Health financing in the world

A geopolitical perspective of the international health agenda

Abstract

Introduction: Health is shaped as the product of a process of social determination, where various 
conditions influence the health status of populations. These determinants cover different levels, from the biological and individual to the macrostructural. The latter has played a crucial role in the uneven evolution of the COVID-19 pandemic in countries, especially in Latin America, and international health becomes a valuable tool to understand this dynamic. Objectives: To analyze international health financing and reflect on the architecture of global health within the context of the pandemic. Methods: Qualitative methodology based on secondary data. An analysis has been conducted on documents and reports related to international health financing, using data from the Institute of Health Evaluation and Metrics (1990-2021) and from the Ibero-American general secretary. Results: Global health 
financing, in WHO, shows an imbalance between mandatory and voluntary contributions, granting power to a handful of rich countries and the private sector. The pandemic highlights weaknesses in the preparation of health systems, the fragmentation of the global health agenda in Latin America, and the unequal distribution of resources. Conclusions: The influence of a group of rich countries, together with actors such as the Bill and Melinda Gates Foundation and public-private alliances, has modified the global health agenda. There is an urgent need for more equitable financing, the strengthening of health systems, and effective coordination in international cooperation. South-South Cooperation emerges as a powerful tool for regional integration and sovereignty, involving various parties in the formulation of health policies. Current challenges require collective responses to address the intersections between international health and environmental and health issues