The Workers’ Health program is involved in several projects and activities in the Region to improve working conditions and environments that are outlined in our 2008-2012 Strategic Plan. 

Our Collaborating Centers and partners play a critical role in providing knowledge, resources, and technical cooperation for these projects and activities, which are aligned with country priorities and the global and regional plans of action on workers’ health. Please see each project and activity for complete descriptions, publications, tools, and collaborators.

The Pan American Health Organization / World Health Organization has coordinated the donation of 175,000 doses of hepatitis A vaccine to Chile, for the immunization of those affected by the February earthquake. PAHO is also supporting Chile in the restoration of health care services around the country.

Preventing Disease and Protecting Health

Vaccines: Preventing Disease and Protecting Health celebrates the various ways vaccines have played a role in improving the health of the world’s populations. In early sections, the book relates successful efforts to fight disease with vaccines, including the eradication of polio from the Americas and the potential contribution of new measles vaccine formulations to reducing measles mortality worldwide. It also looks at the challenges posed in using vaccines to cope with emerging and re-emerging diseases, such as HIV/AIDS and bioterrorism.

Network of PAHO/WHO Collaborating Centres in Occupational Health

Map of PAHO/WHO Collaborating Centers

The following map displays PAHO/WHO's thirteen collaborating centers in the Americas.

View PAHO/WHO Collaborating Centers in Occupational Health in a larger map

PAHO/WHO Collaborating Centers in Occupational Health:

Global Plan of Action Summary for the Americas:

 GPA Summary for the Americas

8th Global Collaborating Centres meeting, Geneva, 18-23 October 2009

Vision

PAHO/WHO Collaborating Centres are key institutions with relevant expertise distributed throughout the world representing a valuable resource and an extended and integral arm of WHO's capacity to implement its mandated work.

Mission

The PAHO/WHO Collaborating Centers play an instrumental role in the implementation of the Organization’s mandated work by supporting its planned strategic objectives at the regional and global levels; enhancing the scientific validity of its global health work, developing as well as strengthening institutional capacities in countries and regions.

The PAHO Revolving Fund for Vaccine Procurement is a mechanism developed by the Pan American Health Organization in 1979 for the purchase of vaccines, syringes/needles, and cold chain equipment for countries in Latin America and the Caribbean.

Six field guides as essential tools in the fight against vaccine-preventable diseases

Six field guides as essential tools in the fight against vaccine-preventable diseases

19-26 April 2008.-

"Vaccination Week in the Americas is an example and reminder of the best of Pan Americanism," said PAHO Director Dr. Mirta Roses. "We are consolidating a true participatory culture for prevention throughout the Americas."

VIDEO Message

Winning the fight against TB: combining efforts of the research and civil society community

Burning this mask was very important to me. I wore it for several months and it was very painful. My peers did not know what my face and smile looked like. When I burned the mask, it was like getting rid of the stigma, I felt free. - Rachel, Border Voices and Images of Tuberculosis Project participant.

What’s the issue? TB in the US-Mexican border region

Tuberculosis, or TB, is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease. In healthy people, infection with Mycobacterium tuberculosis often causes no symptoms, since the person's immune system acts to “wall off” the bacteria. The symptoms of active TB of the lung are coughing, sometimes with sputum or blood, chest pains, weakness, weight loss, fever and night sweats.

Tuberculosis is treatable with a six-month course of antibiotics. About one-third of the world's population is infected with TB, a contagious disease that causes nearly 2 million deaths annually, according to the Centers for Disease Control and Prevention.

TB continues to be a concern for border areas in both Mexico and the United States. Both countries report approximately 15000 cases of all forms of tuberculosis on a yearly basis. In 2005, the tuberculosis incidence rate in Mexico was 15 per 100000, while the United States reported a rate of 4.7 incident TB cases per 100000 population. What is more troubling is that the U.S.-Mexico border states reported a tuberculosis incidence rate higher than the national average, with rates of 7.9 in U.S. border states and 26.3 in Mexican border states.¹

Research to Practice: Improved Research combined with civil advocacy

TB Research has been fundamental in developing effective treatment for acute TB infection. In February 2010, Indiana University School of Medicine researchers identified a mechanism used by the tuberculosis bacterium to evade the body's immune system and identified a compound that blocks the bacterium's ability to survive in the host, which could lead to new drugs to treat tuberculosis and significantly shorten treatment times.²

On the other side, there have been crucial steps by civil society to convey the message that TB is preventable, treatable and curable. An impressive example is the TB Photovoice which presents photographs taken by TB affected community members (survivors, caregivers, friends, family). The photographs and accompanying narratives each represent a life story that serve as a point for discussion about what can be done to change the present situation in regards to TB, stigma, education and related issues.

Another remarkable initiative is Nuestra Casa, a three-dimensional movable house representing the life stories of persons affected by TB, their messages of reality and hope and the surrounding conditions of TB not only at the U.S.-Mexico Border. Ten  participants from all across Mexico have been available at Nuestra Casa to share their personal stories and photos. It gives clear messages how to prevent and get treatment for TB. Nuestra Casa is a tool for advocacy, communication and social mobilization promoting awareness among decision makers, health care providers, and the public in general to get involved in concrete action to prevent the spread of TB, reducing the number of cases and deaths caused by it.

What next: Improved detection through integrated cross-sector approaches

Although medicines to treat TB are available, they must be taken for at least six months to fully eliminate all TB bacteria from the body. People who do not follow the lengthy treatment regimen can become sick and infectious with a more virulent form of the disease that is resistant to standard medicines. As Rachel puts it: “We are told that recovery will take place after a full course of treatment. That’s not always easy when jobs and life’s daily demands take priority. It’s not long before your life-saving medication becomes a daily intrusion—especially without warning that interrupting treatment increases drug resistance and furthers TB infections."

Further, detection of TB remains a huge challenge. Lack of widespread diagnostic tools hinders patients from starting early treatment once the disease is active. At 35, Rachel was diagnosed with diabetes. Since susceptibility to TB is higher with diabetes, hepatitis, HIV/AIDS, smoking and other addictions, malnourishment, and pregnancy, her latent TB infection developed into the active disease within a year. For three agonizing years, Rachel was misdiagnosed with flu, colds, allergies, respiratory infections, pneumonia, and asthma. Her 3-year-old niece also suffered through surgeries to remove a recurring cyst. Only after Rachel was correctly diagnosed, was her removed tissue tested and found positive for TB. They both started the daily medication treatment for active TB disease. Rachel’s case shows the need for upscaling TB detection to allow correct diagnosis and early treatment.

What does this show? There is an urgent need to combine efforts by the scientific community and civil society, so that they become linked in a way that is synergistic. The research community should cooperate with civil society initiatives to promote TB prevention and treatment. Civil society should make use of newest research advances for better decision-making. With regard to the US-Mexican border, implementing effective control, prevention and treatment for TB is particularly difficult. Efforts to control tuberculosis in the United States–Mexico border are reflected in the 2005–2010 Strategic Plan of Ten against Tuberculosis, a binational initiative created by the health officers of the 10 U.S.-Mexico border states in June 1995. However, more efforts are needed facing the lack of coordination among a myriad of actors and stakeholders. Health prevention communication methods are often insufficiently adapted to the border-specific context.

• For more information on TB, please visit WHO’s website.

Our team would like to give special thanks to

• Rachel Orduno, Teresa Rugg and TB Photovoice, who provided us a human face to this case study, as well as PAHO’s US-Mexico Border Office.
• Nuestra Casa was made possible through funding from USAID Mexico. Nuestra Casa is an initiative of Project Concern International SOLUCION TB and The Alliance of Border Collaboratives.
• Project Concern International SOLUCION TB
• The  Alliance of Border Collaboratives and the Border Voices and Images of Tuberculosis Project.

Footnotes:

1. Fig. 1. US–Mexico border map (Institute for Public Strategies, 2003)in: Collins-Dogrul, Julie; Managing US–Mexico ”border health”: An organizational field approach, Social Science & Medicine 63 (2006) 3199–3211, Elsevier, Maryland Heights, USA.
2. Cf. (accessed February 25, 2010)

Background: In 2002, prompted by a measles outbreak in Venezuela and Colombia, the health ministers of countries in the Andean region propose an annual Vaccination Week in the Americas to help prevent such future outbreaks. In the 8 years since VWA was first implemented, over 288 million people have been vaccinated against a wide range of vaccine preventable diseases such as measles, rubella, yellow fever, diphtheria, tetanus, polio, and influenza, as a result of the initiative. Multiple VWA social mobilization campaigns throughout the region have also been undertaken and the initiative has received ever increasing political support. 

To access more information on each year's Vaccination Week activities, click on the year.

2003: In September, Vaccination Week in the Americas is accepted as an annual, hemispheric initiative, by the Directing Council of the Pan American Health Organization, with the adoption of Resolution CD44.R1. The principles underlying Vaccination Week in the Americas are equity, access, and Pan-Americanism.  Nineteen countries participate in the first VWA, the primary focus of which is measles elimination.  With the implementation of this program, more than 16 million people are vaccinated.

2004:  Twenty-three countries participate in the second annual VWA.  The focus for 2004 consists of follow-up campaigns against measles, elimination of rubella and CRS, and the vaccination of older adults.  Over 43 million people are vaccinated in the second year of the VWA campaign.

2005: The third VWA emphasizes the vaccination of indigenous peoples and older adults, rubella elimination campaigns, the strengthening of regular immunization programs and the introduction of new vaccines.  During this campaign, more than 38 million people are vaccinated in the Region. Drawing inspiration from the activities in the Americas, European Immunization Week (EIW) launches in October 2005 and focuses primarily on social communication activities.

2006:  In its fourth year, VWA activities highlight the transition from child to family immunization programs, the strengthening of regular immunization programs, influenza, rubella elimination and the introduction of new vaccines.  Over 49 million people are vaccinated during the 2006 campaign.

In June 2006, the PAHO Executive Committee confirms the organization's commitment to VWA by recommending that the PAHO Directing Council adopt resolution CE138.R4, which would urge member states to continue to support and expand vaccination efforts, including the yearly celebration of Vaccination Week in the Americas.

2007: Forty-five countries and territories participate in Vaccination Week in the Americas, the highest total thus far in the history of the initiative. More than 47 million individuals are vaccinated as a result of the week's initiatives which work to strengthen border coordination, reach isolated populations, strengthen routine programs and advance the control of yellow fever and hepatitis B, among other goals. 

2008: The sixth annual VWA involves the participation of 45 countries and territories in the Region. Multiple VWA launching events take place along binational and trinational borders throughout the Region with the participation of high-ranking authorities under the framework of a Health Caravan. Diverse vaccination campaigns take place as part of the week, including multiple measles/rubella elimination campaigns, focused primarily in Central America. More than 59 million individuals are vaccinated through such efforts.

2009: The seventh annual VWA emphasizes the importance of family vaccination as well as the vaccination of health workers. Multiple launching events are held throughout the Region, including a series of events in the South American Chaco, the border area shared by Argentina, Bolivia, and Paraguay and one of the transnational priority areas as identified by the Pan American Alliance for Nutrition and Development.

2010: Set to begin on April 24 until May1, VWA 2010 will focus on reaching everyone, especially vulnerable populations.  Multiple launching events are being planned, including one on the border of Honduras and Nicaragua and another on the Suriname/French Guiana border.  The latter event will be the first ever bi-Regional launching event, linking both VWA and EIW.  EMRO Region of WHO is also planning to pilot its own vaccination week in 2010, simultaneously with VWA and EIW, moving one step closer to the future goal of a Global Vaccination Week.

Temporary field hospitals have been set up by Chilean armed forces in affected regions of the country, and temporary health facilities sent by other countries will be set up as soon as possible. Argentina, Brazil, Cuba, Peru and Spain have also sent field hospitals to Chile.

What's the issue? Access to Affordable Haemophilus influenzae type B (HiB) Vaccines[i]

Haemophilus influenzae type B, or Hib, is a bacterium estimated to be responsible for some three million serious illnesses and over 350,000 deaths per year, chiefly through meningitis and pneumonia. Almost all victims are children under the age of five, with those between four and 18 months of age especially vulnerable

Hib meningitis is a more serious problem in developing countries, with mortality rates several times higher than seen in developed countries; it leaves 15 to 35% of survivors with permanent disabilities such as mental retardation or deafness.

However, Hib is preventable — highly effective vaccines have been available since the early 1990’s. Yet hundreds of thousands of children die year after year from Hib disease. One major reason is that the Hib vaccine is significantly more expensive than other childhood vaccines; for a low and middle income country the Hib vaccine costs roughly seven times the cost of vaccines against measles, polio, tuberculosis, diphtheria, tetanus, and pertussis combined (about $7 USD versus $1 USD).

Cuban Research, Development and Distribution of Vaccines and Biologicals – Capturing the Entire Supply Chain 

As a result of its integrated vaccine strategy, Cuba has overcome many of the barriers to vaccine research and distribution in middle and low income countries. Thanks to the development of capacities and facilities to internalize the entire supply chain of vaccines, Cuba has been able to develop various vaccines and antibiotics at low cost while ensuring distribution of these life-saving advances throughout the country.

Research to Practice: Development and Distribution of the HiB Vaccine in Cuba

In 1999, the first commercial vaccine containing a synthetic carbohydrate antigen was developed in Cuba against Hib. This vaccine, Quimi-Hib® (Heber Biotech), exhibits several advantages over naturally-derived vaccines such as:

·        Lower production costs compared with conventional vaccines

·        Controlled production of a homogeneous, single compound

·        Minimal batch-to-batch variability during the manufacturing process

·        Higher quality control standards compared with naturally-derived agents[iv]                

In clinical trials, also conducted in Cuba, researchers found that the HiB vaccine provides protection to nearly 100 percent of immunized infants after primary vaccination and a second booster dose. Additionally, clinical trials showed the vaccine to be very safe[v].This lower-cost alternative provides access to the Hib vaccine for those who otherwise would not have been able to afford it.

In 2004, Quimi-Hib® became part of Cuba’s national vaccination program.

Today, Quimi-Hib is being produced in Cuba in a new modern plant at CIGB which has been outfitted with state-of-the-art technology. The plant was designed to produce enough doses to immunized all children in Cuba with the capacity to eventually produce doses for export to other countries.

What’s Next? Overcoming barriers to vaccine development  

The CIGB has also participated in technology transfers, sharing knowledge and scientific protocols, with Brazil, China, Vietnam and Iran. Investigators continue research and development of vaccines and antibiotics to fight various diseases such as Hepatitis A,B and C, Dengue, Malaria, Chagas and Cholera[vi].

However, Cuba (along with many other countries around the world) still faces many barriers to vaccine development and distribution including:

1. High (and increasing) development costs
2. Long development timeframes
3. Patent periods
4. Restrictive regulatory environments
5. Insufficient industrial capacity[vii]

Continued biological and health delivery research will help to address some of these barriers, and ensure the distribution of important vaccines and biologicals around the globe.

[i]Information from the World Health Organization Website: http://www.who.int/mediacentre/factsheets/fs294/en/

[ii]Akira Homma, José Luis di Fabio1 y Ciro de Quadros. Los laboratorios públicos productores de vacunas: el nuevo paradigma. Rev Panam Salud Publica/Pan Am J Public Health 4(4), 1998

[iii]Centro de Ingenieria Genetica y Biotecnologia (Center for Genetic Engineering and Biotechnology):

 http://www.cigb.edu.cu/(in Spanish)

http://www.cigb.edu.cu/index.php?lang=english(in English)

[iv]Astronomo, RD & DR Burton. 2010. Carbohydrate vaccines: developing sweet solutions to sticky situations? Nature Reviews Drug Discovery 9, 308-324.

 [v]Verez-Bencomo, V. et al. A synthetic conjugate polysaccharide vaccine against Haemophilus influenzae type b. Science 305, 522–525 (2004).

 [vi]Centro de Ingenieria Genetica y Biotecnologia (Center for Genetic Engineering and Biotechnology) website

 [vii]Ibid.

The Pan American Health Organization (PAHO) is calling on people in the Americas to support voluntary, altruistic, and repeated blood donation as the only way to ensure a safe and sufficient blood supply. PAHO issued the call on World Blood Donor Day, which recognizes and thanks people who donate blood voluntarily and without remuneration.

Washington, D.C. (PAHO) - For World Blood Donor Day—June 14— Shaila Dúrcal, a singer-songwriter and Champion of Health of the Pan American Health Organization is supporting a PAHO campaign urging young people to donate blood voluntarily.

La Organización Panamericana de la Salud (OPS) movilizó unos 15 millones de dólares para apoyar las acciones de salud pública tras el terremoto que el pasado 27 de febrero azotó el centro y sur de Chile. En ceremonia oficial la Directora de la OPS, Mirta Roses realiza la entrega formal de un vacunatorio móvil al Ministro de Salud del país Jaime Mañalich, como expresión de las acciones de cooperación de la OPS a Chile, vehículo que permitirá llevar vacunas a lugares apartados y reforzar campañas de vacunación.

Introduction | Water | Excreta | Solid Waste

Introduction

"Sanitation" is defined in this guide as all activities involved in proper water supply management and excreta and solid waste disposal.

Mounting a sanitation system in shelters and camps must not only involve the use of simple engineering techniques but consider social and cultural factors at the site of the intervention as well as the costs.

{mosimage}The 63rd World Health Assembly closed on 21 May, and despite a challenging agenda, delegates reached agreement on a large number of resolutions, including a code of practice on the international recruitment of health personnel and a breakthrough global strategy for reducing the harmful use of alcohol.

Washington, D.C., April 21, 2010 (PAHO) — Forty-four countries and territories of the Western Hemisphere will reach out to an estimated 42 million children and adults with vaccines during the Pan American Health Organization's 8th Annual Vaccination Week in the Americas (VWA) on April 24 to May 1.

The U.S.-Mexico Border Health Commission (BHC) has joined the Centers for Disease Control and Prevention (CDC) and the Pan American Health Organization / World Health Organization (PAHO/WHO) to promote immunization in the United States-Mexico border region in conjunction with the U.S.-focused National Infant Immunization Week (NIIW) and with Vaccination Week in the Americas (VWA), PAHO/WHO's campaign to promote immunization throughout the Americas.

Panamá. - Bajo el lema: "Universalización de la vacuna de neumococo”, el Ministerio de Salud, en conjunto con la Organización Panamericana de la Salud (OPS/OMS), realizó el pasado 23 de abril de 2010 el lanzamiento oficial para Panamá de la Semana de Vacunación en las Américas 2010, iniciativa que se desarrollará en todo el continente del 24 de abril al 1 de mayo.

Forty-four countries and territories of the Western Hemisphere will reach out to an estimated 42 million children and adults with vaccines during the Pan American Health Organization's 8th Annual Vaccination Week in the Americas (VWA) on April 24 to May 1. Tens of thousands of health workers and volunteers in North, Central, and South America and the Caribbean are pledged to support the effort.

Press Releases Click Here	Videos Click Here
Slide Shows Click Here	Publications Click Here
Related Links Click Here	FAQ's Click Here

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Press Releases 

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Videos

Dra. Mirta Roses, World Day for Safety and Health at Work

Occupational Health and Infection Prevention in Healthcare Facilities Workshop

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Slide Shows

World Day for Safety and Health at Work (22 April 2010)

Occupational Health

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 Recent Advances in Immunization, 2nd Edition

Order code: SP 619
ISBN: 92 7511619 9
Year Published: 2006
pages: 139
Author: Jon Kim Andrus, MD & Ciro A. de Quadros, MD