Under Chapter XIX of the Charter, specialized organizations are governmental organizations established by multilateral agreements. They have specific functions with respect to technical matters of common interest to the States of the Americas. They enjoy full technical autonomy but must take into account the recommendations of the General Assembly and the Councils. At present there are six specialized organizations: the Pan American Health Organization (PAHO); the Inter-American Children's Institute (IIN); the Inter-American Commission of Women (CIM); the Pan American Institute of Geography and History (PAIGH); the Inter-American Indian Institute (III), and the Inter-American Institute for Cooperation on Agriculture (IICA). Pursuant to Articles 132 and 90.f of the Charter, all specialized organizations are to present detailed reports of their activities, a summary of which appears in this chapter.

TOPICS:

• Decisions of the governing bodies
• Technical cooperation programs
• Cooperation with other organizations
• Other inter-American events

Established by the Second International Conference of American States (Mexico City, 1901-1902), the Pan American Health Organization is also the World Health Organization's regional agency for the Americas. Its basic purpose is to promote and coordinate the efforts of the American countries to combat disease, prolong life and improve the physical and mental health of their peoples. PAHO has its headquarters in Washington, D.C. Its Director is Dr. George Alleyne.

Decisions of the governing bodies

Among the 19 resolutions approved by the Pan American Sanitary Conference, the following are of special interest to the OAS: the resolution on the appointment of Dr. George Alleyne as Director of PAHO and of Dr. Carlyle Guerra de Macedo as Director Emeritus; the evaluation of PAHO's 1991-1994 strategic guidelines and programming priorities and the adoption of its 1995-1998 strategy and program guidelines; the proposal to convene a Pan American Conference on Health and the Environment; a resolution on health and peace amid development and democracy in Central America; the resolution on acquired immune deficiency syndrome (AIDS) in the Americas; and the joint PAHO/ECLAC report on health, social equity, and changing patterns of production in Latin America and the Caribbean.

The strategy and program guidelines that the Conference approved for the next four-year period involve eight broad regional objectives calculated to improve living conditions and increase life expectancy.

The Conference applauded the fact that the Americas are now free of polio and is the only region in the world where the challenge now is to maintain that achievement.

Technical cooperation programs

PAHO continued to provide technical cooperation to the member countries to strengthen their capacity to provide efficient health services. With the growing social inequity among various countries and within any given country, the gap between rich and poor and the increase in the number of people living in poverty, the need to step up efforts to ensure equitable access to health services has become increasingly obvious.

In response, PAHO has stepped up its efforts in areas related to health development; health- sector reform; promotion of health; disease prevention and control; health and the environment; investments in health. It has sharpened its coordination with other government organizations and nongovernmental organizations and has endeavored to improve the administration and delivery of technical cooperation.

The document on Health Conditions in the Americas, published every four years, came out in 1994. The document deals with a number of health-related issues in the hemisphere and in each country.

PAHO provided the member countries with its assistance in developing the legal framework that would facilitate health-sector reform. To energize the process of developing health systems, PAHO continued to promote the concept of decentralization. Recent reports show that significant progress has been made toward reorganization of the State by decentralizing and strengthening local systems. The establishment of networks of local health systems, community participation and decentralized decision-making have improved the communities' ability to pinpoint risk groups and provide them with services. It has also drawn nongovernmental organizations into the process of developing health policy. Coping with contagious diseases continues to be a major challenge as new diseases (such as AIDS) and noncontagious chronic illnesses demand an ever increasing portion of the health budget. The AIDS epidemic and the spread of the HIV virus continue to be a matter of grave concern in the region. The countries have adopted national plans to deal with the AIDS and HIV crisis. In 1994, high-level seminars were held for government officials in charge of these programs in the hemisphere.

PAHO continued to attach priority to its programs in environmental quality and basic fitness in order to lower the impact that environmental degradation has on health.

Aware that improvement of the health sector largely depends upon the quality of its human resources, PAHO has placed considerable emphasis on training for health personnel.

Cooperation with other organizations

PAHO, the Department of Educational Affairs of the OAS General Secretariat and CICAD have worked jointly on the drug issue. PAHO and CICAD jointly chair an interagency group coordinating financing and technical cooperation to the member States in this field.

PAHO has also continued to work with the Inter-American Commission of Women and with the Inter-American Children's Institute. It has furthered strengthened its activities in the area of maternal-infant health, to help women participate in the development process. The cooperation between PAHO and ECLAC has been very close. The PAHO/WHO participated in the Sixth Regional Conference, held in Mar del Plata, Argentina. Its involvement in the Conference started with the preparatory phase and continued up through the actual holding of the Conference. It also took part in a meeting organized by ECLAC and held in Santiago, Chile, in November, to finalize the text of the regional document for the Beijing Conference in 1995.

PAHO is providing countries with support to enable them to put into practice the recommendations of the International Conference on Population and Development held in Cairo, Egypt, in September.

It continued its work with the Secretariat of the International Decade for the Reduction of Natural Disasters and participated in the Conference held on that subject in Cartagena de Indias, Colombia, in March 1994.

The PAHO/WHO continued to coordinate humanitarian relief to Haiti and in early 1994, on behalf of the OAS and the United Nations, assumed responsibility for securing and storing fuel and distributing it to relief agencies in that country.

Other inter-American events

PAHO took an active part in two major inter-American events: the Summit of the Americas and the Inter-American Conference on Society, Violence and Health. The latter was organized and convoked by PAHO and co-sponsored by the OAS, the Inter-American Development Bank, the UNDP, UNICEF, UNESCO and the United States Agency for International Development (USAID). The conference discussed the many manifestations of violence and related issues. In attendance were high-ranking government officials, lawmakers, representatives of the clergy, Nobel prize winners, and members of the scientific, cultural, intellectual and artistic communities of the American nations.

At the Summit of the Americas, PAHO succeeded in getting the topic of equal access to basic health care services on the agenda of that presidential meeting.

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