Global health. The current scenario and future perspectives

42 Global multilateral governance is adapting and responding primarily to geopolitical and commercial interests, while paradoxically still wrestling between the conception of the sovereign state, which does not admit any foreign interference, and the multilateral state, open to establishing diverse international relations based on shared interests as a response to globalization that seem to have no alternative. This period of over 75 years since the end of World War II has been characterized by achievements in terms of human rights, like decolonization and the defeat of apartheid, and the increasing international codification of civil, political, economic, social and cultural rights, among which health, in a broad sense, is always linked to the right to life and well-being. This global architecture or multilateral governance has since evolved alongside rapid globalization of international relations, trade and a broad spectrum of cultural dimensions, towards increasing complexities. On the other hand, other actors have acquired a position in the system, which has led to a profusion of governance systems rather than coordination among participants and, thus, undermines the leadership position of the WHO, which has not adjusted its governance to such change. It is difficult to predict the future of global health governability given the constant tension between states protecting their interests and global issues (like pandemics), which require multinational actions of a public, private, community or multiple networks nature, be they international, regional, neighborhood-based or social. However, it can be anticipated that without a concerted effort by a broad community of nations and global actors to strengthen the existing multilateral architecture and its system of common objectives, norms and rules to achieve “health for all” and leave no one behind, we will face an increasingly uncertain world. Therefore, it is a collective task to unite efforts to function, if not at global level, at least within the Americas by adjusting governance as needed. Let’s not wait for the next pandemic to raise the issue again. References Camou, A. (2001). Los desafíos de la gobernabilidad. Estudio preliminar y compilación. (Flacso/Iisunam, Ed.). México, DF: Plaza y Valdés. COPPPAL (2021). Informe sobre los efectos políticos, sociales, económicos y sanitarios del Covid-19 sobre la integración de América Latina y el Caribe. Coordinator: Marta Maurás Fidler, D. P. (2010). The Challenges of Global Health Governance. Council on Foreign Relations. Disponible in: https://www.cfr.org/report/challenges-global-health-governance G-20 leaders endorse global minimum corporate tax deal and pledge