Global health. The current scenario and future perspectives

32 planet and ensuring full participation of citizens through the exercise of their democratic rights. SDG 3 establishes a specific horizon for the health and well-being of all by recognizing that good health is essential for sustainable development and serves as a framework necessary for addressing the determinants of health. However, it is evident that national averages conceal the fact that some populations, groups and communities are being left behind. For instance, the 31-year difference in life expectancy between countries with shortest and longest life spans highlights the need for a multisectoral approach with a gender perspective and human rights-based focus to address inequalities and ensure equitable and universal access to quality health care. Governability of the Global Health System Strategic actors Like at national level, the global health system incorporates a range of associated and interconnected actors. We have already mentioned the UN agencies which, based on their original mandates or new circumstances in global health, like UNAIDS that was created in the late 1980s to globally respond to the HIV/AIDS pandemic, interact autonomously and transversally with the WHO and support policy formulation and their implementation and operations in the field. At global level, the inclusion of new non-state or hybrid actors around or within the WHO as part of a broad community of health organizations has been a long-standing debate, although a wide variety of these actors are gradually being recognized as part of the system. However, the formal governance of the WHO and the UN agencies remains in the hands of member states. Thus, separate but around the WHO, public-private partnerships have been established to facilitate access to technologies, medical supplies, medicines and vaccines through funding and promotion of research, development, procurement or donations. Despite being autonomous, as they each have their own governing boards with the WHO as one of the members, they often utilize the WHO’s management system. The new non-state or hybrid actors include The Global Alliance for Vaccines and Immunization (GAVI); the Global Fund to Fight AIDS, Tuberculosis, and Malaria; Unitaid; PMHCH; the Access to Covid-19 Tools (ACT) Accelerator and its COVAX vaccine pillar; the Coalition for Epidemic Preparedness Innovations (CEPI); the GAIN in nutrition; Roll Back Malaria; the Stop TB