During the 2024–2025 biennium, Cuba incorporated vaccination against the human papillomavirus (HPV) for 9‑year‑old girls into its national immunization schedule for the first time, marking a key milestone in the prevention of cervical cancer and in advancing the PAHO Disease Elimination Initiative. The campaign, launched in October 2025, had reached 76.7% coverage among the target population by the end of the year, demonstrating the capacity of the national health system to efficiently introduce new health technologies.
For the first time in Cuba, the United Nations Central Emergency Response Fund Anticipatory Action mechanism was activated two days before Hurricane Melissa’s impact on the eastern region of the country. Early activation made it possible to protect the continuity and functionality of health services in a context of high vulnerability compounded by the simultaneous circulation of dengue and chikungunya with sustained nationwide transmission.
During the 2024–2025 biennium, Cuba successfully included 94 municipalities into the Healthy Municipalities, Cities, and Communities Movement, representing more than half of the country’s total municipalities. This sustained growth reflects strengthened local action on the social determinants of health and increased intersectoral commitment at the territorial level.
During the 2024–2025 biennium, Cuba made significant progress in the implementation of an approach that recognizes the interconnectedness of human, animal, and environmental health, supported by a national government project structured around eight priority lines of action, including zoonoses, antimicrobial resistance, surveillance, food safety, and communication. A particularly noteworthy result was the development of a climate‑sensitive early warning system for dengue and its vector, serving as a model for intersectoral integration.
During the 2024–2025 biennium, Cuba substantially strengthened its comprehensive response to noncommunicable diseases (NCDs) through the expansion of the HEARTS initiative and the update of the National Strategic Plan for NCDs. Implementation of HEARTS was reinforced, contributing to the prevention of cardiovascular events associated with ischemic heart disease and stroke, as well as to the reduction of diabetes‑related complications and the progression of chronic kidney disease.
1. Access to comprehensive and quality health services
3. Quality care for older people
4. Response capacity for communicable diseases
5. Access to services for NCDs and mental health conditions
6. Response capacity for violence and injuries
7. Health workforce
8. Access to health technologies
10. Increased public health financing
12. Risk factors for communicable diseases
13. Risk factors for noncommunicable diseases
15. Intersectoral response to violence and injuries
17. Elimination of communicable diseases
18. Social and environmental determinants
19. Health promotion and intersectoral action
21. Data, information, knowledge, and evidence
22. Research, ethics, and innovation for health
23. Health emergencies preparedness and risk reduction
24. Epidemic and pandemic prevention and control
26. CCTs: equity, gender, ethnicity, and human rights
27. Leadership and governance
| Output (OPT) Indicator | Baseline/Target | Rating |
|---|---|---|
| 01.1.a. Number of countries and territories with frameworks in place for integrated health service delivery networks (IHSDN) to improve the resolution capacity of the first level of care and integrate priority programs, including NCDs and the elimination agenda | Baseline 2023 | Achieved |
| 01.2.a. Number of countries and territories implementing strategies and/or plans of action to improve quality of care in health service delivery | Target 2025 | Partially achieved |
| 02.2.e. Number of countries and territories implementing strategies to increase access to responsive and quality health services for adolescents | Baseline 2023 | Partially achieved |
| 03.1.a. Number of countries and territories that implement comprehensive assessments of older persons at the first level of care | Baseline 2023 | Achieved |
| 07.1.a. Number of countries and territories that are implementing a national policy on human resources for health | Baseline 2023 | Achieved |
| 07.2.a. Number of countries and territories with a norm that defines the capacities and scope of practice of inter-professional teams at the first level of care | Baseline 2023 | Achieved |
| 08.1.a. Number of countries and territories with updated national policies and/or strategies on access, quality, and use of medicines and other health technologies | Baseline 2023 | Achieved |
| 08.2.a. Number of countries and territories that have established an institutional development plan to improve regulatory capacity for health products based on the assessment of their national regulatory capacities by the Global Benchmarking Tool | Target 2025 | Achieved |
| 08.4.a. Number of countries and territories implementing a national plan to strengthen access to radiological services and radiation safety | Baseline 2023 | Achieved |
| 08.4.c. Number of countries and territories implementing national strategies/mechanisms to improve access, quality, safety, or rational use of blood in their services | Baseline 2023 | Achieved |
| 08.5.a. Number of countries and territories implementing plans to manage and oversee the essential medicines supply chain, including planning, forecasting, and availability | Baseline 2023 | Achieved |
| 08.6.a. Number of countries and territories that have a strategy/mechanism for antibiotic sales estimation and that enforce antibiotic sales under prescription | Baseline 2023 | Partially achieved |
| 09.2.a. Number of countries and territories with mechanisms for monitoring and evaluating progress toward universal health and primary health care using PAHO’s frameworks and tools | Baseline 2023 | Achieved |
| 09.4.a. Number of countries and territories that have established, reviewed, and/or updated health-related legislation and regulatory frameworks in the last five years in support of universal access to health and universal health coverage, the realization of the right to health, and other health-related matters from a human rights perspective | Baseline 2023 | Achieved |
| Output (OPT) Indicator | Baseline/Target | Rating |
|---|---|---|
| 04.1.a. Number of countries and territories implementing national norms, standards, and tools aligned with PAHO and WHO guidelines on TB, HIV, STIs, and VH, with emphasis on key and vulnerable populations | Baseline 2023 | Achieved |
| 04.2.a. Number of countries and territories implementing the new arboviral disease guidelines for patient care in the Region of the Americas | Baseline 2023 | Achieved |
| 12.1.a. Number of countries and territories that have campaigns on antimicrobial resistance and rational use aimed at the general public and at professional sectors | Baseline 2023 | Achieved |
| 12.4.a. Number of countries and territories that annually provide laboratory-based data on antimicrobial resistance | Baseline 2023 | Achieved |
| 12.5.a. Number of countries and territories reporting participation of communities in the response to HIV, TB, STIs, and viral hepatitis | Baseline 2023 | Achieved |
| 12.8.a. Number of countries and territories that have programs to prevent or mitigate zoonotic diseases and snake/arthropod envenoming | Target 2025 | Achieved |
| 17.1.a. Number of countries and territories implementing PAHO/WHO-recommended interventions in active foci and areas at risk of reestablishment of malaria | Baseline 2023 | Achieved |
| 17.3.a. Number of countries and territories that administer hepatitis B vaccine to newborns during the first 24 hours | Baseline 2023 | Achieved |
| 17.5.a. Number of countries and territories that have maintained their status as free from both wild poliovirus and circulating vaccine-derived poliovirus | Baseline 2023 | Achieved |
| 17.6.a. Number of countries and territories that have met the established minimum annual rate of suspected measles/rubella cases plus at least three of the five surveillance indicators defined in the Plan of Action for the Sustainability of Measles, Rubella, and Congenital Rubella Syndrome Elimination in the Americas 2018-2023 | Baseline 2023 | Achieved |
| 17.8.a. Number of countries and territories implementing plans of action to strengthen prevention, prophylaxis, surveillance, and control for the validation of the elimination of rabies transmitted by dogs | Target 2025 | Partially achieved |
| Output (OPT) Indicator | Baseline/Target | Rating |
|---|---|---|
| 05.1.a. Number of countries and territories that are implementing evidence-based national guidelines/protocols/standards for the management of NCDs (i.e. cardiovascular disease, cancer, diabetes, and chronic respiratory disease) | Baseline 2023 | Achieved |
| 05.3.a. Number of countries and territories with comprehensive mental health services integrated into primary health care in at least 50% of primary health care facilities | Baseline 2023 | Achieved |
| 05.4.a. Number of countries and territories that collect, analyze, and report a core set of mental health indicators within the national health information systems | Baseline 2023 | Achieved |
| 06.1.a. Number of countries and territories that have a single emergency care access number with full national coverage | Baseline 2023 | Partially achieved |
| 13.1.b. Number of countries and territories implementing a national policy or strategy on physical activity | Target 2025 | Achieved |
| 13.1.c. Number of countries and territories implementing policies to reduce salt/sodium consumption in the population | Baseline 2023 | Not achieved |
| 14.1.a. Number of countries and territories that are implementing national policies consistent with the WHO Global Targets 2025 for maternal, infant, and young child nutrition and the nutrition components of the Sustainable Development Goals | Baseline 2023 | Achieved |
| 16.1.a. Number of countries and territories implementing policies and legislative frameworks to promote and improve mental health in line with global human rights instruments | Baseline 2023 | Achieved |
| 16.2.a. Number of countries and territories with national multisectoral strategies and plans aimed at the prevention of suicide across the life course and addressing its main risk factors and social determinants | Baseline 2023 | Achieved |
| Output (OPT) Indicator | Baseline/Target | Rating |
|---|---|---|
| 18.2.d. Number of countries and territories implementing plans, policies, programs, and/or interventions to reduce health risks associated with hazardous chemical exposures, following the WHO Chemicals Road Map, the Minamata Convention, and other chemical-related policies and programs | Baseline 2023 | Achieved |
| 18.2.e. Number of countries and territories implementing plans, policies, programs, and/or interventions to prepare health systems and reduce health risks associated with climate change | Baseline 2023 | Achieved |
| 19.1.a. Number of countries and territories that have laws, regulations, or policies in at least two categories of healthy settings | Baseline 2023 | Achieved |
| 19.2.a. Number of countries and territories that build capacities of local-level governments to integrate health promotion in their planning | Baseline 2023 | Achieved |
| 19.3.a. Number of countries and territories that have established an intersectoral mechanism at national or subnational and local government levels to address the determinants of health, applying the Health in All Policies approach | Baseline 2023 | Achieved |
| 19.4.a. Number of countries and territories implementing a national health promotion policy | Baseline 2023 | Achieved |
| 19.4.b. Number of countries and territories implementing mechanisms that facilitate the participation of community organizations and leaders in public health programs | Baseline 2023 | Achieved |
| 26.2.a. Number of countries and territories implementing policies, plans, and strategies to advance health equity | Baseline 2023 | Achieved |
| 26.3.a. Number of countries and territories implementing policies, plans, and programs to advance gender equality in health | Baseline 2023 | Achieved |
| Output (OPT) Indicator | Baseline/Target | Rating |
|---|---|---|
| 20.1.a. Number of countries and territories that have developed and implemented a plan to strengthen information systems for health based on PAHO’s IS4H maturity assessment model | Baseline 2023 | Partially achieved |
| 20.2.a. Number of countries and territories implementing an updated plan of action for strengthening the quality and coverage of vital statistics | Baseline 2023 | Achieved |
| 21.2.a. Number of countries and territories with mechanisms (policies, standards, tools, etc.) in place for the generation, dissemination, and preservation of, and access to, scientific and technical data, information, and evidence for health | Baseline 2023 | Achieved |
| 21.3.a. Number of countries and territories that generate and disseminate health analyses and/or health intelligence reports on relevant public health topics, including SDG 3 progress monitoring and health equity analyses | Target 2025 | Achieved |
| 22.2.a. Number of countries and territories with the national health authority enabled to address ethical issues and establish effective mechanisms for ethics oversight of research | Target 2025 | Achieved |
| Output (OPT) Indicator | Baseline/Target | Rating |
|---|---|---|
| 23.1.a. Number of States Parties completing annual reporting on the International Health Regulations (2005) | Baseline 2023 | Achieved |
| 23.1.b. Number of countries and territories that have evaluated disaster and emergency preparedness capacities in the health sector | Baseline 2023 | Achieved |
| 23.2.a. Number of States Parties with national action plans developed for strengthening International Health Regulations (2005) core capacities | Baseline 2023 | Achieved |
| 23.2.b. Number of countries and territories with full-time staff assigned to health emergencies | Baseline 2023 | Achieved |
| 23.3.a. Number of States Parties that have conducted simulation exercises or after-action review | Baseline 2023 | Achieved |
| 23.4.a. Number of countries and territories that include safe hospital criteria in the planning, design, construction, and operation of health services | Baseline 2023 | Partially achieved |
| 24.2.a. Number of countries and territories with strategies and/or plans in place to detect and respond to high-threat and emerging pathogens, including emerging zoonotic pathogens | Baseline 2023 | Achieved |
| 24.3.a. Number of countries and territories with access to established expert networks and national laboratory policies to support prediction, detection, prevention, control, and response to high-threat and emerging pathogens, including emerging zoonotic pathogen | Baseline 2023 | Achieved |
| 24.3.c. Number of countries and territories with operational integrated surveillance systems and pandemic preparedness plans for respiratory viruses, including influenza and COVID-19 | Baseline 2023 | Achieved |
| Output (OPT) Indicator | Baseline/Target | Rating |
|---|---|---|
| 27.1.a. Number of countries and territories with a current Country Cooperation Strategy | Baseline 2023 | Achieved |