PAHO outlines health challenges ahead

Pan American Health Organization (PAHO) Director Dr. Mirta Roses has presented a report summarizing PAHO's work over the past year in the Americas, during a special session of a meeting of the region's ministers of health taking place at PAHO headquarters this week.

"As we know, there is a synergy between health and development," Roses said in presenting the Annual Report of the Director 2004. "Health is a key contributor to development, but it is also influenced by other factors of development, including social and environmental determinants."

Among key achievements cited in the report are: multicountry negotiations to cut the costs of treatment for HIV/AIDS; the declaration of Central America as free from cholera; and the regionwide Vaccination Week in the Americas, which reached 40 million children and adults in 35 countries of the Americas.

This year's Vaccination Week included, for the first time, a binational immunization effort along the U.S.-Mexico border.

In presenting the report, Roses observed that "severe acute respiratory syndrome [SARS], the first epidemic of the 21st century, demonstrated that collective, coordinated and transparent work by a group of institutions and countries can mitigate the harmful effects of a new disease on the population."

Roses noted that the Millennium Development Goals-a commitment by the world's countries to improve the quality of life of the poorest populations-have placed investing in health at the core of a new development agenda for 21st century.

Three of the millennium goals refer explicitly to health: reducing infant mortality, improving maternal health, and combating HIV/AIDS, malaria and other infectious diseases. In addition, access to safe drinking water and to essential drugs are also among the goals.

Roses said in her report that enormous effort will be needed for the Americas to meet the millennium targets by 2015. She provided a general overview of this challenge:

• Infant mortality. A recent study carried out by PAHO shows that if current trends continue, the region will succeed in reducing child mortality by only 54 percent, falling short of the two-thirds reduction called for in the millennium goals. In 2003, infant mortality varied from 5.3 per 1,000 live births in Canada to 80.3 per 1,000 live births in Haiti.
• Maternal mortality. These rates also vary widely in the Americas, from 16 per 100,000 live births in Cuba to 680 per 100,000 in Haiti.
• HIV/AIDS. Prevalence rates for HIV infection are 1 percent or higher in 12 countries of the Americas, all of them in the Caribbean. In most other countries of the region, the epidemic is concentrated in certain areas and population groups.
• Malaria. In 2002, 31 percent of the inhabitants of the Americas lived in zones with risk of transmission of the disease. More than 80 percent of reported cases originate in nine countries that share the Amazon rainforest.
• Water and sanitation. According to recent reports on regional and global progress toward these goals, 89 percent of the population of Latin America and the Caribbean had access to safe water in 2002, a 6 percent increase over 1990. There are still 59 million people in the region who lack access to safe drinking water and 134 million without access to basic sanitation.
• Essential drugs. Drug purchases continue to represent up to 25 percent of household spending in some countries of the region, and as much as 60 percent in others. In the Americas, 53 percent of people with HIV/AIDS who need antiretroviral treatment have access to the drugs, despite considerable reductions in the costs of these drugs during the last three years.

"Behind every item on our region's unfinished agenda in health there are real people, real families and real communities with urgent needs. We cannot ignore them or delay our efforts to address their needs," Roses said.

PAHO is working with governments throughout the region, focusing particularly on urgent needs in five priority countries: Bolivia, Guyana, Haiti, Honduras and Nicaragua.

PAHO was established in 1902 and is the oldest organization international health agency in the world. It serves as the Regional Office for the Americas of the World Health Organization and works with its 35 Member States to improve the health and quality of life of all the peoples of the Americas.

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