Global health. The current scenario and future perspectives

250 both in terms of people who have become ill or died from this disease and the impacts resulting from the suspension or postponement of care for other health problems, mainly chronic diseases, because healthcare resources were directed to addressing the pandemic emergency. Beyond its health dimension, the Covid-19 pandemic has had dramatic social consequences. In fact, it has been estimated that there would be a global increase of 176 million and 177 million people living below international poverty lines of USD 3.20/day and USD 5.50/day per person, respectively (World Bank, 2020). In this global panorama, Latin America and the Caribbean region are most affected by the crisis. It is estimated that in 2020 GDP shrank by 9.1%, with 2.7 million businesses closing down, which resulted in 44.1 million unemployed people and 231 million people living in poverty, out of whom 96 million would be people in situations of extreme poverty (ECLAC, 2020). In the context described, the segmentation and fragmentation, equity issues in access and inefficiencies in care that characterize Latin American health systems (Vásquez et al., 2009) have been additional obstacles to facing the extraordinary challenge of Covid-19. In this article, we will review some basic conceptual aspects of health systems and then address the challenges that are emerging so that these systems can contribute to reducing access inequities and strengthening the continuity of healthcare, thus guaranteeing the right to health from the perspective of universal health coverage. Health systems and social security The definition of health systems has important variations, especially regarding their boundaries (Figueras and McKee, 2012). However, the most widely accepted definition is the one proposed by the WHO in its World Health Report of 2000, indicating that a health system corresponds to “the set of organizations, institutions and resources that have the objective of generating health actions” (WHO, 2000:151). Some years later, the WHO expanded the definition by stating that a health system is composed of all organizations, individuals and actions whose main intention is to promote, restore or maintain health as well as compensate for permanent disabilities. This includes public, governmental, nongovernmental or private healthcare agents (WHO, 2007). Health systems are part of larger social security systems, i.e., institutional modalities through which society organizes responses to