In order to tackle this health crisis, MINSAL devised and deployed new activities on different fronts. For example, it began new clinical, pathologic and epidemiologic research and strengthened health services (including surveillance systems in primary care) for CKD prevention and control. It also worked to raise international awareness about CKD and took action to address it.(1010. Rodríguez MI. Chronic kidney disease in our farming communities: implications of an epidemic. MEDICC Rev. 2014 Apr;16(2):7-8.) MINSAL leadership successfully argued the need to designate CKD an emerging health problem in several international fora, among them PAHO's 2011 High-Level Regional Consultation of the Americas against NCDs and Obesity;(1111. Pan American Health Organization. Consulta Regional de Alto Nivel de las Américas sobre Enfermedades No Transmisibles y Obesidad [Internet]. Mexico, D.F.: Pan American Health Organization; 2011 Feb 25 [cited 2019 Jul 10]. 43 p. Available from: -Mexico-Esp.pdf. Spanish. ) the 34th Regular Session of the Council of Ministers of Health of Central America and the Dominican Republic (COMISCA) in 2011 (resulting in the Antigua Declaration);(1212. XXXIV Reunión del Consejo de Ministros de Salud de Centroamérica y República Dominicana (COMISCA). Resolución [Internet]. Ciudad de Antigua (GT): Sistema de la Integración Centroamericana; 2011 Jun 27 [cited 2019 Jul 10]. 13 p. Available from: =60666&idm=1. Spanish. ) and the 37th Session of COMISCA in 2012, which adopted Resolution 54/55.(1313. XXXVII Reunión del Consejo de Ministros de Salud de Centroamérica y República Dominicana (COMISCA). Resolución [Internet]. Managua: Sistema de la Integración Centroamericana; 2012 Dec 4 [cited 2019 Jul 10]. 14 p. Available from: =com_docman&view=download&alias=438-resoluciones-xxxvii-reunion-ordinaria-del-comisca-dic-2012&category_slug=documentos-estrategicos&Itemid=235. Spanish. )
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