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Visión prospectiva de la salud

Woman being examined by nurse

La Región tiene como imperativo construir sistemas de salud resilientes y sostenibles para asegurar la salud universal y como herramienta para hacer frente a actuales y futuras emergencias de salud pública. Es necesario fortalecer la gobernanza en el ámbito de la salud para que los países formulen políticas encaminadas a promover la salud y el bienestar, reducir las inequidades en torno a la salud y alcanzar el ODS 3. Esta publicación muestra que, si bien la mayoría de los países de la Región buscaron una respuesta integral a la pandemia, uno de los desafíos más importantes fue coordinar esa respuesta en un contexto de alta fragmentación estatal y de falta de recursos críticos del sistema de salud. Dicha coordinación dependió de las capacidades políticas e institucionales de las autoridades de salud para dirigir un ejercicio eficaz de las funciones esenciales de la salud pública.

Es necesario promover estrategias prosociales que favorezcan acciones encaminadas a ayudar a las personas y las comunidades, durante la actual pandemia y en las futuras, desde un enfoque de salud mental y física, con el fin de abordar los efectos negativos en la salud mental. Es importante que durante las fases de preparación y respuesta a cualquier evento que amenace la salud, la salud mental forme parte de los planes como uno de los pilares fundamentales que contribuya a salvar vidas y a salvaguardar la salud mental de las personas, haciendo hincapié en los grupos en situación de vulnerabilidad.

La rectoría de las autoridades de salud es una dimensión política e institucional fundamental de una agenda intersectorial para promover sistemas de salud resilientes. La pandemia ha evidenciado que es prioritario que los países dispongan de sistemas de salud con capacidad para reaccionar a futuras emergencias sanitarias, pero también la urgencia de reforzar la respuesta a las condiciones de salud prevalentes. Para hacer frente a nuevas emergencias, los países deben contar con planes actualizados, y mantener operativas las medidas de respuesta para contención y mitigación. Progresar en la Agenda 2030 (3) y retomar el camino hacia el logro de los ODS para "[g]arantizar una vida sana y promover el bienestar para todos en todas las edades" implica avanzar hacia la salud universal.

Uno de los resultados positivos de liderazgo y gobernanza en la Región ha sido la cooperación entre países de las Américas —incluidas experiencias de cooperación horizontal en América Latina y el Caribe— para tener un acceso más equitativo a tecnologías sanitarias como vacunas, equipos médicos, EPP y terapias contra la COVID-19, así como la cooperación desde Canadá y Estados Unidos y para acelerar el acceso a vacunas y otras tecnologías. Se requiere contar con mecanismos multidimensionales de coordinación intersectorial que considere las diferentes condiciones sociales para alcanzar una respuesta de salud efectiva, desde una perspectiva de toda la sociedad y el Estado.

En la Región de las Américas —como en el mundo— las personas en situación de vulnerabilidad han concentrado una mayor carga de la pandemia. Los países necesitan explicitar estrategias de acción para reducir de forma significativa las brechas en salud. Se requieren políticas intersectoriales que promuevan una sinergia entre la salud, la economía, y las dimensiones social y ambiental bajo el concepto de equidad. Atender los determinantes sociales de la salud implica contar con sistemas de protección social universales, integrales y sostenibles para impulsar acciones de salud, más allá de lo asistencial y curativo.

Por otro lado, la pandemia ha revelado el papel central de las comunidades y sus organizaciones sociales, que fueron esenciales tanto para la implementación de la respuesta como para la adherencia a las recomendaciones. Su conocimientos y experiencias permitieron adecuar y adaptar las acciones a la realidad y contextos locales. Los sistemas de salud resilientes y sostenibles deben incorporar a comunidades y sus organizaciones en la formulación e implementación de policías de salud.

Es necesario promover la acción multisectorial desde el enfoque de “Una sola salud” para mejorar la prevención y preparación para la COVID-19 y los desafíos futuros en la interfaz entre los seres humanos, los animales y el medio ambiente. La complejidad del origen de la pandemia de COVID-19 ha evidenciado la necesidad de abordar la prevención de futuros patógenos emergentes, dado que más de 70% de estos agentes patógenos son zoonóticos. Para prepararse mejor ante una próxima epidemia de una enfermedad zoonótica emergente, se deben mejorar los sistemas de análisis de riesgos mediante la incorporación de datos de microorganismos, animales y cadenas de alimentos de origen animal, seres humanos y el medio ambiente.

En cuanto a la dimensión tecnológica, para fortalecer los sistemas de salud es necesario acelerar la transformación digital y fortalecer los sistemas de información para la salud. Durante la pandemia se han planteado retos para llevar a cabo un monitoreo oportuno, debido a la escasez de datos abiertos, de calidad y disponibles en tiempo real que permitan tomar decisiones. Los sistemas de información deben estar interconectados y en línea, ser interoperables y acordes con los estándares internacionales, y disponer de la desagregación necesaria para asegurar resultados con equidad y una toma de decisiones rápida y lo más fundamentada posible, con vistas a no dejar a nadie atrás. La agenda de transformación digital del sector de la salud implica contar con acciones de visión holística que considere los ocho principios rectores acordados por los Estados Miembros de la OPS (, ).

Es necesario robustecer los sistemas de vigilancia epidemiológica para controlar la pandemia actual y anticipar las futuras. Las herramientas de inteligencia epidemiológica deben proporcionar análisis en tiempo real para la toma de decisiones en los diferentes ámbitos (local, nacional, regional, mundial) de forma que sea posible orientar las acciones en lugares y momentos considerando la magnitud de la respuesta necesaria, y la identificación de los grupos de población en situación de mayor vulnerabilidad. Asimismo, el acceso a datos "no convencionales" y "no estructurados", como los de movilidad de la población, alfabetización digital, uso de dispositivos móviles o capacidad de ancho de banda para el uso de telecomunicaciones deben considerarse factores críticos para el éxito en la toma de decisiones informadas del sector de la salud. La creación de mecanismos como la Red Regional de Vigilancia Genómica de COVID-19 han contribuido no solo a la capacidad para la secuenciación del virus, sino a estimular a los países a poner en marcha la vigilancia genómica regular, como estrategia para incrementar la cantidad de datos disponibles a nivel mundial.

La Región debe enfocarse en el aumento de las capacidades regionales de desarrollo y producción de medicamentos y otras tecnologías sanitarias. La pandemia de COVID-19 creó situaciones de desabastecimiento e inequidades en el acceso a productos farmacéuticos, vacunas y otras tecnologías sanitarias esenciales que condicionaron las capacidades de respuesta de los sistemas de salud y limitaron o pusieron en riesgo la provisión de servicios de salud esenciales. El aumento de las capacidades regionales de desarrollo y producción de medicamentos y otras tecnologías sanitarias puede contribuir a mejorar el acceso a ellos y responder mejor a las prioridades y necesidades de salud de la Región, además de aportar a la protección de la seguridad nacional y a la recuperación económica en la Región.

Se deben fortalecer la gobernanza, los liderazgos, las condiciones y las capacidades de los recursos humanos en salud de la Región, que deben ser elementos clave en el fortalecimiento de los sistemas de salud. El fortalecimiento de los recursos humanos requiere de alianzas con actores clave, incluido el sector académico y el sector privado, entre otros. Se debe contemplar el desarrollo de políticas de formación, contratación, y retención del recurso humano para responder a los requerimientos de los sistemas nacionales con miras a alcanzar la salud universal.

La pandemia ha afectado drásticamente a la población mundial y de las Américas, con graves consecuencias económicas, sociales y de salud, y ha revelado una elevada desigualdad social, que se suma a las persistentes debilidades estructurales de los sistemas de salud en la Región. A pesar de esto, la Región ha sabido fortalecer las acciones de cooperación, basándose en la solidaridad y panamericanismo que la caracterizan. Se ha demostrado el valor de la inversión en la preparación para emergencias, el papel central de las comunidades y los procesos participativos, el eje articulador del trabajo intersectorial, los sistemas de información y en la capacidad de desarrollo de tecnologías sanitarias. La OPS continuará, de la mano de sus Estados Miembros, impulsando la salud universal y la equidad en la salud como elemento central para el desarrollo.

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BÚSQUEDA DE LITERATURA INSTITUCIONAL OPS/OMS

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BÚSQUEDA DE LITERATURA CIENTÍFICA

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INDICADORES BÁSICOS

Para obtener los datos más recientes sobre indicadores de salud para la Región de las Américas, asegúrese de visitar el portal de Indicadores Básicos de la OPS.