WASHINGTON, DC - A new report Monday warned that the failure to build resilience within primary health care (PHC) in Latin America and the Caribbean (LAC) could lead to significant preventable losses in both lives and long term economic development.
In a new report released by the World Bank, Pan American Health Organization (PAHO) Lancelot Regional Health Americas Commission warns that if a health emergency, such as a pandemic or natural disaster, were to reduce primary health care delivery by 25–50 per cent for one to five years, the region could face up to 165,000 preventable deaths and economic losses between US$7–37 billion.
The report titled “No Time to Wait: Resilience as the Cornerstone of Primary Health Care in Latin America and the Caribbean” was launched on the sidelines of PAHO’s 62nd Directing Council here that is being attended by ministers of health and high-level delegates from across the region.
The report notes that the deaths could include as many as 11,300 maternal deaths, 10,000 child deaths, and more than 149,000 deaths from noncommunicable diseases (NCDs), along with up to 14 million unintended pregnancies.
“There is no trade-off between building strong primary health care and building resilience—they go hand in hand,” said PAHO director, Dr. Jarbas Barbosa.
“Without resilient PHC, the next crisis will again hit the poorest and most marginalized communities the hardest. With it, we can ensure essential services – prevention, treatment, and care – continue before, during, and after shocks. Resilience is not a luxury—it is the foundation of health security, social stability, and economic growth.”
The report defines resilience as the ability of health systems to maintain essential services equitably before, during, and after shocks, including pandemics, hurricanes, heatwaves, floods, and vector-borne outbreaks. At the heart of resilience is strong, community-rooted PHC capable of reaching everyone, especially the most vulnerable.
The COVID-19 pandemic laid bare the region’s vulnerabilities. Despite accounting for just 8.5 per cent of the world’s population, Latin America and the Caribbean reported 30 per cent of all COVID-19 deaths.
Essential services, such as maternal and newborn care, childhood immunization, and chronic disease treatment, fell by up to 50 per cent, with gaps that in some countries persisted for two years or more.
The region is also one of the most disaster-prone in the world, facing a rising number of hurricanes, floods, and vector-borne outbreaks. Yet health systems remain heavily hospital-centered, fragmented, and underinvested in PHC.
“Strengthening primary health care is one of the greatest health challenges of Latin America and the Caribbean,” said Jaime Saavedra, Director of Human Development for Latin America and the Caribbean at the World Bank.
“The Commission’s report is a roadmap that shows what works to move towards a resilient primary health care. But the hardest part isn’t technical— governments need to place primary health care at the heart of their agendas, invest in it urgently and at scale, and ensure universal coverage so that protecting lives and the economies is not optional but a priority,” Saavedra added.
To prevent future losses, the Commission calls on governments and other stakeholders to implement a five-point action plan to build resilience within primary health care.
These include expand equitable and comprehensive care models that deliver services for all, ensuring that every community has access to culturally sensitive, multi-professional health teams that can continue delivering essential services before, during and after crisis.
Embed essential public health functions within primary care, including surveillance, vaccination, and health promotion at the community level as well as place communities at the center by involving them in decision-making, respecting cultural diversity, and building trust through accountability and clear communication.
The Commission also recommends for work across sectors, recognizing that health outcomes depend on education, housing, climate resilience, and social protection, with public-private collaboration.
It is also urging secure sustainable financing, prioritizing predominantly public investment in primary health care and establishing mechanisms to rapidly mobilize funds during emergencies.
PAHO said that the report’s findings are a call to action for health leaders to make primary health care resilience a political and economic priority.
“By re-anchoring health systems in strong PHC, governments can close financing gaps, strengthen governance, invest in a well-trained and digitally supported health workforce, and advance reforms that promote quality, equity, and people-centered care.”
The World Bank–PAHO Lancet Regional Health Americas Commission on Primary Health Care and Resilience brought together leading researchers, policymakers, and practitioners from across Latin America and the Caribbean, alongside global health experts
Drawing on expert reviews, country case studies, regional surveys, and extensive consultations, the Commission identifies evidence-based strategies to strengthen public health resilience and highlights the grave consequences of inaction.
This is the first Lancet Commission dedicated specifically to primary health care resilience in the Americas, building on decades of commitment to universal health in the region.
