Human rights and the COVID-19 pandemic: a retrospective and prospective analysis.

When the history of the COVID-19 pandemic is written, the failure of many states to live up to their human rights obligations should be a central narrative. The pandemic began with Wuhan officials in China suppressing information, silencing whistleblowers, and violating the freedom of expression and the right to health. Since then, COVID-19's effects have been profoundly unequal, both nationally and globally. These inequalities have emphatically highlighted how far countries are from meeting the supreme human rights command of non-discrimination, from achieving the highest attainable standard of health that is equally the right of all people everywhere, and from taking the human rights obligation of international assistance and cooperation seriously. We propose embedding human rights and equity within a transformed global health architecture as the necessary response to COVID-19's rights violations. This means vastly more funding from high-income countries to support low-income and middle-income countries in rights-based recoveries, plus implementing measures to ensure equitable distribution of COVID-19 medical technologies. We also emphasise structured approaches to funding and equitable distribution going forward, which includes embedding human rights into a new pandemic treaty. Above all, new legal instruments and mechanisms, from a right to health treaty to a fund for civil society right to health advocacy, are required so that the narratives of future health emergencies-and people's daily lives-are ones of equality and human rights.

Health promotion and the agenda for sustainable development, WHO Region of the Americas.

The approaches and tools of health promotion can be useful for civil society groups, local and national governments and multilateral organizations that are working to operationalize the 2030 agenda for sustainable development. Health promotion and sustainable development share several core priorities, such as equity, intersectoral approaches and sustainability, that help maximize their impact across traditional sectoral boundaries. In the Region of the Americas, each of these priorities has strong resonance because of prominent and long-standing health inequities that are proving resistant to interventions driven solely by the health sector. We describe several cases from the World Health Organization's (WHO) Region of the Americas in which the approaches and tools of health promotion, with a focus on cities, healthy settings and multisectoral collaboration, have been used to put the agenda into practice. We highlight areas where such approaches and tools can be applied effectively and provide evidence of the transformative potential of health promotion in efforts to achieve the sustainable development goals.

Les approches et outils de promotion de la santé peuvent être utiles aux groupes de la société civile, aux gouvernements locaux et nationaux et aux organismes multilatéraux qui s'efforcent de mettre en œuvre le Programme de développement durable à l'horizon 2030. La promotion de la santé et le développement durable ont plusieurs priorités centrales en commun, telles que l'équité, la collaboration intersectorielle et la durabilité, qui contribuent à optimiser leur impact au-delà des limites sectorielles habituelles. Chacune de ces priorités a une forte résonance dans la Région des Amériques, où les importantes inégalités en termes de santé durent depuis longtemps et semblent résister aux interventions menées à la seule initiative du secteur de la santé. Dans cet article, nous décrivons divers exemples provenant de la Région des Amériques de l'Organisation mondiale de la Santé (OMS), où plusieurs approches et outils de promotion de la santé (ciblant principalement les populations urbaines, la création d'environnements-santé et une collaboration multisectorielle) sont actuellement employés pour mettre en œuvre le Programme de développement durable. Nous mettons l'accent sur les domaines dans lesquels ces approches et outils peuvent être efficacement appliqués et nous proposons des données probantes sur le potentiel de transformation de la promotion de la santé dans les efforts menés pour atteindre les objectifs de développement durable.

Los enfoques y las herramientas para el fomento de la salud son útiles para los grupos de la sociedad civil, los gobiernos locales y nacionales y las organizaciones multilaterales que trabajan para poner en marcha el programa de desarrollo sostenible de 2030. El fomento de la salud y el desarrollo sostenible comparten varias prioridades básicas, como la equidad, los enfoques intersectoriales y la sostenibilidad, que ayudan a maximizar el impacto dentro de los límites sectoriales tradicionales. En la Región de las Américas, cada una de estas prioridades tiene una fuerte repercusión debido a las inequidades sanitarias prominentes y prolongadas que resisten a las intervenciones impulsadas únicamente por el sector de la salud. Se describen varios casos de la Región de las Américas de la Organización Mundial de la Salud (OMS) en los que los enfoques y las herramientas para el fomento de la salud, centrado en ciudades, entornos saludables y colaboración multisectorial, se han utilizado para poner en práctica el programa. Se destacan las áreas donde tales enfoques y herramientas se pueden aplicar de manera efectiva y ofrecer pruebas del potencial transformador del fomento de la salud en los esfuerzos por alcanzar los objetivos de desarrollo sostenible.

[Health diplomacy: strengthening the international relations offices of health ministries of the AmericasDiplomacia da saúde: fortalecimento dos escritórios de relações internacionais dos ministérios da Saúde das Américas]. / Diplomacia de la salud: fortalecimiento de las oficinas de relaciones internacionales de los ministerios de salud en las Américas.

Given the international dimensions of the social, economic, and environmental determinants of health and their manifestations, countries are increasingly negotiating with each other and actively participating in global health governance and global governance in general, which is unequivocally linked to health. This implies that health ministries need trained staff. This report is a reflection on how to strengthen this function in health ministries through training in health diplomacy. It analyzes the experience of the Program for Strengthening Cooperation for Health Development as part of Cooperation among Countries for Health Development (CCHD), developed by the Department of External Relations, Partnerships and Resource Mobilization of the Pan American Health Organization and the Center for International Relations in Health of the Oswaldo Cruz Foundation (CRS/FIOCRUZ). This analysis is based on feedback from participants and from facilitators and coordinators of CCHD, and it attempts to develop concepts stemming from their experiences, with the aim of explaining the current situation and reflect on the concepts and practices of health governance and cooperation between health ministries. Since health diplomacy is a concept still in construction, training experiences in health diplomacy should promote critical analysis and reflect identity, based on the conceptions and practices of stakeholders in the processes of global governance and cooperation between health ministries. This article also identifies the requirements and processes of human resources training in health diplomacy.

Diante da dimensão internacional dos determinantes sociais, econômicos e ambientais da saúde e das suas manifestações, os países cada vez mais negociam entre si e participam ativamente da governança da saúde global e da governança global em geral, que está incontestavelmente relacionada com a saúde. Os ministérios da Saúde precisam ter pessoal capacitado para exercer estas atividades. Este artigo examina como fortalecer esta função dos ministérios da Saúde por meio da capacitação em diplomacia da saúde e analisa a experiência obtida com o Programa de Fortalecimento da Cooperação para o Desenvolvimento da Saúde (CCHD), desenvolvido em conjunto pelo Departamento de Relações Externas, Parcerias e Captação de Recursos da Organização Pan-Americana da Saúde (OPAS) e Centro de Relações Internacionais em Saúde da Fundação Oswaldo Cruz (CRIS/FIOCRUZ). A análise parte da perspectiva dos participantes, facilitadores e coordenadores do CCHD e busca elaborar os conceitos a partir das experiências deles visando explicar a realidade atual e pensar nos conceitos e práticas dos processos de governança em saúde e cooperação dos ministérios da Saúde. Como a diplomacia da saúde é um conceito em evolução, as experiências de capacitação nesta área contribuem para estimular uma reflexão crítica e conferir identidade a partir de conceitos e práticas dos atores envolvidos nos processos de governança global e cooperação dos ministérios da Saúde. Também são abordados os requisitos e os processos de formação de recursos humanos em diplomacia da saúde.

Health in all policies in the partnership for sustainable development.

This article analyzes the dynamic interaction between the Health in All Policies (HiAP) agenda and the ongoing implementation of the 2030 Agenda for Sustainable Development. At the World Conference on Social Determinants of Health, held in Rio de Janeiro in October 2011, the Rio Political Declaration pledged to use HiAP as a mechanism to address health inequities. In 2014, the Ministers of Health of the Region of the Americas approved a regional Plan of Action of the Pan American Health Organization (PAHO) that sought to call attention to the health consequences and benefits of policies and actions developed by other sectors. The HiAP approach seeks to integrate activities across the pillars of the sustainable development governance framework (economic, social, and environmental development). Advocates of the process are challenged to consider, using guiding questions outlined at the close of this article, how to pursue action at the country level and in what ways the HiAP approach can contribute to timely and effective implementation of the Sustainable Development Goals (SDGs). The authors propose that coordination between the 2030 Agenda and the regional Plan of Action on HiAP can make an important contribution to the implementation of both processes in the Region.

[Role of the UNASUR national institutes of health in generating evidence on the social determinants of health]. / El papel de los institutos nacionales de salud de UNASUR en la generación de evidencia sobre la determinación social de la salud.

The present article analyzes the role of the Union of South American Nations (UNASUR) national institutes of health since their creation at the beginning of the 20th century up until the present time. It postulates that the national institutes of health are in a position to play a strategic role in generating knowledge and evidence to facilitate decision-making through monitoring and research on the social determinants of health and health inequities. To explore this hypothesis, the national institutes of health are analyzed in the context of the current global scenario, which is generating increased social inequalities, thus leading in turn to serious inequities in health conditions. The article proposes a new model of health promotion, disease prevention, and health care, where necessary, as well as policies and intersectoral actions that address these social determinants. In this new stage, the UNASUR national institutes of health should play a significant strategic role in identifying and analyzing correlations between patterns of production and consumption, social divisions that exist in the territory, conditions of development, and the health of their populations. These national institutes of health are members of the UNASUR Network of National Institutes of Health (RINS-UNASUR). The literature on their creation, drawn from the Network's websites and the proceedings of its meetings and seminars, is reviewed. Given that the current globalized development model is generating enormous social inequalities, by definition, the proposed hypothesis is that the national institutes of health should assume a much broader role in addressing the consequent inequities in the health of the population, complementing their traditional activities with this new strategic role. Without a major reduction in the existing social inequalities and economic inequities, it will be impossible to make significant improvements in health in a democratic manner.

Global health postgraduate educational programs profile: a scoping review.

This study aimed to describe a set of global health postgraduate programs profile, emphasizing the importance of promoting education and training in this field to meet global health challenges and ameliorate health outcomes. The present review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) checklist and the Scoping Review Methods Manual proposed by the Joanna Briggs Institute. Eligibility criteria were a set of lato sensu or stricto sensu postgraduate educational programs of global health or lato sensu or stricto sensu postgraduate programs of public health that present a global health concentration area. The search yielded 707 studies: MEDLINE/PubMed, Web of Science, and LILACS. A total of 441 studies and their authors' institutional affiliations were analyzed and 101 institutions that offer educational programs were identified. Most postgraduate programs in Global Health or Public health with a concentration area in Global health are master's degrees, and many of them are taught online. The majority of educational programs are offered by institutions in Europe and North America.

Global Health and Planetary Health: perspectives for a transition to a more sustainable world post COVID-19.

The manuscript discusses interfaces between academic and practical fields of Global Health and Planetary Health, shedding light on some critical perspectives of cumulative and synergistic causes of global crises, and effects on health and food security, on human rights, on migration, and on environment. Concepts of Global Health and Planetary Health and the path for the Sustainable Development Goals -SDG in the context of the Syndemy of Global Crisis, in particular the COVID-19 pandemic, are presented. COVID-19 lessons highlight challenges of infectious diseases and pandemics of the crisis of food insecurity, and of climate emergency. The manuscript advocates for an innovative approach that simultaneously broader awareness of the interconnected problems and of their complex causes and calls for emancipatory knowledge to face urgent challenges for a transdisciplinary research agenda aiming to tackle enormous planetary problems brought by the Anthropocene. It calls for practical solutions, with examples of some nature-based. It highlights the need of a collective reflection on a viable path to promote changes for a more sustainable, equitable, and adaptive future, bridging gaps from Global and Planetary Health.

Health promotion and quality of life: a historical perspective of the last two 40 years (1980-2020). / Promoção da saúde e qualidade de vida: uma perspectiva histórica ao longo dos últimos 40 anos (1980-2020).

This article updates the previous text of the main author published in 2000, revisiting the scientific evidence that reaffirms the contribution of health to the quality of life of individuals and populations. More than the access to health services of any quality, it is necessary to face determinants of health in its entirety, which requires healthy public policies, an effective intersectoral articulation of public power and mobilization of the population. The authors revisit the emergence and development of health promotion, focusing on the analysis of the most promising health strategies for the increase in quality of life, especially in societies with high social and health inequalities, as in the case of Brazil, reinforced by the recent pandemic of COVID-19. Such strategies were concretized on healthy municipalities and intersectoral actions, in health and in all policies which confront social determinants, through their own foundations and practices that are closely related to innovations in public management for integrated and sustainable local development, in view of the 2030 Agenda and its Sustainable Development Objectives (SDG).

Este artigo atualiza o texto anterior do autor principal publicado em 2000, revisitando as evidências científicas que reafirmam a contribuição da saúde para a qualidade de vida de indivíduos e populações. Mais do que o acesso a serviços de saúde de qualidade, é necessário enfrentar os determinantes da saúde em toda a sua amplitude, o que requer políticas públicas saudáveis, uma efetiva articulação intersetorial do poder público e a mobilização da população. Os autores revisitam a emergência e o desenvolvimento da promoção da saúde, centrando sua análise nas estratégias mais promissoras para o incremento da qualidade de vida propostas pelo setor saúde, sobretudo em formações sociais com alta desigualdade sociosanitária, como é o caso do Brasil, reforçada pela recente pandemia de COVID-19. É no movimento dos municípios saudáveis e em ações intersetoriais, na saúde em todas as políticas e no enfrentamentos dos determinantes sociais da saúde que tais estratégias se concretizam, através de seus próprios fundamentos e práticas, que estão estreitamente relacionados com as inovações na gestão pública para o desenvolvimento local integrado e sustentável, "vis a vis" a nova Agenda 2030 e seus Objetivos do Desenvolvimento Sustentável (ODS).

COVID-19 Response in Latin America.

Effective management of a pandemic due to a respiratory virus requires public health capacity for a coordinated response for mandatory restrictions, large-scale testing to identify infected individuals, capacity to isolate infected cases and track and test contacts, and health services for those infected who require hospitalization. Because of contextual and socioeconomic factors, it has been hard for Latin America to confront this epidemic. In this article, we discuss the context and the initial responses of eight selected Latin American countries, including similarities and differences in public health, economic, and fiscal measures, and provide reflections on what worked and what did not work and what to expect moving forward.

Brazilian international cooperation in health in the era of SUS. / Cooperação internacional em saúde do Brasil na era do SUS.

This paper addresses the role of health in Brazil's health diplomacy and international cooperation since the emergence of the Brazilian Unified Health System (SUS), focusing in particular on South-South cooperation, in line with the priorities of the country's international technical cooperation since its creation. It highlights the relationship with the Latin American and Caribbean Countries (LAC) and the Community of Portuguese Speaking Countries (CPLP), more specifically, with the Portuguese Speaking African Countries (PALOP) and East Timor. It emphasizes the roles of the Ministry of Health, through the International Advisory Working Group on Health (AISA) and the Oswaldo Cruz Foundation (Fiocruz), the Brazilian Cooperation Agency (ABC), the Ministry of Foreign Affairs, and the Pan American Health Organization (PAHO). The article points out that the TC-41 Co-operation Agreement is one of the main instruments for enabling cooperation. It presents the cases of the structuring networks of health systems, as well as the paradigmatic negotiations of the Framework Convention on Tobacco Control, the TRIPS Agreement and the establishment of UNITAIDS, in which Brazilian diplomacy had a predominant role.

O artigo aborda a presença da saúde na diplomacia da saúde e na cooperação internacional do Brasil, desde o surgimento do Sistema Único de Saúde (SUS), com ênfase na cooperação Sul-Sul e em linha com as prioridades da cooperação técnica internacional do país desde então, que enfatiza as relações com países da América Latina e Caribe (ALC) e da Comunidade de Países de Língua Portuguesa (CPLP), particularmente com os Países Africanos de Língua Oficial Portuguesa (PALOP) e Timor Leste. Ressalta os papéis do Ministério da Saúde, por meio da Assessoria Internacional em Saúde (AISA) e da Fundação Oswaldo Cruz (Fiocruz), além da Agência Brasileira de Cooperação (ABC), do Ministério das Relações Exteriores, e da Organização Pan-Americana da Saúde (OPAS). Aponta o papel do Termo de Cooperação TC-41 como um dos principais instrumentos da viabilização da cooperação. Apresenta os casos das redes estruturantes dos sistemas de saúde, assim como as negociações paradigmáticas da Convenção-Quadro sobre Controle do Tabaco, do Acordo TRIPS e da criação da UNAIDS, nos quais o papel da diplomacia brasileira foi preponderante.

Global health postgraduate educational programs profile: a scoping review / Perfil dos programas educacionais de pós-graduação em saúde global: uma revisão de escopo

Abstract This study aimed to describe a set of global health postgraduate programs profile, emphasizing the importance of promoting education and training in this field to meet global health challenges and ameliorate health outcomes. The present review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) checklist and the Scoping Review Methods Manual proposed by the Joanna Briggs Institute. Eligibility criteria were a set of lato sensu or stricto sensu postgraduate educational programs of global health or lato sensu or stricto sensu postgraduate programs of public health that present a global health concentration area. The search yielded 707 studies: MEDLINE/PubMed, Web of Science, and LILACS. A total of 441 studies and their authors' institutional affiliations were analyzed and 101 institutions that offer educational programs were identified. Most postgraduate programs in Global Health or Public health with a concentration area in Global health are master's degrees, and many of them are taught online. The majority of educational programs are offered by institutions in Europe and North America.

Resumo Este estudo teve como objetivo descrever o perfil de um conjunto de programas de pós-graduação em saúde global, enfatizando a importância de promover educação e treinamento neste campo para enfrentar os desafios de saúde internacional e melhorar os desfechos de saúde. A presente revisão está de acordo com a lista de verificação Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR) e com o manual para revisões de escopo proposto pelo Joanna Briggs Institute. Os critérios de elegibilidade abarcaram um conjunto de programas de pós-graduação lato sensu ou stricto sensu em saúde global ou programas de pós-graduação lato sensu ou stricto sensu em saúde pública que apresentaram uma área de concentração em saúde global. A busca resultou em 707 estudos: Medline/PubMed, Web of Science e LILACS. Foram analisados 441 estudos e as filiações institucionais de seus autores, e foram identificadas 101 instituições que oferecem esses programas educacionais. A maioria dos programas de pós-graduação em saúde global ou saúde pública com área de concentração em saúde global são mestrados, e muitos deles são ministrados online. A maioria destes programas educacionais é oferecida por instituições na Europa e na América do Norte.