PAHO Encourages Balance In Primary Healthcare Delivery

Pan American Health Organization (PAHO) Director, Dr. Carissa Etienne, is urging member countries to take the necessary steps towards achieving a “careful balance” in public healthcare delivery, particularly at the primary level.

This, she said, is imperative in light of emerging “warning signs” of the coronavirus (COVID-19) pandemic’s “devastating” impact on healthcare services for other ailments, across the region.

The Director was speaking during PAHO’s COVID-19 digital briefing on Tuesday (August 4).

Dr. Etienne said the region of the Americas remains under the pandemic’s “tight grip” as evidenced by the over 9.7 million confirmed cases and 365,000 deaths recorded as at August 3, noting that “these numbers continue to rise”.

She noted that consequent on this development, regional health workers are being redirected to care for the influx of COVID-19 patients in their respective countries.

The PAHO Director cautioned, however, that the unavailability of doctors and nurses to provide other essential services at the first (primary) level of care, such as pregnancy-related care and management of chronic conditions, such as diabetes, or infectious diseases, such as HIV/AIDS, tuberculosis and malaria, is resulting in, or could lead to these services either being severely disrupted “or worse yet, halted entirely”.

Simultaneously, Dr. Etienne said patients who are otherwise ill are apprehensive in seeking care for fear of COVID-19 infection, adding that “some may even assume that care is not available and postpone the help they need, often worsening their health situation”.

She further indicated that clinics and hospitals are also still struggling to restock their inventories with the requisite medicines and personal protective equipment, as the pandemic has strained global supply chains and slowed global trade.

Dr. Etienne advised that 11 PAHO member countries currently have less than three months’ supply of antiretroviral drugs, which could lead to a disruption in treatment for persons living with HIV.

Additionally, she said some countries are likely to run out of tuberculosis medication within the next three months and the reagents they need to diagnose TB in half the time.

“Running out of these supplies is simply not an option; we cannot allow this to happen. A prolonged response to this pandemic must include the provision of other essential life-saving services. Countries must adapt and commit to simultaneously providing these essential primary care services while, at the same time, mitigating the effects of COVID-19,” Dr. Etienne suggested.

She advised that over recent months, PAHO has shared best practices and collaborated with governments to make the necessary adjustments, citing the re-engineering of and investment in essential healthcare delivery as paramount.

Against this background, Dr. Etienne reiterated her call for regional governments to dedicate at least six per cent of their gross domestic product (GDP) to strengthen their countries’ health systems, adding that “the best and most efficient way to do this is by prioritising the first level of care”.

She maintained that with a well-resourced, primary healthcare system, “countries can respond to COVID-19 by providing testing and contact tracing, while also offering other essential services like immunisation [and] mental health support, right there in the first level of care”.

“An integrated approach saves patients, time and resources while improving the quality of care that they receive. Primary healthcare investments also improve efficiency, reduce healthcare costs, and enable hospitals and communities to expand capacity in other areas of care,” Dr. Etienne further noted.