On October 21, 2024, in Santiago, Chile, the Economic Commission for Latin America and the Caribbean (ECLAC) and the Pan American Health Organization (PAHO) presented the report “The Urgency of Investing in Health Systems in Latin America and the Caribbean to Reduce Inequality and Achieve the Sustainable Development Goals.” This report is a clear call to action, emphasizing five key points: 1) strengthen health systems; 2) improve the articulation between social protection and health systems; 3) guarantee universal access to health; 4) ensure the sustainability of systems; and 5) prioritize investment in health.
This report invites us to reflect on the health crisis caused by the Covid-19 pandemic, which exposed the profound weaknesses of health systems in Latin America and the Caribbean. We can no longer allow the hegemonic medical model to define our health management. It is time to adopt a broader vision, focused on public health and social welfare. We must address the social determinants of health, promote equity and strengthen our systems through Primary Health Care (PHC).
Beyond physicians: health leadership from diverse professions
The dependence on ministers of health who are exclusively physicians has been a brake on the management of our systems. Medical training, although valuable, is insufficient in the face of the complex challenges we have. Public health offers a broader vision, focused on disease prevention and policies that truly impact the population. We need health leaders with a background in public health, who combine medical knowledge with skills in management, epidemiology, and health promotion.
It is essential that governments reconsider the profile of their health ministers. A minister with a background in public health can radically transform the design and implementation of health policies. This does not imply that physicians have no role; on the contrary, their expertise is valuable. However, a diversity of expertise in leadership can enrich management and ensure that the multiple factors affecting the health of the population are addressed. Eduardo Menéndez’s critique of the hegemonic medical model highlights the need to incorporate interdisciplinary perspectives into health policymaking. His view stresses that the current approach, which is almost exclusively medically focused, ignores the influence of socioeconomic and cultural factors on health.
The implementation of technicians trained in public health is fundamental for health management. These technicians must be experts in health, but also in the political and economic context. This allows the design and implementation of more comprehensive and effective health policies. The ability to manage resources, influence political decisions and promote health in all sectors are key skills that these leaders must possess.
Investing in health as an economic priority
A critical aspect of strengthening our health systems is adequate investment. It is essential to raise the awareness of finance ministers to the importance of investing in health. Resources allocated to health are an investment in human capital and sustainable development. Finance ministers play a crucial role in allocating budgets and creating policies that prioritize health. Without their support, health initiatives can be neglected.
Investing in health should be considered a strategy for achieving broader social and economic development goals. Every dollar spent on health has a significant return in terms of productivity and social welfare. Strengthening the health system addresses the current needs of the population and also anticipates future crises. The importance of this investment becomes evident when we consider the economic costs derived from untreated illnesses and the loss of productivity associated with disabilities.
Transparency and evaluation of public policies
Investment in health is essential, but it must be accompanied by a firm commitment to transparency and evaluation of public policies. The implementation of monitoring and accountability mechanisms is essential to ensure that resources are used efficiently and effectively. Without a clear evaluation framework, it is difficult to determine the impact of health investments.
Transparency in resource management is key to building public confidence. The implementation of regular audits and the publication of management reports can ensure that health investments are fulfilling their purpose. In addition, continuous evaluation of public policies can identify areas for improvement and adjust strategies as needed.
It is imperative that health policy decisions are backed by sound data and rigorous analysis. This requires training of health officials and collaboration with researchers and academics who can provide the evidence needed to make informed decisions. A culture of evaluation improves the effectiveness of health programs and encourages greater citizen participation in the oversight of their health systems.
The transformation needed for health equity
The health crisis in Latin America and the Caribbean demands a profound change in the way health systems are conceived and managed. We must remember that health is a right and that investing in it is investing in a healthier and more equitable future for all.
Autor
Nutricionista por PUCE y Salubrista Público por USFQ, diploma en Políticas Públicas por FLACSO. Ha coordinado proyectos de salud reconocidos por OPS y trabajado como consultor internacional. Actualmente, es docente en PUCE, enfocado en nutrición comunitaria y salud pública.
