Pan American Health Organization · 1st edition, 2023
PAHO methodological guide for health ministries to construct national elimination profiles for >30 communicable diseases using standardized indicators.
- Issuer
- Pan American Health Organization
- Edition
- 1st edition, 2023
- Audience
- National health authorities, Ministry of Health programme managers, epidemiologists, public health professionals responsible for disease control and elimination programmes
- Evidence
- Expert consensus, synthesis of existing WHO and PAHO strategies, action plans, and technical documents
- Reviewed
- 17 Oct 2026 · GMJ
What this guideline says
GMJ summary
This PAHO guidance document provides a systematic methodology for Member States in the Americas to develop country-specific status profiles on communicable diseases targeted for elimination by 2030 under the PAHO Disease Elimination Initiative. The framework encompasses more than 30 diseases including HIV/AIDS, tuberculosis, malaria, Chagas disease, hepatitis B and C, soil-transmitted helminthiasis, lymphatic filariasis, and vaccine-preventable diseases such as measles, rubella, and neonatal tetanus. The guidance is structured around four strategic lines of action: strengthening health systems integration, improving surveillance and information systems, addressing social and environmental determinants, and strengthening governance and finance.
The document outlines a seven-step process for profile development: organize and prepare, form a technical working group, select diseases and indicators, identify information sources, collect and analyse data, validate data, and write the profile. An extensive annex provides priority indicators for each disease, including transmission rates, mortality, morbidity, disability measures, and programme coverage metrics. For example, elimination targets include HIV MTCT rate ≤2%, cervical cancer incidence <4 per 100,000 women, tuberculosis incidence reduction of 80% versus 2015, malaria incidence and mortality reduction of 90% versus 2015, and prevalence of hepatitis B surface antigen in children aged 4–6 years <0.1%.
The profiles are intended to document progress, identify gaps in health systems, inform evidence-based policy decisions, and mobilize political commitment and resources. They emphasize disaggregation by age, sex, geographical location, and vulnerable populations, supporting targeted interventions aligned with SDG 3 and the concept of health for all.
Key points
For clinicians — doses and thresholds as stated in the guideline
- HIV elimination targets: reduce global incidence to <335,000 new infections annually (90% reduction vs. 2010), reduce HIV-related deaths to <240,000 annually (90% reduction vs. 2010), achieve HIV MTCT rate ≤2%
- Cervical cancer elimination: incidence rate <4 per 100,000 women per year by 2030, requiring 90% HPV vaccination coverage in girls by age 15, 70% screening coverage at ages 35 and 45, and 90% treatment coverage
- Hepatitis B elimination: reduce prevalence of HBsAg in children aged 4–6 years to <0.1%, achieve >90% hepatitis B birth-dose vaccination coverage within 24 hours
- Tuberculosis targets: 90% reduction in TB deaths and 80% reduction in incidence rate (versus 2015 baseline) by 2030, with zero families facing catastrophic costs
- Malaria elimination: absence of new indigenous cases for three consecutive years, with 90% reduction in both incidence and mortality versus 2015
- Chagas disease: interruption of intradomiciliary and peridomiciliary vector transmission for ≥5 years, 100% blood donor screening, universal organ donor screening, and treatment of all detected cases
- Soil-transmitted helminthiasis: reduce prevalence of moderate/severe infections to <2% in preschool and school-age children through annual deworming of children aged 1–15 years in risk areas
- Vaccine-preventable disease elimination maintenance: neonatal tetanus incidence <1 per 1,000 live births, zero endemic measles and rubella transmission for ≥12 months, zero yellow fever epidemics from Aedes aegypti transmission
Four dimensions of communicable disease elimination
Table extracted from the guideline
| Dimension | Definition |
|---|---|
| No transmission | No transmission by direct contact (sexual, mother-to-child, person-to-person) or by vector, intermediate host, or physical environment (water, soil, food, air, waste) |
| No morbidity | No illness caused by the disease |
| No disability | Disability prevented, corrected, limited, or minimized |
| No mortality | No deaths from the disease |
Source: Pan American Health Organization, Guidance for Developing Status Profiles on Communicable Diseases to Further Progress toward Their Elimination in the Region of the Americas. Reproduced in summary form.
From the guideline
Verbatim
“The status profile of communicable diseases in each country should, to the extent possible, provide a systematic, up-to-date, and reliable picture of the subnational or national reality.”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As Chair of the Public Health Institute of Georgia and having worked extensively with WHO on health system strengthening, I see this PAHO framework as highly relevant for Georgia and neighbouring countries in the South Caucasus and Eastern Europe. Our national programmes—hepatitis C elimination since 2015, TB control aligned with the End TB Strategy, universal childhood immunization including hepatitis B birth dose, and HIV prevention—would benefit enormously from systematic profiling using disaggregated, validated indicators to track progress and identify subnational gaps. I would particularly stress to Georgian colleagues the importance of Step 2, forming a truly multidisciplinary technical working group that bridges disease programmes with health information systems and primary care, and Step 6, rigorous data validation through triangulation, because fragmented data across vertical programmes remains a challenge. One realistic caveat: successful implementation requires sustained senior management commitment within the Ministry of Health to coordinate information sharing across programmes, allocate dedicated focal points, and invest in subnational surveillance capacity—resource constraints and competing priorities can easily derail such cross-cutting initiatives despite their strategic value.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 17 Oct 2026
Applicability
Georgia and the South Caucasus
For Georgia and the South Caucasus, this framework offers a systematic approach to documenting progress on diseases relevant to the region. Georgia’s national programmes—including the hepatitis C elimination initiative (launched 2015), tuberculosis control, HIV/AIDS prevention, immunization (achieving high coverage for vaccines including hepatitis B birth dose), and vector-borne disease surveillance—would benefit from structured profiling using standardized PAHO indicators adapted to WHO European Region frameworks. The methodology for multi-sectoral coordination, subnational disaggregation, and integration of surveillance data is directly applicable. National programmes would need to map PAHO indicators to European Region definitions, incorporate WHO European targets (e.g., for TB, HIV, viral hepatitis), and ensure data sources capture populations at higher risk including migrants, displaced persons, and rural communities with limited health system access.
Questions this guideline answers
Quick answers
What is the purpose of developing a country status profile on communicable diseases?
The profile documents the current status and progress toward elimination targets, identifies gaps and pending actions in the health system, provides evidence for policy decisions and resource allocation, and raises awareness among stakeholders to mobilize political commitment and coordinated action across sectors.
Which diseases are included in the PAHO elimination framework?
More than 30 diseases are targeted: HIV/AIDS, cervical cancer, Chagas disease, congenital Chagas and syphilis, cholera, echinococcosis/hydatidosis, fascioliasis, hepatitis B and C, leprosy, lymphatic filariasis, malaria, onchocerciasis, plague, schistosomiasis, sexually transmitted infections (gonorrhoea, syphilis), soil-transmitted helminthiasis, trachoma, tuberculosis, human rabies transmitted by dogs, and vaccine-preventable diseases (polio, measles, rubella, congenital rubella syndrome, neonatal tetanus, yellow fever). Environmental risk elimination includes open defecation and polluting biomass cooking fuels. Eradication targets include foot-and-mouth disease in domestic bovids and yaws.
What are the seven steps for developing a country profile?
Step 1: Organize and prepare—secure policy decision and agreements among stakeholders. Step 2: Form a technical group with expertise in surveillance, disease control, immunization, health systems, equity, and determinants. Step 3: Select diseases and indicators based on epidemiological status and programme priorities. Step 4: Select information sources (health services data, surveillance, surveys, published studies). Step 5: Collect, organize, and analyse data disaggregated by time, place, and person. Step 6: Validate data through triangulation and quality assessment. Step 7: Write the profile concisely, using tables, figures, and maps to highlight progress and gaps.
How should data be disaggregated and validated in the profile?
Data should be disaggregated by age, sex, geographical location (department, municipality, district), and key population groups depending on disease impact. Validation involves comparing multiple sources for internal and external coherence, performing regular assessments and audits, and triangulating findings across demographic categories. When different sources converge, findings gain reliability; when they conflict, causes such as data collection methods or poorly monitored surveys must be examined. Representativeness, source reliability, and methodology should be documented.
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Quality & accreditation
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- Issuer
- Pan American Health Organization
- Type
- Procedures, manuals, guidelines
- Edition
- 1st edition, 2023
- Status
- Current
- Published
- 2023-01-01
- Languages
- English, Spanish
- Scope
- Methodological guidance for developing national status profiles on communicable diseases targeted for elimination in the Region of the Americas
- Audience
- National health authorities, Ministry of Health programme managers, epidemiologists, public health professionals responsible for disease control and elimination programmes
- Licence
- CC BY-NC-SA 3.0 IGO
- ISBN
- 978-92-75-12659-2 (PDF)
- Evidence
- Expert consensus, synthesis of existing WHO and PAHO strategies, action plans, and technical documents
- Record history
- Created 17 Oct 2026 · updated 17 Oct 2026 · next check Apr 2027
Pan American Health Organization. Guidance for Developing Status Profiles on Communicable Diseases to Further Progress toward Their Elimination in the Region of the Americas. Washington, D.C.: PAHO; 2023. Available from: https://doi.org/10.37774/9789275126592GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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