Dr. Amalia Del Riego Unit Chief, HS, PAHO/WHO

Where is the C in HSS Framework? PAHO/WHO Perspective

2

0

50,000

100,000

150,000

200,000

250,000

300,000

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11

0

20

40

60

80

100

Cases Coverage

Catch-up campaigns

*1333 confirmed cases in 2011; data as of 31 August 2012.

Follow-up campaigns

Ro

utin

e in

fan

t vaccin

atio

n c

ov

era

ge

(%)

Co

nfi

rmed

cases (

tho

us

an

ds

)

0

20000

40000

60000

80000

100000

120000

140000

78 80 82 84 86 88 90 92 94 96 98 00 02 04 06 08 10

0

20

40

60

80

100

Pertussis Diphtheria Coverage

Co

vera

ge

(%) N

um

be

r o

f C

ases

Measles elimination*

0

1000

2000

3000

4000

5000

6000

7000

70 72 74 76 78 80 82 84 86 88 90 92 94 96 98 00 02 04 06 08 10

0

10

20

30

40

50

60

70

80

90

100

Cases Coverage

Nu

mb

er

of

cases

Co

vera

ge

(%)

Type 1 vaccine derived virus in 2000 and 2001: 21 cases

Polio Eradication

Diphtheria and

Pertussis

Achievements in the Americas

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11

0

20

40

60

80

100

Cases Routine coverage

Rubella Elimination* Acceleration Campaign

Nu

mb

er

of

cases

Co

vera

ge

(%)

*9 confirmed cases in 2011; data as of 31 August 2012.

Health situation in the region

0

50

100

150

200

250

300

350

1990 1995 2000 2005 2013 2015

Canada Caribbean Latin America United States of America

Mat

ern

al M

ort

aity

Rat

io x

100

.000

lb

Source: Maternal Mortality Estimation Inter-agency Group

(MMEIG)

Regional Inequities in Health– Maternal Mortality

The proportion of municipalities with less than

80% DPT3 coverage varies significantly between

countries.

Between populations

Important differences in population health indicators exist

between Indigenous and non Indigenous populations

Health situation in the region

Inequities in Health Care Access & Use

Within Countries

Current Challenges in Public Health for the Americas

WHO Building Blocks

•Governance

•Service delivery

•Human Resources

•Medicines and Technologies

•Information

•Financing

PAHO Strategy for Universal Access to Health and Universal Health Coverage

C: people and communities at the center

Mean that all people and communities can use the services they need, when they need them, with quality, throughout the life course, without financial hardship.

Universal Access to Health and Universal Health Coverage

Values Right to Health

Equity

Solidarity

Four Simultaneous and Interdependent

Strategic Lines

Strategic line 1: Expanding equitable access to comprehensive, quality, people- and community-centered health services. Empowerment of people

Strategic line 2: Strengthening stewardship and governance. Social participation and social dialogue, accountability

Strategic line 3: Increasing and improving financing, with equity and efficiency, and advancing toward the elimination of direct payment that becomes a barrier. Solidarity

Strategic line 4: Strengthening intersectoral action to address the social determinants of health. Empowerment of communities

How these frameworks can be used?

• Advocacy and mobilization of resources

• Collaboration with countries

• Innovative approaches: HSS and Global Health Initiatives – how to find the right balance?

• Sharing of experiences

• People and community engagement