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New PAHO head wants health coverage for all

Published:Sunday | February 3, 2013 | 12:00 AM
New World Health Organisation regional director for the Americas and director of PAHO, Dr Carissa Etienne (right), with Margaret Chan, director general of the World Health Organisation.

Janet Silvera, Senior Gleaner Writer


As a number of Caribbean and Latin American countries lag behind because of lack of equity, the Pan American Health Organisation's (PAHO) new director, Dr Carissa Etienne, has placed Universal Health Coverage at the core of her agenda.

On the eve of taking up her new role last Thursday, January 31, the Dominican native who boasts the distinction of being the first woman from the Caribbean and the second female to head the 1902-founded organisation said this was one of the main challenges facing the region.

"We have countries lagging behind and populations within countries lagging behind, too. Benefits are not distributed equally and this affects their health, especially those who are vulnerable or marginalised populations."

Speaking from her offices in Washington, DC, Dr Etienne, who twice served as chief medical officer in her homeland, bolstered her comment with the example of non-communicable diseases (NCD) such as cancer, diabetes, heart diseases and chronic respiratory diseases, affecting an ageing population, particularly, in low- and middle-income countries, that are now facing a "double burden" of diseases.

NCD concerns

Her concerns are coupled with the fact that NCDs can become a burden also on health systems, as people cannot afford it, or they don't have health facilities nearby to receive treatment or access to medicines.

Qualifying the importance of providing Universal Health Coverage, Dr Etienne says this means ensuring that the entire population has access to necessary health services, prevention, promotion, treatment and care. She added: "It means that it does not prevent people from receiving health care because they cannot afford it."

According to the PAHO official, who represents some 38 member states, she has learnt from many countries that Universal Health Care is feasible.

"It is based on solidarity and it requires a path for progressively expanding the package of health services. It requires political will among all the levels to work on that path," she posited.

The new PAHO director, who is also the regional director of the World Health Organisation (WHO), lauded the region's member states that have made several advances. "Life expectancy has increased, infant mortality has been reduced. As a region, we will meet the health-related Millenium Development Goals, except for maternal mortality, although even that indicator has been reduced."

Part of her mandate, she acknowledged, was to continue to work with member states to develop new and innovative approaches to deliver results with increased efficiency and coherence.

Pointing to another challenge, Dr Etienne said the social and environmental determinants of health (conditions to health such as access to education, water and sanitation, etc) were among the areas to be addressed to improve the health of the people in the region.

"And this requires the involvement not only of the health sector but of a multisectoral approach (health, plus education, and other sectors of the government, civil society, private sector, academia, etc)," she said.

Dr Etienne, who will serve for five years, succeeded Dr Mirta Roses Periago of Argentina.

Her appointment has been welcomed by the Organisation of American States (OAS).

Speaking during the investiture ceremony on behalf of the OAS, Assistant Secretary General Ambassador Albert Ramdin said: "Today is further proof that regardless of where you come from, the size of your country does not always determine the strength of your voice, or your capacity to lead."

He added: "The hemisphere must be proud, knowing that PAHO will continue from strength to strength in its service to the people."

Dr Etienne holds degrees in medicine and surgery from the University of the West Indies, as well as a master's in community health and an honorary diploma in public health from the London School of Hygiene and Tropical Medicine.

From 2003-2008, Dr Etienne served as assistant director of the PAHO, WHO's Regional Office for the Americas, and from 2008-2012 she was assistant director general, Health Systems and Services, at WHO headquarters in Geneva.

"I see my appointment as a beacon of hope for women in the region. Other women can recognise that we can achieve at the highest level." She concluded that this was a testimony of the standard of "our educational system".