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Fostering Cooperation in Health among Developing Countries

Global health challenges and responses of the South in a time of crisis

Washington, D.C. PAHO HQ.
December 16, 2009.

Welcoming Remarks
*Dr. Mirta Roses Periago, Director,
Pan American Health Organization.

Dear and respected friends,

Public health is way more than a job for us: it is a passion, a heartfelt commitment, our whole life. We keep good company because, fortunately, it is that way not only for us but also for millions of people worldwide. Public health is a sort of a network of networks, where a broad and multifaceted umbrella which protects the well-being of humanity is held up every day by a myriad of individual's actions.

In that regard, I am afraid that the vaunted social networks are anything but new -although, let us be clear, not less valuable because of that. At the end of the day, public health is, and has always been, the ultimate social network, a worldwide-casting connection where millions of people pursue common objectives, share their knowledge and mutually support and reinforce each other's capabilities.

Such a beneficial net must be systematically enhanced, of course, to make sure it covers everyone and the seams are strong enough. Our purpose here is to take stock of the global health challenges as well as of the South-South development solutions we have available, and the ones we could and should foster, to confront them.

It is heartening to hear from Joel Selanikio how the younger social networks can provide such a creative and valuable avenue to incorporate on real-time the contributions of more people to the vast and experienced public health network, as EpiSurveyor has been doing with its groundbreaking phone-based health data collection, analysis and use system. Datadyne's cooperation with both the Pan American Health and the World Health Organization in the Americas and Africa is also an example of the way forward to create synergies that speed up the response to the most pressing public health challenges of our times using public-private partnerships.

Solidarity and close cooperation, among individuals, sectors and institutions, among countries and Regions is also a fundamental characteristic of public health. There are not such things as boundaries for illnesses and health risks, as we have seen time and again, be it with high profile diseases such as AH1N1 or with the ever expanding reach of sometimes neglected diseases due to climate change. No country is too big or too small, too rich or too poor, at the time of making its contribution to global public health levels.

Since the Buenos Aires Plan of Action for Technical Cooperation among Developing Countries in 1976 and continuing all the way through the Accra Agenda for Action, this has always been a pivotal element of the South-South cooperation on public health and must continue being so, because reciprocity, mutual benefit and pursuing common objectives are essential to our endeavors in this realm. In the Americas we are particularly proud that these have been guiding principles of our Technical Cooperation among Countries (TCC) programs to the point that all our Member States have participated in such projects and that we have also pursued TCC projects with other Regions, such as Africa. For that reason we are looking forward to the presentation by João Aprígio Guerra de Almeida, from the Oswaldo Cruz Foundation, about the Brazilian and the Iberoamerican Networks of Human Milk Banks.

Scientific advancement and the promotion of evidence-based interventions to tackle new challenges, to consolidate achievements and to close public health gaps require, on the other hand, fostering a constant and self-reinforcing process of innovation. In an economic crisis context, Southern-grown solutions for global health, such as the Prevention of Hiv/Aids in Migrant Workers (PHAMIT) project that will be presented by Thongphit Pinyosinwat, of Thailand's Raks Thai Foundation, are at a premium -and even more so given that this concerted effort of a consortia of NGOs and the Ministry of Health implies health benefits transcending national borders. Since resources are even scarcer in poor countries we must keep a close eye on the cost-effectiveness of interventions, to make sure that our societies get a high rate of social return on their health investments.

The silver lining about this reality is that it creates, out of necessity, a breeding ground for new ways of doing things more efficiently without sacrificing the effectiveness of public health interventions. However, in order to take full advantage of the vast possibilities and promises of all that trove of experimentation and advance it is critical to share the best practices and the lessons learnt, much as we are doing in this forum. Thus the relevance of Southern-based solutions for accessing and sharing health information, presented by Abel Packer from the Latin American and the Caribbean Center on Health Sciences Information (BIREME), aimed at transforming our Southern-grown innovation efforts into widely applied, and beneficial, sanitary interventions.

This points out to the most crucial feature in any South-South cooperation in public health endeavor: that of capacity building. I must confess here that at PAHO we are very proud of our TCC efforts, both regarding its scope and its qualitative aspects. In particular, let me highlight that our five priority countries are also the most active, accounting for more than 40% of the TCC projects implemented in the last few years. We also have a wealth of trans-border projects and we are pursuing not only intra-regional but also inter-regional TCC programs. As per financing modalities the experiences cover all the range, from country-funded initiatives to multilateral financing, passing through triangulation projects such as those related to Hiv-Aids cooperation from Brazil to Bolivia and Ecuador financed by the DFID from the United Kingdom, the polio eradication program between AMRO and AFRO and the Deliver Now for Women and Children initiative involving Chile, Brazil, Bolivia and Ecuador with Norway's active support, as well as the increased attention paid to the South-South agenda by cooperation agencies in their resource allocation and strategic plans.

The importance of this facet can hardly be exaggerated, since capacity building in all developing countries is a crucial stepping stone in the quest to achieve the Millennium Development Goals (MDGs) and being able to sustain advances already made. In particular, it is pivotal to address the need for strengthening the public health systems in order to ensure that they are able to cope with the increased demands resulting from the economic crisis and also have the necessary flexibility to adapt to changing health needs caused by the transition in health profiles and by climate change.

Experience makes clear that there is still a need for systematizing the practice of South-South cooperation in health and to improve the monitoring, evaluation and impact-measuring tools. Doing so would significantly enhance the visibility and predictability of such efforts, contribute to simplify the joint planning processes with cooperation agencies, strengthen institutional capacity for South-South cooperation, and -needless to say- ensure a bigger beneficial impact on the health levels of the population.

At the end of the day, that is what really matters. What gives sense to all our endeavors relating South-South cooperation in public health is to increase our ability to fight inequality and to promote the highest attainable level of health for all. The Americas have a sad global record of inequality, but this is clearly a worldwide scourge. Since health is a public and instrumental good for individuals, families, and communities, it should be within the reach of all, and we must keep hammering at the need for not replicating in public health the inequalities that mar other aspects of our societies.

It is particularly galling that today millions of people still suffer, and die, from neglected diseases despite the fact that we possess the knowledge and the tools with which to make them virtually disappear. I have expressed in many fora my conviction that we are ethically bound to make a determined effort to implement them without further delay -that is why we have a lot to learn from the Community-Directed Treatment for the Elimination of Neglected Diseases project that will be presented by Oladele Akogun, of the Centre for Research and Development of Nigeria's Federal University of Technology, a collaborative effort that shows a very valuable way to advance on this public health and moral imperative.

Dear Friends,

Today's activity is about breaking traditional molds and concepts, about unleashing the creative capacities of the South countries in order to respond to the health and equity challenges of our time. Instead of top-down approaches to health cooperation, we are promoting horizontal approaches where equally committed partners help each other to reach mutually beneficial goals. There are multiple actors in cooperation, bringing to the fore varied and valuable experiences from different fields and looking for more inclusive ways of advancing our common goals. Therefore, it is not surprising that cooperation in health resembles more and more an ever-expanding network of alliances and associations among countries, academic centers, scientists, NGOs, public sector and private enterprises, working on many different realms at the same time. On public health, all of us, no matter our origin, find a common house, a common cause, a common passion.

Over more than 107 years the Pan American Health Organization has devoted itself to the tireless effort of being at the forefront of the response to the regional and global challenges in public health and, particularly, to serve as an instrument for bringing health to the most neglected, vulnerable, marginalized, and excluded populations.

Because of that institutional DNA, it is a profound honor for us to have the opportunity to host this world-class forum, with such first-rate expositors, a very distinguished moderator, and pivotal subjects. A new vision of cooperation in health is already dawning. Allow me to thank all of you for being here and willing to make this activity a very valuable turning point for South-South cooperation in public health, so that we continue advancing the fulfillment of our common passion and commitment, that of health for all.

Thank you.


- Unleashing Southern Capacities for Development
   Mr. Yiping Zhou, Director, UNDP Special Unit for South-South Cooperation

- Protecting Global Health in a time of crisis
   Dr. Anarfi Asamoa-Baah, Deputy Director, World Health Organization

- Message at the Opening Ceremony of the Global South-South Development Expo 2009.
   Dr. Margaret Chan Director-General, World Health Organization.


- GSSD Expo Promotion Video

More information:

- Global South-South Development Expo 2009 Website

PAHO Press Releases:

- PAHO Recognizes "Winning Global Health Solutions"

- South-South Development Solutions Forum on Global Health

Event PhotoGallery

The Global South-South Development Expo showcases successful southern-grown development solutions. The Expo has served as a vibrant platform for the international community to celebrate achievements; share development successes; explore new avenues for collaboration; forge innovative South-South, triangular and public-private partnerships; and launch concrete collaborative schemes towards achieving internationally agreed development goals, including the Millennium Development Goals.