The Pan American Sanitary Code: 100 Years of Health Collaboration

A Century of the Pan American Sanitary Code in the Americas

The Pan American Sanitary Code, signed ad referendum by 18 countries of the Americas on 14 November 1924 in Cuba, represents a remarkable milestone in public health. It was the first multilateral treaty of its kind, committing the Region of the Americas to cooperative efforts in preventing the international spread of communicable diseases and to notify of the appearance in its territories of suspected cases of any dangerous contagion liable to be spread.

The 18 countries that signed the Code in 1924 were: Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Guatemala, Haiti, Honduras, México, El Salvador, Panama, Paraguay, Peru, United States of America, Uruguay and Venezuela.

The Code remains in force today and is one of the greatest achievements in health policy, as it laid the foundation for a unified approach in the region to protect and promote the health and well-being of its populations. It continues to underpin the work of the Pan American Health Organization (PAHO) and its Member States and highlights the scope and importance of health cooperation and the values of Pan-Americanism.

The Code, ratified by all countries in the Region of the Americas, established responsibilities for countries to report diseases among themselves and to the Pan American Sanitary Bureau (PAHO Secretariat). It promoted standardization of the collection of morbidity and mortality data, mutual interchange of information for improving the public health, and on the prevention and control measures for combating diseases, recognizing the importance of health cooperation for international trade development.

The Code also inspired the creation of other global health cooperation frameworks, including the first International Health Regulations (IHR) that entered into force in 1951.

Ratification of the Pan American Sanitary Code (in Spanish) – 1926 (Ratification by Costa Rica, Cuba, Chile, Honduras, Nicaragua, Peru, United States of America)
Haiti ratifies the Pan American Sanitary Code (in Spanish) – 1927
Approval of the Pan American Sanitary Code by Brazil (in Portuguese) – 1929

Other resolutions and articles about the Code and the history of PAHO:

Resolutions of the 7th Pan American Sanitary Conference (1924) (CSP7) (CSP7.R1 dealt with the approval of the Code)

The Pan American Sanitary Code: Toward a Hemispheric Health Policy

Pro Salute Novi Mundi: A History of the Pan American Health Organization

The first fifty years of the Pan American Sanitary Bureau (Spanish)

View Code

100th anniversary of the Pan American Sanitary Code

On 14 November 2024, the Pan American Health Organization (PAHO) Director, Dr. Jarbas Barbosa, today convened Ministers of Health and other high-level health authorities for a panel discussion to celebrate the 100^th anniversary of the Pan American Sanitary Code. During the opening of the celebration, Dr. Barbosa noted that “today, a century later, 20 articles of the Pan American Sanitary Code remain in force,” establishing the fundamental duties of PAHO as a regional public health agency. The recent challenges of the COVID-19 pandemic “have shown us that, a hundred years later, the principles of Pan Americanism and solidarity, established in the Pan American Sanitary Code, remain valid and necessary,” the PAHO Director added.

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View Event Agenda and Panelists +

Opening Remarks
Dr. Jarbas Barbosa da Silva Jr.,
Director, PAHO

Genesis and evolution of the Pan American Sanitary Code

Sir George Alleyne
Director Emeritus, PAHO

Dr Mirta Roses
Director Emeritus, PAHO

Video - Pan American Sanitary Code: a century protecting health in the Americas

Panel: A Century of the Pan American Sanitary Code in the Americas

Moderator
Dr. Ciro Ugarte
Director, Health Emergencies, PAHO

Health systems in the context of the Pan American Sanitary Code

Dr. Ximena Aguilera
Minister of Health
Chile

Health surveillance and the Pan-American Sanitary Code: A century of collaboration towards global health security

Dr. Kayla Laserson
Director, Global Health Center
Centers for Disease Control and Prevention (CDC)
United States of America

Scientific research and innovation for the prevention, control and elimination of infectious diseases
Dr. Vivian Kourí Cardella
Director, Pedro Kouri Institute
Cuba

Advancing collaboration to prevent and control health emergencies in the Region of the Americas
Dr. Nisia Trindade
Minister of Health
Brasil

Aviation codes through time: tracing their roots and evolution including the Pan American Sanitary Code
Mr. Juan Carlos Salazar
Secretary General
International Civil Aviation Organization

A century of immunization under the Pan American Sanitary Code: triumphs, setbacks, and the road ahead
Dr. Peter Figeroa
Professor Public Health, Epidemiology & HIV/AIDS, University of West Indies
Jamaica

Closing remarks
Dr. Jarbas Barbosa da Silva Jr.,
Director, PAHO

“The Pan American Sanitary Code is one of the most important health documents in the world. The Code is a living manifestation of the relevance of the Pan-American doctrine, and I trust that its expression in health continues to find expression in the Pan American Health Organization from generation to generation.”

Dr. George Alleyne – Director Emeritus, PAHO

"The Pan American Sanitary Code, “represents the greatest achievement in the standardization of health in the American continent and the culmination of decades of international initiatives aimed at prolonging life and achieving human happiness.”

Dr. Mirta Roses – Director Emeritus, PAHO

“From my perspective, the Pan American Sanitary Code represents a landmark – in the acknowledgement of countries of the Americas about the State’s responsibility when it comes to health issues, in the promotion of public health systems, and the contextualization of the roles of public health.”

Dr. Ximena Aguilera, Minister of Health of Chile

“Even 100 years ago, with the Code being initiated, the idea of surveillance and the idea of finding all the problems that there are and stopping them at their source, was there from the very beginning. But even then, as we know today, you can’t stop or control or prevent what you can’t count or see or measure.” “As we think about surveillance and the data and the people behind surveillance, we also think about partnerships and the partnership with PAHO has really been longstanding. We are similar institutions that have worked well together for years and years.”

Dr. Kayla F. Laserson, Director of Global Health Center at the United States Centers for Disease Prevention and Control (CDC)

“When the Pan American Sanitary Code was signed in Cuba, communicable diseases at the time were a barrier for the implementation of the sanitary code and they continue to be a threat today. Despite the progress that we have seen in molecular biology and modern medicine, we also have modern challenges when it comes to the elimination and control of communicable diseases. No country is free from these hazards.”

Dr. Vivian Kouri Cardella, Director of the Pedro Kouri Institute, Cuba

“This important milestone in public health has helped in the advancement of surveillance, epidemiology, services and health security. I hope that this milestone is another step forward in intensifying collaboration among the peoples of the Americas.”

Dr Nisia Trinidade, Minister of Health of Brazil

“A century ago, as aircraft were just beginning to transform our world, visionary leaders gathered to sign the Pan American Sanitary Code. They made a remarkable decision – to include aviation in their groundbreaking health regulations. In an era when international travel meant long ocean trips and most health measures focused on seaports, these pioneers looked to the skies and saw the future.”

Juan Carlos Salazar, Secretary General of the International Civil Aviation Organization (ICAO)

“The elimination of smallpox is one of the most outstanding public health achievements of the Americas and globally.” “When I was growing up, children were dying of measles or crippled by polio but now this is no longer the case thanks to the success of regional vaccination programs,” that have taken place over the past 100 years of the Code. “We must sustain these historic gains in the Americas.”

Dr. Peter Figueroa, Professor of Public Health at the University of the West Indies, Jamaica

A century protecting health in the Americas

Recording: 100th Anniversary Virtual Event

Photo Gallery

The code was signed at the assembly hall of the former Academy of Medical, Physical, and Natural Sciences (now the Carlos J. Finlay Museum of Science History), in Cuba. The images showcase the hall on the day the Pan American Sanitary Code was signed, featuring the authors of the Code, as well as recent photos of the auditorium.

The history of PAHO is replete with men and women of vision, determination, knowledge, and dedication. Over the generations, they have formed a pageant of mostly nameless movers and shakers that have blazed a trail of progress toward health for all. Yet, in the end, it is the institution, the Pan American Health Organization—a coalition of countries— maintaining a united front against disease and improving health care throughout the Americas.