Ministers and senior representatives from the Americas call for more equity and solidarity to better address future pandemics – PAHO/WHO

Geneva, May 23, 2023 (PAHO/WHO) – Ministers of Health and high-level delegates from the Americas addressed the World Health Assembly this week in Geneva, Switzerland, where they reviewed the topic of health in the aftermath of the COVID-19 emergency, highlighting lessons learned and considering actions for better preparedness against future health emergencies, including their position on the future pandemic instrument being discussed at the Assembly this year.  

Below some highlights of their interventions:

Argentina: Opportunities are generated in the deepest crises

After congratulating the WHO for its anniversary and thanking its teams for helping countries confront HIV/AIDS-19, the Minister of Health of Argentina, Carla Vizzotti, considered that the pandemic “made visible the challenges faced to achieve equitable access to critical inputs such as vaccines.”

Ministra de Salud de Argentina, Carla Vizzotti

“If the pandemic left us with anything, it is the lesson that opportunities are generated from the deepest crises,” she stressed, adding that regional capacities to produce critical inputs were strengthened, including Argentina’s, which was selected by WHO as one of the centers for the production of mRNA vaccines.

Minister Vizzotti acknowledged the work done to strengthen surveillance and genomic sequencing and said that Argentina was invited to join the leadership committee for the international pathogen surveillance network launched on Saturday during the Assembly.

“We have the opportunity and the unavoidable responsibility to sustain health as the central axis in the political agenda – this requires even more multilateral and regional integration, more cooperation, more development, but above all, more solidarity and more empathy,” she stressed.

The Minister of Health also shared the country’s progress in regulatory frameworks for non-communicable diseases, including a bill sent to Congress to ratify the WHO Framework Convention on Tobacco Control and efforts to control tuberculosis and antimicrobial resistance.

Brazil: National health systems better prepared for emergencies to come

Brazil’s Minister of Health, Nísia Trindade, stressed the need to have “national health systems that are better prepared for the emergencies to come.”

Dr. Trindade urged countries to learn from the lessons of the pandemic that “left six million dead in the world, 700 thousand of which were in Brazil, with a great impact on the health system, mental health, the economy and the social fabric in general.”

“Brazil is back: we are resuming our agenda in defense of equality in health, a culture of peace and multilateralism,” she stressed before the World Health Assembly in Geneva.

The Brazilian Health Minister considered that the world needs to “strengthen surveillance and health systems in general”, as well as “redouble efforts in innovation, technology transfer and financing” to advance towards more equitable health systems.

“We must decentralize the production of medicines, vaccines and other strategic inputs to ensure equitable access to everyone,” she said, and called for work to “reduce inequities, including inequality in access to the benefits of scientific and technological knowledge.”

For Minister Trindade, a strengthened multilateralism will be important. “We will not achieve these objectives without a reform of the global health architecture.” However, she considered that for the new instrument on pandemics to be successful, “we must create a stronger health diplomacy, based on the principles of equality and solidarity”.

Peru: Countries still facing the devastating consequences of the pandemic

Ambassador Luis Chuquihuara, Permanent Representative of Peru to the United Nations in Geneva, said that, although COVID-19 ceased to be considered a public health emergency of international concern a few days ago, “countries are still facing the devastating consequences of the pandemic on their health systems.”

“Other diseases such as dengue fever and natural phenomena such as the coastal El Niño, which recently affected the north of Peru, continue to test and affect numerous health facilities in our country,” he said.

Chuquihuara considered essential to strengthen the international health architecture, particularly to prevent future pandemics. “Peru is convinced that the new international treaty – to face future pandemics – should have as its main pillar the principle of equity, which will guarantee universal access to medical tools such as vaccines without discrimination or privileges,” he stressed.

The Peruvian Ambassador also said that his country has submitted to the 76th World Health Assembly, together with a group of countries, a draft resolution on the impact of chemicals, pollution and waste on human health. He noted that pollution is considered by the United Nations one of the three planetary crises affecting humanity, disproportionately impacting developing countries and countries vulnerable to natural disasters.

“Peru will continue to support the strengthening of multilateralism and the WHO and will constructively support efforts to strengthen global, regional and national capacities for preparedness and response to health emergencies and future pandemics,” Chuquihuara said.

Chile: Increasing solidarity and multilateral cooperation is essential

Chile’s Minister of Health, Ximena Aguilera, stated that the COVID-19 pandemic “reshaped the global health landscape and showed the interdependence between health security and economic security”.”

Minister of Health of Chile, Ximena Aguilera

According to Aguilera, “the crisis also exposed the enormous inequities that exist between States, as well as within countries, which were reflected, for example, in the unequal availability and distribution of vaccines during the emergency.”  

“It is therefore essential to increase solidarity and multilateral cooperation, and Chile is committed to this, as well as to improve preparedness, prevention and response capacities for health emergencies both globally and regionally and in each one of our countries with the WHO at the center of this process,” she stressed.

Minister Aguilera pointed out that Chile has set three priorities to address the direct consequences of the pandemic, as well as to tackle structural problems related to the lack of equity and justice in access to health: to recover the capacity of health services and reduce waiting times; to address the mental health of the population that “is severely affected”; and “to advance in guaranteeing the right to health by building a fair and dignified health system.”

“Chile is moving towards universal health coverage based on primary health care (PHC) with universal and free access,” she said. “At the end of the Government’s mandate, the aim is for PHC to be of universal in half of the country’s municipalities. In addition, all public hospitals have been made free of charge for their users, who represent 80% of the population, reducing out-of-pocket expenses,” she added.

El Salvador: When there is a vision and political commitment at the highest level, the most complex challenges are overcome

After highlighting “the optimism of overcoming the COVID-19 pandemic”, the Vice Minister of Health Management and Development of El Salvador, Dr. Carlos Alvarenga, affirmed “the importance of having a global vision on health as an imperative of the international development agenda and as a common good for humanity.”

Dr. Alvarenga thanked WHO for the support provided to El Salvador during the pandemic. “We are the best example that, when there is a vision and political commitment at the highest level, the most complex challenge can be overcome,” he said.

According to the Salvadoran Deputy Minister of Health, the pandemic has taught them “the importance of strengthening the health system through the development of comprehensive health networks, the modernization of infrastructure and equipment, the strengthening of supply chains and equipment, epidemiological intelligence, the use of new technologies, the development of human resource competencies, and digital transformation as a springboard to improve the quality of health services.”

“Our goal is to continue transforming the healthcare system to achieve sustainable wellness that guarantees a better future for the next generations,” he said. “Let us continue to work together to guarantee the right and access to health for all humanity,” Dr. Alvarenga pleaded before the 76th World Health Assembly.

Canada: Addressing the pandemics of mental health, substance use and gender-based violence

Canada’s Minister for Mental Health and Addictions, Carolyn Bennett, said that the lessons from COVID-19 “reaffirm the need to work with international partners to reduce barriers to health and care, but also to address the parallel pandemics of mental health, substance use and gender-based violence.”

On the 75th anniversary of the birth of the World Health Organization, Bennett considered that we need the organization’s leadership today more than ever, and recalled the words of the WHO’s first Director-General, Canadian psychiatrist Brock Chisholm, who said that “without mental health, there can be no real physical health.”

The Canadian Minister for Mental Health and Addictions highlighted the improvement in the collection of information during the pandemic, something made possible to know the status of vaccinated, hospitalized and deceased people in real time. “Now we need to build on that improved information to achieve better community health indicators and have real-time data to address the continuing inequities in access to health,” she said.

“We need to listen to science, to communities and to those with lived experience,” she added. “The very difficult last few years have highlighted how important today’s lessons learned will be in enabling us to succeed in preventing, preparing for and responding to a future crisis.” Bennett added that Canada is supporting efforts to update the International Health Regulations (IHR) and to develop an international pandemic instrument, as it is “crucial to develop a global health community where everyone is included and participates in a meaningful way.”

Ecuador: Working for health is a collective responsibility

The Minister of Health of Ecuador, José Ruales, considered that WHO “is essential to have a positive impact on health governance,” as well as to prepare Member States to “better respond to possible disasters or pandemics and to face other health challenges”.

“Working for health is not the individual responsibility of a country, but a collective one that must convey various actors at the local, regional and global levels, which is why we promote South-South and North-South cooperation, multilateralism and regional integration, especially in the Americas and in the Andean Area,” he said.

Dr. Ruales called for countries to “continue to work collaboratively and in solidarity at a global level for health.” He highlighted that “the road traveled over the last 75 years with WHO and 120 years with PAHO has been worthwhile” and that the “advances have been important, but there is still a long way to go to achieve health for all.”

The Ecuadorian Minister of Health also highlighted the 10-year health plan promoted by his country. He pointed out that the government defends equality in health, which is why Ecuador is working on strategies to tackle chronic child malnutrition and gender violence.

He also said that Ecuador is working to “improve the living conditions for the population to keep people healthy,” and promoting disease prevention.

Dr. Ruales noted that the country is working to improve timely and quality care, and highlighted that, in this regard, they are promoting digital transformation, intercultural health and community mental health.

Guatemala: Multilateralism has allowed us to achieve significant advances in health care

Guatemala’s Vice-Minister of Primary Health Care, Dr. Edwin Montúfar, highlighted that the world has moved into a post-pandemic phase for COVID-19, an emergency that “introduced new challenges to public health at a global level.”

On the 75th anniversary of WHO, Dr. Montúfar considered that “multilateralism has allowed us to achieve significant progress in terms of health, however, we continue to face health crises compounded by armed conflicts around the world.”

During his speech, the Guatemalan Vice-Minister listed some of the advances in health in his country, including the deployment of comprehensive health care and nutrition brigades to combat malnutrition.

“Due to Guatemala’s intercultural nature, we face the challenge of providing culturally relevant health care. To this end, we are working hand in hand with more than 19,800 midwives to respond to the needs of indigenous peoples,” he said.

He also pointed out that his country has begun to offer care for non-communicable diseases at the rural level, and that, through the National Digital Health Strategy, Guatemala has brought telemedicine to some local communities. “Care for preventable diseases is a priority,” Dr. Montúfar said.

United States: Let us commit to reaching agreement on future pandemic instrument

U.S. Secretary of Health and Human Services Xavier Becerra called on delegates participating in the 76th World Health Assembly in Geneva to commit to “reaching agreement on both the pandemic instrument and amendments to the International Health Regulations (IHR) in the coming year.”

Xavier Becerra

“Let us seize this moment and regain momentum to achieve our global health goals, embrace mutual aid and work collectively for peace, health and equity for all,” he pleaded.

On the 75th anniversary of WHO, Becerra considered that the Organization “represents our shared values and remains vitally important in the global struggle for health and well-being”. He remarked that “President Biden and the United States are fully committed to the WHO.”

The U.S. Secretary of Health and Human Services said that the world faces “common health problems that require shared solutions.”. Among these, he cited maternal mortality, cancer, infectious diseases, behavioral health, substance use disorders – especially synthetic drugs – and climate change.

“The next pandemic is never far away,” he warned. “We have joined forces in the past to achieve bold goals and address threats, and we have succeeded. We can do it again,” he said.

Cuba: More than ever, humanity needs resilient health systems

Cuba’s Minister of Public Health, José Ángel Portal Miranda, said that the world should look at the WHO’s anniversary “as an opportune moment to analyze challenges and perspectives in order to continue to improve health for all.”  

José Ángel Portal Miranda

“What we have experienced in recent years shows that, more than ever, humanity needs resilient health systems that guarantee the right to health for all, and the fulfillment of the Sustainable Development Goal (SDG) related to health,” he said.

Portal Miranda considered it important to carry out “special monitoring” on the effects of climate change “to address and minimize the risks of social determinants that may have an impact on the emergence of new health emergencies.”

“Public health in Cuba is a right of all people, and it is the responsibility of the State to guarantee access, free of charge, to quality care, protection and recovery service,” said the Cuban Minister of Health. “On these bases we found strengths to successfully face COVID 19.”

Portal Miranda detailed that the health management of the pandemic in Cuba “was based on the access to innovative medicines, the result of which was the development of the Cuban biopharmaceutical industry.” The country carried out “an unprecedented national vaccination campaign that made it possible to immunize more than 98% of the vaccine-eligible population over 2 years of age,” he said.

“Strengthening and improving our health systems are challenges that we are obliged to work on in order to achieve real access to health services for people,” he said.

Dominican Republic: Time to design new initiatives to address future pandemics and emergencies

The Vice Minister of Collective Health of the Dominican Republic, Dr. Eladio Pérez, considered that the end of the COVID-19 emergency was “a milestone in global health,” but stressed that “the pandemic is not yet over and it is time to design new initiatives to face other pandemics and future health emergencies.”

Dr. Perez indicated that his country “is fully committed to adopting a strategic and institutional vision to ensure that policies respond to the needs of our population”, and that they have developed the Ruta de la Salud strategy, which has a comprehensive approach to promote healthy lifestyles.

Among the achievements in health in the Dominican Republic, the Vice-Minister highlighted: “we have achieved that 98% of the population has social security, free access to innovative treatments against COVID-19, a 100% increase in the amount of coverage for catastrophic diseases, a 189% increase in the number of high-cost patients and a budget increase of more than 150% in our program.”

Dr. Perez also pointed out that they have strengthened epidemiological surveillance for the “efficient control of epidemics such as cholera and smallpox, with the support of PAHO.” They also allocated a special budget for a new school health program and are developing a mental health initiative that offers free telephone assistance.

The Vice Minister underlined his country’s commitment “to continue to work with the support of PAHO and other actors to advance towards the goal of health for all.”

Colombia: Ensuring the right to health with more equity

Colombia’s Vice Minister of Public Health and Service Delivery, Jaime Urrego, stressed the importance of ensuring affordable health services. “Because they deal with the fundamental right to life, health systems must be universal, public and free, so that access does not depend on people’s ability to pay.”

Viceministro de Salud Pública y Prestación de Servicios de Colombia, Jaime Urrego

Urrego also pointed out the need to support countries in facing climate change. “Climate change cannot be seen as a one-off issue, what we are witnessing is a real emergency. WHO and public health must be at the center of discussions to advance urgent adaptation and mitigation actions framed in climate justice.”

The Deputy Minister also called for equity in health technologies to address new pandemics or emergencies. “Let us understand that intellectual property rights and the logic of pharmaceutical industries cannot be above the right to health. The real preparation for new health emergencies involves adjusting the rules of the game, so that not only the interests of the few are served. It cannot happen again that a pandemic ends and the concentration of resources in a few territories implies the denial of access to millions of people”, he considered.

Mexico: Working together to improve emergency preparedness 

Ambassador Francisca Elizabeth Mendez Escobar, Permanent Representative of Mexico to the United Nations in Geneva said, “Together, we have contributed to life-year increases, the reduction of child mortality and the eradication of smallpox. Together we have also worked to control neglected tropical diseases, limit tobacco use, and overcome the H1N1 and COVID-19 pandemics, among many other things. These advances are an example that solidarity and international cooperation are indispensable components in addressing the health challenges of our time.”

Embajadora Francisca Elizabeth Mendez Escobar

The Mexican Ambassador stressed that, despite the achievements in WHO’s 75 years, much remains to be done. “This anniversary coincides with a period of change and reflection. The COVID-19 pandemic revealed the fragility of our health systems, but also the limits of international coordination and of our multilateral institutions, including WHO. The lessons learned open up an opportunity to reformulate global health policy and strengthen this organization,” she said.

For that, she added, “it is necessary for Member States to make new commitments to global public health and multilateralism, commitments that in our opinion must follow a social approach to promote global public goods, overcome all types of exclusion, promote harmony with the environment, and strengthen the foundations in favor of access and solidarity.”

Paraguay: Addressing inequalities and current emergencies

Ambassador Marcelo Scappini Ricciardi, Permanent Representative of Paraguay to the United Nations in Geneva, highlighted the health reforms in his country. “The reform of the national health system is our priority. The guide for the implementation of healthy environments and the general human resources policy are tools to improve health conditions for various population groups and territorial spaces,” he said.

Hon. Marcelo Scappini Ricciardi

Scappini Ricciardi also recalled the current health threat Paraguay is facing, such as the Chikungunya epidemic. “We talk in the future tense, thinking about the future pandemic and forget that many of the emergencies that put health systems at risk still give us no respite. In my country, where dengue has been historically endemic, we are going through a complex epidemiological scenario. We are experiencing the worst Chikungunya epidemic in our history, one of the largest in South America”, he stressed.

The Paraguayan ambassador highlighted the need to promote equity to face health emergencies. “Let’s not wait for a new pandemic to work in a spirit of solidarity to face health emergencies that destroy health systems. Trust in multilateralism will be restored with concrete actions to strengthen preparedness and response to public health threats and emergencies,” he said.

“Paraguay will continue to participate in the negotiations of the future instrument on pandemics and the strengthening of the IHR, both of which should embody the special needs of countries with different levels of development and ensure equitable, effective and timely circulation and access to supplies for countermeasures, medical products, goods, services and technologies,” he said.

Costa Rica: Science, cooperation to address health challenges

Shara Duncan Villalobos, Alternate Permanent Representative of Costa Rica to the United Nations in Geneva, underscored the role of science and cooperation in addressing health challenges.

“My country agrees that only through science, research and cooperation at all levels will we be able to address the threats to human health that arise in the context of health, such as new diseases or socioeconomic, political or legal barriers that prevent access to quality health services,” she said.

Duncan Villalobos also highlighted the inequity in progress towards universal health in the world: “despite scientific progress, we have yet to make progress to ensure equitable access for all States and all people to therapeutic and health products, including medicines and vaccines.”

“Costa Rica reiterates the importance of strengthening primary care, health surveillance, health infrastructure and the full enjoyment of well-being in society as key aspects to achieve the highest standards of health in all its dimensions.”

The Costa Rican representative also stressed her country’s support for multilateralism. “We reiterate our unconditional support to the valuable work and guidance provided by WHO, and our regional organization PAHO, and we look forward to continuing to contribute to the achievement of health for all, without exception.”

Nicaragua: Attention to the Sustainable Development Goals (SDGs)

The delegate of Nicaragua recalled his country’s health efforts, challenges and achievements in recent decades, also during the COVID-19 pandemic. He underscored the need for cooperation and for more attention to the Sustainable Development Goals, especially health.

“We emphasize that, as the preamble of the constitution of this organization states, the health of peoples is a fundamental condition for achieving peace and security and depends on the broadest cooperation of people and States,” he said. He added that “to this end, it is vital to continue working together with common objectives and without measures that hinder progress or politicize the heart of this international organization.”

Haiti: Equitable access to medicines at fair prices to promote international health security

Justin Viard, Permanent Representative of Haiti to the United Nations in Geneva, highlighted gains in health since the inception of WHO, along with challenges.

Justin Viard, Representante Permanente de Haití ante las Naciones Unidas en Ginebra

“Universal health coverage has been the goal all those years, and different resolutions have tried to get us closer to that goal. Undoubtedly, significant progress has been made in improving health systems, fighting against diseases and their determinants. Nonetheless, poverty and inequality persist. COVID-19 highlighted the structural challenges facing health systems around the world,” he said.

The Haitian Representative also reflected on the lessons from COVID-19, and called for more equitable access to face future emergencies:

“The COVID-19 pandemic surprised us and revealed the limits of our global health architecture. It also reminded us that we are members of the same human family. We all live on the same planet. We share air, earth, oceans […] We all admit that no one is protected, no one is healthy, unless we are all protected, unless we are all healthy.

Countries like Haiti need universal and equitable access to vaccines, medicines and products at reasonable prices and that are safe and efficient. These are vital conditions for international health security and to protect future generations. We are committed to strengthening primary health care as part of a global effort.”

Barbados: Focus on recovering losses, tackling current challenges such as noncommunicable diseases

Dr J.X. Walcott, Minister of Health of Barbados, took stock of health gains and challenges facing the world post-pandemic.

Dr. Jerome Walcott

“As we look forward to the post-COVID period in my country, we recognize that we have receded in some of the progress made towards achieving the SDGs. This is particularly so in the areas of immunization against vaccine-preventable diseases and on the management of NCDs. In addition, challenges like new and emerging infectious diseases, climate change and health, anti-microbial resistance and building resilient health systems now have to be vigorously addressed.”

He called for “a rethink of WHO’S strategic direction within the context of universal health care that promotes empowerment of our citizens and communities to achieve better health outcomes.”

In addition, Dr Walcott highlighted plans to tackle current health challenges, and the upcoming high-level meeting to discuss health in the context of Small Island Developing States (SIDS). “Barbados, at this time, we are especially interested in the health of our children, particularly as it relates to the prevention and control of childhood obesity and the early detection and management of persons at risk from and living with NCDs, and problems of mental health. Barbados is also very pleased to host the high-level meeting for SIDS on NCDs and mental health. We look forward to a strong outcome document that would enhance the health of persons in small island developing states.”

The Minister of Health of Barbados further thanked PAHO for its support towards improving emergency preparedness. “We are pleased to receive technical expertise and support in the development of our health national adaptation plan. We appreciate the support being received by the Pan American Health Organization and the Caribbean Public Health Agency in our efforts for future pandemic readiness through access to the global pandemic fund.”

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