Challenges

Meningitis continues to be a significant public health challenge in the region, requiring effective coordination between countries for its elimination. For this purpose, nations with similar characteristics in terms of territorial extent, population, and structures of their health systems have been identified, which face common challenges and have implemented diverse strategies. 

 Brazil, for example, has developed specific action plans, while El Salvador is advancing in the development of its strategy, based on the validation of the monitoring tool of the five fundamental pillars: prevention and control of epidemics, diagnosis and treatment, epidemiological surveillance, care for affected individuals, and advocacy and community participation. These initiatives serve as a reference for Caribbean countries to design effective strategies aimed at achieving the same goal.

Toward a Solution

The initiative seeks to integrate countries in the region (Central America, South America, and Anglophone Caribbean) that share sociodemographic characteristics and similar health systems, to leverage strategies and experiences in the development of plans and pathways for the elimination of meningitis by 2030. The global roadmap to defeat meningitis by 2030 from the World Health Organization (WHO) and related guiding documents is used as a reference. 

Through interprogrammatic participation, complementing the five pillars of the work route (Emergencies, Communicable Diseases, Determinants of Health, Immunizations, Rehabilitation, and Environmental Determinants), the aim is to identify the entry point for the articulation of the strategy and the formation of multidisciplinary teams for its implementation. Following the exchange workshop held in November 2024, agreements, steps to follow, and support from the regional office of PAHO along with the countries were obtained. Representatives from the ministries of health of the involved countries participated in the workshop, as well as representatives from WHO and PAHO in the areas of Determinants of Health, communicable diseases, Immunizations, and Emergencies from the regional office and the countries. 

 Key countries and actors from health ministries and institutions were identified. The follow-up agreements obtained included the adoption of strategies that have worked in the countries, and support was provided by PAHO for the development of routes and plans to eliminate meningitis by 2030. 

 This strategy is part of the compliance with Sustainable Development Goals (SDG) 3, 4, 5, 8, 10, and 17; in the case of SDG 3, it specifically focuses on the secondary objectives 3.3, 3.8, and 3.d. Additionally, it is part of the 30+ elimination strategy, with bacterial meningitis being one of the prioritized communicable diseases to achieve elimination goals in the Americas region. 

 This good practice is innovative because it offers a model that has not been used in the countries of the region previously, highlighting key actors within the countries according to the complexity and structure of their health services, following the five work pillars. Additionally, it evaluates similar countries to exchange tools and strategies that they can adopt and adapt, based on local evidence and emphasizing the importance of meningitis as a health issue, promoting the creation of close ties between the countries of the region. 

 Although the language barrier can be a limitation, cooperation and Pan-Americanism transcend and integrate participation. Furthermore, it seeks to establish ties of cooperation between countries despite cultural and linguistic differences, enriching Pan-Americanism over time. 

 This sustainable initiative through the communication and monitoring of national offices regarding the agreements reached establishes the commitment of the health ministries/secretariats of the governments, participation of civil society organizations, and other cooperation agencies focused on assisting health problems. It can be adapted and replicated by identifying other countries with similar experiences, not only regarding bacterial meningitis but also in other health issues, with the support of the national and regional offices of PAHO and the WHO team. This methodology is suitable for the coordination of countries in the region with similar characteristics, being replicable and efficient to optimize efforts in achieving common goals, not only for bacterial meningitis. 

 The lessons learned highlight that the Pan American Health Organization (PAHO) and the World Health Organization (WHO) are facilitators to integrate the participation of countries in the region in identifying common goals and objectives through intersectoral work and a comprehensive approach to health problems. South-South cooperation is identified as a sustainable means of collaboration among the countries in the region.