In September 2012, when I was elected Director of the Pan American Sanitary Bureau (PASB) by the 28th Pan American Sanitary Conference, I pledged to lead a process of renewal that would uphold the core values and principles of this more-than-a-century-old institution and also encourage innovation to make it a more effective agent for change. Since I assumed the post of Director in February 2013, I have been pleased to find that the core values of universality, equity, and Pan American solidarity remain robust within the Organization, while a collective confidence and optimism have combined to create heightened expectations about PAHO’s future. It is a source of great satisfaction to find myself at the helm of an organization with strong traditions of excellence and pride in its achievements but also with a palpable openness to change and improvement.

One of my first tasks as Director was to begin a process of consultations with staff and Member States on how to restructure PASB, PAHO’s secretariat, to enhance synergy and complementarity in our technical cooperation programs. Two months later, I announced a new organizational structure, with a first round of changes that took effect on 1 July 2013. My goal in this undertaking was to position PAHO as a flexible, transparent, and responsive organization that brings expertise and innovation to its collaboration with Member States.

I have continued to consult with staff, our Member States, and other partners and stakeholders to share ideas, assess needs, and identify opportunities in which PAHO’s work can make a real difference in improving health conditions in the Americas. In all these consultations I have advocated for four priorities: reducing inequities in health, strengthening health systems, addressing the social and environmental determinants of health, and achieving universal health coverage, by which I mean access to quality health care for everyone without fear of impoverishment. I believe that advancing these priorities is critical to realizing the vision for the Region of the Americas: societies that are free of inequity, where people have the social conditions and the healthy environments they need to live long, dignified, healthy, and productive lives.

In my consultations, I have been heartened, though not surprised, to find that PAHO’s staff and stakeholders share this vision, welcome these priorities, and are equally eager to find new opportunities to work together to advance them more effectively and sustainably.

I have also been heartened to confirm, during my first months as PASB’s Director, that PAHO is beginning its new journey from a position of strength. I have been impressed by the wealth of expertise, the energy and the enterprise, the passion and the dedication that PAHO’s staff and partners bring to their work.

These first months have also reconfirmed my view that our countries, our Region, and our Organization are facing new times and new conditions that call for new ways of working to advance public health. We know that our Member States are the repositories of much of the knowledge, expertise, and wisdom that we need to improve health throughout the Region. This means that one of PAHO’s most important roles—if not its most important role—is as a strategic partner that supports efforts to build political will, share knowledge, and mobilize collaborative, multisectoral action both within and among our member countries.

Reviewing this report, it is clear that PAHO’s technical cooperation has contributed to important progress in a wide range of areas, from the elimination and control of infectious diseases to the strengthening of health systems, tackling the social determinants of health, and ensuring that those who are affected by diseases have access to prevention, care, and rehabilitation services.

This report presents highlights of this progress and specific achievements over the past year, from mid-2012 to mid-2013. This period includes the final seven months of PAHO’s former administration and the first five months under my leadership. The Organization’s work during this period was guided by the 2008–2013 PAHO Strategic Plan but also included the development of a new Strategic Plan for 2014–2019.

As required by PAHO’s Governing Bodies, the report provides an accounting of the activities of PASB, and every achievement described herein was supported with technical cooperation from PASB programs at the regional or country level. However, the great majority of these achievements were the result of joint efforts between PASB staff, their counterparts in the ministries of health, and partners within Member States and in the international community. For this reason, the report refers not just to activities of PASB but to the achievements of PAHO, that is, the secretariat and the Member States together.

This report presents strong evidence of this Organization’s continuing strength and the value of its work. In this regard, I wish to acknowledge and thank my predecessor, former PASB Director Mirta Roses Periago, for her stewardship of this Organization. I believe that PAHO has a bright future, with great potential to play an even larger role in improving health conditions and strengthening health on the international and national development agendas. I look forward to leading this Organization into that future, with strong support from our Member States, so that we can together complete our unfinished business, take on new challenges, and ultimately realize the dream of health for every woman, man, and child in the Americas.

Dr. Carissa F. Etienne
Director

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