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Mirta Roses Periago Director. PAHO/WHO Washington D.C. 15 September 2010

Informative Session Permanent Representatives to the Organization of American States and Representatives of Member States of PAHO/WHO 30th Anniversary of Smallpox Eradication and the Establishment of the PAHO Revolving Fund for Vaccine Procurement

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Mirta Roses Periago Director. PAHO/WHO Washington D.C. 15 September 2010

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  1. Informative SessionPermanent Representatives to the Organization of American States and Representatives of Member States of PAHO/WHO 30th Anniversary of Smallpox Eradication and the Establishment of the PAHO Revolving Fund for Vaccine Procurement Mirta Roses Periago Director. PAHO/WHO Washington D.C. 15 September 2010

  2. PAHO Executive Committee 2007 – 2010 Bolivia Mexico (President) Suriname (Rapporteur) 2008 - 2011: Argentina Guatemala Haiti (Vice President) 2009 – 2012: Colombia St Vincent and the Grenadines Venezuela 2010 – 2013 Candidates: United States of America Grenada Peru

  3. WHO Executive Board 2008 – 2011: Brazil (PBAC) 2009 – 2012: Canada (PBAC), Chile 2010 – 2013: Barbados, Ecuador, USA

  4. WHO Candidates Executive Board 2011-2014 (one opening available in the Region) Candidate: Mexico TDR 2011-2014(one opening available) Candidate: Peru

  5. Dr. Esperanza Martínez, Paraguay, Directing Council President, incumbent Dr. Mirta Roses, Director of PAHO José Miguel Insulza, Secretary-General of the OAS Kei Kawabata, Manager, Social Sector, IDB Dr. Margaret Chan, WHO Director-General (Video-message) Dr. Bill Corr,Deputy Secretary, Department of Health and Human Services of the United States of America 50th PAHO Directing CouncilOpening session Washington D.C. PAHO HQ. 27 September 2010, 09:00am Dais

  6. 50th PAHO Directing Council • Proposed Officers: • General Committee: • President: Mexico • Vice President: Peru • Vice President: A Caribbean Country to be designated • Rapporteur: Canada • Cuba • Panama • Uruguay • CredentialsCommittee : • Chile • Jamaica • Nicaragua

  7. Items on: Regulation Constitution Program policy Administration and Finance Awards General Information 50th PAHO Directing CouncilWashington, D.C. 27 September – 1 October 2010Agenda

  8. 50th PAHO Directing Council Events

  9. 50th PAHO Directing Council Events

  10. Report on the fourth session of the Subcommittee on Program, Budget, and Administration Washington, D.C., 17-19 March 2010 Participating countries: Barbados, Bolivia (Vice President), Cuba, Guatemala, Mexico (Rapporteur), St. Vincent and the Grenadines (President), and United States of America. Observers: Brazil, Canada, Honduras, Suriname

  11. Awards for Excellence in Inter-American Public Health 2010 Monday, 27 September 2010. 3:30 pm PAHO Award for Administration • Dr. Elsa Yolanda Palou, Honduras Abraham Horwitz Award (Leadership in Inter-American health) • Dr. Carlos Monteiro, Brazil Clarence Moore Award (Community service) • Peruvian Association to Fight Cancer, Peru Pedro Acha Award (Veterinary public health) • Dr. Luis Zanoli, Brazil Manuel Velasco Suarez Award (Bioethics) • Dr. Paulina Taboada, Chile Sergio Arouca Award (Universal health care) • Dr. Maria Fatima de Sousa, Brazil

  12. This is the first progress report on implementation of the Strategic Plan 2008-2012 . The report includes: Overview of public health in the Region, including achievements and challenges during the 2008-2009 biennium Progress toward achieving the strategic objectives (SOs) Budgetary assessment by level (country, subregion and region) and by SO Information on resource mobilization Lessons learned, conclusions, and recommendations At the end of the first execution period of the Strategic Plan(biennium 2008-2009), the Organization is well on the way to achieving its objectives Program and Budget 2008-2009 End-of-biennium Assessment Interim PAHO Strategic Plan 2008-2012Progress Report

  13. Budgetary implementation by organizational level, end of biennium, 2008-2009 • The distribution of resources by organizational level (as a percentage of total funds available for the biennium) according to the regional program budget policy. • There was a high level of budgetary implementation at all levels during the biennial. Note: These figures do not include funds from projects financed internally by the governments or resources from the Revolving Fund, the Strategic Fund, or other funds that are not used to directly finance the Strategic Plan.

  14. Status of financial gap during the biennium 2008-2009 US$ Millions PP 08-09 Semester I Semester II Semester III End of Biennium Resources mobilized Financial gap Regular budget Note: The figures do not include project funds covered internally by government or resources from the Revolving Fund, the Strategic Fund and other funds that are not used for direct financing of the Strategic Plan.

  15. Modernization of the Pan American Sanitary Bureau’s Management Information System • A request was made to the Pan American Sanitary Bureau’s Management Information System Committee to evaluate various options for modernizing the multiple components of the Bureau’s management information system. • This report will present the results of that work, including the guiding principles, a summary of the analysis of institutional processes, and analysis of options and costs. • This report will be presented to the Directing Council for approval of the guiding principles and recommendations. CE14610 Anexo A Guiding Principles Modernization of the Pan American Sanitary Bureau’s Management Information System Pan American Sanitary Bureau Management Information System Committee. BPB.060.ALL001 February 2010

  16. Evaluation of the Regional Program Budget Policy • In September 2004, the 45th Directing Council adopted Resolution CD45.R6, which, among other things, requested the Director of the Pan American Sanitary Bureau (the Director) to “present to the Directing Council or Pan American Sanitary Bureau a thorough evaluation of the Regional Program Budget Policy…“ • The Director gave instructions to the Office of Internal Oversight and Evaluation Services (IES) to undertake this evaluation and include it in its 2010 work plan. • The Office of Internal Oversight and Evaluation Services will report to the next Council on the progress made and present its preliminary results.

  17. Strategy to reduce abuse of psychoactive substances This document proposes a regional public health strategy to respond to health problems related to the consumption of psychoactive substances in the Region of the Americas that includes five areas of action: formulation of national policies and resource allocation; promotion of universal prevention; early intervention, attention and treatment systems; research, monitoring, and evaluation; and formation of strategic alliances. A A

  18. Strategy and Plan of Action for Chagas’ Disease Prevention, Control and Care Southern Cone:INCOSUR • Plan of Action Goals for 2015 • Goals 1: • Interrupt vector-borne, transfusional, and other types of T. cruzi transmission in all subregions of the Americas. This will require expanding the coverage of prevention and control measures, bearing in mind the characteristics of the health system and the ecology of each subregion. • Goals 2:Reduce morbidity and mortality by improving access to health services for infected people, both symptomatic and asymptomatic, as well as increasing coverage of diagnosis, quality medical attention and timely treatment of cases. Central America:IPCA Amazon:AMCHA Andes:IPA

  19. Strategy and Plan of Action for the Elimination of Mother-to-Child Transmission of HIV and Congenital Syphilis  • Objective • Eliminate congenital syphilis and mother-to-child HIV transmission in the Americas by 2015. • Time frame • The Strategy and Plan of Action will be executed during the period 2010-2015. • Goals • Reduce mother-to-child transmission of HIV to 2% or less. • Reduce the incidence of mother-to-child transmission of HIV to 0.3 cases or less per 1,000 live births. • Reduce the incidence of congenital syphilis to 0.5 cases or less (included stillborns) per 1,000 live births. ElliminationInitiative

  20. Strategy for Health Personnel Competency Development in Primary Care-based Health Systems • The purpose of the strategy for developing health worker competencies is to strengthen the capacity for leadership, administration, management and the delivery of services required for: the renewal of primary health care, the operation of integrated delivery networks, and appropriate performance of the essential public health functions. Intensive use of information and communication technology (ICT) is proposed for implementing the strategy.

  21. Health, Human Security, and Well-being • The document contains the following objectives: • Introduce the concept of human security; • Describe the relationship between human security and specific public health conditions; • Show the relationship between the concept of human security and the Millennium Development Goals (MDGs) and health determinants; and • Explore proposals for regional and national policies on the subject. • A proposed resolution will be submitted to the Directing Council for consideration.

  22. Strengthening Immunization Programs • Presentation of the Regional Vision and Strategy on Immunization, with the goal of reducing morbidity and mortality from vaccine-preventable diseases to levels that no longer constitute a public health problem, pursuant to the goals set in 1977 during the launch of EPI • The objectives are: • Sustain the achievements: a Region free of poliomyelitis, measles, rubella, and congenital rubella syndrome, with control of diphtheria, whooping cough, and Hib. • Complete the unfinished agenda: elimination of neonatal tetanus; epidemiological control of hepatitis B, seasonal influenza, and yellow fever; ensure that all municipalities have coverage above 95% (using DPT3 as the tracer), and complete the transition from an immunization approach geared to children to one focused on comprehensive family immunization. • Tackle new challenges: introduce new vaccines that contribute to the achievement of the MDGs; improve national decision-making capacity; promote the financial sustainability of the EPI, and strengthen vaccination and immunization services within the framework of systems and services based on primary health care.

  23. Plan of Action for Safe Hospitals • The purpose of this Plan of Action is to facilitate adoption by the Member States of the theme “hospitals safe from disasters” as a national risk reduction policy, and achievement of the goal of constructing all new hospitals with a level of protection that better ensures their ability to keep operating in disasters. It also seeks the implementation of adequate mitigation measures to improve the safety of existing health facilities.

  24. Health and Human Rights Examples of ties between health and human rights • This concept paper: • Analyzes the relationship between the health of the most vulnerable groups and human rights established by international human rights instruments; • Examines the trends and challenges that the Pan American Sanitary Bureau (the Bureau) has observed in its technical cooperation activities (1998 - 2009) and; • Proposes recommendations for the Members States of PAHO in the application of human rights instruments within the context of the activities undertaken by the national health authorities and other governmental and nongovernmental actors. Source: WHO

  25. Administrative and Financial Matters Pan American Health Organization

  26. Source of Financial Resources WHO Other sources WHO allocation PAHO Other funds PAHO Fiduciary funds US$ Millions Revolving Fund / Immunization (EPI) Reimb. Proc./ Strategic Fund Misc. income Payment of quotas Bienniums

  27. Total quota contributions received as of31 August, 2000 – 2010 *Data for 2000 is up to December 2000

  28. Balance of Arrears on 31 August, 2000 - 2010 * 2000 data is as of 31 December 2000

  29. Appointment of the External Auditor for PAHO(2012-2013) and (2014-2015) The mandate of the current External Auditor at PAHO will end when the auditing of financial period 2011 is completed. The procedure to be followed for appointing the External Auditor will be sent to Executive Committee. A note verbale, which includes details of the appointment process, will be sent to the Member States, Participating States and Associate Members, requesting that proposals be sent to the Secretariat by 20 April 2011. A document containing all valid nominations will be sent to the 51st Directing Council in September 2011. The 51st Directing Council will select the External Auditor for the financial period 2012 – 2015.

  30. PAHO procurement mechanisms include: Reimbursable purchases in the name of the Member States Revolving Fund for Vaccine Procurement Regional Revolving Fund for Strategic Public Health Supplies During the biennium 2008-2009, total income from procurement in the name of Member States was $745.7 million, representing an increase of $491.1 million over 1998-1999 levels. The 3% charge for the three procurement mechanisms came to $18.9 m, of which: $18.2 m was deposited in the capitalization account of the two Revolving Funds. Only $750,361 was available to help with administrative costs and personnel related to these procurement activities. Proposal: It is proposed that the 3% charge currently in effect for PAHO procurement mechanisms be raised to 3.5%. 0.5% will be allocated to the service account to financial additional costs in personnel and related aspects Review of charge assessed on the procurement of public health supplies for Member States

  31. Information

  32. This document presents information on the progress made since its introduction in PAHO and briefly describes the different elements of this management method. PAHO defines Results-Based Management as a management process in which: The programs are formulated around a set of predefined objectives and expected results. Expected results justify the resource requirements, which are derived from the outputs needed to achieve such results. Actual performance in achieving results is measured objectively by performance indicators. PASB managers and staff are accountable for achieving results and are given the tools and resources they need to do so. PAHO Results-based Management (RBM) Framework

  33. PAHO’s Integrity and Conflict Management System (ICMS) • Ethics Office • Ombudsperson • Human Resource Management • Office of the Legal Counsel • Internal Oversight and Evaluation Services • Information Security Office • Grievance Panel • Board of Appeal • International Labor Organization Administrative Tribunal (ILOAT) ICMS resources • PAHO/AMOR Staff Association Additional Resources

  34. Opening Session (20 minutes) Opening remarks from the President of the Directing Council Opening conference (15 minutes): Presentation by a special guest on the improvement of health in cities Presentation on urban health by Dr. Luiz A. Galvão, Manager, PAHO Sustainable Development and Environmental Health Area Discussion Panels (60 minutes) After the opening session, discussion panels representative of each of the subregions and taking language preferences into consideration will be convened to discuss the pertinent elements of the basic document on urban health Expected Results The document with the discussions and conclusions will provide additional input and serve as the basis for PAHO to develop a regional plan of action on urban health with clear objectives, outcomes, and indicators for monitoring program implementation. Round Table on Urbanism and Healthy Living

  35. 30th Anniversary of Smallpox Eradication and the Establishment of the PAHO Revolving Fund for Vaccine Procurement An anniversary celebration is proposed, to be held during the 50th Directing Council of PAHO. The objectives of the celebration are: a) To review the legacy of smallpox eradication in public health programs in the Region, especially in the Expanded Program on Immunization; b) To recognize the Revolving Fund’s contributions to public health--past, present, and future.

  36. Implementation of the International Health Regulations (2005) Update on the Pandemic (H1N1) 2009 Plan of Action for Strengthening Vital and Health Statistics Regional Core Health Data Initiative and Country Profiles WHO Framework Convention on Tobacco Control: Opportunities and Challenges for its Implementation in the Region of the Americas Implementation of the Regional Strategy and Plan of Action for an Integrated Approach to the Prevention and Control of Chronic Diseases, including Diet, Physical Activity, and Health Elimination of Rubella and Congenital Rubella Syndrome Achieving the Health-related Millennium Development Goals in the Region of the Americas Progress Reports on Technical Matters

  37. Other Matters Pan American Health Organization

  38. Regional consultation of the World Health OrganizationRegional consultations on policies, strategies, national health plans, and future financing of the WHO At the 127th session of the Executive Board, to be held in January 2011, WHO will present reports on the framework for policies, strategies and national health plans and on future WHO funding. In 2010 WHO invited Member States to participate in the discussions on future WHO funding. In the report on WHO funding, emphasis was placed on the preparation and integration of policies, strategies and plans as a national responsibility and as the cornerstone for harmonization and alignment, pursuant to the Paris Declaration and the Accra Agenda for Action. The deadline for submitting comments was extended to the end of September 2010. World Health Organization A FRAMEWORK FOR NATIONAL HEALTH POLICIES, STRATEGIES AND PLANS

  39. Comments are welcome …Thank you

  40. Informative SessionPermanent Representatives to the Organization of American States and Representatives of Member States of PAHO/WHO 30th Anniversary of Smallpox Eradication and the Establishment of the PAHO Revolving Fund for Vaccine Procurement Mirta Roses Periago Director. PAHO/WHO Washington D.C. 15 September 2010

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