Q&A: New PAHO Director Jarbas Barbosa on public health in the Americas
==========================================================================

* Mark Barna

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/53/5/5/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/53/5/5/F1)

Barbosa

Jarbas Barbosa, MD, MMedSci, began his five-year term as director of the Pan American Health Organization in February. He has been with PAHO since 2007, serving as the organization’s assistant director for the past six years. His public health career, which began in a poor community in Pernambuco, Brazil, has spanned vaccines, sexually transmitted infections, epidemiology, medicines and outbreak response.

Barbosa talks to *The Nation’s Health* about his goals as director, the most pressing health problems in the Americas and lessons learned from the COVID-19 pandemic.

## What are your priorities as PAHO director?

The first is to help countries transition from the COVID-19 emergency to sustained control of the disease, using the best tools we have at hand: surveillance, vaccines and accessible and effective antivirals.

My second priority is to apply the lessons learned from the pandemic — one of the most important of which is to ensure equitable access to health technologies. This is why PAHO launched its Platform to Advance the Manufacturing of COVID-19 Vaccines and other Health Technologies in the Americas. Under this initiative, we will work to strengthen regulatory capacity, technology transfer and capacity building for manufacturing to benefit all countries in the region.

The third priority is to help countries to recover better from the negative impacts of the pandemic, incorporating new strategies and technologies to address priority health challenges. These include making greater use of telehealth tools to expand access and quality of care and using new PCR tests for the detection of HPV.

A push for renewed and strengthened primary health care in the region is my fourth priority. This means broadening the focus beyond maternal and infant care to include health promotion, prevention, surveillance and the provision of care for the most prevalent diseases in a community, for example chronic conditions such as hypertension.

Finally, my fifth priority is to strengthen PAHO’s capacity to support member states, streamlining its management, promoting increased transparency, and improving agility, efficiency and gender equity to make the organization fit for the next decades.

## What recent public health successes in the Americas are you most proud of?

Shortly after COVID-19 arrived on our shores, the Americas took extraordinary steps to protect the health of its people. We saw the speed at which the region was able to rise to the challenge: ramping up surveillance, working with PAHO virologists to equip national laboratories with PCR-testing capacity within weeks, reinforcing health services to accommodate an influx of COVID-19 patients, and the unprecedented rollout of 2.13 billion doses of COVID-19 vaccine in 30 months to the farthest reaches of our continent.

At the same time, the region made great strides in the prevention and control of noncommunicable diseases, implementing laws and regulations to reduce tobacco use and adopting new front-of-packaging rules to make people aware of processed food with high content of sugar, sodium and fat.

The Americas also reached key disease elimination milestones in the past five years.

## What are the most pressing public health issues in the Americas?

Due to a decline in immunization, the risk of vaccine-preventable disease outbreaks is at a 30-year high in our region. In 2021, more than 2.7 million children under age 1 in the Americas did not receive all their vaccine doses — this means that almost 1 in every 5 children are not fully protected against diphtheria, tetanus and whooping cough. This is very worrying.

![Figure2](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/53/5/5/F2.medium.gif)

[Figure2](http://www.thenationshealth.org/content/53/5/5/F2)

A child celebrates after receiving his immunizations in Barbados as part of Vaccination Week in the Americas in 2015. Millions of children in the Americas have not received all their recommended vaccinations, a trend PAHO Director Jarbas Barbosa named “very worrying.” He called for strategic communications to tackle misinformation and vaccine hesitancy.

Photo courtesy PAHO

> “Recovering vaccination rates is a priority. We must work with all tools available to boost immunization programs, including strategic communications to tackle misinformation and vaccine hesitancy.”
> 
> —Jarbas Barbosa

Recovering vaccination rates is a priority. We must work with all tools available to boost immunization programs, including strategic communications to tackle misinformation and vaccine hesitancy, a major barrier in many countries.

We also face a big burden of non-communicable diseases — some of the highest rates of hypertension and diabetes in the world — and many communicable diseases, along with violence and increased climate-related events, particularly in our small island states of the Caribbean.

## PAHO recently partnered with Grindr to share public health information on mpox. Tell us about that.

Providing timely information about symptoms and protective measures is key to controlling and preventing infectious disease outbreaks. To achieve this goal, we must meet populations in the spaces where they are most comfortable, and this means working with various partners in civil society, academia and even the private sector.

The current outbreak of mpox, which began in Europe and then spread to the Americas, particularly affects men who have sex with men, so it was critical to get accurate messages to these groups.

The social networking app Grindr is a tool that many among this target audience use in their daily lives, so it was important to make the most of this channel to share mpox information.

## What advice would you give young public health professionals?

I believe that it is now more important than ever to combine a solid academic background on “traditional” public health subjects — such as epidemiology, statistics, planning and management — with new areas, like anthropology and political science.

This will give us more tools to understand public health within specific contexts in different societies, as well as the complex epidemiological scenario we have nowadays. It will also help us better identify the specific needs of population groups and the barriers — economic, social, cultural — they face to access health services and programs.

## What inspires you in your public health work?

The possibilities of public health interventions to breaking the vicious circle-- between poverty and illness, and the collective gains of our work to reduce suffering and increase quality of life, have always inspired me.

I started working in a very poor municipality, Olinda, in my home state of Pernambuco, Brazil. Since then, I have always been amazed by the changes we can produce to improve health and well-being through interventions, strategies and technologies.

*For more information on PAHO, visit [www.paho.org](http://www.paho.org).*

*This interview was edited for style, clarity and length.*

*   Copyright The Nation’s Health, American Public Health Association