Biennial Program Budget of the Pan American Health Organization

Abstract

Over the period 1980-2000, the number of people living in poverty in Latin America and the Caribbean increased by 85 million to almost 220 million people. Close to 16% lives on less than a dollar a day, an increase of almost 20% over the number in 1987. There continues to be great disparities in income, and these disparities are on the increase. All the evidence is clear that those in the poorest sectors of the population are the most disadvantaged, not only from an economic standpoint but also because they have no voice in society. Poverty, unemployment, lack of schooling, and ethnic, gender, and age discrimination continue to have a negative impact on health and psycho-social pathologies such as violence against women, domestic and community violence, and substance abuse and tobacco dependency, which contribute to the morbidity, mortality, and disabilities in the Region. There has been obvious progress in health, when measured by such indicators as life expectancy and infant mortality, and this has occurred primarily as a result of decreases in incidence of infectious diseases. Notwithstanding the occurrence of a poliomyelitis vaccine-derived outbreak in the Dominican Republic and Haiti this year, the Region continues to take pride in its eradication of wild polio and measles. With the Caribbean's lead, rubella might also be eliminated within the decade. Although the health status of the people in the Region has improved considerably in the last few decades, this situation favors more those with higher incomes and status in society. Increasing urbanization, population growth, and migration contribute significantly to the deterioration of the environment and to the increased demand for public health services. Although water supply in Latin America and the Caribbean increased from 80% to 85% between 1990 and 2000, almost 64 million people still do not have access to this basic requirement for living, and where systems do exist, many have operational and maintenance problems. In urban areas, potable water coverage is approximately 90% while in rural areas it is 64%. Almost 32% of the population does not have appropriate systems for the elimination of solid and liquid waste...