Global health. The current scenario and future perspectives

147 studying epidemic outbreaks in low-income countries. Other areas that require improvement include reaching populations with difficult access, selecting suitable community members for data collection and reporting, integrating CBS into the overall surveillance system, expanding surveillance beyond low-income countries to where vulnerable populations are in need, prioritizing the determinants of disease (not just the disease itself) and connecting with community-based organizations for permanent data collection linked to formal health systems. (Guerra, Acharya, et al., 2019; Guerra, Bayugo, et al., 2019). The Covid-19 pandemic shows that both global and local surveillance systems (within the framework of the broad concept of public health surveillance) will have to face the challenges related to the rapid spread of emerging and reemerging diseases and the significant social impact that these health crises generate worldwide, especially among disadvantaged populations. It will be necessary for the only currently available international consensus, the International Health Regulations (IHR), to adapt its content and scope to ensure that prevention and control measures of epidemic outbreaks are implemented equitably and reach everyone alike, in respect of human rights worldwide. Countries will also need to address the social impact of the epidemic from a systemic and integrative perspective, as well as articulate national initiatives to improve institutional frameworks, not only for providing rapid responses to health emergencies but also for having technical references that enable appropriate decision- making with a genuine population health perspective. References Abubakar, I., Aldridge, R. W., Devakumar, D., Orcutt, M., Burns, R., Barreto, M. L., … Zhou, S. (2018). The UCL–Lancet Commission on Migration and Health: The health of a world on the move. The Lancet , 392 (10164), 2606-2654. https://doi.org/10.1016/S0140-6736 (18)32114-7. Barreto, M. L., Teixeira, M. G., Bastos, F. I., Ximenes, R. A., Barata, R. B. & Rodrigues, L. C. (2011). Successes and failures in the control of infectious diseases in Brazil: Social andenvironmental context, policies, interventions, and research needs. The Lancet , 377 (9780), 1877-1889. https://doi.org/10.1016/S0140-6736 (11)60202-X. Braveman, P. (2011). Accumulating knowledge on the social determinants of health and infectious disease. Public Health Reports , 126 (SUPPL. 3), 28- 30. https://doi.org/10.1177/00333549111260s306. Caro-Murillo, A. M., Castilla Catalán, J. & Amo Valero, J. del. (2010). Epidemiología de la infección por VIH en inmigrantes en España: Fuentes de información, características, magnitud y tendencias. Gaceta Sanitaria , 24 (1), 81-88. https://doi.org/10.1016/j.gaceta.2009.06.009.