WHO Director General Praises Primary Health Care in Cuba

José A. de la Osa At the end of November, the World Health Organization (WHO) will begin to distribute the vaccine against the A H1N1 virus among over 100 countries, including Cuba, which won’t be affected by any political barrier, announced WHO Director General Dr. Margaret Chan during the lecture she gave on Monday at the Cuban capital’s Pedro Kourí Tropical Medicine Institute. Margaret Chan, upon her arrival at the tropical medicine institute, greets minister José Ramón Balaguer. to her left, professor Gustavo Kourí, directorof the center. I’m aware, she said, of the economic and financial impact the US blockade suffered by Cuba represents and, nevertheless, what you have achieved under these circumstances in terms of access to health care and public health, and in the aid you give many countries, it’s really amazing. The high-ranking official continued by saying that the blockade is another example of how health can be affected by policies aimed at sectors other than health, because they intervene beyond public health and the WHO mandate. Doctor Chan stated that in the same way Cuban medical brigades have been helping other countries, Cuba would receive, if necessary, all the support of the WHO/PAHO. She said that since the top international organization declared in June the A H1N1 influenza a pandemic, the best of the positive forces formed by cooperation for the 21st century have been seen in the “response” to the current pandemic. But, that at the same time, we’ll probably witness the consequences of decades of failure to achieve equity in health and in the public health basic systems and infrastructure, and stressed that “what I’m now saying does not refer to Cuba.” Cubans must feel very happy, she highlighted, with having leaders that worry about and are aware of the importance of investment in the primary health sector and because the entire population has free access to medical treatment. With regard to the current pandemic she said that everybody knows that the influenza virus is one of the most unpredictable we have had to deal with. My opinion is that a pandemic ends when a good number of people have been immunized. In short, it will end once we achieve enough population immunity. Professor Chan pointed out that as we speak in Havana, some countries are suffering from “a second wave” of influenza. But, she stressed, the knowledge people have about the virus and the disease it can cause is incredible. While referring to international experience, she said that the virus has not mutated, which could cause more severe diseases; “we know that the vaccine for this pandemic adjusts to circulating viruses and that resistance to antiviral drugs is so far very low.” The WHO Director General also said that doctors have evidence showing that when the antivirus is administered within the first 48 hours of the appearance of the flu it reduces the severity of the disease and the need to hospitalize the patient. This new virus affects a younger age group, people generally under 25 years of age. In the flu season, almost 90% of deaths occur in elderly people with more delicate health. Chan described it as “a virus of extremes”, because it can affect people either slightly or severely, and said that pneumonia, which develops very fast, is the main cause of death. Today, she underlined, science affirms that the risk of the appearance of the disease in a severe form takes place mainly in three groups: pregnant women, especially during the third trimester of their pregnancy; children under two years of age; and people suffering from chronic lung diseases, particularly asthma. There are other observations: neurological problems in children can trigger the severity of this disease. She clarified that although “the exact role of obesity” is not yet sufficiently known, morbid obesity has been present in severe or fatal cases, so it’s considered a risk factor. In the morning, Dr. Chan met with the management board of the Ministry of Public Health, during which Minister José Ramón Balaguer gave her details of the development of the island’s public health system and presented her with the commemorative medal for the centennial of the founding of the Ministry of Public Health. A group of executives from research centers in west Havana’s scientific area also informed her about the advances of science in Cuba.


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