Organization of American States Summits of the Americas
Follow-up and Implementation: Mandates

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HEALTH: Accessible Health Services

  1. Promote and encourage the use of digital technologies in the health sector to improve, inter alia, patient accessibility, process efficiency, and service delivery, while accommodating those who do not have digital access. (Regional Agenda for Digital Transformation, IX Summit of the Americas, Los Angeles, 2022).

  1. Address, with solidarity and equity, the effects of the COVID-19 pandemic, in all its stages, through the aforementioned Action Plan, in accordance with national contexts, needs, and priorities with the aim of assessing and strengthening the capacity and resilience of health systems and health value chains at the national and regional levels, placing individuals at the core of health and resilience policies, the integration of the delivery of health services, including physical and mental health services, accounting for the amplified impact on and unique needs of members of groups that have been historically marginalized, discriminated against, and/or in vulnerable situations, as well as all women and girls, taking into account their diverse conditions and situations, in a manner consistent with national legislation and international law, promoting the implementation of universal health coverage for all, without discrimination, to further the wellbeing of current and future generations. (Action Plan on Health and Resilience in the Americas, IX Summit of the Americas, Los Angeles, 2022).

  1. Develop an evidence-based Action Plan that takes into account the sociocultural, economic, and structural challenges facing the Americas region and includes, among others, identifying measures for national and international coordination and cooperation, taking into account the global commitments assumed by the states with respect to health and resilience, with a view to:

    • a. Expanding equitable access to comprehensive people-and-community-centered health services of quality and strengthening primary care to move toward universal access to health services. To that end, promote the sharing of experiences and best practices regarding policies, regulations, and standards; strengthen intersectoral coordination in order to address the social determinants of health; and strengthen institutional structures, including building capacities for the regulation and evaluation of health systems to ensure health services and medicines are safe, effective, and of high quality; with due attention to building capacities to perform essential public health functions and implement the International Health Regulations (2005);

    • c. Examining financing mechanisms that guide the involvement of national and international financial institutions and the public and private sectors in strengthening health systems in the management of new financing models aimed at improving efficiency, effectiveness, transparency, sustainability, and equity in financing, increasing and improving public financing, and making progress towards eliminating out-of-pocket expenses, when applicable, as well as pandemic prevention, preparedness, and response, encouraging international financial institutions to grant financing to the developing countries;

    • d. Strengthening regional and global health security and public health emergency preparedness for the future in keeping with previously established commitments, and increase health research and development funding, promoting regional actions to build and strengthen national and regional development and sustainable production capacities for raw materials, pharmaceuticals, and medicines, including safe and effective vaccines, medical supplies, and other essential health technologies; improving affordability and access; and responding to regional health needs, as appropriate, particularly during health emergencies;(Action Plan on Health and Resilience in the Americas, IX Summit of the Americas, Los Angeles, 2022).

  1. Place persons and communities at the center of the Action Plan, addressing inequalities and inequities, promoting gender equality, to ensure universal access to sexual and reproductive health and reproductive rights, as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences, as expressed in Target 5.6 of the 2030 Agenda for Sustainable Development. (Action Plan on Health and Resilience in the Americas, IX Summit of the Americas, Los Angeles, 2022).

  1. To continue moving toward the attainment of universal access to health and universal, quality, comprehensive, timely health coverage without discrimination, taking into consideration gender differences in health and including the availability of safe, affordable, effective, quality essential medications, as essential elements in achieving equity and social inclusion. To that end, we reaffirm our support for the Strategy for Universal Access to Health and Universal Health Coverage adopted by the member states of the Pan American Health Organization (PAHO) in 2014, and we request the collaboration of PAHO and other institutions engaged in this area to support national efforts for its implementation, consistent with international obligations, and its ongoing monitoring over time. (Health, Initiatives VII Summit of the Americas, Panama City, 2015).

  1. To continue working towards comprehensive health coverage being available to everyone at every stage of life, while ensuring that the use of health services does not expose people to financial hardship, particularly groups in a vulnerable situation. (Health, Initiatives VII Summit of the Americas, Panama City, 2015).

  1. We recognise that the problem of inequality of access to comprehensive health care and health services persists, especially among vulnerable groups. We therefore commit to redoubling our efforts to promote social protection and to identify and implement strategies to advance towards universal access to quality comprehensive health care, taking into account labour, environment, gender-sensitive and social security policies, as well as the Health Agenda for the Americas 2008–2017, and will seek to provide necessary resources in order to improve our health indicators. (Declaration of Port of Spain, 2009).

  1. We commit to improving the health of our people through the renewal of primary health care and access by the population to comprehensive health care and health services, as well as to essential medicines. We therefore commit to take the necessary actions, in accordance with the laws, needs and capabilities of each of our countries, bearing in mind the Health Agenda for the Americas 2008-2017, the 2005 Declaration of Montevideo on the New Orientations for Primary Health Care, and the 30-15 Buenos Aires Declaration of 2007, as appropriate. (Declaration of Port of Spain, 2009).

  1. To implement – with the support of the PanAmerican Health Organization (PAHO) – the “Three Ones Initiative: one HIV/AIDS action framework, one national AIDS coordinating authority, and one country-level surveillance and evaluation system” developing primary prevention of HIV/AIDS and strengthening health services for young people and other vulnerable groups, with special attention to the problem of stigma and discrimination in the labor environment, taking into account the ILO Code of Conduct on HIV/AIDS in the workplace. To promote efforts to provide integral prevention, treatment, and care to HIV/AIDS carriers with the aim of providing as close as possible universal access to treatment for all those who need it as soon as possible (Plan of Action Mar del Plata, 2005)

  1. To strengthen, within national health systems , primary health care actions as a step to prevent diseases and their consequences and reduce morbidity with the purpose of ensuring equal access to health services for all people in the hemisphere (Plan of Action Mar del Plata, 2005).

  1. We emphasize that one of the pillars of human development and national progress is social protection for health and, accordingly, we will continue to broaden our prevention, care, and promotion strategies as well as investment in this field in an effort to provide quality health care for all and to improve, to the extent possible, social protection for all people, with a particular focus on the most vulnerable segments of society (Declaration of Nuevo León, 2004).

  1. Pursuant to the relevant resolutions of the United Nations and its specialized agencies, the relevant decisions of the World Trade Organization and the World Health Organization’s 3x5 Initiative, we commit to facilitate affordable treatment for HIV/AIDS, with the goal of providing antiretroviral therapy to all who need it as soon as possible and to at least 600,000 individuals needing treatment by the year 2005 (Declaration of Nuevo León, 2004).

  1. We are therefore committed to reinforcing promotion, prevention, control, and treatment programs, continuing to develop and strengthen technical cooperation strategies among the countries of the region, and to deepening technical cooperation with Pan-American Health Organization, the Inter-American Development Bank, and other inter-American agencies and key actors, with a view to implementing integral public health activities for the control and eradication of these diseases (Declaration of Nuevo León, 2004).

  1. We emphasize that good health and equal access to medical attention, health services and affordable medicine are critical to human development and the achievement of our political, economic and social objectives (Declaration of Québec, 2001).

  1. Recognizing - further to the commitments made at the Miami and Santiago Summits and in accordance with agreed-upon international development goals in the areas of maternal, infant, child and reproductive health - that good physical and mental health is essential for a productive and fulfilling life, and that equitable access to quality health services is a critical element in the development of democratic societies, and for the stability and prosperity of nations; that the enjoyment of the highest standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition, as set forth in the Constitution of the World Health Organization; that gender equality and concern for indigenous peoples, children, the elderly and under-served groups must be of paramount concern in the development of health policy; that health outcomes are affected by physical, social, economic and political factors and that the technical cooperation of the Pan American Health Organization (PAHO) and other relevant international organizations should continue to support health actions in the Hemisphere, in a manner consistent with the Shared Agenda for Health in the Americas signed by PAHO, the IDB, and the World Bank: (Plan of Action Québec, 2001).

  1. Reaffirm their commitment to an equity-oriented health sector reform process, emphasizing their concerns for essential public health functions, quality of care, equal access to health services and health coverage, especially in the fields of disease prevention and health promotion, and improving the use of resources and administration of health services; promote the continued use of scientifically validated, agreed-upon, common indicators for assessing effectiveness, equity and efficiency of health systems; (Plan of Action Québec, 2001).

  1. Strengthen and promote development of domestic standards of practice, accreditation and licensing procedures, codes of ethics, and education and training programs for health personnel; improve the mix of health personnel in the provision of health services to better respond to national health priorities; (Plan of Action Québec, 2001).

  1. Intensify efforts and share and promote best practices to:

    • reduce maternal and infant morbidity and mortality;
    • provide quality reproductive health care and services for women, men and adolescents; and
    • carry out commitments made at the Cairo International Conference on Population and Development and its five-year follow-up in New York; (Plan of Action Québec, 2001).

  1. Commit, at the highest level, to combat HIV/AIDS and its consequences, recognizing that this disease is a major threat to the security of our people; in particular seek to increase resources for prevention, education and access to care and treatment as well as research; adopt a multi sectoral and gender sensitive approach to education, to prevention and to controlling the spread of HIV/AIDS and Sexually Transmitted Diseases (STDs) by developing participatory programs especially with high risk populations, and by fostering partnerships with civil society including the mass media, the business sector and voluntary organizations; promote the use of ongoing horizontal mechanisms of cooperation to secure the safety of blood; increase national access to treatment of HIV/AIDS related illnesses through measures striving to ensure the provision and affordability of drugs, including reliable distribution and delivery systems and appropriate financing mechanisms consistent with national laws and international agreements acceded to; continue dialogue with the pharmaceutical industry and the private sector in general to encourage the availability of affordable antiretrovirals and other drugs for HIV/AIDS treatment, and promote strategies to facilitate the sharing of drug pricing information including, where appropriate, that available in national data banks; promote and protect the human rights of all persons living with HIV/AIDS, without gender or age discrimination; utilize the June 2001 UN General Assembly Special Session on AIDS as a platform to generate support for hemispheric and national HIV/AIDS programs; (Plan of Action Québec, 2001).

  1. Implement community based health care, prevention and promotion programs to reduce health risks and non communicable diseases such as cardiovascular disease and including hypertension, cancer, diabetes, mental illness as well as the impact of violence and accidents on health; (Plan of Action Québec, 2001).

  1. Provide sound, scientific and technical information to health workers and the public, utilizing innovations such as the Virtual Health Library of the Americas; encourage the use of tele-health as a means to connect remote populations and to provide health services and information to under served groups, as a complement to the provision of existing health care services; (Plan of Action Québec, 2001).

  1. Seek, through public and private efforts, or partnerships between them, to enhance the availability, access to, and quality of drugs and vaccines, especially for the most needy, by promoting efforts to safeguard the quality, rational selection and use, safety and efficacy of pharmaceutical products, with special emphasis on vital and essential drugs; and by supporting regional initiatives that by the year 2002 will facilitate research, development, production and utilization of vaccines, which will reduce the incidence of diseases, such as pneumonia, meningitis, measles, rubella and mumps. (Plan of Action Santiago, 1998).

  1. Promote policies designed to improve women's health conditions and the quality of health services at every stage of their lives. (Plan of Action Santiago, 1998).

  • Initiative 4. Improve the coverage and quality of the health services available to the population, for example, services related to diseases arising from environmental pollution, with emphasis on primary care for the most vulnerable groups, giving priority to preventive and promotional aspects and to access to family planning information and services, with the participation of the various sectors concerned.(Plan of Action Santa Cruz de la Sierra, 1996).

  • 17.3 Endorse a basic package of clinical, preventive and public health services consistent with World Health Organization, Pan American Health Organization (PAHO) and World Bank recommendations and with the Program of Action agreed to at the 1994 International Conference on Population and Development. The package will address child, maternal and reproductive health interventions, including prenatal, delivery and postnatal care, family planning information and services, and HIV/AIDS prevention, as well as immunizations and programs combating the other major causes of infant mortality. The plans and programs will be developed according to a mechanism to be decided upon by each country. (Plan of Action Miami, 1994).

  • 17.4 Develop or update country action plans or programs for reforms to achieve child, maternal and reproductive health goals and ensure universal, non-discriminatory access to basic services, including health education and preventive health care programs. The plans and programs will be developed according to a mechanism to be decided upon by each country. Reforms would encompass essential community-based services for the poor, the disabled, and indigenous groups; stronger public health infrastructure; alternative means of financing, managing and providing services; quality assurance; and greater use of non-governmental actors and organizations. (Plan of Action Miami, 1994).

  • 17.5 Strengthen the existing Inter-American Network on Health Economics and Financing, which serves as an international forum for sharing technical expertise, information and experience, to focus on health reform efforts. The network gathers government officials, representatives of the private sector, non-governmental institutions and actors, donors and scholars for policy discussions, analysis, training and other activities to advance reform; strengthens national capabilities in this critical area; and fosters Hemisphere-wide cooperation.
    Convene a special meeting of hemispheric governments with interested donors and international technical agencies to be hosted by the IDB, the World Bank and PAHO to establish the framework for health reform mechanisms, to define PAHO's role in monitoring the regional implementation of country plans and programs, and to plan strengthening of the network, including the cosponsors' contributions to it. (Plan of Action Miami, 1994).

  • 17.7 Urge the March 1995 World Summit for Social Development and the September 1995 Fourth World Conference on Women to address the issue of access to health services. (Plan of Action Miami, 1994).



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