Geneva, 22 May 2019 (PAHO/WHO) – Health authorities from the Region of the Americas continued to share their views on how to achieve universal health coverage and access, as well as the challenges they face in ensuring that no one is left behind.

A summary of their presentations follows:

Chile: Healthy aging and including it in the health model

Chile’s Minister of Health, Emilio Santelices, said that the country is trying to change the history of older adults in terms of health, since they are in a new stage of life that is longer and full of challenges.

“The elderly and older people have historically been at a disadvantage, a situation we are determined to correct,” the minister emphasized, referring to how a steady increase in life expectancy entails the obligation to start thinking differently about old age. He said that Chile has launched a comprehensive national health plan for older people, in order to make the objectives of the Decade of Healthy Aging a reality and to ensure that the nation’s policies and programs effectively recognize this stage of life, by promoting healthy living so that people age healthfully.

Uruguay: Health system reform reduced social inequality and led to universal health coverage

The Undersecretary of the Uruguayan Ministry of Public Health, Jorge Quian, said that the national health system was what did the most to reduce social inequality, and that despite the challenges, health sector reform is here to stay, and to continue improving the health of the people.

Quian reported that after 11 years of implementing this reform, the health system finance, management, and care model has changed. “What is most significant is that health sector reform led to all people being able to access health services, thus achieving universal coverage and improving access to a broad array of services with equitable financing,” he said. The Undersecretary of Public Health said that they are also taking steps to address the risk factors that contribute to noncommunicable diseases, which is one of the main challenges currently faced by Uruguay. These measures range from reducing tobacco use to promoting healthy and active lifestyles.

Venezuela: Challenges in obtaining medicines and vaccines

The Venezuelan Minister of Health, Carlos Alvarado, described what Venezuela has done in the last 20 years to change the health system and provide comprehensive health services, by developing the public system and increasing communication efforts. However, in the past five years or so, the country has faced problems in obtaining drugs and vaccines, among other items.

Alvarado also spoke on behalf of the non-aligned nations, and called for strengthening national health systems and working together to achieve universal health coverage and promote more effective cooperation among the southern countries. He urged them to foster unity and solidarity, as well as inter-country cooperation to promote a more equitable health model.

Honduras: The challenge is focusing on health as a basis for development

The advisor to the Honduran Public Health Office, Claudia Elizabeth Quiroz Alvarado, said that although Honduras and other countries have made progress with their public health policies, there are still people who do not have access to health care. “The biggest challenge is focusing on health as a basis for the development of our countries,” she stressed.

Quiroz Alvarado said that there is still a wide gap in universal health in Honduras, but that they are working to close it. She said a steady, unwavering process is required to strengthen certain areas such as primary health care skills.

Trinidad and Tobago: Communicable diseases are the focus of health care

The Health Minister of Trinidad and Tobago, Terrence Deyalsingh, said that this country remains firmly committed to building a health system based on primary care. He said that this is the most “cost effective” thing they can do, given the burden of noncommunicable diseases in the country. They have worked hard to implement the vision of prevention, treatment and diagnosis in the health system, with special emphasis on improving efficiency and access to primary health care.

The official said that the health system is trying to address these diseases in different ways, such as providing free medicines and diagnoses, and is also working to ensure access to surgical care that is available in the private sector.

Guyana: Climate change is testing health systems in the Caribbean

The Minister of Health of Guyana, Volda Lawrence, emphasized the impact that climate change has had on the countries of the Caribbean and stressed the need to adopt measures that mitigate its effect on health systems. Lawrence expressed Guyana’s support for the Climate Change and Health in Small Island Developing States initiative and mentioned PAHO’s aid in the formulation of the regional plan presented a few weeks ago.

The minister said that health systems in the Caribbean are constantly being tested by natural disasters that negatively impact the economies and people of these countries. She reported that this often means having to shut down health care facilities, which is why the country is currently working to make hospitals resilient to natural disasters through the “Smart Hospitals” initiative. Lawrence added that the Ministry of Health, with PAHO’s support, is in the process of developing a national climate change adaptation plan, but stressed the need for financial support so that it can be implemented.

Guatemala: A primary health care-based service and management model focused on the individual, family, and community

Guatemala’s Minister of Health, Carlos Soto, said that the country has adopted the universal health coverage and access strategies promoted by PAHO, including the formulation and adoption of an individual-, family-, and community-centered service and management model that is based on primary health care and is culturally and gender appropriate. He said that this reform is aimed at reorganizing the healthcare service and management model through integrated health networks, in order to strengthen primary health care and enhance response capacity, among things.

Soto added that they are also working on a national policy to plan, manage, and develop human resources for health, and provide wider access to vaccines and increased immunization coverage. He also described the plans to prevent chronic malnutrition and encourage a healthy diet aimed at preventing noncommunicable diseases, through measures such as front-of-package labeling and taxes on products with high fat, salt, and sugar content. He said that together with other Central American countries, they are working on a transborder health plan that provides comprehensive care for populations in border areas and in transit.

MOH Guatemala at the 72nd World Health Assembly

— Read the speech here

Costa Rica: Universal health coverage with inclusion, innovation, self-determination, and cooperation

Costa Rica’s Ambassador to the United Nations, Elayne Whyte, said that all members of society need to understand that working together for the common good with mutual respect for one another is the only way to achieve universal health coverage in 2030.

Whyte said that Costa Rica has been trying to achieve universal health coverage since the 19th century, and that the countries can do this provided it is based on four principles: inclusion, innovation, self-determination, and cooperation. Inclusion, she explained, refers not only to increasing the number of beneficiaries, but also the services provided, and innovation means finding better ways to offer these services so that more people have access. Self-determination, the ambassador continued, refers to ensuring ways for the countries to assert their rights and find the best alternatives to address actual conditions, while cooperation entails strengthening what the nations can do to obtain the financing needed to achieve the goal of universal health coverage.

MOH of Costa Rica


Canada’s Chief Public Health Officer, Theresa Tam, emphasized that the country is fully aligned with WHO’s vision of a world in which everyone can live healthy, productive lives. This concept is at the core of Canada’s universal health system, “which we know is not perfect,” she said. Tam reported that Canada is working to overcome the problems faced by lower-income or marginalized people in accessing health.

She described the recent work the country has done to make medicines more affordable and reduce inequities between those that can afford them and those that can’t. She said that addressing inequities requires an understanding of who is being left behind and why, as well as taking joint action to address the social and economic determinants of health that lead to these inequities. Tam emphasized the need to work on mental health and continue responding to emergencies such as the Ebola outbreak in the Democratic Republic of the Congo. She called for setting differences aside in order to work together on the issues that unite the countries, so that all people have access to health.

Delegate of Canada at 72 World Health Assembly