CD61/DIV/3 - Presentation of the 2024 Annual Report, Dr. Jarbas Barbosa Da Silva Jr., Director of the Pan American Sanitary Bureau and Regional Director of the World Health Organization for the Americas

30 September 2024

Esteemed ministers, ambassadors, delegates, and colleagues across the Americas.

It is a pleasure to address this audience today and to share our annual report, which is the first to cover a full year under my tenure. 

I want to start by thanking all Member States and you for the trust placed in me and for the opportunity to serve the people of our Region. It is a true honor. 

This report takes us forward to how the Pan American Sanitary Bureau (the Bureau) has taken the opportunity to focus its efforts with Member States on seizing the significant opportunities presented by the COVID-19 pandemic for advancing substantial positive transformation, regaining health advances, and improving equity to achieve health for all. Pandemic lessons, particularly those that speak to deeper structural issues and neglected determinants of health, have guided strategic approaches to identifying those who are most vulnerable and addressing barriers to access to health.

These are challenges that we must acknowledge, learn from, and be prepared to face again. In spite of them, I am happy to state unequivocally that we have made progress. 

The report on the activities of PASB reflects the progress achieved on many fronts. The document provides a comprehensive account of how this Organization has touched on every health priority of this Region by being a close partner and source of technical cooperation to all countries in the Americas. 

To represent our broad scope, I would like to highlight some key initiatives we launched or enhanced in the period covered in the report. These initiatives carry the potential to transform health in the Americas.

The first is our Disease Elimination Initiative, which has been refreshed and prioritized under my tenure. Our goal is to dramatically accelerate progress towards eliminating 30 diseases and conditions over the next five years. This is an achievable goal—we have the tools and the knowledge required—that we can only reach with ambition and coordination. Take cervical cancer, or vertical transmission of HIV: the path is clear, as long as we work together towards it. Just this year, Brazil, Colombia, and El Salvador have launched national elimination strategies aligned with our initiative, and Bolivia, Chile, and Guyana are developing roadmaps for elimination. 

A year ago we launched the Better Care for Noncommunicable Diseases (NCDs) initiative, putting primary health care at the forefront of the fight against NCDs in our Region, addressing key drivers of morbidity such as hypertension, diabetes, asthma and improving cancer screening. This program is grounded in our conviction that primary health care is the backbone of resilient health systems and the best entry point for timely care. This program is empowering and equipping primary health care staff to meet the shifting epidemiological burden in our Region. To date, 33 countries in Latin America and the Caribbean have committed to implementing HEARTS. In fact, eight countries are already implementing the program throughout their primary healthcare network. By the end of June 2024, 6500 primary healthcare facilities covering approximately 34 million adults were implementing HEARTS. The program has 4.4 million people under treatment, of which 62% reach the best standard of care. Indeed, if the Americas improved population-based hypertension control from the current level of 36% to a target of 50%, over 400 000 cardiovascular disease (CVD) deaths could be avoided. Furthermore, if secondary CVD prevention efforts were expanded, many more deaths could be averted.

The digital transformation of the health sector in the Americas offers an unprecedented opportunity to bridge the gap between health services and underserved populations; but it takes a concerted effort to ensure we use these tools to overcome disparities in access. At the Pan American Health Organization, we are actively collaborating across sectors in every country to ensure that digital transformation becomes a driving force to improve health, enhance data, and improve efficiencies within health systems. I am pleased to report that countries have already made significant progress, particularly in key areas such as information systems, telehealth, artificial intelligence, and platforms for ensuring cross-border interoperability, ultimately supporting more equitable and interconnected health.

The COVID-19 pandemic revealed the structural dependence of Latin America and the Caribbean on imported health products and other health technologies, the geographic concentration of innovation and production capacities, and the vulnerability of global supply chains. As a result, in 2021, Member States recognized the need to increase production capacity for essential medicines, health technologies, and vaccines in our Region. 

The Special Program for Innovation and Regional Platform for the Production of Medicines and Health Technologies was created to promote the development of initiatives and regional ecosystems that strengthen the capacity for innovation, development, and production of health technologies. Significant progress was made in strengthening capacities for the development and production of mRNA vaccines in the Region, such as the creation of a public-private partnership in Argentina that includes the Ministry of Health, the National Agency for the Promotion of Research, Development and Innovation, the National Administration of Laboratories and Health Institutes (ANLIS), and the company Sinergium Biotech, to develop capacities for the production of mRNA vaccines and strategic inputs to improve equitable access at the regional level. Also in the area of innovation, cooperation between PAHO and the Fiocruz Bio-Manguinhos Institute resulted in significant progress in preclinical studies for the development of a new self-replicating mRNA vaccine for COVID-19. Also, Sinergium Biotech launched a new project aimed at accelerating development and access to candidate mRNA vaccines against human avian influenza (H5N1), a public health issue of concern in the Region due to outbreaks in mammals since last year, ranging from sea lions in Chile to cattle in the United States of America already this year.

As was mentioned this morning, PAHO is in advanced negotiations with a major producer, Pfizer, to provide early access to one of the most advanced vaccines in Pfizer's product portfolio. This negotiation involves a Latin American manufacturer, a concrete example of the efforts we are making to use the Regional Revolving Funds not only to expand countries' access to vaccines but also to ensure, with the support of the Funds, that we have the opportunity to sign multi-year contracts that also strengthen sustainable production capacity in our own Region.

PAHO's Regional Revolving Funds have been a pillar of our Organization for decades and are crucial to ensure a secure supply and fair prices for our countries. We are working to make the Funds even more relevant to the Member States by updating their operation and creating incentives to increase regional production capacity, which will be the subject of a resolution to be discussed by this Directing Council. This year, we launched the digital demand planning tool, which helps countries forecast their procurement needs in real time. Over the past two years, 160 million people benefited from the procurement systems set up by the Regional Revolving Funds, with the participation of 37 countries and territories in the Region. 

In the last two years, the countries of the Region managed to halt the decline in routine vaccination coverage and, in fact, achieved an increase for most antigens, achieving, as I mentioned this morning, 88% coverage for the third dose of the DTP vaccine. In a recent report that WHO and UNICEF disseminated globally, our Region—and I believe this is a source of pride for each of the countries present here—was the Region that made the most progress in the recovery of vaccination coverage after the negative impacts of the COVID-19 pandemic. This was an important effort that greatly reduced the number of children with zero doses in our Region. However, we need to be even more ambitious and continue the effort to achieve the levels of coverage necessary to keep our Region free of many diseases. 

The Zero Maternal Deaths Initiative addresses the unacceptably high maternal mortality rates in our Region in an effort to recover from the devastating impact of the pandemic; in truth, however, even before the pandemic, we were unfortunately already seeing an increase in maternal mortality in some countries in our Region. We have intensified training for emergency care in all priority countries, dramatically improved maternal morbidity surveillance, and are working hard to track and address the obstacles to protecting women from premature death. Again, the tools and knowledge exist, but they are not reaching the most vulnerable people as they should. PAHO is committed to changing this reality by working with each and every country and with all partners in order to change this situation very quickly in our Region.

Our work over the past year has been guided by two fundamental principles: an appetite for innovation and a commitment to equity. 

Significant progress has been made in operational efficiency, transparency, and accountability with the implementation of the PAHO Forward initiative, based on innovation and systematic modernization of management practices, while cultivating a respectful and inclusive work environment. A number of policies and procedures were revised to streamline administrative operations, while internal controls and compliance measures were strengthened.

Equity is our moral compass in the pursuit of health for all people. And innovation reflects the drive to always improve the way we work, adopting the best tools and evidence that can generate the greatest impact. 

In this spirit, PAHO will continue to work with and among countries to build resilience in our health systems so that they serve the needs of the people of the Region of the Americas.

We have made a lot of progress but together we can do much more.

Thank you for your attention.