Global health. The current scenario and future perspectives

192 development of EPHF in 2002, leading to the emergence of new high- prevalence public health problems and associated costs, increasingly demand that health systems be better prepared to respond to the challenges posed by health problems and their determinants” (p.5) (PAHO, 2020). The PAHO highlights current topics such as health equity, outbreaks of infectious diseases, population aging, mental health, non-communicable diseases, irregular and forced migration, climate change, natural disasters and access to medicines and vaccines. The need for strengthening cooperation processes between countries and supranational organizations is emphasized as it allows addressing social determinants of health within global policies. This resulted in the development of a renewed conceptual framework for Essential Public Health Functions in the Americas region (Figure 2), which has a special hallmark for expanded stewardship and governance in healthcare systems. The foundations of this renewed proposal are based on four pillars (PAHO, 2020): • Pillar 1: Applying ethical values of public health to address inequities related to health and its causes. • Pillar 2: Addressing social, economic, cultural and political conditions that determine population’s health. • Pillar3: Ensuring universal access to comprehensive, integrated individual and collective public healthcare services. • Pillar 4: Expanding the stewardship function of health authorities to address public health challenges. Eleven essential functions have been developed that are challenging for the region’s health systems, as they urge them to assess the population’s health status and determinants of poor health, develop policies to strengthen health systems and address determinants, allocate necessary resources and ensure access to all public health interventions and services. The Essential Public Health Functions for Latin America are: 1. Monitoring and evaluation of health and well-being, equity, social determinants of health and performance and impact of health systems. 2. Public Health Surveillance: control and management of health risks and emergencies. 3. Promotion and management of research and knowledge in the field of health. 4. Formulation and implementation of healthcare policies, promoting legislation that protects the population’s health. 5. Social participation and mobilization, including strategic actors and transparency.