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In response to the need to strengthen vaccine innovation and production in Latin America and the Caribbean, the Pan American Health Organization (PAHO), the United States Agency for International Development (USAID), and the Regionalized Vaccine Manufacturing Collaborative (RVMC) organized the workshop “Regional Vaccine Manufacturing: Mapping of Mappings in the Latin America and Caribbean region” on 10 October, 2024, in Washington, D.C. The objective of the workshop was to review and compare the findings from the various mappings and landscape research efforts, distill the knowledge as well as data gaps identified and explore opportunities for action. Experts from different organizations were invited to present mappings that have been commissioned in the past years and analyze strategic information on the region’s capabilities and needs, as well as identify opportunities for collaboration to strengthen vaccine innovation and production. The mappings presented in the workshop showed that Latin America and the Caribbean has existing and growing manufacturing capacity but remains reliant on external supply of vaccines, especially for drug substances, as well as on innovation capacities. In order to strengthen local production, it is necessary to identify needs and generate information on demand. There was consensus among specialists the importance of continuing to work on the consolidation and dissemination of information for evidence-driven decision making. Participans agreed on the importance of generating information to identify the main gaps and opportunities for strengthening regional innovation and production, aimed at ensuring sustainability and the resilience of value chains.

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Human resources for health (HRH) are essential for building an equitable health system based on primary health care and for achieving universal health. The COVID-19 pandemic had a significant impact on the availability, distribution, and quality of health personnel and exposed chronic shortfalls in the health workforce across the Americas. The Pan American Health Organization (PAHO) and its Member States are taking decisive action to address the critical shortage of health workers in the Americas through PAHO’s Policy on the Health Workforce 2030. This comprehensive approach focuses on: Strengthening governance, policy, and planning for human resources Supporting frameworks to enable a competent, fit-for-service workforce Promoting interprofessional teams and their implementation at the first level of care Building HRH capacities to address population health priorities Improving working conditions and advocating for reasonable and safe work environments for health workers.

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Active case-finding is a quality control tool for routine epidemiological surveillance that can detect cases of vaccine-preventable diseases (VPD) which may or may not have been reported to the system for whatever reason. Traditionally, active case-finding has been implemented on an individual basis to document the presence or absence of cases of acute flaccid paralysis (AFP), measles, and rubella during routine surveillance or when there are outbreaks. In this regard, active case-finding for cases of AFP, measles, and rubella is conducted in health facilities (active institutional case-finding), in communities (active community case-finding), and in laboratories (active laboratory case-finding) in order to identify opportunities to improve the sensitivity of the epidemiological surveillance system for VPD. Cases detected in active case-finding should be reported, investigated, and classified according to the recommended case definitions for surveillance of these diseases. The purpose of this publication is to provide technical guidance and data collection tools for conducting comprehensive active case-finding for AFP, measles, and rubella at the institutional (health facility) and community levels. The aim of joint implementation of active case-finding for these three diseases is to create synergy between human and financial resources, according to the specific characteristics of each disease. This publication is intended for health workers at the national and subnational levels who are responsible for organizing and implementing active case-finding in health facilities and in the community, including analysis of results and report writing.

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Vaccination Week in the Americas (VWA) 2024 was celebrated across the Region of the Americas with a variety of initiatives aimed at increasing vaccination coverage, particularly in remote areas and among populations with limited access to health services. During VWA 2024, some 65 million vaccines were administered. Participation in VWA is flexible, allowing countries and territories to tailor their campaigns to local needs. In 2024, efforts focused on vaccinating health workers, pregnant individuals, children, youth and adolescents, older adults, and people with chronic conditions. Some countries and territories highlighted the political importance of vaccination, with high-level officials participating in their VWA events or multinational events held in border communities. Vaccines were administered against diseases like COVID-19, influenza, polio, measles, mumps, rubella, yellow fever, human papillomavirus, tetanus, diphtheria, pertussis, rotavirus, and other serious diseases that can cause significant harm or death for populations in the Region. Countries and territories utilized a variety of digital, print, and in-person platforms to sensitize their populations about the importance of vaccination at all stages of life, the risks of being unvaccinated, and how and when to access immunization services. Efforts were also made to counter misinformation and disinformation about vaccines and vaccination that could affect public perceptions of vaccine safety and, consequently, reduce the likelihood of individuals or their loved ones being vaccinated. This report highlights the regional VWA campaign, including the regional launch, communications materials, activities, and summaries of country and territory celebrations.

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In 2024, the Pan American Health Organization (PAHO) completed a comprehensive evaluation of the integration of gender equality into its technical cooperation. This evaluation, conducted by an independent external team from February to November 2024, employed face-to-face and remote data collection methods and geographically covered the entire Region of the Americas. The primary objective was to evaluate the extent to which gender equality has been incorporated into PAHO’s technical cooperation and to determine the effectiveness and efficiency of these efforts in promoting gender equality across the Americas. The evaluation had both a summative (accountability) and formative (learning) purpose. It sought to provide insights, findings, and recommendations to enhance PAHO’s ongoing efforts in integrating gender equality into health initiatives and to inform the development of the PAHO Strategic Plan 2026–2031. Covering a broad geographical scope across the Americas, the evaluation included in-depth studies in Colombia, Panama, and Trinidad and Tobago, as well as less detailed analyses in Brazil, Cuba, Mexico, and Uruguay. This approach allowed for a nuanced understanding of the diverse regional, subregional, and national contexts in which PAHO has been operating. The evaluation focused on actions taken from 2005 to 2023, reflecting PAHO's long-term commitment to gender equality, as outlined in the PAHO Gender Equality Policy of 2005 and subsequent strategic plans from 2008 to 2023. The methodology combined contribution analysis, theory of change, interviews, and personnel online surveys, ensuring a comprehensive assessment and understanding of PAHO’s efforts on the theme.

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Evacuation of a hospital should be a last resort to deal with the effects of a threat, but if the risk assessment so determines, it will be carried out preventively. The evacuation of a hospital always risks patients' lives, especially those in severe health conditions. Therefore, each hospital should develop its capabilities to execute an evacuation, which should be part of the “Hospital Emergency Health and Disaster Response Plan.” The evacuation and transfer of patients should be the result of planning that includes staff training, that has the necessary equipment and supplies, that maintains the evacuation routes fully accessible, and that establishes the relevant agreements or adjustments with the security systems, pre-hospital transfer and other facilities of the health services network, which allow for an efficient response. The objective of this tool is to facilitate the development or updating of the evacuation procedure* as part of the emergency and disaster management of a hospital (item 147 of the 2nd edition of the Hospital Safety Index [HSI] of the World Health Organization [WHO] and the Pan American Health Organization [PAHO]). The document is intended for hospital managers, planners, and coordinators in health emergency, disaster response, and recovery preparedness.

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This document has been designed to support primary healthcare (PHC) teams, particularly primary care institutions serving a defined population or territory, within the context of PAHO’s HEARTS in the Americas program. It aims to facilitate understanding of the evaluation methodology and to provide standardized, practical tools for its implementation. The primary users of this publication are the quality committees or quality groups within primary care centers (PCCs) that have adopted HEARTS. Additionally, it targets local health teams responsible for the clinical and administrative management of PCCs, enabling them to conduct quality self-evaluations. National or subnational entities within each country's health system can also utilize this document for external evaluations. The slowing decline in cardiovascular disease mortality, coupled with suboptimal hypertension control levels across populations, indicates that the current health service model is no longer sufficient. In this context, HEARTS in the Americas emerges as the regional adaptation of the World Health Organization's Global HEARTS Initiative. The program focuses on continuous quality improvement for the comprehensive and integrated management of hypertension and cardiovascular risk within primary healthcare services. Furthermore, it extends its applicability to other prevalent chronic conditions—including cerebrovascular, kidney, and metabolic diseases—that represent significant disease burdens in every country across the Region. The HEARTS quality improvement evaluation emphasizes the systematic and standardized assessment of fidelity, feasibility, acceptability, and effectiveness of the interventions promoted by the program. HEARTS in the Americas views quality assessment as a non-punitive process centered on self-evaluation, learning, and organizational commitment. This process aims to identify barriers to implementation and foster innovative, effective, and sustainable local solutions to improve both process quality and health outcomes.

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The digital transformation of the health sector in the Americas is reshaping healthcare delivery, making it more accessible, efficient, and centered around people’s needs. As health systems become increasingly interconnected, the Pan American Health Organization (PAHO) is championing innovative approaches to bridge gaps in healthcare access and empower data-driven decision-making for better health outcomes.

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In the current digital age, where cyber threats are becoming increasingly sophisticated and pervasive, the health sector remains a critical component of a national infrastructure. This sector's significance transcends its operational boundaries, directly impacting the health and safety of patients and the citizens in general. Information security is one of the eight guiding principles for the digital transformation of the health sector promoted by the Pan American Health Organization (PAHO). This policy brief presents key concepts, recommended lines of action, and monitoring indicators, with the objective of advancing information security. Cybersecurity threats pose significant challenges and risks to health systems and the delivery of services. One of the foremost challenges is the potential for disruptions to critical operations. Cyber-attacks, such as ransomware, can immobilize entire health information technology (IT) systems, leading to delayed surgeries, diversion of emergency patients, and disruption of routine care, among others, which can compromise patient safety. As defined by PAHO, this principle aims to establish mechanisms that ensure trust and safeguard information in the digital public health environment, and to “adopt regulatory instruments for the treatment and protection of sensitive health data, as well as international security guidelines and standards for patient-centered information systems. Implementation of these systems must respect health-related rights in order to generate a ‘culture of safe and reliable data management’, understood as the balance between the need to access data and the need for privacy”. This joint effort speaks of a deep commitment to support countries against cyber threats. More importantly, it is about providing complementary technical support to guarantee the continuity of operations of the health sector, thus ensuring the well-being and safety of patients and society in general. Our collective goal with this document is to foster a resilient and secure health system environment, capable of withstanding and responding effectively to the dynamic landscape of cyber threats.

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High sodium intakes have been recognized as an issue for many Caribbean countries. Given that noncommunicable diseases and their associated mortalities and morbidities are highly prevalent in Caribbean Community Member States, regional health agencies such as the Pan American Health Organization, the Caribbean Public Health Agency, and local health ministries have begun to take a closer look at the amount of sodium consumed at the population level. In addition, several evidence-based policies have been developed for implementation at the regional level. Chronic consumption of dietary sodium in excess of the World Health Organization’s recommendations (2000 mg/day) is associated with many health complications including higu blood pressure and cardiovascular diseases. Is is estimated that 1.89 million deaths each year are aasociated with excessive sodium intake. To protect the health of Caribbean populations, it is important to promote dietary practices consistent with the World Health Organization´s principales for healthy diets, including those that encourage sodium and potassium intakes consistent with WHO´s guidelines. This review provides a summary of studies examining dietary intake, content in food products, and urinary excretion of sodium and potassium in Caribbean (and occasionally Latin American countries) populations. Collectively, the available evidence points to an excess of sodium consumption, almost twice the World Health Organization’s recommendation and widespread low potassium consumption. To rectify this, Caribbean Community countries need to accelerate the development of policies and legislation to regulate the sodium content in foods and implement available cost-effective evidence-based interventions that promote healthy eating and healthy lifestyles, including those described in the SHAKE technical package, such as front-of-package warning labelling, marketing restrictions on processed and ultra-processed foods with excessive sodium content and implementing the updated PAHO regional sodium reduction targets.

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[WEEKLY SUMMARY]. Regional Situation: Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) activity has shown a general decline in most subregions in recent weeks, except in North America, where an increase in ILI and SARI cases has been reported. SARS-CoV-2 activity continues to decrease, reaching low levels in North America, while showing an upward trend in Brazil and the Southern Cone. Influenza activity has slightly increased in some countries of the Andean subregion, the Southern Cone, North America, and the Caribbean. Respiratory Syncytial Virus (RSV) activity remains high in some Central American countries, with an upward trend and elevated activity in North America and several countries and territories in the Caribbean.

[RESUMEN SEMANAL]. Situación regional: La actividad de Enfermedad Tipo Influenza (ETI) e Infección Respiratoria Aguda Grave (IRAG) ha mostrado una tendencia general a la baja en las últimas semanas en la mayoría de las subregiones, con excepción de América del Norte, donde se ha registrado un aumento en los casos de ETI e IRAG. La actividad de SARS-CoV-2 se mantiene en descenso, alcanzando niveles bajos en América del Norte, mientras que muestra una tendencia ascendente en Brasil y el Cono Sur. Por su parte, la influenza ha registrado un ligero aumento en algunos países de la subregión Andina, el Cono Sur, América del Norte y el Caribe. La actividad del Virus Respiratorio Sincitial (VRS) continúa siendo alta en algunos países de América Central, con una tendencia ascendente y una actividad elevada en América del Norte y en varios países y territorios del Caribe.