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Pan American Health Organization Pan American Sanitary Bureau Regional Office for the Americas for the World Health Organization

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Pan American Health OrganizationPan American Sanitary Bureau

Regional Office for the Americas for the

World Health Organization

Pan American Health Organization 2001 2

Partnerships for Advancing Health in the Americas

Collaboration between CDC and PAHO

David Brandling-BennettPan American Health Organization

Pan American Health Organization 2001 3

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

Pan American Health Organization 2001 4

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

Pan American Health Organization 2001 5

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

Pan American Health Organization 2001 6

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

Pan American Health Organization 2001 7

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

Pan American Health Organization 2001 8

Some Areas of Collaboration in Infectious Diseases, cont’d

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

Pan American Health Organization 2001 9

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

Pan American Health Organization 2001 10

Some Other Collaborations, cont’d

• 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

Pan American Health Organization 2001 11

Polio-infected countries(map as of 27 June 2001) 253 cases*

350,000 cases

* EPI data as of August 2001

Polio Eradication Progress, 1988-2001*Polio Eradication Progress, 1988-2001*

Pan American Health Organization 2001 12

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

0

20

40

60

80

100

Cases Coverage

Source: PAHO/WHO* Data as of 18 August 2001 - 384 confirmed cases

# Coverage data for children <1 year of age

Catch-up campaigns

Follow-up campaigns

Ro

utin

e infan

t vaccinatio

n co

verage (%

)C

on

firm

ed c

ases

(th

ou

san

ds)

Vaccination coverage and reported number of measles cases Region of the Americas,

1980-2001*#

Pan American Health Organization 2001 13

PAHO Measles Laboratory

Network

PAHO Measles Laboratory

Network

CDC, Atlanta

CAREC, Trinidad

INH, VenezuelaCCG, Panama

LDI, Argentina

FIOCRUZ, Brazil

IPK, Cuba

Inst. Adolfo Lutz, Brazil

LCM, Uruguay

LHU, Haiti

LNSP, Dominican Republic

LR, Costa Rica

LCMSP, El Salvador

LNR, Guatemala

CNDR, Nicaragua

Laboratories testing via EIA IgM Serology

Canada

INDRE, Mexico

INS, Colombia

INS, Peru

INH, Ecuador

ISP, Chile

LCSP, ParaguayCenetrop, Bolivia

Pan American Health Organization 2001 14

Salmonella Drug Resistance by Site (1998/1999)

0

5

10

15

20

25

30

Lima (N=23) Callao (N=33) Sta Cruz (N=12) NARMS 98 (N=1466)

Chloramphenicol Ciprofloxacin

Gentamicin Nalid. Acid

Sulfa/Trim

TetracyclineCephalothin

Kanamycin

% Resistant

Pan American Health Organization 2001 15

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

Pan American Health Organization 2001 16

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

Pan American Health Organization 2001 17

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.