The Pan American Journal of Public Health, the scientific publication of the Pan American Health Organization (PAHO), has released a special issue focused on strengthening primary health care to address noncommunicable diseases (NCDs) in the Americas. NCDs—including cardiovascular diseases, cancer, diabetes, and chronic respiratory conditions—are the leading cause of death in the region, responsible for six million deaths in 2021, nearly four out of ten of which were premature, affecting people under 70 years of age. Over 250 million people in the Americas live with an NCD and require ongoing care, and evidence shows that many premature deaths could be prevented through more accessible, effective, and higher-quality primary care services.
The special issue highlights the progress, challenges, and lessons learned from initiatives led by ministries of health, academic institutions, civil society organizations, and PAHO to improve the screening, diagnosis, treatment, and management of NCDs at the primary care level. A central focus is PAHO’s Better Care for NCDs initiative, including the HEARTS program, which has contributed to improved hypertension and NCD management across multiple countries in the region. The articles demonstrate that investing in primary care for NCDs is a feasible, necessary, and cost-effective strategy, and a key component of achieving the Sustainable Development Goal of reducing premature NCD mortality by one-third by 2030.
Supported financially by the Government of Denmark through WHO, the special issue includes studies and experiences from Argentina, Bolivia, Brazil, Chile, Peru, and Trinidad and Tobago. Topics explored include the implementation of clinical guidelines, integrated care models, and the influence of social determinants on treatment adherence, emphasizing the importance of a person- and community-centered approach.
Highlighted contributions in the issue include an editorial by the PAHO Director on integrating NCDs into primary care, a report on essential NCD care conditions in Bolivia’s Chaco region, a study from Argentina on the use of clinical practice guidelines, Chilean research on social determinants affecting cardiovascular treatment adherence, and analyses from Peru on the HEARTS program and cardiometabolic screening in Amazonian populations. Additionally, Brazilian studies focus on hypertension and diabetes care pathways and the role of nursing staff, while Trinidad and Tobago presents a cross-sectional evaluation of hypertension control using the HEARTS approach in primary care.
