Washington, D.C., December 31, 2013 (PAHO/WHO) — The elimination of onchocerciasis in the Americas, the vaccination of over 44 million people in the Region, the progress made toward universal access to HIV treatment, campaigns to control hypertension and tobacco advertising, actions to make health systems more responsive, especially to the most vulnerable populations: these significant public health achievements in 2013 accompany the challenges still pending in the Americas.

The following is a summary of some of the main issues that the Pan American Health Organization/World Health Organization (PAHO/WHO) has worked on during the year, together with its Member States, to improve the health and well-being of families in the Americas.


The first Caribbean public health agency begins operations
On January 1, 2013 the Caribbean Public Health Agency (CARPHA) began operations to help CARICOM Member States tackle their health challenges. PAHO/WHO and international partners provided support for the development of CARPHA, which merges five regional health institutions.

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Violence against women: a public health concern
A report by PAHO/WHO and CDC, presented on January 17, 2013, warned that physical and sexual violence against women is widespread in Latin America and the Caribbean, and that it affects women in all socioeconomic groups. The report offers a comparative analysis of population data in 12 countries.

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Carissa F. Etienne begins her term as PAHO's new Director
Dr. Carissa F. Etienne, of Dominica, began her term as the new Director of PAHO, after taking office on January 31. She pledged to work in close partnership with PAHO member countries to extend the benefits of health progress to all people in the Americas. Etienne, who succeeded Mirta Roses Periago as director, said that her highest priority would be accelerating progress toward universal access to high-quality health care. Jon Andrus, of the United States, continued as Deputy Director of PAHO, and Francisco Becerra, of Mexico, took office in November as Assistant Director of the Organization.

Read more: New PAHO Director will promote universal health coverage, make "health a driving force for change" and Francisco Becerra of Mexico is sworn in as PAHO/WHO Assistant Director.


Global Status Report on Road Safety 2013: Supporting a Decade of Action
A WHO report, presented in March 2013 and containing data from the Americas, called attention to the urgent need for changes in legislation to reduce traffic deaths, especially among the most vulnerable groups. Traffic crashes—which claimed nearly 150,000 lives in the Americas in 2010—are the leading cause of death for children aged 5 to 14 and the second-leading cause for people aged 15 to 44. Pedestrians, motorcyclists, and bicyclists are most vulnerable and are the most common fatal crash victims in most countries in the Hemisphere.

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World Health Day 2013: controlling high blood pressure
In April 2013, WHO and its associates addressed the global problem of hypertension. Although it affects one in three adults, it continues to be largely hidden. A large number of people do not know they have hypertension because it does not always have symptoms. However, it causes over nine million deaths a year. A PAHO campaign invited the population to have their blood pressure checked and to "know their numbers" to prevent heart attack, stroke, and chronic kidney disease.

Read more: World Health Day - Silent killer, global public health crisis y World Health Day: In the Americas, one in three adults has hypertension.

Over 44 million people vaccinated against diseases
Over 44 million people received vaccines against different vaccine-preventable diseases during the 11th Vaccination Week in the Americas, held in late April 2013. This year's slogan was "Vaccination: a shared responsibility." A binational launch event was held on the border of Belize and Guatemala, while the launch in Haiti focused on vaccination to protect over 1.2 million women and to prevent tetanus in the more than 240,000 children born each year.

A Haitian woman is vaccinated to prevent tetanus and neonatal tetanus in Port au Prince, Haiti.

Read more: 11th Vaccination Week in the Americas seeks to protect 44 million people in 44 countries and territories against dangerous diseases, Belize and Guatemala jointly launch Vaccination Week in the Americas 2013, and Haiti will vaccinate against tetanus and neonatal tetanus during Vaccination Week in the Americas.


Diego Forlán leads PAHO campaign against misleading tobacco advertising
With the slogan "Don't buy lies," PAHO launched an anti-tobacco campaign featuring Uruguayan football star Diego Forlán. Its aim was to raise awareness among young people in the Americas of the harmful effects of tobacco and the deceptive nature of the tobacco industry's marketing campaigns. On World No Tobacco Day, PAHO/WHO urged the countries of the Americas to enact a total ban on tobacco advertising, promotion, and sponsorship, one of the measures most effective to reduce its consumption.

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Stronger action to eliminate cholera in Haiti and the Dominican Republic
Members of the Regional Coalition to Eliminate Cholera Transmission on Hispaniola Island announced financial support of almost US$30 million for efforts to eliminate cholera from Haiti and the Dominican Republic, through major investments in water and sanitation, and health systems strengthening. These funds were allocated to support the implementation of national action plans to eliminate cholera in the two countries. PAHO/WHO serves as the Secretariat of the Coalition, which was launched in 2012.

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Consortium agrees on actions to reduce salt intake to half by 2020
To promote the prevention of cardiovascular disease, a multisector consortium convened by PAHO/WHO (the SaltSmart consortium) endorsed a plan to reduce dietary salt consumption in the Americas by half by the year 2020. The first multisectoral plan for 2013-2018 proposes a series of commitments, including campaigns to raise public awareness of the benefits of using less salt in food. A multisectoral initiative similar to SaltSmart consortium was launched in February to integrate efforts to step up the prevention and control of cervical and breast cancer in the Region.

Read more here and here.


Onchocerciasis elimination in the Americas
In July 2013, WHO verified that Colombia had become the first country in the world to eliminate river blindness (onchocerciasis). This disease——the second-leading infectious cause of blindness in the world——was eliminated after 16 years of uninterrupted work led by the National Health Institute, with the support of the Ministry of Health and Social Protection, the Ministry of Health of Cauca Department, academic and research institutions, the Onchocerciasis Elimination Program for the Americas (OEPA), and PAHO/WHO.

Credit: WHO/TDR/Mark Edwards

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Jamaica 100% smoke-free
On July 15, 2013, new tobacco control regulations entered into force in Jamaica. The new law includes a ban on smoking in enclosed, public, and work places, and requires health warnings to cover 75% of the main surfaces of cigarette packets. This law makes Jamaica the fourth country in the Caribbean community (CARICOM) to become 100% smoke-free, after Trinidad and Tobago, Barbados, and Suriname. It is the seventeenth country in the Americas to take this step.

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Foreign physicians begin providing health care to marginalized communities in Brazil
In August 2013 Brazil launched the Más Médicos (More Physicians) program, an initiative to deploy physicians from Brazil and other countries to the country's most underserved areas to expand access to health care for vulnerable populations.

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WHO recommendations call for earlier initiation of HIV treatment
In August, WHO launched new HIV recommendations emphasizing that earlier initiation of treatment for people living with HIV improves their quality of life. The recommendations, issued in Buenos Aires, Argentina, promote earlier initiation of antiretroviral therapy (ART) to keep patients with HIV healthy, while also reducing the amount of virus in the blood, which reduces the risk of transmitting it to other people.

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Reducing health inequities that cause maternal and child deaths in the Americas
In September, high-level delegates from over 26 countries of the Americas, together with an alliance of international and bilateral agencies, and civil society organizations, pledged to reduce health inequities that cause preventable maternal and child deaths in Latin America and the Caribbean. At the Promise Renewed for the Americas conference, they signed the Declaration of Panama——a call for action in the Region in the framework of A Promise Renewed, the global commitment to child survival. In December, PAHO/WHO presented model legislation on reproductive health and healthy motherhood with a human rights focus.

Read more: 26 Governments Sign 'Declaration of Panama' to Eliminate Health Inequalities in Latin America & Caribbean y PAHO/WHO presents model legislation on reproductive health and healthy motherhood, with human rights focus.

Disability is included on the global development agenda
For the first time, a High-level Meeting of the United Nations General Assembly addressed the issue of disability and development, in September 2013 in New York. World leaders agreed to include people with disabilities on the post-2015 development agenda and to address the barriers that these people face, including difficulties in accessing health care. WHO is preparing a global action plan to benefit the 1 billion people living with disabilities in the world.

Read more: Governments to agree increased focus on people with disabilities in development strategies and Countries prepare plan to address obstacles and improve access to health for people with disabilities.


Countries of the Americas pledge to improve access to health care for LGBT people
Ministers of Health and other delegates from throughout the Americas approved a PAHO resolution to promote equal access to health care in their countries' policies, plans and legislation, and to collect data on health care and the stigma and prejudice against lesbians, gays, bisexuals, and transsexuals (LGBT) in order to support equal access.

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Chronic kidney disease in agricultural communities in Central America is a severe public health problem
Ministers of Health of the Americas declared that chronic kidney disease of unknown causes that has claimed thousands of lives in agricultural communities in Central Americas is a serious public health problem. They called for stepped-up efforts to address the environmental and occupational factors associated with the problem and to continue investigating its causes.

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Universal Health Coverage: a goal for the Americas
Ministers of Health and representatives of the governments of the Americas expressed broad support for achieving the goal of universal health coverage, during the 52nd Directing Council of PAHO in October. In a series of debates and discussions, the participants said that progress toward universal access to accessible, high-quality health care is fundamental to ensure a healthy population, reduce health inequities, and promote social and economic development in the countries of the Region. While universal coverage is making gradual progress, they emphasized that it is a goal that countries at all income levels can aspire to achieve.

Read more: Health leaders from throughout the Americas set sights on universal health coverage, Health leaders from the Americas support universal health coverage, and Experts stress importance of PAHO role in advancing universal health coverage in the Americas.


Cancer mortality is declining in some countries of the Americas
Deaths from all types of cancer are declining in at least nine countries in the Americas, while deaths from certain types of cancer are decreasing. However, cancer remains the second-leading cause of death in the Americas, taking nearly 1.2 million lives a year, according to Cancer in the Americas: Country Profiles 2013, a PAHO/WHO report released in November.

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Global health workforce shortage to reach 12.9 million in coming decades
The report, "A Universal Truth: No health without a workforce", released by WHO at the Third Global Forum on Human Resources for Health, held in Brazil in November 2013, estimates that the world will be lacking 12.9 million health workers in 2035; today, that figure stands at 7.2 million. Most countries in the Americas have sufficient health personnel but face challenges in distribution, migration, and training. The Forum concluded with a commitment by the countries to increase the number of health professionals and distribute them to meet people's health needs.

Read more: Global health workforce shortage to reach 12.9 million in coming decades, Most countries in the Americas have sufficient health personnel but face challenges in distribution, migration and training and The Recife Political Declaration on Human Resources for Health.

PAHO/WHO collaborates in emergency health response in Philippines
As part of the actions undertaken by WHO, a team of PAHO experts travelled to the Philippines to help respond to the health emergency following typhoon Yolanda, which struck the country on November 8. The team of experts is providing support in areas including coordination of the health cluster, information management, environmental health, and damage and needs assessment, as well as logistics and communications in disaster response.

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The Region advances toward universal access to HIV treatment
Three out of four people who need antiretroviral treatment (ART) in Latin America and the Caribbean are receiving it, according to a new PAHO/WHO report in December 2013. That leaves one in four without the life-saving treatment but represents a 10% improvement in just two years and puts Latin America and the Caribbean ahead of all other developing regions in levels of ART coverage. In June it was announced that the countries of the Region can procure more affordable rapid diagnostic tests and treatment supplies for HIV/AIDS through the PAHO/WHO Strategic Fund.

Read more: Latin America and the Caribbean advance toward universal access to HIV treatment and Countries of the Americas Can Procure More Affordable Diagnostic and Treatment Supplies for HIV/AIDS.

Countries of the Americas reduce malaria deaths by 70%
The WHO World Malaria Report 2013, issued in December in Washington, D.C., reported that malaria deaths had declined by 70% and that the incidence of malaria had declined in 18 of 21 endemic countries of the Region between 2000 and 2012. Seven countries are now in the pre-elimination phase. Three initiatives from Colombia, the Dominican Republic, and Brazil were recognized as the 2013 "Malaria Champions in the Americas" for being model projects that integrate malaria interventions with solutions to other health problems.

Read more: Countries of the Americas have reduced malaria deaths by 70% since 2000, but 145 million people in the region remain at risk and Projects from Colombia, Brazil and the Dominican Republic are honored as "Malaria Champions of the Americas 2013".