When the first international sanitary conference of the American republics meets in Washington, D.C. in 1902, its principal remit is to receive reports on health conditions in the ports and territories of countries throughout the hemisphere. Two decades later, the Pan American Sanitary Code, drafted in Havana in 1924, firmly establishes the quintessential role of the Pan American Sanitary Bureau as clearinghouse for regional health information.
By mid-century, the Bureau's director, Dr. Fred Soper, claims that: "Considerable progress has been made in the quality of the data reported [in Health Conditions in the Americas, 1953-1956], especially in the field of vital statistics and communicable diseases." His successor, Dr. Abraham Horwitz, expresses the hope that: "As data are further improved--and the extensive statistical program of the Organization is contributing to this goal--it will become possible to formulate programs, allocate resources, and invest funds on a more rational basis, in short to accelerate progress." (Health Conditions in the Americas, 1961-1964)
Still, the collection of health statistics leaves much to be desired, as Dr. Héctor Acuña notes in the mid-1970s: "Renewed efforts should be made to improve civil registration and the coverage, quality, and timeliness of the vital statistical data, particularly for rural areas. This is especially crucial given the number of sectors that are involved in improving the quality of life of the rural and disadvantaged populations." (Health Conditions in the Americas, 1973-1976)
As the problem persists, in 1986 PAHO, under the administration of Dr. Carlyle Guerra de Macedo, sets up a new program--health situation and trend assessment--that promotes the use of epidemiology as an instrument in the planning and technical and administrative management of services and as an essential element for understanding the factors that influence changes in the health profiles of populations.
Today, the Secretariat--through its core health data initiative and its geographic information system in health, among other pioneering epidemiological contributions to the practice of public health--is providing evidence that will advance the quest for equity in health throughout the Americas.
