Global health. The current scenario and future perspectives

251 provide protection to individuals facing different states of need. Therefore, the values that prevail in a society are reflected in health systems and expressed in legal and institutional frameworks for formulating and implementing health policies and developing healthcare organizations. In this way, countries organize their health systems according to national values and principles to achieve their proposed health objectives. Within this conceptual framework, a health system, besides its ultimate objective of contributing to the global improvement of health level, would also have two intermediate objectives. First, to respond to user expectations which are not technical expectations but rather related to dignity, confidentiality, autonomy, timely care, social support, basic amenities and choice of providers (WHO, 2000). Second, to aim for fair financial contribution, i.e., every individual contributes financially based on their financial capacity and uses the system based on their needs (WHO, 2000). This objective rests on the concepts of fairness and solidarity which are at the heart of any social security arrangement. To achieve these objectives, within the conceptual framework proposed in its 2000 report focused on health system performance assessment, the WHO identified four basic functions of a health system: service delivery or provision, resource generation or creation, financing (resource mobilization and allocation) and stewardship (WHO, 2000). Among these functions, the first three can be carried out by public or private agents, but stewardship is an irremovable function of the State. Subsequently, WHO itself shifts focus from functions to components of a health system, in which it identifies six components: service delivery or provision, human resources for health, information, medicines and technology, financing and governance and stewardship (WHO, 2007). This new approach, which practically disaggregates the function of resource generation from the previous conceptual framework into human resources for health, information and medicines and technology, beyond its limitations, has generated a common language and provided a useful tool for planning processes, financing decisions and priority setting (Sacks et al., 2019). In a broad perspective regarding the contribution that a health system makes to the society’s well-being in which it is embedded, some authors (Figueras and McKee, 2012) recognize three areas: i) by producing health itself, which is a component of well-being; ii) as the health system is an important actor in economy, this means that the health system has a direct impact on economic growth; iii) by directly contributing to the society’s well- being, since the existence of a health system and people’s ability to access this contributes directly to satisfaction, whether or not they are effective or used by the population. According to the social determinants of health approach, health