From its initial emphasis on quarantinable diseases, the thrust of the work of the Pan American Sanitary Bureau increasingly shifts to the development of health services. As early as 1936, the Bureau-sponsored Conference of Directors of Health debates the question of public health administration and recommends the establishment of special technical services to study public health problems, the organization of national health activities, and the creation of urban and rural health units staffed with trained full-time health workers.
The 1947 Pan American Sanitary Conference addresses the organization of national health services and relations between public health and social security agencies. Then, in 1953, the Directing Council approves long-range Bureau health programs "based on continuous survey and evaluation of the needs and resources of the member countries," which would serve to strengthen basic health services and, thereby, to promote and preserve health.
The Charter of Punta del Este, in 1961, indicates that the goal of better health requires, among other measures, that governments "improve basic health services at national and local levels." A decade later, the countries' ministers of health, in the Ten-Year Health Plan for the Americas (1972), set as their principal goal the extension of health services to the un- and underserved urban and rural populations "to make it feasible to attain total coverage of the population by the health service system in all countries of the Region."
To reach the goal of Health for All, in the late 1970s the countries of the Americas establish national and regional basic health strategies that target primary health care to raise the levels of well-being and extend health services to the entire population, community participation in health sector matters, use of appropriate technologies for local conditions, and technical cooperation among countries. By 1980, all the countries have formulated national health strategies, and many have developed national health sector plans.
In 1983, PAHO launches the Regional Program on Essential Drugs to support the development and application of basic drug tables and help the countries create drug programs and policies based on their national health needs and their supply-and-demand profile.
In 1988, PAHO's Directing Council recognizes "the urgent need to accelerate the transformation of national health systems" to attain health for all through extension of services to those previously unreached. The Organization promotes and supports national efforts to establish networks of local health systems that respond to the specific needs of the people and communities they serve.
