Preliminary Assessment of COVID-19 Implications for the Water and Sanitation Sector in Latin America and the Caribbean.

COVID-19 has had a severe impact on human health, as well as in social and economic terms, with implications for the management and governance of the water and sanitation sector. These implications are evident in Latin America and the Caribbean due to existing challenges the region faces in accessing water and sanitation services. In spite of significant advances, around 65 million people in the LAC region currently lack appropriate access to water and soap to wash their hands-one of the most basic measures to prevent the spread of disease. Furthermore, social and economic vulnerabilities have exacerbated the effects of the pandemic in the region, particularly among those living in poverty. The COVID-19 pandemic thus requires the mobilization of frameworks such as the human rights to water and sanitation, specifically considering the region's realities. This paper provides a review of some of the challenges currently faced in the region and advances a series of recommendations for enhancing access to water, sanitation and hygiene. The importance of effective governance, management and communication strategies in the water provisioning sector is highlighted in the context of the pandemic, and the role of science and research for adequate decision making is emphasized.

Advancing environmental public health in Latin America and the Caribbean.

This paper highlights the important leadership role of the public health sector, working with other governmental sectors and nongovernmental entities, to advance environmental public health in Latin America and the Caribbean toward the achievement of 2030 Sustainable Development Goal 3: Health and Well-Being. The most pressing current and future environmental public health threats are discussed, followed by a brief review of major historical and current international and regional efforts to address these concerns. The paper concludes with a discussion of three major components of a regional environmental public health agenda that responsible parties can undertake to make significant progress toward ensuring the health and well-being of all people throughout Latin America and the Caribbean.

En este artículo se destaca el importante papel de liderazgo que tiene el sector de la salud pública, en colaboración con otros sectores gubernamentales y entidades no gubernamentales, en el fomento de la salud pública medioambiental en América Latina y el Caribe con el fin de alcanzar para el 2030 el Objetivo de Desarrollo Sostenible número 3: salud y bienestar. Se abordan las amenazas de salud pública medioambiental actuales y futuras más urgentes, y se presenta una breve revisión de las principales medidas históricas y actuales adoptadas a nivel regional e internacional para abordar estas cuestiones. El artículo finaliza con un análisis de los tres principales componentes de un programa regional de salud pública ambiental que las partes responsables pueden ejecutar para realizar progresos significativos en la garantía de la salud y el bienestar de todos en América Latina y el Caribe.

Este artigo destaca o importante papel de liderança do setor de saúde pública, trabalhando com outros setores governamentais e entidades não governamentais, para promover a saúde pública ambiental na América Latina e no Caribe a fim de atingir o Objetivo de Desenvolvimento Sustentável 3 para 2030: Saúde e Bem-Estar. São discutidas as ameaças ambientais mais urgentes para a saúde pública, atuais e futuras, seguidas por uma breve revisão dos principais esforços históricos e atuais, internacionais e regionais, para abordar essas preocupações. O artigo conclui com uma discussão de três componentes essenciais de uma agenda regional de saúde pública ambiental que as partes responsáveis podem adotar para avançar significativamente no sentido de garantir a saúde e o bem-estar de todas as pessoas na América Latina e no Caribe.

Advancing environmental public health in Latin America and the Caribbean

[ABSTRACT]. This paper highlights the important leadership role of the public health sector, working with other governmental sectors and nongovernmental entities, to advance environmental public health in Latin America and the Carib-bean toward the achievement of 2030 Sustainable Development Goal 3: Health and Well-Being. The most pressing current and future environmental public health threats are discussed, followed by a brief review of major historical and current international and regional efforts to address these concerns. The paper concludes with a discussion of three major components of a regional environmental public health agenda that responsible parties can undertake to make significant progress toward ensuring the health and well-being of all people throughout Latin America and the Caribbean.

[RESUMEN]. En este artículo se destaca el importante papel de liderazgo que tiene el sector de la salud pública, en colaboración con otros sectores gubernamentales y entidades no gubernamentales, en el fomento de la salud pública medioambiental en América Latina y el Caribe con el fin de alcanzar para el 2030 el Objetivo de Desarrollo Sostenible número 3: salud y bienestar. Se abordan las amenazas de salud pública medioambi-ental actuales y futuras más urgentes, y se presenta una breve revisión de las principales medidas históricas y actuales adoptadas a nivel regional e internacional para abordar estas cuestiones. El artículo finaliza con un análisis de los tres principales componentes de un programa regional de salud pública ambiental que las partes responsables pueden ejecutar para realizar progresos significativos en la garantía de la salud y el bienestar de todos en América Latina y el Caribe.

[RESUMO]. Este artigo destaca o importante papel de liderança do setor de saúde pública, trabalhando com outros seto-res governamentais e entidades não governamentais, para promover a saúde pública ambiental na América Latina e no Caribe a fim de atingir o Objetivo de Desenvolvimento Sustentável 3 para 2030: Saúde e Bem- Estar. São discutidas as ameaças ambientais mais urgentes para a saúde pública, atuais e futuras, seguidas por uma breve revisão dos principais esforços históricos e atuais, internacionais e regionais, para abordar essas preocupações. O artigo conclui com uma discussão de três componentes essenciais de uma agenda regional de saúde pública ambiental que as partes responsáveis podem adotar para avançar significativa-mente no sentido de garantir a saúde e o bem-estar de todas as pessoas na América Latina e no Caribe.

The United States-Mexico border environmental public health: the challenges of working with two systems.

This report shares the challenges and opportunities encountered by a binational project that examined the availability of environmental and public health information for the United States-Mexico border area. The researchers interviewed numerous national and binational agencies on both sides of the border, endeavoring to develop a framework to advance the knowledge of academic and public health professionals in the area of environmental border health. However, the lack of standardized indicators and metrics in both countries validates the emergent need to establish a viable framework for the collection, analysis, and dissemination of environmental information. Recommendations for next steps are included.

The United States–Mexico border environmental public health: the challenges of working with two systems / La salud pública ambiental en la frontera entre México y los Estados Unidos: los retos que plantea trabajar con dos sistemas / A saúde pública ambiental na fronteira entre o México e os Estados Unidos: os desafios de trabalhar com dois sistemas

This report shares the challenges and opportunities encountered by a binational project that examined the availability of environmental and public health information for the United States–Mexico border area. The researchers interviewed numerous national and binational agencies on both sides of the border, endeavoring to develop a framework to advance the knowledge of academic and public health professionals in the area of environmental border health. However, the lack of standardized indicators and metrics in both countries validates the emergent need to establish a viable framework for the collection, analysis, and dissemination of environmental information. Recommendations for next steps are included.

En este informe se describen los retos y las oportunidades que ha detectado un proyecto binacional que examinó la disponibilidad de información sobre salud ambiental y salud pública en la zona fronteriza entre México y los Estados Unidos. Los investigadores entrevistaron a numerosos organismos nacionales y binacionales a ambos lados de la frontera, a fin de elaborar un marco para la difusión del conocimiento de los profesionales académicos y de la salud pública en el ámbito de la salud ambiental fronteriza. La falta de indicadores y métodos de medición normalizados en ambos países confirma la necesidad emergente de establecer un marco viable para la recopilación, el análisis y la difusión de información ambiental. Se incluyen recomendaciones para los próximos pasos.

Este relatório apresenta os desafios e oportunidades encontrados por um projeto binacional que examinou a disponibilidade de informações ambientais e de saúde pública na região da fronteira entre o México e os Estados Unidos. Os pesquisadores entrevistaram diversas agências nacionais e binacionais em ambos os lados da fronteira, procurando desenvolver um sistema destinado a promover os conhecimentos de profissionais acadêmicos e de saúde pública na área da saúde ambiental em regiões de fronteira. No entanto, a falta de indicadores e métodos de medição padronizados entre os dois países destaca a necessidade emergente de estabelecer um sistema viável para a coleta, análise e difusão de informações ambientais. São feitas recomendações sobre as próximas medidas a serem tomadas.

Transportation Matters: A Health Impact Assessment in Rural New Mexico.

This Health Impact Assessment (HIA) informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1) 84% for health services; (2) 83% for formal and informal education opportunities; and (3) 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident's health through improved access to: (1) health services, and fresh foods, especially for older adults; (2) education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3) economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1) long distances to travel; (2) difficulties in scheduling to meet all needs; and (3) poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

Interventions that facilitate sustainable development by preventing toxic exposure to chemicals: an overview of systematic reviews.

Objective To identify interventions that 1) facilitate sustainable development by preventing toxic exposure to chemicals, including pesticides, and 2) have a positive impact on health. Methods This overview utilized systematic review methods to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted based on a predefined protocol, including clear inclusion criteria. To be classified as "sustainable" interventions needed to aim (explicitly or implicitly) to 1) have a positive impact on at least two key dimensions of the United Nations integrated framework for sustainable development and 2) include measures of health impact. Results Thirteen systematic reviews and two economic evaluations met the inclusion criteria. The interventions that were most likely to have a positive impact on health included 1) legislation to ban Endosulfan pesticide to prevent fatal poisonings; 2) testing of drinking water for contamination with arsenic, and dissemination of the results to households; and 3) implementation of organic farming / diet to reduce exposure to pesticides. However, the cost-effectiveness of these three interventions and their impact(s) on health inequalities is not known. Strict enforcement of interventions to reduce lead in houses with children was cost-beneficial. Education and dust control interventions performed by cleaning professionals to reduce blood lead levels in children were ineffective. Conclusions What is needed now is careful implementation of the interventions whose impacts are likely to be positive. Ineffective interventions need to be replaced with more effective and cost-effective interventions. Finally, more and better-quality research on the prevention of toxic exposure to chemicals is needed to better support policy development.

Interventions that facilitate sustainable development by preventing toxic exposure to chemicals: an overview of systematic reviews / Intervenciones que facilitan el desarrollo sostenible al prevenir la exposición tóxica a los productos químicos: síntesis de revisiones sistemáticas

ABSTRACT Objective To identify interventions that 1) facilitate sustainable development by preventing toxic exposure to chemicals, including pesticides, and 2) have a positive impact on health. Methods This overview utilized systematic review methods to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted based on a predefined protocol, including clear inclusion criteria. To be classified as “sustainable” interventions needed to aim (explicitly or implicitly) to 1) have a positive impact on at least two key dimensions of the United Nations integrated framework for sustainable development and 2) include measures of health impact. Results Thirteen systematic reviews and two economic evaluations met the inclusion criteria. The interventions that were most likely to have a positive impact on health included 1) legislation to ban Endosulfan pesticide to prevent fatal poisonings; 2) testing of drinking water for contamination with arsenic, and dissemination of the results to households; and 3) implementation of organic farming / diet to reduce exposure to pesticides. However, the cost-effectiveness of these three interventions and their impact(s) on health inequalities is not known. Strict enforcement of interventions to reduce lead in houses with children was cost-beneficial. Education and dust control interventions performed by cleaning professionals to reduce blood lead levels in children were ineffective. Conclusions What is needed now is careful implementation of the interventions whose impacts are likely to be positive. Ineffective interventions need to be replaced with more effective and cost-effective interventions. Finally, more and better-quality research on the prevention of toxic exposure to chemicals is needed to better support policy development.

RESUMEN Objetivo Señalar aquellas intervenciones que: 1) faciliten el desarrollo sostenible al prevenir la exposición tóxica a los productos químicos, incluidos los plaguicidas; y 2) tengan una repercusión positiva sobre la salud. Métodos Mediante la metodología de revisión sistemática se sintetizaron los datos probatorios de varias revisiones sistemáticas y evaluaciones económicas. Se realizó una búsqueda exhaustiva siguiendo un protocolo predefinido con criterios de inclusión concretos. Para considerarse “sostenibles”, las intervenciones debían perseguir los siguientes objetivos (explícitos o implícitos): 1) influir de forma positiva sobre al menos dos dimensiones clave del marco integrado de las Naciones Unidas para el Desarrollo Sostenible; y 2) incluir medidas que repercutan en la salud. Resultados Cumplieron los criterios de inclusión 13 revisiones sistemáticas y dos evaluaciones económicas. Las intervenciones con mayores probabilidades de influir positivamente en la salud son: 1) la prohibición por ley de los plaguicidas de endosulfán para prevenir las muertes por intoxicación; 2) los análisis del agua potable para detectar la contaminación por arsénico y la comunicación de los resultados a los hogares; y 3) la implantación de la agricultura o la alimentación orgánicas para reducir la exposición a los plaguicidas. Sin embargo, no se conoce la rentabilidad de estas tres intervenciones ni su repercusión sobre las desigualdades en la salud. La aplicación estricta de las intervenciones para reducir el plomo en los hogares con niños resultó rentable. Por el contrario, fueron ineficaces las intervenciones educativas y de desempolvado, a cargo de profesionales de la limpieza, para reducir los niveles de plomo en la sangre de los niños. Conclusiones Es conveniente aplicar correctamente las intervenciones que tienen mayor probabilidad de generar repercusiones positivas, en tanto que las intervenciones ineficaces deben sustituirse por otras más eficaces y rentables. Se necesitan más investigaciones y de mejor calidad sobre la prevención de la exposición tóxica a los productos químicos, para mejorar las bases sobre las cuales sustentar las correspondientes políticas.

Interventions that facilitate sustainable development by preventing toxic exposure to chemicals: an overview of systematic reviews / Intervenciones que facilitan el desarrollo sostenible al prevenir la exposición tóxica a los productos químicos: síntesis de revisiones sistemáticas

Objective. To identify interventions that 1) facilitate sustainable development by preventing toxic exposure to chemicals, including pesticides, and 2) have a positive impact on health. Methods. This overview utilized systematic review methods to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted based on a predefined protocol, including clear inclusion criteria. To be classified as “sustainable” interventions needed to aim (explicitly or implicitly) to 1) have a positive impact on at least two key dimensions of the United Nations integrated framework for sustainable development and 2) include measures of health impact. Results. Thirteen systematic reviews and two economic evaluations met the inclusion criteria. The interventions that were most likely to have a positive impact on health included 1) legislation to ban Endosulfan pesticide to prevent fatal poisonings; 2) testing of drinking water for contamination with arsenic, and dissemination of the results to households; and 3) implementation of organic farming / diet to reduce exposure to pesticides. However, the cost-effectiveness of these three interventions and their impact(s) on health inequalities is not known. Strict enforcement of interventions to reduce lead in houses with children was costbeneficial. Education and dust control interventions performed by cleaning professionals to reduce blood lead levels in children were ineffective. Conclusions. What is needed now is careful implementation of the interventions whose impacts are likely to be positive. Ineffective interventions need to be replaced with more effective and cost-effective interventions. Finally, more and better-quality research on the prevention of toxic exposure to chemicals is needed to better support policy development.

Objetivo. Señalar aquellas intervenciones que: 1) faciliten el desarrollo sostenible al prevenir la exposición tóxica a los productos químicos, incluidos los plaguicidas; y 2) tengan una repercusión positiva sobre la salud. Métodos. Mediante la metodología de revisión sistemática se sintetizaron los datos probatorios de varias revisiones sistemáticas y evaluaciones económicas. Se realizó una búsqueda exhaustiva siguiendo un protocolo predefinido con criterios de inclusión concretos. Para considerarse “sostenibles”, las intervenciones debían perseguir los siguientes objetivos (explícitos o implícitos): 1) influir de forma positiva sobre al menos dos dimensiones clave del marco integrado de las Naciones Unidas para el Desarrollo Sostenible; y 2) incluir medidas que repercutan en la salud. Resultados. Cumplieron los criterios de inclusión 13 revisiones sistemáticas y dos evaluaciones económicas. Las intervenciones con mayores probabilidades de influir positivamente en la salud son: 1) la prohibición por ley de los plaguicidas de endosulfán para prevenir las muertes por intoxicación; 2) los análisis del agua potable para detectar la contaminación por arsénico y la comunicación de los resultados a los hogares; y 3) la implantación de la agricultura o la alimentación orgánicas para reducir la exposición a los plaguicidas. Sin embargo, no se conoce la rentabilidad de estas tres intervenciones ni su repercusión sobre las desigualdades en la salud. La aplicación estricta de las intervenciones para reducir el plomo en los hogares con niños resultó rentable. Por el contrario, fueron ineficaces las intervenciones educativas y de desempolvado, a cargo de profesionales de la limpieza, para reducir los niveles de plomo en la sangre de los niños. Conclusiones. Es conveniente aplicar correctamente las intervenciones que tienen mayor probabilidad de generar repercusiones positivas, en tanto que las intervenciones ineficaces deben sustituirse por otras más eficaces y rentables. Se necesitan más investigaciones y de mejor calidad sobre la prevención de la exposición tóxica a los productos químicos, para mejorar las bases sobre las cuales sustentar las correspondientes políticas.

Salud, resiliencia y seguridad humana: hacia la salud para todos / Health, Resilience, and Human Security: Moving Toward Health for All

[PANORAMA]. La finalidad de este documento es explicar a los profesionales y técnicos en los campos del desarrollo y la salud en qué consiste un enfoque de la seguridad humana y mostrar cómo puede aplicarse a fin de encaminar a las personas y las comunidades hacia el logro de un ciclo virtuoso de buena salud, bienestar y resiliencia. En particular, en el documento se pone de relieve la forma en que el enfoque de la seguridad humana aborda los nexos entre diferentes fuentes de amenazas para la salud y asegura que las intervenciones sean integradas a fin de adquirir y mantener resiliencia en salud a nivel individual, comunitario e institucional como camino hacia la salud para todos mediante la cobertura universal de salud (CUS)2. En el documento también se explica la forma en que la seguridad puede ayudar a plasmar los avances en la salud en mejoras del bienestar en mayor escala. En otras palabras, un énfasis en la seguridad humana puede ayudarnos a ir más allá de la supervivencia y abordar los medios de vida, el bienestar y la dignidad. Los responsables de la política y de la dotación de fondos se beneficiarán de una comprensión más clara no solo del valor agregado de la seguridad humana para las preocupaciones en el ámbito de la salud, sino también de las oportunidades para integrar los principios de la seguridad humana en las iniciativas de salud nuevas o en curso. Este documento también permitirá a los profesionales y técnicos en salud y desarrollo hacer el mejor uso posible del enfoque de la seguridad humana en sus actividades. La mayoría de los profesionales en los campos de la salud pública y el desarrollo conocen uno o más aspectos del enfoque y probablemente estén utilizándolos, pero en general están poco familiarizados con el panorama completo, de manera que no están adoptando conscientemente el enfoque de una manera integral. En otras palabras, los componentes de los enfoques de la seguridad humana no son nuevos y muchos de ellos se encuentran en programas de salud.

Health, Resilience, and Human Security: Moving Toward Health for All

[OVERVIEW]. The purpose of this document is to explain to experts in the health and development fields what a human security approach is and show how it can be applied in an attempt to put individuals and communities on a path toward achieving a virtuous cycle of good health, wellbeing, and resilience. In particular, the document focuses on how the human security approach addresses the linkages among different sources of health threats and ensures that interventions are integrated so as to build and sustain health resilience at the individual, community, and institutional levels as a path toward health for all through universal health coverage (UHC).2 It also focuses on how human security can help translate health gains into improvements in wellbeing on a larger scale. In other words, an emphasis on human security can help us to move beyond focusing on survival to focusing on livelihoods, wellbeing, and dignity. Policymakers and funders will benefit from a clearer understanding not only of the added value of human security to health concerns but also of the opportunities that exist to integrate principles of human security into both new and existing health initiatives. This document will also allow health and development experts to make the best use of the human security approach in their activities. Most public health and development practitioners are aware of—and are likely using—one or more aspects of the approach. But they generally are unfamiliar with the full picture, so they may not be consciously adopting the approach in a comprehensive manner. In other words, the individual components of human security approaches are not new, and many of them are found in existing health programs. In fact, research conducted during the preparation of this report found that many health interventions include components of the human security approach even though they do not necessarily use the term “human security” or even connect the components with the approach. It is our hope that this document can be used to accelerate the process of integrating human security components into new and existing activities by allowing readers to learn from the experience of their colleagues in the field, thus accelerating the progress toward achieving the freedom from fear, the freedom from want, and the freedom to live in dignity for one and all.

Healthy vinton: a health impact assessment focused on water and sanitation in a small rural town on the US-Mexico border.

We conducted a Health Impact Assessment (HIA) focused on water and sanitation in Vinton, TX, a small rural town on the U.S./Mexico Border. We present the Vinton HIA as a case study to inform the practice of HIA in rural limited resource communities with higher than average levels of unemployment and poverty, and limited infrastructure. Household surveys, focus groups, and interviews provided quantitative and qualitative data on water sources and quality, sanitation practices, and community health. We found that some of the current water sources in Vinton did not meet drinking water standards for total dissolved solids and arsenic; the majority of septic tanks were not managed properly; and there was a short-term risk of water scarcity due to prolonged drought in the region. Prevalent ailments reported by participants included stomach problems, diarrhea, and skin problems. These ailments can be related to arsenic and/or biological organisms in water. The positive direct and indirect health impacts of improved water and sanitation in Vinton included: reduced gastrointestinal illnesses and skin disorders; improved water quality, quantity, and pressure; reduced risks from failing septic systems; increased property value; potential economic growth; and enhanced quality of life. The negative direct and indirect impacts included: residents' initial and monthly costs; increased property taxes; increased debt by local government; and the need for ongoing support from changing elected decision makers. The unique challenges in completing this HIA included: (a) limited available data; (b) a culture of fear and distrust among residents; (c) residents' lack of education, awareness, and civic discourse regarding water and sanitation issues and their impact on public health; and (d) lack of civic discourse and participation in the democratic process. An important outcome of the HIA was the characterization of local water supplies, which motivated and empowered the community members to become more involved in civic discourse concerning their water supplies. Results are transferable to similar low-income rural communities worldwide where residents are lacking in information about their water supplies and in political "voice".

Equidad en salud para las minorías étnicas en Colombia. Desarrollo de sistemas y servicios / Equidade em saúde para minorias étnicas na Colômbia. Desenvolvimento de sistemas e serviços / Health equity for ethnic minorities in Colombia. Development of systems and services

[Extraído de la Introducción]. El estudio que se presenta a continuación examina dos experiencias de acción intersectorial (AI) en Colombia, ambas resultantes de la combinación de estrategias orientadas al mejoramiento de la equidad en salud. Para ello, se adopta la definición de la acción intersectorial (AI) como una relación reconocida entre diferentes sectores para actuar sobre asuntos que mejoren la salud y la equidad en salud.

Directrices para la elaboración de planes de acción locales para mejorar la calidad del aire

[Presentación]. La contaminación del aire es una amenaza aguda, acumulativa y crónica para la salud humana, otros aspectos del bienestar humano y el ambiente. La exposición a ella puede provocar o agravar afecciones respiratorias y cardiacas, entre otras. Puede ser especialmente dañina para personas con enfermedades pulmonares o cardiacas crónicas, mujeres embarazadas, ancianos y niños. Representa un riesgo para la población pobre que trabaja en las calles y vive en condiciones precarias. Los problemas de salud causados por este tipo de contaminación pueden verse influidos por la magnitud, alcance y duración de la exposición, la edad y la susceptibilidad de cada persona, entre otros factores. El objetivo de esta publicación es ofrecer a los países de la Región un marco de referencia para la elaboración de planes de acción locales para mejorar la calidad del aire. El Consejo Nacional del Ambiente (CONAM) del Perú ha usado este documento como base para el cumplimiento del Reglamento de Estándares Nacionales de Calidad Ambiental del Aire (Decreto Supremo N.° 074-2001-PCM)

Diagnóstico de las condiciones locales y situación actual de la Dirección de Medio Ambiente de la M.I. Municipalidad de Guayaquil para implementar el Sistema de Monitoreo y Vigilancia de la Calidad del Recurso Aire en la Ciudad

[Introducción]. Desde finales de los años cincuenta la Organización Mundial de la Salud (OMS) a través de la Organización Panamericana de la Salud (OPS) ha proporcionado la asistencia técnica a los gobiernos y sus autoridades sanitarias y ambientales en países de América Latina y el Caribe, para promocionar el interés en la gestión de la calidad del aire. La aplicación de los programas para conformar las primeras redes de muestreo y monitoreo del aire, tales como: Red Panamericana de Muestreo Normalizado de la Contaminación del Aire – Red Panaire; Red Mundial de Vigilancia y Evaluación de la Calidad del Aire Urbano GEMS/AIR y actual Programa Air Management Informatión Sistem – AMIS, permitieron evaluar la situación actual de la calidad del aire en las principales ciudades de la región y establecer medidas para el control de la contaminación atmosférica, en casos y lugares que ameriten.