Regional immunization programs as a model for strengthening cooperation among nations.

At the top of the agenda of the meeting were the complex public health issues involved in fighting yellow fever and other epidemic infectious diseases. The final resolution of the first convention stated, " It shall be the duty of the International Sanitary Bureau to lend its best aid and experience toward the widest possible protection of the public health of each of the said Republics, in order that disease may be eliminated and that commerce between said Republics may be facilitated. " In the 19th century, efforts at inter-American cooperation had been limited almost exclusively to assisting commerce, and had had almost nothing to do with health. In 1923 the International Sanitary Bureau changed its name to the Pan American Sanitary Bureau , which would eventually become known as the Pan American Health Organization (PAHO) (1). Pan-Americanism is the guiding principle upon which PAHO was founded. That principle is expressed in the PAHO Member States' commitment to working together to improve the health of their citizens and to support the countries facing the greatest need. This principle recognizes that many health problems require a collective effort. The PAHO Member States acknowledge that the health and public health of one's neighbors is a shared responsibility of all. Pan-Americanism is grounded in values aimed at breaking down the barriers of health inequities. This principle is perhaps even more relevant today in a world of free trade and vast movements of people. In the 20th century, Pan-Americanism spawned several disease control initiatives that strengthened the collective efforts for improving technical cooperation among PAHO Member States, and that enhanced the strategy of " regional programs. " These initiatives included yellow fever eradication and malaria eradication. The targets were not achieved with these two initiatives, mostly because the strategies were not technically feasible. Experience has subsequently demonstrated that it is virtually impossible to eradicate diseases that have mosquito vectors. However, the use of immunization and vaccine technologies enabled Member States and PAHO to establish the program to eradicate smallpox in the Western Hemisphere, a target achieved in the Region of the Americas well in advance of