Equity and Panamericanism: Basic Pillars of PAHO

Washington, DC, June 20, 2002 (PAHO) -- Equity and Panamericanism, beyond being nice words, are the pillars of much of the Pan American Health Organization's work, with precise definitions that have been converted into operational principles that govern the daily work of the Organization.

Since 1995, the Pan American Health Organization has identified the reduction of health inequities as the main goal of its technical cooperation, according to its Director, Dr. George Alleyne. "Equity in health is indeed important," he said. "Health promotion strategies are essential to bridge the gaps and decrease the disparities that are unjust and unfair, and therefore represent inequity."

The experience has shown practical benefits, such as the solidarity that helped Central America after Hurricane Mitch, and many other examples. Collaboration in health reached the highest political levels when the heads of state at the Summit of the Americas in Santiago, Chile approved a health initiative called Health Technology Linking the Americas.

The countries of Latin America and the Caribbean joined together more than 20 years ago to purchase vaccines through a revolving fund set up by PAHO. That action produced tangible benefits and helped promote the efforts of PAHO to eradicate or control diseases preventable by vaccination. This was one of the most notable successes of the Organization, starting with the eradication of smallpox from the Americas in 1973, followed five years later by world eradication of the feared disease. Polio was declared eradicated from the Americas in 1994, and PAHO is now working to eliminate measles transmission in the Americas.

Equity is a continuous struggle, based on the perception that the Americas as a region should be capable of meeting the health needs of citizens of all its member countries. Health for all, the slogan of PAHO is inspired by this battle for equity.

"It is not enough to look at health outcomes," Dr. Alleyne said. "One must look at those social conditions that determine health outcome - the determinants of health. Many of the constitutions of our countries speak to the right to health or, as better put by the American Declaration of the Rights and Duties of Man. It is of fundamental importance that in discussions on equity we understand the difference between disparities in health status and disparities in the determinants of health that cause these health inequalities or inequities," he added.

PAHO's essential mission is to lead strategic collaborative efforts among member countries and other partners to promote equity in health, to combat disease, and to improve the quality of, and lengthen, the lives of the peoples of the Americas.

"Equity is one of the basic principles that I have espoused loudly and vigorously in the Pan American Health Organization and it represents a basic focus of our technical cooperation represents. We ask if there are gaps in health outcomes or determinants and whether our technical cooperation can address them. We have concrete examples to demonstrate that this is possible," Dr. Alleyne said.

A recent study by Bernardo Kliksberg of the Inter-American Development Bank showed that although there has been considerable improvement in the health conditions of the region, when the data are analyzed closely there are notable differences among the countries and within each of them. These differences are manifested clearly in three of the principal public health indicators: life expectancy, infant mortality, and maternal mortality.

The study showed marked deficiencies in crucial aspects of public health and disturbing differences between various geographical areas and population groups. It said access to drinking water, health facilities, sewerage and electric power is limited for broad sectors of the population, creating risk factors for health. It estimated that 130 million people lack drinking water, and said that the cost of water for poor people is much higher than for middle and upper class people.

PAHO, which also serves as the Regional Office for the Americas of the World Health Organization, was established in 1902 and is the oldest health organization in the world. It works with all the countries of the Americas to improve the health and raise the living standards of their people.

Related Information:
PAHO BOOK: Equity and Health: Views from the Pan American Sanitary Bureau