Geneva, May 28, 2024 (PAHO/WHO) –Ministers of health and high-level health authorities from the Americas have come together this week for the 77th World Health Assembly in Geneva, Switzerland, to discuss pressing health issues, including amendments to the International Health Regulations (IHR) and the creation of a global instrument on pandemic prevention, preparedness and response.
Here are some highlights of their interventions:
Chile: Responding to new challenges facing global health
While Chile has managed to rebuild the capacity of its public health system following the COVID-19 pandemic, as well as emergencies such as forest fires and floods, the country continues to experience a backlog in health care services, the Minister of Health of Chile, Ximena Aguilera, said.
“We have improved access to mental health care, including for health care workers,” and “reduced out of pocket spending with our zero co-pay strategy,” she added.
At the global level, Minister Aguilera welcomed “a consensus-based instrument for pandemic prevention, preparedness and response, based on the principles of equity, solidarity, sovereignty and respect for human rights.”
Chile also looked forward to reaching consensus with the amendments of the International Health Regulations (IHR). “Collaboration in finding effective solutions will be vital to respond to the new challenges facing global health.”
Argentina: Strengthening international capacities for pandemic response
Regarding the negotiations that will take place during the 77th World Health Assembly, the pandemic agreement, and the amendments to the IHR, Silvia Prieri, Chief of Staff of the Ministry of Health of Argentina, underscored that “Argentina’s priorities have always been to achieve an international agreement” and to “strengthen international capacities for pandemic response, promoting technological development and scientific collaboration.”
Prieri highlighted Argentina’s ongoing work on a variety of strategic issues, including “digitalizing health systems, strengthening supply chains, combatting antimicrobial resistance, and promoting health research and development.”
The Chief of Staff also underscored that while Argentina “supports the WHO’s mission as the directing and coordinating body on health,” it has concerns regarding the process of amending the IHR 2005.
“It is important to move forward with sustainable commitments for developing countries in particular.”
Canada: Closing health equity gap
“A meaningful pandemic agreement is consensus based and one all member states can agree on,” Chief Public Health Officer of Canada, Theresa Tam, said.
Canada remains committed to working together to prevent and minimize the consequences of health emergencies and pandemics, and “urges all member states to support WHO’s emergencies work.”
“Everyone everywhere should have the best level of care possible to promote wellbeing and prosperity,” she said.
Tam underscored Canada’s commitment to addressing health equity globally and addressing the root causes of ill health. “Together, we must improve health promotion efforts to reduce disease burden and foster mental and physical health and wellbeing.”
For Canada, an integrated approach to health service delivery requires inclusion of nutrition, sexual and reproductive health and rights, and routine vaccination.
“Gender equality is foundational to a peaceful, prosperous, and sustainable future for all. Let us continue to fight racism, sexual and gender-based violence, and discrimination against marginalized groups including LGBTQI+ people, women and girls,” she said.
Uruguay: A historic opportunity
Following the COVID-19 pandemic, the Minister of Public Health of Uruguay, Karina Rando, highlighted the need for countries to work together to strengthen the global health architecture.
“For Uruguay, the negotiations taking place to amend the IHR and the negotiations for a new pandemic agreement are a historic opportunity for the international community, defining a legal framework to enable us to work together to prevent a future pandemic,” and “guarantee access to affordable medications, information and technology to enable us to respond better to such pandemics,” she said.
“We must continue to strengthen dialogue, exchange, search for peace and ensuring the right to health for all.”
Primary health care is also an important issue for Uruguay, as is intelligent health spending, with a focus on access to medicines and new technologies.
Rando also underscored mental health as another important issue that has worsened since the COVID-19 pandemic. “Uruguay is investing strongly in an integral plan for the prevention and treatment of mental health problems and addictions.”
Mexico: We cannot forget the lessons of the pandemic
“We cannot expect a better future unless we deal with the deep underlying inequalities that divide us. Inequity undermines health and, in particular, timely affordable access to medicines and health products,” Francisca Elizabeth Mendez Escobar, Permanent Representative of Mexico to the United Nations in Geneva, said.
Highlighting Mexico’s active participation in the negotiation process for the pandemic instrument, Mendez Escobar underscored that “international cooperation is vital to be better prepared for future emergencies, without leaving the most vulnerable behind”.
“Our position on the amendments to the IHR and the new legal instrument on pandemics is based on principles of solidarity and equity, identifying specific opportunities to improve global preparedness, such as strengthening regional and local production capacities, addressing patents in emergency situations and the effective use of technical cooperation for better impact.”
Mendez Escobar welcomed the WHO’s recognition that it must transform in order to respond to a world in constant change and called for a renewed commitment to strengthening health systems and achieving the 2030 agenda.
“Peoples’ health has been effected by policies that put economic interest ahead of health.”
Peru: Timely and equitable access to health tools
Ana Cecilia Gervasi, Permanent Representative of Peru to the United Nations in Geneva highlighted the devastating consequences of the COVID-19 pandemic, which revealed underlying inequities in health.
“Peru therefore engaged constructively in the process to create better pandemic prevention, preparedness and response, according to the principles of solidarity and equity,” she said.
However, for Peru, the text drafted so far lacks ambition. “We must continue to work together to consolidate our national capacities and strengthen international collaboration for a mechanism for more timely and equitable access to health tools, the implementation of a One Health approach, technology transfer, and the exchange of pathogens.”
Welcoming progress in the negotiation of amendments to the IHR, Gervasi believes this will improve national processes and capacities to prevent and respond to public health emergencies.
“We in Peru cannot forget the devastating consequences and loss of life generated by the pandemic because of inequitable access to health tools.”
She highlighted that the country, and the world, continues to face global challenges including emerging health threats and climate change. Peru has also faced dengue outbreaks, the impact of which has worsened due to increasing temperatures and rainfall due to climate change.
Peru, along with the Netherlands, has therefore submitted a resolution on climate change and health that is “designed to strengthen national health systems to make them more resilient to climate change and ensure that health systems are increasingly more sustainable.”
Colombia: Strengthening primary health care
The Vice Minister of Health of Colombia, Jaime Urrego, underscored the importance of “life before everything” and outlined the country’s efforts to carry out significant health care reforms to achieve universal health based on primary health care, preventative approaches and intercultural work.
He thanked the WHO Director-General for sending a support mission for primary health care as a key component for the country’s health system reform. He stated that Colombia is “moving forward with immediate and executive measures to ensure greater equality, and to have a better impact on social determinants of health.”
Vice Minister Urrego also said that it is crucial the country’s national health insurance benefits everyone, including Indigenous persons, persons of African descent, and remote populations.
Guatemala: Working together to strengthen pandemic preparedness and response
Guatemala's Minister of Health, Óscar Cordón, invited delegates from WHO member countries “to work together to increase our global pandemic preparedness and response capacities.”
With 17 million inhabitants and a GDP of 77 billion dollars, he said, Guatemala is the largest economy in Central America. However, he added, “we are the country in the region with the highest proportion of children living in multidimensional poverty and the highest rate of stunting in childhood.”
Cordón recognized the need to build a health response framework aimed at halting and reversing the growth of chronic conditions and infectious diseases in a health partnership involving municipalities and other state ministries.
In reference to chronic non-communicable diseases, he pointed out that their prevention and control should be priority objectives. “In the last 10 years, chronic kidney disease has increased in the country and has caused it to be one of the main causes of mortality in the region,” he said.
He also highlighted the country's vulnerability to climate change, noting that tropical storms have affected the health of the population.
Despite these challenges, Cordón welcomed the efforts Guatemala is making to improve the health of the population and expand health coverage.
Cuba: Call for cooperation and investment in public health
The Minister of Public Health of Cuba, José Ángel Portal Miranda, stressed the urgency of genuine collaboration and investment in public health at the global level during his speech at the World Health Assembly.
In an increasingly interconnected world, the minister stressed the importance of recognizing that global health issues transcend the realm of health, influencing all sectors. “Working on a global scale is inevitable if we are to achieve a true collaborative framework between international organizations and governments,” he stated, emphasizing the need for sustainable solutions and adequate financial mechanisms.
In this regard, Portal Miranda highlighted Cuba's commitment in the negotiations associated with the legal instrument promoted by WHO to support pandemic preparedness, prevention and response. “Given the need to carry out actions that not only avoid the repetition of crises, but also put our countries in a better position to face them, Cuba has actively participated in these negotiations,” he said.
The minister concluded his speech by saying that “the world needs true cooperation and investment in public health; more than words, we need concrete actions. Only by working together, he added, will we be able to forge a future in which health is a right accessible to all.
United States: Investing in global Health security is essential for global stability
Xavier Becerra, US Secretary of the Department of Health and Human Services, urged global collaboration to address ongoing health threats.
Secretary Becerra acknowledged the success of international cooperation in tackling the COVID-19 pandemic. However, he highlighted the need to sustain this momentum to address future challenges.
“The world emerged from the COVID-19 pandemic thanks to unprecedented collaboration,” Secretary Becerra said. “But as urgency fades, unprecedented collaboration will be needed again if we are to prevent, detect, contain and respond quickly to the many common threats we face.”
He emphasized the importance of seizing the current opportunity and finalizing the proposed amendments to the International Health Regulations (IHR). “Those amendments, especially the tiered alert system, will immediately make a difference in improving global preparedness,” he stated.
Secretary Becerra further underscored the interconnectedness of health security and global stability. “There is no stability without health, there is no security without health,” he declared. “Healthy nations are strong nations.” The US Secretary concluded his address by calling for a continued commitment to global health. “There is never a wrong moment to strike a good deal for humanity and health,” he asserted.
Bolivia: Achieving equity to better respond to emergencies
Dr. Maya Espinoza, head of the Bolivian delegation to the 77th World Health Assembly, reaffirmed the country's commitment to work for universal health and the well-being of humanity, emphasizing the importance of equity as a fundamental element to better respond to health emergencies.
“The decisions we make in this assembly must be guided by a commitment to health and life, and against inequities in terms of access to universal health, vaccines and medicines, which must be considered as a right in favor of life,” she stated.
In her speech, she highlighted the progress made in the work of the Intergovernmental Negotiating Body (INB) on the pandemic agreement and emphasized the importance of building on what has been achieved so far. “We must establish clear timelines and clear modalities based on transparency and inclusiveness,” she added.
Emphasizing the relevance of the One Health approach, Espinoza asked not to forget that the main objective of both the INB and the IHR amendments is “to achieve equity under principles of solidarity and respect for rights, which will enable us to respond more effectively to future health emergencies.”
Ecuador – A historic opportunity to consolidate the right to health
Permanent Representative of Ecuador to the United Nations in Geneva, Cristian Espinosa, highlighted the importance of the World Health Assembly in addressing crucial issues that could redefine the future of multilateralism and global health.
During his address, Espinosa emphasized that Ecuador sees this juncture as a historic opportunity to improve international cooperation, especially through the WHO investment round, and to consolidate the right to health on a global scale.
Espinosa stressed that universal health coverage and access to health services are fundamental to achieving the SDGs by 2030. However, he noted that “gaps persist in coverage, quality and access, particularly for the most vulnerable.”
“Ecuador is committed to strengthening its own health systems to achieve this goal,” Espinosa said, inviting WHO delegates to “rethink health management paradigms for the benefit of the most vulnerable.”
The Ecuadorian representative also outlined several areas of focus for his country, including the treaty on pandemic prevention, preparedness and response; the stalled progress towards universal coverage following the pandemic; the need to invest in the fight against neglected tropical diseases; and the relationship between health and climate change.
Barbados – Recognizing the special circ*mstances of SIDS
For Barbados, the critical principles of equity and solidarity lie at the core of the pandemic treaty, Permanent Secretary of the Ministry of Health and Wellness of Barbados, Wayne Marshall, said.
“There is a therefore a need to fully recognize the special circ*mstances of SIDS and least developed countries in relation to pandemic prevention, preparedness and response.”
The Permanent Secretary underscored that WHO’s pursuit to address these concerns “must remain at the forefront of its efforts to ensure no Member State is left behind,” and urged WHO to face global challenges head on “so the peoples of the world become ever more resilient and protected.”
Venezuela – Democratizing health to achieve global goals
The Vice-Minister of Collective Health Networks of the Venezuelan Ministry for Popular Power for Health, Jesus Osteicochea, underscored the importance of democratizing health as a path to achieve global goals, emphasizing the need to address this challenge with an approach based on equality, equity and humanism.
The Vice Minister detailed the country’s efforts to integrate health policies for the benefit of the population, with more than 28 programs implemented by the Ministry of Health. For Osteicochea, these programs place health as an obligation of the state, with the participation of the citizens.
Among the initiatives, he highlighted the 1x10 system, a digital platform designed to identify individual, and community needs in real time. He also mentioned the BRICOMILES initiative, which is focused on strengthening health infrastructure capacities and training of personnel, with the aim of ensuring universal health coverage.
Osteicochea highlighted Venezuela’s achievements, including 100% coverage for treatment of renal patients, as well as treatment for those with HIV, tuberculosis and malaria. He also underscored the country’s recertification as measles-free in November 2023.
“We believe in, and practice, health for all,” the Vice Minister said, adding that “our achievement can be seen in our more resilient and sustainable health care systems.”
Nicaragua – Highlights advance in health and advocates for increased WHO funding for the Americas
Dr. Carlos Saenz, Secretary General of the Nicaraguan Ministry of Health, reaffirmed the country’s commitment to universal access, and extending free, quality health service coverage for the wellbeing of all Nicaraguans.
Dr. Saenz highlighted the country’s achievements in public health from 2006 to 2023, which are thanks to the implementation of a family and community health model, as well as the commitment of health workers and the community.
He emphasized the country’s 70% decrease in maternal mortality, the 57% reduction in infant mortality, the 56% drop in neonatal mortality, the 14% decline in chronic malnutrition in children under the age of 5 years, and an overall vaccination coverage of more than 95%.
Dr. Saenz also highlighted some of the interventions that have contributed to these achievements, including the strengthening and expansion of health infrastructure.
The Secretary General of the Nicaraguan Ministry of Health also called on WHO to increase funding for the region of the Americas, as well as for other regions of the Organization.
Panama – Commitment to collaborative work for universal healthcare
Dr. Ivette Berrio, Panama’s Vice Minister of Health, reaffirmed her country’s commitment to universal and equitable health care.
“Echoing the theme of this year’s World Health Assembly - “All for health, health for all,” a call to action that reminds us that only together will we contribute to a healthy and equitable world, we reiterate our commitment to continue working collaboratively with WHO and Member States,” she said.
During her intervention, Dr. Berrio stressed that Panama has made great strides in health over the past five years, laying the groundwork for universal access. The country has directed particular efforts to health promotion, social participation and the modernization of health services at the national level.
Panama’s Vice Minister of Health reiterated the country’s commitment to Indigenous peoples through the implementation of a roadmap towards the health and wellbeing of all. She also highlighted the strengthening of a primary health care network for those entering the country through the Darien jungle, as well as a strategic plan to address the health of migrant populations and host communities.
Costa Rica – A call for global action to address post-COVID-19 health challenges
Mary Munive Angermüller, Minister of Health of Costa Rica, called for global action to address the health challenges exacerbated by the COVID-19 pandemic and its repercussions on health and the economy.
“The theme of the Assembly, ‘All for health, health for all,’ is an objective we share in Costa Rica because we know that health issues do not respect borders,” she said.
The Minister of Health highlighted the need to prioritize chronic NCDs, mental health, migration and climate change, “challenges which oblige us to work together,” she added.
Munive Angermüller maintained that while her country is doing its best to address the health of migrants, it cannot do it alone. “The support of the international community is essential for us to continue to provide services to such a vulnerable population along the entire migratory route,” she said.
The Minister of Health also urged countries not to forget the lessons learned during the pandemic and the inequities exposed. “We must continue to strengthen national and regional capacities for prevention, preparedness, management, and strengthening supply chains,” she said.
Paraguay – Towards more efficient and accessible health policy
During her intervention, the Minister of Public Health of Paraguay, María Teresa Barán, highlighted the country’s progress and commitments in the field of health.
She emphasized that the government of Paraguay is aware of the challenges and opportunities when it comes to health and has therefore taken significant steps, including the construction of new hospitals and the reconfiguration of health services and networks towards a primary health care approach.
“These actions are pillars of a health policy that seeks to be more efficient and accessible to the population,” said the Minister.
Paraguay is also focusing on digital health through its GIS system, which not only automates care processes, but also significantly improves the quality of processes, benefiting both users, health professionals and senior management.
Recognizing the importance of international collaboration and coordination of efforts to effectively address the challenges of communicable diseases, Minister Barán underscored the need to reflect on the challenges faced in rebuilding health systems following the pandemic, as well as preparing for future health emergencies.
The Minister also emphasized that the sovereignty of countries must be respected at all times and that any document to be discussed at the WHA must reflect this fundamental principle.
Haiti – Health is a human right we must all protect
Expressing Haiti’s “resolute commitment to the negotiations of the first global agreement in history that aims to protect communities, countries and the planet from the threat related to pandemics,” Permanent Representative of Haiti to the UN in Geneva, Justin Viard, outlined the importance of international collaboration.
“It is important for our generation to be able to implement the promise of the sustainable development goals, which will require healthcare systems that are resilient and stable, with equitable access to innovation and care, and that are able to overcome the risks related to pandemics and the climate crisis,” he said.
Inequality, as well as “armed conflict and avoidable epidemics have a significant impact on healthcare systems, as well as on the populations they serve,” the Permanent Representative added. This “must be eliminated if we want to pass onto future generations a planet in which life will be possible.”
Bahamas – Preparing and recovering from impact of climate change
The Minister of Health and Wellness of the Bahamas, Michael Darville, highlighted the vulnerability of small island developing states to climate change-related events. “Our population is dispersed over more than 30 islands, which presents particular challenges when it comes to accessibility and health equity,” he said
Highlighting the country’s recovery from hurricane Dorian, and the COVID-19 pandemic, “the mental, social and economic fallout left in the wake of these devastating national disasters, reinforces my country’s commitment to WHO’s agenda to promote economic recovery and revitalize healthcare delivery systems through universal health coverage.”
The Bahamas has been placed in a “repetitive pattern of borrowing to repair and rebuild our healthcare infrastructure after each hurricane,” he added. “Reducing carbon footprints is therefore critical for healthcare delivery in small island developing states like ours.”
St Kitts and Nevis – Essential services must be maintained during an emergency
Thanking WHO and PAHO for their continued support in health emergencies and the implementation of the IHR, Chief Medical Officer of St. Kitts and Nevis, Hazel Laws, underscored the country’s efforts to develop a strategic plan for health, which will include a roadmap for ensuring a health system that can withstand any health emergency while maintaining essential services.
For St. Kitts and Nevis, while addressing non-communicable diseases (NCDs) is a priority, “with 84% of mortality attributed to NCDs over the period 2017-2021,” the country is also “plagued by communicable diseases such as HIV and dengue.”
The Chief Medical Officer highlighted country efforts to scale up its NCD response by tackling risk factors. This has been made possible thanks to partnerships with WHO and PAHO.
Trinidad and Tobago – Steadfast in its commitment to universal health
The Charge d’Affaires a.i at the Permanent Mission of Trinidad and Tobago to the UN in Geneva, Allison St. Brice, highlighted the country’s commitment to free universal primary healthcare for all its citizens.
Trinidad and Tobago “ensures that all health services are optimized and that medical treatments, education, practices and policies are relevant, innovative, technology-driven and, most importantly, accessible,” she said.
St. Brice also underscored efforts to transform national blood transfusion services. This has led to an increase in voluntary donors from 0.5% in 2022 to 9.5% to date.
Regarding NCDs, “we have strengthened our focus on behavior change strategies,” with the country’s healthy lifestyle movement continuing to gain momentum across the country.
Trinidad and Tobago will “continue to focus on the delivery of quality health care services for all as part of the broader push to achieve the WHO SDG targets by 2030,” she added.
St Vincent and the Grenadines – Health care must be built on access and equity
Reaffirming its “unwavering commitment to universal health access and coverage,” the Minister of Health, Wellness and the Environment of St. Vincent and the Grenadines, St. Clair Prince, underscored the country’s vision of a health care system as one “built on access and equity and tailored to our specific context.”
While acknowledging “notable progress towards achieving health for all,” including through addressing equity and expanding healthcare infrastructure, achieving significant improvement will require the country to tackle disparities, Prince said.
The Minister also highlighted achievements, including the elimination of mother to child transmission of HIV and syphilis, a reduction in infant and child mortality, and increased life expectancy.
Moving forward, St. Vincent and the Grenadines will continue to implement policy measures to reduce the risk factors of NCDs.
Jamaica – Human resources for health crucial for SIDS
Congratulating WHO for the successful launch of its investment round - “a bold step in the right direction,” Minister of Health and Wellness, Christopher Tufton urged greater commitment from the global community “as the timeline for achieving the SDGs inches closer.”
Regarding Jamaica’s focus on primary health care, the Minister highlighted the country’s development of a hospital model that decentralizes specialist services, “ensuring easier access and decreased waiting times for high demand services, including the management of illnesses that contribute to our mortality and morbidity burden.”
For Tufton, one of the most urgent priorities for Jamaica, and other SIDS, is to address the issue of human resources for health which “are threatening to erode the gains made.” During his intervention, he called on WHO to “strengthen its efforts to help small countries develop resilience through forging partnerships with training institutions, accreditation bodies, clinical training, and training of trainers to enable the number [of health personnel] trained in small countries to satisfy their needs.”
“Achieving health for all requires all hands on deck to solve this decades-old problem.”
Guyana – Completing a pandemic treaty
During her intervention, the representative from the delegation of Guyana, Shanti Singh, urged countries to adopt the amendments to the IHR 2005 and pledged the country’s support in providing the negotiators with extra time “to complete the job of getting a new pandemic treaty.”
Singh highlighted Guyana’s progress in various areas, including the expansion of its NCD program to include mental health and cancers, and its work towards the elimination of several neglected diseases before 2030.
“We have seen the impact of the investments we are making,” she said, such as “a decline in maternal and neonatal mortality and an increase in life expectancy.”
However, despite the demonstrable progress, “we remain vulnerable to the impact of climate change on our health systems, the resurgence of diseases such as dengue, the emerging AMR crisis, the migration of skilled healthcare workers, and the access to affordable pharmaceuticals, reagents and equipment.”
