The Inter-American Development Bank, the Pan American Health Organization and the World Bank signed today an agreement to develop a Shared Agenda for Health in the Americas to coordinate efforts to help Latin American and Caribbean countries improve health conditions and public health services.
The agreement, signed by IDB President Enrique V. Iglesias, PAHO Director Dr. George A.O. Alleyne, and World Bank Vice President David de Ferranti, creates a coordination group of the three organizations that will meet monthly to share critical information and identify opportunities to implement joint actions. Particular attention will be focused on improving the health conditions of the most vulnerable groups of the population and on fostering quality and equal access to health services.
This initiative will allow the three institutions to coordinate and complement each other’s activities in health in the region at all levels at which they work–regionally, subregionally, nationally, and locally–while continuing to pursue their ongoing independent activities. The document identifies three fundamental areas for collaboration:
- Support for the health sector reform process, including not only health services but also basic sanitation.
- Institutional strengthening of public health programs, on health promotion as well as disease prevention and control.
- Strengthening the leadership of health authorities in all developmental areas that affect health.
The strategic alliance will provide a platform "to seek to increase the value added from each organization’s work, and to give their joint and/or coordinated activities continuity, consistency and stability" in response to suggestions from the public and private sectors and civil society in the region.
The Shared Agenda for Health in the Americas underscores that health concerns not only improved individual and community well-being, but that it is also a key factor in supporting economic growth by increasing the capabilities of people and raising their productivity. A concern for better health of the citizenry and of excluded or marginalized groups is an important aspect of strengthening democratic institutions in the hemisphere. Thus a central focus of the collaboration will be to improve the health of the poorest 33 percent of the population in Latin America and the Caribbean that is surviving on incomes of less than US$2 a day. Unfortunately, income inequality is not only associated with poorer health status, but also with reduced access to services. The three organizations are concerned with providing assistance to help overcome problems related to differences in living conditions, knowledge of how to manage health problems, and access to essential services for health, potable water, and sanitation. Many of these differences are rooted in the extraordinary inequality of income the region.
There have been great successes on which to build, such as the example of eliminating immuno-preventable diseases like poliomyelitis. The region is now well on its way to achieving a similar success with measles, led by PAHO, which provides tremendous benefits to poor households. With health expenditures averaging 7.3% of GDP in the region, the three institutions and their member governments realize that much can be done to improve health outcomes by improving the efficiency of current spending, the efficacy of existing institutions and programs, and the distribution of the benefits of public spending.
Under the Shared Agenda, the Pan-American Health Organization, the World Bank and the Inter-American Development Bank will initially set up working groups in four areas: pharmaceuticals, public health and disease surveillance, the environment, and national health accounts.
- Pharmaceuticals: The focus in pharmaceuticals will be to improve the regulatory framework for pharmaceuticals, knowledge by consumers and retailers of the use of pharmaceuticals, and improving access by the poor to good quality essential drugs.
- Public Health and Disease Surveillance: The three institutions will collaborate to strengthen regional surveillance of communicable diseases, assist in developing capacity to monitor chronic diseases, and help to develop regional goal-setting for health outcomes.
- Environment: Recognizing the importance of water and sanitation in affecting differential health outcomes for the poor, the serious urban air pollution problems in the hemisphere, and opportunities for public action to prevent accidents and injuries, the three institutions will develop a joint program to address high-priority issues in these areas.
- National Health Accounts: National Health Accounts (NHAs) provide track spending on health services by individuals, governments, and businesses. They have become an essential tool for informed debates of health policy in Europe and North America over the past 20 years, but they exist in only a handful of countries in Latin America and the Caribbean. The three organizations, together with the United States Agency for International Development, have committed themselves to work to help all governments in the region to produce national health accounts within three years and to institutionalize the capacity to maintain the accounts.
The Shared Agenda represents a breakthrough in collaboration among multilateral organizations to take advantage of the unique capacities each brings to health policy and activities in the region. The setting up of a coordinating group and the choice of four specific areas for collaboration are designed to go beyond a simple declaration and to make a difference on the ground in how health systems in the hemisphere perform in achieving better health for all people in the region.