Health Leaders of the Americas Define New Policy Directions

During the week-long meeting, held Sept. 27 to Oct. 1, representatives of 38 countries, including 27 ministers, defined new directions for health policy and programs in such areas as access to essential medicines, scaling-up treatment for HIV/AIDS, revising the International Health Regulations, and achieving the Millennium Development Goals.

The conference's opening session was attended by LEE Jong-wook, director-general of the World Health Organization (WHO); Miguel Angel Rodriguez, then secretary general of the Organization of American States; and Tommy G. Thompson, U.S. Secretary of Health and Human Services.

WHO's Lee noted the importance of a key agenda item, updating the International Health Regulations, which govern cooperation between countries in the case of disease outbreaks. "Epidemics continue to threaten the Americas and the world," said Lee. "The new International Health Regulations will help minimize that danger. But real dangers remain, and we must be prepared for crisis and response." (See "New Health Regulations Reviewed.")

Another agenda item—the impact of natural disasters on health facilities—acquired special significance as news of the impact of the 2004 hurricane season flowed into PAHO headquarters throughout the week. Ministers from the affected countries appealed for help in recovering from the series of hurricanes and storms that swept the Caribbean in September. (See "PAHO Joins International Relief Efforts in Storm-Struck Caribbean.")

U.S. Secretary Thompson, at the opening session, expressed sympathy for the affected countries and urged PAHO to take the lead in forming a new disaster response "strike force," whose members include trained doctors and nurses who "can go immediately into a country and assist people who have suffered."

In a final resolution, members of the Directing Council called on PAHO member countries to ensure that new health facilities are built to withstand the impact of disasters and, in the case of older facilities, to reinforce them to make them more disaster resistant. (See "Call for Disaster-Safe Hospitals.")

The meeting offered an opportunity to take stock of progress toward meeting the United Nations Millennium Development Goals, which call for major advances in health and quality of life for the world's poor by the year 2015. A PAHO report prepared for the meeting noted progress toward a number of health targets but warned that no country in the Americas will likely reach all of the millennium goals. In a declaration, the ministers called on PAHO member countries to formulate national plans of action for pursuing the goals, to promote greater involvement by different sectors, and to support research on and monitoring of progress toward the goals. They also called on PAHO to support these efforts through its technical cooperation.

An important outcome of this year's meeting was the approval of a new Regional Program Budget Policy that, for the first time, allocates PAHO resources according to member countries' needs. It targets 40 percent of the organization's total budget to country-level work and 7 percent to subregional programs.

Another key item on the council's agenda was the HIV/AIDS epidemic. In a resolution, the ministers welcomed recent cuts in the prices of antiretroviral drugs as a result of multicountry negotiations led by PAHO/WHO and UNAIDS. They also called on PAHO Member States to take steps to counter stigma and discrimination against people living with HIV/AIDS. (See "PAHO Seeks Fast Track for ART.")

On the issue of essential drugs, the council endorsed the use of generics to contain costs and urged PAHO member countries to develop policies and regulatory mechanisms to ensure product quality and safety. They also urged countries to adapt their trade policies to allow them to benefit fully from provisions in the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) regarding access to drugs.

Other issues discussed during the conference included the migration of qualified registered nurses from Latin America and the Caribbean, human resources in health, primary health care, health research in the region, and PAHO's process of organizational change.

Nicaragua's health minister, Jose Antonio Alvarado, presided over this year's meeting as council president. In the closing session, he described the results as "an example of what the hemisphere can do jointly on behalf of regional health."