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).

DPT vaccination coverage has been affected by the pandemic. Although efforts are being made to improve coverage and reduce dropout rates, the goal is to ensure that the under-vaccinated are reached.

Since 2020, a decrease in vaccination coverage with the third dose of PCV vaccine has been noted. In 2023, a very slight improvement was noted compared to 2022 (81% vs. 80%). This, together with improvement in coverage of other vaccines (e.g., pentavalent), could indicate that PCV3 vaccination coverage has started to recover. It is important to closely monitor the progress of member states.

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.

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.

The number of countries that have generated and produced analytical health reports which include disaggregated data on a regular basis has increased from 5 to 17. Additionally, countries are increasingly making these reports and other health data and information more accessible both internally and externally. Improved national health information systems and advances in digital transformation have led to increased data demand and utilization. Such data increasingly include the social determinants of health and allow countries to monitor progress and gaps. PASB provided technical cooperation through ongoing capacity-building efforts in health analysis, particularly for monitoring SDG3 indicators among interdisciplinary country teams at national and subnational levels. This has been crucial to the progress achieved for OCM 21.b. An additional 13 countries are on track to achieve this indicator.
No agreement was reached for three countries and territories. PASB assessed that the criteria as detailed on the technical note for the indicator were not met, and no documentation was submitted or otherwise available at the time of the assessment.

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.

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.