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Washington, D.C., 23 September 2018 (PAHO/WHO) — The Pan American Health Organization (PAHO) has been working with its member countries to advance the goal of “universal health” ever since ministers of health from throughout the Americas collectively endorsed that goal in 2014.

The framework for these efforts is known as the primary health care (PHC) strategy, but it refers to much more than the first level of care.

“Primary health care is a strategic approach to developing, organizing, and financing health systems and services that are equitable, sustainable, and centered on people, families, and communities,” said PAHO Director Carissa F. Etienne in presenting her 2018 Annual Report of the Director to ministers of health gathered for the 56th PAHO Directing Council. “It guides all our efforts to transform ‘health for all’ from vision into reality.”

The publication of the 2018 Annual Report of the Director, subtitled “Primary health care: the time is now,” coincides with the 40th anniversary of the International Conference on Primary Health Care, held in 1978 in Alma-Ata (now Almaty), Kazakhstan. The Alma-Ata conference famously called for achieving “health for all by 2000” and endorsed the primary health care approach as the best means to reach that goal.

“This historic international conference 40 years ago provided a strategy for human and social development and gave the world PHC as an approach and a strategy for health and well-being, and for health systems development,” writes Etienne in the Annual Report’s introduction.

The Director’s Annual Report describes PAHO technical cooperation with member countries during 2017 and 2018 in the framework of primary health care. It presents examples that range from support for implementing PHC-focused national health road maps, to monitoring country progress in eliminating barriers to access for vulnerable groups.

“Leaving no one behind requires that we move expeditiously to strengthen the PHC approach, promoting and protecting health; removing the barriers to access; giving a voice to those who are not being heard; and enabling social participation, government action, intersectoral and multisectoral work, and advocacy.”

PAHO support for countries as they initiated or deepened reforms aimed at strengthening the first level of care but also to improve the organization, management, and financing of health systems overall to increase their effectiveness, efficiency and sustainability. It also details focused efforts on addressing the special needs of vulnerable groups such as indigenous and Afro-descendant people, migrants, adolescents, older adults, LGBT people, and women and children.

Other specific examples of PAHO technical cooperation described in the report include:

  • Support to help 17 countries strengthen their health financing systems
  • Technical cooperation to eight countries for their implementation of integrated health service delivery networks
  • Accelerated implementation of the “Zero Maternal Deaths by Hemorrhage” initiative, which seeks to reduce the equity gap in maternal mortality in 10 countries where women are most at-risk of dying in childbirth.
  • Support for the creation of local intersectoral commissions that give parents, teachers, students, neighborhoods, street vendors, professionals, and others the opportunity to play an active role in health decision-making
  • Support for countries throughout the Americas from PAHO’s Revolving Fund to procure vaccines
  • Coordination with 17 countries to exchange pharmacovigilance alerts
  • Compiling evidence on the impact of NCDs on social and economic development for health authorities to use in advocating with heads of state and ministries of finance
  • Technical cooperation aimed at strengthening laboratory capacity in countries throughout the Region.

Also during the reporting period, PAHO provided key assistance to member countries in following hurricanes Irma and Maria in 2017, which broke records for their severity in the Caribbean, and after the eruption of Guatemala’s Fuego volcano in 2018, helping health authorities address the health needs of affected communities. This complemented support for ongoing efforts in the Caribbean and elsewhere in the Region to strengthen disaster preparedness, including early warning and rapid response systems, and to reduce risks in the health sector through the PAHO Smart Hospitals Initiative.

“I am confident that all our stakeholders will see in this report the many ways that PAHO’s technical cooperation programs and health leadership are helping to bring our Region closer to realizing the dream of ‘health for all,” said Etienne.

The Directing Council of the Pan American Health Organization (PAHO) brings together ministers of health and high-level delegates of the PAHO/WHO Member States in Washington, D.C. (USA) to discuss and analyze regional health policies and set priorities for technical cooperation and collaboration among countries.


— Annual Report of the Director 2018
56th Directing Council document
56th Directing Council website