Pan American Health Organization

1
Pan American Health Organization

• Pan American Sanitary BureauRegional Office for
  the Americas for theWorld Health Organization

2
Partnerships for Advancing Health in the
AmericasCollaboration between CDC and PAHO

• David Brandling-Bennett
• Pan American Health Organization

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A Brief History of PAHO

• 1902 - Established to help American republics
  prevent the spread of diseases without impeding
  travel or trade
• 1924 - Pan American Sanitary Code defines
  functions of PAHO
• 1949 - Becomes the WHO Regional Office for the
  Americas
• 1950 - Recognized as the specialized health
  agency in the Inter-American system

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How Does PAHO Function?

• A presence in every country
• Country-specific and regional programs
• A technical cooperation agency, not a funding
  agency
• Promotes cooperation among countries
• Relies on partnerships for technical and
  financial resources

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What is Technical Cooperation?

• Building internal capacity to address national
  and regional health needs
• The functions of technical cooperation
• Training
• Setting norms and standards
• Mobilizing resources
• Disseminating information
• Research

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The Benefits of Partnership

• Skills and knowledge are mobilized and resources
  are shared
• Experience builds expertise
• Common interests and approaches are developed
• Further knowledge is gained and shared
• Awareness of how to transfer and build capacity
  is enhanced

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Some Areas of Collaboration in Infectious Diseases

• Poliomyelitis
• Measles
• Influenza
• HIV/AIDS
• STIs
• Tuberculosis
• Dengue
• Hemorrhagic fevers
• Foodborne diseases

• Malaria
• Chagas disease
• Lymphatic filariasis
• Onchocerciasis
• Cysticercosis
• Rabies
• Plague
• Equine encephalitis
• Hepatitis

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Some Areas of Collaboration in Infectious
Diseases, contd

• Infectious disease surveillance
• Response to epidemics and emergencies
• Drinking water disinfection
• Antimicrobial resistance
• Response to emerging infections
• Building public health laboratory capacity

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Some Other Collaborations

• Tobacco control
• Reproductive health
• Maternal mortality
• Birth defects
• Nutrition
• Oral health
• Violence
• Injury surveillance, prevention, control
• Lead poisoning

• Environmental epidemiology
• Toxic hazards
• Occupational health
• Insecticide quality control
• Diabetes
• Blood lipids
• Physical activity

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Some Other Collaborations, contd

• Behavioral risk factor surveillance
• Non-communicable disease surveillance
• Essential public health functions
• Public health performance assessment
• Laboratory management and performance
• Disease classification
• Mortality data analysis
• Geographical information systems
• U.S.-Mexico border health

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Polio Eradication Progress, 1988-2001
350,000 cases

Polio-infected countries (map as of 27 June 2001)
253 cases
EPI data as of August 2001
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Vaccination coverage and reported number of
measles cases Region of the Americas, 1980-2001
Catch-up campaigns
Follow-up campaigns
Confirmed cases (thousands)
Routine infant vaccination coverage ()
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PAHO Measles Laboratory Network
CDC, Atlanta
IPK, Cuba
LHU, Haiti
INDRE, Mexico
LNSP, Dominican Republic
CAREC, Trinidad
LNR, Guatemala
CCG, Panama
INH, Venezuela
LCMSP, El Salvador
CNDR, Nicaragua
LR, Costa Rica
INS, Colombia
INH, Ecuador
INS, Peru
LCSP, Paraguay
Cenetrop, Bolivia
FIOCRUZ, Brazil
Inst. Adolfo Lutz, Brazil
LCM, Uruguay
ISP, Chile
LDI, Argentina
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Salmonella Drug Resistance by Site (1998/1999)
Resistant
30
25
20
15
10
5
0
Chloramphenicol
Ciprofloxacin
Sulfa/Trim
Kanamycin
Gentamicin
Nalid. Acid
Tetracycline
Cephalothin
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Potential Problems in Collaboration

• Tendency to do the job rather than transfer and
  build capacity
• Unclear lines of supervision and responsibility
• Need to report back to the head office before
  decisions are taken
• Lack of familiarity with how to work with
  multiple partners

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Elements Essential for Success

• Technology must be appropriate, evidence-based,
  and sustainable
• Mutual respect, shared commitment, open
  communication
• Adequate human and financial resources
• Longer-term commitments when needed
• Consistency with regional and global objectives

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Conclusions

• We must work to build capacity and generate
  resources so that progress is sustained
  internally.
• Collaboration usually involves multiple partners,
  including several government agencies, NGOs,
  universities, and others.
• Situations may change quickly, requiring
  sensitivity and flexibility.