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[[Experiences and lessons from Cuba on the road to Universal Health in the Americas]].

Health strategy, as defined in the resolution adopted by the Member States of the Pan American Health Organization (PAHO) (1). The country’s importance is underlined both by its achievements in health and by the strength and resiliency of its national health system (known as the SNS), which responds to people’s needs with comprehensive and quality services that are provided through integrated networks based on primary health care. In the SNS, the first level of care focuses on people and their families, ensuring community outreach that is the material expression of an intersectoral approach that puts health in all policies. Coherent governance of the sector—based on strong leadership and the participation of national, provincial, and local health authorities in the relevant decision-making bodies—is complemented by the high fiscal priority attributed to the SNS. This makes it possible both to provide sufficient financing for the incorporation of appropriate and innovative health technologies at the different levels of care, and also to maintain and develop human resources for health in sufficient quantity and quality to serve the country’s needs. Indeed, even the needs of other countries can be met, as is demonstrated by the mobilization of medical brigades to remote areas in different countries, as well as emergency disaster and response teams that are deployed wherever the need arises. This special supplement of the Pan American Journal of Public Health begins with an overview of the transformations necessary to ensure that the SNS achieves a higher level of efficiency in order to consolidate its achievements and guarantee the sustainability of Cuba’s journey toward Universal Health. In 2010 an important process got underway, aimed at regionalizing, concentrating, and increasing the efficiency of the SNS’s socially organized response to the needs of a population that is undergoing significant changes in its epidemiological profile (noncommunicable chronic diseases are the main cause of morbidity and mortality, in addition to the burden of new and old communicable diseases) and in its demographic make-up (with nearly 20% of the population over 60 years of age, Cuba has one of the highest rates of population aging among the countries of the Region). From different angles, six articles address Cuba’s main results in health. The first article deals with communicable disease prevention and control, and the other five touch on various aspects of health throughout the life course and the response to communicable diseases: maternal and child care, the quality of maternal mortality statistics, experiences in immunization, the challenges involved in the response to communicable diseases, and the challenges that an aging population poses for the SNS. These articles explain, for example, how Cuba has implemented actions to contain vaccine-preventable diseases (and successfully eliminate 11 of them), in response to several PAHO resolutions on the right to vaccination (2-6). They also discuss how Cuba has tackled communicable diseases, becoming the first country in the world to certify the elimination of vertical transmission of HIV and congenital syphilis, after taking specific action to prevent and control HIV infection and sexually transmitted infections, as PAHO has urged (7). These articles also show PAHO’s recommendations are linked with Cuban programs in order to address neglected diseases (8,9), advance toward the elimination of tuberculosis (10), prevent and control arboviral diseases (11), and implement the International Health Regulations (12). Three other articles offer a better understanding of factors related to the components and structure of the SNS that have contributed to achieving the health outcomes Editorial Pan American Journal of Public Health