In this article published on the International Journal for Quality in Health Care by Garcia Elorrio Ezequiel, Arrieta Jafet, Arce Hugo, Delgado Pedro, Malik Ana Maria, Orrego Villagran Carola, Rincon Sofia, Sarabia Odet, Tono Teresa, Hermida Jorge and Ruelas Barajas Enrique the authors discuss how the experience in the Latin American and Caribbean region with public health emergencies (PHE), such as the current COVID-19 pandemic and the previous Zika, and H1N1 Influenza, has highlighted existing weakness in health systems across region to effectively prepare for and respond to PHEs.  Furthermore, PHEs have underscored pre-existing gaps and heterogenous behaviors in access to and quality of care. Learning has been limited and there is an opportunity for change.