Information Session to the Permanent Ambassadors of the

Information Session to the Permanent Ambassadors of the Organization of American States (OAS) and other Ambassadors of PAHO Member States 49 th PAHO Directing Council 61 st Session of the WHO Regional Committee Washington, D. C. [ 28 September - 2 October, 2009 ] Mirta Roses Periago Director

PAHO Executive Committee 2008 - 2011 2007 - 2010 2006 - 2009 Argentina Bolivia (Vice President SPBA 2) Trinidad and Tobago (President SPBA 3) Guatemala (Vice President SPBA 3) Mexico (Rapporteur 08 -09) United States of America (Rapporteur 06 -07) Haiti Suriname (Vice President 08 -09) Uruguay (President 08 -09; Vice President 07 -08) Candidacies Period 2009 -2012 Colombia Saint Vincent and the Grenadines Venezuela Period 2010 – 2013 Peru

WHO Executive Board 2009 - 2012 2008 - 2011 2007 - 2010 Canada Brazil (PBAC) Bahamas (PBAC) Chile Paraguay (NGO) Peru (Vice President 62 WHA 2009) Candidacies Period 2010 -2013 (3 positions) Period 2011 – 2014 (1 position) Barbados Cuba Ecuador United States of America Mexico

PAHO 49 th Directing Council Agenda • Matters related to: – Procedures – Constitution – Program policy – Administration and finance – General information

PAHO 49 th Directing Council Authorities proposed • PAHO 49 th Directing Council o o ˉ General Committee o ‾ Canada, Cuba, Dominican Republic, Nicaragua, Paraguay, United States of America Committee on Credentials o President: PARAGUAY Vice President: NICARAGUA Vice President: DOMINICA Rapporteur: CANADA Belize, Brasil, Costa Rica TDR (1 position) Ecuador, Guatemala, Peru HRP (2 positions) Guatemala, Paraguay BIREME (5 positions)

PAHO 49 th Directing Council Highlighted Events Monday, 28 September Time & Place 8: 30 am at Room B 9: 00 am at Room B 10: 00 am PAHO Lobby Heads of delegation meeting Inaugural Ceremony Launch of exhibits: 20 Years of SUS Brazil; 100 Years of the Cuba Ministry of Health; 85 Years of the International Sanitary Code UNASUR Countries Meeting with Minister of Health of Ecuador International Health Regulations and Influenza discussion 12: 30 pm at State Plaza Hotel Meeting Room pm session at Room A Tuesday, 29 September Time & Place 7: 30 Director’s meeting room at 10 th floor 2: 30 -4: 30 pm at Room A Director’s Breakfast with WHO/EB Countries Panel Discussion on the Pan American Alliance for Nutrition and Development for the Achievement of the MDGs PAHO/PAHEF Award Dinner 7: 00 pm at the Hall of the Americas at OAS’ Headquarters.

PAHO 49 th Directing Council Highlighted Events Wednesday, 30 September Time & Place – Roundtable on Safe Hospitals 2: 30 -4: 30 pm at Rooms A, B and 1017 Thursday, 1 October Time & Place – Heads of delegation meetings 8: 30 am at Room B – Lunch-dialogue: 12: 30 pm at Room B World Economic Recession and MDGs

PAHO Awards 2009 • PAHO Award for Administration – Dr. Merceline Dahl-Regis, Bahamas • The Horwitz Award (lifetime leadership public health); – Dr. Eduardo A Pretell Zárate, Peru • The Moore Award (voluntary service); – Redlactrans (Red de America Latina y el Caribe de Personas Transgénero) Argentina • The Acha Award (veterinary health thesis); – Ilane Hernández Morales, Mexico • The Soper Award (journal article) – Dr. Guilherme Luiz Guimaraes Borges, Mexico

Proposed PAHO Program Budget 2010 2011 • Three segments: – PAHO/WHO base programs – Epidemics, crises, and response – Government financed internal projects • US$ 644 million in PAHO regular budget and other sources • Three regular budget scenarios and an increase of 3. 5% in the contributions

Reduction in Regular Budget Fixed Term Posts over the past 3 decades 1, 222 1, 038 757

PAHO and WHO (AMRO share) Regular Budget in Current Dollars. Biennia 1970 1971 / 2008 2009

PAHO/WHO Program Budget Regular Budget (RB) and Other Sources (OS). Biennia 1988 1989 / 2008 2009

Total PAHO/WHO Expenditure (1992– 2007) vs. Total Workforce Expenditure

PAHO/WHO Workforce Efficiency Rate 1992 1993 / 2006 2007

Productivity of Total PAHO/WHO Expenditure in Constant Dollars Per Full Time Equivalent * 1990 1991 / 2006 2007 * Value added per FTE in dollars at constant 2000 prices.

New Quota Scale • OAS with new quota scale for 2009 2011 • PAHO Resolution CE 140. R 5 , June 2007. New OAS Scale adopted and applied for 2010 2011

Plan of Action for Implementing the GENDER EQUALITY POLICY Evidence building Gender Equality Policy Goal: Institutionalization, monitoring and evaluation Achievement of gender equality in health status and health development Core objective Optimal health status and well being for men & women Equity in resource allocation for health Equal participation & empowerment of men & women in terms of their health Fairness in the distribution of the burden and rewards associated with health work between men & women Participation of civil society Capacity building

Plan of Action on ADOLESCENT and YOUTH HEALTH

HIV PREVALENCE in the population aged 15 49 and 15 24 by major Regions of the World 2007 (%) * Source: UNAIDS/ WHO. 2008 Report on the global AIDS epidemic.

Plan of Action on the HEALTH OF OLDER PERSONS including Active and Healthy Aging

Regional Strategy and Plan of Action on MENTAL HEALTH PURPOSE Strengthen the response of the health sector through implementation of mental health promotion, prevention, treatment, and rehabilitation interventions Capacity , ies lic , Po ns n pla latio is leg / ces ur so re to produce informatio n / evaluation St re ng the of n re hu so m ing ur an ce s PROBLEM High prevalence and burden of mental and Promotion of mental health substance use disorders (morbidity, disability, and mortality) WEAK POINTS and prevention of psychological disorders Treatment gap Funding gap Information gap Stigma Poverty, inequities, and social exclusion STRONG POINTS 1. 2. 3. Political will Global and Regional Program Support: · WHO Global Mental Health Plan · Regional Strategic Plan (PAHO) · Health Agenda for the Americas Renewal of Primary Health Care 4. 5. 6. 7. Scientific progress around the world National social policy Experiences in the region over the past decade Cooperation among countries Delivery of services Care and rehabilitation for priority conditions/ PHC

Plan of Action for the PREVENTION of AVOIDABLE BLINDNESS and VISUAL IMPAIRMENT Cataracts: Leading Cause of Blindness LE AB Diabetic Retinopathy and Glaucoma IS S NT VE RE P Low Vision ES DN LIN Blindness and Visual. B F Impairment in Children 8 0% O 5, 000 blind people and 20, 000 people with severe visual impairment per million inhabitants

Policy Framework for HUMAN ORGAN DONATION AND TRANSPLANTATION • In the 1990 s: 20, 800 kidney transplants were performed in Latin America, a figure that represented 8. 9% of the world total. ; tion a lant sp ran t ; ices • In 2007: over 8, 200 kidney transplants wereerv performed, s the total of transplants d a figure that represents more than 12. 5% t plan of n an s io performed worldwide. tran nat o n do ss t e ga acc f or l y American countries were on waiting • In 2006: 44, 120 epatients in 9 Latin o m itab icac in Canada uris u f o lists to q d ef te e receive a kidney transplant; plant t the figure was 4, 195, and o in Statesan rom the United afety 76, 313. trans P s d ü the e g an v n • mprocountries with ickimost successful organ donation programs have The the I aff t the demonstrated r advantages of having strong national organizations that ü n rga coordinate, and regulate organ donation and transplantation. o can promote, ight F ü

Elimination of NEGLECTED DISEASES • Neglected diseases help perpetuate the cycle of poverty 12 priority diseases • • Eliminating them is an ethical imperative and part of the unfinished agenda • Eliminating them by 2015 is technically feasible • Political commitment is urged to make the dream a reality “A Latin America and Caribbean free of these diseases” Adoption of Resolution CE 144/10 Group 1, objective: eliminate as a public health problem (10) • Group 2, objective: drastic reduction in the burden of disease (2) • Other diseases: merit greater investigation and scientific advances

INTEGRATED HEALTH SERVICES DELIVERY Networks Consultations in the Region Place Date Countries Quito, Ecuador 1 May 2008 Ecuador Santiago, Chile 14 May 2008 Chile Guatemala City, Guatemala 18 -19 June 2008 Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama, and Dominican Republic Brasilia, Brazil 5 August 2008 Brazil Asunción, Paraguay 8 August 2008 Paraguay Buenos Aires, Argentina 9 September 2008 Argentina Belize City, Belize 14 October 2008 Belize Montevideo, Uruguay 16 -17 October 2008 Uruguay Bridgetown, Barbados 23 -24 October 2008 Anguilla, Antigua and Barbuda, Barbados, British Virgin Islands, Dominica, Grenada, Montserrat, St. Kitts and Nevis, St. Lucia and St. Vincent Havana, Cuba 23 October 2008 Cuba St. Clair, Trinidad and Tobago 30 October 2008 Trinidad and Tobago Mexico City, Mexico 3 November 2008 Mexico Total 27 countries

Panel discussion on the Pan American ALLIANCE for NUTRITION and DEVELOPMENT • Date: Tuesday, 29 September 2009. Opening remarks: Sara Ferrer, UNDP Spain MDG achievement Fund. Guest speaker: Dr. Oscar Ugarte, Minister of Health of Peru. Other presenters: • Dr. Mirta Roses (PAHO) • Dr. Pedro Medrano (Regional Director of the World Food Program) • Dr. Ricardo Uauy (President of the International Union of Nutrition Sciences). Commentators: • Carmen Maria Gallardo (Vice president ECOSOC) • Betty Mc. Collum (U. S. Congress) • Joy Phumaphi (World Bank) • David Oods (Save the Children)

Roundtable on SAFE HOSPITALS • Date: Wednesday, 30 September 2009. Guest Speaker : Dr. Claude de Ville. Participants: . Ministers of Health, . UN agencies, . Cooperation Agencies. OBJECTIVE: To assess the socioeconomic impact of disasters on health; To share lessons learned in the execution of the safe hospitals initiative; and, To strengthen coordination and cooperation among the health sector, disaster reduction agencies, and other sectors to achieve safe hospitals by 2015.

Administrative and Financial Matters

Quotas received to 10 September 2000 2009

Pending Arrears as of 10 September 2000 2009

Proposed Major Changes in Financial Regulations of PAHO • International Public Sector Accounting Standards (IPSAS) replace the United Nations System Accounting Standard (UNSAS) – • Audited Annual Financial Statements with a Biennial Program Budget; – • new financial statement requirements Movement from modified accrual and cash basis accounting to full accrual accounting – • new terminology and introduction of best practices impact on surplus and internal borrowing Capitalization of property, plant , and equipment with expensing of depreciation – valuation of assets and budgetary impact

Proposal for the Establishment of an AUDIT COMMITTEE* Purpose: Establish a governance framework that reflects international best practices Role of the Committee • Review and monitor the risk assessment and management processes used in the Organization, the system of internal and external controls, and the timely and effective implementation by management of audit recommendations; • Advise on issues related to the system of internal and external controls, their strategies, work plans, and performance; Continued … * The Audit Committee does not replace the functions of the Executive Committee of PAHO or its SPBA

Proposal for the Establishment of an AUDIT COMMITTEE Role of the Committee • Notify on any matter of PAHO policy and procedure requiring corrective action and on improvements recommended in the area of controls, including evaluation, audit, and risk management; • Advise on accounting policies and disclosure practices and assess changes and risks in those policies; and • Advise the Director in the selection process of the Auditor General of PAHO and the Executive Committee in the selection of the External Auditor.

Progress Report on INTERNATIONAL HEALTH REGULATIONS [ includes the Report on the Pandemic (H 1 N 1) 2009 ] • Date: Monday, 28 th September 2009 • Presenter: Dr. Jarbas Barbosa Manager Health Surveillance, Disease Prevention and Control (HSD) • Selected affected countries: Argentina, Brazil, Canada, Chile, Costa Rica, Mexico, USA • Open Discussion

Pandemic (H 1 N 1) 2009 Number of Laboratory Confirmed Cases and Number of Deaths Reported to PAHO/WHO as of 6 September 2009

Progress Report on Technical Matters What do the IHR require? • Strengthening of national surveillance and control capacity, including that related to travelers and transportation [ Evaluation / Action Plan, Deadline: 15 June 2009 ] • Prevention, alert, and response to international public health emergencies [ Influenza A (H 1 N 1) ] • Global partnerships and international collaboration • Rights, responsibilities, and procedures and monitoring of progress

PAHO’s Response • Monitoring the regional situation and advising countries on surveillance, laboratory, and infection control measures necessary for identifying and treating cases and following contacts • Distributed diagnostic kits to National Influenza Centers through its Collaborating Centers • Dispatched experts in epidemiology, virology, laboratory testing, infection control, emergency response , logistics and risk communication to several countries in the Region • Updated treatment guidelines • Sent oseltamivir (Tamiflu) to countries in the Region • Holds weekly teleconferences with ministries of Health or directors of Epidemiology of all the countries of the Americas

Thank you