Washington, D.C., July 21, 2025 (PAHO) — To reflect on progress and challenges toward universal health in the Americas, the Pan American Health Organization (PAHO) brought together experts and policymakers for the webinar Universal Health in the Americas: Addressing Unmet Health Care Needs through Primary Health Care. The event presented the findings of the recent regional report on universal health and fostered a dialogue on innovative strategies to address persistent challenges in the Region.
In his opening remarks, Cristian Morales, PAHO/WHO Representative in Brazil and moderator of the seminar, stated: “When countries collaborate, learn from each other, and prioritize strong primary care, we move closer to ensuring health for all.”
The report Progress in Universal Health in the Region of the Americas, published by PAHO in December 2024, reveals that 35.2% of the Region’s population reports unmet health care needs, a figure that rises to 38.5% among the lowest-income groups. It also shows that coverage of essential services, which had reached 80% in 2019, dropped to 74% in 2021. In addition, between 1.5% and 7.8% of the population incurs catastrophic health expenditures. The analysis is based on three integrated indicators: unmet health care needs, coverage of essential services, and financial protection.
Ernesto Báscolo, Chief of PAHO’s Primary Health Care and Integrated Service Delivery Unit, presented the report’s findings and emphasized: “Achieving universal access to health means ensuring that everyone has access to comprehensive, appropriate, timely, and quality services, without discrimination or barriers. These data allow us to recognize progress, identify inequities, and guide policies that prioritize equity and strengthen primary health care with a territorial approach.”
The roundtable brought together three international experts to delve deeper into the report’s key themes. Adriano Massuda, Executive Secretary of Brazil’s Ministry of Health, noted that one-third of people in the Region forgo needed health care and outlined the four strategic lines that Brazil is pursuing to address this challenge: strengthening primary care, improving governance, using indicators for management, and reducing barriers to access. He also highlighted initiatives such as investments in telehealth, digital technologies, and the Agora Tem Especialistas program, which aims to reduce waiting times for specialized care.
James Macinko, Professor at the University of California, Los Angeles (UCLA), explained that combining the three indicators —unmet health care needs, coverage of essential services, and financial protection— provides a more comprehensive view of the challenges facing health systems. He also underscored the need to incorporate people’s lived experiences, recognize subnational inequalities, and design more context-sensitive policies.
Rouselle Lavado, Technical Officer on Financial Protection, Equity, and Poverty at the World Health Organization (WHO), addressed the financial barriers to accessing health services, highlighting that 7.8% of the population incurs catastrophic health expenditures and 14.2% forgoes care for economic reasons. She also emphasized the remaining data gaps and the importance of strengthening information systems to monitor coverage and guide equitable resource allocation.
The seminar concluded with remarks by James Fitzgerald, Director of PAHO’s Department of Health Systems and Services, who stated: “Universal health is not a single destination but an ongoing process that requires shared vision, persistent effort, and the ability to innovate and adapt.” He called for investments in primary care, improved quality and use of data, and the building of more inclusive, resilient, and people-centered health systems.
The event was part of the Primary Health Care Webinar Series and brought together 1,330 participants from 59 countries and territories —39 from the Region of the Americas and 20 from other regions— including policymakers, health professionals and managers, researchers, civil society representatives, and international partners.
Download the full report here and watch the full event video here.
