Commissioners are collecting information on the root causes of health inequalities in the Americas. They will present their final report this year, along with concrete recommendations to reduce or eliminate health equity gaps.

Port Spain, January 25, 2018 (PAHO/WHO) - The Pan American Health Organization (PAHO) Commission on Equity and Health Inequalities in the Americas met with senior government officials and leaders from civil society and academia in Trinidad and Tobago from January 23 to 25, to better understand the factors that lead to health inequities in the Americas and to find ways to address them.

The members of the Commission focused on issues surrounding human rights, universal health coverage and social determinants of health in the context of the Caribbean subregion. During their visit, they met with Minister of Health of Trinidad and Tobago Terrence Deyalsingh, Chief Medical Officer Roshan Parasram, members of the Equal Opportunities Commission, and Permanent Secretary of the Ministry of Planning and Development Joanne Deoraj.

Commission on equity
From left to right: Dr. Heidi V. Jimenez (PAHO), Sir Michael Marmot (Chair of the Commission), Terrence Deyalsingh Minister of Health of Trinidad and Tobago, Nila Heredia (commissioner), Mabel Bianco (commissioner), Bernadette Theodore-Gandi (PWR). Standing from left to right: Dr. Jessica Allen (IHE), Dr. Roshan Parasram, Chief Medical Officer, Jo Ivey Boufford (commissioner), Pastor Murillo (commissioner), David Satcher (commissioner), Tracy Robinson (commissioner), Maria Paula Romo (commissioner), Fernanda Alonso (PAHO), Dr. Peter Goldblatt (IHE).

Alicia Yamin, visiting professor of law at Georgetown University and program director of the Health and Human Rights Initiative at the university's O'Neill Institute for National and Global Health Law, discussed linkages between human rights and health and how a focus on human rights could be incorporated into the final recommendations of the Commission.

Members of civil society and academia briefed Commission members on the situation of Trinidad and Tobago and the Caribbean region. During their meeting, they gave information on violence, gender, the situation of the LGBTI community, and challenges and opportunities related to human rights. Other participants included: Michelle Braithwaite, from the Office of the Resident Coordinator for Barbados; Rhonda Reddock, professor at University of the West Indies; Roger McLean of the Family Planning Association of Trinidad and Tobago; Colin Robinson of the Coalition Advocating for Inclusion of Sexual Orientation; and Roberta Clarke, a civil society representative. 

The Commission also visited the Family Planning Association of Trinidad and Tobago, which offers sexual and reproductive health services and has a special clinic for young people from 14 to 25 years old.

The Pan American Health Organization (PAHO) established the independent Commission on Equity and Health Inequalities in the Americas in 2016. Its members are public health experts who are evaluating evidence on the elements that lead to health inequalities and who are expected to propose actions to improve the health of the people in the region. The Commission's approach, like PAHO's activities and programs, aims to incorporate gender, equity, human rights and ethnicity as "cross-cutting themes" into its analyses and its recommendations. 

Trinidad and Tobago is one of 15 countries in the Americas that have partnered with the Commission to collaborate on data collection. The others are Argentina, Belize, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, El Salvador, Jamaica, Mexico, Peru, Suriname, and the United States. These countries are providing information and advice based on case studies that have had successful outcomes as well as others that have failed to improve equity and health inequalities. The countries are also expected to contribute suggestions for recommendations made by the Commission at the end of its work.

The Commission has already begun the process of examining evidence, and preliminary results and recommendations are being discussed this week in Trinidad and Tobago. PAHO country representatives based in Cuba, Chile, Mexico, Peru, Suriname, and Trinidad and Tobago are also participating in this week's meetings. 

Since the Commission was established, the commissioners have met twice in Washington, D.C.; once in Bogotá, Colombia; and once in Costa Rica. The Commission is expected to present its recommendations to PAHO Member States during the next PAHO Directing Council in September 2018.

The Commission on Equity and Health Inequalities in the Americas is chaired by Sir Michael Marmot of the Institute of Health Equity at University College London. Its members include Paulo Buss and Cesar Victora of Brazil, Nila Heredia of Bolivia, Tracy Robinson of Jamaica, Cindy Blackstock of Canada, Mirna Cunningham of Nicaragua, María Paula Romo of Ecuador, Pastor Murillo of Colombia, Mabel Bianco and Victor Abramovich of Argentina, and David Satcher and Jo Ivey Boufford of the United States.

More information on the Commission