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Washington, D.C., 2 October 2014 (PAHO/WHO) Ministers of health and other high-level delegates from countries in the Americas agreed on a series of actions to advance toward universal access to health and universal health coverage.

"Today we have agreed on a roadmap to progressively ensure that all people have access to the health services they need, when they need them, without fear of financial hardship," said Dr. Carissa F. Etienne, Director of the Pan American Health Organization (PAHO). "This will be a gradual process, and each country will follow its own path. But achieving universal access and universal health coverage will not only promote the well-being of people throughout our region but also contribute in an important way to the development of our countries."

The roadmap is laid out in a regional strategy approved by the 53rd PAHO Directing Council, made up of health officials from North, South and Central America and the Caribbean who have been meeting at PAHO headquarters this week.

The new strategy addresses inequities in access to health systems and services that prevent people from enjoying optimal health. Currently, some 30% of people in the Americas cannot access health care for financial reasons, according to PAHO estimates, and 21% lack access to care because of geographical barriers. Groups living in vulnerable conditions, children, women, older adults and ethnic minorities are those most affected by these problems.

Additionally, many countries' health systems are not well equipped to meet their population's health needs. Many countries have shortages of trained healthcare personnel, especially in rural and remote areas, and face continuous challenges in ensuring access to medicines and health technologies. Many countries' health services are not organized in a way that allows them to provide people with comprehensive, integrated health care.

A shortage of public funds for health is a challenge for most of the region's countries, especially those in Latin America and the Caribbean, where public spending on health as of 2011 averaged only 3.8% of GDP, compared with 8% of GDP in countries of the Organization for Economic Cooperation and Development (OECD). In addition, out-of-pocket payments for health services remain high in many countries of the Americas, often pushing people into poverty.

To address these and related problems, PAHO member countries agreed to:

  • Advance toward providing universal access to comprehensive health services that address people's health needs, including the needs of vulnerable groups
  • Progress toward the elimination of out-of-pocket payments that are a barrier to access to care, replacing them with pooled contributions based on taxes and other sources of financing.
  • Establish national targets and goals and a roadmap for advancing toward universal access to health and universal health coverage, setting national priorities for the period 2014 to 2019
  • Improve the organization, management and efficiency of health services using healthcare models that focus on the needs of people and communities
  • Improve care at the primary level by strengthening  multidisciplinary health teams and integrated health service networks
  • Increase employment options, especially at the first level of care, with attractive labor conditions and incentives, particularly in underserved areas, and provide healthcare workers with access to health information and telehealth services (including telemedicine)
  • Improve health authorities' capacity to provide leadership in the health sector and to influence policies and legislation in other sectors that have an impact on health or on social conditions that impact health.

The strategy also calls for increased public financing of health, citing as a benchmark public spending of 6% of GDP.

In approving the strategy, the countries called on PAHO to provide technical cooperation to strengthen the leadership capacity of health authorities, develop participatory processes to define targets and goals, and promote innovation, country-to-country collaboration, and information sharing to help countries transform or strengthen their health systems to provide universal health coverage or universal access to health.

The Pan American Health Organization (PAHO) was established in 1902 and is the world's oldest international public health organization. It works with all the countries of the Americas to improve the health and quality of life of the people of the hemisphere and serves as the Regional Office for the Americas of the World Health Organization (WHO).