Advancing towards universal health in the Americas
My vision for the future of PAHO is to make it the leading Organization in supporting the countries of the Americas with the most innovative and efficient strategies to recover better than they were before, overcome inequalities, and build resilient health systems to improve the response to emergencies and disasters and to achieve universal health care.
To implement this vision, it must be PAHO's priority for the next five years to lead the Region and support the countries in five strategic pillars:
- Completion of pandemic control.
- Implementation of lessons learned during the pandemic.
- Recovery from the impacts of the pandemic on priority health programs, returning better than we were in 2019.
- Construction of resilient National Health Systems based on renewed and strengthened Primary Health Care.
- Permanent modernization and improvement of PAHO's management.
The first pillar is a commitment to help Member States end the pandemic in the Americas with the best tools we have at hand, especially surveillance and vaccines.
PAHO is ready to work with countries to end the pandemic by strengthening health surveillance to monitor any changes in the epidemiological trends and new variants, as well as ensuring adequate vaccination coverage. This includes increasing access to boosters for vulnerable groups, identifying appropriate strategies to address vaccine hesitancy and improving access to effective antivirals.
Our Region was the epicenter of the pandemic due to poverty and inequalities that jeopardized the public health measures adopted before vaccines were available. In countries where so many rely on informal economic activities, so many live in slums with poor access to water and sanitations and so many depend on crowded public transportation, it was almost impossible to keep people safe from getting infected.
Even when vaccines were developed, we faced unconscionable obstacles: our vast region struggled to access sufficient supplies, just as misinformation increased vaccine hesitancy. Against these barriers, PAHO has worked hard to support National Immunization Plans, reinforce the cold chain capacity, provide training for health workers, improve communication strategies, and expedite access through our Revolving Fund.
Now, we have the tools to control transmission and must work hard, together to reach the groups that are not yet vaccinated and end the pandemic in the Americas.
The second pillar is a push to apply the lessons we learned from the pandemic and actively address our vulnerabilities, so that we are much better prepared to face new threats as they emerge.
PAHO is ready to support the implementation of the crucial lessons from the pandemic across several issues.
We will support our Member States to strengthen their national capacity to detect and respond to public health emergencies, build strong health surveillance systems based on the "One Health" approach, ensuring countries can rapidly scale up these capacities in the event of an emergency or disaster.
We will also reinforce our ability to provide regional coordination by implementing the recommendations from the external evaluation of our performance during the pandemic.
PAHO will work with the countries to expand the development and production of medicines, vaccines, and medical products in Latin America and the Caribbean, strengthening regulatory capacity, and implementing strategic, sustainable projects that benefit all countries in our region, including by making better and expanded use of regional mechanisms like the Revolving and Strategic Funds.
We must also support our Member States' participation in the global debate about the new instrument to respond to pandemics. COVID-19 has revealed the critical importance of guaranteeing genuine equitable access to vaccines, medicines, and health products during a pandemic.
I believe this is the only way the world will be better prepared for future emergencies and ensure that the people who lost their lives during this period did not do so in vain, including the brave health professionals that continued to provide care even without proper protection.
There is one more lesson that we must take with us as we grow from this pandemic. Any problem, no matter how small, must be approached together, as a region. By working across sectors, across borders, and across languages, we will be able to achieve a healthier region.
The third pillar is to ensure timely and equitable access to health innovations for all countries in the Region.
PAHO stands ready to support countries in building back from the negative impacts of the pandemic on priority health programs. But this alone is not enough; we must go further and ensure that all countries, and all population groups within each country, are on track to achieve the Sustainable Development Goals for health.
We will support countries toward a more rapid incorporation of new technologies and implementation of innovative and more effective strategies, all based on the best available scientific evidence, adapted to each national reality. This will allow us to protect existing achievements, build back priority programs, and make faster progress in improving the health of our populations.
This transformation is particularly urgent so that we may:
- reduce maternal and child mortality more quickly;
- hasten elimination of cervical cancer, TB, HIV, malaria, leprosy, and other neglected diseases;
- strengthen and modernize immunization programs with renewed, high-level political and social commitment, new tools for analysis to identify groups that are being left behind and the barriers that hinder their access, and innovative communication and social mobilization strategies to recover adequate vaccination coverage;
- boost the use of telehealth and telemedicine as tools to achieve greater response capacity in Primary Health Care; expand access for all, especially those most vulnerable groups; and improve the quality of care, including mental health care.
We must urgently transform the excellent pilot projects which have already proved successful in the Region into policies for incorporation into health systems and into PHC.
The fourth pillar is to build resilient national health systems based on renewed and strengthened Primary Health Care.
PAHO stands ready to support countries in achieving sufficient public financing to ensure universal health systems, strengthen governance by their ministries of health, and ensure a sufficient and appropriately trained health workforce.
The core component of a resilient health system is efficient Primary Health Care, capable of concerted action for the promotion, prevention, surveillance, and care of the most prevalent health conditions in the communities it serves.
It is urgent that we prepare PHC to face the challenges posed by a complex epidemiological context and an aging population.
Such action requires the development and implementation of strategies to ensure adequate financing for the health sector, training and retention of human resources, improvement of information systems, the use of technologies such as telemedicine, and digital transformation.
Health systems must increase their capacity to identify barriers to access and establish strategies to address these barriers, while listening to population groups and communities.
We must not forget that we live in a region beset by historical inequities between and within countries. No health system can respond to the needs of the population unless it is permanently concerned with identifying those groups that are being left behind and promoting equity.
Indigenous peoples, Afro-descendants, poor families living in peripheral urban and rural areas, women, and LGBTQIA+ people need health systems to see them and hear them so that their needs are reflected in ensuring access to respectful and welcoming health care.
Finally, the fifth pillar is strengthening PAHO’s capacity to support Member States.
PAHO stands ready to move forward and further secure the advances that Dr. Etienne implemented during her term to streamline its management, promote increased transparency, and improve agility, efficiency, and gender equity.
Our staff, at Headquarters and in our Country Offices, is our greatest strength in providing high-quality technical cooperation. They are committed to the principles of the Organization and spare no effort to support countries as their endeavor to improve the health and lives of their populations.
I will always seek to recognize their achievements, keep an open and transparent dialogue, strengthen their growing professional qualifications, and maintain a respectful and welcoming work environment.
I will improve our prevention programs and zero-tolerance policy against any form of sexual harassment, exploitation, or abuse of PAHO employees or populations served by PAHO.
I will work tirelessly, with our qualified and committed personnel, to ensure that PAHO maintains all of its many achievements to date, renewing itself every step of the way, always building networks, and working as a bridge for understanding, solidarity, and innovation.
This is how I see our Organization: strengthening itself to respond to current and future challenges and to place health at the heart of the development agendas of the Americas.