Seeing a hemisphere United by health.

The Pan American Health Organization (PAHO) holds the distinction of being the world's oldest ongoing international public health agency. This year, PAHO entered its second century, a milestone that coincides with my inauguration as its director, and I have the honour of being the first woman and the first Argentine to serve in that capacity.

On a personal note, I am humbled, but not daunted, by the challenges and opportunities facing the Organization. I draw strength from the past and the impressive successes we have witnessed, such as becoming the first region to overcome smallpox, polio and measles.

The work of the health sector in the countries of the Americas stands as an example for others. Will and determination translated words into actions when health workers from Canada to the tip of South America took to the streets, crossed mountains and went door to door to vaccinate every child against cruel, crippling and deadly diseases, following the pioneering efforts in the Caribbean.

Last year, we celebrated the 100th anniversary of PAHO. All countries in the Americas took part, once again highlighting the uniqueness and richness of the region's culture and the drive to stand behind a common cause. We share a historical bond and a common interest in seeking to better the lives of all, especially the most vulnerable, with special emphasis on children. We are doubly blessed with our ties to the inter-American system and the United Nations. Today we take pride in the past, but look to the future and envision a PAHO that will thrive in the twenty-first century, maintaining our advances while confronting new challenges.

My goal is to see a hemisphere united by health, committed to reducing the gaps in health outcomes, by working together, pooling resources, valuing mutual contributions and eagerly seeking to exchange information and share resources.

The region of the Americas is a very special one, because despite all the advances and successes, despite the increased life expectancy and the elimination of many diseases, tremendous inequities still exist.

Our focus must be on those who try to eke out a life in a context of extreme poverty, those who are excluded from health services, those who are the most marginalized, the most vulnerable. We must reduce those inequities. We must provide better access to health services, clean water, safe blood, healthy housing and safe food for all inhabitants.

The countries of the Americas face adverse economic conditions marked by aging populations, chaotic urban sprawl and environmental degradation. Some 76 per cent of the region's 850 million inhabitants live in urban areas. The globalization that links us for trade batters us when it comes to diseases and produces unequal benefits that exacerbale inequities. I place progress in containing the AIDS epidemic, with emphasis on the Caribbean, among my top goals, as well as improving health conditions in the poorest of the poor, such as Haiti.

PAHO aspires to be the health forum for the Americas and a consensus-builder and creator of partnerships, bringing together defenders of health, as well as an advocate for social equity, social protection and access to effective health services. The Organization will defend the linkages between primary health care, health promotion, citizenship and human rights, and will continue to be a generator of reliable health information.

Our public health objectives for the Americas are to: develop and strengthen a culture of life and health, and healthy settings that create optimal living conditions and greater opportunities; control risks and threats to public health; ensure quality and safety of goods and services; provide effective responses to needs; and understand the determinants and processes involved in generating public health. The strategic plan of PAHO focuses on special population groups, such as low-income populations, ethnic and racial groups, and women, children and the elderly, as well as key countries and priority technical areas, addressing cross-cutting critical issues. Priority areas include prevention, control and reduction of both communicable and chronic diseases, as well as promotion of healthy lifestyles and social environments, healthy growth and development, and safe physical environments.

Ensuring universal access to integrated and sustainable health systems for individual and public health is another priority, as are disaster management and effective health input into social, economic cultural and development policies. My strategic objectives for organizational change include increased efficiency, transparency and productivity.

At my inauguration on 31 January 2003, I committed myself to creating a new model of collective action to help people define their goals, meet their challenges and monitor their success. As an example of that, for the first time in memory we are staging a vaccination week this year for the whole of the Americas.

At an enthusiastic meeting with many Ministers of Health from the Americas, I called on them to set their own objectives for the vaccination week, seek out the most vulnerable and those who have been left behind, and evaluate their success by gauging how far they had come. We can and must work to build consensus and partnerships, strengthening hemispheric and global solidarity, while encouraging new actors to get involved to defend health.

I also want to focus the attention of the hemisphere on the Millennium Development Goals and the contribution of health to these goals, which will be attainable if we make them the basis for action and unity. The call for collective action echoes the one heard 25 years ago at Alma-Ata; that historic signing of an agreement to implement a primary health-care strategy and seek "Health for All" will be celebrated this year. It is now time to renew our commitment to health for all and to create a new model of joint action that invites and entices our friends, allies and partners to join in the pursuit of better health. We will celebrate all the nameless volunteer and community health workers who have worked so tirelessly and continue to work in public health. Everyone wins when the community is healthy, educated and capable of working and sharing resources. Whether we are talking about good public health infrastructure or disease surveillance, we are seeking to attain good health for all.

UN Agencies Strengthen Response to HIV/AIDS in the Americas

United Nations leaders in health and development, citing their deep concern over the "relentless growth" of HIV/AIDS in Latin America and the Caribbean, in June 2003 committed to join and expand efforts to curb the crisis.

"We call for immediate action from countries in the region and the international community to prevent the significant demographic and socio-impact of the growing epidemic, which will undermine the realization of major development goals", according to a statement from the Joint United Nations Programme on HIV/AIDS (UNAIDS) and its eight co-sponsors--United Nations Development Programme, United Nations Office on Drugs and Crime, United Nations Educational, Scientific and Cultural Organization, United Nations Children's Fund, United Nations Population Fund, International Labour Organization, World Health Organization (WHO), and the World Bank.

"Immediate action is required to scale up HIV prevention and support efforts among those at highest risk of HIV infection", said the statement issued after the 11 June meeting, sponsored by UNAIDS and the Pan American Health Organization (PAHO), the regional office for WHO. The discussions served as a follow up to the UN General Assembly special session on HIV/AIDS held in June 2001.

Almost 2 million people are living with HIV/AIDS in Latin America and the Caribbean, according to UNAIDS figures. The Caribbean, with about 500,000 people with HIV/AIDS, has the second highest HIV-prevalence rate after sub-Saharan Africa.

"We see this meeting as an opportunity to address some of the real challenges of this pandemic", said Dr. Mirta Roses Periago, Director of PAHO. "Together, we confront a situation that is simply unacceptable." The statement calls for increased policy dialogue on HIV/AIDS at the highest levels, coordinated United Nations effort to mobilize resources, enhanced cooperation, and stepped-up involvement of the private sector and those living with HIV/AIDS. Special emphasis will be given to the Dominican Republic, Guyana, Haiti and Honduras.

The UN agencies called on countries in the region to significantly strengthen their national responses to HIV/AIDS through "a comprehensive and multisectoral approach, so as to reduce the vulnerability of populations at risk and of young people, and empower them to become active partners in the effort against the epidemic", the statement said. Source: PAHO

Dr. Mirta Roses Periago has been Director of PAHO since 31 January 2003 and also serves as the Regional Director for the Americas of the World Health Organization. A physician and surgeon specializing in the epidemiology of infectious diseases, she joined PAHO in 1984, serving in various regional posts, and in 1995 was named Assistant Director. She also worked in Argentina's Ministry of Public Health in the areas of epidemiology, research and emergency preparedness.