Through implementation of the EMTCT Plus Initiative, PASB has been working with national health authorities to strengthen national responses to syphilis and congenital syphilis, toward the achievement of elimination targets. The coverage of syphilis treatment among infected pregnant women has been historically high in Latin America and the Caribbean, reaching 89% in 2023. Eleven countries have been validated for the dual EMTCT of HIV and syphilis, and additional countries have shown progress and may be ready to seek validation in the near future.

PASB will continue supporting at-risk countries in conducting follow-up campaigns to update the vaccination status of unvaccinated children under 5 years of age. This should improve MMR-1 and MMR-2 vaccination coverage by the end of 2023. Countries report 2023 data in the first quarter of 2024 via the PAHO-WHO/UNICEF electronic Joint Immunization Data Reporting Form (eJRF).

The countries of the Region have made great efforts to incorporate the vaccine into their national vaccination schedules; as of December 31, 2023, only 4 countries had not introduced the HPV vaccine. 26 countries in the Region are vaccinating children and 12 countries have switched to a single-dose schedule.

Although the current rating of this indicator is “No progress” due to a regression from the baseline, it should be noted that, of the total number of countries (14), 5 achieved the target and 7 are on track to achieve it; only 2 countries are at risk. Countries that are on track to achieve the indicator have progressed in expanding blood collection capacity and reducing blood loss or expiration as they improve their quality processes. Additional efforts are being made to support Caribbean countries through quality training so that better performance also improves the availability of blood for transfusion. Likewise, the promotion of voluntary blood donation was strengthened with the World Blood Donor Day campaign and through regional seminars. Greater support will be provided to the countries that are at risk to help them reach the target by 2025.

Important advances have been made in the Region toward the institutionalization of health technology assessments (HTA) as a tool to inform decision-making related to the incorporation of health technologies into health systems. Five countries have already achieved the indicator, and 3 are on track to achieve it (Chile, Costa Rica, and El Salvador). PASB has been supporting Member States through technical cooperation to develop institutional frameworks, public policies, methodological documents, and capacity building. As the Secretariat of the Regional HTA Network (RedETSA), PASB has been promoting collaboration and information exchange among the 21 participating countries. Only one country is at risk, but PASB is working with the national health authorities to help them achieve the indicator by 2025.

At the regional level, the indicator showed progress for the target countries, for which the average public expenditure on health as a share of Gross Domestic Product (GDP) rose from 4.3% to 5.3% between 2019 and 2021. Nine countries (Argentina, Aruba, Bermudas, Canada, Colombia, Cuba, El Salvador, Montserrat, and Uruguay) have achieved this indicator, investing more than 6% of GDP in the health sector using public sources of funding. Of the 7 target countries, two (Chile and Honduras) are working to achieve the indicator, but progress is at risk. In Chile, public expenditure on health rose from 4.8% in 2019 to 5.5% in 2020 but subsequently decreased to 5.2%. On other hand, Honduras increased public expenditure on health from 2.9% to 3.4% in 2020, remaining stagnant. In terms of data collection, new data from the WHO Health Expenditure Database in 2024 will allow assessment of the progress of countries that have not fully achieved this indicator.

Achieving this outcome indicator involves continuously monitoring and supporting national policies and agendas for health research and promoting their alignment with the Policy on Research for Health (CD49/10) and WHO’s Strategy on Research for Health (WHA 58.34). PASB also supports countries to assess and report on financial flows for health research. This process often requires intersectoral action, because while priorities are usually set by the health sector, funding is frequently allocated by other sectors, such as science and technology.
In addition to providing direct technical cooperation, PASB has issued technical documents and a checklist to assist countries in developing a national policy or agenda on health research. PAHO also collaborates with WHO’s Global Observatory on Research for Health and Development, harmonizing indicators with those monitored by WHO, UN, UNESCO, and OECD to improve consistency and reduce the reporting burden on countries. PAHO collates this information on a public website and works with WHO, Member States, and data providers to keep the data updated.

PASB supported Member States in the development and revision of national standards governing the ethics of research, such as laws, regulations, and national policies, with the goal of ensuring that they adhere to international ethical standards for research with human participants. The COVID-19 pandemic brought increased attention to the importance of adhering to international standards to expedite the conduct of high-impact clinical trials. Furthermore, international standards for research now include specific provisions for research in emergencies (as described in PAHO’s Catalyzing Ethical Research in Emergencies: Ethics guidance, lessons learned from the COVID-19 pandemic and pending agenda), and PASB supported countries in including these provisions in national standards, thus improving ethics preparedness to conduct research in future emergencies. Measuring progress in this indicator has often entailed distinguishing the ethical from the strictly regulatory oversight of research with human participants.

In the 2022-23 biennium, progress was made toward strengthening country capacity for all-hazards health emergency and disaster risk management. As of the latest assessment, 22 countries fully meet or exceed minimum capacities to manage public health risk associated with emergencies, with another 15 on track to do so. PASB's technical support, including the development of assessment tools and coordinator meetings, remains essential for achieving the 2025 target of 37 countries. Continuous monitoring and emphasis on gender-sensitive disaster preparedness, supported by tools such as the Preparedness Index for Health Emergencies and Disasters and the monitoring survey for the Plan of Action on Disaster Risk Reduction, are critical for maintaining and building on the progress made.

The majority of countries and territories express satisfaction with PAHO/WHO's leading role on global and regional health issues, indicating that the Organization’s efforts and initiatives are generally perceived positively across the region. This widespread satisfaction underscores PAHO/WHO's role as a leading public health authority, engaging countries and territories in the regional and global public health agenda at the highest level – politically, strategically, and technically. Efforts will continue to ensure alignment between biennial work plans and the priorities indicated by national health authorities. This commitment involves ongoing coordination and collaboration with national health authorities to tailor PAHO/WHO's biennial work plans to address the specific health challenges and priorities identified by each country.