Annual Report Cites Inequities

The 2003 annual report of the Pan American Health Organization (PAHO) says that the countries of the Americas have registered significant health improvements in recent years, but the benefits of this progress have been unevenly distributed.

PAHO's annual report for 2003, Moving towards a New Century of Health in the Americas, was presented at the 44th PAHO Directing Council meeting, held Sept. 22–26 in Washington, D.C.

The report says that different countries and groups of people within countries have not shared the health advances of the late 20th century equally.

PAHO Director Mirta Roses Periago noted in the report that similar inequities plague countries across the globe. "The disparity between the 'haves' and the 'havenots' is the greatest hurdle to be surmounted in achieving progress throughout the world," she wrote.

Among the report's central findings on health in the Americas:

• During the second half of the 20th century, median life expectancy increased from 55.2 years to 72.9 years in the Americas region. Moreover, the gap in life expectancy between rich countries and poor ones narrowed overall. However, equity gaps persist and in some cases have widened between different income groups within countries.
• Median infant mortality in the region dropped from 42.5 deaths per 1,000 births in the early 1980s to 32 per 1,000 in the late 1990s. However, gaps between population groups within countries remained virtually unchanged.

"Overall, these findings point to the need for international cooperation and political commitment to confront a double challenge: continue to pursue decreases in average health risk, and specifically support the definition and implementation of health strategies that have inequality reduction as a clear target," said the report.

To address these needs, PAHO announced a millennium health initiative, modeled on the United Nations Millennium Development Goals, which set targets for improvements by the year 2015. Among the PAHO goals for the Americas region:

• Improve conditions for populations that have lagged behind so that they can benefit from the overall health progress achieved in the region.
• Consolidate gains in important health indicators over the last quarter century.
• Meet new challenges including the emergence of new diseases and threats such as international terrorism.

"For the Region of the Americas, the Millennium Development Goals represent an unfinished agenda—the ethical commitment of ensuring that, by 2015, priority countries and population groups lagging farthest behind can attain indicator values today considered to be average values for the Regional populations as a whole," says the report.