During the 2024–2025 biennium, PAHO supported Ecuador in strengthening the intercultural health approach as a structural strategy to improve access, quality, and cultural relevance of maternal and neonatal care. In coordination with the Ministry of Public Health, PAHO provided guidance on strengthening the intercultural health approach to reduce maternal and neonatal mortality, consolidating a model of articulation between the national health system and traditional ancestral medicine.
During the 2024–2025 biennium, PAHO played a key role in strengthening the normative and institutional environment for mental health in Ecuador, promoting a community based model grounded in primary health care (PHC), a human rights approach, and the life course perspective.
During the 2024–2025 biennium, PAHO supported Ecuador in strengthening immunization coverage by using the Vaccination Week in the Americas (VWA) as a strategic platform to recover coverage levels and address priority public health risks. In 2024, with PAHO technical cooperation, the country achieved 100% of the national target for human papillomavirus (HPV) vaccination, immunizing nearly 500 000 girls and boys – a significant step toward the elimination of cervical cancer.
During 2024–2025, PAHO provided sustained technical support to Ecuador to advance toward malaria elimination in zones 4 and 8 of the country, within the framework of the Disease Elimination Initiative.
During the 2024–2025 biennium, Ecuador made progress in the implementation of the Global Platform for Access to Childhood Cancer Medicines, an initiative aimed at improving the availability of essential treatments for children under five years of age diagnosed with cancer.
| Outcome Indicator | Baseline/Target | Rating |
|---|---|---|
| 01.b. Number of countries and territories that have implemented strategies to strengthen the response capacity of the first level of care | Target 2025 | Achieved |
| 02.e. Number of countries and territories with capacity to implement and monitor national policies or strategies to improve the health and development of young children that are informed by the WHO/UNICEF framework Nurturing Care for Early Childhood Development | Baseline 2019 | Achieved |
| 03.a. Number of countries and territories with capacity to prevent care dependence | Target 2025 | Achieved |
| 07.a. Number of countries and territories that have reduced the density gap with respect to physicians, nurses, and midwives, achieving at least 25 health workers per 10,000 population in underserved areas, keeping in mind the global target of 44.5 by 2030 | Target 2025 | Partially achieved |
| 07.b. Number of countries that have an interprofessional health team at the first level of care, consistent with their model of care | Baseline 2019 | Achieved |
| 08.a. Number of countries that ensure that products listed on the essential medicine list are available without out-of-pocket expenditure at the point of care | Baseline 2019 | Achieved |
| 08.b. Number of countries and territories with regulatory systems that reach level 3 under the WHO Global Benchmarking Tool (GBT) | Target 2025 | Not achieved |
| 08.d. Number of countries and territories that have regulations and oversight that ensure access to quality and safe radiological services | Target 2025 | Partially achieved |
| 11.a. Number of countries and territories that have decreased by 20% the percentage of population in households experiencing out-of-pocket catastrophic health spending | Target 2025 | Not achieved |
| 11.b. Number of countries and territories that have decreased by 10% the percentage of people in households experiencing impoverishment due to out-of-pocket health expenditure | Target 2025 | Not achieved |
| Outcome Indicator | Baseline/Target | Rating |
|---|---|---|
| 04.e. Number of countries with >70% of malaria cases diagnosed and treated within 72 hours of the start of symptoms | Baseline 2019 | Achieved |
| 04.f. Number of countries and territories with capacity to conduct integrated surveillance of arbovirus cases | Target 2025 | Achieved |
| 04.j. Number of countries and territories that have incorporated HPV vaccines in their national vaccination program | Baseline 2019 | Achieved |
| 12.a. Number of countries and territories reporting data on discrimination in health services experienced by men who have sex with men (MSM) in the past 12 months | Baseline 2019 | Achieved |
| 12.b. Number of countries and territories where the entire endemic (by vector transmission) territory or territorial unit has a domestic infestation index (by the main triatomine vector species or by the substitute vector, as the case may be) of less than or equal to 1% | Target 2025 | Not achieved |
| 12.c. Number of countries and territories with increased antimicrobial resistance (AMR) surveillance capacity to guide the public health interventions for decreasing the risk and preventing the spread of multidrug-resistant infections through intersectoral action | Baseline 2019 | Partially achieved |
| 17.a. Number of countries and territories that achieve 90% of viral suppression (viral load <1,000 copies/ml) in persons on antiretroviral therapy (ART) | Target 2025 | Achieved |
| 17.b. Number of countries and territories with >80% of malaria cases investigated and classified in areas targeted for elimination or prevention of reestablishment | Target 2025 | Achieved |
| 17.c [b]. Interruption of transmission of neglected infectious diseases (NID) in countries, following WHO criteria and guidelines [Chagas Disease] | Target 2025 | Not achieved |
| 17.c [c]. Interruption of transmission of neglected infectious diseases (NID) in countries, following WHO criteria and guidelines [Dog-mediated human rabies] | Baseline 2019 | Partially achieved |
| 17.c [f]. Interruption of transmission of neglected infectious diseases (NID) in countries, following WHO criteria and guidelines [Onchocerciasis] | Baseline 2019 | Achieved |
| 17.d. Number of countries and territories with established capacity and effective processes to eliminate human rabies transmitted by dogs | Baseline 2019 | Achieved |
| Outcome Indicator | Baseline/Target | Rating |
|---|---|---|
| 05.a. Number of countries and territories that achieve the 2025 global NCD target to halt the rise in diabetes assessed by age-standardized prevalence of raised blood glucose/diabetes among adults aged 18+ years | Target 2025 | Not achieved |
| 05.b. Number of countries and territories that reach a target of 35% prevalence of controlled hypertension at population level (<140/90mmHg) among persons with hypertension 18+ years of age | Target 2025 | Partially achieved |
| 05.e. Number of countries and territories whose surveillance systems have the capacity to report on key indicators of the Global Monitoring Framework for Noncommunicable Diseases | Target 2025 | Achieved |
| 05.h. Number of countries and territories that have increased the rate of persons admitted with mental disorders to general hospitals | Target 2025 | Not achieved |
| 13.d. Number of countries and territories that have eliminated industrially produced trans fatty acids | Target 2025 | Partially achieved |
| 15.a. Number of countries and territories with an operational advisory committee or lead agency on road safety that supports the development and/or implementation of a national road safety strategy | Baseline 2019 | Achieved |
| 15.b. Number of countries and territories that have a national or multisectoral plan addressing violence that includes the health system | Baseline 2019 | Achieved |
| 16.a. Number of countries and territories with ongoing collaboration between government mental health services and other departments, services, and sectors | Target 2025 | Partially achieved |
| Outcome Indicator | Baseline/Target | Rating |
|---|---|---|
| 18.g. Number of countries and territories with capacity to address health in chemical safety (including human health exposure to metals and/or pesticides) | Target 2025 | Achieved |
| 18.h. Number of countries and territories with capacity to address the health-related effects of climate change | Target 2025 | Achieved |
| 19.c. Number of countries and territories that are implementing policies or strategies based on regional guidance for healthy schools | Target 2025 | Achieved |
| 26.a. Number of countries and territories with institutional responses and accountability mechanisms that are advancing health equity, gender and ethnic equality in health, and human rights | Target 2025 | Achieved |
| Outcome Indicator | Baseline/Target | Rating |
|---|---|---|
| 20.a. Number of countries and territories that implement integrated interoperable information systems for health that include subnational disaggregation | Target 2025 | Not achieved |
| 21.a. Number of countries and territories with functional governance for generating and using evidence integrated into health systems | Target 2025 | Achieved |
| 21.b. Number of countries and territories that generate, analyze, and use data and information according to health priorities, disaggregated by geopolitical and demographic strata, as appropriate to the national context | Target 2025 | Achieved |
| 21.c. Number of countries and territories with established mechanisms on knowledge management, multilingualism, open access, and publishing | Target 2025 | Achieved |
| 22.a. Number of countries and territories implementing a funded policy, strategy and/or agenda on research and innovation for health | Target 2025 | Achieved |
| 22.b. Number of countries and territories that have ethical standards for conducting research with human subjects | Target 2025 | Achieved |
| Outcome Indicator | Baseline/Target | Rating |
|---|---|---|
| 23.a. Number of countries and territories that meet or exceed minimum capacities to manage public health risks associated with emergencies | Baseline 2019 | Achieved |
| 23.b. Number of States Parties meeting and sustaining International Health Regulations (IHR) requirements for core capacities | Target 2025 | Discrepancy |
| 24.a. Number of countries and territories with installed capacity to effectively respond to major epidemics and pandemics | Target 2025 | Discrepancy |
| 24.b. Number of endemic countries and territories with ≥ 80% coverage for yellow fever vaccine | Target 2025 | Discrepancy |
| Outcome Indicator | Baseline/Target | Rating |
|---|---|---|
| 27.a. Proportion of countries and territories where the national health authority reports satisfaction with PAHO/WHO’s leading role on global and regional health issues | Target 2025 | Achieved |
| 27.b. Number of countries and territories for which there is alignment between the national health policy, strategy, or plan and the outcomes defined in the PAHO Strategic Plan 2020-2025 | Target 2025 | Achieved |
1. Access to comprehensive and quality health services
2. Health throughout the life course
3. Quality care for older people
4. Response capacity for communicable diseases
5. Access to services for NCDs and mental health conditions
7. Health workforce
8. Access to health technologies
11. Strengthened financial protection
12. Risk factors for communicable diseases
13. Risk factors for noncommunicable diseases
15. Intersectoral response to violence and injuries
16. Intersectoral action on mental health
17. Elimination of communicable diseases
18. Social and environmental determinants
19. Health promotion and intersectoral action
20. Integrated information systems for health
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 | Partially achieved |
| 02.2.b. Number of countries and territories that measure percentage of pregnant women who received antenatal care four or more times, disaggregated by age, race/ethnicity, and place of residence | Baseline 2023 | Achieved |
| 02.2.e. Number of countries and territories implementing strategies to increase access to responsive and quality health services for adolescents | Target 2025 | Achieved |
| 03.1.a. Number of countries and territories that implement comprehensive assessments of older persons at the first level of care | Target 2025 | Partially achieved |
| 07.1.a. Number of countries and territories that are implementing a national policy on human resources for health | Target 2025 | Not 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 |
| 07.3.a. Number of countries and territories enabled to strengthen health workforce competencies and capacity-building programs through the Virtual Campus for Public Health and other WHO platforms | Target 2025 | 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 |
| 08.1.b. Number of countries and territories with policies and/or strategies on research and development, innovation, and/or manufacturing to promote access to affordable health products | Target 2025 | Partially 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 |
| 08.3.b. Number of countries and territories updating, developing, and implementing medicines pricing policies and monitoring systems | 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 | Target 2025 | 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 |
| 09.5.a. Number of countries and territories implementing interventions and actions to promote and protect the health and well-being of the migrant population within national health policies, plans, and programs | 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 |
| 04.3.a. Number of NID-endemic countries and territories that implement PAHO recommendations on integrated interventions to reduce the burden of NIDs through their health systems | Target 2025 | Achieved |
| 04.4.a. Number of countries and territories that implement PAHO/WHO recommended policies and inter programmatic approaches related to malaria | Baseline 2023 | Achieved |
| 04.5.a. Number of countries and territories with DPT3 immunization coverage of at least 95% that are implementing strategies to reach unvaccinated and under-vaccinated populations | Target 2025 | Not achieved |
| 04.6.a. Number of countries and territories that have conducted Integrated Management Strategy arbovirus evaluations | Baseline 2023 | Discrepancy |
| 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 |
| 12.2.a. Number of countries and territories with active programs to control antimicrobial resistance through scaling up of infection prevention and control and provision of water, sanitation, and hygiene in health facilities | Target 2025 | Partially achieved |
| 12.4.a. Number of countries and territories that annually provide laboratory-based data on antimicrobial resistance | Baseline 2023 | Partially achieved |
| 12.5.a. Number of countries and territories reporting participation of communities in the response to HIV, TB, STIs, and viral hepatitis | Target 2025 | Discrepancy |
| 12.6.a. Number of NID-endemic countries and territories that use the framework of the WHO WASH-NTD strategy as part of their national or subnational approach to tackle NIDs | Target 2025 | Partially 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 |
| 12.9.a. Number of countries and territories with integrated territorial actions for prevention, control, and/or surveillance of vector-borne transmission of Trypanosoma cruzi | Target 2025 | Not 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 |
| 17.4.a. Number of countries and territories with official status as foot-and-mouth disease free, with or without vaccination, in accordance with the timeline and expected results established in the PHEFA Action Plan 2021–2025 | 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 | Target 2025 | 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 | Baseline 2023 | Achieved |
| Output (OPT) Indicator | Baseline/Target | Rating |
|---|---|---|
| 05.2.a. Number of countries and territories that have surveillance systems in place to enable reporting on the global and regional NCD commitments | Baseline 2023 | Achieved |
| 05.2.b. Number of countries and territories with implementation plans for population-based surveys developed with direct support from PASB | Target 2025 | 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 | Target 2025 | Partially achieved |
| 06.1.a. Number of countries and territories that have a single emergency care access number with full national coverage | Baseline 2023 | Achieved |
| 06.2.a. Number of countries and territories that are implementing national standard operating procedures, protocols, and/or guidelines for the health system response to violence, aligned with PAHO and WHO guidelines | Baseline 2023 | Achieved |
| 13.1.b. Number of countries and territories implementing a national policy or strategy on physical activity | Baseline 2023 | Partially achieved |
| 13.1.c. Number of countries and territories implementing policies to reduce salt/sodium consumption in the population | Baseline 2023 | Achieved |
| 13.1.d. Number of countries and territories implementing policies and/or actions to regulate unhealthy food and drink products | Baseline 2023 | 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 |
| 14.1.b. Number of countries and territories implementing policies to protect, promote, and support optimal breastfeeding and complementary feeding practices | Baseline 2023 | Achieved |
| 15.2.a. Number of countries and territories that have a national multisectoral coalition/task force to prevent and respond to violence that includes the health sector | 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 | Target 2025 | 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 | Target 2025 | Not achieved |
| Output (OPT) Indicator | Baseline/Target | Rating |
|---|---|---|
| 18.2.b. Number of countries implementing plans, policies, programs, and/or interventions to increase climate resilience and environmental sustainability of health care waste management practices, following WHO Guidelines | Target 2025 | Achieved |
| 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 | Target 2025 | 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 |
| 26.4.a. Number of countries and territories implementing policies, plans, and programs to advance ethnic equality in health | Target 2025 | Achieved |
| 26.5.a. Number of countries and territories using human rights norms and standards in the formulation and implementation of health-related policies, plans, programs, and legislation | 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 | Target 2025 | 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 |
| 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 | Baseline 2023 | Achieved |
| 22.3.a. Number of countries and territories that have increased the number of scientific publications on health that respond to priority research agendas and the SDGs | 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 | Target 2025 | Not achieved |
| 23.3.a. Number of States Parties that have conducted simulation exercises or after-action review | Target 2025 | Not achieved |
| 23.4.a. Number of countries and territories that include safe hospital criteria in the planning, design, construction, and operation of health services | Target 2025 | 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 |