The 57th PAHO Directing Council, Washington, D.C., USA, 30th September – 4th October, 2019

Professor David L. Heymann receives the certificate and stole of the Gamma Kappa chapter of the Delta Omega Honor Society from two Honorary members: Dr. Charles R. Modica and Dr. Calum N. L. Macpherson

The Grenadian Delegation who attended the Directing Council meeting included:

Hon. Nickolas Steele, MP (Head of Delegation) Minister for Health, Social Security and International Business
Dr. George Mitchell, MD, MPH (Chief Medical Officer, MOH, Grenada)
Dr. Calum Macpherson, PhD (SGU/WINDREF Representative)
Dr. Trevor Paul Noël, MPH,  PhD, (SGU/WINDREF Representative)

The PAHO Directing Council ends with regional agreements to eliminate diseases and improve the quality of health care for all people. The 57th Directing Council of the Pan American Health Organization (PAHO) ended following a week of discussions by Ministers of Health and other delegates on health priorities in the Americas. The meeting approved seven new regional initiatives, including a joint initiative to eliminate more than 30 diseases and conditions from the hemisphere by 2030 and a strategy to improve the quality of health care as part of PAHO member countries’ efforts to achieve “universal health.” In addition, to the Heads of Delegation meetings and discussions with Ministers of Health and CMO’s and other delegates there were four Interventions by the Grenada delegation (1 – 4 below). There were a number of special topic breakout meetings; on issues of migration, mental health, violence and measles. In addition, the delegates had face to face meetings with a number of the participants.  Notable meetings were held with: 1. Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization (WHO) 2. Dr. Carissa Etienne, Director, PAHO. 3. Dr. Godfrey Xuereb,  PAHO/WHO Representative, Barbados and the Eastern Caribbean Countries. 4. Dr Marcos Espinol PAHO Director, Infectious Diseases 5. Dr. Steven Ault, Former PAHO Director, Infectious Diseases and presently a PAHO Consultant. 6. Dr. Joy St. John, Executive Director, CARPHA.

Intervention 1:

Thank you Mr. President, Dr. Ettienne, Colleague Ministers, distinguish members. The Grenada delegation would like to join with the rest of our colleagues especially from the CARICOM region in expressing our profound gratitude to Dr. Ettienne and PAHO for the pivotal role in the provision of healthcare in our region. We note the many areas of critical progress and achievements made over the period and congratulate the director and her hard working and experience team. However we also note and saw in the video the disparities in healthcare of the peoples in the region. We note the strategy on Universal Health Coverage and the key role of Primary Health Care in ensuring that the health objectives of PAHO and the gains made in the region are achieved in the quickest possible time. Leaving no one behind. Mr. President while we note and endorse the strategy we will like to highlight the need to accelerate the strategy and support for the continued development of the health workforce particularly that of nursing. Mr. President without adequately trained workforce we will not be able to deliver on the people's mandate and we will fail to achieve our many health targets including that of the SDG’s in 2030.
Grenada will be hosting the global nursing conference next year under the theme “nursing and midwife valued jewels of healthcare”. We therefore extend a warm invitation to all Ministers of Health and nursing organizations to attend with the sole purpose of finding practical solutions to this critical developmental issue. We would like PAHO to support this activity as best it can as we look forward to welcoming you to Pure Granada. Through the assistance of PAHO, Grenada has been able to advance the health of it population in several areas including; the maintenance of acceptable immunization coverage, our principal hospital attaining the status of being Baby friendly. In addition, as I speak PAHO is assisting Grenada with Primary Health Care strengthening, health systems strengthening and the imminent roll out of our National Health Insurance and the retrofitting of many of our medical facilities to become climate smart (we hope that they will be smart enough to withstand the monstrous weather systems that have become even more frequent and more destructive). As such we extend our solidarity to our brothers and sisters in Bahamas another year and again another CARICOM member state have suffered a climatic disaster. While this has become the new norm for us so too has the support of PAHO in the aftermath. Dr. Ettiene to you and through you we express our gratitude on behalf of the people of the Caribbean in general and the people of the Bahamas in this instance. Mr. president we must not and cannot allow the enormous gains in healthcare delivery to our population in this region to be reversed   We must do all that it takes to support this prestigious health institution to continue its work in region of the America’s and so we urge member states to live up to their obligations particularly timely payments and that of our peoples We in the CARICOM region despite our challenges are doing so we thank you Mr. President.

Intervention 2:
Item 5:1 Assessed Contributions.
Thank you Mr. President, Dr. Etienne, Colleague ministers, distinguish members The Grenada delegation would like to join with other colleague delegations in expressing our deep concern at the non-payment of quota contributions. While we recognize that the allocation and payment of assessed quotas is at the discretion and the prerogative of each member nation, we would like to draw members to the fact that the risks and threats being created within the region by PAHO not being able to carry out its mandate, the possible disease burden and delay or roll back of strides made in health care for all in the region will not respect any borders or national interest.
Further if these payments continue to be unduly delayed their eventual payment may be too late to avoid disease burdens or health disasters in the region.

Intervention 3:
Item 4.5 PAHO Disease Elimination Initiative
Mr. President through you, Grenada congratulates the Director and Dr. Espinoza and his team on the initiative, the document and the resolution being tabled. Grenada commits to fully cooperating with PAHO on the elimination of the diseases listed and ensuring no resurgence or reintroduction of the diseases that have no clinical presence in Grenada. We particularly welcome the cooperation on the elimination of HIV/AIDS, The Vector-borne diseases listed and the elimination of cervical cancer. We specifically look forward to the implementation of best practices in the elimination of these diseases and where necessary the development of new best practices. We therefore welcome documentCD57/7 and support resolution CE 164.r2

Intervention 4:

Thank you Mr. President and the Director, Dr. Etienne.
Mr. President through you …. our Grenada delegation welcomes and enthusiastically supports the midterm review on the progress made on the elimination of the neglected infectious diseases and post elimination actions 2016 – 2022 from our hemisphere Document CD57 Information 10 A. We congratulate the dedicated teams in the field and also the direction and vision provided by the PAHO leadership. These diseases have plagued mankind since the dawn of time; these successes have been hard worked gains which have demonstrated to the rest of the world that the conquering of these insidious infectious diseases can be achieved.

Perhaps the most difficult challenge in this elimination process still lies ahead as it will require the same determination and sustained political and financial support to ensure that the pressure on these infectious diseases is maintained. Too often, the successes made have been subsequently lost because as there importance dwindles, so does the political will. At this stage, there is a great need for appropriate and innovative research and to incorporate the Governments goals and actions in partnership with the combined knowledge and skills of those in academia, and NGOs through the public private partnership. This elimination process adheres to the sustainable development goals; 1,3,4,6,17 as outlined by the World Health Organization. In keeping with the sustainable development goal, Number 17, the Government of Grenada is partnering with its local university (St. George's University) and the research institution (the Windward Islands Research and Education Foundation (WINDREF) a WHO
Collaborating Centre to help facilitate the success of the elimination programs. Specifically, the non-zoonotic soil transmitted helminths(STHs),  have been eliminated from Grenada through innovative educational and targeted treatment programs. We have for the last two years monitored the sustainability of this achievement. Non zoonotic STHs – do not confer immunity nor are vaccinatable and leave populations susceptible to infection. We would like to highlight the role that education played in our STH elimination program. Education is an essential component that is often overlooked in control and elimination programs. We reaffirm Grenada's support for the elimination of the neglected infectious diseases and post elimination programs. We Thank you Mr. President.

We would like to thank Dr. Andy Sussman for support to attend this meeting.