MEXICO (CMC) — The Director of the Pan American Health Organization (PAHO), Dr Jarbas Barbosa, has underscored the need to address public health challenges in Latin America and the Caribbean.

In addressing the inauguration of the Mexican National Institute the Public Health’s (INSP) 20th Public Health Research Congress 2025, Barbosa highlighted the challenges facing public health in Latin America and the Caribbean, characterised by demographic transition, persistent inequities and setbacks resulting from the pandemic.

Despite this, he presented concrete proposals to address these challenges and underscored the progress achieved.

During his lecture, titled “The Priority Health Agenda in Latin America and the Caribbean”, Dr Barbosa stated that “the region of the Americas is the most inequitable in the world”, emphasising the stark disparities between countries, from the richest nation, the United States, to the poorest, Haiti, whose health conditions are severely affected by political and social instability.

Additionally, he mentioned internal inequities within countries, noting that “disparities in health indicators and outcomes, such as mortality, are a fundamental characteristic of our region, which compels us to actively seek out the vulnerable, identify the barriers that hinder their access to health, and take measures to overcome them”.

The PAHO director also addressed the phenomenon of the ageing population in the region, which represents an imminent challenge for health systems.

He said that, in 2015, only 8 per cent of the population was over 60 years old, and that, by 2030, one in six inhabitants of the region will be older than that, warning about the additional pressure that this trend places on public services.

Dr Barbosa highlighted that thanks to advances such as vaccines and the reduction in infant mortality, life expectancy has increased in the region.

However, he warned that it is crucial that these additional years are lived equitably and healthily.

“It’s not just about living more years, but ensuring they are quality years, where people can fully enjoy life and contribute to development, without an increase in disability,” he said.

The PAHO director acknowledged that the COVID-19 pandemic deepened pre-existing inequities in the region, disproportionately affecting the most vulnerable, who faced limited access to health services and difficulties in following public health recommendations, which resulted in an increase in mortality.

However, he also emphasised that “the pandemic, although challenging, left us with important lessons”.

“We are currently working with countries in the region to strengthen preparedness and response capacity for future outbreaks and pandemics,” he said.

In this nexus, he mentioned PAHO initiatives such as collaboration with countries to access resources from the Pandemic Fund and strengthening the capacity to produce vaccines in the region.

“Our focus is on applying the lessons learned and ensuring more equitable access to the inputs and technologies that are essential to save lives in future pandemics,” Barbosa said.

Regarding post-pandemic recovery, he highlighted the efforts made to improve vaccination rates in the region.

“The Americas have stood out for having achieved the most significant advances in vaccine coverage in 2023 and 2024 compared to other regions, according to WHO (World Health Organization) and UNICEF (United Nations Children’s Fund) data,” he said.

However, the PAHO director warned that despite progress, significant inequalities persist noting that in many countries, overall coverage rates mask local disparities where the most vulnerable groups continue to lack access to vaccines.

Barbosa also addressed a critical issue that requires “reflection and commitment”: maternal mortality.

During the pandemic, he said maternal mortality grew by almost 100 per cent.

He said this increase reflects not only limited access to health services but also quality of care.

“Fortunately, some countries have already managed to return to pre-pandemic levels, but we cannot settle for this,” said Dr Barbosa, underscoring the launch of PAHO’s Zero Maternal Deaths initiative.

He called for recognition of the influence of social, economic and commercial determinants on population health, stating that the most vulnerable groups are the most affected by factors such as obesity, lack of access to healthy food and insecurity in their communities.

He alluded to the growth of non-communicable diseases (NCDs), which are responsible for more than 80 per cent of deaths in the region.

In this regard, Barbosa emphasised the importance of adopting comprehensive public policies that not only promote healthy habits but also work “intersectorally to improve the living conditions of the population”.

“The health sector must lead, but with the support of sectors such as education, security and social development,” he said.

Despite the challenges facing the region, Dr Barbosa highlighted the progress and the need to incorporate innovative tools, strategies and technologies to accelerate progress.

“It is crucial to rethink how we organise public health programmes,” he said. “Primary care must be more integrated, and we must identify and reach the most vulnerable people to reduce the burden of diseases” such as tuberculosis, malaria and HIV.

Among the key initiatives promoted by PAHO, he mentioned Better Care for Non-Communicable Diseases in Primary Health Care, the Disease Elimination Initiative and the digital transformation of health systems. He also highlighted the need to introduce and expand the use of HPV tests and PrEP (pre-exposure prophylaxis) to address cervical cancer and HIV.

“If we promote the rapid use of new molecular tests to identify HPV lesions that women can self-administer, we can significantly reduce deaths from cervical cancer, which continues to take more than 40,000 lives each year, particularly in those women with the most difficulties accessing health services,” he said.

“It is essential that health professionals, students, and all those involved in health systems reflect on how to change traditional approaches and seek innovative solutions to reach the most vulnerable,” he said. “The central question should be: How can I use the available data to identify those who have been left behind and what new strategies should I implement to reach them?”

In advocating for challenging expectations about the future of health in the region, Dr Barbosa referred to the goals of the Sustainable Development Goals (SDGs) for 2030.

“Some predict that we will not achieve many of these goals, but as health professionals, we must show that these predictions can be challenged,” he said. “Even if we don’t achieve everything, we must get as close as possible. Through new strategies and technologies, we can move towards a more equitable future for all.”

The PAHO director reaffirmed the importance of the health sector as an essential engine to break the vicious circle between poverty and poor health.

“Health has the power to contribute to breaking this cycle,” he said. “By identifying and removing vulnerabilities, we can move towards a more equitable and healthy future in Latin America and the Caribbean.”