Work is ongoing to strengthen countries’ arboviral disease surveillance capacities, facilitating the monitoring of the largest dengue epidemic ever recorded in the Americas. Significant progress has been made via operationalization of collaborative surveillance through the implementation of Virtual Collaboration Spaces. In addition, a new Integrated Surveillance Manual for Arboviral Diseases has been completed following two consultation meetings with country experts.

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.

During the biennium, countries in the Region made progress in eliminating malaria or interrupting its transmission both at the national and subnational levels, as well as preventing re-establishment in malaria-free countries and receptive territories. Case investigation is being incorporated by endemic and non-endemic countries, including improvements in guidelines, instruments, and surveillance processes. These actions should integrate the efforts made so far by vertical programs with more cross-cutting epidemiologic surveillance processes and actors. Important challenges remain in this aspect of integration and in the quality of investigations. Pending improvements include the adoption of investigation in endemic territories where the small number of cases already justifies this action to accelerate elimination, as well as improvements in response. The technical cooperation that PAHO has developed in this area has been replicated with partner implementation actions, such as the RMEI initiative in Central America.

Saint Lucia is on track to achieve this indicator. The status of schistosomiasis transmission in Puerto Rico remains active, posing continued risks. Suriname has not made progress in assessing the status of schistosomiasis transmission. Antigua and Barbuda did not show progress on this indicator due to suspected interruption of transmission, pending confirmation through necessary studies.

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.

Progress has been observed in the Americas regarding the generation, circulation, and utilization of scientific and technical information, as well as the promulgation of knowledge-sharing initiatives among Members States, PASB, and stakeholders.
Overall, the impact factor of the scientific output and the number of journals increased across all Member States during the period 2022-2023, with special emphasis on medicine, public health, and related topics. The increase in implementation of open-access platforms and policies helped ensure more equitable and accessible access to scientific production in public health-related fields.
The contribution from documentation centers to regional databases such as LILACS, MedCarib, and other open-access platforms worldwide has also increased. A total of 22 countries and territories are eligible to access the Research4Life (R4L) program, and there has been an increase in the number of registered institutions, which have helped to meet the need for more equitable access to scientific and technical information and to reduce the digital divide across the Region. El Salvador became the first Member State to participate in the R4L Country Connector initiative.
Despite a slight decrease in the number of new designations and re-designations, PAHO/WHO Collaborating Centers (CC) have proven to be an important mechanism of technical cooperation. PAHO/WHO CCs support the Organization in fulfilling the mandates and priorities of the Region and globally, by developing research models and evidence-based literature and providing health analysis and methodologies. By December 2023, there were 179 CCs in the Region, distributed across 15 Member States.
Despite these advancements, persistent efforts to strengthen research systems, enhance knowledge sharing, and promote evidence-informed policies are needed. Institutionalizing knowledge, evidence, and science at the national level is essential, as is fostering integrated policies for information use and knowledge dissemination. Furthermore, capacity building and a continued focus on digital literacy are necessary to ensure that public health workers, decision-makers, researchers, and communities have access to the best scientific and technical information.

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.