In 2019, the Pan American Health Organization (PAHO) and its Member States approved the Elimination Initiative: an ambitious, comprehensive, community- and person-centered framework aimed at eliminating more than 30 communicable diseases and related conditions in the Americas by 2030. It builds on the Region's successes while addressing emerging challenges and further strengthening health systems. While the COVID-19 pandemic slowed the pace of the Elimination Initiative, programs developed many innovative approaches during this period to ensure the provision of quality healthcare services. These continue to be valuable strategies today.

In September 2023, PAHO relaunched the Elimination Initiative to stimulate a renewed, stronger, and more mature effort to complete its goal and implement lessons learned during the pandemic. This edition of Health in the Americas: Accelerating disease elimination examines why the Elimination Initiative is important at this moment in time, takes stock of progress toward its targets, and advances the discussion on what will accelerate actions necessary for achieving elimination targets.

The Elimination Initiative provides a common and sustainable framework to facilitate concerted efforts among countries, civil society organizations, communities, partners, and donors to work toward four fundamental lines of action required to achieve the elimination targets: (1) strengthening the integration of health systems and service delivery, (2) strengthening strategic health surveillance and information systems, (3) addressing the environmental and social determinants of health, and (4) strengthening governance, stewardship, and finance.

While the Region has made significant progress in disease elimination, its countries face ongoing challenges, and data reveal great disparities both among and within countries. Accelerating progress toward the initiative’s targets requires urgent action to address social and environmental determinants of health.

The Elimination Initiative is not just a possibility but also a call to action, promoting collaboration and innovation to transform health outcomes across the Region. Its framework is uniquely adaptable to the context of each country. Its tailored approach supports countries to create and implement specific action plans based on the endemic diseases and unique health challenges they face and customize strategies to local needs that maximize impact for countries to effectively eliminate targeted diseases and conditions.

Investing in disease elimination offers substantial benefits for both health and economic development in the Americas. Global estimates suggest high cost-effectiveness for interventions against neglected infectious diseases, with returns ranging from USD 25 to USD 115 per dollar invested across various diseases. The socioeconomic benefits of eliminating diseases like leprosy, leishmaniasis, and Chagas disease are estimated in the billions of dollars. Countries are called to action to tackle critical communicable diseases by harnessing regional expertise, driving highlevel advocacy, forging partnerships, and integrating elimination efforts into primary health care. Cross-border collaboration, strategic alliances with donors, and community engagement are crucial for achieving and sustaining elimination targets, making a lasting impact in the fight against communicable diseases.

The Elimination Initiative presents a unique opportunity to foster collaboration among countries to overcome common challenges in their efforts to eliminate diseases and to share good practices, resources, and innovations. To accelerate disease elimination efforts in the Americas, Member States should implement proven and innovative strategies, ensure access to new technologies, enhance data collection and use, emphasize intercultural approaches, and foster collaboration across sectors and stakeholders.

As the leading public health organization supporting countries in the Americas, PAHO – with historical roots firmly planted in controlling the spread of disease – remains steadfast in its commitment with Member States to achieve the targets of the Elimination Initiative.

Dr. Jarbas Barbosa da Silva Jr.
Director of the Pan American Health Organization

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