Health and Education

Serious health problems still greatly affect the Western Hemisphere. Issues such as the high infant-mortality rate in Latin American and the Caribbean, the effect of communicable diseases on morbidity and mortality, and other problems caused by new and resurgent infectious diseases, environmental hazards and an increase in violence must all be considered in the future as real threats to the region's long-term and overall health. Moreover, much is lacking in the areas of education and social awareness. These problems must also be addressed if the region's commitment to sustainable development is to be reinforced in the area of health. The Bolivian Summit, in addressing these issues, took into account the topics below, which are related to health and education:

Environmental Health

Among others, the following actions have been taken to improve access to safe drinking water:

  • A regional meeting took place in Peru, 1996, on drinking water quality. The Pan-American Health Organization (PAHO) also formulated baseline data on access to water disinfection levels and water quality and incorporated it into its mid-decade evaluation.
  • Several Latin American countries have elaborated projects on cholera prevention which promote social mobilization within communities and the development of basic technologies and small enterprises to improve water sanitation. Along with this, indigenous populations have worked towards the improvement of basic sanitation in an effort to address water supply problems.
  • A working group, consisting of PAHO, the United Nation's Children Fund (UNICEF), the World Bank, the U.S. Agency for International Development (USAID), the Canadian International Development Agency (CIDA), the OAS, the IDB, the National Sanitation Foundation and the U.S. Environmental Protection Agency (USEPA), was formed by the Inter-American Task Force for Bolivia Summit Follow-Up to address coordination of technical cooperation for improving access to and the quality of potable water.

In order to reduce the effects of environmental problems on children's health, the following efforts are underway:

  • Countries in the region and PAHO have worked together to strengthen the framework of the "Care of the Sick Child Strategy," which supports the integral development and growth of the child.
  • Several countries are in the process of revising their laws on infants' and children's rights, access to and coverage of health and nutrition services and educational opportunities.
  • Several regional meetings have taken place which serve as fora for the exchange of information and experience on health promotion strategies.
  • Countries in the region have also undertaken mass-media campaigns for health promotion and protection and education on the abuse of alcohol, drugs and tobacco.

Governments are working to improve health coverage and the quality of health services available. In doing this, they are focusing on preventive and educational issues and offering access to family planning information and services.

  • Several countries are formulating a basic health care package to be guaranteed to all citizens. Venezuela has focused on providing medications to outpatients, paying special attention to vulnerable groups such as pregnant women, children and the elderly. Nicaragua has developed a basic services package to vulnerable groups that emphasizes preventive health to reduce infant mortality.
  • Non-governmental organizations (NGOs) and women's groups have been active in implementing national health policies with a particular emphasis on reproductive health services and pre- and post-natal care.
  • PAHO has supported countries that are working to build their capacity to analyze and formulate health policy plans and to strengthen cooperation between them. PAHO has also distributed a document that establishes parameters for health sector reform; its emphasis lies in universal coverage with equity.

Emerging and Infectious/Contagious Diseases

The following steps have been taken in addressing these issues:

  • In Latin America and the Caribbean, a survey was done on countries' capacity for surveillance of emerging and re-emerging infectious diseases. The results will be used as the base for setting technical cooperation priorities.
  • Countries continue to review their national and health sector plans in the areas of response to disease outbreaks and disaster planning, preparedness and mitigation.
  • The United Nations Development Program (UNDP), the Caribbean Disaster Emergency Response Agency, the International Federation of Red Cross and Red Crescent Societies and PAHO have collaborated to help strengthen response mechanisms in the Caribbean. The Safety System of the Caribbean and CARICOM work together in training programs for health administration in the event of disaster as well.
  • The United Nations Commission on Latin America and the Caribbean (ECLAC) and the International Decade for Natural Disaster Reduction jointly prepared a series of technical training modules directed to professionals in structural engineering and the design of hospitals.
  • PAHO prepared a guide on the vulnerability of water systems when exposed to disasters. Technical documents have also been prepared as a result of case studies on the damage caused by earthquakes in the urban water-supply systems in Costa Rica and Ecuador, by the volcanic eruption in Montserrat, and by landslides and floods in Brazil and other countries.

Education for Sustainable Development

Educational and communications policy changes reflect the different needs and realities of the hemisphere regarding instruction in sustainable development. The following activities mark progress made in this effort:

  • Countries have developed multi-sectoral plans for health promotion efforts, and as a follow-up to international accords regarding this subject, different groups of civil society have been involved in these efforts.
  • Several countries' health sectors have initiated studies and training for the improvement of indigenous people's living conditions. In order to reach diverse communities, alternative models of communications and service delivery are being researched with the help of the media itself in order to effectively transmit information to target populations.
  • Training models are also being developed for quality of care, preparation of human resources, and adolescent health. These models are based on an initial assessment and knowledge of what target populations see as their needs.
  • In seeking sustainable development, countries have formed partnerships with NGOs and the private sector which have led to greater efficiency and increased accountability in their ministries of health. An example of this occurred in Nicaragua, where a National Committee for Environmental Education was founded in 1994, with the participation of the ministries of education and health, other government agencies and representatives of civil society. This institution analyzes, prepares, proposes and implements national policies in the areas of environmental protection and health.
  • USAID and PAHO are working in coordination to support a project, entitled "Equitable Access to Basic Health Services," which will foster regional or inter-country activities aimed at developing tools, providing support and to designing, implementing and monitoring reform processes.
  • The United Nations Educational, Scientific, and Cultural Organizations (UNESCO) and the OAS will assist in the training of teachers on the topic of sustainable development.


  • Countries have encountered difficulties in assessing their health sectors, especially with the need to clarify the functions of different actors involved in regulation, financing, and the provision of services.
  • Along with this, there is a general lack of medical and non-medical supplies, inadequate infrastructure, and insufficient and poorly kept equipment. Furthermore, access to services by underprivileged groups, such as indigenous and rural populations, is very limited in several countries.
  • Education is poorly funded in public schools serving low-income groups. A lack of awareness of the harm being done by polluting habits is widespread, and educational efforts to increase public knowledge of this issue are inadequate.
  [Bolivian Summit/tracker.htm]