Technical Cooperaon among countries in Health (TCC)
Pan American Health Organizaon/World Health Organizaon
Lan America and Caribbean countries (LAC)
Since early ´80s, and as a concrete response to Buenos Aires Plan of Acon, PAHO/WHO Secretariat has provided Technical Cooperaon among Countries (TCC), as a singular instrument for solidarity, horizontal cooperaon, understanding, and strengthening of the instuonal capacity of the countries to meet their health needs.
The origins of Technical Cooperaon among Countries (TCC) in health, as a strategy for accelerang health development through the countries’ capacity and potenal, lie in the concept of Technical Cooperaon among Developing Countries (TCDC). The agreement that marked a milestone in the applicaon of this concept was the Buenos Aires Plan of Acon for Promong and Implemenng Technical Cooperaon among Developing Countries, signed by 138 States at an event sponsored by the United Naons Organizaon in 1978. The Mission of PAHO is: “to lead strategic collaborave 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 Organizaon’s main instruments for accomplishing its mission. Since its founding, PAHO has promoted sanitary measures for disease prevenon in and among countries, developing an extensive web of agreements with internaonal instuons and cooperaon agencies. In 1977, through resoluon CD25.R28 of its Direcng Council, the countries of the Region expressed their connuing interest in TCDC. In the 1980s, the Governing Bodies reaffirmed PAHO’s posion in order to promote and support TCDC as a mechanism for encouraging the self-sufficiency of the countries, both individually and collecvely, in the health sector. The Secretariat of PAHO submied two documents “Technical Cooperaon among Countries: Panamericanism in the Twenty-first Century” in 1998 and “Technical Cooperaon 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 instuted by the Director of PAHO in 2004 established five strategic objecves, among them: “Respond beer to country needs” and “Foster innovave modalies of Technical Cooperaon.” This commitment implies “working in close connecon with all the polical, technical, and social networks, and mobilizing the resources that are or may become available." TCC constutes 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 acons and consensus-based public policies aimed at aaining the highest possible level of health for all.
In essence, projects for Technical Cooperaon among Countries (TCC) are a means or instrument for facilitang sharing of knowledge in public health issues as well as for capacity building in the countries. The main areas of cooperaon are: a) Intersectoral acon and sustainable development: Health and human security, Healthy spaces and local development (includes border areas and neighboring countries), Nutrion and food security, Food safety, and Human ecology and environmental health. b) Health informaon and technology: Knowledge management and research, Health informaon and analysis, Informaon and communicaon technology, Essenal drugs, and Clinical technology and blood safety. c) Universal access to health services: Public health infrastructure and leadership, Social protecon 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, Educaon and social communicaon, Mental health and substance abuse, Immunizaon and vaccine development, and AIDS and sexually transmied infecons. It should be noted, however, that a sizable number of projects address more than one area. PAHO has idenfied three modalies of TCC (as stated in the documents presented to its governing bodies menoned before), which are: reciprocity, exchange, and contribuon. It should be borne in mind that these categories are not mutually exclusive, but rather, interrelated and combinable. Reciprocity is understood as cooperaon between two or more states that assume commitments, combining efforts and capacies in a complementary manner depending on their areas of greatest progress and technical experse for mutual benefit. This is the modality that makes it possible to take fullest advantage of TCC’s potenal. Exchange, or cooperavism, consists of cooperaon grounded in common objecves or goals, facilitang informaon and technology. Contribuon includes projects in which technology resources are transferred from one country to another or others, leaving producve capacity that contributes to collecve 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 enty responsible for each of these projects. Notwithstanding this official sectoral funcon in priorizaon, supervision, and coordinaon, it is the naonal programs, health facilies, and centers of excellence under the ministries that most oen parcipate substanvely in these projects. The trend has been towards diversificaon of the instuons involved in the execuon of TCC, partly because of the rise in the number of projects that can be classified, though not exclusively, under the area of intersectoral acon and sustainable development. Furthermore, this trend seems to respond to greater recognion of the varying degrees of the different types of naonal capacity at each level to execute projects for cooperaon among countries. In order of frequency, universies and academic research centers have exhibited the greatest parcipaon, followed by other ministries - Agriculture, Educaon, Women's Secretariats, Municipalies and civil society organizaons.
The main contribuons of TCC is the boosng of naonal technical capacity to address a parcular Public Health problem. The coordinaon expressed through joint plans of acon, and the signing of agreements are one of the major achievements of the TCC. The growing involvement of regional or local enes in TCC makes it possible to broaden opportunies for interchange and enrichment with analogous enes in other countries, going beyond the central or naonal enes to strengthen capacies at the subnaonal level. Another achievement is the adaptaon 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 documentaon of a process or systemazaon and publicaon of documents, sensizaon of the authories, the development of standards, policy-making, situaonal diagnosis, etc. In pracce, all these products reveal the importance of TCC as a policaltechnical instrument that not only contributes to the soluon of a parcular problem, but fosters interse ctoral coordinaon, public policy-making, and the disseminaon of knowledge and informaon. 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 relaons between countries to deal with problems in a coordinated manner. TCC as a Strategy to Strengthen Instuonal Capacity for Naonal Health Development Naonal capacity building is recognized by the countries as one of the most important contribuons of the TCC projects. The exchange established via TCC should be viewed as a first step in a lengthier sustainable process that requires addional financing and me. Evaluaon, Documentaon, and Knowledge Management as a Key Element of TCC Examinaon of the available PAHO´s TCC reports yields a great wealth of experiences, not only for the parcipang countries but for others with similar needs. This requires work to strengthen the mechanisms for systemazing and disseminang the informaon, thus enabling the countries that request cooperaon to have the necessary informaon and knowledge about the available experiences. As a first step in this direcon, PAHO has published available final reports on its Web to facilitate joint systemazaon of the experience as part of TCC’s contribuon to the countries’ development: hp://new.paho.org /hq/index.php?opon=com_content&task=view&id=2128&Itemid=1850
Taking into account all the above, it is clear that TCC supports naonal leadership and ownership and it contributes to aid effecveness principles. TCC is aligned to naonal priories, represents and effort to establish coordinaon with other programmes and development actors and promotes results based management, through empowerment of naonal authories. TCC is based in horizontal partnerships, projects are executed based on countries demands and needs.
At individual level, all parcipants benefit from TCC, from the exchange of experiences, knowledge and informaon. At the organizaonal level, there are many lessons learned derived from TCC experiences. As menoned in the outcomes above, PAHO understands TCC as an opportunity for countries to share experiences, mobilize complementary resources, build partnerships towards strengthening instuonal capacity for naonal health development. There are many achievements, somemes not so visible, related to polical sensizaon, policy making, decision making. As previously menoned, TCC contributes in a considerably way to the boosng of naonal technical capacies to address parcular issues.
Duraon On going program
1.0 million dollars per year
Rebecca de los Rios
Senior Advisor, Partnerships and Alliances PAHO