Global health. The current scenario and future perspectives

269 had ideological reasons not to register the medication in Chile. Therefore, CENABAST and APROFA 31 had to make arrangements with the ISP to import it through this exceptional route and make it available to users. Thus, Levonorgestrel, in addition to being part of ministerial programs on sexual and reproductive health, was included in the National Formulary. This exceptional authorization process is also being used for distribution of vaccines for Covid-19 treatment since there are no health registrations granted by the ISP, only exceptional authorizations for distribution within the country. International trade agreements and access to medicines in Chile Surprisingly, Chile is the country with most agreements in the world: 30 agreements with 65 economies. These are commitments or trade obligations of different categories: Strategic Partnership Agreements (SPA), Free Trade Agreements (FTA), Economic Complementation Agreements (ECA) and Partial Scope Agreements (PSA). The political chronology of Chile shows that, in 1949, the country signed trade agreements, not because they were visionaries but because the nitrate catastrophe forced them to integrate into international trade, according to history. Chile was a founding member of GATT and in 1995 became a founding member of the WTO. It established an ECA with MERCOSUR 32 , and agreements with Central America, the European Union, China and Japan among others. However, in terms of health, the most impactful agreement is the FTA signed in 2004 with the USA, since many obligations related to pharmaceuticals under TRIPS were incorporated into this text with more demanding clauses. Therefore, this agreement is called TRIPS Plus 33 . On another note, we have the Trans-Pacific Partnership (TPP), which is an agreement led by the US and has a high impact on health as it introduces strong measures for intellectual property protection. The TPP originated from the Trans-Pacific Strategic Economic Partnership Agreement, also known as P4 Agreement, and was created in the Asia-Pacific Economic Cooperation Forum (APEC). It is a free trade agreement that Chile signed in 2006 along with Brunei Darussalam, New Zealand and Singapore. 31 Chilean Association for Family Protection. Organization website : www.aprofa.cl. 32 Southern Common Market. Organization website: https://www.mercosur.int/. 33 The Free Trade Agreement between Chile and the United States was signed on June 6 th , 2003, and entered into force in Chile on January 1 st , 2004. Available at: https://www.subrei.gob.cl/acuerdos- comerciales/acuerdos-comerciales-vigentes/ee-uu.