PAHO Highlights Primary Care Role in NCD Control

The Pan American Journal of Public Health, the scientific publication of the Pan American Health Organization (PAHO), has released a special issue focused on strengthening primary health care as a response to noncommunicable diseases (NCDs) across the Americas, a region where these conditions remain the leading cause of death.

The Americas rank among the regions with the highest prevalence of risk factors for noncommunicable diseases worldwide. Over 59% of the population in the region lives with overweight or obesity, with rates well above the global average, positioning it as the region with the highest obesity prevalence, reports the Mexican Government. 

Cardiovascular diseases, cancer, diabetes and chronic respiratory diseases accounted for about 6 million deaths in the Americas in 2021, according to PAHO data. Nearly four out of every 10 of those deaths were considered premature, occurring in people under the age of 70. Beyond mortality, the burden on health systems is substantial, with estimates indicating that more than 250 million people in the region live with at least one NCD and require ongoing care.

“The region is grappling with a growing burden of NCDs like diabetes, heart disease, and cancer, which require long-term, coordinated care. The traditional fee-for-service model is ill-equipped to handle these challenges, often leading to fragmented care, high costs, and poor health outcomes,” writes Hector Barillas, General Manager, Wiener lab Mexico, on MBN.

The special issue brings together scientific evidence showing that many NCDs can be effectively controlled and that quality of life can be improved when patients have access to timely, continuous, and higher-quality primary care services. The articles also underscore that a significant share of premature deaths linked to NCDs could be avoided through stronger first-level care, particularly in screening, early diagnosis, and long-term management.

Through case studies and evaluations, the publication documents advances and persistent challenges in NCD care, drawing on initiatives led by ministries of health, academic institutions, civil society organizations, and PAHO itself. The experiences analyzed cover efforts to improve detection and treatment protocols, expand access to essential medicines and strengthen follow-up at the community level.

A central theme of the issue is PAHO’s Better Care for NCDs initiative, which includes the HEARTS initiative for cardiovascular disease prevention and control. As part of that initiative, in December 2025, the PAHO introduced a new quality framework aimed at strengthening the prevention and management of hypertension and cardiovascular risk across the Americas, translating years of regional experience into a model that countries can implement immediately through primary health care, reports MBN.

Recent studies show that these programs have contributed to better management of hypertension and other chronic conditions within primary care settings in several countries, supporting more standardized and evidence-based practices.

PAHO also argues that investing in primary health care for NCDs is not only feasible but cost-effective, particularly in health systems facing increasing demand and limited resources. Strengthening primary care is presented as a critical component for countries seeking to meet the Sustainable Development Goal of reducing premature mortality from NCDs by one-third by 2030.

Financial support for the special issue was provided by the Government of Denmark through the World Health Organization (WHO). The publication includes experiences from Argentina, Bolivia, Brazil, Chile, Peru, and Trinidad and Tobago, offering a regional perspective on how different health systems are addressing similar challenges.

Topics explored range from the implementation of clinical guidelines and integrated models of care to the role of social determinants in treatment adherence. Across the studies, the importance of person- and community-centered approaches emerges as a recurring finding, reinforcing the view that effective NCD management depends on care models that are both clinically sound and responsive to local contexts.