At the opening of the Pan American Health Organization’s (PAHO)’s annual meeting on Monday, officials celebrated progress made in tackling regional health challenges – despite political and economic challenges.

However, the US warned PAHO’s 63rd Directing Council not to stray into “ideological” issues, as it continues to withhold millions in unpaid members’ dues.

The opening highlighted the regional achievements, including the elimination of mother-to-child transmission of HIV in Brazil and the Bahamas, Chile’s elimination of leprosy, and immunization recovery following the COVID-19 pandemic. 

“For more than 120 years, the Pan American Health Organization has worked with countries across the Americas to make yesterday’s impossible the reality of today,” said PAHO Regional Director Dr Jarbas Barbosa.

Barbosa argued that PAHO was born from the “powerful idea” of pan-Americanism: “The conviction that we are stronger when we work together and more effective when we move forward with a common purpose.”

Yet, despite Barbosa’s call for cooperation, the underlying political tensions currently afflicting the region, particularly the polarizing effect of the Trump administration’s anti-globalism stance, were evident. 

Geopolitical tensions surface

Tensions escalated as country delegates made their interventions after presentations by PAHO’s director and the General Committee’s annual report.  

The General Committee reported that its sub-committee on Program, Budget, and Administration had recommended the continuation of official relations with several non-state actors, including the Clean Air Institute, but had been unable to reach consensus on the renewal of relations with the World Association for Sexual Health, which was referred back to the Executive Committee.

However, the US contested the admission of the Clean Air Institute and the World Association for Sexual Health. 

US Health and Human Services Director of Global Affairs Bethany Kozma also warned PAHO not to stray into “a divisive political and social agenda, including expanding resources to overhype the impact of the climate crisis on health, promoting a gender ideology approach on health issues and impeding freedom of expression with so-called anti-misinformation campaigns.”

While most countries highlighted national advances achieved with PAHO’s support, the US  and Cuba had an altercation after the Caribbean delegate reported how US embargoes are negatively affecting its population. 

The oil blockade enforced by the US in 2026 has disrupted the Cuban health care system and sanitation services, exacerbating what PAHO described as an “unparalleled crisis” for Cuba. 

However, the US stated that the embargoes were legal and wouldn’t end without a change in government on the island. 

“The US message to Cuban regime leaders is simple: they must make immediate and irreversible political and economic reforms,” said one of the US delegates. 

In response, the Cuban representative reasserted his country’s sovereignty, saying that the US couldn’t interfere in their government, that such a demand had no place at the council, and that it was hypocritical for the US to push for a change of government. 

Innovation and resilience drive health gains 

Presenting the highlights of the organization’s annual report, Barbosa noted that the year marked a “critical transition” for the region as it met financial constraints and health challenges with resilience and innovative approaches. 

He stressed achievements across key pillars, including strengthening primary healthcare, improving vaccination, expanding digital health, preventing and controlling outbreaks, reducing deaths from chronic diseases, and advancing disease elimination.

PAHO’s annual report also pointed to milestones in disease elimination across several nations, including Chile’s elimination of leprosy, and Brazil and the Bahamas’s elimination of mother-to-child transmission of HIV. 

Advances in digital health were especially emphasised as a response to the region’s unequal access to care. PAHO’s surveillance systems analyzed more than 2.2 million signals related to potential public health events and more than 780 telehealth kits were distributed to 20 countries.

Ilan Goldfajn, president of the Inter-American Development Bank, told the meeting that over the past three years, nearly one in four dollars in the bank’s health portfolio supported digital health initiatives. He added that the current goal is to increase that investment by 50% by 2030.

The ‘fragility of hard-won progress’  

However, the challenges are evident. Last year, the Americas lost its measles-free status after several countries faced sustained outbreaks. This year, cases have tripled with dozens of deaths reported and in the US, the number of babies infected at birth, once a rarity, is increasing. 

With seven of the 42 member countries reporting less than 80% coverage for the first dose of the measles, PAHO urged countries to strengthen immunization activities. 

“The resurgence of measles reminds us that our work is far from finished,” said Barbosa.

“Viruses don’t recognize borders,” said Chile’s Minister of Health, Dr May Chomalí Garib, who was elected as the council’s president on Monday. “An emergency in one country can quickly become a regional emergency.”

“When we speak about anticipating disease, we can’t only look at what takes place in health systems,” said Garib. “We also need to take a look at the conditions in which people live: the environment, the changes that are occurring in the ecosystem, and our relationship to those changes.” 

Climate challenges

Over the past year, PAHO also monitored more than 24 health emergencies and mobilized 174 tons of essential supplies to help countries prepare for and respond to disasters like Hurricane Melissa, which affected Cuba, Haiti, and Jamaica, and the earthquakes that hit Venezuela. 

This year’s Super El Niño is an additional concern for the region, as rising temperatures, changing rainfall patterns, and extreme weather events can expand the areas where mosquitoes and other disease vectors circulate.

The Americas face a wide variety of health emergencies and disasters that are increasing in scale and frequency. According to the United Nations Population Fund (UNFPA), 41% of the population and 37.5% of emergency hospitals in the region are located in medium to high hazard zones. 

This year marks the 50th anniversary of PAHO’s Health Emergencies Program, initiated in 1976. 

Lisa Cummins, Minister of Health and Wellness of Barbados and outgoing president of the Directing Council, warned that emergency preparedness “cannot be a promise made in crisis and forgotten when the fear passes.

“The measure of regional solidarity and hemispheric capacity is when we build it together and keep it ready for the people who will need it,” she said. 

Financial threats to PAHO

Barbosa also drew member states’ attention to the financial sustainability of the organization. The US, PAHO’s largest donor, hasn’t paid its membership fees since 2024, and owes the body over $134 million. In addition, the Trump administration has signalled its intention to cut all funds to PAHO by 2027.

Last year, member states approved a 19% budget reduction, which Barbosa said had affected the organization’s ability to sustain operations across the region. 

At the same time, PAHO’s director said that, despite growing financial constraints, the body has demonstrated resilience, adaptability and leadership. 

The meeting approved a change that unified technical cooperation mechanisms into one single Regional Revolving Fund, which should be stronger and more efficient. 

“Being efficient doesn’t just mean spending less. It also means better use of public resources,” said Garib. “Every resource that is better used becomes surgery on time, timely detection, medication, care that doesn’t impose great economic burden on families.”

Image Credits: Toposdigitales .