Geneva, 23 May 2018 (PAHO/WHO) - With the mission of discussing how to achieve health for all with a commitment to universal coverage, ministers and delegates from the countries of the Americas continued to share their experiences at the plenary meeting of the 71st World Health Assembly.

Health authorities from the Region shared their experiences and confirmed their deep commitment to achieving universal health.

More than 25 delegations from the Americas spoke at the plenary meeting. Presentations by Canada, Cuba, Argentina, Honduras, Curaçao, and Ecuador were given on 21 May, the opening day of the Assembly.

A summary of the presentations of other countries in the Region follows:

Brazil: International cooperation to strengthen health systems in Brazil

In his address to the World Health Assembly, the Minister of Health of Brazil, Gilberto Occhi, described the challenges involved in managing a universal health system, particularly for developing countries. He said this is why his country pays particular attention to international cooperation in health as a strategy for the promotion of sustainable development.

He pointed out that Brazil has worked with the Pan American Health Organization (PAHO) and the World Health Organization (WHO) to tackle a measles outbreak on the northern border of Brazil as well as yellow fever. "In partnership with South American neighbors, we are intensifying epidemiological surveillance actions and strengthening health care in the border regions," he said.

The minister also said there can be no universal health without access to medicines, vaccines, technologies, and health services. For this reason, the Brazilian government announced its commitment to make a voluntary donation to WHO to promote access to medicines and vaccines.

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Mexico: Health is not a commodity and the market should not determine the course of health care

The Minister of Health of Mexico, José Ramón Narro Robles, addressed inequalities that threaten health. "We live in a world of contrasts and the main challenge for humankind is to reduce inequalities, including access to health services," he said.

Narro Robles stated that health is a human right, but the individual must also be responsible, for example, for tackling the risk factors of noncommunicable diseases. He added that some "enemies" of health can be changed, such as having an informed population and access to services. " Health is not a commodity and the market should not determine the course of health care," he stressed.

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Costa Rica: Positioning health in all policies

The ambassador of Costa Rica to the United Nations, Elayne Whyte, explained the process that her country followed for decades in order to achieve universal health coverage, and described the impact that this has had on increasing life expectancy. According to Ms. Whyte, this is why "it is essential to position health in all policies."

Whyte stated that her country is aware of the major challenges that still need to be confronted to ensure universal health. She called for international coordination mechanisms so that information on good practices can be shared at the global level.

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The United States: US$7 million commitment to WHO to combat the Ebola outbreak

The Secretary of Health and Human Services of the United States, Alex M. Azar, said that WHO's main priority should be infectious diseases that can cross borders. "We are better prepared partly because the United States has generously invested in prevention both at home and abroad," he said.

Azar stressed that WHO should continue to strengthen its coordination efforts to address global emergencies. As an example, he mentioned the current Ebola outbreak in the Congo to illustrate that WHO must focus on its most essential function. He announced that the United States will release an additional US$7 million to respond to the outbreak, complementing the technical expert assistance it is already providing.

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Jamaica: Primary health care is key to achieving universal health

The health minister of Jamaica, Christopher Tufton, said an innovative vision is required to address the challenges in achieving universal health coverage. He emphasized that his country firmly believes that primary health care is the key to achieving universal health, and that the focus should be on prevention and community-based health to ensure that the communities are participating in health. Tufton listed the measures that his country is taking, which include a 10-year strategic plan to develop national health insurance.

He also expressed his pleasure that the impact of climate change on health will be included in WHO's programme of work, since it is an issue that affects his region. He called on the countries to pay special attention to the scarcity of health workers, particularly nurses, which poses a challenge to universal health.

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Uruguay: Universal health entails political decisions that involve more sectors

The Minister of Health of Uruguay, Jorge Basso, said his country has been implementing a series of public policies to ensure universal health, including the Health Sector Reform, the National Health Care System, and improvements in the educational system, "which, along with economic policy that has created stability, employment, and investment, has enabled the Uruguayan people to benefit from continuous economic growth over the last 14 years."

He said that the country's biggest challenge is being able to deepen and improve the quality of these policies so that they have the greatest possible impact and make the country's development process sustainable.

Basso also pointed out that the president of Uruguay Tabare? Va?zquez, together with the Finnish and Russian authorities, are promoting an initiative introduced by the Director-General of WHO, Tedros Ghebreyesus, which will allow the countries to make political decisions to decrease the burden of premature death linked to noncommunicable diseases. He said they hope that the outcomes of this work will result in a substantial contribution and that political leadership will be renewed at the United Nations meeting in New York so that decisive action can be made to move forward in the prevention and the control of these diseases, giving clear signs that there are health priorities that are more important than any other interest.

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Peru: Universal health based on equity and solidarity

The Minister of Health of Peru, Silvia Pessah Eljay, explained that universal health coverage is not sufficient, and that there must also be a supply and delivery of quality services. In this regard, Peru has been working on promoting a comprehensive and affordable system that prioritizes the most disadvantaged populations.

The minister said they are still working on closing the gaps to reach all people "on the basis of equity and solidarity," with personalized network health insurance to complement the services. They are also working on closing funding gaps in universal health coverage.

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Colombia: New challenges in health security

In her address to the World Health Assembly, the Colombian ambassador in Geneva, Beatriz Londoño, described the path taken by her country to implement universal health care, with a single benefits plan for citizens, equitable access to medicines, and a new health care model that includes the implementation of the commitments made in the country's peace agreements. She said that there are still some challenges in reaching rural areas and maintaining steady financing.

Londoño also described the "new challenges in health security," such as the recent outbreaks of measles, diphtheria, and yellow fever in the region. The ambassador explained that her country has been taking in a high number of Venezuelan immigrants and described the health care they are receiving. She mentioned the cost this has entailed for the country in first four months, adding that we must "move forward with a regional response and international cooperation" to be able to fully respond to this situation.

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Venezuela: Measures to address current challenges

The Vice Minister of Health of Venezuela, Indhriana Parada, said that in the last 20 years, her country has gone from a social welfare health system to a comprehensive, equitable, and participatory system that provides free care to the entire population.

Parada explained that in 2017, after the introduction of diphtheria and measles in the country, an extensive vaccination program was developed with the support of PAHO/WHO and teams of Cuban doctors, in order to contain the outbreaks. She also reported that her country pays 100% of the cost of medicines and also produces them, but faces an economic embargo that keeps it from procuring drugs and vaccines. She also said that they are investing in actions to prevent malaria, among other things.

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Panama: Reducing the burden of socially transmitted diseases

The Minister of Health of Panama, Miguel Mayo Di Bello, confirmed his country's commitment to remove all barriers against achieving universal coverage, such as poverty and social exclusion.

In this regard, the health system reform that is being implemented includes policies such as improving water and basic sanitation systems, strengthening primary health care, and providing more training for human resources. It also seeks to reduce the burden of noncommunicable, or "socially transmitted" diseases, where controlling risk factors is a national priority." He said that they are working on food labeling and imposing taxes on sweetened beverages, among things.

Mayo also mentioned the 2030 Health Agenda, as a guide for developing future health plans.

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Chile: Aging is a challenge to the health system

Chile's Undersecretary of Health, Paula Daza, said that the country has moved toward an efficient, solidarity-based health system over the last ten years, but now faces the challenge of an aging population, which will entail new problems for the health system over time.

"90% of older adults currently receive public health care, which is why work is being done to develop prevention policies over the life course," she explained. Daza said that promoting people's health is a priority of the Chilean government.

In her address, she described the measures taken in coordination with PAHO to reduce the risks posed by natural disasters, in order to build the country's emergency capacities.

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El Salvador: Breaking down barriers to universal health

"Universal health is an opportunity for millions of people who have historically been excluded from the right to health. For those people, we are breaking down economic, geographical, technological, and cultural barriers," said the Minister of Health of El Salvador, Violeta Menjívar, who gave a detailed description of the actions taken.

The minister pointed out that the number of primary care facilities has doubled, and the country has been working on increasing the density of human resources in the most remote rural areas and promoting community social participation as the basis for the model. She said that their goals, given the country's particular conditions, are consistent with WHO's objectives. She thanked PAHO for its assistance in addressing all these reforms.

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Guatemala: Intersectoral work will lead to universal health coverage

The Guatemalan Minister of Health, Carlos Soto, referred to the health challenges his country faces, and explained how they are working to overcome them. "The government has identified health as a priority. Our commitment is to ensure that all Guatemalans have access to health, which is the strategic line of action" of health reform, the minister said. He thanked PAHO for the support in the training provided on various aspects of this reform.

"We have big challenges in Guatemala, but we have the conviction that intersectoral work will lead to universal health coverage," he said.

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