CIDA-funded $10 million project (2003 – 2009) aims to address communicable disease prevention and control in vulnerable popluations.

The Pan American Health Organization (PAHO) is the executing agency for this Program, which supports the prevention and control of the most widespread communicable diseases for girls, boys, women, and men in South America.

The PCPCD was initiated in five countries (Colombia, Ecuador, Paraguay, Peru, Venezuela) and includes five diseases and/or disease strategies: Chagas disease, dengue, Integrated Management of Childhood Illness (IMCI) strategy, sexually transmitted infections (syphilis and congenital syphilis), tuberculosis (TB), and the cross cutting component of gender equality. The intent of the Program is to reach vulnerable and hard to reach populations in the target countries to address program gaps in communicable disease prevention and control using recognized global and/or regional strategies.

Addressing the Millennium Development Goals (MDGs)

The PCPCD addresses the following MDGs and contributes to their national achievement in the participating countries through the execution of its programmed activities:
MDG3: Promote gender equality and empower women
MDG4: Reduce child mortality
MDG5: Improve maternal health
MDG6: Combat HIV/AIDS, malaria and other diseases

PCPCD Components PAHO is working closely with national counterparts in each of the participating countries to achieve the following objectives:

Tuberculosis activities in Colombia

To implement the DOTS strategy for TB control among indigenous populations in Colombia using a community participation model. IMCI actions were incorporated in 2006 with the development of an integrated TB/IMCI program.

Chagas Disease activities in Ecuador, Paraguay and Peru

To design and implement a surveillance system for Triatoma infestans, the vector of Chagas disease, with active community participation including schools in endemic areas of Paraguay; to strengthen vector control and community based surveillance in the Southern Region of Peru (Arequipa, Moquegua and Tacna); and, to strengthen epidemiological and entomological surveillance of Chagas disease with community participation in the provinces of El Oro, Loja and Manabi in Ecuador.

The PCPCD actions are based on the recommendations of the Intergovernmental Commission for the Elimination of Triatoma infestans and the Interruption of Blood-borne Transmission of Trypanosoma cruzi of the Southern Cone Initiative (INCOSUR).

Dengue activities in Colombia, Ecuador, Paraguay, Peru, and Venezuela

To promote the adoption of the Integrated Management Strategy for dengue prevention and control (PAHO Directing Council Resolution CD44.R9) and the development of national integrated dengue plans. Support is provided for the implementation of the social communication and epidemiological and entomological surveillance components of the Strategy (EGI-Dengue in Spanish).

STI activities in Paraguay

To strengthen the capacity to expand the prevention and control of sexually transmitted infections, with special attention to gender issues and socioeconomic status. The PCPCD actions are focused on syphilis and congenital syphilis and are contributing to the national effort to eliminate congenital syphilis at country level.

IMCI activities in Colombia, Ecuador, Paraguay, and Peru.

To introduce changes in the academic curricula of health professions (nursing, medicine, public health) in target areas in order to include the principles of IMCI and improve primary health care services to reduce mortality from diseases and health problems in children under 5 years of age. Community IMCI activities were added in all countries in 2006 based on identified country priorities. The social actor community model implemented in these countries promotes a bottom up approach with early involvement of all community members. It works at the national, local, and household levels to increase the coverage of community based interventions by using a combination of outreach services, family, and social actor participation.

Integrated Health Program in the Paraguayan Chaco, Boquerón

The integrated approach of this program addresses the health priorities of the population and makes more effective use of limited human resources using a primary health care approach in the participating communities.

Gender Equality

The PCPCD includes a gender equality cross cutting component aimed at promoting gender awareness in communicable diseases among health professionals that involves gender sensitivity training and analysis of health data and the integration of a gender approach in program planning and implementation in Paraguay and Peru.

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Key Program Results

In Tuberculosis:

• •Contributed to placing TB control in the indigenous population as a public health priority in Colombia.

• •Promoted interinstitutional cooperation in the implementation of the DOTS strategy and is a successful collaboration between the Ministry of Social Protection of Colombia, PAHO, and CIDA both at the national and departmental levels.
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• •More than 500 health professionals, community health promoters, and indigenous leaders trained in the management of TB (DOTS strategy) and more than 50 in the integrated TB/IMCI community approach.
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• •Provided access to treatment for more than 1,300 patients in program areas.
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• •Treatment success rates have increased and default rates decreased.

In Chagas disease:

Paraguay

• •Established an agreement between the Ministry of Public Health and Wellbeing and the Ministry of Education and Culture to involve schools in Chagas disease surveillance activities, which led to Chagas disease becoming part of the regular academic activities and curriculum as a core competency in science in primary schools.
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• •As part of community surveillance of the vector, over 1,000 schools in endemic areas are participating in Chagas disease activities and over 2,000 community leaders have been trained to carry out surveillance activities.
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• Health Surveillance, Disease Prevention and Control
• November 2008
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• •Program actions made it possible to certify the interruption of the vector transmission of Trypanosoma cruzi by Triatoma infestans in the Eastern Region of Paraguay in July 2008 which represents a significant public health achievement in the country.
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Peru

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• •The health of individuals of more than 35,000 households has been improved by interventions to prevent the infestation of Chagas disease in program areas.
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• •Over 500 community surveillance posts to conduct integrated vector surveillance have been established in the program areas in Arequipa, Moquegua, and Tacna.
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• •A strong social communication and health promotion component has led to the active participation of men, women and children in prevention and control activities.
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• •Colombia, Ecuador, Paraguay, Peru, and Venezuela have adopted the PAHO Integrated Management Strategy for Dengue prevention and control and developed a national plan to support it, and are implementing activities.
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• •Program actions are targeted to the communities to develop safe water, environmental, and health practices to prevent and control dengue at the local level.
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• •Thirty health sciences schools (medicine, nursing and technical) have incorporated the IMCI strategy as part of their academic curriculum and human resources development.
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• •More than 200 community health workers, professors, and health personnel trained in community IMCI in Peru.
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• •More than 300 community health workers and health personnel trained in community IMCI in Ecuador.
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• •More than 1,300 health professionals trained in clinical IMCI in all PCPCD countries.

• •Contributed to increasing government and public awareness of the importance of preventing the transmission of syphilis as a public health priority in Paraguay.
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• •More than 480 health providers trained in the syndromic management approach for the prevention and control of sexually transmitted infections.
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• •More than 50,000 pregnant women have received testing for syphilis and over 2,800 have been treated in the program areas.

• •More than 50 health providers trained to provide comprehensive care with an intercultural focus in thirty seven indigenous communities.
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• •Supported the development of curriculum for a culturally appropriate health care approach for indigenous persons in the Chaco region.
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• •Through collaboration with the Women’s Secretariat, Ministry of Health of Public Health and Wellbeing, and the National University of Asunción, the PCPCD has contributed to integrating a gender perspective in the health system in Paraguay, which includes ensuring that information and education are targeted to men and women and improving access to health services and treatment.
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• •Mesas tematicas en género in Paraguay have been successful in creating gender awareness in communicable disease prevention and control among government sectors, civil society, as well as at the community level. The mesas tematicas have resulted in political interinstitutional agreements and efforts to address specific problems that affect maternal and child health such as:
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• •Free diagnosis and treatment of syphilis and HIV in pregnant women
• Free formulae for women with HIV