Investing in public health: A new age for globalization of solidarity and cooperation

Health as a public good is a collective good, a right for all, a right that social, economic and political actors in each country must defend and preserve. It is an inalienable right of the people, non-negotiable and whose enjoyment is not supported by any rivalry [1].

The neoliberal economic model advocates reducing the figure of the State and its capacity to intervene, which encourages the systematic destruction of its capacity as guarantor and does not solve the problems of equity and social justice.

Many health systems in the world are characterized by high levels of fragmentation of their health services. The accumulated experience shows that the excessive fragmentation of these services leads to difficulties in accessing them, the provision of low quality technical services, irrational and inefficient use of available resources, an unnecessary increase in production costs and low citizen satisfaction [2]. In the overall system performance, fragmentation is manifested as the lack of coordination between the different levels and sites of care, duplication of services and infrastructure, idle installed capacity and health services provided at the wrong site.

This fragmentation, underdevelopment and often extreme poverty in many parts of the world or the lack of action by the international community to address the root causes of the problems, among other factors, has severely affected the possibility of the health system, infrastructure and education response of many countries. These conditions favor division and disrupting channels of communication causing that a relevant set of health care decisions may fail to see the whole picture. However, the division of health systems into parallel and incommunicado subsystems is not only a problem of developing countries. The fragmentation on health services during an emergency situation like COVID-19 pandemic may result in wrong decision-making processes, compromising health and safety of people and communities.

Therefore, a resilient health system must be based on the comprehensive, integrated and continuous primary health care; capable of integrating with other levels and which should have a number of elements that will address later to promote its sustainable development and progress towards universal health coverage.

✻ The Human Capital is the greatest strength of a health system and it should be the foundation for the development and realization of the assumptions. Its training, preparation and continuous improvement should harmoniously integrate the needs of the programs implemented or to be implemented.

✻ The Political Commitment: The commitment of governments in conducting the national vision for the development of the health sector. Once the health needs and gaps in the health system are identified, the governments can develop strategic plans but with an executive decentralization for their implementation.

✻ The long-term design requires the Sustainability of the systems and actions to be implemented; they must be sufficiently flexible and dynamic to allow relevant and timely adjustments, based on the existing scenarios and planned results.

✻ The intersectoral approach should be seen as an essential part to improve the health and wellbeing of the population and plays a central role in increasing the risk perception, the citizen self-responsibility, the health empowerment, and the embracing of actions for health and sustainability.

✻ The interdisciplinary approach as an organizational form of health work can address with more integration, quality and efficiency the complex problems of health and diseases.

✻ The Community, rather than the object and beneficiary of the health programs and services, is the raison d’être of the system. Its participation in the identification and prioritization of the health problems, in the intervention actions being performed and, in the monitoring, and evaluation of results, represents an assurance that public health responds to the interests and needs of the peoples and the society.

✻ The Scientific and Technological Development should be considered successful if it is accessible and affordable to the population and increases the health coverage. This should be the focus through a holistic strategy with a long-term perspective with favorable incentives to promote innovation, scientific cooperation and the development of affordable health technologies.

✻ The development of regulatory strategies, regional regulatory mechanisms and alliances to guarantee the quality and safety of approved drugs, biologicals, vaccines and health technologies are essential to promote public health and patients timely access to innovative medicines and technologies.

✻ International Solidarity and cooperation, a principle to health workers, scientists and governments, which contributes to the humanistic and scientific-technical training in the health sector and will stimulate creative and innovative forms of organization and performance of programs, services and institutions. Today we should talk about an era of globalization of solidarity and cooperation.

Once again a disease has highlighted countries weaknesses in Global Health such as: the need for a culture of preparedness, emphasizing the individual as a fundamental component of the response and the need for the mobilization and participation of communities. Current situation continuous to emphasize the importance of a preventive, multidisciplinary and inclusive approach to successfully respond to infectious outbreaks, pandemics or emergency situations with health consequences. However, more work is needed to achieve comprehensive health services, where the creation of efficient capacities for health care, the adequate data collection and analysis of risks, the exchange of knowledge, the science and technology at services of the people health and the analysis of vulnerability of health systems. Health in different countries, with a view to informing local governments and communities and assisting them in decision-making, are practical expressions to ensure equity and the right to health. In pandemic times, individualistic approaches have an enormous impact on societal disasters, only growing and deepening solidarity and cooperation ensure preparedness, response capacity and health for all.

1. International Health Conference (‎2002). Constitution of the World Health Organization. 1946. Bulletin of the World Health Organization 80: 983-984. Link: https://bit.ly/37SNpsz
2. Stange KC (2009) The problem of fragmentation and the need for integrative solutions. Ann Fam Med 7: 100-103. Link: https://bit.ly/3rz9Tqw