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Technical Coopera􀆟on among countries in Health (TCC)


Pan American Health Organiza􀆟on/World Health Organiza􀆟on


La􀆟n America and Caribbean countries (LAC)


Since early ´80s, and as a concrete response to Buenos Aires Plan of Ac􀆟on, PAHO/WHO Secretariat has provided Technical Coopera􀆟on among Countries (TCC), as a singular instrument for solidarity, horizontal coopera􀆟on, understanding, and strengthening of the ins􀆟tu􀆟onal capacity of the countries to meet their health needs.


The origins of Technical Coopera􀆟on among Countries (TCC) in health, as a strategy for accelera􀆟ng health development through the countries’ capacity and poten􀆟al, lie in the concept of Technical Coopera􀆟on among Developing Countries (TCDC). The agreement that marked a milestone in the applica􀆟on of this concept was the Buenos Aires Plan of Ac􀆟on for Promo􀆟ng and Implemen􀆟ng Technical Coopera􀆟on among Developing Countries, signed by 138 States at an event sponsored by the United Na􀆟ons Organiza􀆟on in 1978. The Mission of PAHO is: “to lead strategic collabora􀆟ve efforts among the Member States and other partners to promote equity in health, to combat disease, and to improve the quality of, and lengthen, the lives of the peoples of Americas”. Thus, TCC is one of the Organiza􀆟on’s main instruments for accomplishing its mission. Since its founding, PAHO has promoted sanitary measures for disease preven􀆟on in and among countries, developing an extensive web of agreements with interna􀆟onal ins􀆟tu􀆟ons and coopera􀆟on agencies. In 1977, through resolu􀆟on CD25.R28 of its Direc􀆟ng Council, the countries of the Region expressed their con􀆟nuing interest in TCDC. In the 1980s, the Governing Bodies reaffirmed PAHO’s posi􀆟on in order to promote and support TCDC as a mechanism for encouraging the self-sufficiency of the countries, both individually and collec􀆟vely, in the health sector. The Secretariat of PAHO submi􀆩ed two documents “Technical Coopera􀆟on among Countries: Panamericanism in the Twenty-first Century” in 1998 and “Technical Coopera􀆟on among countries in the Region” in 2005 which advanced the concept of TCC and served as a progress report on TCC to its Governing Bodies. The Management Strategy for the work of the Bureau ins􀆟tuted by the Director of PAHO in 2004 established five strategic objec􀆟ves, among them: “Respond be􀆩er to country needs” and “Foster innova􀆟ve modali􀆟es of Technical Coopera􀆟on.” This commitment implies “working in close connec􀆟on with all the poli􀆟cal, technical, and social networks, and mobilizing the resources that are or may become available." TCC cons􀆟tutes an ideal mechanism and an opportunity to build partnerships and develop networks with different sectors of society to address the determinants of health through concrete ac􀆟ons and consensus-based public policies aimed at a􀆩aining the highest possible level of health for all.


In essence, projects for Technical Coopera􀆟on among Countries (TCC) are a means or instrument for facilita􀆟ng sharing of knowledge in public health issues as well as for capacity building in the countries. The main areas of coopera􀆟on are: a) Intersectoral ac􀆟on and sustainable development: Health and human security, Healthy spaces and local development (includes border areas and neighboring countries), Nutri􀆟on and food security, Food safety, and Human ecology and environmental health. b) Health informa􀆟on and technology: Knowledge management and research, Health informa􀆟on and analysis, Informa􀆟on and communica􀆟on technology, Essen􀆟al drugs, and Clinical technology and blood safety. c) Universal access to health services: Public health infrastructure and leadership, Social protec􀆟on in health, Health services, and Human resources for health. d) Disease control and risk management: Tobacco, Environmental risk management, Tuberculosis and emerging diseases, Malaria and other vector-borne diseases, Neglected diseases and research, Non-communicable diseases, and Veterinary public health. e) Family and Community Health: Maternal and women’s health, Child and adolescent health, Educa􀆟on and social communica􀆟on, Mental health and substance abuse, Immuniza􀆟on and vaccine development, and AIDS and sexually transmi􀆩ed infec􀆟ons. It should be noted, however, that a sizable number of projects address more than one area. PAHO has iden􀆟fied three modali􀆟es of TCC (as stated in the documents presented to its governing bodies men􀆟oned before), which are: reciprocity, exchange, and contribu􀆟on. It should be borne in mind that these categories are not mutually exclusive, but rather, interrelated and combinable. Reciprocity is understood as coopera􀆟on between two or more states that assume commitments, combining efforts and capaci􀆟es in a complementary manner depending on their areas of greatest progress and technical exper􀆟se for mutual benefit. This is the modality that makes it possible to take fullest advantage of TCC’s poten􀆟al. Exchange, or coopera􀆟vism, consists of coopera􀆟on grounded in common objec􀆟ves or goals, facilita􀆟ng informa􀆟on and technology. Contribu􀆟on includes projects in which technology resources are transferred from one country to another or others, leaving produc􀆟ve capacity that contributes to collec􀆟ve self-sufficiency. Regarding actors involved, given the intergovernmental nature of PAHO and the very concept of TCC, PAHO´s Secretariat only supports projects that have been endorsed by the ministries of health of its Member States. Ministries of health are always involved, as the en􀆟ty responsible for each of these projects. Notwithstanding this official sectoral func􀆟on in priori􀆟za􀆟on, supervision, and coordina􀆟on, it is the na􀆟onal programs, health facili􀆟es, and centers of excellence under the ministries that most o􀅌en par􀆟cipate substan􀆟vely in these projects. The trend has been towards diversifica􀆟on of the ins􀆟tu􀆟ons involved in the execu􀆟on of TCC, partly because of the rise in the number of projects that can be classified, though not exclusively, under the area of intersectoral ac􀆟on and sustainable development. Furthermore, this trend seems to respond to greater recogni􀆟on of the varying degrees of the different types of na􀆟onal capacity at each level to execute projects for coopera􀆟on among countries. In order of frequency, universi􀆟es and academic research centers have exhibited the greatest par􀆟cipa􀆟on, followed by other ministries - Agriculture, Educa􀆟on, Women's Secretariats, Municipali􀆟es and civil society organiza􀆟ons.


The main contribu􀆟ons of TCC is the boos􀆟ng of na􀆟onal technical capacity to address a par􀆟cular Public Health problem. The coordina􀆟on expressed through joint plans of ac􀆟on, and the signing of agreements are one of the major achievements of the TCC. The growing involvement of regional or local en􀆟􀆟es in TCC makes it possible to broaden opportuni􀆟es for interchange and enrichment with analogous en􀆟􀆟es in other countries, going beyond the central or na􀆟onal en􀆟􀆟es to strengthen capaci􀆟es at the subna􀆟onal level. Another achievement is the adapta􀆟on of models, methodologies, or technologies in a country as a result of the exchange with another country that transfers them. There are other achievements as well, such as the documenta􀆟on of a process or systema􀆟za􀆟on and publica􀆟on of documents, sensi􀆟za􀆟on of the authori􀆟es, the development of standards, policy-making, situa􀆟onal diagnosis, etc. In prac􀆟ce, all these products reveal the importance of TCC as a poli􀆟caltechnical instrument that not only contributes to the solu􀆟on of a par􀆟cular problem, but fosters interse ctoral coordina􀆟on, public policy-making, and the dissemina􀆟on of knowledge and informa􀆟on. Intrinsic Value of TCC The opportunity to share experiences and take advantage of complementary resources are one of the major benefits of TCC. Countries acknowledge that the projects’ main achievement has been the improvement of rela􀆟ons between countries to deal with problems in a coordinated manner. TCC as a Strategy to Strengthen Ins􀆟tu􀆟onal Capacity for Na􀆟onal Health Development Na􀆟onal capacity building is recognized by the countries as one of the most important contribu􀆟ons of the TCC projects. The exchange established via TCC should be viewed as a first step in a lengthier sustainable process that requires addi􀆟onal financing and 􀆟me. Evalua􀆟on, Documenta􀆟on, and Knowledge Management as a Key Element of TCC Examina􀆟on of the available PAHO´s TCC reports yields a great wealth of experiences, not only for the par􀆟cipa􀆟ng countries but for others with similar needs. This requires work to strengthen the mechanisms for systema􀆟zing and dissemina􀆟ng the informa􀆟on, thus enabling the countries that request coopera􀆟on to have the necessary informa􀆟on and knowledge about the available experiences. As a first step in this direc􀆟on, PAHO has published available final reports on its Web to facilitate joint systema􀆟za􀆟on of the experience as part of TCC’s contribu􀆟on to the countries’ development: h􀆩p:// /hq/index.php?op􀆟on=com_content&task=view&id=2128&Itemid=1850 Aid Effec􀆟ve Taking into account all the above, it is clear that TCC supports na􀆟onal leadership and ownership and it contributes to aid effec􀆟veness principles. TCC is aligned to na􀆟onal priori􀆟es, represents and effort to establish coordina􀆟on with other programmes and development actors and promotes results based management, through empowerment of na􀆟onal authori􀆟es. TCC is based in horizontal partnerships, projects are executed based on countries demands and needs.

Capacity Development

At individual level, all par􀆟cipants benefit from TCC, from the exchange of experiences, knowledge and informa􀆟on. At the organiza􀆟onal level, there are many lessons learned derived from TCC experiences. As men􀆟oned in the outcomes above, PAHO understands TCC as an opportunity for countries to share experiences, mobilize complementary resources, build partnerships towards strengthening ins􀆟tu􀆟onal capacity for na􀆟onal health development. There are many achievements, some􀆟mes not so visible, related to poli􀆟cal sensi􀆟za􀆟on, policy making, decision making. As previously men􀆟oned, TCC contributes in a considerably way to the boos􀆟ng of na􀆟onal technical capaci􀆟es to address par􀆟cular issues.

Dura􀆟on On going program


1.0 million dollars per year



Contact Name

Rebecca de los Rios

Contact Title

Senior Advisor, Partnerships and Alliances PAHO


Washington DC



Indepth Study