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Washington, DC, 15 February  2019 (PAHO) – The Americas region is home to more than one billion people. Every year, 15 million babies are born, and nearly 7 million people die. Life expectancy is 80.2 years for women and 74.6 for men. More than 8 in 10 people live in urban areas. These are some of the key statistics presented in the new “2018 Basic Indicators,” just published by the Pan American Health Organization (PAHO).

The compendium, produced annually, presents PAHO’s most recent data from 49 countries and territories on the demographic and socioeconomic situation of the Americas, the population’s health status, risk factors, and coverage of health care services and health systems.

“Indicators are an essential element in the production of evidence in health to inform decision making,” says PAHO Director Carissa F. Etienne, in the preface to the publication. Such evidence means that “decision-making will be better informed and lead to increased opportunities for more effective interventions that have a greater impact on health outcomes.”

Health status

The document shows—among other findings—that approximately 6,000 women die from pregnancy-related causes each year in the Region, and more than 163,700 infants die.

The publication also shows that women in the Americas have on average two children, while teenage mothers (ages 15 to 19) have 48 newborns per 1,000 women, with subregional differences ranging from a low of 18 teen births per 1,000 women in North America to 61 per 1,000 in Latin America and the Caribbean.

Noncommunicable diseases—such as heart disease, cancer, and stroke—are the main causes of death in the Americas. Regionwide, the death rate from noncommunicable diseases is 427.6 people per 100,000 population, which is seven times higher than the death rate from communicable (infectious) diseases, at 59.9 people per 100,000 population.

With regard to infectious diseases, in 2017 Latin America and the Caribbean reported approximately 580,000 cases of dengue (44% of this total were reported from Brazil), more than 31,000 cases of leprosy (nearly 90% from Brazil), and more than 13,800 cholera cases (99% from Haiti). The HIV diagnostic rate was 14.6 people per 100,000 population regionwide, and for every new HIV diagnosis among women, there were 3.6 HIV diagnoses among men.

Protective and risk factors for health

Data are also presented on risk factors (variables that increase the chances for ill health) and protective factors (which reduce that risk). For example, breast milk is a protective factor, as it meets all a young child’s nutritional and immunological needs. In the short term, it reduces the risk of disease and death from diarrhea, respiratory and ear infections, and sudden infant death syndrome. In the long term, it reduces the risk of dental malocclusion, overweight/obesity, and diabetes mellitus. In women, it reduces the risk of invasive breast cancer, ovarian cancer, overweight/obesity, and diabetes.

Despite ample evidence that breastfeeding benefits children’s health, cognitive development and likely even their long-term economic prospects, the prevalence of exclusive breastfeeding at 6 months varies considerably among countries, ranging from 2.8% to 68%.

Regarding risk factors, about 8% of newborns in the Region have low birthweight (less than 2,500 grams/5.5 pounds). Chronic malnutrition affects 10% of children under 5, and 6% of children in the same age group are overweight (data from 2012). Rates of overweight and obesity are high among adults in the Americas: in 2016, 64% of men and 61% of women were overweight or obese. Additionally, 39% of adults do not perform enough physical activity.

In the Americas, 13% of adolescents consume tobacco, a percentage that varies across countries from a low of 3.8% in Canada to 25% in Chile and Dominica.

High blood pressure affects 21% of men and 15% of women in the Region (latest available data from 2015), while diabetes mellitus affects 9% of men and 8% of women.

Vaccination

Vaccination coverage in 2017 varies for different vaccines: 94% percent of the target population of children in the Americas received the tuberculosis (BCG) vaccine; 90% received the vaccine for the first dose of measles, mumps, and rubella (MMR1); 88% received three doses of diphtheria, tetanus and pertussis (DTP3) vaccine; 85% received three doses of polio vaccine; and 73% received the last dose of rotavirus vaccine.

Health systems

 In the Americas, there are 18 doctors, 59.7 nurses and 6.7 dentists per 10,000 population. Public expenditure on health as a percentage of gross domestic product (GDP) is 5% on average regionwide (below the 6% recommended by PAHO’s Strategy for Universal Access to Health and Universal Health Coverage). The percentage in North America (8%) is twice that of Latin America and the Caribbean (4%). Out-of-pocket expenditure as a percentage of total health expenditure was 22% as of 2015. PAHO’s strategy on universal health recommends eventually eliminating out-of-pocket payments altogether because they constitute a significant barrier to access health services.

Blood donation from voluntary donors, the safest way to collect blood, varied from 100% in North America to an average of 40% in the rest of the Region (data from 2015).

Special topics: air pollution and homicides

This year’s publication also includes three special features: the burden of disease attributable to air pollution, recommendations on the limitations of epidemiological analysis when handling small numbers, and a map showing the distribution of homicides in the countries of the Region.

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 The Pan American Health Organization (PAHO) works with the countries of the Americas to improve the health and quality of life of its population. Founded in 1902, it is the world’s oldest international public health agency. It serves as the Regional Office of WHO for the Americas and is the specialized health agency of the Inter-American system.

LINKS

For more information, see the Basic Indicators 2018:

http://iris.paho.org/xmlui/bitstream/handle/123456789/49511/CoreIndicators2018_eng.pdf?sequence=1&isAllowed=y

MEDIA CONTACTS

Leticia Linn: Tel.: +1 202 974 3440. Cell: +1 (202) 701 4005. Email: linnl@paho.org

Sebastián Oliel: Tel.: +1 202 974 3459. Cell: +1 (202) 316 5679. Email: oliels@paho.org

Ashley Baldwin: Tel.: +1 202 974 3872. Cell: +1 (202) 340 4025. Email: baldwinash@paho.org

The evaluation of the Caribbean Regional Strategic Framework (CRSF) 2014-2018 was completed and was accepted by the Priority Areas Coordinating Committee (PACC) and the Executive Board earlier this month. Among other findings, the evaluation revealed that while the Caribbean has made progress in responding to the HIV epidemic, the impact of the prevention response has been inadequate, particularly among key populations.

The evaluation reinforced the critical need for member states to invest in activities to achieve prevention and the UNAIDS 90-90-90 Targets. The Board called upon countries and the Partnership to renew efforts to build capacity and work together to achieve the targets. Members noted the legal judgments in Caribbean courts affirming human rights arising from litigation and called on countries not to wait on litigation but to make amendments to laws to recognize the rights of key populations and the rights of all to access sexual and reproductive health services. The board also noted that while tens of thousands of cases of HIV infections have been prevented there is a critical need to significantly reduce new infections. This requires countries to promote age-appropriate sexual education and skills and extend sexual reproductive health services to all youth and key populations. Members recommended the introduction of innovative prevention approaches and the improvement of prevention services to ensure greater impact in reducing new HIV infections.

The Board also called on the PACC to develop a new CRSF for the period 2019 to 2023 and agreed on the following strategic priority areas:

• An Enabling Environment
• Prevention of HIV Transmission
• Care, Treatment and Support
• Integrate HIV into Health and Socioeconomic Development
• Sustainability
• Strategic Information, Monitoring and Evaluation and Research.

The evaluation also reinforced the critical need for PANCAP to accelerate the implementation of its Resource Mobilization Strategy 2018-2020 to buffer member states as they fully transition to domestic resources for HIV. We need to work with member states to get more people to know their HIV status, retain more people on treatment and get more people virally suppressed. We must intensify our efforts to achieve the 90-90-90 Targets by the end of 2020.

The PANCAP Advisory Group on Resource Mobilization will meet in the middle of February to discuss and agree on strategies for increasing our donor base including the private sector. The Group will also explore how to stimulate creative and innovative fundraising that would be developed and packaged in a very competitive way to attract potential funders/sponsors without compromising the strategic interests of PANCAP. We look forward to using the innovative strategies agreed to accelerate the implementation of the Resource Mobilization Strategy 2018-2020.

Image: (L-R) Parliamentarians Hon. Nigel Dharamlall, M.P., Hon. Gail Teixeira, M.P., of the People’s Progressive Party (PPP), Managing Director of SASOD Guyana, Mr Joel Simpson and Hon. Dr Nicolette Henry, M.P, Minister of Education (Guyana). 

In December 2018, Guyana’s Society against Sexual Orientation Discrimination (SASOD) celebrated its 15th anniversary with a cocktail reception at the Impeccable Banquet Hall in Georgetown, Guyana. For over 15 years, SASOD Guyana has been a dedicated voice for the LGBTQ+ Guyanese and has promoted non-discrimination and equality in the country and the Caribbean region.

The Hon. Dr Nicolette Henry, M.P, Minister of Education, delivered special remarks on behalf of the Government of Guyana. Minister Henry spoke about SASOD’s notable achievements on local, regional, and international stages such as engaging local government, leading public education and sensitization on gender and sexual diversity, and providing essential services to Guyana’s most marginalized citizens.

Minister Henry also commended SASOD for the recent victory at the Caribbean Court of Justice where the organization played a critical role in demolishing a colonial-era law that criminalized cross-dressing and disproportionately penalized transgender and gender non-conforming persons. She said that this landmark decision highlights the fact that outdated laws do not reflect the current realities and values of inclusion and cohesion in Guyana today. The Minister confirmed the Government’s commitment to ending all forms of discrimination and fulfilling the promise of equality and a good life for all Guyanese.

Founder and Managing Director, Joel Simpson, spoke on behalf of SASOD Guyana. Simpson spoke fondly of the humble beginnings of the grassroots movement as a student-led lobby group, and proudly of the acclaimed, influential movement, it has become.

“SASOD Guyana has represented the LGBTQ+ community for the past 15 years and has used every opportunity possible to hold the state accountable for its human rights obligations. SASOD will continue to advocate for equality and inclusion of all persons in Guyana”, stated the Managing Director.

Also in attendance were Opposition Chief Whip, Hon. Gail Teixeira, M.P., and Hon. Nigel Dharamlall, M.P., of the People’s Progressive Party (PPP). The two PPP parliamentarians joined the Education Minister and Simpson in cutting the SASOD 15th Anniversary cake.

The celebratory event was supported by the United Nations Development Programme (UNDP) and COC Netherlands, a Dutch organization that supports LGBT people.

In December 2018, three civil society partners, “Care 242”, “The DMARCO Organization” and the “Bahamian Transgender Empowerment for Healthy Living” (BTEHL) collaborated with corporate entities in the Bahamas to bring holiday cheer by providing personal care supplies and psychosocial support to residents of “The All Saints Camp”, an organization focused on People Living with HIV (PLHIV) located in Nassau, New Providence, The Bahamas.

The collaboration is depicted in the images below:

Image: SASOD Guyana Public Health Consultant Dr Nastassia Rambarran (left) and Managing Director Joel Simpson with Junior Health Minister Dr Karen Cummings (second, from left) and Deputy Chief Medical Officer Dr Karen Campbell

In January 2019, the Society against Sexual Orientation Discrimination (SASOD) Guyana Public Health Consultant Dr. Nastassia Rambarran and Managing Director Joel Simpson met with Junior Health Minister Dr. Karen Cummings and Deputy Chief Medical Officer Dr. Karen Campbell to discuss recommendations stemming from the organization’s “Assessment of Knowledge, Attitudes and Delivery Preferences for HIV Pre-Exposure Prophylaxis (PrEP) among Key Populations in Guyana.”

In a brief statement, SASOD Guyana said the meeting agreed that a study on the cost-effectiveness of implementing PrEP in terms of averting new infections would strengthen public policy in this area.

As a result, it announced that it has accepted the challenge to find resources and complete the cost-effectiveness study within the next six months. Based on its assessment, SASOD had called last year on the Government to include PrEP as part of its combination prevention approach for adult HIV infections.

One of the key findings of the assessment revealed that in Guyana knowledge of PrEP appears to be minimal, with 60% of the 47 participants stating that they did not know of PrEP, while a significant number of those who claimed to be aware of the option were actually confusing PrEP with Post-exposure Prophylaxis (PEP).

The assessment was conducted via focus groups in Regions Three, Four, Five, Six and Ten, with financial support from the International HIV and AIDS Alliance’s Rapid Response Fund.

Following research on its effectiveness, the World Health Organization (WHO) in 2014 recommended PrEP as an additional HIV prevention choice for groups, such as men who have sex with men and transgender women. This recommendation was extended to all groups in 2015.

Image: Richard David with Joel Earl Simpson (bottom row, third and fourth from left, respectively) with community leaders and attendees at “Equality in Guyana”.

Guyana is the only country in South America where intimacy between a same-sex couple is still illegal. The statute on the books is antiquated as it originated from British colonial days. There could be a window to change this in the near future.

On Saturday, 5 January 2019, Richard David, District Leader of NYS Assembly District 32 hosted a conversation with Joel Earl Simpson, Founding and Managing Director of the Society against Sexual Orientation Discrimination (SASOD) at The Figure Studio in South Ozone Park. Titled “Equality in Guyana,” the event addressed specifically how equal rights can become an election issue in Guyana and how the diaspora can help to promote equal rights, even from afar.

“With elections on the horizon, we want the parties and their candidates to speak favourably about human rights and equality for LGBTQ Guyanese,” said David. “When they come to New York for support, we should be asking them for a plan, a timeframe, a clear position on this issue because they have both abandoned it once in office. This issue brings all ethnicities together, and it is why we have brought together a coalition of community leaders in New York.”

Among that coalition of leaders were co-sponsoring partners including SASOD USA Diaspora Network, Caribbean Equality Project, Indo-Caribbean Alliance, Inc., Guyana Tri-State Alliance, Sadhana Coalition of Progressive Hindus, New American Voters Association, Indian Diaspora Council, Guyanese Girls Rock Foundation, The Figure Studio and Jahajee Sisters.

The event underscored the important roles that community-based organizations and religious institutions in New York City could play in bringing forward a progressive legal ruling in Guyana as it pertains to homophobic policies. As Joel Earl Simpson of SASOD mentioned at the event, if the statutory language were removed, Guyana would follow countries like India, which recently repealed Section 377 of its Constitution and the Republic of Trinidad and Tobago, which repealed its Sexual Offences Act, along with other countries like Kenya and Singapore.

David also sought to create a space where Guyanese residents in New York City could have community conversations about positive matters. At the event, David mentioned that the neighbourhood is “thriving with religious groups, clothing stores and cutting-edge entrepreneurs who are just out of college and looking to become small business owners. It is therefore important that the neighbourhood is understood and loved for all the great things it has to offer, rather than all the negativity often pitched by media outlets that blemish the community’s reputation”.

Inviting Simpson to South Ozone Park for a high-level conversation on Guyanese policy provided a chance for community leaders and concerned members of the diaspora to present questions and express support of Simpson’s efforts. Simpson himself has an illustrious background, with a Law Degree and a Master’s Degree in Human Rights Law.

David’s conversation with Simpson also paved the way for impacted individuals like Twinkle, also with SASOD, to tell their personal stories. Twinkle, who recently migrated from Guyana to New York City, is a transgender woman and hate crime victim who was denied access to the Guyana Court System simply because she presented as a transgender woman.

“Supporting work and activists on the ground has always been, for me, the key to building sustainable change,” said David. “There is no stronger leader than Joel Earl Simpson and SASOD who are at the grassroots. They are winning hearts and minds, even as they mobilize to take legal action. I hope all Guyanese will find it in their conscience that the LGBTQ community deserves to live as equal citizens.”

Sustainability of youth advocacy beyond donor funding will be the focus of the upcoming Meeting of Youth Leaders scheduled for May 2019. The editor of the PANCAP Newsletter recently discussed the upcoming event with PANCAP Youth Network Chair, Kevin Mendez, who has helmed the PANCAP Youth response to HIV for the last two years.

The Chair expressed enthusiasm about the meeting and explained that it will “serve as a platform to present and organize the youth sexual and reproductive health advocacy efforts exercised by youth leaders, key population members, and Caribbean Youth Ambassadors in their countries and the region”.

The Chair further explained that the Youth Meeting would be a space to celebrate the achievements of the Youth Network and most importantly, critically analyze the current situation regarding youths’ vulnerability to HIV. Participants will also collaborate to develop a “call to action” aimed at decision makers and the network’s sustainable strategic plan post-Global Fund grant.

“As we meet for the third time with the support of PANCAP, sustainability – through partnership – is at the core of our discussions”, stated Kevin.

He further explained, “The Steering Committee is active in identifying local, regional and international organizations and government allies to commit to integrating the advocacy efforts into their existing strategies and how together we can continue improving youth’s access to comprehensive sexual and reproductive health services and our rights”.

“As the planning continues, we are excited for the outcomes of this creative, fun, inclusive and invaluable conference,” stated the Chair.

Press Release:– Efforts to continue developing a framework to overcome HIV, TB and STIs as a public health threat by 2022 are underway as the OECS Regional Coordinating Mechanism (RCM) and Global Fund met recently.

The OECS RCM is making preparations to sign another three –year grant proposal with the Global Fund aimed at eliminating HIV, TB and Sexually Transmitted Infections (STIs).

The project will operate in six participating OECS Member States: St. Vincent and the Grenadines, Antigua and Barbuda, St. Lucia, Dominica, St. Kitts and Nevis and Grenada.

Project Coordinator for the OECS HIV/TB Grant Dr Cleophas D’Auvergne highlighted the goals of this project.

“The major goals of the grant are to reduce the incidence of HIV in line with the 90-90-90 Targets and also move towards TB elimination using a framework for low incidence countries because most of the OECS countries are low incidence countries. The second goal is to improve services for key populations for HIV, TB and STIs. And, ensuring that these services are accessible and affordable.”

Minister for Health and Wellness Sen. Hon. Mary Isaac says the project is extremely important to Saint Lucia as it addresses a critical need for persons with HIV, TB and STIs.

“This grant is aimed at assisting persons living with HIV as well as TB and other STIs. This is a population that we usually don’t remember exists, but they are quite challenged in that there is a lot of stigma attached to these people. So, funding like that comes at a time when it is extremely critical that these people have the ability to access their medications and manage other health issues that they might have.”

The project is being co-funded by the Global Fund for over US $5.5 million dollars for the period of three years spanning April 2019 to April 2022.