CDC in Central America

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A field researcher from Universidad del Valle-Guatemala (UVG) collects a sample from a participant in an antimicrobial resistance (AMR) research project in Quetzaltenango, Guatemala. Photo by Nicholas Tenorio/CDC

The Centers for Disease Control and Prevention (CDC) has collaborated with public health institutions in Central America since the 1960s, initially focusing on parasitic diseases. In 2003, CDC established a Central America Regional (CAR) office in Guatemala which has supported work in Belize, Costa Rica, El Salvador, Honduras, Guatemala, Nicaragua, Panama, and has managed projects in Brazil, Colombia, and the Dominican Republic. CDC recently announced the establishment of a new regional office covering Central America and the Caribbean in Panama. Guatemala will continue to support activities throughout the region. CDC works with the ministries of health (MOH), the Council of Ministers of Health of Central America (COMISCA), the Pan American Health Organization (PAHO), and other regional and international partners to address COVID-19, HIV, tuberculosis, vector-borne disease, and antimicrobial resistance. CDC also strengthens laboratory, surveillance, and workforce capacities to prevent, detect, and respond to infectious diseases across the region.

Download Central America Fact Sheet [PDF – 193 KB]

CDC Impact in Central America

Global Health Security

Helping countries respond to public health threats quickly and effectively within their borders is critical to preventing the spread of disease regionally and around the world. In 2006, CDC expanded the scope of the Central America Regional office to support disease outbreak response, surveillance, laboratory systems, and workforce development in coordination with local, regional, and global public health organizations. CDC has partnered with Brigham and Women’s Hospital, Baylor College of Medicine, Washington State University, and Universidad del Valle de Guatemala since 2018 to strengthen epidemiological surveillance for acute febrile illnesses (AFI) and antimicrobial resistance (AMR) in the Dominican Republic, Belize, Guatemala, and El Salvador.

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CDC’s AFI surveillance network in Central America and the Dominican Republic identifies emerging and re-emerging disease threats, strengthens regional collaborations, and increases regional capacity for disease surveillance

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CDC collaborates with ministries of agriculture, health, environment, and defense across Central America to conduct One Health Zoonotic Disease Prioritization workshops to increase opportunities for cross-disciplinary surveillance, prevention, and control

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Since 2017, CDC has participated in outbreak investigations for measles, rabies, fungal infections (mucormycosis), dengue, foodborne diseases, and COVID-19

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Starting in 2022, CDC is collaborating with the Government of El Salvador to pilot the region’s first use of bacteria (Wolbachia) to control mosquito-borne disease transmission

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CDC and COMISCA support strengthened surveillance of healthcare-associated bloodstream infections (candidemia) in six hospitals in El Salvador

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CDC partners with the Executive Secretariat of COMISCA to strengthen the National Institute of Health in El Salvador  

Field Epidemiology Training Program (FETP)

CDC’s FETP strengthens the public health workforce capacity to investigate and respond to disease outbreaks. Three FETPs – Frontline, Intermediate, and Advanced – train epidemiologists to identify and contain outbreaks before they become epidemics. Trainees also develop skills to gather critical data and turn it into evidence-based action. COMISCA and MOHs lead FETP activities across the Central America region. Advanced FETP participants earn a master’s degree through Universidad del Valle-Guatemala (UVG).

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As of 2021, more than 3,600 Frontline, 1,000 Intermediate, and 170 Advanced residents have graduated from FETPs in Central America

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Since 2012, over 100 FETP Central America residents have presented their work at international scientific conferences

COVID-19

The first case of COVID-19 in Central America was confirmed in Costa Rica on March 6, 2020. Since the pandemic was declared, CDC has engaged in technical collaboration with Central American countries across response activities. Previous collaborations between CDC and MOHs to expand regional laboratory capacities and surveillance were critical to the region’s COVID-19 response. FETP graduates are also instrumental to the response as they lead efforts to increase vaccination rates and provide epidemiological technical support to MOHs.

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To support Central American countries’ COVID-19 response, CDC leveraged existing surveillance platforms to test for SARS-CoV-2 (the virus that causes COVID-19)

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CDC partnered with PAHO to strengthen the region’s genomic sequencing capacity for SARS-CoV-2. This partnership supports national laboratories in Panama and Costa Rica to analyze samples referred from throughout Central America

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CDC and partners implement serological surveys to understand COVID-19 trends in communities and healthcare, agriculture, hospitality, and market worker populations in Belize, Dominican Republic, El Salvador, and Guatemala

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CDC supports COVID-19 vaccine rollout in Guatemala, Honduras, El Salvador, and Belize. CDC assists with vaccination program management and operations, vaccine promotion in local languages, vaccine outreach to pregnant women, and vaccination scale-up

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To support the COVID-19 response, CDC donated laboratory equipment and supplies, antigen tests, personal protective equipment, and other supplies

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CDC also helped strengthen rapid response teams’ skills in community testing, vaccination promotion campaigns, and home-based care, and collaborated to investigate COVID-related fungal infections (mucormycosis)

HIV and Tuberculosis (TB)

Since 2003, CDC has collaborated with MOHs to respond to the HIV epidemic in Central America. CDC supports countries in Central America to achieve UNAIDS 95-95-95 goals by 2030. CDC works with partners to prioritize increased quality of services for people living with HIV and other populations living with higher risk of infection. CDC supports the scale-up of evidence-based programs that close gaps in HIV prevention, case finding, early antiretroviral treatment (ART) initiation, optimized treatment, and viral load suppression. CDC focuses on:

  • Enhancing local capacity for laboratory quality assurance and supporting national efforts to improve the quality of rapid HIV testing
  • Strengthening laboratory capacity and network for HIV testing and viral load monitoring
  • Preventing new infections among populations living with increased risk of HIV infection, including men who have sex with men, transgender women, and sex workers
  • Increasing access to HIV testing through close contact testing and provider-initiated testing and counseling
  • Supporting clinics to improve HIV-related health outcomes by linking patients to care after diagnosis, reengaging people whose treatment was interrupted, initiating rapid and early treatment, viral load suppression, and managing other illnesses that occur more frequently among people living with HIV
  • Increasing workforce capacity to care for people living with HIV by using the Extension for Community Healthcare Outcomes (ECHO) model to mentor healthcare workers across the region
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CDC supports 44 HIV clinics in Central America with more than 23,000 people receiving ART as of December 2021

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Central America was the first region supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to integrate data on recent infection into HIV surveillance systems. Data are used to identify potential infection clusters to enhance resource delivery and maximize investment and impact

Laboratory Systems Strengthening

For the past 20 years, CDC has supported laboratory-based disease surveillance and detection of novel strains and pathogens. CDC also supports the Regional Network of National Laboratories (REDLAB) strategic plan. CDC activities include:

  • Training more than 2,000 laboratory staff personnel through seminars and workshops
  • Strengthening capacities of national laboratories in Belize and El Salvador to diagnose fungal (mycotic) diseases
  • Enhancing laboratory surveillance of norovirus and rotavirus (viruses that cause vomiting and diarrhea) in Costa Rica
  • Supporting biosafety training for local laboratory staff
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CDC supports laboratory biosafety activities across the region, such as hosting regional biosafety and biosecurity workshops and certifying biosafety hoods in national laboratories in Guatemala, El Salvador, Honduras, and Belize

Migration and Border Health

Global migration and border health systems impact the health of migrants and potential cross-border movement of pathogens. CDC engages with national governments, U.S. embassies, COMISCA, and other partners to improve HIV services for Venezuelan migrants, enhance border health processes, and understand health-related reasons for migration. CDC activities include:

  • Implementation of a survey and virtual regional workshop to identify regional challenges in border health systems and points of entry
  • Assessment visits at points of entry on Guatemala’s land borders to identify strengths and challenges
  • Integration of border health topics into FETP-Frontline
  • Partnership with the Latin American Faculty of Social Sciences (FLACSO) and COMISCA to conduct traveler mobility and COVID-19 KAP (knowledge, attitudes, and practices) surveys with people crossing borders
  • Engagement in technical collaboration to enhance HIV prevention, care, and treatment services for migrants throughout Central America. For example, CDC and local partners support increased access to HIV prevention, testing, treatment, and laboratory services for Venezuelan migrants in Colombia and Peru
  • Support of COVID-19 testing and vaccination for migrants returning to Central America from the U.S. and Mexico
CDC Staff in Central America
  • 4 U.S. Assignees
  • 20 Locally Employed
Central America Country Facts Table
Data facts of countries in region
BELIZE COSTA RICA EL SALVADOR GUATEMALA
Population > 397 thousand > 5 million > 6.4 million > 16.8 million
Per Capita Income $5,880 $19,840 $8,050 $8,690
Life Expectancy at Birth F 78 / M 72 years F 83 / M 78 years F 79 / M 71 years F 77 / M 70 years
Infant Mortality Rate 13/1,000 live births 8/1,000 live births 13/1,000 live births 20/1,000 live births
Top 10 Causes of Death
  1. Ischemic heart disease
  2. Diabetes mellitus
  3. Stroke
  4. Interpersonal violence
  5. Chronic kidney disease
  6. Lower respiratory infections
  7. HIV/AIDS
  8. Road injuries
  9. Cirrhosis and other chronic liver diseases
  10. Neonatal disorders
  1.  Ischemic heart disease
  2. Stroke
  3. Chronic kidney disease
  4. Alzheimer’s disease and other dementias
  5. Chronic obstructive pulmonary disease (COPD)
  6. Stomach cancer
  7. Cirrhosis and other chronic liver diseases
  8. Road injuries
  9. Colon and rectum cancer
  10. Lower respiratory infections
  1. Ischemic heart disease
  2. Chronic kidney disease
  3. Interpersonal violence
  4. Lower respiratory infections
  5. Diabetes mellitus
  6. Stroke
  7. Alzheimer’s disease and other dementias
  8. Cirrhosis and other chronic liver diseases
  9. Road injuries
  10. Chronic obstructive pulmonary disease (COPD)
  1. Lower respiratory infections
  2. Ischemic heart disease
  3. Diabetes mellitus
  4. Interpersonal violence
  5. Chronic kidney disease
  6. Cirrhosis and other chronic liver diseases
  7. Stroke
  8. Stomach cancer
  9. Diarrheal diseases
  10. Neonatal disorders
Data facts of countries in region
HONDURAS NICARAGUA PANAMA
Population  > 9.9 million > 6.6 million  > 4.3 million
Per Capita Income $5,050 $5,410 $25,010
Life Expectancy at Birth F 78 / M 73 years  F 79 / M 73 years  F 82 / M 76 years
Infant Mortality Rate 16/1,000 live births 13/1,000 live births 11/1,000 live births
Top 10 Causes of Death
  1. Ischemic heart disease
  2. Stroke
  3. Interpersonal violence
  4. Chronic kidney disease
  5. Cirrhosis and other chronic liver diseases
  6. Chronic obstructive pulmonary disease (COPD)
  7. Neonatal disorders
  8. Tracheal, bronchus, and lung cancer
  9. Diarrheal diseases
  10. Road injuries
  1. Ischemic heart disease
  2. Chronic kidney disease
  3. Stroke
  4. Diabetes mellitus
  5. Cirrhosis and other chronic liver diseases
  6. Chronic obstructive pulmonary disease (COPD)
  7. Lower respiratory infections
  8. Road injuries
  9. Alzheimer’s disease and other dementias
  10. Hypertensive heart disease
  1. Ischemic heart disease
  2. Stroke
  3. Diabetes mellitus
  4. Chronic kidney disease
  5. Alzheimer’s disease and other dementias
  6. Lower respiratory infections
  7. Chronic obstructive pulmonary disease (COPD)
  8. Interpersonal violence
  9. HIV/AIDS
  10. Road injuries

Sources:
World Bank 2020, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama
Population Reference Bureau 2021, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama
GBD Compare 2019, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama

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Page last reviewed: May 27, 2022
Content source: Global Health