Partners in Health: WONCA and PAHO Sign Landmark MOU
WONCA and PAHO: A Milestone for Primary Health Care in the Americas
Submitted to WONCA News by Jaqueline Ponzo,
Past-President of WONCA Iberoamerica-CIMF
Version en espagñol.
In May 2025, a significant milestone was achieved with the signing of the Memorandum of Understanding (MOU) between the World Organization of Family Doctors (WONCA) and the Pan American Health Organization (PAHO), the regional office of the World Health Organization (WHO) for the Americas. This event marks the culmination of a long journey—not its conclusion—but rather the beginning of a new era of collaboration.
PAHO has long played a vital role in shaping health systems across the Americas, and its presence is especially relevant in Latin America and the Caribbean. Its mission aligns closely with WONCA’s, especially within its Iberoamericana-CIMF and North America regions. Shared goals such as strengthening primary health care (PHC) and developing the health workforce have provided fertile ground for collaboration. However, despite PAHO’s participation in eight Ibero-American Family Medicine Summits held between 2002 and 2022, consistent and sustained coordination had remained elusive.
The celebration of the 40th anniversary of Alma-Ata Declaration in 2018 served as a catalyst, with WONCA Iberoamericana participating in various regional activities and being part of the WONCA delegation in Astana. While efforts in 2019—including the participation of PAHO at the WONCA Rural Health Summit in New Mexico—were beginning to lead to concrete outcomes, the onset of the COVID-19 pandemic in 2020 shifted both organizations’ focus to crisis response.
In 2022, coordination resumed around the VIII Ibero-American Summit in Guatemala, with PAHO representation in attendance. However, it wasn't until 2023 that dialogue formally restarted, building on earlier momentum to seek sustained regional cooperation. A key turning point occurred in July 2023 during the International Conference on The Critical Role of Primary Health Care to Health Security and Securing Health, held in Washington, D.C. at the National Academy of Sciences and Medicine. The event was organized by the Center for Professionalism and Value in Health Care and joined by global partners—including PAHO and the global organization of WONCA, alongside its North American and Iberoamericana regions. This meeting allowed key stakeholders to gather in PAHO’s host city to resume discussions.
On July 21, 2023, a pivotal meeting was held at the beautiful PAHO headquarters in Washington with the participation of James Fitzgerald (PAHO Director of Health Systems and Services), Jaqueline Ponzo (WONCA Iberoamericana CIMF President), Jeff Markuns (WONCA North America President), and Viviana Martinez-Bianchi, who had been in negotiations for a WONCA–PAHO agreement during her time as WONCA–WHO Liaison from 2016 to 2021. This meeting laid the groundwork for the agreement that followed.
Over the next 18 months the two organizations collaborated to:
- resume dialogue toward the signing of the MOU
- develop collaborative research on human talent for family medicine/family and community medicine in the Americas region
- WONCA’s participation in regional events convened by PAHO
The MOU—originally drafted in Iberoamerica in 2018 following WONCA’s agreement with the WHO—was revisited and revised beginning in 2023. This time it included both the CIMF and North American regions, with close coordination by the global organization. Collaborative work, both synchronous and asynchronous, led to a revised document reflecting the current regional context, finalized in November 2023.
In parallel, the two regions of WONCA worked with PAHO and the PAHO Collaborating Center at the University of New Mexico’s Department of Family Medicine on a joint research project titled "The Situation of Family Medicine and Family & Community Medicine Professionals in the Region of the Americas" (publication forthcoming).
In 2024, WONCA North America and Iberoamericana representatives participated for the first time in the PAHO Annual Assembly as a non-governmental member.
Meanwhile, integration was further strengthened through WONCA’s participation in:
The integration of both regions of WONCA within these shared efforts has been historic and necessary.
Shared Commitments Under the MOU
The recently signed MOU formalizes the shared commitment of PAHO and WONCA to collaborate in the following areas:
- Advancing universal health coverage through strengthening of PHC teams, focusing on family doctors, general practitioners, and community-based care, including care and follow-up to health emergencies.
- Promoting the provision of primary care and the central role of family doctors / family and community doctors, and general practitioners in providing such care.
- Promoting the improvement of stewardship and governance functions within health systems to expedite their transformation in line with the principles of PHC.
- Developing and implementing joint programs through consultation with member organizations in the Iberoamerican-CIMF and North American regions.
- Strengthening the presence of family and community doctors in national health systems, addressing workforce shortages exacerbated by the pandemic, and promoting adequate working conditions and the well-being of healthcare professionals.
This retrospective invites us to reflect on the construction of inter-institutional collaborative work. It illustrates how the length of time required for its consolidation, the role of events and in-person meetings as opportunities for building together, and the role of the people who represent the institutions are key to progress. The interconnected network that develops through close dialogue and shared work is the best way to establish a strong and assertive bond. What emerges is a dynamic, interconnected network built through trust, dialogue, and shared purpose.
This collaboration also represents an unprecedented bridge between WONCA’s two regions in the Americas—laying the foundation for future regional integration and synergy.
In conclusion, the signing of the MOU symbolizes both the culmination of years of effort and the launch of a new chapter in collaborative action. It reflects a deep mutual commitment between WONCA and PAHO to jointly shape the future of health in the Americas through equity-driven, primary care–centered strategies.
Video: Ceremonial Signing in Panama
WONCA Iberoamericana-CIMF President Dora Bernal speaks during the ceremonial signing event in Panama (October 2024), marking the commitment of member organization representatives, WONCA CIMF, and the global WONCA organization to collaborate and strengthen family and community medicine in the region.