Table 1

Key actions for transformation

Elevating health as a human security economic and social development issueThe COVID-19 pandemic has shown that health is a social, economic and human security issue. Elevating health as a national priority is central to this action, under the stewardship of the executive branch of government and in coordination with all relevant sectors. Elevating the health portfolio within the government will permit countries to more rapidly advance in achieving resilient societies and health systems, ensuring universal health, while protecting and promoting public health. The decision to elevate health and social development within government, on par with economic and foreign affairs portfolios, will have a direct impact on health security and will support countries in improving policy development and implementation with a more balanced allocation of limited resources in the interests of a more inclusive, equitable society, leaving no-one behind. The opportunity now to affect real change is evident, as societies are fully engaged in health, equity and social development, and social participation in public policy implementation and oversight has never been greater.
Prioritising integrated policy and planningHealth, social development and the economy must work hand-in-glove to balance societal core values in access to health and social protection, with inclusive economic and sustainable development. COVID-19 has reminded the world that health is a national priority for human development and security, and as such, health policy must become a political priority. The most effective manner in which this can be done is through collective and integrated policy and planning development processes, under the direct leadership of the Executive, and based on evidence. Governance in health, through national health authorities, must be strengthened through effective coordination mechanisms with other sectors, and with increased capacity in the area of international relations. The private sector has a key role to play, recognising its capacity in the provision of health services, the production of goods and technological innovation. Principles of good governance and action against corruption are required in all sectors. Affording priority to health policy per se and as part of a broader social protection system can significantly contribute to poverty alleviation. Policies aimed at poverty elimination (including the development of so-called safety nets) in social development and economic policy will contribute to improved social cohesiveness within society and increased response capacity in the face of a national emergency.
Transforming health systems to achieve universal health and human securityPrioritising investment and the transformation of health systems to achieve universal health is central to sustainable development and human security at the national and global levels. Such action is required to address inequities in access, addressing the needs of the most vulnerable, while ensuring the health system is prepared to respond to external threats. Strengthening health systems based on primary health care contributes directly to the achievement of universal health and to strengthen their resilience. Priority should be placed on ensuring equitable access to comprehensive health services to respond to the needs of all the population. Barriers to access, fragmentation and segmentation in health systems11 must be addressed through coherent policy reform and progressive integration of sub-systems. The primary health care strategy12 is central to this action, improving the organisation and management of adaptive health services within integrated health networks based on a highly resolutive first level of care, with the active engagement and participation of the community. In addition to improve epidemiological surveillance, diagnostic capacity and rapid response capability, supportive digital transformation and the application of artificial intelligence is required to improve access, quality and resolutive capacity of health services.
Investing in science, technology and innovation to ensure equitable access to medicines, vaccines and other health technologiesEquity in access to quality, affordable medicines, vaccines, diagnostics and other health technologies remains one of the central pillars of a health system. The COVID-19 pandemic has revealed important vulnerabilities in the global research and development framework for essential public health supplies, as well as structural deficiencies in the global supply chain. Latin America and the Caribbean remain highly dependent on innovation and production capacity in a small and concentrated number of countries globally, impacting access to supplies during a pandemic. Collaboration across countries is required to ensure access and pooling of knowledge and data during a global health crisis to rapidly increase the availability of medicines, vaccines and health technologies for all. Global action and cooperation in support of the WHO ACT Accelerator ( remain a priority to ensure equity in the allocation of limited resources for developing country needs. The Pan American Health Organization’s revolving fund mechanisms for the procurement of vaccines and other strategic public health supplies are regional public goods in this regard. National action, however, is required to update pharmaceutical policy and strengthen supply chain management and regulatory capacity for medicines, vaccines and other health technologies.
Strengthening the essential public health functions and national capacity in risk reduction and mitigationTo ensure that foundations in public health and preparedness are strong and that a nation is prepared in the event of any multifaceted threat to human security, strengthening the implementation of the Essential Public Health Functions13 and the International Health Regulations14 is necessary. Capacities in public health management, risk reduction and mitigation require strengthening across the Americas to protect the health and well-being of all and to ensure improved preparedness for the rapid mitigation of threats. National capacity is required to improve preparedness and reduce the risk in the event of (1) the emergence of new pathogens in humans, such as the SARs-CoV2; (2) pathogens becoming more dangerous to mankind, such as anti-microbial resistance; (3) environmental risk factors including those related to climate change; and (4) other man-made disasters and natural disasters.15