Ministers, Secretaries of Health and high-level delegates brought together at the 56th Directing Council of PAHO

26/09/2018 - Aline Abreu



From September 23rd through 27th, health authorities of the Americas will be establishing priorities and plans to address the main health challenges faced by the region during the 56th Directing Council (DC) of the Pan American Health Organization (PAHO), held in Washington D.C.

The DC of PAHO brings together ministers of health and high-level delegates of the PAHO Member States to discuss and analyze health policies and set priorities for technical cooperation and collaboration among countries. Through the DC meeting PAHO is able to identify and propose measures to deal with the special needs of each defined area, one of its functions as one of the regional divisions of the World Health Organization (WHO).

The DC meeting sets PAHO policies and priorities for technical cooperation, discusses regional public health challenges, as well as establishes strategies and plans of action to improve population health and prevent diseases and death. It also provides a forum to exchange information and ideas. Other decisions related to the regional level are also discussed in the DC, such as the organization’s budget and the selection of the countries, designated by regions, that will integrate the various PAHO’s working groups and bodies, such as the Executive Council, for the next annual period, including next year’s DC.


South America and ISAGS:

The twelve South American countries participated of the Opening Session on the 23rd represented by their Ministers, Secretaries of Health, or other high-level authorities, as well as the Executive Director of ISAGS-UNASUR, Carina Vance. On the 24th, Dr. Tabaré Vázquez, President of Uruguay, received PAHO’s highest distinction as “Health Hero of the Americas”, in recognition of his leadership role to prevent and control non-communicable diseases and to ensure tobacco control in Uruguay. On the same day, Carina Vance participated in PAHO Side Event to present the Progress Report of the High-level Commission “Universal Health in the 21st century: 40 years of Alma-Ata”.

Participating in PAHO’s Directing Council meetings is part of ISAGS’ functions in supporting the formulation of strategies and policies of National Health Systems in South America, as well as strengthening Health Diplomacy in the region; aligning positions and promoting a virtuous circle for health cooperation in articulation with similar regional and international institutions.

Some of the main issues to be debated during the 56th DC, which is at the same time the 70th Session of the Regional Committee of WHO, are actions to reduce the shortage in health personnel; lower the number of cases of, and deaths from cervical cancer, and improve the health of women, children and adolescents; as well as discuss action plans to improve vector control in order to prevent diseases such as Malaria, Zika and Chagas disease; as well as Human Resources for Universal Health Access and Universal Health Coverage. These issues are essential for the fulfillment of health as a fundamental right in South America, universally accessible, promoted in a sustainable and intersectoral way, as well as in respect to the cultural diversity of the region.

 Main Documents:

 Core documents about the health situation in the Americas and the goals for the region guide the discussions and decisions made during the DC meeting. It implies the compliance with the PAHO Strategic Plan 2014-2019 and the Strategy for Universal Access to Health and Universal Health Coverage, as well as the Sustainable Health Agenda for the Americas 2018-2030.

Throughout this process, the decisions aiming to achieve equitable health for all, in particular for women, children, ethnic groups, indigenous populations and people living in conditions of vulnerability, are taken in accordance to regional and global agreements. Another example of a guiding agenda is the 2030 Agenda which comprises the Sustainable Development Goals (SDG); specifically SDG 3, which aims to “guarantee a healthy life and promote well-being for all in all ages”.

Besides this, the celebration in September of the 40th anniversary of the International Conference on Primary Health Care, in Alma-Ata, Kazakhstan in 1978, also reinforces principles and measures to guarantee a Primary Health Care approach to achieve universal health. This space also constitutes an opportunity to bring together common understandings of these important issues, in light of the Global Conference on Primary Health Care, to be held in Astana, Kazakhstan in the end of October.


The Plans of Action:

 Among the main proposals discussed by the DC this year, is the Plan of Action for Cervical Cancer Prevention and Control 2018-2030, which establishes, as a necessary measure, the integral development and implementation of accessible, equitable, comprehensive, and cost-effective interventions, envisioning a future in which cervical cancer will no longer be a public health problem.

Cancer is the second cause of death in the Americas. Meanwhile cervical cancer is the leading cause of death from cancer among women in eleven countries and is the second leading cause of death in twelve others. Each year, about 83,200 women are diagnosed and 35,680 die of this disease in the region; a significant proportion (52%) of them are under the age of 60 (Source: Plan of Action for Cervical Cancer Prevention and Control 2018-2030). To deal with this scenario, the plan highlights the importance of health systems strengthening, early diagnosis and treatment, and access to preventative measures including vaccines against the human papilloma virus (HPV), Papanicolaou test and better treatments against cancer.

The Plan also recognizes the contribution of the “Regional Plan of Integrated Actions: Platform for the Exchange of Experiences and Technical Assistance for the Prevention and Control of Cervical Cancer in South America” developed by the Network of National Cancer Institutes of UNASUR (RINC-UNASUR). This project was funded by the Common Initiatives Fund of UNASUR, and has been recognized as one of the best practices of South-South Cooperation to address the SDGs, by UNOSSC (UN Office for South-South Cooperation) in 2018.

In addition to this proposal, the 56th DC analyzed the Plan of Action for Women’s, Children’s, and Adolescents’ Health 2018-2030 which has its structure based on the Global Strategy for Women’s, Children’s and Adolescents’ Health and identifies three general objectives: to survive – end preventable deaths; to thrive – ensure physical and mental health and well-being; and to transform – expand enabling environments.

What is specific about these objectives is that, beyond survival, authorities in the region have set, as a goal, to guarantee the highest possible level of well-being throughout the life course, thereby better enabling individuals to thrive. For this, the Plan considers putting an end to all forms of malnutrition by addressing nutritional needs; ensuring universal access to sexual and reproductive health-care services and rights; ensuring that all girls and boys have access to resources to promote good-quality early childhood development; substantially reducing pollution-related deaths and illnesses; and achieving universal health.

Another document under consideration was the Plan of Action on Entomology and Vector Control 2018-2023. This Plan is also in consonance with WHO guidelines, specially through the Global Response for Vector Control 2017-2030; the Integrated Management Strategy for Dengue Prevention and Control in the Region of the Americas; the Plan of Action for the Elimination of Neglected Infectious Diseases and Post-Elimination Measures 2016-2022 and the Plan of Action for the Elimination of Malaria 2016-2020.

The Plan of Action on Entomology and Vector Control 2018-2023 contains five lines of action, which incorporate the main needs to meet the challenges related to the prevention and control of vector-borne diseases. Some of the main challenges in the region are the wide geographical distribution, severity and potential to generate epidemics of these diseases in a large territory of the American countries (including throughout the South American region), as well as the shortcomings of the measures currently used for their control. Arboviruses (e.g., chikungunya, dengue, yellow fever, and Zika), malaria, and selected neglected infectious diseases (Chagas disease, leishmaniasis, lymphatic filariasis, onchocerciasis, schistosomiasis, and others) are some of the illnesses directly approached by this Plan.

These Plans, as well as all the debates during the 56th DC, will allow regionalarticulation and diplomacy for the joint determination of the main strategies and actions in health policies for the continent. For South America, it is also an opportunity of articulation among the 12 member countries and to improve their governments in health based on the specificities of the region, looking for inclusive health systems able to guarantee universal health access.


Aline Abreu

International Relations and Cooperation Coordinator at ISAGS -UNASUR