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Pan American Health Organization. Pan American Sanitary Bureau Regional Office for the Americas for the World Health Organization. Partnerships for Advancing Health in the Americas Collaboration between CDC and PAHO. David Brandling-Bennett Pan American Health Organization.
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Pan American Health Organization Pan American Sanitary BureauRegional Office for the Americas for theWorld Health Organization
Partnerships for Advancing Health in the AmericasCollaboration between CDC and PAHO David Brandling-Bennett Pan American Health Organization
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
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
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
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
Poliomyelitis Measles Influenza HIV/AIDS STIs Tuberculosis Dengue Hemorrhagic fevers Foodborne diseases Malaria Chagas disease Lymphatic filariasis Onchocerciasis Cysticercosis Rabies Plague Equine encephalitis Hepatitis Some Areas of Collaboration in Infectious Diseases
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
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 Some Other Collaborations
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
Polio Eradication Progress, 1988-2001* 350,000 cases Polio-infected countries (map as of 27 June 2001) 253 cases* * EPI data as of August 2001
Source: PAHO/WHO * Data as of 18 August 2001 - 384 confirmed cases # Coverage data for children <1 year of age Vaccination coverage and reported number of measles cases Region of the Americas, 1980-2001*# Catch-up campaigns Follow-up campaigns Confirmed cases (thousands) Routine infant vaccination coverage (%)
Canada Laboratories testing via EIA IgM Serology PAHO Measles Laboratory Network CDC, Atlanta IPK, Cuba LHU, Haiti INDRE, Mexico LNSP, Dominican Republic CAREC, Trinidad LNR, Guatemala CCG, Panama INH, Venezuela LCMSP, El Salvador CNDR, Nicaragua LR, Costa Rica INS, Colombia INH, Ecuador INS, Peru LCSP, Paraguay Cenetrop, Bolivia FIOCRUZ, Brazil Inst. Adolfo Lutz, Brazil LCM, Uruguay ISP, Chile LDI, Argentina
Salmonella Drug Resistance by Site (1998/1999) Lima (N=23) Callao (N=33) Sta Cruz (N=12) NARMS 98 (N=1466) % Resistant 30 25 20 15 10 5 0 Chloramphenicol Ciprofloxacin Kanamycin Sulfa/Trim Cephalothin Gentamicin Nalid. Acid Tetracycline
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
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
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.