IN A NUTSHELL
Author's note
…if steady financing were to be secured through laws, maybe the health sector in all countries could improve and thrive. Is not only having the funds, is how wisely ministries spend these. Is there proper planning? Are priorities set and a clear plan devised to achieve these?...
By Francisco Becerra-Posada, MD, MPH, DrPH
Health and Financing
One of the fields that has an impact on the lives of populations is public health. The actions of policies and programs that seek to improve the population, not in the field of the clinic in one-to-one interactions, but through collective actions together with social improvements, have a positive impact expressed in a decrease in morbidity and mortality rates.
The region of the Americas is, among the six regions of the World Health Organization, the ones that have shown the best progress in one of the actions that is perhaps the most equitable to provide children with an equitable start in life, vaccines. The WHO established the Expanded Program on Immunization and PAHO endorsed it in 1977, just 2 years after we began our studies.
It was the Pan American Health Organization, which last year celebrated its 120th anniversary, that made the fastest progress with the Expanded Program on Immunizations. The research and development of vaccines led to the availability of biologics against measles, rubella and mumps in the 1960s, and then with the production of the vaccine against chickenpox and inactivated Japanese encephalitis in the 1970s. By then, most of our generation had already been vaccinated against smallpox and almost certainly most of us suffered from “childhood” diseases, as we used to write in our medical records.
It was our children and now our grandchildren, who have benefited from the development of vaccines. What was a vaccination scheme of six biologicals, we now have a vaccination perspective for the life course, from birth to reaching older adults, and that we now benefit from these new vaccines for those over 60 years of age.
I had the opportunity and honor to be selected to serve as PAHO’s Assistant Director between 2013 and 2018. An interesting period for the region in terms of health. The elimination of rubella and measles was achieved, the proposal towards universal health coverage and access was launched (before the WHO did so), the PAHO Public Health Review was strengthened, among many other initiatives approved by the countries of the Region.
Advances in public health and health systems in countries have come a long way, and PAHO’s role is not equal in all countries. However, the COVID pandemic demonstrated the fragility of health systems around the world. PAHO is now renewing efforts with countries to strengthen primary health care and encourage health financing.
Health financing depends on many factors, political and social decisions and commitment. However, if steady financing were to be secured through laws, maybe the health sector in all countries could improve and thrive. Is not only having the funds, is how wisely ministries spend these. Is there proper planning? Are priorities set and a clear plan devised to achieve these?
Having secure funding, would protect immunization programs, there must be financial space for incorporation of novel vaccines, and to save towards an emergency vaccine fund as a preparedness measure for when the next pandemic reaches us. We have to learn from the COVID-19 experience and the resources needed for vaccines and medical care that had to be taken from other programs to face the emergency.
Sadly, few governments have a limited vision, and rather than thinking on state policies and decisions, they are motivated by priorities set by the government in charge that sadly, are limited in time. Have we learned something from the pandemic? Will ministries continue to move as usual? Hopefully, we will see a change. Are you going to contribute to it?
By the same Author on PEAH Immunization Programs and Health Services Apropos of COVID-19: Shall We Question Ourselves? Implications of Covid-19 Pandemic on Health Systems Have Countries Forgotten about the Sustainable Development Goals? The Case of the Americas