PAN AMERICAN HEALTH ORGANIZATION

The origin of the Pan American Health Organization (PAHO) dates back to 1902 when the First International Sanitary Convention of the American Republics, meeting in Washington, DC, established the International Sanitary Bureau. The bureau was to provide a mechanism for sharing information about the occurrence of diseases and agreeing on control measures that could be applied. The fundamental purposes of PAHO, stated in its constitution, are to promote and coordinate efforts of the countries of the western hemisphere to combat diseases, lengthen life, and promote the physical and mental health of the people.

In 1924, delegates to the Seventh Pan American Sanitary Conference agreed on the first international sanitary treaty for the American States, called the Pan American Sanitary Code. The code, which is still in effect today, establishes the functions and duties of the Pan American Sanitary Bureau, which is the secretariat of the organization. One of the objectives of the code, as the first article says, is stimulation of the mutual interchange of information that may be of value in improving the public health and combating the diseases of humankind. In 1949, PAHO became, by formal agreement with the World Health Organization, its Regional Office for the Americas. A year later, a formal agreement was signed with the Organization of American States recognizing PAHO as the specialized health organization for the Inter-American System, formalizing the status that the organization had held for nearly fifty years.

All states and territories in the Americas are members of PAHO and pay a quota contribution to the organization according to a budget approved by the member states. PAHO has an office in every country, with the exception of the smaller island states of the eastern Caribbean, which are served by the Caribbean Program Coordination Office located in Barbados. PAHO's technical interests in Canada are represented by the Canadian Society for International Health. PAHO's programs are carried out through technical cooperation, which helps build the capacity of member states to address health issues that they identify as priorities. Though PAHO is not primarily a funding agency, it does mobilize external funds that supplement the regular budget to support specific projects throughout the region.

The organization operates under two basic principles: Pan-Americanism and equity. Pan-Americanism facilitates the cooperation of countries to share information and experiences and to address common goals, as envisioned in the Pan American Sanitary Code and PAHO's constitution. For example, the member states worked together to eradicate smallpox in 1971 and poliomyelitis in 1991, and measles was targeted for eradication from the region by the end of the year 2000.

The second principle, equity, is driven by the fact that the enormous economic disparities in the Americas adversely affect the health of many of its people. The level of health status extends from that found in Canada, which has many of the best health indicators, to that found in Haiti, the least developed country in the region. Even within countries one finds enormous differences. For example, in southern parts of Brazil, health indicators may be as good as those in industrialized nations, while people living in northeastern Brazil may suffer diseases at the same rate as communities in the poorest parts of Africa. Large disparities are present in all countries of the region. They result in part from the lack of access to health services of appropriate quality, including services for health promotion and disease prevention. Disparities are not simply unjust in themselves, they impede development, including economic development. Because it is critical that countries address inequities in health and health services if they are to improve the health status of their people and their prospects for development, PAHO puts considerable emphasis on understanding, documenting, and overcoming inequities.

PAHO's work on inequities focuses on five areas: health in human development, health promotion and protection, health systems and services development, disease prevention and control, and health and environment. Each of these areas, which is addressed by a division, consists of several specific programs. All country offices and regional programs plan and evaluate their activities annually, so as to ensure the optimal use of limited resources and maximum benefit to health in the Americas.

George A. O. Alleyne

A. David Brandling-Bennett

(see also: International Development of Public Health; International Health; United States Agency for International Development [USAID]; World Health Organization )

Bibliography

Gwatkin, D., and Gullet, M. (1999). The Burden of Disease Among the Poor: Current Situation, Future Trends, and Implications for Strategy. Washington, DC: The World Bank.

Pan American Health Organization (1998). Health in the Americas. Washington, DC: Author.

—— (1998). Leading Pan American Health. Washington, DC: Author.