The Priority Countries (PC), are those singled out for special attention in the Pan American Health Organization (PAHO) Strategic Plan (SP) 2003-2007, due to the fact that their health status remains unacceptable to the Member States of PAHO. These countries are: Bolivia, Guyana, Haití, Honduras and Nicaragua. Initially, those are the Highly Indebted Poor Countries (HIPC), where the rate of debt payment leaves little national income for increasing expenditure in the development of the social sectors. In these countries, the health institutions and infrastructure are extremely weak. In the case of Haiti, while not an HIPC, its maternal and infant mortality rates, two of the most sensitive health development indicators, are the highest in the Region and among the highest in the world.
Perhaps more so than the other countries in the Region, these countries need to make progress toward the achievement of the Millennium Development Goals, and PAHO’s focus, in its new technical cooperation (TC) framework, is to work with these countries in Addressing the Unfinished Agenda. It refers to the need to liquidate the cumulative health debt in terms of health problems for which technology applicable on a large scale already exists – a debt that consequently reflects unjust and avoidable gaps in health and well-being. The new managerial strategy 2003-2007 emphasizes the centrality of the countries in defining and consolidating technical cooperation from the Secretariat. It also redefines the very concept of a regional program based on this renewed emphasis on country-focused cooperation in line with World Health Organization (WHO) priorities.
The Director of the Pan American health Organization established a PC Working Group in 2003, which produced a concept paper to guide policy and actions in these countries. The concept paper identified the following elements of the PC Strategy: redefinition of the nature of TC through development of a strategic agenda; harmonization of TC with the efforts of other development agencies and partners; integration of the redefined TC into PAHO’s managerial processes; and appropriate re-profiling of PAHO/WHO’s country presence. An additional critical element is resource mobilization.
Activities have been ongoing to strengthen technical cooperation (TC) with the countries, promote collaboration among the PCs themselves, and advocate for them to development partners and donors. Bolivia was highlighted in a presentation by the Minister of Health just before the 2004 World Health Assembly (WHA) and a well-received meeting of PC Ministers of Health and PAHO/WHO Representatives was held during that WHA. The Minister of Health and the PAHO/WHO Representative from Guyana both participated in a presentation “Country Focus in Action: The Case of Guyana”, which was made at the 2005 WHA. During WHA held in 2006, the cases of Honduras and Nicaragua were presented in a special session on Country Cooperation Strategy (CCS).