The COVID-19 pandemic has exposed long-standing weaknesses in Latin American health systems and underscored the need to explore approaches that go beyond an immediate response to future public health emergencies. It is from this perspective that Cadernos de Saúde Pública publishes the supplement “Challenges Facing Health Systems in Post-Pandemic Latin America“, edited by Cristiani Vieira Machado, Mónica Uribe-Gómez, and Alex Alarcón Hein.
Including an Editorial, Perspectives, an Essay, a Review, and Articles, this issue brings together eleven manuscripts that analyze the recent trajectories of the region’s health systems, featuring case studies on Brazil, Chile, Argentina, Colombia, and Mexico, as well as cross-cutting articles on access to vaccines during the pandemic and racial and gender inequalities in health. The topics covered include financing, health reforms, public-private partnerships, primary care, health workforce management, and pathways toward universal access to health care in the region.
In the editorial introducing the supplement, the editors argue that current challenges go beyond emergency preparedness and require addressing structural issues that constrain access to and the quality of health care. These include the segmentation of health systems, technological dependence, the fragility of public financing, and barriers that limit the universalization of the right to health.
These topics are explored in depth in the new episode of Interview with Authors, available on CSPCast and the ENSP YouTube channel. Moderated by Hudson Pacífico da Silva, editor of the supplement, the conversation features Cristiani Vieira Machado, a researcher at the Sergio Arouca National School of Public Health (ENSP/Fiocruz) and one of the special issue’s organizers.
During the interview, Cristiani explains that the idea for the supplement arose from a network of Latin American researchers and the need to reflect on the lessons learned from the pandemic a few years after its most critical phase. “The issue does not focus on the pandemic itself. Several articles address its consequences, but the focus is on the structural problems of Latin American health systems, which must be addressed by governments and society,” she states.
When discussing the main challenges shared by the countries studied, the researcher highlights persistent social inequalities, fragmented social protection systems, and the strong presence of the private sector in organizing health care. In her view, building more universal and equitable systems depends on policies that combine adequate funding, strengthened primary care, valuing health care professionals, and greater regional cooperation. “The health challenges we face are much greater than infectious diseases or public health emergencies. Health systems must be prepared to respond on an ongoing basis and promote health as a right for all people,” she says.
When asked about priorities for the coming years, Cristiani advocates increasing public health funding—which currently stands at less than 4% of GDP in most of the region, far below the 6% benchmark recommended by the WHO—curbing and regulating the growth of the private sector, investing in science, technology, and regional integration, enhancing the training and career development of health professionals, and consolidating systems guided by the universal right to health, with equity policies focused on vulnerable populations, such as indigenous peoples, Black communities, riverine and quilombola communities, and people with disabilities.
Watch the full episode of Interview with Authors and access the supplement articles on the Cadernos de Saúde Pública website.