The key challenges that health systems face in providing primary care are the equity, quality of care and efficiency. Health technologies play an essential role on health system. On the one hand, they are fundamental to the quality of care and on the other, represent a growing budgetary impact threatening the sustainability of health systems. Therefore, the decision about which technologies should be provided by health systems is critical for countries to achieve maximum health benefits.
In September 2012, at the 28th Pan American Sanitary Conference, Member States were pioneers in the world to adopt a resolution on the evaluation and incorporation of health technologies in health systems. The CSP28.R9 resolution is an innovative policy document which intends to link evidence-based decisions for technology assessment in decision-making in health systems to manage and use health technology. The CSP28.R9 resolution inspired SEARO* countries to adopt, in 2013, a resolution on this same topic. Finally, in 2014, the World Health Assembly adopted resolution WHA67.23 – “Evaluation of interventions and technologies ofhealth support of universal health coverage”. Regional cooperation has gained strength in health technology assessment (HTA) topics. During the Regional Meeting on HTA in Buenos Aires in October 2010, representatives of 12 countries and a total of 20 institutions, including ministries of health in collaborating countries, Pan American Health Organization/ World Health Organization (PAHO /WHO) and other networks and institutions, agreed to form the Network Technology Assessment in Health of the Americas (RedETSA). RedETSA was officially launched in June 2011 in Rio de Janeiro, with the signing of cooperation agreements with the National Health Surveillance Agency (ANVISA) in Brazil, Canadian Agency for Pharmaceuticals and Health (CADTH) and the United Agency States for International Development (USAID), to exchange information, promote the adoption of common methodologies, and prioritize work together to build capacity in HTA. After the founding meeting, a second meeting was held in April 2012 in Lima, in which the network priorities were set and a work plan was established.
During the Pan American Sanitary Conference, the countries have recognized the importance of RedETSA and it was established that PAHO exercise its secretariat. In June of the same year in the city of Bilbao, Spain, a workshop (Fouth RedETSA Meeting) was held together with the European Network (EUnetHTA) and the Asian network (HTAsiaLink) where an agreement for future joint activities was initiated. In December, in Bogotá, Colombia, the “Workshop on Prioritization Processes and Health Technology Assessment in the Americas,” was organized with the Inter-American Development Bank (IDB) and the Centre for the Development Global. On that occasion the fifthRedETSA meeting was held where the implementation of the resolution was discussed.
In 2013, two new important projects were started:
- The Advanced HTA project, funded by the European Commission and coordinated by the London School of Economics; PAHO and Andalusian School of Public Health led a working group on HTA in emerging countries whose main activities were the realization of a mapping on the situation of HTA in Central America and the Caribbean; studies of the HTA in the decision-making process in certain countries of the region; and development of a toolbox to help countries improve their decision making;
- A project on the interaction between HTA and Regulation, funded by USAID, whose main activities were the development of case studies on medical devices; development of online course; workshop with the participation of regulatory authorities and members of RedETSA. In June 2014, during the fouth RedETSA Annual Meeting, a high-level panel on HTA and Universal Heath Coverage at PAHO headquarters in Washington, DC was organized with great success. Representatives of the Andalusian School of Public Health, EUROSCAN, HTAi, NICE, WHO, Royal Australasian College of Surgeons and University of Maastricht were also present at the meeting. The sixth RedETSA Meeting was held on the “10th National Health Technologies Forum” organized by the National Mexico Health Technology Center (CENETEC) and the third HTAi Regional Meeting in Mexico City in November 2014. The topic of the forum was the Health Technology Assessment in Universal Health Coverage.
*WHO South-East Asia Region