the PAHO Gender Equality Policy, which was approved by the 46th Directing Council in 2005 (CD46.R16). In addition to calling for mainstreaming gender into health planning, programming, and interventions by the countries and in PAHO’s technical cooperation programs, the policy and its Plan of Action called on PASB itself to strive for parity between the sexes in recruitment and career development.

A 2009 U.N. report showed that PAHO had already achieved sex parity among professionals at Headquarters, ahead of many other U.N. agencies. However, in the Organization’s country offices, women were underrepresented among professional staff and among long-term and new appointees. Yearly progress reports since the gender policy’s adoption have shown increased recruitment of women both at Headquarters and in PAHO country offices and at both the professional and the administrative levels.

In 2004, PAHO adopted its first policy addressing harassment in the workplace. Aimed at fostering a respectful work environment through prevention and prompt resolution of harassment, the policy covered two types of workplace harassment—personal and sexual—and explained how to use informal and formal resolution processes to deal with conduct that might constitute harassment.

In 2012, the policy was expanded to include bullying, abuse of authority, and a hostile work environment as other forms of harassment. Other changes included eliminating peer review in the formal complaint process and setting time limits to ensure prompt resolution of allegations.

In May 2006, PAHO established an independent Ethics Office, which reports directly to the Governing Bodies through the PAHO Executive Committee. Its mandate is to promote a culture of ethics and integrity in the Organization by providing guidance, advice, and training to help staff make the right ethical decisions in compliance with PAHO’s Code of Ethical Principles and Conduct, implemented in January 2006. It is also responsible for investigating allegations of misconduct, including harassment, as well as suspected violations of the PAHO ethics code.

The Ethics Office is accessible to all PASB staff, family members, clients, stakeholders, and vendors. In June 2007, an Ethics Help Line was implemented to enable people both inside and outside the Organization to report suspected wrongdoing or to ask questions about issues that could have ethical implications. The Help Line is administered by an external vendor and allows callers to remain anonymous if they wish.

In 2005, the Organization launched a new Ombudsman Office to provide conflict management and dispute resolution services for staff members with concerns, problems, or challenges related to their work. The office follows practices and procedures that are consistent with the Standards of Practice and the Code of Ethics of the International Ombudsman Association. Its work is based on four principles—confidentiality, impartiality, independence, and informality—and it is an advocate of PAHO’s core values—equity, excellence, solidarity, respect, and integrity.

The Ombudsman Office supports PAHO’s mission by promoting fairness in organizational processes. It places priority on addressing employee concerns at the earliest opportunity with the goal of preventing, managing, limiting, or resolving conflicts before they escalate. Its services are available to anyone working in any PASB workplace, including at PAHO Headquarters, in country offices, and Centers, regardless of the person’s contract status. During the past five years, more than 750 employees have consulted the Ombudsman Office with questions or concerns. Visitors have consistently reflected the demographic profile of the Organization in terms of location, gender, and contract status. The office also acts as an observer and forecaster, providing timely feedback to PAHO’s Administration and Managers in an effort to prevent avoidable harm to individuals or the Organization.

In October 2007, PAHO launched an Integrity and Conflict Management System (ICMS). The ICMS incorporates all internal resources that handle integrity and conflict resolution issues into a coherent system so they can be more accessible, effective, and easily understood by PASB staff. These resources include the Ombudsman Office, the Ethics Office, the Legal Office, the Information Security Office, Human Resources Management, the PAHO/WHO Staff Association, the Office of Internal Oversight and Evaluation Services (IES), and the Board of Appeal. In November 2011, PAHO for the first time appointed an external chairperson for its Board of Appeal.

Each of these resources plays a distinct role, and the ICMS provides clear information about the mandate, scope of work, authority and decision-making ability, reporting relationships, accessibility, level of confidentiality, independence and accountability, and access to officials and records of each individual resource.

Since its inception, the ICMS has been the catalyst for the development of a number of important institutional initiatives related to good governance, including a Confidentiality Declaration program (2007), a policy on Protecting People who Report Wrongdoing or Cooperate in an Investigation or Audit (2009), and a Protocol for Conducting Investigations in the Workplace (2010).

To promote staff health and well-being, PASB created a Wellness Committee as an advisory body to the Director. It provides a forum for discussion and recommendations about issues related to health in the PASB workplace. The committee has also spearheaded an effort known as “Green PAHO” aimed at reducing the Organization’s carbon footprint.

Competencies and Learning

In 2003, PAHO established a Working Group on Human Capital (WGHC) whose responsibility was to analyze and make recommendations on the staff competencies and skills seen as necessary for the Organization’s effective performance. The group produced a first draft of a Competencies Map, consisting of 20 competencies divided into three sections: (a) general competencies, (b) technical competencies for professionals involved with technical cooperation, and (c) competencies for staff associated with administrative support services. The initial map was reviewed and revised by the Area of Human Resources Management (HRM) in 2006 as part of PAHO’s Strategic Assessment and Resources Alignment (SARA) initiative and again in 2007. Changes included the addition of levels and descriptions of desired behaviors associated with different competencies. In 2007, the map was again revised and subsequently validated by an outside consulting firm.

The Competencies Map was part of a larger effort to implement competency-based human resources management. This effort has also included the use of interviews and psychometric tests based on competencies in the staff selection process and the alignment, updating, and improvement of post descriptions through the incorporation of requirements based on the Competencies Map.

Starting in 2004, PASB launched a major effort to strengthen itself as a learning organization, to ensure that the skills and knowledge of its staff grow and evolve in tandem with new technological, scientific, policy, and organizational advances.

To guide this process, the Learning Board was created and assigned the responsibilities of evaluating priority learning needs, spearheading initiatives that address those needs, and ensuring that such initiatives are aligned with PAHO’s business needs, corporate policies, and the objectives of the PAHO Strategic Plan.

Since 2004, the Learning program has developed regional and global learning plans focused on eight “learning tracks”: induction and updating, PAHO fundamentals, leadership and managerial excellence, project management, technical excellence, administrative excellence, administrative skills, and support skills. All staff are required to take a mandatory induction course, a course on PAHO’s Code of Ethical Principles and Conduct, and two courses (basic and advanced) on Security in the Field. Starting in 2012, each PASB staff member is also required to include 10 days/80 hours of learning activities in their personal work plans (see also below).

E-Manual and Country-Level Operations Manual

Transparency, Accountability, and Oversight

In line with recommendations of the Working Group on PAHO in the 21st Century, the PASB instituted a number of changes aimed at increasing transparency and accountability in PAHO’s work. These included the adoption of the first specific rules governing the election of the PASB Director. Based on the recommendations of a special Working Group on Streamlining the Governance Mechanisms of PAHO, the new rules included criteria for use by the Member States in selecting their nominees, a timeline and procedures for nominations and for holding the election, and the establishment of a new Candidates’ Forum, timed to coincide with meetings of the Executive Committee, to allow candidates to present their platforms and answer questions from Member States.

The rules also included specific regulations regarding candidates who are PAHO or WHO staff members as well as oversight mechanisms related to contracting delegates from Member States participating in the election and the use of certain funds of the Organization before and after the election.

In 2009, WHO instituted a new global process for selecting Heads of WHO Country Offices (HWCOs), also known as PAHO/WHO Representatives (PWRs). The process seeks to guarantee the leadership qualities and skills of PWRs/HWCOs through a competitive selection process, continuing education, and a rigorous assessment of performance, combined with proper induction, mentoring, and coaching, as well as responsive back-up and support.

The new process includes a Global Roster of pre-qualified candidates from which all PWRs/HWCOs are to be selected. The Global Roster Assessment Committee, made up of senior officers from the six Regional Offices and WHO Headquarters, ensures that applicants meet the minimum essential requirements for the post and that the assessment process has complied with institutional norms. The process includes a written test to assess candidates’ knowledge of fundamental aspects of public health and the values of the United Nations and WHO, as well as interviews and simulations to assess their political skills in situations commonly faced by PWRs/HWCOs.

For PWR (AMRO) vacancies, candidates from the Global Roster are reviewed by the PAHO Senior Selection Committee, which proposes one candidate to the WHO Director-General. Appointments proceed on the basis of mutual agreement with the host government.

In addition to these changes, PASB also decided to modify the process for selecting PAHO’s External Auditor. Over a 30-year period prior to the 2008-2009 biennium, the National Audit Office of the United Kingdom of Great Britain and Northern Ireland (NAO) had been appointed by the Governing Bodies to serve as PAHO’s External Auditor. In an effort to improve transparency in oversight processes, PASB adopted the procedure used by WHO, in which nominations are requested for an External Auditor who serves for no more than two successive biennia. In 2008, the NAO was the sole nominee and was again selected as External Auditor for two biennia. In 2011, the Member States appointed the Spanish Court of Audit for the 2012-2013 and 2014-2015 biennia after a competitive process.

Several other new entities and processes were established to enhance governance through improved oversight, risk management, and evaluation. These included the new Office of Internal Oversight and Evaluation Services (IES), established in 2009 and headed by the PAHO Auditor General. IES is responsible for conducting internal audits and evaluations, identifying risk and internal control issues, making recommendations, and following up on their implementation. IES acts independently of management and provides advisory services on an ad-hoc basis.

A related development was the creation of the PAHO Audit Committee, which met for the first time in 2010. Made up of experienced professionals who operate independently of both the Member States and PASB, the committee contributes to enhanced institutional governance, risk management, and internal control processes by conducting internal audits and evaluations and providing advice to PASB management. Its members also participate in meetings of the ICMS, the Asset Protection and Loss Prevention (APLP) committee, and the PMIS modernization project, among others.

The new Standing Committee on Asset Protection and Loss Prevention (APLP) was established in 2009 to make recommendations on policies and measures to prevent the loss, misuse, or theft of PAHO resources and assets. One of its first recommendations, implemented in 2010, was that all reports of suspected theft, loss, or misconduct should be reported to one focal point in the Organization, namely the Ethics Office. In 2012, a new policy was issued under the auspices of the APLP committee to hold staff accountable when property or equipment belonging to the Organization is lost or stolen due to negligence or misconduct.

PAHO instituted other new processes aimed at ensuring integrity, transparency, and accountability in carrying out its mandates. As of 2005, staff members at certain grade levels and in relevant positions are required to submit a Declaration of Interest disclosing any financial, professional, or other interests that could potentially give rise to a conflict of interest. The declaration also requires disclosure of any relevant interests of immediate family members.

Starting in 2010, the Organization adopted the International Public Sector Accounting Standards (IPSAS) in its accounting and financial reporting; previously it had used the U.N. System Accounting Standards (UNSAS). PAHO was one of eight U.N. system organizations that succeeded in implementing the new standards by 2010.

Institutional Response Framework and EOC

The 2009 H1N1 influenza pandemic and the 2010 earthquake in Haiti proved to be among the largest and most complicated response operations since PAHO’s emergency program was created in 1976. As a result of these experiences and the considerable demands they placed on the Organization, PAHO began modifying its own disaster management and response operations.

This process involved extensive consultations within and outside the Organization with experts from a variety of disciplines, including emergency management specialists, first responders, epidemiologists, and administrators, among others. The result was a new Institutional Response to Emergencies and Disasters Framework aimed at improving the Organization’s capacity to respond with adequate speed, agility, and effectiveness to Members States’ needs in times of emergency.

As part of the new framework, the space formerly occupied by the Library in the Headquarters building was adapted to host the new Emergency Operations Center (EOC) and Knowledge Center, with interconnected and flexible work spaces to allow different technical areas within the Organization to collaborate in a public health response. The EOC plays a coordinating role, connecting all points of operations to ensure a timely and effective response to urgent public health events. Its integration with PAHO’s Library and Information Networks (KMC/LI) and the International Health Regulations’ Alert and Response and Epidemic Diseases (HSD/IR) team allows better collaboration between the Area on Emergency Preparedness and Disaster Relief (PED), Knowledge Management and Communications (KMC), Health Surveillance and Disease Prevention and Control (HSD), and other technical and administrative areas. The new EOC/Knowledge Center space was inaugurated during the 150th Session of the Executive Committee in June 2012.

Information and Communication Technologies

Complementing the new institutional response framework and contributing to business continuity and operational efficiency were new efforts to improve the Organization’s information and communications infrastructure.

The basic framework for these efforts was the new PAHO ICT Strategy, which articulates the consensus on the needs of the PAHO community and its partner base and presents a comprehensive vision of where ICT in PAHO needs to be in the medium term. A draft of the policy was developed through a region-wide consultation involving 13 focus groups and the participation of more than 100 PASB staff.

Based on a five-year planning horizon, the ICT Strategy assimilates near-term industry trends in virtualization, cloud computing, standardization, consolidation, and service management. As the Organization continues its progressive shift to the use of mobile services and devices, these approaches and technologies are expected to improve the agility and capacity of ICT to respond to the evolving needs of PAHO and its communities.

The PAHO ICT Strategy emphasizes positioning the Organization as a leader in electronic health information as well as in collaboration and networking. It reflects PAHO’s Country Focus and stresses increased network connectivity to ensure equitable access for all, in support of PAHO’s Strategic Objectives.

Projects included in the strategy have been implemented collaboratively by the Information Technology Services (ITS) team with the Area of Knowledge Management and Communications (KMC) to ensure integration with the KMC conceptual model and interoperability with the PAHO Intranet/Extranet 2.0, the WHO Global Institutional Repository, and the Virtual Campus of Public Health.

Major ICT projects have included:

• (a) The Desktop Technology Refresh Project, which provides a common desktop experience for staff at Headquarters, in the country offices and Pan American Centers, and on multiple devices. It facilitates single-instance management of desktop software configuration, improves standardization, and simplifies local proximity support.
• (b) The Email Modernization Project, which has progressively upgraded the email systems of PAHO’s country offices and Centers, while migrating many offices to the WDC Datacenter to consolidate hardware and improve business continuity. As part of the PAHO Business Continuity Plan, ITS also implemented a new Email Management System (EMS) that includes alternate email infrastructure in case of an outage on PAHO’s core email systems.
• (c) The PAHO Server Virtualization Project, which has provided a stronger and more flexible server infrastructure at Headquarters and has allowed faster response to business continuity demands.

Knowledge Management and Communications Strategy and Web 2.0

In 2011, PAHO approved its first corporate strategy aimed at integrating knowledge management and communications. The strategy’s development involved contributions from 13 different working groups and the incorporation of elements of a previous Knowledge Management Strategy and an existing strategy for Human Resources and Information Technology.

The new Knowledge Management and Communications Strategy provides guidance for the planning of knowledge management and communications policies, identifying strategic goals in areas including collaboration, learning, networks, and health communication. The strategy is being implemented throughout the Organization under the primary responsibility of the Area of Knowledge Management and Communications (KMC).

A major change instituted as part of the Knowledge Management and Communications Strategy was a shift to the Web 2.0 model of online presence. In contrast to traditional web models, Web 2.0 implies interaction and collaboration among users who are able to create and generate content as members of a virtual community, rather than users essentially being passive recipients of content created for their consumption.

The Organization’s embrace of Web 2.0 has opened up new opportunities for information-sharing, networking, interaction, interoperability, and content generation. PAHO’s implementation of the model has emphasized:

• (a) Standards for information management that allow for joint evolution among different users.
• (b) Interoperability to allow the consolidation of internal and external information flows.
• (c) Targeting of user groups in content production and sharing.
• (d) Expanding networks for dissemination of information and innovation, including through communities of practice and the use of social media.
• (e) Creation of new functional forms to prepare for mobile devices and access.
• (f) Preservation of knowledge, expertise, and historical memory.

PASB Management Information System

In 2010, PASB launched a multiyear project to modernize its management information system, formerly known as the Corporate Management System (CMS) and more recently renamed the PASB Management Information System (PMIS). PMIS provides critical support for PAHO’s technical cooperation programs by automating the information needed for planning, program management, budgeting, finance, human resources management, payroll, procurement, and evaluation, among others.

A special PMIS Committee analyzed the Organization’s business processes, developed a set of guiding principles, and identified various options for modernization along with their advantages, disadvantages, and estimated costs. The committee’s report, approved by PAHO’s 50th Directing Council (CD50/7 and CD50/7, Corr.1) in 2010, called for modernizing the PMIS to align with the WHO Global Management System while taking into account PAHO’s separate legal status and ensuring that neither the authority of PAHO’s Governing Bodies nor levels of service to PAHO Members States are compromised.

In line with the PMIS Committee’s recommendations, the PMIS modernization effort seeks to enhance accountability and transparency, collaboration, human resources management, support for emergency operations, and operational efficiency. It also seeks to streamline administrative processes; facilitate multilingual operations at the country, subregional, and regional levels; and ensure that information management helps strengthen management at all levels of PASB.

Procurement, Hiring, and Performance

PAHO has dramatically increased its procurement activity in recent years, in large part due to increased use by Member States of the PAHO Revolving Fund and the Strategic Fund. From 2000 to 2011, total procurement grew nearly fivefold, from US$ 105 million to US$ 505 million. To better respond to this growing demand, the Organization undertook a major Procurement Transformation Project, informed by both external and internal assessments, aimed at streamlining processes for efficiencies and alignment of organizational structures for strategic effectiveness.

Among the most significant changes in procurement practices during the past 10 years was increased delegation of authority at both Headquarters and the country level. This trend was in line with other efforts to streamline and decentralize functions in the Organization and is part of a longer-term effort to institute a new procurement model based on “centralized control with decentralized execution.”

To improve performance in procurement by both internal and external stakeholders, PAHO instituted the use of digital dashboards, or digital interfaces that (a) present performance information in a graphic format that allows users to quickly identify performance issues and assist in their correction, (b) deliver more timely information by moving away from manually intensive methods of integrating and disseminating information, and (c) facilitate the analysis and management of procurement processes with respect to key goals and objectives. The dashboards make use of key performance indicators (KPI) to measure efficiency and effectiveness of procurement activity and facilitate corrective actions to better meet organizational targets and goals.

PAHO’s Area of Human Resources Management (HRM) also implemented changes to streamline and clarify its contracting modalities, primarily to reduce recruitment times and facilitate rapid deployment. These changes have included:

• (a) Harmonization of PAHO’s contracting modalities with those of the U.N. Common System to ensure consistency and inter-agency mobility.
• (b) Development of automated systems to address urgent needs and funding challenges, such as short-term funding.
• (c) Delegation of authority to allow managers to make hiring decisions without extensive HRM involvement in certain situations (e.g., hiring non-U.N. staff as temporary advisors and consultants).
• (d) Development of general services rosters to facilitate rapid hiring of personnel for project or program support.

• (a) A Human Resources Tracking System (HRT) to facilitate better follow-up of hiring requests.
• (b) An E-Select tool that automates most of the steps for documenting the recruitment process and allows managers more control over the timeline of each phase.
• (c) Reconfiguration of the Advisory Selection Panel (ASP) to permit better programming of the selection process.

Back to top