The 59th Directing Council of the Pan American Health Organization [PAHO]) was convened virtually from 20-24 September and attended by health ministers and authorities from throughout the Americas. During the meeting, health ministers adopted 13 resolutions to strengthen health policies in the Americas and tackle urgent challenges, such as the erosion of routine immunization coverage and responding to the continuing COVID-19 pandemic.

The Directing Council, which meets annually during the intervening years between the Pan American Sanitary Conference, is responsible for setting PAHO’s policies and priorities for technical cooperation and to consider matters of public health significance.

“You once again emphasized the need to strengthen health systems to be more resilient and responsive to public health emergencies such as this COVID-19 pandemic,” PAHO Director Carissa F. Etienne told ministers at the closure of the meeting. “I was particularly heartened that you explicitly acknowledged the need for greater investment in health systems including the essential public health functions.”

Dr. Etienne acknowledged the many challenges that have impacted national pandemic responses, including “global supply chain failures, inequities in availability and distribution of essential supplies, limited or no regional production capacity, inadequate regulatory and support systems,” all of which together deepened regional vulnerability.

She appealed for support to strengthen a policy of self-sufficiency in the region, “which would enable increased national and regional production and increased access to vaccines, essential medicines, and health technology.”

Dr Etienne also called for urgent efforts to boost immunization, saying this week “we lamented the general decline in vaccination coverage in the Americas with increasing levels of vaccine hesitancy, all of which have been exacerbated by the COVID-19 pandemic.” She urged “genuine attention to expanding coverage, improving vaccine outreach programs, investing in the first level of care, and addressing the issue of vaccine hesitancy.”

She welcomed commitments made by major stakeholders at the US-led Global COVID-19 Summit this week, to meet the goal of vaccinating at least 70% of all people in every country by the end of 2022.

The Council also discussed global health issues, particularly the World Health Organization’s (WHO) preparedness for future health emergencies, including legal and financial aspects. Dr. Etienne stressed that much can be learned from PAHO’s decades of experience in responding to and managing emergencies.

“I am very confident that together, unified in the spirit of Pan American solidarity, we will vanquish this SARS-CoV-2 and be much better prepared in real terms for the next, having taken on board and to heart the lessons learned in this chapter of public health,” Dr. Etienne said, “Our people as well as history will demand that we learn from this experience.”

The 13 resolutions of the 59th Directing Council include:

• Increasing Production Capacity for Essential Medicines and Health Technologies: It focuses on regional production to increase access to essential medicines and other health technologies. Specifically, the resolution calls for creating government mechanisms that strengthen national capacity in research, development, innovation, and production.

• Reinvigorating Immunization as a Public Good for Universal Health: It calls for reinvigorating immunization programs through diverse lines of action, among them, strengthening governance, leadership, and financing of vaccination programs; bolstering integration of immunization programs into primary health care systems; and developing communication strategies to build trust in vaccines.

• Strategy for Building Resilient Health Systems and Post COVID-19 Pandemic Recovery to Sustain and Protect Public Health Gains: The resolution aims to repair structural deficiencies in health systems exposed by the pandemic and build resilient health systems that expand coverage, address social determinants of health, and are prepared to cope with health emergencies. Specific actions include increasing public health financing and transforming health systems, based on a primary health care approach, to accelerate pandemic recovery, recuperate and sustain public health gains, and progress toward universal health.

• One Health: A Comprehensive Approach for Addressing Health Threats at the Human-Animal-Environment Interface: It calls for fostering collaboration to prevent and prepare for health challenges at the human-animal-environment interface. Specific actions include promoting strategic planning, emergency preparedness and response, integrated disease and health surveillance and reporting, and laboratory testing and networks.

• Roadmap for the Digital Transformation of the Health Sector in the Region of the Americas: It calls for developing human capital and infrastructure that allow digital technologies to be used inclusively, ethically, and securely in public health. The resolution includes actions aligned with UN goals such as universal connectivity in health by 2030 and inclusive digital health that emphasizes the most vulnerable populations.