AMRO Region

Region of Americas

END OF BIENNIUM
RESULTS REPORT 2024 - 2025

Region of Americas

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PAHO Director Dr. Jarbas Barbosa da Silva, Jr.Dr Jarbas Barbosa WHO Regional Director for the Americas

As we close the 2024–2025 biennium and the GPW 13, and as the Region of the Americas concludes the PAHO Strategic Plan 2020–2025, this is a moment to recommit—to results, to accountability, and to one another. Above all, it is a recommitment to the people of the Americas, whose health and well-being remain at the center of everything we do.  I would like to thank Member States for their leadership, collaboration and commitment to achieving results, which led to many remarkable achievements in public health across the Americas.


The WHO Region of the Americas/Pan American Health Organization (AMRO/PAHO) continued working with Member States to advance a more unified vision for primary health care as the foundation of resilient health systems and effective service delivery. The Alliance for Primary Health Care in the Americas welcomed new countries, with several already leveraging financing from the Inter-American Development Bank and the World Bank to renovate health centers, buy new equipment, implement telehealth and telemedicine services, and train healthcare workers. Through the Better Care for Noncommunicable Diseases and Disease Elimination initiatives, countries strengthened integrated services addressing communicable and noncommunicable diseases and mental health.  


During 2024-2025, our Regional Revolving Funds procured and delivered more than 464 million vaccine doses, 112 million injection devices, 23 million diagnostic tests, 10 million treatments, and 2 million vector-control supplies, and expanded their portfolio to include high-cost medicines for cancer and rare diseases. Five new high-priced treatments for cancer and multiple sclerosis were incorporated, enabling price reductions of up to 90% relative to country-reported prices.


The biennium also marked important public health milestones, such as the certification of Suriname as malaria free; the elimination of mother-to-child transmission of HIV in Brazil; expanded HPV vaccination coverage among girls under 15 years to 76%; and verification of more than 2.1 million surveillance alerts and detection of 157 public health events in 2025 alone, ranging from disease outbreaks to climate-related emergencies. Advances were also made in digital transformation, innovations in regional vaccine manufacturing, and the strengthening of national regulatory authorities, reinforcing countries’ capacity to deliver safe, effective, and timely health interventions.


Despite financing constraints, I have seen our organization collectively pull together to adapt and deliver results. In 2025, we launched the PAHO People Strategy 3.0 to better align skills, roles, and capacity with strategic priorities. Throughout the reporting period, we strengthened financial stewardship and accountability, advanced PAHO Forward reforms, and modernized business processes. 


As we transition to a new planning cycle, results, accountability, and evidence-based approaches must continue to guide our work. In a constrained financing environment, success will depend on sharper prioritization, stronger collaboration, expanded strategic partnerships, and effective use of technology. AMRO/PAHO’s value-added lies in regional solidarity, collective action, and shared experiences and proven tools—delivering results that are visible, credible, and that make a measurable difference in the health and well-being of the peoples of the Americas.


PROGRESS ON THE TRIPLE BILLION TARGETS

Regional Aggregation

These charts illustrate the contributions of various tracer indicators driving progress toward the Triple Billion targets for universal health coverage, health emergencies and healthier populations. Each stacked bar shows the relative contribution of these indicators over time, highlighting both gains and areas where progress has reversed. The overlaid lines indicate the net impact of outcome indicators associated with each target, providing a broader view of how health impact is evolving.

WHO CONTRIBUTION TOWARDS HEALTH OUTCOMES

Regional Aggregation Of The Output Prioritization

This table provides a regional overview of the financing and implementation of prioritized outputs. It presents planned costs, available funds and utilization, alongside the number of offices (countries, territories and areas) that have identified each output as high or medium priority.


OUTPUT SCORECARDS

WHO’s Output Scorecard Measures Its Performance For Accountability

These scorecards provide an overview of progress in the delivery of outputs across the Region. Performance is assessed across six dimensions, each with specific criteria for technical and enabling outputs. Select an outcome to explore the related scorecards.

HIGHLIGHTED RESULTS

Explore WHO’s Contribution To Health Outcomes Across The Region

  •   Universal health coverage 
  •  Health emergencies protection 
  •  Healthier populations 
  •  Effective and efficient WHO 
  • AM-1_Disease elimination accelerated through integrated health systems

    The 2024–2025 biennium saw continued progress towards the elimination of communicable diseases through integrated, multi-disease approaches anchored in health system strengthening. AMRO/PAHO supported countries in translating political commitments under the regional Disease Elimination Initiative into operational results by strengthening surveillance, expanding access to prevention and treatment, and embedding elimination actions within primary health care.

    Concrete elimination outcomes were achieved. Belize, Jamaica and Saint Vincent and the Grenadines eliminated mother-to-child transmission of HIV and syphilis. Brazil achieved the elimination of mother-to-child transmission of HIV, while the Bahamas and Barbados, and Turks and Caicos advanced through validation processes for mother-to-child transmission of these diseases. Suriname was certified malaria-free, becoming the first Amazonian country to reach this milestone. Brazil eliminated lymphatic filariasis, Bolivia and Brazil were declared free of foot-and-mouth disease in bovids without vaccination, and five states in Argentina were verified as being free of vector-borne transmission of Chagas disease. Chile progressed towards elimination of leprosy, and multiple countries advanced elimination dossiers for neglected tropical diseases. Mexico completed a hepatitis C pre-elimination assessment and defined a national roadmap to close gaps and advance elimination.

    Integrated, multi-disease service delivery models expanded access in hard-to-reach settings. In Amazon basin territories in Colombia and other countries, combined interventions for malaria, trachoma, skin NTDs and ocular health improved access and efficiency by reducing parallel service delivery. Thanks to AMRO/PAHO’s partnership with the Government of Canada, access to integrated health service delivery was strengthened for populations in conditions of vulnerability to accelerate the elimination of trachoma and other diseases in Bolivia, Brazil, Colombia, Ecuador, El Salvador, Guatemala, Mexico and Venezuela.

    By the end of the biennium, four countries had launched integrated, multi-disease elimination plans; seven were advancing plans under development; and fourteen were implementing accelerated disease elimination strategies, reflecting growing political commitment. The initiative Zero AIDS deaths by 2030 Initiative, supported by UNITAID, generated regional momentum, expanding to 22 countries in Latin America and the Caribbean. AMRO/PAHO launched in 2025 the Regional Alliance for HIV Elimination in the Americas.

    Best buys for each disease and condition under the Elimination Initiative were published by AMRO/PAHO and are used to advocate for evidence-based investments to accelerate elimination. Additionally, the regional data portal and monitoring and action framework were published to track indicators, identify gaps and guide priority actions towards multi-disease elimination.

  • AM-1_Immunization coverage recovered and sustained despite measles setbacks

    Restoring and sustaining immunization coverage after pandemic-related disruptions was a major outcome of the 2024–2025 biennium. By 2024, immunization coverage for most antigens had recovered to between 84% and 90% across the Region, surpassing pre-pandemic levels for several indicators. Coverage increased for rotavirus, pneumococcal, measles-containing and hepatitis B vaccines between 2023 and 2024.

    According to WHO/UNICEF estimates, the Region of the Americas continued to lead globally in post-pandemic immunization recovery, having surpassed 2019 levels in key vaccination indicators. The Region remained free of wild poliovirus and circulating vaccine-derived poliovirus and sustained the elimination of rubella, congenital rubella syndrome and tetanus. These achievements include more than three decades free of polio.

    Although the Region lost measles elimination certification due to a prolonged outbreak in Canada, countries reinforced routine immunization services, strengthened catch-up and follow-up campaigns, surveillance and outbreak response to prevent wider resurgence, and strengthened surveillance systems to sustain gains and address renewed transmission risks, with support from AMRO/PAHO.

    At the same time, the biennium advanced progress towards vaccine-preventable disease elimination. The Region continued to lead globally in human papillomavirus (HPV) vaccination efforts, achieving 76% coverage among girls under 15 years. With support from AMRO/PAHO and Gavi, Cuba introduced HPV vaccination in 2025, bringing the total number of countries and territories in the Region with HPV vaccination in national schedules to 49 out of 51. Twenty-nine countries transitioned to one-dose HPV schedules, expanding coverage while improving programme efficiency. Surveillance performance also strengthened, with all core measles–rubella surveillance indicators meeting regional targets, even as countries responded to renewed measles transmission.

    Overall, the biennium marked a transition from recovery towards more resilient and integrated immunization systems capable of sustaining high coverage and supporting elimination goals. However, persistent gaps remained among marginalized and vaccine-hesitant populations. Countries increasingly used disaggregated data and community-based strategies to better reach these groups.

  • AM-1_Mental health services strengthened and suicide prevention capacity expanded

    The 2024–2025 biennium marked a significant strengthening of mental health system capacity across the Americas, anchored by the launch of a regional initiative on suicide prevention. Recognizing suicide as both a public health and systems challenge, AMRO/PAHO supported countries in reinforcing governance, modernizing legal and policy frameworks, expanding community-based services, and integrating mental health into primary health care as a foundation for prevention, care and continuity.

    Across the Region, countries advanced the modernization of mental health laws, such as in Ecuador, which developed regulations to implement its mental health law, and Guatemala, which is undertaking a landmark deinstitutionalization process through a new community-based service model. Reforms supported by AMRO/PAHO reoriented services away from institutional models and expanded coverage through community-based and primary health care-linked services. Large-scale capacity-building initiatives strengthened the ability of health teams to detect, manage and refer mental health conditions, including depression, anxiety and psychosocial distress, particularly among adolescents, young people and populations affected by violence, displacement and emergencies.

    Collaboration with the Organization of American States (OAS) represented a major strategic advance during the biennium, culminating in the adoption of a new mental health resolution at the OAS General Assembly in 2025[TH1.1][RD1.2]. This milestone reflects the elevated political prioritization of mental health and provides a high-level framework to strengthen sustained intersectoral action.

    Outcome-level progress was particularly notable in Guyana, where sustained mental health system reforms—including rights-based legislation, decentralization of services, workforce development and intersectoral prevention measures in line with the new Regional Suicide Prevention Initiative—were implemented. Community gatekeeper programmes, school-based interventions, strengthened surveillance and improved service organization reinforced early detection and response.

    While suicide prevention requires sustained, long-term effort, work during the biennium established a coherent regional platform for action, aligning governance, services and monitoring to support measurable reductions in suicide mortality over time.

  • AM-1_Primary health care strengthened as the foundation of health system transformation

    Strengthening PHC as the cornerstone of service delivery contributed to measurable improvements in first-level resolution capacity and reductions in avoidable hospitalizations.

    In Brazil, Chile, Costa Rica and Mexico, sustained declines in hospitalizations for ambulatory care–sensitive conditions reflected stronger preventive and chronic care management at the primary care level. In Honduras, analysis of avoidable hospitalizations was used to reorganize PHC services linked to 25 public hospitals, guiding targeted investments in diabetes and hypertension management. In Jamaica, technical cooperation supported the definition of an essential benefits package for PHC, clarifying service entitlements and strengthening alignment between financing and service delivery.

    Progress was reinforced through the advancement of integrated health service delivery networks (IHSDNs) as a core strategy to reduce fragmentation. More than 10 countries strengthened IHSDN frameworks. In Chile, integration efforts under the national care policy improved referral coordination and continuity across levels of care.

    Stewardship for PHC reform was strengthened through structured policy dialogue and multisectoral engagement. Through the Alliance for Primary Health Care in the Americas, jointly launched by AMRO/PAHO, the World Bank and the Inter-American Development Bank, Dominican Republic and El Salvador also joined the alliance in 2024, and Chile, Panama and Paraguay in 2025. These 5 countries have established permanent national coordination mechanisms and linked ministries of health with finance, reinforcing fiscal sustainability and institutional ownership of PHC-centred transformation. These advances positioned PHC as the foundation for resilient and cost-effective health systems across the Americas.

  • AM-1_Regional self‑reliance advanced through increased access to medicines, vaccines, and other health technologies

    Progress towards health self-reliance accelerated during the 2024–2025 biennium as countries strengthened access to medicines, vaccines, diagnostics and other health technologies. AMRO/PAHO supported these advances through pooled procurement, regulatory strengthening and regional production initiatives, reinforcing collective capacity to meet health needs more sustainably.

    Regional production and supply chain resilience advanced through technology transfer and manufacturing partnerships. Argentina and Brazil expanded production capacity based on the mRNA platform, reducing dependence on external suppliers for critical technologies. At the same time, participation of regional manufacturers in pooled procurement increased significantly, providing greater flexibility in the use of PAHO’s Regional Revolving Funds (RRF) to incentivize regional innovation and manufacturing. As a result, regional producers now represent a growing share of the RRF portfolio, strengthening supply security and diversification.

    Through the RRF, uninterrupted access to essential health products was ensured at scale. During the biennium, the RRF procured more than 464 million vaccine doses, 112 million injection devices, 23 million diagnostic tests, 10 million treatments and 2 million vector control supplies, and facilitated over 4 500 deliveries. These shipments represented an estimated total transaction value of US$ 1.7 billion for the biennium and contributed to protecting around 135 million people through vaccine delivery and providing treatment, diagnostics or vector control supplies to cover an estimated 35 million people. Portfolio modernization further expanded access to high-cost medicines, paediatric oncology products and next-generation vaccines, delivering substantial price reductions and improving affordability for national programmes. Five new high-priced treatments for cancer and multiple sclerosis were incorporated (Enzalutamida, Abiraterona, Palbociclib, Cladribina and Glatiramer Acetate), enabling price reductions of up to 90% relative to country-reported prices.

    These actions directly contributed to strengthening the regional manufacturing ecosystem, improving supply security and accelerating technological diversification. Regulatory convergence and health technology assessment capacities were also reinforced, improving oversight, transparency and evidence-based decision-making. Collectively, these advances positioned health self-reliance as a strategic pillar of regional resilience.

  • AM-2_Regional health security strengthened through integrated emergency preparedness and response

    During the 2024–2025 biennium, countries in the Americas strengthened emergency preparedness and response as core public health functions, enhancing their capacity to anticipate, manage and respond to health emergencies. The Region of the Americas/Pan American Health Organization (AMRO/PAHO) supported the institutionalization of integrated systems linking preparedness planning, surveillance, epidemic intelligence, risk assessment and response operations—moving countries beyond ad hoc emergency action towards routine, system-embedded health security capacities.

    Preparedness capacities were reinforced through strengthened laboratory, genomic and surveillance systems, including the decentralization of diagnostic capacity to subnational and border areas. Countries advanced integrated approaches combining indicator-based surveillance, event-based surveillance and epidemic intelligence, supported by risk assessment and preparedness planning. Under a One Health approach, integrated epizootic surveillance enhanced early warning for zoonotic threats and informed anticipatory preparedness measures. In Bolivia, Colombia and Ecuador, strengthened epizootic surveillance enabled earlier detection of yellow fever virus circulation, allowing preventive actions that reduced the risk of urban transmission.

    In line with the Regional Action Plan for Epidemic Intelligence, preparedness was further strengthened through standardized information exchange between laboratories and International Health Regulations (IHR) National Focal Points, improving detection-to-notification timelines and readiness to activate response mechanisms. Several countries began applying structured timeliness metrics across detection, notification and response, strengthening preparedness monitoring, operational accountability and performance management under health security frameworks.

    Preparedness investments translated into measurably stronger response performance during major emergencies across the Region. In Jamaica, preparedness investments were tested during Hurricane Melissa, where strengthened health emergency operations, trained personnel and resilient health facilities enabled faster mobilization, improved coordination and continuity of essential health services despite widespread damage. In Haiti, AMRO/PAHO supported sustained emergency response to cholera and complex humanitarian conditions, reinforcing surveillance, response coordination and continuity of public health operations amid a protracted crisis. In Venezuela, emergency response capacities were sustained through coordinated, cross-organizational mechanisms that enabled continued implementation of priority emergency interventions despite prolonged operational constraints.

    By embedding preparedness and response capacities within health systems, the biennium marked a shift towards more resilient, responsive and sustainable health security capacities across the Americas.

  • AM-3_Noncommunicable disease burden addressed through integrated primary health care approaches

    Noncommunicable diseases (NCDs) remained the leading causes of death in the Americas, prompting scaled implementation of integrated primary care models during the biennium. Through the Better Care for NCDs initiative and HEARTS in the Americas, AMRO/PAHO supported countries in expanding evidence-based services at scale. By 2025, seventeen countries reported significant advances in integrating NCD care into primary health care, with eleven scaling HEARTS to more than 80% of primary care facilities, 16 countries adopting new clinical pathways for diabetes, HPV testing supported in five [TH1.1] countries, as well as progress in tobacco cessation and healthy lifestyle counselling. Seven countries – representing 71% of the regional population – now have comprehensive tobacco cessation services, while 15 are missing just one element to achieve best practice implementation.

    AMRO/PAHO supported countries to increase access to essential NCD medicines and technologies expanded through pooled procurement, including automated blood pressure devices, HbA1c tests, HPV tests and diabetes technologies. Expanded large-scale training strengthened clinical capacity, with 500 000 providers completing coursework during 2025.

    Through the Global Initiative on Childhood Cancer and the Global Platform for Access to Childhood Cancer Medicines, supported by St Jude Children’s Research Hospital in partnership with WHO, UNICEF and AMRO/PAHO, more than 700 children and adolescents in Ecuador received life-saving medicines with delivery times under 48 hours, while 14 countries strengthened national childhood cancer plans, 17 regional clinical guidelines were developed, and over 123 000 health professionals in 32 countries were trained—contributing to earlier diagnosis and improved continuity of care, including measurable gains in Panama and Peru.

    Surveillance capacity for NCDs and risk factors improved through population surveys for adolescents in nine countries and adults in two countries, as well as updated regional scorecards, strengthening monitoring and accountability.

    Together, these results reflect a shift from fragmented approaches towards integrated PHC-based NCD care.

  • AM-3_Scalable approaches strengthened to address the determinants of health through intersectoral action

    During the 2024–2025 biennium, countries demonstrated the feasibility and scalability of approaches to address social and environmental determinants of health through institutionalized, decision-oriented and sustainable approaches. AMRO/PAHO advanced the adaptation and implementation of an operational framework for monitoring the determinants and related policies, with a focus on strengthening information systems that support intersectoral decision-making, accountability and action across levels of governance.

    In Costa Rica’s Brunca Region, an operational framework for the social determinants of health was implemented across six health areas and 77 integrated health care teams. This strengthened capacity to act on social determinants in coordination with local governments and territorial actors. As a direct result of this implementation, the Costa Rican Social Security Fund (CCSS) formally expressed interest in institutionalizing and scaling the framework nationwide, demonstrating its operational viability and potential for national adoption.

    Elsewhere, AMRO/PAHO provided sustained technical leadership to support territorial health strategies across 23 municipalities with over 1.5 million inhabitants and three capital cities with over 20 million inhabitants across six countries (Chile, Colombia, Costa Rica, Ecuador, Mexico and Peru). These strategies were adapted to diverse local priorities and governance contexts, reinforcing intersectoral coordination and action. Scalability was further supported through the expansion of the Movement of Healthy Municipalities, Cities and Communities (MCCS), which provides an enabling framework for institutionalizing local action on priority public health initiatives.

    Environmental determinants were also addressed through scalable actions that strengthened health system resilience and reduced risk exposure. During the biennium, more than 450 000 people gained access to cleaner household energy for cooking, while the application of PAHO air quality and urban health tools in 25 cities guided investments that improved air quality, reduced greenhouse gas emissions, expanded green spaces and enhanced active mobility systems for more than 80 million people. Expanded access to safely managed water and sanitation services enabled 22 million additional people to benefit from improved WASH conditions, while 1.37 million fewer people practised open defecation between 2023 and 2024.

  • AM-4_Digital transformation accelerated access to services and strengthened surveillance across the Americas

    During the 2024–2025 biennium, digital transformation enabled improved access, service continuity and public health surveillance. AMRO/PAHO supported countries in strengthening information systems for health and digital public goods that directly contributed to primary health care performance and evidence-based decision-making.

    A major focus was the expansion of telehealth as an integrated component of primary health care, particularly in rural and hard-to-reach areas. Through regional platforms, equipment deployment and workforce training, teleconsultations and remote monitoring were scaled in 22 countries, reducing geographic barriers and improving continuity of care. The deployment of telehealth kits in 14 countries and the implementation of the PAHO All-in-One Telehealth Platform in 7 countries strengthened service delivery networks and expanded access to specialist care in remote areas.

    Under the Pan American Highway for Digital Health, AMRO/PAHO contributed to landmark advances in cross-border digital interoperability, transforming regional health security infrastructure. Building on systems initially developed for COVID-19 vaccination certification, AMRO/PAHO supported the implementation of digital yellow fever vaccination certificates aligned with international standards, with Costa Rica and El Salvador becoming the first countries in the world to issue such certificates using globally interoperable specifications. In parallel, AMRO/PAHO advanced a regional roadmap for the digital transformation of civil registration and vital statistics systems in the Caribbean, addressing long-standing structural constraints faced by Small Island Developing States.

    During the biennium, AMRO/PAHO strategically strengthened its role as a regional catalyst for large-scale digital health investment by mapping and engaging a rapidly expanding financing landscape. Investments linked to information systems for health exceeded US$ 1.4 billion, primarily through loans from the Inter-American Development Bank, World Bank and Development Bank of Latin America and the Caribbean, reflecting strong country demand and confidence in the Organization’s technical leadership.

    By bridging policy, technical standards and financing, AMRO/PAHO created a new model of cooperation in which digital transformation is not only funded but technically governed and quality-assured. These results strengthen long-term sustainability, support Member States in managing complex digital transformations, and position AMRO/PAHO as a trusted partner for translating financial resources into integrated, resilient health information systems.

  • AM-4_Strategic partnerships expanded and multiplied AMRO/PAHO’s health impact across the Americas

    During the 2024–2025 biennium, AMRO/PAHO significantly expanded its political engagement and partnerships through sustained participation in high-level global and regional forums, strengthening its visibility and influence with governments, multilateral institutions and non-state actors. Strategic engagement by AMRO/PAHO reached a historic milestone during this biennium, featuring a record 50 events at the United Nations General Assembly, alongside targeted bilateral meetings with key partners. Furthermore, AMRO/PAHO maintained a robust global presence by participating in 49 additional high-level international events.

    As a result of strengthened strategic relationships, PAHO’s voluntary contribution resource mobilization reached US$ 552 million during the reporting period, reflecting increased partner confidence despite a broader decline in global development assistance for health. The Organization also expanded its partner base, increasing the number of financial partners from 18 to 30 and securing new and strengthened collaborations with governments, multilateral actors and foundations.

    These partnerships were a critical enabler of results across the Region, expanding the scale, coherence and sustainability of health actions aligned with national priorities and regional mandates. Collaboration with international financial institutions supported the transition from policy dialogue to implementation, particularly for NCDs, primary health care–centred reforms and digital transformation, ensuring that financing translated into tangible system improvements.

    Partnerships also played a central role in advancing disease elimination, immunization recovery, emergency preparedness and regional production of health technologies. Collaboration with bilateral partners, global initiatives and foundations supported access to vaccines, medicines and diagnostics, while reinforcing regional self-reliance and supply security. In emergency contexts, coordinated partnerships enabled rapid mobilization of expertise and resources, protecting essential services and lives.

    Expanded political engagement and strategic partnerships strengthened AMRO/PAHO’s partnership ecosystem and financing base, reinforcing the conditions for effective technical cooperation and sustained delivery of results across the Americas.