The Americas have made significant progress toward eliminating a variety of diseases from malaria to HIV to neglected infectious and zoonotic diseases such as Chagas and trachoma in 30 nations by the year 2030, according to the new edition of the Pan American Health Organization (PAHO) flagship report, “Health in the Americas: Accelerating Disease Elimination.”
PAHO launched its Elimination Initiative in 2019, only to face a worldwide pandemic in 2020 which brought many health-related initiatives to a standstill by diverting attention and resources to COVID-19 prevention and treatment.
This latest edition of Health in the Americas examines why the Elimination Initiative is important at this moment in time, takes stock of progress toward its targets, and advances the discussion on what will accelerate actions necessary for achieving elimination targets.
“The Elimination Initiative is not just a possibility but also a call to action, promoting collaboration and innovation to transform health outcomes across the Region,” wrote PAHO Director Jarbas Barbosa da Silva Jr., in the report’s foreword. “Investing in disease elimination offers substantial benefits for both health and economic development in the Americas. … Countries are called to action to tackle critical communicable diseases by harnessing regional expertise, driving high-level advocacy, forging partnerships, and integrating elimination efforts into primary health care.”
The Johns Hopkins Center for Communication Programs was a collaborative partner that provided technical assistance in the development, information and content synthesis, writing, editing, design, and layout of the report. The CCP team was led by Sarah Harlan, Mariana Ortiz Barreto, Marcela Aguilar, Rebecca Pickard and Mark Beisser.
Harlan says PAHO brought in the CCP team to ensure that the report wasn’t too technical for the general public to read. They wanted readers to comprehend the many issues at play in a world where a long list of diseases cause death and lifelong health consequences, despite public health leaps in recent years.
The presence of more than 30 diseases and conditions in the Elimination Initiative varies across the region’s diverse countries and territories. While some diseases like sexually transmitted infections and viral hepatitis are found in all settings, others – like vector-borne, zoonotic, and neglected infectious diseases – affect specific areas and populations. Consequently, each country tailors its strategies based on the context of each disease.
PAHO is focusing on four lines of action to guide the Elimination Initiative: strengthening the integration of health systems and service delivery; strengthening health surveillance and information systems; addressing the environmental and social determinants of health and strengthening governance, stewardship, and finance.
Seven diseases have been eliminated regionally – Guinea worm disease and six vaccine-preventable diseases: smallpox, poliomyelitis, rubella, congenital rubella, measles, and neonatal tetanus. Some diseases, while not eliminated regionally, have been eliminated in certain countries.
For example, 19 countries in the region have eliminated malaria, and 11 Caribbean countries and territories have seen the elimination of mother-to-child transmission of syphilis and HIV.
But challenges remain before countries achieve elimination status. While unconfirmed, human rabies transmitted by dogs is close to being eliminated in 37 countries and territories. Meanwhile, health officials suspect nine countries and territories in the Caribbean have eliminated schistosomiasis. For some other diseases – cervical cancer, tuberculosis, hepatitis C, hepatitis B, HIV/AIDS, bacterial meningitis, and sexually transmitted infections – no countries in the region have achieved elimination targets.
While some diseases impact all three dozen member states of PAHO – which includes larger countries like the United States and Brazil and smaller ones such as Suriname and Trinidad and Tobago – and some get more attention, such as HIV and malaria, the Elimination Initiative sees the value that strengthening the overall health systems could bring for reducing all diseases in all countries.
“The Elimination Initiative presents a unique opportunity to foster collaboration among countries to overcome common challenges in their efforts to eliminate diseases and to share good practices, resources, and innovations,” de Silva says.
