Election process

When does the election process start?

March 1, 2017.

What happens on that day?

The President of the PAHO Executive Committee notifies PAHO Member States, Participating States, and Associate Members and invites them to submit nominations for the position of Director.

What is the deadline for nominations?

May 1, 2017.

Who may submit nominations?

Each Member State, Participating State, or Associate Member may nominate one candidate, who must be a national from a country within the Region.

When and where will the elections take place?

Between 25-29 September 2017, at PAHO Headquarters, in Washington, D.C., during the 29th Pan American Sanitary Conference.

Who votes in the election?

Delegates of all PAHO Member States and Participating States.

What are the requirements for the candidates?

1. A strong technical and public health background, extensive experience in international health, and an understanding of the inter-American and United Nations systems.

2. A proven history and evidence of public health leadership, and management skills appropriate for a complex health-related organization.

3. Sensitivity to and respect for the cultural, social, political, and economic diversity within and among the countries in the Region.

4. Knowledge of the regional health situation and of the wide range of health systems in the Region.

5. A strong commitment to the work of PAHO.

6. Good physical condition, as required of all staff members of the Organization.

7. Fluency in one of the official languages and a working knowledge of one of the others.

Who have served as directors of the Sanitary Bureau?

The current director is Dr. Carissa F. Etienne who began her term on 1 February 2013.  Previous directors include Dr. Mirta Roses Periago (2003-2013)Dr. George Alleyne (1995-2003), Dr. Carlyle Guerra de Macedo (1983-1995), Dr. Héctor Acuña (1975-1983), Dr. Abraham Horwitz (1959-1975), Dr. Fred Soper (1947-1959), Dr. Hugh Cumming (1920-1947), Dr. Rupert Blue (1912-1920), and Dr. Walter Wyman (1902-1911).

Where can I find more information on the election process?

Articule 21, paragraph A of the PAHO Constitution; Part IX, Rule 56 of the Rules of Procedure of the Conference and Rules Governing the Election Process for the Position of Director of the Pan American Sanitary Bureau, as approved by Resolution CD47.R4: process for the election of the Director of the Pan American Sanitary Bureau, available in English, French, Portuguese, and Spanish.

Dr. Carissa F. Etienne re-elected for second term as PAHO Director

Washington, D.C., September 27, 2017 (PAHO/WHO) -- Dr. Carissa F. Etienne was re-elected today for a second five-year term as Director of the Pan American Health Organization (PAHO) by the Member States of the organization.

Ministers of health meeting at the 29th Pan American Sanitary Conference voted unanimously to re-elect Dr. Etienne. Her candidacy, which was not contested, was submitted by the Government of Dominica, her native country. She will assume her second term as Director of the Pan American Sanitary Bureau, PAHO's Secretariat, on February 1, 2018.


In her acceptance speech, Dr. Etienne cited her "commitment to deliver to all of our peoples, from all walks of society, a long and productive life, with quality care into our senior years; access to quality health services without fear of impoverishment; access to medicines and vaccines that we can afford, including effective antibiotics; freedom from preventable diseases, with reduced exposure to disease vectors."

She said access to sexual and reproductive health services; to healthy, nutritious food; and to clean water and adequate sanitation were important, along with safe refuge and adequate health care in the face of disasters and health emergencies.

"Action by the health sector alone will not be sufficient to achieve our objectives," Dr. Etienne said. "This is why, when I visit your countries, I meet with heads of state and officials from across other sectors. Looking beyond government, however, I am convinced that we must mobilize our partners in academia, civil society and the private sector" to improve health.

WHO Director-General Tedros Adhanom Ghebreyesus, who is attending this week's conference, said, "I can see the unity of this region" in voting unanimously for Dr. Etienne. "I have seen her leadership in dealing with Zika, hurricanes and emergencies and how swiftly she reacts. We will communicate often and work well together."

During Etienne's first term, the countries of the Americas achieved several important health milestones with PAHO's support. These included the elimination of rubella and congenital rubella syndrome in 2015 and the elimination of measles in 2016. Countries also advanced in the elimination of neglected diseases including trachoma, Chagas disease, and onchocerciasis (river blindness) and the elimination of mother-to-child transmission of HIV and syphilis. PAHO Member States also approved a regional strategy to achieve universal health, becoming the first WHO region to do so.

Under Etienne's leadership, PAHO has supported Member States in coping with major epidemics, including Zika, chikungunya and yellow fever, as well as disasters that have ranged from hurricanes and catastrophic flooding to earthquakes and droughts. PAHO's technical cooperation has also helped countries strengthen their abilities to detect and respond to health threats of potential international concern, under the International Health Regulations (IHR).

As detailed in the Quinquennial Report of the Director (link below), PAHO support during the past five years has also helped Member States expand access to health services, strengthen regulatory systems for medicines and other health technologies, enhance the health workforce, improve access to safe and effective medicines, and strengthen health information systems to support evidence-based policymaking and health interventions.

Dr. Etienne began her career as a medical officer at the Princess Margaret Hospital in Dominica, where she eventually became the Chief Medical Officer. She has also served in other high-level posts in Dominica, including coordinator of the National AIDS Program, disaster coordinator for the Ministry of Health, chair of the National Advisory Council for HIV/AIDS, and director of Primary Health Care Services.

She received her medical degree (bachelor of medicine and bachelor of surgery- MBBS) from the University of the West Indies, Jamaica; and her master in science (MSc) in community health in developing countries from the London School of Hygiene and Tropical Medicine.

Dr. Etienne began her first five-year term as PAHO Director on 1 February 2013, after being elected in September 2012. Previously, from 2008 until 2012, she had served as assistant director-general for health systems and services at the World Health Organization in Geneva, Switzerland.

Prior to that post in Geneva, she was assistant director of PAHO from 2003 to 2008, in charge of five technical areas: Health Systems and Services; Technology, Health Care and Research; Health Surveillance and Disease Management; Family and Community Health; and Sustainable Development and Environmental Health.

During her tenures at WHO and PAHO, Dr. Etienne has led efforts to promote universal health coverage and renew primary health care to strengthen health systems to be more integrated and to function better. She has also spearheaded policy directions for reducing health inequalities and advancing health for all through universal coverage, people-centered care, the integration of health into broader public policies, and inclusive and participatory health leadership.

She has been heavily involved in the struggle to help countries reduce the growing burden of noncommunicable diseases through efforts to combat obesity and curb the tobacco epidemic. She has also supported expansion of immunization programs in the Americas, and earlier this month accepted the Measles and Rubella Initiative Champion Award for PAHO's work to eliminate measles and rubella from the Americas.

Dr. Etienne produced the World Health Report on "Health systems financing: the path to universal coverage," which was recognized worldwide for its agenda for action by all countries to reach universal coverage and improve health outcomes. She also chaired the International Health Partnership (IHP+) initiative, which seeks to commit partners to work together and put into practice international principles for effective aid and development cooperation in the health sector.


29th Pan American Sanitary Conference
- Quinquennial Report of the Director
Acceptance speecch of the Director

CV Dr. Carissa F. Etienne


pdf English  | pdf Spanish  | pdf French  |  pdf Portuguese

Key Information

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Frequently Asked Questions

Key Deadlines in the Process for the Election of the Director

Related Links

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PAHO's history and past achivements

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Flags of the Americas


On 22 June 2012 the Member States of the Pan American Health Organization (PAHO) attended the Candidates Forum for the Post of Director of the Pan American Sanitary Bureau. The following five candidates nominated for this post participated in the Forum:

  • Caroline Judith Chang Campos (Ecuador)
  • Carissa Faustina Etienne (Dominica)
  • Socorro Gross Galiano (Costa Rica)
  • María Julia Muñoz Melo (Uruguay)
  • Oscar Raúl Ugarte Ubilluz (Peru)

The Member States of PAHO will elect the next Director of the Pan American Sanitary Bureau at the 28th Pan American Sanitary Conference, to be held 17—21 September 2012 at PAHO headquarters in Washington, D.C.

The candidate elected will begin a five-year term on 1 February 2013, replacing Dr. Mirta Roses Periago, of Argentina, who has served in the post since 1 February 2003.

The President of the Executive Committee of PAHO, Venezuela's  Vice Minister of Collective Public Health, Dr. Miriam Cecilia Morales de Mavares, opened the Candidates' Forum, and subsequently delegated responsibility for conducting the Forum to Mr. Leandro Luiz Viegas, delegate of Brazil, in his capacity as Vice President of the Executive Committee.

Under the Rules Governing the Election Process for the Post of Director of the Pan American Sanitary Bureau, the nominated candidates were invited to make a presentation to  PAHO Member States, Participating States, and Associate Members attending the Candidates' Forum, either in person or virtually.

The candidates presented the platforms, visions, policy priorities, and financial and programmatic direction that they propose for the Organization.

The order of the presentations was decided by lot at the beginning of the Forum. Each candidate had 30 minutes to give an oral presentation, followed by an hour to answer questions from the Member States, Participating States, and Associate Members.

This week, during the 28th Pan American Sanitary Conference, the candidacies of María Julia Muñoz Melo (Uruguay) and Oscar Raúl Ugarte Ubilluz (Peru) were withdrawn by their respective countries. Therefore, the Member States of PAHO will elect the Organization's next Director from among the following three candidates:

  • Caroline Judith Chang Campos — Ecuador
  • Carissa Faustina Etienne — Dominica
  • Socorro Gross Galiano — Costa Rica

The candidate who is selected will begin her five-year mandate on 1 February 2013, replacing Dr. Mirta Roses Periago, who has been Director since 1 February 2003.

Five official candidates for the post of Director of the Pan American Sanitary Bureau, Secretariat of the Pan American Health Organization (PAHO), presented their candidacies to PAHO Members States during a special Candidates' Forum on 22 June. The candidates presented their proposed platforms, policy priorities, and financial and programmatic proposals for the Organization.