Global health. The current scenario and future perspectives

31 making processes that reflect the diverse perspectives and priorities of countries. However, it is important to note that non-state actors, such as civil society organizations and the private sector, in global health governance have become increasingly heard in recent years. Overall, the governance of global health within the UN system follows a multilateral approach that strives to foster collaboration, coordination and accountability among member states and other stakeholders in addressing global health challenges and promoting equitable health outcomes for all. In this context, the WHO is consolidated as the preeminent normative organization in the world for health matters. It certifies vaccines, approves new drugs and treatments, validates and shares scientific research and strives to coordinate efforts towards accessible and quality global health. Over time, as globalization processes became more complex and interconnected, the WHO system expanded and branched out into a network of its own and associated institutions at global and regional levels, involving both governmental and increasingly non-governmental entities. However, this expansion occurred within an increasingly confrontational global and regional environment and faces significant funding challenges. Evolution of the concept of health and development The definition of health as a state of well-being rather than simply the absence of disease implies that there are other disciplines and institutions involved in achieving health. Furthermore, the recognition of health as an investment in human capital, which started explicitly with the World Bank’s 1993 report, brought financial organizations into the spotlight. Since the 1980s, international financial institutions (IFIs) such as the World Bank, and regional ones like the Inter-American Development Bank (IDB) and the Andean Development Corporation (CAF, today the Development Bank of Latin America), have evolved from merely financing hospital infrastructure to intervening in the development of health systems. Adoption of the Millennium Development Goals in 2000 made the role of public health in development explicit by involving other health disciplines, which had been coming up in the longitudinal study on the Determinants of Health and were further reaffirmed in the Sustainable Development Agenda (United Nations, 2015) with its 17 Sustainable Development Goals (SDGs). Science and technology, climate change and migration pose new challenges for global health that intersect with the SDGs established by unanimity at the General Assembly to “leave no one behind”, by eradicating poverty, incorporating social and economic development, protecting the environment and the