Global health. The current scenario and future perspectives

41 Greater regional collaboration and integration during this pandemic would be an asset for addressing immediate and complex problems, such as border closures, economic speculation due to shortages of personal protective equipment and tests, international logistics management, control of new variants and equitable vaccine distribution. As highlighted by Chile’s former President Ricardo Lagos, the question is why this region, with three G-20 members, seems to be lagging. (Lagos, 2021). We add: Could a new “G-4” of Latin America and the Caribbean promote a shared financing agreement for a distribution and/or production plan of supplies, medicines, vaccines and support for healthcare personnel that could bend the curve of the pandemic and establish sustainable healthcare systems? Equally important is collaboration and agreement to jointly address longer- term problems, like collaborative production of drugs and vaccines, development and implementation of information and surveillance systems, joint work on technical and resource support, among other advantages of collective action vis-à-vis Covid 19. These tasks, however, need to be viewed in the broader context of an increasing weakness of the integration mechanisms, dialogue and collaboration in the region, beyond the PAHO. The discontinuation or paralysis of institutions that were expected to promote progressive integration routes – such as the Hipólito Unanue Agreement, UNASUR, SICA and CARICOM – has made it more challenging to confront this crisis with strong, robust and adequately resourced mechanisms for mobilizing resources, reaching minimal political, economic and social agreements on how to address the crisis, negotiate with the private health sector (including laboratories), define public health and employment policies, etc. Covid-19 emerged in this region just as political regression and a growing weakening of political dialogue initiatives were evident, particularly in South America. The fabric of integration was distorted and in this scenario, economic, political and social vulnerabilities to face the crisis collaboratively or jointly increased. It has been repeatedly argued that integration processes provide an opportunity to advance social and economic consensus, strengthen rights and define common objectives. Perhaps the challenge is exactly the opposite. The pandemic and its complex economic, social and political effects offer an opportunity to rebuild that much-needed regional framework for political dialogue, achieve perhaps simpler and more specific agreements instead of grand frameworks and ultimately activate the necessary health and well- being initiatives. Final Reflections