The Pan-American Highway, which we all know, connects the entire American continent, stretching from Alaska to the southernmost tip of Argentina. However, this highway is not seamless: there is a 130-kilometer gap between Panama and Colombia where the route abruptly ends. In healthcare, interruptions like this are a daily occurrence.
These interruptions manifest in various ways: access to healthcare may be hindered by physical distances; the quality of care may be compromised if, during an emergency, a doctor lacks critical information about a patient’s allergies; public health monitoring may falter when a traveler presents a counterfeit vaccination certificate, potentially spreading disease; and health policies may suffer when there is insufficient data to design effective action plans tailored to the real needs of the population.
The Inter-American Development Bank (IDB), together with the Pan-American Health Organization (PAHO) and the countries of the region, has long been aware of these problems and we consider digital health to be a key tool for addressing these shortcomings and evolving towards a new reality. Digital tools such as telehealth, the international patient summary and digital health certificates represent key solutions to these challenges.
Benefits and Key Features of the Pan-American Highway for Digital Health
To ensure that everyone in the region can access quality health services regardless of their location or circumstances, we set out to create a Pan-American Highway for Digital Health (PH4H). The PH4H will also improve countries’ preparedness for future pandemics and other health threats. Currently, patients’ health data is often held by their providers. Moreover, when a person migrates, not only is their health data left behind, but if they wish to use a prescription from their GP in another country they cannot do so. With PH4H we aim for patients, both inside and outside their own countries, to be the owners of their data, being able to share data with whoever they wish or to access it whenever they need it.
In addition, we aim to ensure that interoperability enables electronic prescriptions to be valid regionally and that medical teams anywhere—be it a city, province, or country—can access a patient’s medical history to provide informed, quality care.
Cross-Border Care Continuity and Digital Vaccination Certificates
A key element in making PH4H possible is interoperability, both within and among countries. For this reason, during the launch of PH4H, we held the third regional connectathon, a connectivity marathon with technical teams from 18 ministries of health in the region. The goal of these connectathons is to technically equip governments to interoperate and subsequently create a robust digital infrastructure throughout the region. On this occasion, the connectathon focused on cross-border continuity of care and digital vaccination certificates. Recently, together with digital health colleagues, we published a paper on the need to move towards the definitive implementation of digital health certificates. In this day and age, continuing to use paper certificates not only affects the efficiency but also the effectiveness of global health. The World Health Organization has taken a significant step in this area by creating the Global Digital Health Certification Network (GDHCN), a trust framework for countries to easily verify the authenticity of digital health certificates operated in this framework.
PH4H created a trust domain within the GDHCN so that countries that are part of our initiative can verify the authenticity of digital certificates circulating in the region. During the connectathon, we developed use cases within the GDHCN framework. Notably, 17 out of 18 countries learned the technical requirements and their implementation to join the PH4H domain of the GDHCN.
An important milestone from the PH4H launch was the decision to adopt the yellow fever vaccination certificate as the cross-border exchange use case for 2025, with 18 countries committed to its implementation. If achieved, Latin America and the Caribbean will be the first region globally to offer these certificates in line with WHO standards.
Next Steps in Building the Pan-American Highway for Digital Health
Latin America and the Caribbean have made enormous progress in the digital transformation of their healthcare systems. To mention a few examples, Jamaica managed to implement an electronic medical records system in at least 13 clinics; the municipality of Sao Paulo, in Brazil, managed to implement a telemedicine platform with more than half a million consultations since 2020 and a 2/3 reduction in triage time in emergency services. In addition, Suriname is the first country in the region to launch a system for digital death certificates, with an app for their storage using the WHO’s ICD11 coding (International Classification of Diseases)—an unprecedented global achievement.
But we must go beyond local efforts, hence the relevance of PH4H. This initiative was approved by all the countries of the region during the last PAHO Directing Council , which brings together all the ministers of health of the continent. It was officially launched by the IDB, PAHO and 22 countries in Bogota, Colombia, at the end of October 2024. We hope that more countries will join and that more donors and partners will want to be part of it. The first official donor of PH4H is the government of Japan.
By 2025, PH4H aims to have at least three countries exchanging health data via digital vaccination certificates. We also plan to establish the PH4H Knowledge Center, with at least 10 countries trained and certified in key digital health competencies. In October 2025, we will host the fourth regional Connectathon in El Salvador.
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